WorldWideScience

Sample records for surveillance designing risk

  1. Designing and evaluating risk-based surveillance systems

    DEFF Research Database (Denmark)

    Willeberg, Preben; Nielsen, Liza Rosenbaum; Salman, Mo

    2012-01-01

    Risk-based surveillance systems reveal occurrence of disease or infection in a sample of population units, which are selected on the basis of risk factors for the condition under study. The purpose of such systems for supporting practical animal disease policy formulations and management decisions...... with prudent use of resources while maintaining acceptable system performance. High-risk category units are selected for testing by identification of the presence of specific high-risk factor(s), while disregarding other factors that might also influence the risk. On this basis we argue that the most...... applicable risk estimate for use in designing and evaluating a risk-based surveillance system would be a crude (unadjusted) relative risk, odds ratio or apparent prevalence. Risk estimates found in the published literature, however, are often the results of multivariable analyses implicitly adjusting...

  2. Youth Risk Behavior Surveillance System

    Science.gov (United States)

    ... Youth Risk Behavior Surveillance System (YRBSS) monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, including— Behaviors that contribute ...

  3. Risk based surveillance for vector borne diseases

    DEFF Research Database (Denmark)

    Bødker, Rene

    of samples and hence early detection of outbreaks. Models for vector borne diseases in Denmark have demonstrated dramatic variation in outbreak risk during the season and between years. The Danish VetMap project aims to make these risk based surveillance estimates available on the veterinarians smart phones...... in Northern Europe. This model approach may be used as a basis for risk based surveillance. In risk based surveillance limited resources for surveillance are targeted at geographical areas most at risk and only when the risk is high. This makes risk based surveillance a cost effective alternative...... sample to a diagnostic laboratory. Risk based surveillance models may reduce this delay. An important feature of risk based surveillance models is their ability to continuously communicate the level of risk to veterinarians and hence increase awareness when risk is high. This is essential for submission...

  4. Youth Risk Behavior Surveillance System (YRBSS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Youth Risk Behavior Surveillance System (YRBSS) monitors 6 types of health-risk behaviors that contribute to the leading causes of death and disability among...

  5. CDC Behavioral Risk Factor Surveillance System (BRFSS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys that collects information on health risk behaviors, preventive...

  6. Risk effectiveness evaluation of surveillance testing

    International Nuclear Information System (INIS)

    Kim, I.S.; Samanta, P.K.; Martorell, S.; Vesely, W.E.

    1991-01-01

    To address the concerns about nuclear power plant surveillance tests, i.e., their adverse safety impact due to negative effects and too burdensome requirements, it is necessary to evaluate the safety significance or risk effectiveness of such tests explicitly considering both negative and positive effects. This paper defines the negative effects of surveillance testing from a risk perspective, and then presents a methodology to quantify the negative risk impact, i.e., the risk penalty or risk increase caused by the test. The method focuses on two important kinds of negative effects, namely, test-caused transients and test-caused equipment degradations. The concepts and quantitative methods for the risk evaluation can be used in the decision-making process to establish the safety significance of the tests and to screen the plant-specific surveillance test requirements. 6 refs., 2 figs., 2 tabs

  7. Riesgo de brucela en humanos. Diseño de un sistema de vigilancia Risk of brucellosis in human being. A design of a system of disease surveillance

    Directory of Open Access Journals (Sweden)

    Sergio Márquez Jaca

    2012-04-01

    Full Text Available La brucelosis es una zoonosis que se trasmite directa o indirectamente al hombre, a partir de reservorios animales, y es considerada una enfermedad ocupacional. Con el objetivo de estratificar el riesgo de brucela, para el diseño de un sistema de vigilancia, se realizó una investigación de innovación tecnológica bietápica durante los años 2009-2010 en el municipio San Cristóbal. Durante la primera se estratificó el riesgo de brucela y en la segunda, se diseñó un sistema de vigilancia. Las unidades de análisis para la investigación están constituidas por la totalidad de animales, pertenecientes al sector estatal del municipio, de la cual se abastece (carnes, leche y derivados, la población y la totalidad de trabajadores expuestos ocupacionalmente al riesgo de brucela. La brucelosis es un importante problema de salud entre la masa animal, incide en ello, los bovinos, porcinos y los búfalos, todas las fuentes de alimento de la población, las principales zonas de riesgo para la salud de los humanos se encuentran en los Consejos Populares José Martí y López Peña, considerados estos de alto riesgo epidemiológico para la salud de la población. Se propone un sistema de vigilancia conjunto con medicina veterinaria que garantizará el control de la enfermedad, tanto en los animales como en las personas.Brucellosis is a zoonosis that is directly or indirectly transmitted to human being from reservoir of animals, and it is considered an occupational disease. Aimed at stratifying the risk of brucellosis to design a system of disease surveillance a research of technological innovation was carried out in two stages from 2009-2010 in San Cristobal. During the first stage the stratification of brucellosis risk was completed; designing the system of disease surveillance on the second stage. Units of analysis were constituted from the total of animals belonging to the state sector in the municipality, from which the locality obtains

  8. Colorectal cancer surveillance in Hodgkin lymphoma survivors at increased risk of therapy-related colorectal cancer : study design

    NARCIS (Netherlands)

    Rigter, Lisanne S; Spaander, Manon C W; Moons, Leon M; Bisseling, Tanya M; Aleman, Berthe M P; de Boer, Jan Paul; Lugtenburg, Pieternella J; Janus, Cecile P M; Petersen, Eefke J; Roesink, Judith M; Raemaekers, John M M; van der Maazen, Richard W M; Cats, Annemieke; Bleiker, Eveline M A; Snaebjornsson, Petur; Carvalho, Beatriz; Lansdorp-Vogelaar, Iris; Jóźwiak, Katarzyna; Te Riele, Hein; Meijer, Gerrit A; van Leeuwen, Flora E; van Leerdam, Monique E

    2017-01-01

    BACKGROUND: Second primary malignancies are a major cause of excess morbidity and mortality in cancer survivors. Hodgkin lymphoma survivors who were treated with infradiaphragmatic radiotherapy and/or high-dose procarbazine have an increased risk to develop colorectal cancer. Colonoscopy

  9. Designing a risk-based surveillance program for Mycobacterium avium ssp. paratuberculosis in Norwegian dairy herds using multivariate statistical process control analysis.

    Science.gov (United States)

    Whist, A C; Liland, K H; Jonsson, M E; Sæbø, S; Sviland, S; Østerås, O; Norström, M; Hopp, P

    2014-11-01

    Surveillance programs for animal diseases are critical to early disease detection and risk estimation and to documenting a population's disease status at a given time. The aim of this study was to describe a risk-based surveillance program for detecting Mycobacterium avium ssp. paratuberculosis (MAP) infection in Norwegian dairy cattle. The included risk factors for detecting MAP were purchase of cattle, combined cattle and goat farming, and location of the cattle farm in counties containing goats with MAP. The risk indicators included production data [culling of animals >3 yr of age, carcass conformation of animals >3 yr of age, milk production decrease in older lactating cows (lactations 3, 4, and 5)], and clinical data (diarrhea, enteritis, or both, in animals >3 yr of age). Except for combined cattle and goat farming and cattle farm location, all data were collected at the cow level and summarized at the herd level. Predefined risk factors and risk indicators were extracted from different national databases and combined in a multivariate statistical process control to obtain a risk assessment for each herd. The ordinary Hotelling's T(2) statistic was applied as a multivariate, standardized measure of difference between the current observed state and the average state of the risk factors for a given herd. To make the analysis more robust and adapt it to the slowly developing nature of MAP, monthly risk calculations were based on data accumulated during a 24-mo period. Monitoring of these variables was performed to identify outliers that may indicate deviance in one or more of the underlying processes. The highest-ranked herds were scattered all over Norway and clustered in high-density dairy cattle farm areas. The resulting rankings of herds are being used in the national surveillance program for MAP in 2014 to increase the sensitivity of the ongoing surveillance program in which 5 fecal samples for bacteriological examination are collected from 25 dairy herds

  10. Digital dashboard design using multiple data streams for disease surveillance with influenza surveillance as an example.

    Science.gov (United States)

    Cheng, Calvin K Y; Ip, Dennis K M; Cowling, Benjamin J; Ho, Lai Ming; Leung, Gabriel M; Lau, Eric H Y

    2011-10-14

    Great strides have been made exploring and exploiting new and different sources of disease surveillance data and developing robust statistical methods for analyzing the collected data. However, there has been less research in the area of dissemination. Proper dissemination of surveillance data can facilitate the end user's taking of appropriate actions, thus maximizing the utility of effort taken from upstream of the surveillance-to-action loop. The aims of the study were to develop a generic framework for a digital dashboard incorporating features of efficient dashboard design and to demonstrate this framework by specific application to influenza surveillance in Hong Kong. Based on the merits of the national websites and principles of efficient dashboard design, we designed an automated influenza surveillance digital dashboard as a demonstration of efficient dissemination of surveillance data. We developed the system to synthesize and display multiple sources of influenza surveillance data streams in the dashboard. Different algorithms can be implemented in the dashboard for incorporating all surveillance data streams to describe the overall influenza activity. We designed and implemented an influenza surveillance dashboard that utilized self-explanatory figures to display multiple surveillance data streams in panels. Indicators for individual data streams as well as for overall influenza activity were summarized in the main page, which can be read at a glance. Data retrieval function was also incorporated to allow data sharing in standard format. The influenza surveillance dashboard serves as a template to illustrate the efficient synthesization and dissemination of multiple-source surveillance data, which may also be applied to other diseases. Surveillance data from multiple sources can be disseminated efficiently using a dashboard design that facilitates the translation of surveillance information to public health actions.

  11. Scientific-methodological approaches to designing risk-oriented model of control and surveillance activities in the sphere of consumer rights protection

    Directory of Open Access Journals (Sweden)

    N.V. Zaitseva

    2017-06-01

    Full Text Available We present scientific-methodological approaches to defining risk categories of economic entities which are subject to surveillance in the sphere of consumer rights protection. Risk is suggested to be assessed as a product of violations frequency comprising violations of separate provisions of the law on consumer rights protection detected in the course of scheduled and unscheduled inspections; a number of claims per one detected violation which were satisfied by courts in favor of consumers; each separate case of harm accepted by court in money terms (as a sum of physical and moral damage to health and damage to property; and coefficient of a potential impact scope which differentiates risks for economic entities belonging to micro-, small, medium-sized and large business. Our information sources are official statistic data obtained due to realization of state control in the sphere of consumer rights protection and court practice collected in all the RF regions over 2012–2016. It is shown that a share of economic entities with extremely high risk potential which can cause total material damage to consumers in sums greater than 10 million rubles per year amounts to about 0.15 % of the total number of economic entities (both juridical persons and private entrepreneurs; economic entities with high risk potential account for about 2 %. Such groups are made of companies involved in financial markets, share construction services, insurance and tourism. About 23 % of juridical persons and private entrepreneurs can be classified as having low risk potential and they can be excluded from scheduled inspections. Economic entities structure in general corresponds to world practices. It is shown that risk-oriented surveillance model development requires improvements in keeping registers of juridical persons and private entrepreneurs as such registers should contain comprehensive information; it is necessary for correct risk category (or hazard category

  12. Counselees’ expressed level of understanding of the risk estimate and surveillance recommendation are not associated with breast cancer surveillance adherence.

    NARCIS (Netherlands)

    Albada, A.; Dulmen, S. van; Dijkstra, H.; Wieffer, I.; Witkamp, A.; Ausems, M.G.E.M.

    2016-01-01

    We studied counselees’ expressed understanding of the risk estimate and surveillance recommendation in the final consultation for breast cancer genetic counseling in relation with their risk perception, worry and cancer surveillance adherence 1 year post-counseling. Consecutive counselees were

  13. World Alliance for Risk Factor Surveillance White Paper on Surveillance and Health Promotion

    Directory of Open Access Journals (Sweden)

    Stefano Campostrini

    2015-02-01

    Full Text Available This is not a research paper on risk factor surveillance. It is an effort by a key group of researchers and practitioners of risk factor surveillance to define the current state of the art and to identify the key issues involved in the current practice of behavioral risk factor surveillance. Those of us who are the principal authors have worked and carried out research in this area for some three decades. As a result of a series of global meetings beginning in 1999 and continuing every two years since then, a collective working group of the International Union of Health Promotion and Education (IUHPE was formed under the name World Alliance of Risk Factor Surveillance (WARFS. Under this banner the organization sought to write a comprehensive statement on the importance of surveillance to health promotion and public health. This paper, which has been revised and reviewed by established peers in the field, is the result. It provides the reader with a clear summary of the major issues that need to be considered by any and all seeking to carry out behavioral risk factor surveillance.

  14. The Surveillance Database Development of Risk Factor for Dengue Fever in Mataram District Health Office

    Directory of Open Access Journals (Sweden)

    Sinawan Sinawan

    2015-05-01

    Full Text Available System of DHF epidemiological surveillance that is currently running in Mataram District Health Office has not been able to provide information about the incidence of DHF is based on risk factors. Besides, the process of manufacturing and analysis of data were still done manually, so the level of consistency and accuracy of data was still less. This research aimed to develop database surveillance risk factor of DHF incidence. This type of research is action research. This research was conducted at the Mataram District Health Office NTB province at April 2014 until August 2014, informants in this study consists of three (3 members, namely Head of P2PB Section, DHF P2 Program Manager and Surveillance Staff. The data used are primary and secondary data. Database design includes logical and physical design. Performed on the logic design is the normalization of the data, create relationships between data illustrates the entity relationship diagram (ERD and proceed to the physical design to create a prototype database using Epi Info software application for Windows version 3.5.1. Trial involving two (2 the informants. Evaluation trials database surveillance of risk factors DHF incidence to assess the ease, speed, accuracy and completeness of the resulting data. Results of this study is new database surveillance risk factor of DHF incidence that can be used easily, quickly and can be results more accurate information. Keywords: DHF, surveillance, risk factor, database.

  15. Risk analysis of a video-surveillance system

    NARCIS (Netherlands)

    Rothkrantz, L.; Lefter, I.

    2011-01-01

    The paper describes a surveillance system of cameras installed at lamppost of a military area. The surveillance system has been designed to detect unwanted visitors or suspicious behaviors. The area is composed of streets, building blocks and surrounded by gates and water. The video recordings are

  16. DASH - Youth Risk Behavior Surveillance System (YRBSS): High School

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1991-2015. High School Dataset. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young...

  17. Nutrition, Physical Activity, and Obesity - Behavioral Risk Factor Surveillance System

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes data on adult's diet, physical activity, and weight status from Behavioral Risk Factor Surveillance System. This data is used for DNPAO's Data,...

  18. DASH - Youth Risk Behavior Surveillance System (YRBSS): Middle School

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1991-2015. Middle School Dataset. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young...

  19. Nutrition, Physical Activity, and Obesity - Youth Risk Behavior Surveillance System

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes data on adolescent's diet, physical activity, and weight status from Youth Risk Behavior Surveillance System (YRBSS). This data is used for...

  20. Cryptosporidium surveillance and risk factors in the United States.

    Science.gov (United States)

    Yoder, Jonathan S; Beach, Michael J

    2010-01-01

    Surveillance for Cryptosporidium in the United States indicates that the reported incidence of infection has increased dramatically since 2004. The reasons for this increase are unclear but might be caused by an actual increase in incidence, improved surveillance, improved awareness about cryptosporidiosis, and/or increases in testing practices resulting from the licensing of the first-ever treatment for cryptosporidiosis. While regional differences remain, the incidence of cryptosporidiosis appears to be increasing across the United States. Onset of illness is most common during the summer, particularly among younger children. Cryptosporidiosis case reporting also influences outbreak detection and reporting; the recent rise in cases coincides with an increase in the number of reported cryptosporidiosis outbreaks, particularly in treated recreational water venues. Risk factors include ingesting contaminated recreational or drinking water, exposure to infected animals, having close contacts with cryptosporidiosis, travel to disease-endemic areas, and ingestion of contaminated food. Advances in molecular characterization of clinical specimens have improved our understanding of the changing epidemiology and risk factors. Prevention and control of cryptosporidiosis requires continued efforts to interrupt the transmission of Cryptosporidium through water, food, and contact with infected persons or animals. Of particular importance is continued improvement and monitoring of drinking water treatment and advances in the design, operation, and management of recreational water venues coupled with behavioral changes among the swimming public. Published by Elsevier Inc.

  1. Hepatocellular carcinoma: risk groups, surveillance and outcome

    NARCIS (Netherlands)

    van Meer, S

    2016-01-01

    The burden of hepatocellular carcinoma (HCC) has changed in the past few decades. Although the majority of HCC cases develops in East Asia and Sub-Saharan Africa, HCC has become an increasing problem in Western countries such as the Netherlands. Surveillance for HCC is controversial because of

  2. Extending cluster Lot Quality Assurance Sampling designs for surveillance programs

    OpenAIRE

    Hund, Lauren; Pagano, Marcello

    2014-01-01

    Lot quality assurance sampling (LQAS) has a long history of applications in industrial quality control. LQAS is frequently used for rapid surveillance in global health settings, with areas classified as poor or acceptable performance based on the binary classification of an indicator. Historically, LQAS surveys have relied on simple random samples from the population; however, implementing two-stage cluster designs for surveillance sampling is often more cost-effective than ...

  3. Reduced risk of surgical site infections through surveillance in a network

    NARCIS (Netherlands)

    Geubbels, Eveline L. P. E.; Nagelkerke, Nico J. D.; Mintjes-de Groot, A. Joke; Vandenbroucke-Grauls, Christina M. J. E.; Grobbee, Diederick E.; de Boer, Annette S.

    2006-01-01

    OBJECTIVE: To estimate the effect of multicentre surveillance for nosocomial infections on patients' risk of surgical site infection (SSI). DESIGN: Prospective multi-centre cohort study, from January 1996 to December 2000. SETTING: Acute care hospitals in The Netherlands. STUDY PARTICIPANTS: All 50

  4. Extending cluster lot quality assurance sampling designs for surveillance programs.

    Science.gov (United States)

    Hund, Lauren; Pagano, Marcello

    2014-07-20

    Lot quality assurance sampling (LQAS) has a long history of applications in industrial quality control. LQAS is frequently used for rapid surveillance in global health settings, with areas classified as poor or acceptable performance on the basis of the binary classification of an indicator. Historically, LQAS surveys have relied on simple random samples from the population; however, implementing two-stage cluster designs for surveillance sampling is often more cost-effective than simple random sampling. By applying survey sampling results to the binary classification procedure, we develop a simple and flexible nonparametric procedure to incorporate clustering effects into the LQAS sample design to appropriately inflate the sample size, accommodating finite numbers of clusters in the population when relevant. We use this framework to then discuss principled selection of survey design parameters in longitudinal surveillance programs. We apply this framework to design surveys to detect rises in malnutrition prevalence in nutrition surveillance programs in Kenya and South Sudan, accounting for clustering within villages. By combining historical information with data from previous surveys, we design surveys to detect spikes in the childhood malnutrition rate. Copyright © 2014 John Wiley & Sons, Ltd.

  5. A generic rabies risk assessment tool to support surveillance.

    Science.gov (United States)

    Ward, Michael P; Hernández-Jover, Marta

    2015-06-01

    The continued spread of rabies in Indonesia poses a risk to human and animal populations in the remaining free islands, as well as the neighbouring rabies-free countries of Timor Leste, Papua New Guinea and Australia. Here we describe the development of a generic risk assessment tool which can be used to rapidly determine the vulnerability of rabies-free islands, so that scarce resources can be targeted to surveillance activities and the sensitivity of surveillance systems increased. The tool was developed by integrating information on the historical spread of rabies, anthropological studies, and the opinions of local animal health experts. The resulting tool is based on eight critical parameters that can be estimated from the literature, expert opinion, observational studies and information generated from routine surveillance. In the case study presented, results generated by this tool were most sensitive to the probability that dogs are present on private and fishing boats and it was predicted that rabies-infection (one infected case) might occur in a rabies-free island (upper 95% prediction interval) with a volume of 1000 boats movements. With 25,000 boat movements, the median of the probability distribution would be equal to one infected case, with an upper 95% prediction interval of six infected cases. This tool could also be used at the national-level to guide control and eradication plans. An initial recommendation from this study is to develop a surveillance programme to determine the likelihood that boats transport dogs, for example by port surveillance or regularly conducted surveys of fisherman and passenger ferries. However, the illegal nature of dog transportation from rabies-infected to rabies-free islands is a challenge for developing such surveillance. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Surveillance

    DEFF Research Database (Denmark)

    Albrechtslund, Anders; Coeckelbergh, Mark; Matzner, Tobias

    Studying surveillance involves raising questions about the very nature of concepts such as information, technology, identity, space and power. Besides the maybe all too obvious ethical issues often discussed with regard to surveillance, there are several other angles and approaches that we should...... like to encourage. Therefore, our panel will focus on the philosophical, yet non-ethical issues of surveillance in order to stimulate an intense debate with the audience on the ethical implications of our enquiries. We also hope to provide a broader and deeper understanding of surveillance....

  7. Design and Implementation of an Embedded Smart Intruder Surveillance System

    Directory of Open Access Journals (Sweden)

    Sabri Naseer

    2018-01-01

    Full Text Available Remote and scattered valuable and sensitive locations such as labs and offices inside university campus need efficient monitoring and warning system. As well as scattered area and belonging. This research presents a Real-Time intruder Surveillance System based on a single board computer (SBC. Thus the design and development of a cost effective surveillance management system based SBC that can be deployed efficiently in remote and scattered locations such as universities belonging. The fusion of embedded Python codes with SBC that attached to cameras, Long distance sensors, alerting circuitry and wireless module presents a novel integration based effective cost solution and enhances SBC of much flexibility of improvement and development for pervasive remote locations. The system proves the high integrity of smooth working with web application, it’s cost effective and thus can be deployed as many of units to seize and concisely covered remote and scattered area as well as university belonging and departments. The system can be administrated by a remote user sparsely or geographically away from any networked workstation. The proposed solution offers efficient stand alone, flexibility to upgrade and cheap development and installation as well as cost effective ubiquitous surveillance solution. In conclusion, the system acceptable boundaries of successful intruder recognition and warning alert are computed between 1m and 3m distance of intruder from system camera. Recognition rate of 95% and 83% are achieved and the successful warning alert were in the range of 86-97%.

  8. Development of an active risk-based surveillance strategy for avian influenza in Cuba.

    Science.gov (United States)

    Ferrer, E; Alfonso, P; Ippoliti, C; Abeledo, M; Calistri, P; Blanco, P; Conte, A; Sánchez, B; Fonseca, O; Percedo, M; Pérez, A; Fernández, O; Giovannini, A

    2014-09-01

    The authors designed a risk-based approach to the selection of poultry flocks to be sampled in order to further improve the sensitivity of avian influenza (AI) active surveillance programme in Cuba. The study focused on the western region of Cuba, which harbours nearly 70% of national poultry holdings and comprise several wetlands where migratory waterfowl settle (migratory waterfowl settlements - MWS). The model took into account the potential risk of commercial poultry farms in western Cuba contracting from migratory waterfowl of the orders Anseriformes and Charadriiformes through dispersion for pasturing of migratory birds around the MWS. We computed spatial risk index by geographical analysis with Python scripts in ESRI(®) ArcGIS 10 on data projected in the reference system NAD 1927-UTM17. Farms located closer to MWS had the highest values for the risk indicator pj and in total 31 farms were chosen for targeted surveillance during the risk period. The authors proposed to start active surveillance in the study area 3 weeks after the onset of Anseriformes migration, with additional sampling repeated twice in the same selected poultry farms at 15 days interval (Comin et al., 2012; EFSA, 2008) to cover the whole migration season. In this way, the antibody detectability would be favoured in case of either a posterior AI introduction or enhancement of a previous seroprevalence under the sensitivity level. The model identified the areas with higher risk for AIV introduction from MW, aiming at selecting poultry premises for the application of risk-based surveillance. Given the infrequency of HPAI introduction into domestic poultry populations and the relative paucity of occurrences of LPAI epidemics, the evaluation of the effectiveness of this approach would require its application for several migration seasons to allow the collection of sufficient reliable data. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Design and implementation of distributed multimedia surveillance system based on object-oriented middleware

    Science.gov (United States)

    Cao, Xuesong; Jiang, Ling; Hu, Ruimin

    2006-10-01

    Currently, the applications of surveillance system have been increasingly widespread. But there are few surveillance platforms that can meet the requirement of large-scale, cross-regional, and flexible surveillance business. In the paper, we present a distributed surveillance system platform to improve safety and security of the society. The system is constructed by an object-oriented middleware called as Internet Communications Engine (ICE). This middleware helps our platform to integrate a lot of surveillance resource of the society and accommodate diverse range of surveillance industry requirements. In the follow sections, we will describe in detail the design concepts of system and introduce traits of ICE.

  10. Avian Influenza Risk Surveillance in North America with Online Media.

    Directory of Open Access Journals (Sweden)

    Colin Robertson

    Full Text Available The use of Internet-based sources of information for health surveillance applications has increased in recent years, as a greater share of social and media activity happens through online channels. The potential surveillance value in online sources of information about emergent health events include early warning, situational awareness, risk perception and evaluation of health messaging among others. The challenge in harnessing these sources of data is the vast number of potential sources to monitor and developing the tools to translate dynamic unstructured content into actionable information. In this paper we investigated the use of one social media outlet, Twitter, for surveillance of avian influenza risk in North America. We collected AI-related messages over a five-month period and compared these to official surveillance records of AI outbreaks. A fully automated data extraction and analysis pipeline was developed to acquire, structure, and analyze social media messages in an online context. Two methods of outbreak detection; a static threshold and a cumulative-sum dynamic threshold; based on a time series model of normal activity were evaluated for their ability to discern important time periods of AI-related messaging and media activity. Our findings show that peaks in activity were related to real-world events, with outbreaks in Nigeria, France and the USA receiving the most attention while those in China were less evident in the social media data. Topic models found themes related to specific AI events for the dynamic threshold method, while many for the static method were ambiguous. Further analyses of these data might focus on quantifying the bias in coverage and relation between outbreak characteristics and detectability in social media data. Finally, while the analyses here focused on broad themes and trends, there is likely additional value in developing methods for identifying low-frequency messages, operationalizing this

  11. Northeast Regional Cancer Institute's Cancer Surveillance and Risk Factor Program

    Energy Technology Data Exchange (ETDEWEB)

    Lesko, Samuel M.

    2007-07-31

    . For colorectal cancer, the stage at diagnosis of cases diagnosed in northeast Pennsylvania was compared to data from prior years. A population-based interview study of healthy adults was conducted to document the status of cancer screening and to estimate the prevalence of established cancer risk factors in this community. This study is similar in design to that used by the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS). EXPERIMENTAL METHODS AND PROCEDURES: This program includes two distinct but related projects. The first project uses existing data to conduct cancer surveillance in northeast Pennsylvania, and the second is a population-based study of cancer risk factors and cancer screening behaviors in this same population. HUMAN SUBJECTS CONSIDERATIONS This program includes two projects: cancer surveillance and a population-based study of cancer risk factors and screening behavior. The cancer surveillance project involves only the use of existing aggregate data or de-identified data. As such, the surveillance project is exempt from human subjects considerations. The study of cancer risk factors and screening behaviors includes data from a random sample of adult residents of northeast Pennsylvania who are 18 or more years of age. All races, ethnicities and both sexes are included in proportion to their representation in the population. Subjects are interviewed anonymously by telephone; those who are unable to complete an interview in English are ineligible. This project has been reviewed and approved by the Scranton-Temple Residency Program IRB (IRB00001355), which is the IRB for the Northeast Regional Cancer Institute.

  12. Risk management and post-marketing surveillance of CNS drugs.

    Science.gov (United States)

    Henningfield, Jack E; Schuster, Charles R

    2009-12-01

    Drugs affecting the central nervous system span a broad range of chemical entities, dosage forms, indications, and risks. Unintended consequences include potential abuse and overdose in non-patient drug abusers, deliberate tampering of drug dosage forms, and criminal behavior associated with diversion. Regulators must consider diverse factors to find the appropriate conditions of approval to minimize unintended consequences while enabling a level of access desired by health care providers and patients. This commentary appears as part of a special issue of Drug and Alcohol Dependence that focuses on risk management and post-marketing surveillance and addresses key issues that pose real-world challenges to pharmaceutical sponsors and regulators in particular. For example, in the U.S., Controlled Substances Act drug scheduling can be considered a risk management strategy but its legal authorities and administrative processes are independent from those of risk management (including Risk Evaluation and Mitigation Strategies or REMS); better harmonization of these approaches is vital from drug development and regulatory perspectives. Risk management would ideally be implemented on a strong science foundation demonstrating that the tools employed to mitigate risks and ensure safe use are effective. In reality, research and evaluation of tools in this area is in its infancy and will necessarily be an evolutionary process; furthermore, there is little precedent for linking interventions and program evolution to unintended consequences such as regional outbreaks of abuse and diversion. How such issues are resolved has the potential to stimulate or stifle innovations in drug development and advance or imperil health care.

  13. Pervasive surveillance-agent system based on wireless sensor networks: design and deployment

    International Nuclear Information System (INIS)

    Martínez, José F; Bravo, Sury; García, Ana B; Corredor, Iván; Familiar, Miguel S; López, Lourdes; Hernández, Vicente; Da Silva, Antonio

    2010-01-01

    Nowadays, proliferation of embedded systems is enhancing the possibilities of gathering information by using wireless sensor networks (WSNs). Flexibility and ease of installation make these kinds of pervasive networks suitable for security and surveillance environments. Moreover, the risk for humans to be exposed to these functions is minimized when using these networks. In this paper, a virtual perimeter surveillance agent, which has been designed to detect any person crossing an invisible barrier around a marked perimeter and send an alarm notification to the security staff, is presented. This agent works in a state of 'low power consumption' until there is a crossing on the perimeter. In our approach, the 'intelligence' of the agent has been distributed by using mobile nodes in order to discern the cause of the event of presence. This feature contributes to saving both processing resources and power consumption since the required code that detects presence is the only system installed. The research work described in this paper illustrates our experience in the development of a surveillance system using WNSs for a practical application as well as its evaluation in real-world deployments. This mechanism plays an important role in providing confidence in ensuring safety to our environment

  14. Rural Veterans' dental utilization, Behavioral Risk Factor Surveillance Survey, 2014.

    Science.gov (United States)

    Wiener, R Constance; Shen, Chan; Sambamoorthi, Usha; Findley, Patricia A

    2017-09-01

    Rural residents are overrepresented in the military; however, access to Veteran services is limited in rural areas. There is a need to identify rural Veteran healthcare utilization. This study addresses that need and has two purposes: a) to determine if there is an association between rural dwelling and Veteran utilization of dental services; and b) to determine if there is an association between rural dwelling and the oral health outcome of missing teeth. Data from the 2014 Behavioral Risk Factor Surveillance Survey were used in this study. Chi square and logistic regression analyses were conducted. Rural Veterans were less likely to have a dental visit during the previous year as compared with metropolitan Veterans in unadjusted analysis (Odds ratio = 0.71, 95% Confidence Interval, 0.64, 0.77) and in adjusted analysis [0.87 (95% Confidence Interval, 0.78, 0.96)]. In cases in which all teeth were missing, rural Veterans had an unadjusted odds ratio of 1.79 [95% Confidence Interval, 1.55, 2.08] and an adjusted odds ratio of 1.37 [95% Confidence Interval, 1.17, 1.62] as compared with metropolitan Veterans. The Veterans Health Administration develops policies for establishing centers for care for Veterans. The policy development should take into consideration that rural Veterans have not been as likely as urban Veterans to utilize dental services and have poorer oral health outcomes. © 2017 American Association of Public Health Dentistry.

  15. Repeated participation in pancreatic cancer surveillance by high-risk individuals imposes low psychological burden

    NARCIS (Netherlands)

    Konings, Ingrid C. A. W.; Sidharta, Grace N.; Harinck, Femme; Aalfs, Cora M.; Poley, Jan-Werner; Kieffer, Jacobien M.; Kuenen, Marianne A.; Smets, Ellen M. A.; Wagner, Anja; van Hooft, Jeanin E.; van Rens, Anja; Fockens, Paul; Bruno, Marco J.; Bleiker, Eveline M. A.

    2016-01-01

    When assessing the feasibility of surveillance for pancreatic cancer (PC), it is important to address its psychological burden. The aim of this ongoing study is to evaluate the psychological burden of annual pancreatic surveillance for individuals at high risk to develop PC. This is a multicenter

  16. Integrated design of intelligent surveillance systems and their user interface

    NARCIS (Netherlands)

    Toet, A.

    2005-01-01

    Modern complex surveillance systems consisting of multiple and heterogeneous sensors, automatic information registration and data analysis techniques, and decision support tools should provide the human operator an integrated, transparent and easily comprehensible view of the surveyed scene.

  17. A National Surveillance Survey on Noncommunicable Disease Risk Factors: Suriname Health Study Protocol

    Science.gov (United States)

    Smits, Christel CF; Jaddoe, Vincent WV; Hofman, Albert; Toelsie, Jerry R

    2015-01-01

    Background Noncommunicable diseases (NCDs) are the leading cause of death in low- and middle-income countries. Therefore, the surveillance of risk factors has become an issue of major importance for planning and implementation of preventive measures. Unfortunately, in these countries data on NCDs and their risk factors are limited. This also prevails in Suriname, a middle-income country of the Caribbean, with a multiethnic/multicultural population living in diverse residential areas. For these reasons, “The Suriname Health Study” was designed. Objective The main objective of this study is to estimate the prevalence of NCD risk factors, including metabolic syndrome, hypertension, and diabetes in Suriname. Differences between specific age groups, sexes, ethnic groups, and geographical areas will be emphasized. In addition, risk groups will be identified and targeted actions will be designed and evaluated. Methods In this study, several methodologies were combined. A stratified multistage cluster sample was used to select the participants of 6 ethnic groups (Hindustani, Creole, Javanese, Maroon, Chinese, Amerindians, and mixed) divided into 5 age groups (between 15 and 65 years) who live in urban/rural areas or the hinterland. A standardized World Health Organization STEPwise approach to surveillance questionnaire was adapted and used to obtain information about demographic characteristics, lifestyle, and risk factors. Physical examinations were performed to measure blood pressure, height, weight, and waist circumference. Biochemical analysis of collected blood samples evaluated the levels of glucose, high-density-lipoprotein cholesterol, total cholesterol, and triglycerides. Statistical analysis will be used to identify the burden of modifiable and unmodifiable risk factors in the aforementioned subgroups. Subsequently, tailor-made interventions will be prepared and their effects will be evaluated. Results The data as collected allow for national inference and

  18. Behavioral Risk Factor Surveillance System (BRFSS) Historical Questions

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1984-2016. Centers for Disease Control and Prevention (CDC). BRFSS Survey Data. The BRFSS is a continuous, state-based surveillance system that collects information...

  19. Life through a Lens: Risk, Surveillance and Subjectivity

    Directory of Open Access Journals (Sweden)

    Gavin Smith

    2016-03-01

    Full Text Available Drawing on findings from a two-year empirical study examining the culture of closed-circuit television (CCTV operation in the UK, this paper analyses how CCTV camera operators subjectively experience the visual media that they work to produce. It seeks to excavate some of the social meanings that these vicarious risk flâneurs ascribe to the telemediated events that they indirectly encounter, and how these ‘narratives of the street’ come to inscribe themselves on the subjectivities of the camera operators in a disciplinary manner. In so doing, the paper reveals the work of watching to be an ambiguous social practice, an activity that far exceeds its formal framing as a dispassionate and standardised procedure. As such, I contend that CCTV camera operators engage in two distinct modes of work – ‘surface’ and ‘deep’ – as they watch the screens and codify the spectacles that are mediated through the camera lens. The ‘surface’ work they enact is officially acknowledged and concerns their focusing attention on the screens to identify harmful behaviours, to capture evidence and to share information with other collaborators in the security network. This mode of work is principally performed for professional imperatives and economic returns. In contrast, the ‘deep’ work rituals they execute are informal in scope and therapeutic in purpose. Such individualised practices are an unseen and unrecognised work relation that mitigates the negative effects of CCTV viewing. They are operationalised through diverse behavioural repertoires which function to insulate the self from its exposure to mediated traumas, and from the contradiction of mobilising ‘(inaction at a distance’. Overall, the paper accentuates the messy realities that hinge on the practice of urban surveillance, showing these realities to be meditated by the vagaries of subjective experience and social relations.

  20. Use of surveillance data for prevention of healthcare-associated infection: risk adjustment and reporting dilemmas.

    LENUS (Irish Health Repository)

    O'Neill, Eoghan

    2009-08-01

    Healthcare-associated or nosocomial infection (HCAI) is of increasing importance to healthcare providers and the public. Surveillance is crucial but must be adjusted for risk, especially when used for interhospital comparisons or for public reporting.

  1. Behavioral Risk Factor Surveillance System (BRFSS) Prevalence Data (2010 and prior)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1995-2010. BRFSS land line only prevalence data. BRFSS is a continuous, state-based surveillance system that collects information about modifiable risk factors for...

  2. DASH - Youth Risk Behavior Surveillance System (YRBSS): High School - Excluding Sexual Identity

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1991-2015. High School Dataset. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young...

  3. Risk of metachronous neoplasia on surveillance colonoscopy in young patients with colorectal neoplasia.

    Science.gov (United States)

    Kim, Hyun Gun; Cho, Young-Seok; Cha, Jae Myung; Shin, Jeong Eun; Kim, Kyeong Ok; Yang, Hyo-Joon; Koo, Hoon Sup; Joo, Young-Eun; Boo, Sun-Jin

    2018-03-01

    Few prior reports exist that address the appropriate colonoscopy surveillance interval for individuals  .1). In the baseline low-risk adenoma group (n = 1869), the 5-year risk of metachronous advanced neoplasia was 4.9% in the younger patients on screening colonoscopy and 5.1% in the older patients (P > .1). Similarly, in the baseline no neoplasia group (n = 7013), the 5-year risk of metachronous advanced neoplasia was 4.1% in the younger patients on screening colonoscopy and 5.6% in the older patients (P > .1). Considering the similar risk of metachronous advanced neoplasia in younger and older individuals, we suggest a 3-year surveillance interval for high-risk adenoma and a 5-year surveillance interval for low-risk adenoma in young individuals without a strong family history. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  4. 21 CFR 822.11 - What should I consider when designing my plan to conduct postmarket surveillance?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false What should I consider when designing my plan to conduct postmarket surveillance? 822.11 Section 822.11 Food and Drugs FOOD AND DRUG ADMINISTRATION... Surveillance Plan § 822.11 What should I consider when designing my plan to conduct postmarket surveillance...

  5. POSSIBILITIES OF IMPROVING THE METHODS AND TECHNIQUES USED IN THE SURVEILLANCE OF CREDIT RISK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Balogh Peter

    2010-12-01

    Full Text Available Through their daily activities, credit institutions are subject to various risks which could affect both the bank and the whole banking system, national and transnational. The activity field of the banks, marked by volatility, by the internationalization and liberalization of the financial markets, is in a continuous change. The contagion effect, as it has been proved by the spread of the financial crisis effects, determines the surveillance authorities to pay increased attention to the financial risks and implicitly to the systemic risk. In this study, to start with, there shall be presented some aspects regarding the banking rating systems used by the surveillance authorities and then some ways of improving the models of managing credit risk in banks. In the end, there will be demonstrated that the risk profile of the banking institution has a determining role in the management of the credit portfolio.

  6. Detection capacity, information gaps and the design of surveillance programs for invasive forest pests

    Science.gov (United States)

    Denys Yemshanov; Frank Koch; Yakov Ben-Haim; William Smith

    2010-01-01

    Integrated pest risk maps and their underlying assessments provide broad guidance for establishing surveillance programs for invasive species, but they rarely account for knowledge gaps regarding the pest of interest or how these can be reduced. In this study we demonstrate how the somewhat competing notions of robustness to uncertainty and potential knowledge gains...

  7. NASA Astronaut Occupational Surveillance Program and Lifetime Surveillance of Astronaut Health, LSAH, Astronaut Exposures and Risk in the Terrestrial and Spaceflight Environment

    Science.gov (United States)

    Keprta, Sean R.; Tarver, William; Van Baalen, Mary; McCoy, Torin

    2015-01-01

    United States Astronauts have a very unique occupational exposure profile. In order to understand these risks and properly address them, the National Aeronautics and Atmospheric Administration, NASA, originally created the Longitudinal Study of Astronaut Health, LSAH. The first LSAH was designed to address a variety of needs regarding astronaut health and included a 3 to 1 terrestrial control population in order to compare United States "earth normal" disease and aging to that of a microgravity exposed astronaut. Over the years that program has been modified, now termed Lifetime Surveillance of Astronaut Health, still LSAH. Astronaut spaceflight exposures have also changed, with the move from short duration shuttle flights to long duration stays on international space station and considerable terrestrial training activities. This new LSAH incorporates more of an occupational health and medicine model to the study of occupationally exposed astronauts. The presentation outlines the baseline exposures and monitoring of the astronaut population to exposures, both terrestrial, and in space.

  8. Youth Risk Behavior Surveillance System: 2011 National Overview

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors six priority health-risk behaviors that contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States. These behaviors, often established during childhood and early adolescence, include: (1) Behaviors that contribute to…

  9. Tailoring Risk Management in Design

    DEFF Research Database (Denmark)

    Tegeltija, M.; Oehmen, J.; McMahon, C. A.

    2018-01-01

    While risk quantification research has grown over the last few decades, only a limited number of studies have addressed the overall process integration of these approaches in design risk management. This paper argues that the choice of risk quantification method has strong implications for several...... process aspects. We investigate current risk management maturity models and suggest an expansion to accommodate requirements originating from the choice of quantification method, and to inform the choice of quantification method, based on other process parameters, validated through 3 case companies....

  10. Active surveillance can reduce overtreatment in patients with low-risk prostate cancer

    DEFF Research Database (Denmark)

    Thomsen, Frederik Birkebæk; Røder, Martin Andreas; Hvarness, Helle

    2013-01-01

    The incidence of prostate cancer in Denmark rose approximately 50% from 2000 to 2009 in parallel with the introduction of prostate-specific antigen (PSA)-testing. Available evidence indicates a significant overtreatment of patients with low-risk prostate cancer. Active surveillance has been...

  11. Comparing cancer screening estimates: Behavioral Risk Factor Surveillance System and National Health Interview Survey.

    Science.gov (United States)

    Sauer, Ann Goding; Liu, Benmei; Siegel, Rebecca L; Jemal, Ahmedin; Fedewa, Stacey A

    2018-01-01

    Cancer screening prevalence from the Behavioral Risk Factor Surveillance System (BRFSS), designed to provide state-level estimates, and the National Health Interview Survey (NHIS), designed to provide national estimates, are used to measure progress in cancer control. A detailed description of the extent to which recent cancer screening estimates vary by key demographic characteristics has not been previously described. We examined national prevalence estimates for recommended breast, cervical, and colorectal cancer screening using data from the 2012 and 2014 BRFSS and the 2010 and 2013 NHIS. Treating the NHIS estimates as the reference, direct differences (DD) were calculated by subtracting NHIS estimates from BRFSS estimates. Relative differences were computed by dividing the DD by the NHIS estimates. Two-sample t-tests (2-tails), were performed to test for statistically significant differences. BRFSS screening estimates were higher than those from NHIS for breast (78.4% versus 72.5%; DD=5.9%, pNHIS, each survey has a unique and important role in providing information to track cancer screening utilization among various populations. Awareness of these differences and their potential causes is important when comparing the surveys and determining the best application for each data source. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. A risk analysis approach applied to field surveillance in utility meters in legal metrology

    Science.gov (United States)

    Rodrigues Filho, B. A.; Nonato, N. S.; Carvalho, A. D.

    2018-03-01

    Field surveillance represents the level of control in metrological supervision responsible for checking the conformity of measuring instruments in-service. Utility meters represent the majority of measuring instruments produced by notified bodies due to self-verification in Brazil. They play a major role in the economy once electricity, gas and water are the main inputs to industries in their production processes. Then, to optimize the resources allocated to control these devices, the present study applied a risk analysis in order to identify among the 11 manufacturers notified to self-verification, the instruments that demand field surveillance.

  13. Conditional Risk of Relapse in Surveillance for Clinical Stage I Testicular Cancer.

    Science.gov (United States)

    Nayan, Madhur; Jewett, Michael A S; Hosni, Ali; Anson-Cartwright, Lynn; Bedard, Philippe L; Moore, Malcolm; Hansen, Aaron R; Chung, Peter; Warde, Padraig; Sweet, Joan; O'Malley, Martin; Atenafu, Eshetu G; Hamilton, Robert J

    2017-01-01

    Patients on surveillance for clinical stage I (CSI) testicular cancer are counseled regarding their baseline risk of relapse. The conditional risk of relapse (cRR), which provides prognostic information on patients who have survived for a period of time without relapse, have not been determined for CSI testicular cancer. To determine cRR in CSI testicular cancer. We reviewed 1239 patients with CSI testicular cancer managed with surveillance at a tertiary academic centre between 1980 and 2014. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: cRR estimates were calculated using the Kaplan-Meier method. We stratified patients according to validated risk factors for relapse. We used linear regression to determine cRR trends over time. At orchiectomy, the risk of relapse within 5 yr was 42.4%, 17.3%, 20.3%, and 12.2% among patients with high-risk nonseminomatous germ cell tumor (NSGCT), low-risk NSGCT, seminoma with tumor size ≥3cm, and seminoma with tumor size testicular cancer is very low. Consideration should be given to adapting surveillance protocols to individualized risk of relapse based on cRR as opposed to static protocols based on baseline factors. This strategy could reduce the intensity of follow-up for the majority of patients. Our study is the first to provide data on the future risk of relapse during surveillance for clinical stage I testicular cancer, given a patient has been without relapse for a specified period of time. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  14. Implementation of condition-dependent probabilistic risk assessment using surveillance data on passive components

    International Nuclear Information System (INIS)

    Lewandowski, Radoslaw; Denning, Richard; Aldemir, Tunc; Zhang, Jinsuo

    2016-01-01

    Highlights: • Condition-dependent probabilistic risk assessment (PRA). • Time-dependent characterization of plant-specific risk. • Containment bypass involving in secondary system piping and SCC in SG tubes. - Abstract: A great deal of surveillance data are collected for a nuclear power plant that reflect the changing condition of the plant as it ages. Although surveillance data are used to determine failure probabilities of active components for the plant’s probabilistic risk assessment (PRA) and to indicate the need for maintenance activities, they are not used in a structured manner to characterize the evolving risk of the plant. The present study explores the feasibility of using a condition-dependent PRA framework that takes a first principles approach to modeling the progression of degradation mechanisms to characterize evolving risk, periodically adapting the model to account for surveillance results. A case study is described involving a potential containment bypass accident sequence due to the progression of flow-accelerated corrosion in secondary system piping and stress corrosion cracking of steam generator tubes. In this sequence, a steam line break accompanied by failure to close of a main steam isolation valve results in depressurization of the steam generator and induces the rupture of one or more faulted steam generator tubes. The case study indicates that a condition-dependent PRA framework might be capable of providing early identification of degradation mechanisms important to plant risk.

  15. Youth Risk Behavior Surveillance--United States, 2005

    Science.gov (United States)

    Eaton, Danice K.; Kann, Laura; Kinchen, Steve; Ross, James; Hawkins, Joseph; Harris, William A.; Lowry, Richard; McManus, Tim; Chyen, David; Shanklin, Shari; Lim, Connie; Grunbaum, Jo Anne; Wechsler, Howell

    2006-01-01

    In the United States, 71% of all deaths among persons aged 10-24 years result from 4 causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2005 national Youth Risk Behavior Survey (YRBS) indicated that during the 30 days preceding the survey, many high school students engaged in behaviors that…

  16. Design, Implementation, and Evaluation of the Adolescents and Surveillance System for the Obesity Prevention Project.

    Science.gov (United States)

    Tabacchi, Garden; Bianco, Antonino; Alessi, Nicola; Filippi, Anna Rita; Napoli, Giuseppe; Jemni, Monèm; Censi, Laura; Breda, João; Schumann, Nathali Lehmann; Firenze, Alberto; Vitale, Francesco; Mammina, Caterina

    2016-03-01

    The Adolescents Surveillance System for Obesity prevention (ASSO) Project aimed at developing standardized and web-based tools for collecting data on adolescents' obesity and its potential determinants. This has been implemented and piloted in the local area of Palermo city, Italy. The aim of the present study is to provide an overview of the Project's design, implementation, and evaluation, highlighting all the aspects for a potential scale-up of the surveillance system on the whole national territory and abroad, as a sustainable and effective source of data.The overall structure and management, the ASSO-toolkit, the ASSO-NutFit software, and all developed and used procedures for recruiting, training, and data collecting/analyzing are addressed. An interim evaluation has been performed through a feasibility study; a final Project evaluation has been performed reporting the Strengths, Weaknesses, Opportunities, and Threats (SWOT) and the attributes that a surveillance system should have.This article provides a detailed overview of the Project and highlights that ASSO can be considered a valid, logical, coherent, efficient, and sustainable surveillance system that is consistent with countries' needs and priorities.The system developed by the ASSO Project provides high-quality data and complies with several characteristics typical of a suitable surveillance system. It has a potential of being adopted within the National Health Service and other countries' Health Services for monitoring adolescents' obesity and its determinants, such as food intakes, behaviors, physical activity, and fitness profiles.

  17. Cost-effectiveness of surveillance programs for families at high and moderate risk of hereditary non-polyposis colorectal cancer

    DEFF Research Database (Denmark)

    Olsen, Kim R.; Bojesen, Stig E.; Gerdes, Anne-Marie M.

    2007-01-01

    for the group at high risk. The aim of the present study is to determine cost-effectiveness of surveillance programs where families at both high and moderate risk of HNPCC participate. METHODS: A decision analytic model (Markov model) is developed to assess surveillance programs where families at high......OBJECTIVES: Surveillance programs are recommended to both families at high risk (Amsterdam-positive families with known- and unknown mutation) and moderate risk (families not fulfilling all Amsterdam criteria) of colorectal cancer (CRC). Cost-effectiveness has so far only been estimated...

  18. National weighting of data from the Behavioral Risk Factor Surveillance System (BRFSS

    Directory of Open Access Journals (Sweden)

    Ronaldo Iachan

    2016-11-01

    Full Text Available Abstract Background The Behavioral Risk Factor Surveillance System (BRFSS is a network of health-related telephone surveys--conducted by all 50 states, the District of Columbia, and participating US territories—that receive technical assistance from CDC. Data users often aggregate BRFSS state samples for national estimates without accounting for state-level sampling, a practice that could introduce bias because the weighted distributions of the state samples do not always adhere to national demographic distributions. Methods This article examines six methods of reweighting, which are then compared with key health indicator estimates from the National Health Interview Survey (NHIS based on 2013 data. Results Compared to the usual stacking approach, all of the six new methods reduce the variance of weights and design effect at the national level, and some also reduce the estimated bias. This article also provides a comparison of the methods based on the variances induced by unequal weighting as well as the bias reduction induced by raking at the national level, and recommends a preferred method. Conclusions The new method leads to weighted distributions that more accurately reproduce national demographic characteristics. While the empirical results for key estimates were limited to a few health indicators, they also suggest reduction in potential bias and mean squared error. To the extent that survey outcomes are associated with these demographic characteristics, matching the national distributions will reduce bias in estimates of these outcomes at the national level.

  19. Design, construction, operation, shutdown and surveillance of repositories for solid radioactive wastes in shallow ground

    International Nuclear Information System (INIS)

    1984-01-01

    This report is a part of the IAEA publications under its Programme on Underground Disposal of Radioactive Wastes and is addressed to administrative and technical authorities and specialists who consider the shallow-ground disposal of low- and intermediate-level solid radioactive wastes of short half-lives. The report emphasizes the technological aspects, however it briefly discusses the safety philosophy and regulatory considerations too. The design, construction, operation, shutdown and surveillance of the repositories in shallow ground are considered in some detail, paying special attention to their interrelated aspects. In particular, a review is given of the following aspects: main design and construction considerations in relation to the natural features of the site; design and construction aspects during the repository development process; activities related to operational and post-operational stages of the repository; major steps in repository operation and essential activities in shutdown and operational and post-operational surveillance

  20. Wisconsin’s Environmental Public Health Tracking Network: Information Systems Design for Childhood Cancer Surveillance

    Science.gov (United States)

    Hanrahan, Lawrence P.; Anderson, Henry A.; Busby, Brian; Bekkedal, Marni; Sieger, Thomas; Stephenson, Laura; Knobeloch, Lynda; Werner, Mark; Imm, Pamela; Olson, Joseph

    2004-01-01

    In this article we describe the development of an information system for environmental childhood cancer surveillance. The Wisconsin Cancer Registry annually receives more than 25,000 incident case reports. Approximately 269 cases per year involve children. Over time, there has been considerable community interest in understanding the role the environment plays as a cause of these cancer cases. Wisconsin’s Public Health Information Network (WI-PHIN) is a robust web portal integrating both Health Alert Network and National Electronic Disease Surveillance System components. WI-PHIN is the information technology platform for all public health surveillance programs. Functions include the secure, automated exchange of cancer case data between public health–based and hospital-based cancer registrars; web-based supplemental data entry for environmental exposure confirmation and hypothesis testing; automated data analysis, visualization, and exposure–outcome record linkage; directories of public health and clinical personnel for role-based access control of sensitive surveillance information; public health information dissemination and alerting; and information technology security and critical infrastructure protection. For hypothesis generation, cancer case data are sent electronically to WI-PHIN and populate the integrated data repository. Environmental data are linked and the exposure–disease relationships are explored using statistical tools for ecologic exposure risk assessment. For hypothesis testing, case–control interviews collect exposure histories, including parental employment and residential histories. This information technology approach can thus serve as the basis for building a comprehensive system to assess environmental cancer etiology. PMID:15471739

  1. Comparison of 2 Disability Measures, Behavioral Risk Factor Surveillance System, 2013

    OpenAIRE

    Stevens, Alissa C.; Courtney-Long, Elizabeth A.; Okoro, Catherine A.; Carroll, Dianna D.

    2016-01-01

    Introduction Beginning in 2013, in addition to the 2-item disability question set asked since 2001, Behavioral Risk Factor Surveillance System (BRFSS) began using 5 of the 6 items from the US Department of Health and Human Services?recommended disability question set. We assess and compare disability prevalence using the 2-question and 5-question sets and describe characteristics of respondents who identified as having a disability using each question set. Methods We used data from the 2013 B...

  2. Core state preconception health indicators - pregnancy risk assessment monitoring system and behavioral risk factor surveillance system, 2009.

    Science.gov (United States)

    Robbins, Cheryl L; Zapata, Lauren B; Farr, Sherry L; Kroelinger, Charlan D; Morrow, Brian; Ahluwalia, Indu; D'Angelo, Denise V; Barradas, Danielle; Cox, Shanna; Goodman, David; Williams, Letitia; Grigorescu, Violanda; Barfield, Wanda D

    2014-04-25

    Promoting preconception health can potentially improve women's health and pregnancy outcomes. Evidence-based interventions exist to reduce many maternal behaviors and chronic conditions that are associated with adverse pregnancy outcomes such as tobacco use, alcohol use, inadequate folic acid intake, obesity, hypertension, and diabetes. The 2006 national recommendations to improve preconception health included monitoring improvements in preconception health by maximizing public health surveillance (CDC. Recommendations to improve preconception health and health care-United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR 2006;55[No. RR-6]). 2009 for 38 indicators; 2008 for one indicator. DESCRIPTION OF SURVEILLANCE SYSTEMS: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing state- and population-based surveillance system designed to monitor selected self-reported maternal behaviors, conditions, and experiences that occur shortly before, during, and after pregnancy among women who deliver live-born infants. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing state-based telephone survey of noninstitutionalized adults aged ≥18 years in the United States that collects state-level data on health-related risk behaviors, chronic conditions, and preventive health services. This surveillance summary includes PRAMS data from 29 reporting areas (n = 40,388 respondents) and BRFSS data from 51 reporting areas (n = 62,875 respondents) for nonpregnant women of reproductive age (aged 18-44 years). To establish a comprehensive, nationally recognized set of indicators to be used for monitoring, evaluation, and response, a volunteer group of policy and program leaders and epidemiologists identified 45 core state preconception health indicators, of which 41 rely on PRAMS or BRFSS as data sources. This report includes 39 of the 41 core state preconception health indicators for which

  3. Standard Practice for Design of Surveillance Programs for Light-Water Moderated Nuclear Power Reactor Vessels

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This practice covers procedures for designing a surveillance program for monitoring the radiation-induced changes in the mechanical properties of ferritic materials in light-water moderated nuclear power reactor vessels. This practice includes the minimum requirements for the design of a surveillance program, selection of vessel material to be included, and the initial schedule for evaluation of materials. 1.2 This practice was developed for all light-water moderated nuclear power reactor vessels for which the predicted maximum fast neutron fluence (E > 1 MeV) at the end of license (EOL) exceeds 1 × 1021 neutrons/m2 (1 × 1017 n/cm2) at the inside surface of the reactor vessel. 1.3 This practice applies only to the planning and design of surveillance programs for reactor vessels designed and built after the effective date of this practice. Previous versions of Practice E185 apply to earlier reactor vessels. 1.4 This practice does not provide specific procedures for monitoring the radiation induced cha...

  4. Analysis of Swine Movements in a Province in Northern Vietnam and Application in the Design of Surveillance Strategies for Infectious Diseases.

    Science.gov (United States)

    Baudon, E; Fournié, G; Hiep, D T; Pham, T T H; Duboz, R; Gély, M; Peiris, M; Cowling, B J; Ton, V D; Peyre, M

    2017-04-01

    While swine production is rapidly growing in South-East Asia, the structure of the swine industry and the dynamic of pig movements have not been well-studied. However, this knowledge is a prerequisite for understanding the dynamic of disease transmission in swine populations and designing cost-effective surveillance strategies for infectious diseases. In this study, we assessed the farming and trading practices in the Vietnamese swine familial farming sector, which accounts for most pigs in Vietnam, and for which disease surveillance is a major challenge. Farmers from two communes of a Red River Delta Province (northern Vietnam) were interviewed, along with traders involved in pig transactions. Major differences in the trade structure were observed between the two communes. One commune had mainly transversal trades, that is between farms of equivalent sizes, whereas the other had pyramidal trades, that is from larger to smaller farms. Companies and large familial farrow-to-finish farms were likely to act as major sources of disease spread through pig sales, demonstrating their importance for disease control. Familial fattening farms with high pig purchases were at greater risk of disease introduction and should be targeted for disease detection as part of a risk-based surveillance. In contrast, many other familial farms were isolated or weakly connected to the swine trade network limiting their relevance for surveillance activities. However, some of these farms used boar hiring for breeding, increasing the risk of disease spread. Most familial farms were slaughtering pigs at the farm or in small local slaughterhouses, making the surveillance at the slaughterhouse inefficient. In terms of spatial distribution of the trades, the results suggested that northern provinces were highly connected and showed some connection with central and southern provinces. These results are useful to develop risk-based surveillance protocols for disease detection in the swine familial

  5. Rapid prototyping of an automated video surveillance system: a hardware-software co-design approach

    Science.gov (United States)

    Ngo, Hau T.; Rakvic, Ryan N.; Broussard, Randy P.; Ives, Robert W.

    2011-06-01

    FPGA devices with embedded DSP and memory blocks, and high-speed interfaces are ideal for real-time video processing applications. In this work, a hardware-software co-design approach is proposed to effectively utilize FPGA features for a prototype of an automated video surveillance system. Time-critical steps of the video surveillance algorithm are designed and implemented in the FPGAs logic elements to maximize parallel processing. Other non timecritical tasks are achieved by executing a high level language program on an embedded Nios-II processor. Pre-tested and verified video and interface functions from a standard video framework are utilized to significantly reduce development and verification time. Custom and parallel processing modules are integrated into the video processing chain by Altera's Avalon Streaming video protocol. Other data control interfaces are achieved by connecting hardware controllers to a Nios-II processor using Altera's Avalon Memory Mapped protocol.

  6. Feasibility of using pedometers in a state-based surveillance system: 2014 Arizona Behavioral Risk Factor Surveillance System

    Directory of Open Access Journals (Sweden)

    Alberto Flórez-Pregonero

    2018-01-01

    Conclusion: The feasibility of using pedometers in a state-based surveillance system is modest at best. Feasibility may potentially be improved with easy-to-use pedometers where data can be electronically downloaded.

  7. Multiple cardiovascular risk factors in Kenya: evidence from a health and demographic surveillance system using the WHO STEPwise approach to chronic disease risk factor surveillance.

    Science.gov (United States)

    Bloomfield, Gerald S; Mwangi, Ann; Chege, Patrick; Simiyu, Chrispinus J; Aswa, Daniel F; Odhiambo, David; Obala, Andrew A; Ayuo, Paul; Khwa-Otsyula, Barasa O

    2013-09-01

    To describe the distribution of cardiovascular risk factors in western Kenya using a Health and Demographic Surveillance System (HDSS). Population based survey of residents in an HDSS. Webuye Division in Bungoma East District, Western Province of Kenya. 4037 adults ≥ 18 years of age. Home based survey using the WHO STEPwise approach to chronic disease risk factor surveillance. Self-report of high blood pressure, high blood sugar, tobacco use, alcohol use, physical activity, and fruit/vegetable intake. The median age of the population was 35 years (IQR 26-50). Less than 6% of the population reported high blood pressure or blood sugar. Tobacco and alcohol use were reported in 7% and 16% of the population, respectively. The majority of the population (93%) was physically active. The average number of days per week that participants reported intake of fruits (3.1 ± 0.1) or vegetables (1.6 ± 0.1) was low. In multiple logistic regression analyses, women were more likely to report a history of high blood pressure (OR 2.72, 95% CI 1.9 to 3.9), less likely to report using tobacco (OR 0.08, 95% CI 0.06 to 0.11), less likely to report alcohol use (OR 0.18, 95% CI 0.15 to 0.21) or eat ≥ 5 servings per day of fruits or vegetables (OR 0.87, 95% CI 0.76 to 0.99) compared to men. The most common cardiovascular risk factors in peri-urban western Kenya are tobacco use, alcohol use, and inadequate intake of fruits and vegetables. Our data reveal locally relevant subgroup differences that could inform future prevention efforts.

  8. On-line pressurizer surveillance system design to prevent small break LOCA through PORV using micro-computer

    International Nuclear Information System (INIS)

    Lee, Jong-Ho; Chang, Soon-Heung

    1986-01-01

    Small break LOCA caused by a stuck-open PORV is one of the important contributors to nuclear power plant risk. This paper deals with the design of a pressurizer surveillance system using micro-computer to prevent the malfunction of system and has assessed the effect of this improvement through Probabilistic Risk Assessment (PRA) method. Micro-computer diagnoses the malfunction of system by a process checking method and performs automatically backup action related to each malfunction. Owing to this improvement, we can correctly diagnose ''Spurious Opening'', ''Fail to Reclose'' and ''Small break LOCA'' which are difficult for operator to diagnose quickly and correctly and reduce the probability of a human error by an automatic backup action. (author)

  9. PIPEX - A model of a design concept for reprocessing plants with improved containment and surveillance features

    International Nuclear Information System (INIS)

    1979-03-01

    This paper explains that the PIPEX concept is essentially a reprocessing plant using the PUREX process but with in-built improved containment and surveillance features resulting in increased health protection and environmental safety as well as higher resistance to diversion of fissile material. The paper gives a general description of the design and operating philosophy of such a plant and goes on to examine the safeguards and safety principles and implications

  10. Prediagnostic prostate-specific antigen kinetics and the risk of biopsy progression in active surveillance patients.

    Science.gov (United States)

    Iremashvili, Viacheslav; Barney, Shane L; Manoharan, Murugesan; Kava, Bruce R; Parekh, Dipen J; Punnen, Sanoj

    2016-04-01

    To analyze the association between prediagnostic prostate-specific antigen kinetics and the risk of biopsy progression in prostate cancer patients on active surveillance, and to study the effect of prediagnostic prostate-specific antigen values on the predictive performance of prostate-specific antigen velocity and prostate-specific antigen doubling time. The study included 137 active surveillance patients with two or more prediagnostic prostate-specific antigen levels measured over a period of at least 3 months. Two sets of analyses were carried out. First, the association between prostate-specific antigen kinetics calculated using only the prediagnostic prostate-specific antigen values and the risk of biopsy progression was studied. Second, using the same cohort of patients, the predictive value of prostate-specific antigen kinetics calculated using only post-diagnostic prostate-specific antigens and compared with that of prostate-specific antigen kinetics based on both pre- and post-diagnostic prostate-specific antigen levels was analyzed. Of 137 patients included in the analysis, 37 (27%) had biopsy progression over a median follow-up period of 3.2 years. Prediagnostic prostate-specific antigen velocity of more than 2 ng/mL/year and 3 ng/mL/year was statistically significantly associated with the risk of future biopsy progression. However, after adjustment for baseline prostate-specific antigen density, these associations were no longer significant. None of the tested prostate-specific antigen kinetics based on combined pre- and post-diagnostic prostate-specific antigen values were statistically significantly associated with the risk of biopsy progression. Historical prediagnostic prostate-specific antigens seems to be not clinically useful in patients diagnosed with low-risk prostate cancer on active surveillance. © 2016 The Japanese Urological Association.

  11. Specialized surveillance for individuals at high risk for melanoma: a cost analysis of a high-risk clinic.

    Science.gov (United States)

    Watts, Caroline G; Cust, Anne E; Menzies, Scott W; Coates, Elliot; Mann, Graham J; Morton, Rachael L

    2015-02-01

    Regular surveillance of individuals at high risk for cutaneous melanoma improves early detection and reduces unnecessary excisions; however, a cost analysis of this specialized service has not been undertaken. To determine the mean cost per patient of surveillance in a high-risk clinic from the health service and societal perspectives. We used a bottom-up microcosting method to measure resource use in a consecutive sample of 102 patients treated in a high-risk hospital-based clinic in Australia during a 12-month period. Surveillance and treatment of melanoma. All surveillance and treatment procedures were identified through direct observation, review of medical records, and interviews with staff and were valued using scheduled fees from the Australian government. Societal costs included transportation and loss of productivity. The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]); the cost discounted across 20 years was A $11,546 (95% CI, A $10,263-$12,829) (US $7839 [95% CI, US $6969-$8710]). The mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710]); the cost discounted across 20 years was A $12,721 (95% CI, A $12,554-$14,463) (US $8637 [95% CI, US $8523-$9820]). Diagnosis of melanoma or nonmelanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for positively skewed health system costs. Microcosting techniques provide an accurate cost estimate for the provision of a specialized service. The high societal cost reflects the time that patients are willing to invest to attend the high-risk clinic. This alternative model of care for a high-risk population has relevance for decision making about health policy.

  12. Snapshot from Superstorm Sandy: American Red Cross mental health risk surveillance in lower New York State.

    Science.gov (United States)

    Schreiber, Merritt D; Yin, Rob; Omaish, Mostafa; Broderick, Joan E

    2014-07-01

    Disasters often cause psychological injury, as well as dramatic physical damage. Epidemiologic research has identified a set of disaster experiences and predisposing characteristics that place survivors at risk for post traumatic stress disorder (PTSD), depression, and anxiety. Rapid triage of at-risk survivors could have benefits for individual and population-level outcomes. We examine American Red Cross mental health risk surveillance data collected from October 29 to November 20, 2012, immediately after Hurricane Sandy in 8 lower New York State counties to evaluate the feasibility and utility of collecting these data. PsySTART, an evidence-based disaster mental health triage tool, was used to record survivor-reported risk factors after each survivor contact. Red Cross disaster mental health volunteers interfaced with survivors at disaster operation sites, including shelters, emergency aid stations, and mobile feeding and community outreach centers. Risk data were called into the operations center each day and reported by county. PsySTART risk surveillance data for 18,823 disaster mental health contacts are presented for adults and children. A total of 17,979 risk factors were reported. Overall levels of risk per contact were statistically different (χ(2)(1, N=6,045)=248.1; PSuperstorm Sandy indicate substantial population-level impact suggestive of risk for disorders that may persist chronically without treatment. Mental health triage has the potential to improve care of individual disaster survivors, as well as inform disaster management, local health providers, and public health officials. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  13. Risk based seismic design criteria

    International Nuclear Information System (INIS)

    Kennedy, R.P.

    1999-01-01

    In order to develop a risk based seismic design criteria the following four issues must be addressed: (1) What target annual probability of seismic induced unacceptable performance is acceptable? (2) What minimum seismic margin is acceptable? (3) Given the decisions made under Issues 1 and 2, at what annual frequency of exceedance should the safe-shutdown-earthquake (SSE) ground motion be defined? (4) What seismic design criteria should be established to reasonably achieve the seismic margin defined under Issue 2? The first issue is purely a policy decision and is not addressed in this paper. Each of the other three issues are addressed. Issues 2 and 3 are integrally tied together so that a very large number of possible combinations of responses to these two issues can be used to achieve the target goal defined under Issue 1. Section 2 lays out a combined approach to these two issues and presents three potentially attractive combined resolutions of these two issues which reasonably achieves the target goal. The remainder of the paper discusses an approach which can be used to develop seismic design criteria aimed at achieving the desired seismic margin defined in resolution of Issue 2. Suggestions for revising existing seismic design criteria to more consistently achieve the desired seismic margin are presented. (orig.)

  14. Mathematical models used to inform study design or surveillance systems in infectious diseases: a systematic review.

    Science.gov (United States)

    Herzog, Sereina A; Blaizot, Stéphanie; Hens, Niel

    2017-12-18

    Mathematical models offer the possibility to investigate the infectious disease dynamics over time and may help in informing design of studies. A systematic review was performed in order to determine to what extent mathematical models have been incorporated into the process of planning studies and hence inform study design for infectious diseases transmitted between humans and/or animals. We searched Ovid Medline and two trial registry platforms (Cochrane, WHO) using search terms related to infection, mathematical model, and study design from the earliest dates to October 2016. Eligible publications and registered trials included mathematical models (compartmental, individual-based, or Markov) which were described and used to inform the design of infectious disease studies. We extracted information about the investigated infection, population, model characteristics, and study design. We identified 28 unique publications but no registered trials. Focusing on compartmental and individual-based models we found 12 observational/surveillance studies and 11 clinical trials. Infections studied were equally animal and human infectious diseases for the observational/surveillance studies, while all but one between humans for clinical trials. The mathematical models were used to inform, amongst other things, the required sample size (n = 16), the statistical power (n = 9), the frequency at which samples should be taken (n = 6), and from whom (n = 6). Despite the fact that mathematical models have been advocated to be used at the planning stage of studies or surveillance systems, they are used scarcely. With only one exception, the publications described theoretical studies, hence, not being utilised in real studies.

  15. Risk factors of major noncommunicable diseases in Bahrain. The need for a surveillance system.

    Science.gov (United States)

    Hamadeh, Randah R

    2004-09-01

    Noncommunicable diseases NCDs are the major cause of morbidity and mortality in Bahrain. The review examines the prevalence of risk factors of major NCDs from the available literature and determines the impact of the rapid socio economic changes on their burden. It further recommends ways of improving their reporting and monitoring. Smoking, obesity, diabetes, hypertension, hyperlipidemia, physical activity and nutrition are considered. The review points out that data on some of the factors is available but deficient for others. The call for the establishment of an integrated surveillance system using the World Health Organization STEPwise approach is stressed.

  16. Surveillance Monitoring Management for General Care Units: Strategy, Design, and Implementation.

    Science.gov (United States)

    McGrath, Susan P; Taenzer, Andreas H; Karon, Nancy; Blike, George

    2016-07-01

    The growing number of monitoring devices, combined with suboptimal patient monitoring and alarm management strategies, has increased "alarm fatigue," which have led to serious consequences. Most reported alarm man- agement approaches have focused on the critical care setting. Since 2007 Dartmouth-Hitchcock (Lebanon, New Hamp- shire) has developed a generalizable and effective design, implementation, and performance evaluation approach to alarm systems for continuous monitoring in general care settings (that is, patient surveillance monitoring). In late 2007, a patient surveillance monitoring system was piloted on the basis of a structured design and implementation approach in a 36-bed orthopedics unit. Beginning in early 2009, it was expanded to cover more than 200 inpatient beds in all medicine and surgical units, except for psychiatry and labor and delivery. Improvements in clinical outcomes (reduction of unplanned transfers by 50% and reduction of rescue events by more than 60% in 2008) and approximately two alarms per patient per 12-hour nursing shift in the original pilot unit have been sustained across most D-H general care units in spite of increasing patient acuity and unit occupancy. Sample analysis of pager notifications indicates that more than 85% of all alarm conditions are resolved within 30 seconds and that more than 99% are resolved before escalation is triggered. The D-H surveillance monitoring system employs several important, generalizable features to manage alarms in a general care setting: alarm delays, static thresholds set appropriately for the prevalence of events in this setting, directed alarm annunciation, and policy-driven customization of thresholds to allow clinicians to respond to needs of individual patients. The systematic approach to design, implementation, and performance management has been key to the success of the system.

  17. A Systematic Approach to Discussing Active Surveillance with Patients with Low-risk Prostate Cancer.

    Science.gov (United States)

    Ehdaie, Behfar; Assel, Melissa; Benfante, Nicole; Malhotra, Deepak; Vickers, Andrew

    2017-06-01

    Physicians report difficulty convincing patients with prostate cancer about the merits of active surveillance (AS); as a result, a majority of patients unnecessarily choose to undergo radical treatment. To develop and evaluate a systematic approach for physicians to counsel patients with low-risk prostate cancer to increase acceptance of AS. A systematic counseling approach was developed and piloted in one clinic. Then five surgeons participated in a 1-h training session in which they learned about the approach. A total of 1003 patients with Gleason 3+3 prostate cancer were included in the study. We compared AS rates for 761 patients who were counseled over a 24-mo period before the training intervention with AS rates for 242 patients who were counseled over a 12-mo period afterwards, controlling for temporal trends and case mix. A systematic approach for communicating the merits of AS using appropriate framing techniques derived from principles studied by negotiation scholars. The rate of AS acceptance by patients for management of low-risk prostate cancer. In the pilot phase, 81 of 86 patients (94%) accepted AS after counseling by the physician who developed the counseling approach. In the subsequent study, the cohort for the training intervention comprised 1003 consecutive patients, 80% of whom met the Epstein criteria for very low-risk disease. The proportion of patients who selected AS increased from 69% before the training intervention to 81% afterwards. After adjusting for time trends and case mix, the rate of AS after the intervention was 9.1% higher (95% confidence interval -0.4% to 19.4%) than expected, a relative reduction of approximately 30% in the risk of unnecessary curative treatment. A systematic approach to counseling can be taught to physicians in a 1-h lecture. We found evidence that even this minimal intervention can decrease overtreatment. Our novel approach offers a framework to help address cancer screening-related overtreatment that occurs

  18. High-risk populations identified in Childhood Cancer Survivor Study investigations: implications for risk-based surveillance.

    Science.gov (United States)

    Hudson, Melissa M; Mulrooney, Daniel A; Bowers, Daniel C; Sklar, Charles A; Green, Daniel M; Donaldson, Sarah S; Oeffinger, Kevin C; Neglia, Joseph P; Meadows, Anna T; Robison, Leslie L

    2009-05-10

    Childhood cancer survivors often experience complications related to cancer and its treatment that may adversely affect quality of life and increase the risk of premature death. The purpose of this manuscript is to review how data derived from Childhood Cancer Survivor Study (CCSS) investigations have facilitated identification of childhood cancer survivor populations at high risk for specific organ toxicity and secondary carcinogenesis and how this has informed clinical screening practices. Articles previously published that used the resource of the CCSS to identify risk factors for specific organ toxicity and subsequent cancers were reviewed and results summarized. CCSS investigations have characterized specific groups to be at highest risk of morbidity related to endocrine and reproductive dysfunction, pulmonary toxicity, cerebrovascular injury, neurologic and neurosensory sequelae, and subsequent neoplasms. Factors influencing risk for specific outcomes related to the individual survivor (eg, sex, race/ethnicity, age at diagnosis, attained age), sociodemographic status (eg, education, household income, health insurance) and cancer history (eg, diagnosis, treatment, time from diagnosis) have been consistently identified. These CCSS investigations that clarify risk for treatment complications related to specific treatment modalities, cumulative dose exposures, and sociodemographic factors identify profiles of survivors at high risk for cancer-related morbidity who deserve heightened surveillance to optimize outcomes after treatment for childhood cancer.

  19. Designing Surveillance of Healthcare-Associated Infections in the Era of Automation and Reporting Mandates

    NARCIS (Netherlands)

    van Mourik, Maaike S M; Perencevich, Eli N; Gastmeier, Petra; Bonten, Marc J M

    2018-01-01

    Surveillance and feedback of infection rates to clinicians and other stakeholders is a cornerstone of healthcare-associated infection (HAI) prevention programs. In addition, HAIs are increasingly included in public reporting and payment mandates. Conventional manual surveillance methods are resource

  20. Designing Surveillance of Healthcare-Associated Infections in the Era of Automation and Reporting Mandates.

    NARCIS (Netherlands)

    van Mourik, Maaike S M; Perencevich, Eli N; Gastmeier, Petra; Bonten, Marc J M

    2018-01-01

    Surveillance and feedback of infection rates to clinicians and other stakeholders is a cornerstone of healthcare-associated infection (HAI) prevention programs. In addition, HAIs are increasingly included in public reporting and payment mandates. Conventional manual surveillance methods are resource

  1. The Design of the Longitudinal Autopilot for the LSU-05 Unmanned Aerial Surveillance Vehicle

    Science.gov (United States)

    Fajar, Muhammad; Arifianto, Ony

    2018-04-01

    Longitudinal autopilot design for the LAPAN Surveillance Vehicle LSU-05 will be described in this paper. The LSU-05 is the most recent Unmanned Aerial Vehicle (UAV) project of the Aeronautics Technology Center (Pusat Teknologi Penerbangan – Pustekbang), LAPAN. This UAV is expected to be able to carry 30 kg of payload, four surveillance purposes. The longitudinal autopilot described in this paper consists of four modes, those are Pitch damper, Pitch Attitude Hold, Altitude Hold, and Speed Hold. The Autopilot of the UAV will be designed at four operating speeds, namely 15 m/s, 20 m/s, 25 m/s, and 30 m/. The Athena Vortex Lattice software is used to generate the aerodynamic model of the LSU-05. Non-linear longitudinal aircraft dynamics model is then developed in MATLAB/SIMULINK environment. Linearization of the non-linear model is performed using the linearization tool of SIMULINK. The controller is designed, based on the linear model of the aircraft in the state space form. A Proportional-Integral-Derivative (PID) controller structure is chosen, using root locus method to determine mainly the proportional (P) gain. Integral (I) and derivative (D) gain will only be used if the proportional gain can not achieve the desired target or if an overshoot / undershoot reduction is required. The overshoot/undershoot should not exceed 5% and settling time is less than 20 seconds. The controller designed is simulated using MATLAB and SIMULINK. Preliminary analysis of the controller performance shows that the controller can be used to stabilize the aircraft and to automatize the speed and altitude control throughout the considered speed range.

  2. Impact of sensor-scene interaction on the design of an IR security surveillance system

    International Nuclear Information System (INIS)

    Claassen, J.P.; Phipps, G.S.

    1982-01-01

    Recent encouraging developments in infrared staring arrays with CCD readouts and in real time image processors working on and off the focal plane have suggested that technologies suitable for infrared security surveillance may be available in a two-to-five year time frame. In anticipation of these emerging technologies, an investigation has been undertaken to establish the design potential of a passive IR perimeter security system incorporating both detection and verification capabilities. To establish the design potential, it is necessary to characterize the interactions between the scene ad the sensor. To this end, theoretical and experimental findings were employed to document (1) the emission properties of scenes to include an intruder, (2) the propagation and emission characteristics of the intervening atmosphere, and (3) the reception properties of the imaging sensor. The impact of these findings are summarized in the light of the application constraints. Optimal wavelengths, intruder and background emission characteristics, weather limitations, and basic sensor design considerations are treated. Although many system design features have been identified to this date, continued efforts are required to complete a detailed system design to include the identifying processing requirements. A program to accomplish these objectives is presented

  3. Surveillance of vector-borne pathogens under imperfect detection: lessons from Chagas disease risk (mis)measurement.

    Science.gov (United States)

    Minuzzi-Souza, Thaís Tâmara Castro; Nitz, Nadjar; Cuba, César Augusto Cuba; Hagström, Luciana; Hecht, Mariana Machado; Santana, Camila; Ribeiro, Marcelle; Vital, Tamires Emanuele; Santalucia, Marcelo; Knox, Monique; Obara, Marcos Takashi; Abad-Franch, Fernando; Gurgel-Gonçalves, Rodrigo

    2018-01-09

    Vector-borne pathogens threaten human health worldwide. Despite their critical role in disease prevention, routine surveillance systems often rely on low-complexity pathogen detection tests of uncertain accuracy. In Chagas disease surveillance, optical microscopy (OM) is routinely used for detecting Trypanosoma cruzi in its vectors. Here, we use replicate T. cruzi detection data and hierarchical site-occupancy models to assess the reliability of OM-based T. cruzi surveillance while explicitly accounting for false-negative and false-positive results. We investigated 841 triatomines with OM slides (1194 fresh, 1192 Giemsa-stained) plus conventional (cPCR, 841 assays) and quantitative PCR (qPCR, 1682 assays). Detections were considered unambiguous only when parasitologists unmistakably identified T. cruzi in Giemsa-stained slides. qPCR was >99% sensitive and specific, whereas cPCR was ~100% specific but only ~55% sensitive. In routine surveillance, examination of a single OM slide per vector missed ~50-75% of infections and wrongly scored as infected ~7% of the bugs. qPCR-based and model-based infection frequency estimates were nearly three times higher, on average, than OM-based indices. We conclude that the risk of vector-borne Chagas disease may be substantially higher than routine surveillance data suggest. The hierarchical modelling approach we illustrate can help enhance vector-borne disease surveillance systems when pathogen detection is imperfect.

  4. Surveillance of primary sclerosing cholangitis with ERC and brush cytology: risk factors for cholangiocarcinoma.

    Science.gov (United States)

    Boyd, Sonja; Mustonen, Harri; Tenca, Andrea; Jokelainen, Kalle; Arola, Johanna; Färkkilä, Martti A

    2017-02-01

    Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease leading to bile duct strictures and fibrosis, and predisposing to cholangiocarcinoma (CCA). Biliary dysplasia is a known precursor of CCA. In our unit, PSC patients undergo regular surveillance with ERC and brush cytology (BC), and liver transplantation is an option in case with biliary dysplasia. We evaluated the risk factors for biliary dysplasia and CCA based on ERC imaging, BC and liver function tests. Seven hundred and eighty-eight ERCs were performed with BC for 447 PSC patients. ERC images were evaluated using the modified Amsterdam score, neutrophilic inflammation was assessed in BC, and liver function tests were collected. Ploidy analysis with DNA flow cytometry was performed in cases with advanced PSC or previous suspicious BC/aneuploidy. The endpoint was either a benign disease course (follow-up for ≥2.4 years after the latest ERC), benign histology, biliary dysplasia or CCA. Benign disease course was seen in 424/447 (including 23 cases with biliary dysplasia), and CCA in 17 (3.8%) patients. Gallbladder carcinoma/carcinoma in situ was diagnosed in three patients. Advanced ERC findings, male gender, suspicious BC, aneuploidy in flow cytometry, inflammation, and elevation of ALP, bilirubin, ALT, AST, GGT, CEA and CA19-9 represented significant risk factors for CCA in univariate analysis. PSC patients with advanced bile duct disease and elevated liver enzymes, CEA or CA19-9, inflammation or suspicious BC are most likely to develop CCA. These patients may benefit from surveillance with BC if early liver transplantation is possible.

  5. Remarks on sequential designs in risk assessment

    International Nuclear Information System (INIS)

    Seidenfeld, T.

    1982-01-01

    The special merits of sequential designs are reviewed in light of particular challenges that attend risk assessment for human population. The kinds of ''statistical inference'' are distinguished and the problem of design which is pursued is the clash between Neyman-Pearson and Bayesian programs of sequential design. The value of sequential designs is discussed and the Neyman-Pearson vs. Bayesian sequential designs are probed in particular. Finally, warnings with sequential designs are considered, especially in relation to utilitarianism

  6. Evaluating the use of cell phone messaging for community Ebola syndromic surveillance in high risked settings in Southern Sierra Leone.

    Science.gov (United States)

    Jia, Kangbai; Mohamed, Koroma

    2015-09-01

    Most underdeveloped countries do not meet core disease outbreak surveillance because of the lack of human resources, laboratory and infrastructural facilities. The use of cell phone technology for disease outbreak syndromic surveillance is a new phenomenon in Sierra Leone despite its successes in other developing countries like Sri Lanka. In this study we set to evaluate the effectiveness of using cell phone technology for Ebola hemorrhagic fever syndromic surveillance in a high risked community in Sierra Leone. This study evaluated the effectiveness of using cell phone messaging (text and calls) for community Ebola hemorrhagic fever syndromic surveillance in high risked community in southern Sierra Leone. All cell phone syndromic surveillance data used for this study was reported as cell phone alert messages-texts and voice calls; by the Moyamba District Health Management Team for both Ebola hemorrhagic fever suspect and mortalities. We conducted a longitudinal data analysis of the monthly cumulative confirmed Ebola hemorrhagic fever cases and mortalities collected by both the traditional sentinel and community cell phone syndromic surveillance from August 2014 to October 2014. A total of 129 and 49 Ebola hemorrhagic fever suspect and confirmed cases respectively were recorded using the community Ebola syndromic surveillance cell phone alert system by the Moyamba District Health Management Team in October 2014. The average number of Ebola hemorrhagic fever suspects and confirmed cases for October 2014 were 4.16 (Std.dev 3.76) and 1.58 (Std.dev 1.43) respectively. Thirty-four percent (n=76) of the community Ebola syndromic surveillance cell phone alerts that were followed-up within 24 hours reported Ebola hemorrhagic fever suspect cases while 65.92% (n=147) reported mortality. Our study suggests some form of underreporting by the traditional sentinel Ebola hemorrhagic fever disease surveillance system in Moyamba District southern Sierra Leone for August

  7. Trends in screening mammograms for women 50 years of age and older - behavioral risk factor surveillance system, 1987

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    To assess whether the media attention to breast cancer screening and the promotional efforts in 1987 were paralleled by increases in screening of women greater than or equal to 50 years of age, CDC analyzed data from 33 states that participated in the 1987 Behavioral Risk Factor Surveillance System (BRFSS)

  8. [Risk assessments and control strategies of plague in five key surveillance counties, Zhejiang province].

    Science.gov (United States)

    Shi, Guoxiang; Ju, Cheng; Zhang, Rong; Zhang, Zheng; Sun, Jimin; Wang, Miaoruo; Zhang, Xiaohe; Ye, Xianming; Zhu, Zhihong; Xing, Jianguang; Liao, Xiaowei; Chen, Zhiping

    2015-10-01

    To analyze the epidemiology data on plague in five counties in Zhejiang province and to evaluate the risk of plague in theses areas. We selected five monitoring stations as a risk assessment (Qingyuan county, Longquan city, Yiwu city, Wencheng county, and Ruian city) in Zhejiang province where the plague epidemic more serious in the history. At least one constant site and 1-4 variable sites where plague occurred in history were selected for monitoring. We collected the five counties (cities) surveillance data of indoor rat density, indoor Rattus flavipectus density, the Xenopsylla cheopis index of rat, the Xenopsylla cheopis index of Rattus flavipectus in 1995-2014. Isolation of Yersinia pestis was conducted among 171,201 liver samples and F1 antibody were detected among 228,775 serum samples. Risk matrix, Borda count method, and Delphi approach were conducted to assess risk of the plague of five counties (cities) in Zhejiang province. Indoor rat density in Qingyuan county, Longquan city, Yiwu city, Wencheng county, Ruian city was 1.58%-5.50%, 1.13%-9.76%, 0.56%-3.67%, 2.83%-16.08%, 7.16%-15.96%, respectively; Indoor Rattus flavipectus density of five counties (cities) was 0.08%-2.23%, 0-2.02%, 0-0.54%, 0.71%-5.58%, 0.55%-4.92%, respectively. The Xenopsylla cheopis index of rat in Qingyuan county and Wencheng county was 0.011-0.500 and 0.015-0.227, respectively; The Xenopsylla cheopis index of Rattus flavipectus of Qingyuan county and Wencheng county was 0.119-3.412 and 0.100-1.430, respectively; Ruian City and Yiwu city cannot collected Xenopsylla cheopis, Long quan city only collected the Xenopsylla cheopis index of rat in the five years. Yersinia pestis were not isolated in five counties (cities).There were 3 Apodemus agrarius samples positive of plague F1 antibody test, in Longquan city and Yiwu city in 2005. Borda count method to assess the Longquan city, Yiwu (Borda point were both 321) plague risk was higher than three other regions; Delphi approach to

  9. Adult informal caregivers reporting financial burden in Hawaii, Kansas, and Washington: Results from the 2007 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Kusano, Claudia T; Bouldin, Erin D; Anderson, Lynda A; McGuire, Lisa C; Salvail, Florentina R; Simmons, Katrina Wynkoop; Andresen, Elena M

    2011-10-01

    Given the unpaid nature of the work, informal caregiving can create a financial burden for caregivers. Little has been done to identify specific predictors of experiencing financial burden. This study investigated demographic and health factors comparing caregivers who reported having or not having financial burden. Data are derived from adult caregivers (N = 3,317) as part of the 2007 Behavioral Risk Factor Surveillance System in Hawaii, Kansas, and Washington. The adjusted odds ratios for reporting a financial burden were estimated for demographic and other risk factors. Caregivers who reported a financial burden were younger, had lower incomes, were more likely to be current smokers, have had a stroke, and rate their health as fair or poor compared to caregivers who did not report a financial burden. Caregivers who were younger (ages 18-34), resided with care recipients, spent 20-39 hours per week providing care, and reported having a disability were at a statistically significantly higher odds of reporting a financial burden. Given the current economic difficulties faced by many Americans, further insights into the perceived financial burdens experienced by informal caregivers as well as linkages to policy and programs designed to support caregivers are critical for public health professionals to address the expanding needs in states and communities. Published by Elsevier Inc.

  10. Multi-Centre Study on Cardiovascular Risk Management on Patients Undergoing AAA Surveillance.

    Science.gov (United States)

    Saratzis, A; Dattani, N; Brown, A; Shalhoub, J; Bosanquet, D; Sidloff, D; Stather, P

    2017-07-01

    The risk of cardiovascular events and death in patients with abdominal aortic aneurysms (AAA) is high. Screening has been introduced to reduce AAA related mortality; however, after AAA diagnosis, cardiovascular modification may be as important to patient outcomes as surveillance. The aim of this study was to assess cardiovascular risk reduction in patients with small AAA. Institutional approval was granted for The Vascular and Endovascular Research Network (VERN) to retrospectively collect data pertaining to cardiovascular risk reduction from four tertiary vascular units in England. Patients with small AAA (January 2013-December 2015) were included. Demographic details, postcode, current medications, and smoking status were recorded using a bespoke electronic database and analysed. In a secondary analysis VERN contacted all AAA screening units in England and Wales to assess their current protocols relating to CV protection. In total, 1053 patients were included (mean age 74 ± 9 years, all men). Of these, 745 patients (70.8%) had been prescribed an antiplatelet agent and 787 (74.7%) a statin. Overall, only 666 patients (63.2%) were prescribed both a statin and antiplatelet. Two hundred and sixty eight patients (32.1%) were current smokers and the proportion of patients who continued to smoke decreased with age. Overall, only 401 patients (48.1%) were prescribed a statin, antiplatelet, and had stopped smoking. In the secondary analysis 38 AAA screening units (84% national coverage) replied. Thirty-one units (82%) suggest changes to the patient's prescription; however, none monitor compliance with these recommendations or assess whether the general practitioner has been made aware of the AAA diagnosis or prescription advice. Many patients with small AAA are not prescribed an antiplatelet/statin, and still smoke cigarettes, and therefore remain at high risk of cardiovascular morbidity and mortality. National guidance to ensure this high risk group of patients is

  11. Surveillance of Candida spp Bloodstream Infections: Epidemiological Trends and Risk Factors of Death in Two Mexican Tertiary Care Hospitals

    Science.gov (United States)

    Corzo-Leon, Dora E.; Alvarado-Matute, Tito; Colombo, Arnaldo L.; Cornejo-Juarez, Patricia; Cortes, Jorge; Echevarria, Juan I.; Guzman-Blanco, Manuel; Macias, Alejandro E.; Nucci, Marcio; Ostrosky-Zeichner, Luis; Ponce-de-Leon, Alfredo; Queiroz-Telles, Flavio; Santolaya, Maria E.; Thompson-Moya, Luis; Tiraboschi, Iris N.; Zurita, Jeannete; Sifuentes-Osornio, Jose

    2014-01-01

    Introduction Larger populations at risk, broader use of antibiotics and longer hospital stays have impacted on the incidence of Candida sp. bloodstream infections (CBSI). Objective To determine clinical and epidemiologic characteristics of patients with CBSI in two tertiary care reference medical institutions in Mexico City. Design Prospective and observational laboratory-based surveillance study conducted from 07/2008 to 06/2010. Methods All patients with CBSI were included. Identification and antifungal susceptibility were performed using CLSI M27-A3 standard procedures. Frequencies, Mann-Whitney U test or T test were used as needed. Risk factors were determined with multivariable analysis and binary logistic regression analysis. Results CBSI represented 3.8% of nosocomial bloodstream infections. Cumulative incidence was 2.8 per 1000 discharges (incidence rate: 0.38 per 1000 patient-days). C. albicans was the predominant species (46%), followed by C. tropicalis (26%). C. glabrata was isolated from patients with diabetes (50%), and elderly patients. Sixty-four patients (86%) received antifungals. Amphotericin-B deoxycholate (AmBD) was the most commonly used agent (66%). Overall mortality rate reached 46%, and risk factors for death were APACHE II score ≥16 (OR = 6.94, CI95% = 2.34–20.58, p<0.0001), and liver disease (OR = 186.11, CI95% = 7.61–4550.20, p = 0.001). Full susceptibility to fluconazole, AmBD and echinocandins among C. albicans, C. tropicalis, and C. parapsilosis was observed. Conclusions The cumulative incidence rate in these centers was higher than other reports from tertiary care hospitals from Latin America. Knowledge of local epidemiologic patterns permits the design of more specific strategies for prevention and preemptive therapy of CBSI. PMID:24830654

  12. Methodology implementation in order to evaluate the biological risks in the Centre for Research and Rehabilitation of Hereditary Ataxias of Cuba: a biosecurity surveillance method

    Directory of Open Access Journals (Sweden)

    Dailín Cobos Valdes

    2014-12-01

    Full Text Available Introduction: The Center for Research and Rehabilitation of Hereditary Ataxias faces biological risks. Nevertheless a Biosafety system was not yet implemented. Objective: To apply the methodology in order to evaluate these risks Materials and Methods: Interview with the researchers of the center and the use of the methodology for evaluating biological risks designed for Cobos, 2009. Results: Fifty-three biological risks were identified and evaluated, 32 as moderated, 18 as tolerable and 3 as trivial. Such classification are crucial to establish its management priorities and represent a way of surveillance in Biosafety field. Conclusion: The results of this research represent an essential factor for the Biosafety documentation development adapted to the Center and according to the legal basis in terms of biological safety in Cuba.

  13. An Example of Risk Informed Design

    Science.gov (United States)

    Banke, Rick; Grant, Warren; Wilson, Paul

    2014-01-01

    NASA Engineering requested a Probabilistic Risk Assessment (PRA) to compare the difference in the risk of Loss of Crew (LOC) and Loss of Mission (LOM) between different designs of a fluid assembly. They were concerned that the configuration favored by the design team was more susceptible to leakage than a second proposed design, but realized that a quantitative analysis to compare the risks between the two designs might strengthen their argument. The analysis showed that while the second design did help improve the probability of LOC, it did not help from a probability of LOM perspective. This drove the analysis team to propose a minor design change that would drive the probability of LOM down considerably. The analysis also demonstrated that there was another major risk driver that was not immediately obvious from a typical engineering study of the design and was therefore unexpected. None of the proposed alternatives were addressing this risk. This type of trade study demonstrates the importance of performing a PRA in order to completely understand a system's design. It allows managers to use risk as another one of the commodities (e.g., mass, cost, schedule, fault tolerance) that can be traded early in the design of a new system.

  14. Radiation risk, medical surveillance programme and radiation protection in mining and milling of uranium ores

    International Nuclear Information System (INIS)

    Rakshit, A.K.

    1991-01-01

    Mining and milling of uranium ores comprise multiple operations such as developement, drilling, blasting, handling, crushing, grinding, leaching of the ore and concentration, drying, packaging and storing of the concentrate product. Apart from the hazards of any metal mining and milling operations due to dust, noise, chemicals, accidents etc there are radiation risks also resulting from exposure to airborne radioactivity and external radiation. The inhalation risk is of more concern in underground mines than in open pit mines. The objective of a Medical Surveillance Programme (an occupational Health Programme) is to ensure a healthy work force. It should ultimately lead to health maintenance and improvement, less absenteeism increased productivity and the achievement of worker and corporate goals. The programme includes prevention, acute care, counselling and rehabilitation. Radiological workers require special monitoring for their work-related radiation exposure effect by film monitoring service, whole body counting and bioassay. Radiation protection in the mining and milling of Uranium ores include the use of personal protective equipment, work station protection, personal hygiene and house keeping. (author). 15 refs

  15. Modelling characteristics to predict Legionella contamination risk - Surveillance of drinking water plumbing systems and identification of risk areas.

    Science.gov (United States)

    Völker, Sebastian; Schreiber, Christiane; Kistemann, Thomas

    2016-01-01

    For the surveillance of drinking water plumbing systems (DWPS) and the identification of risk factors, there is a need for an early estimation of the risk of Legionella contamination within a building, using efficient and assessable parameters to estimate hazards and to prioritize risks. The precision, accuracy and effectiveness of ways of estimating the risk of higher Legionella numbers (temperature, stagnation, pipe materials, etc.) have only rarely been empirically assessed in practice, although there is a broad consensus about the impact of these risk factors. We collected n = 807 drinking water samples from 9 buildings which had had Legionella spp. occurrences of >100 CFU/100mL within the last 12 months, and tested for Legionella spp., L. pneumophila, HPC 20°C and 36°C (culture-based). Each building was sampled for 6 months under standard operating conditions in the DWPS. We discovered high variability (up to 4 log(10) steps) in the presence of Legionella spp. (CFU/100 mL) within all buildings over a half year period as well as over the course of a day. Occurrences were significantly correlated with temperature, pipe length measures, and stagnation. Logistic regression modelling revealed three parameters (temperature after flushing until no significant changes in temperatures can be obtained, stagnation (low withdrawal, qualitatively assessed), pipe length proportion) to be the best predictors of Legionella contamination (>100 CFU/100 mL) at single outlets (precision = 66.7%; accuracy = 72.1%; F(0.5) score = 0.59). Copyright © 2015 Elsevier GmbH. All rights reserved.

  16. An assessment of Prostate Cancer Research International: Active Surveillance (PRIAS) criteria for active surveillance of clinically low-risk prostate cancer patients

    Science.gov (United States)

    da Silva, Vitor; Cagiannos, Ilias; Lavallée, Luke T.; Mallick, Ranjeeta; Witiuk, Kelsey; Cnossen, Sonya; Eastham, James A.; Fergusson, Dean A.; Morash, Chris; Breau, Rodney H.

    2017-01-01

    Introduction Active surveillance is a strategy to delay or prevent treatment of indolent prostate cancer. The Prostate Cancer Research International: Active Surveillance (PRIAS) criteria were developed to select patients for prostate cancer active surveillance. The objective of this study was to compare pathological findings from PRIAS-eligible and PRIAS-ineligible clinically low-risk prostate cancer patients. Methods A D’Amico low-risk cohort of 1512 radical prostatectomy patients treated at The Ottawa Hospital or Memorial Sloan Kettering Cancer Centre between January 1995 and December 2007 was reviewed. Pathological outcomes (pT3 tumours, Gleason sum ≥7, lymph node metastases, or a composite) and clinical outcomes (prostate-specific antigen [PSA] recurrence, secondary cancer treatments, and death) were compared between PRIAS-eligible and PRIAS-ineligible cohorts. Results The PRIAS-eligible cohort (n=945) was less likely to have Gleason score ≥7 (odds ratio [OR] 0.61; 95% confidence interval [CI] 0.49–0.75), pT3 (OR 0.41; 95% CI 0.31–0.55), nodal metastases (OR 0.37; 95% CI 0.10–1.31), or any adverse feature (OR 0.56; 95% CI 0.45–0.69) compared to the PRIAS-ineligible cohort. The probability of any adverse pathology in the PRIAS-eligible cohort was 41% vs. 56% in the PRIAS-ineligible cohort. At median follow-up of 3.7 years, 72 (4.8%) patients had a PSA recurrence, 24 (1.6%) received pelvic radiation, and 13 (0.9%) received androgen deprivation. No difference was detected for recurrence-free and overall survival between groups (recurrence hazard ratio [HR] 0.71; 95% CI 0.46–1.09 and survival HR 0.72; 95% CI 0.36–1.47). Conclusions Low-risk prostate cancer patients who met PRIAS eligibility criteria are less likely to have higher-risk cancer compared to those who did not meet at least one of these criteria. PMID:28798822

  17. Designing a Low-Resolution Face Recognition System for Long-Range Surveillance

    NARCIS (Netherlands)

    Peng, Y.; Spreeuwers, Lieuwe Jan; Veldhuis, Raymond N.J.

    2016-01-01

    Most face recognition systems deal well with high-resolution facial images, but perform much worse on low-resolution facial images. In low-resolution face recognition, there is a specific but realistic surveillance scenario: a surveillance camera monitoring a large area. In this scenario, usually

  18. Integrated Detection and Prediction of Influenza Activity for Real-Time Surveillance: Algorithm Design.

    Science.gov (United States)

    Spreco, Armin; Eriksson, Olle; Dahlström, Örjan; Cowling, Benjamin John; Timpka, Toomas

    2017-06-15

    Influenza is a viral respiratory disease capable of causing epidemics that represent a threat to communities worldwide. The rapidly growing availability of electronic "big data" from diagnostic and prediagnostic sources in health care and public health settings permits advance of a new generation of methods for local detection and prediction of winter influenza seasons and influenza pandemics. The aim of this study was to present a method for integrated detection and prediction of influenza virus activity in local settings using electronically available surveillance data and to evaluate its performance by retrospective application on authentic data from a Swedish county. An integrated detection and prediction method was formally defined based on a design rationale for influenza detection and prediction methods adapted for local surveillance. The novel method was retrospectively applied on data from the winter influenza season 2008-09 in a Swedish county (population 445,000). Outcome data represented individuals who met a clinical case definition for influenza (based on International Classification of Diseases version 10 [ICD-10] codes) from an electronic health data repository. Information from calls to a telenursing service in the county was used as syndromic data source. The novel integrated detection and prediction method is based on nonmechanistic statistical models and is designed for integration in local health information systems. The method is divided into separate modules for detection and prediction of local influenza virus activity. The function of the detection module is to alert for an upcoming period of increased load of influenza cases on local health care (using influenza-diagnosis data), whereas the function of the prediction module is to predict the timing of the activity peak (using syndromic data) and its intensity (using influenza-diagnosis data). For detection modeling, exponential regression was used based on the assumption that the beginning

  19. Youth Risk Behavior Surveillance--United States, 2005. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 55, Number SS-5

    Science.gov (United States)

    Eaton, Danice K.; Kann, Laura; Kinchen, Steve; Ross, James; Hawkins, Joseph; Harris, William A.; Lowry, Richard; McManus, Tim; Chyen, David; Shanklin, Shari; Lim, Connie; Grunbaum, Jo Anne; Wechsler, Howell

    2006-01-01

    Problem: Priority health-risk behaviors, which contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, are interrelated, and are preventable. Reporting Period Covered: October 2004-January 2006. Description of the System: The Youth Risk…

  20. Youth Risk Behavior Surveillance--United States, 2007. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 57, Number SS-4

    Science.gov (United States)

    Eaton, Danice K.; Kann, Laura; Kinchen, Steve; Shanklin, Shari; Ross, James; Hawkins, Joseph; Harris, William A.; Lowry, Richard; McManus, Tim; Chyen, David; Lim, Connie; Brener, Nancy D.; Wechsler, Howell

    2008-01-01

    Problem: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, are interrelated, and are preventable. Reporting Period Covered: January-December 2007. Description of the System: The…

  1. Youth Risk Behavior Surveillance--United States, 2009. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 59, Number SS-5

    Science.gov (United States)

    Eaton, Danice K.; Kann, Laura; Kinchen, Steve; Shanklin, Shari; Ross, James; Hawkins, Joseph; Harris, William A.; Lowry, Richard; McManus, Tim; Chyen, David; Lim, Connie; Whittle, Lisa; Brener, Nancy D.; Wechsler, Howell

    2010-01-01

    Problem: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, and are interrelated and preventable. Reporting Period Covered: September 2008-December 2009. Description of the…

  2. Youth Risk Behavior Surveillance--United States, 2011. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 61, Number 4

    Science.gov (United States)

    Eaton, Danice K.; Kann, Laura; Kinchen, Steve; Shanklin, Shari; Flint, Katherine H.; Hawkins, Joseph; Harris, William A.; Lowry, Richard; McManus, Tim; Chyen, David; Whittle, Lisa; Lim, Connie; Wechsler, Howell

    2012-01-01

    Problem: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, and are interrelated and preventable. Reporting Period Covered: September 2010-December 2011. Description of the…

  3. Risk Management Post-Marketing Surveillance for the Abuse of Medications Acting on the Central Nervous System: Expert Panel Report

    Science.gov (United States)

    Johanson, Chris-Ellyn; Balster, Robert L.; Henningfield, Jack E.; Schuster, Charles R.; Anthony, James C.; Barthwell, Andrea G.; Coleman, John J.; Dart, Richard C.; Gorodetzky, Charles W.; O’Keeffe, Charles; Sellers, Edward M.; Vocci, Frank; Walsh, Sharon L.

    2010-01-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October, 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and eleven recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized. PMID:19783383

  4. Sources of Safety Data and Statistical Strategies for Design and Analysis: Postmarket Surveillance.

    Science.gov (United States)

    Izem, Rima; Sanchez-Kam, Matilde; Ma, Haijun; Zink, Richard; Zhao, Yueqin

    2018-03-01

    Safety data are continuously evaluated throughout the life cycle of a medical product to accurately assess and characterize the risks associated with the product. The knowledge about a medical product's safety profile continually evolves as safety data accumulate. This paper discusses data sources and analysis considerations for safety signal detection after a medical product is approved for marketing. This manuscript is the second in a series of papers from the American Statistical Association Biopharmaceutical Section Safety Working Group. We share our recommendations for the statistical and graphical methodologies necessary to appropriately analyze, report, and interpret safety outcomes, and we discuss the advantages and disadvantages of safety data obtained from passive postmarketing surveillance systems compared to other sources. Signal detection has traditionally relied on spontaneous reporting databases that have been available worldwide for decades. However, current regulatory guidelines and ease of reporting have increased the size of these databases exponentially over the last few years. With such large databases, data-mining tools using disproportionality analysis and helpful graphics are often used to detect potential signals. Although the data sources have many limitations, analyses of these data have been successful at identifying safety signals postmarketing. Experience analyzing these dynamic data is useful in understanding the potential and limitations of analyses with new data sources such as social media, claims, or electronic medical records data.

  5. Surveillance of Candida spp bloodstream infections: epidemiological trends and risk factors of death in two Mexican tertiary care hospitals.

    Directory of Open Access Journals (Sweden)

    Dora E Corzo-Leon

    Full Text Available Larger populations at risk, broader use of antibiotics and longer hospital stays have impacted on the incidence of Candida sp. bloodstream infections (CBSI.To determine clinical and epidemiologic characteristics of patients with CBSI in two tertiary care reference medical institutions in Mexico City.Prospective and observational laboratory-based surveillance study conducted from 07/2008 to 06/2010.All patients with CBSI were included. Identification and antifungal susceptibility were performed using CLSI M27-A3 standard procedures. Frequencies, Mann-Whitney U test or T test were used as needed. Risk factors were determined with multivariable analysis and binary logistic regression analysis.CBSI represented 3.8% of nosocomial bloodstream infections. Cumulative incidence was 2.8 per 1000 discharges (incidence rate: 0.38 per 1000 patient-days. C. albicans was the predominant species (46%, followed by C. tropicalis (26%. C. glabrata was isolated from patients with diabetes (50%, and elderly patients. Sixty-four patients (86% received antifungals. Amphotericin-B deoxycholate (AmBD was the most commonly used agent (66%. Overall mortality rate reached 46%, and risk factors for death were APACHE II score ≥ 16 (OR = 6.94, CI95% = 2.34-20.58, p<0.0001, and liver disease (OR = 186.11, CI95% = 7.61-4550.20, p = 0.001. Full susceptibility to fluconazole, AmBD and echinocandins among C. albicans, C. tropicalis, and C. parapsilosis was observed.The cumulative incidence rate in these centers was higher than other reports from tertiary care hospitals from Latin America. Knowledge of local epidemiologic patterns permits the design of more specific strategies for prevention and preemptive therapy of CBSI.

  6. Guidelines for designing messages in risk communication

    International Nuclear Information System (INIS)

    Takashita, Hirofumi; Horikoshi, Hidehiko

    2004-07-01

    Risk Communication Study Team (hereafter called RC team) has designed messages for risk communication based on the analysis of the local residents' opinions which were expressed in several questionnaire surveys. The messages are described in a side format (Power Point format) every single content. This report provides basic guidelines for making messages that are used for risk communication, and does not include concrete messages which RC team designed. The RC team has already published the report entitled 'Information materials for risk communication' (JNC TN8450 2003-008) separately, and it gives the concrete messages. This report shows general cautions and checklists in designing messages, comments on the messages from outside risk communication experts, and opinions from local residents. (author)

  7. Occupational health surveillance: a means to identify work-related risks.

    Science.gov (United States)

    Froines, J R; Dellenbaugh, C A; Wegman, D H

    1986-09-01

    The lack of successful disease surveillance methods has resulted in few reliable estimates of workplace-related disease. Hazard surveillance--the ongoing assessment of chemical use and worker exposure to the chemicals--is presented as a way to supplement occupational disease surveillance. Existing OSHA (Occupational Safety and Health Administration) and NIOSH (National Institute for Occupational Health) data systems are adapted to this function to characterize the distribution and type of hazardous industry in Los Angeles County. A new method is developed for ranking potentially hazardous industries in the county using actual exposure measurements from federal OSHA compliance inspections. The strengths of the different systems are presented along with considerations of industrial employment and types of specific chemical exposures. Applications for information from hazard surveillance are discussed in terms of intervention, monitoring exposure control, planning, research, and as a complement to disease surveillance.

  8. The design and evaluation of an antimicrobial resistance surveillance system for neonatal intensive care units in Iran.

    Science.gov (United States)

    Rezaei-Hachesu, Peyman; Samad-Soltani, Taha; Yaghoubi, Sajad; GhaziSaeedi, Marjan; Mirnia, Kayvan; Masoumi-Asl, Hossein; Safdari, Reza

    2018-07-01

    Neonatal intensive care units (NICUs) have complex patients in terms of their diagnoses and required treatments. Antimicrobial treatment is a common therapy for patients in NICUs. To solve problems pertaining to empirical therapy, antimicrobial stewardship programs have recently been introduced. Despite the success of these programs in terms of data collection, there is still inefficiency in terms of analyzing and reporting the data. Thus, to successfully implement these stewardship programs, the design of antimicrobial resistance (AMR) surveillance systems is recommended as a first step. As a result, this study aimed to design an AMR surveillance system for use in the NICUs in northwestern Iranian hospitals to cover these information gaps. The recommended system is compatible with the World Health Organization (WHO) guidelines. The business intelligence (BI) requirements were extracted in an interview with a product owner (PO) using a valid and reliable checklist. Following this, an AMR surveillance system was designed and evaluated in relation to user experiences via a user experience questionnaire (UEQ). Finally, an association analysis was performed on the database, and the results were reported by identifying the important multidrug resistances in the database. A customized software development methodology was proposed. The three major modules of the AMR surveillance are the data registry, dashboard, and decision support modules. The data registry module was implemented based on a three-tier architecture, and the Clinical Decision Support System (CDSS) and dashboard modules were designed based on the BI requirements of the Scrum product owner (PO). The mean values of UEQ measures were in a good range. This measures showed the suitable usability of the AMR surveillance system. Applying efficient software development methodologies allows for the systems' compatibility with users' opinions and requirements. In addition, the construction of interdisciplinary

  9. Risk informed life cycle plant design

    International Nuclear Information System (INIS)

    Hill, Ralph S. III; Nutt, Mark M.

    2003-01-01

    Many facility life cycle activities including design, construction, fabrication, inspection and maintenance are evolving from a deterministic to a risk-informed basis. The risk informed approach uses probabilistic methods to evaluate the contribution of individual system components to total system performance. Total system performance considers both safety and cost considerations including system failure, reliability, and availability. By necessity, a risk-informed approach considers both the component's life cycle and the life cycle of the system. In the nuclear industry, risk-informed approaches, namely probabilistic risk assessment (PRA) or probabilistic safety assessment (PSA), have become a standard tool used to evaluate the safety of nuclear power plants. Recent studies pertaining to advanced reactor development have indicated that these new power plants must provide enhanced safety over existing nuclear facilities and be cost-competitive with other energy sources. Risk-informed approaches, beyond traditional PRA, offer the opportunity to optimize design while considering the total life cycle of the plant in order to realize these goals. The use of risk-informed design approaches in the nuclear industry is only beginning, with recent promulgation of risk-informed regulations and proposals for risk-informed codes. This paper briefly summarizes the current state of affairs regarding the use of risk-informed approaches in design. Key points to fully realize the benefit of applying a risk-informed approach to nuclear power plant design are then presented. These points are equally applicable to non-nuclear facilities where optimization for cost competitiveness and/or safety is desired. (author)

  10. Health behaviour surveillance of Health Sciences students in Northern Germany: Design and first results

    Directory of Open Access Journals (Sweden)

    Sandra Tobisch

    2015-09-01

    Full Text Available BackgroundHealth of students have most often been neglected in recent studies, although students face a transition of life during their studies which has strong implications on health.  During that time, universities play a key role as a setting where future professionals develop independence and learn skills possibly affecting their development and health. Nevertheless, less in known about this group in society and consequently, the aim of this research project was to monitor health of Health Sciences students through a long-term health surveillance system.MethodsSince 2014, an almost complete convenience sample of Health Sciences students is surveyed twice a year at Hamburg University of Applied Sciences. A paper-pencil questionnaire, which includes questions about socio-demographics, well-being, health-promoting and health-risk behaviours, is administered during courses.ResultsOur first surveys achieved response rates of more than 97%. Up to 83% of enrolled students were reached. Undergraduate Health Sciences students reported health-risk behaviours, e.g. binge-drinking on 1 to 2 days (33.9%, regular cannabis use (4.2%, regular cognitive-enhancement (4.0%. Moreover, unhealthy diet was prevalent but almost all students were physically active.ConclusionsA short paper-pencil questionnaire administered during courses and conducted according to standardized processes provides complete data on students’ health with little effort. Trends can be determined, which assist in making decision whether to take action in prevention and/or to evaluate campaigns. These first results show the need for a more targeted health promotion action for students.

  11. Design and development of a compact lidar/DIAL system for aerial surveillance of urban areas

    Science.gov (United States)

    Gaudio, P.; Gelfusa, M.; Malizia, A.; Richetta, M.; Antonucci, A.; Ventura, P.; Murari, A.; Vega, J.

    2013-10-01

    Recently surveying large areas in an automatic way, for early detection of harmful chemical agents, has become a strategic objective of defence and public health organisations. The Lidar-Dial techniques are widely recognized as a cost-effective alternative to monitor large portions of the atmosphere but, up to now, they have been mainly deployed as ground based stations. The design reported in this paper concerns the development of a Lidar-Dial system compact enough to be carried by a small airplane and capable of detecting sudden releases in air of harmful and/or polluting substances. The proposed approach consists of continuous monitoring of the area under surveillance with a Lidar type measurement. Once a significant increase in the density of backscattering substances is revealed, it is intended to switch to the Dial technique to identify the released chemicals and to determine its concentration. In this paper, the design of the proposed system is described and the simulations carried out to determine its performances are reported. For the Lidar measurements, commercially available Nd- YAG laser sources have already been tested and their performances, in combination with avalanche photodiodes, have been experimentally verified to meet the required specifications. With regard to the DIAL measurements, new compact CO2 laser sources are being investigated. The most promising candidate presents an energy per pulse of about 50 mJ typical, sufficient for a range of at least 500m. The laser also provides the so called "agile tuning" option that allows to quickly tune the wavelength. To guarantee continuous, automatic surveying of large areas, innovative solutions are required for the data acquisition, self monitoring of the system and data analysis. The results of the design, the simulations and some preliminary tests illustrate the potential of the chosen, integrated approach.

  12. One Health-ness Evaluation of Cysticercosis Surveillance Design in Portugal

    Directory of Open Access Journals (Sweden)

    Ana Gloria Fonseca

    2018-03-01

    Full Text Available The increasing occurrence of human cysticercosis, a zoonotic neglected disease, is challenging the traditional prevention and control paradigm and calling for One Health (OH solutions in industrialized countries. OH solutions for health interventions are increasingly being used to capture expected and unexpected outcomes across people, animals, and the environment. The Network for Evaluation of One Health (NEOH proposes an evidence-based framework, relying on systems and mixed methods approaches to evaluate the One Health-ness. In this case study, this tool is used to evaluate the design of the Observatory of Taeniasis and Cysticercosis, as an example of intersectorial collaboration for surveillance in Portugal. The OH Initiative (drivers and expected outcomes and its system (boundaries, aim, dimensions, actors, and stakeholders were described. The different aspects of this Initiative were scored with values from 0 (=no OH approach to 1 (=perfect OH approach. The OH index was 0.31. Its OH ratio is 1.98. Overall scores were as follows: OH thinking 0.75; OH planning 0.60; OH working 0.60; OH sharing 0.35; OH learning 0.50; and systemic organization 0.50. Operational levels of the Initiative are the main strengths, indicating a comprehensive multidimensional innovative approach and transdisciplinarity. Critical issues in the supporting infrastructure were observed, related to communication, learning and organizational gaps in the project, with the evaluation being conducted as the project is being designed and implemented. The strengths and weaknesses detected may be used to refine the Initiative. This case study therefore exemplifies and supports OH assessment also for ongoing projects, at design and early implementation stages for guiding and guaranteeing an OH-oriented perspective.

  13. Employment status of women with disabilities from the Behavioral Risk Factor Surveillance Survey (1995-2002).

    Science.gov (United States)

    Smith, Diane Lynn

    2007-01-01

    Among working aged adults (18-64) with disabilities, three out of 10 (32%) work full or part-time, compared to eight out of 10 (81%) of those without disabilities [9]. In addition, 24.7% of women with a severe disability and 27.8% of men with a severe disability are employed, while women with a non-severe disability have an employment rate of 68.4% and men with a non-severe disability have an employment rate of 85.1% [14]. This study examined data from the Behavioral Risk Factor Surveillance Survey from 1995-2002 to determine whether or not disparities exist in the rate of unemployment for women with disabilities, compared to men with disabilities and women and men without disabilities. In addition, regression analysis looked at the how disability and gender predict the outcome of unemployment. Results showed that there has been essentially no change with regard to employment for any of these populations. In addition, disability and gender were found to be the strongest predictors of unemployment for women with disabilities. Possible explanations were discussed as to the reasons for the results and issues were presented for future research.

  14. Comparison of 2 Disability Measures, Behavioral Risk Factor Surveillance System, 2013.

    Science.gov (United States)

    Stevens, Alissa C; Courtney-Long, Elizabeth A; Okoro, Catherine A; Carroll, Dianna D

    2016-08-11

    Beginning in 2013, in addition to the 2-item disability question set asked since 2001, Behavioral Risk Factor Surveillance System (BRFSS) began using 5 of the 6 items from the US Department of Health and Human Services-recommended disability question set. We assess and compare disability prevalence using the 2-question and 5-question sets and describe characteristics of respondents who identified as having a disability using each question set. We used data from the 2013 BRFSS to estimate the prevalence of disability for each question set and the 5 specific types of disability. Among respondents identified by each disability question set, we calculated the prevalence of selected demographic characteristics, health conditions, health behaviors, and health status. With the 2-question set, 21.6% of adults had a disability and with the 5-question set, 22.7% of adults had disability. A total of 51.2% of adults who identified as having a disability with either the 2-question or 5-question set reported having disabilities with both sets. Adults with different disability types differed by demographic and health characteristics. The inclusion of the 5 new disability questions in BRFSS provides a level of detail that can help develop targeted interventions and programs and can guide the adaptation of existing health promotion programs to be more inclusive of adults who experience specific types of disabilities.

  15. Korean Youth Risk Behavior Surveillance Survey: Association Between Part-time Employment and Suicide Attempts.

    Science.gov (United States)

    Jo, Sun-Jin; Yim, Hyeon Woo; Lee, Myung-Soo; Jeong, Hyunsuk; Lee, Won-Chul

    2015-04-01

    This study investigated the association between in-school students' part-time work and 1-year suicide attempts in Korea. The authors analyzed Korean Youth Risk Behavior Surveillance data (2008), which included 75 238 samples that represent Korean middle and high school students. Multiple logistic regression analysis was performed to investigate the association between part-time work and suicide attempt during the past 1 year, controlled by sociodemographic, school-related, lifestyle, and psychological factors. Among high school students, there was no association between part-time work and suicide attempts. However, part-time work was associated with suicide attempts significantly among middle school students (odds ratio = 1.59; 95% confidence interval = 1.37-1.83). Despite the limitation that details of the part-time work were not included in this study, it was found that middle school students' part-time work may increase suicide attempts, and the circumstances of Korean adolescents' employment, especially that of younger adolescents, would need to be reconsidered to prevent their suicide attempts. © 2014 APJPH.

  16. Control and design of multiple unmanned air vehicles for persistent surveillance

    Science.gov (United States)

    Nigam, Nikhil

    Control of multiple autonomous aircraft for search and exploration, is a topic of current research interest for applications such as weather monitoring, geographical surveys, search and rescue, tactical reconnaissance, and extra-terrestrial exploration, and the need to distribute sensing is driven by considerations of efficiency, reliability, cost and scalability. Hence, this problem has been extensively studied in the fields of controls and artificial intelligence. The task of persistent surveillance is different from a coverage/exploration problem, in that all areas need to be continuously searched, minimizing the time between visitations to each region in the target space. This distinction does not allow a straightforward application of most exploration techniques to the problem, although ideas from these methods can still be used. The use of aerial vehicles is motivated by their ability to cover larger spaces and their relative insensitivity to terrain. However, the dynamics of Unmanned Air Vehicles (UAVs) adds complexity to the control problem. Most of the work in the literature decouples the vehicle dynamics and control policies, but their interaction is particularly interesting for a surveillance mission. Stochastic environments and UAV failures further enrich the problem by requiring the control policies to be robust, and this aspect is particularly important for hardware implementations. For a persistent mission, it becomes imperative to consider the range/endurance constraints of the vehicles. The coupling of the control policy with the endurance constraints of the vehicles is an aspect that has not been sufficiently explored. Design of UAVs for desirable mission performance is also an issue of considerable significance. The use of a single monolithic optimization for such a problem has practical limitations, and decomposition-based design is a potential alternative. In this research high-level control policies are devised, that are scalable, reliable

  17. G.I.S. Surveillance of Chronic Non-occupational Exposure to Heavy Metals as Oncogenic Risk

    Directory of Open Access Journals (Sweden)

    Mariana Vlad

    2016-02-01

    Full Text Available Introduction: The potential oncogenic effect of some heavy metals in people occupationally and non-occupationally exposed to such heavy metals is already well demonstrated. This study seeks to clarify the potential role of these heavy metals in the living environment, in this case in non-occupational multifactorial aetiology of malignancies in the inhabitants of areas with increased prevalent environmental levels of heavy metals. Methods: Using a multidisciplinary approach throughout a complex epidemiological study, we investigated the potential oncogenic role of non-occupational environmental exposure to some heavy metals [chrome (Cr, nickel (Ni, copper (Cu, zinc (Zn, cadmium (Cd, lead (Pb and arsenic (As—in soil, drinking water, and food, as significant components of the environment] in populations living in areas with different environmental levels (high vs. low of the above-mentioned heavy metals. The exposures were evaluated by identifying the exposed populations, the critical elements of the ecosystems, and as according to the means of identifying the types of exposure. The results were interpreted both epidemiologically (causal inference, statistical significance, mathematical modelling and by using a GIS approach, which enabled indirect surveillance of oncogenic risks in each population. Results: The exposure to the investigated heavy metals provides significant risk factors of cancer in exposed populations, in both urban and rural areas [χ² test (p < 0.05]. The GIS approach enables indirect surveillance of oncogenic risk in populations. Conclusions: The role of non-occupational environmental exposure to some heavy metals in daily life is among the more significant oncogenic risk factors in exposed populations. The statistically significant associations between environmental exposure to such heavy metals and frequency of neoplasia in exposed populations become obvious when demonstrated on maps using the GIS system. Environmental

  18. HIV test offers and acceptance: New York State findings from the behavioral risk factor surveillance system and the National HIV behavioral surveillance, 2011-2012.

    Science.gov (United States)

    John Leung, Shu-Yin; Sinclair, Amber H; Battles, Haven B; Swain, Carol-Ann E; French, Patrick Tyler; Anderson, Bridget J; Sowizral, Mycroft J; Ruberto, Rachael; Brissette, Ian; Lillquist, Patricia; Smith, Lou C

    2015-01-01

    The New York State HIV testing law requires that patients aged 13-64 years be offered HIV testing in health care settings. We investigated the extent to which HIV testing was offered and accepted during the 24 months after law enactment. We added local questions to the Behavioral Risk Factor Surveillance System (BRFSS) and the National HIV Behavioral Surveillance (NHBS) surveys asking respondents aged 18-64 years whether they were offered an HIV test in health care settings, and whether they had accepted testing. Statewide prevalence estimates of test offers and acceptance were obtained from a combined 2011-2012 BRFSS sample (N = 6,223). Local estimates for 2 high-risk populations were obtained from NHBS 2011 men who have sex with men (N = 329) and 2012 injection drug users (N = 188) samples. BRFSS data showed that 73% of New Yorkers received care in any health care setting in the past 12 months, of whom 25% were offered an HIV test. Sixty percent accepted the test when offered. The levels of test offer increased from 20% to 29% over time, whereas acceptance levels decreased from 68% to 53%. NHBS data showed that 81% of men who have sex with men received care, of whom 43% were offered an HIV test. Eighty-eight percent accepted the test when offered. Eighty-five percent of injection drug users received care, of whom 63% were offered an HIV test, and 63% accepted the test when offered. We found evidence of partial and increasing implementation of the HIV testing law. Importantly, these studies demonstrated New Yorkers' willingness to accept an offered HIV test as part of routine care in health care settings.

  19. Anxiety, depression, and oral health among US pregnant women: 2010 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Silveira, Marushka L; Whitcomb, Brian W; Pekow, Penelope; Carbone, Elena T; Chasan-Taber, Lisa

    2016-01-01

    Maternal periodontal disease is associated with adverse perinatal outcomes. Anxiety and depression adversely impact oral health in nonpregnant women; however, this association has not been evaluated during pregnancy, a time characterized by higher rates of anxiety and depression. Therefore, we examined the association between these factors and oral disease and oral healthcare utilization among 402 pregnant respondents to the 2010 Behavioral Risk Factor Surveillance System. Self-reported lifetime diagnoses of anxiety, depression, and current depression were assessed. Oral health outcomes included self-reported tooth loss and dental visits in the past year. One-fifth (21.2 percent) of respondents reported a tooth loss and 32.5 percent reported nonuse of oral health services. The prevalence of lifetime diagnosed anxiety and depression was 13.6 percent and 11.3 percent, respectively, whereas 10.6 percent reported current depression. After adjusting for risk factors, pregnant women with diagnosed anxiety had increased odds of one or more tooth loss [odds ratio (OR) = 3.30; 95 percent confidence interval (CI): 1.01-10.77] compared with those without the disorder. Similarly, after adjusting for socioeconomic factors, women with anxiety had increased odds of nonuse of oral health services (OR = 2.67; 95 percent CI: 1.03-6.90); however, this was no longer significant after adjusting for health behaviors and body mass index. We observed no significant association with depression. In this population-based sample, we found a two- to threefold increased odds of tooth loss and nonuse of oral health services among pregnant women with a lifetime diagnosis of anxiety. To our knowledge, this is the first study to examine these associations among pregnant women. © 2015 American Association of Public Health Dentistry.

  20. [Risk adjusted assessment of quality of perinatal centers - results of perinatal/neonatal quality surveillance in Saxonia].

    Science.gov (United States)

    Koch, R; Gmyrek, D; Vogtmann, Ch

    2005-12-01

    The weak point of the country-wide perinatal/neonatal quality surveillance as a tool for evaluation of achievements of a distinct clinic, is the ignorance of interhospital differences in the case-mix of patients. Therefore, that approach can not result in a reliable bench marking. To adjust the results of quality assessment of different hospitals according to their risk profile of patients by multivariate analysis. The perinatal/neonatal data base of 12.783 newborns of the saxonian quality surveillance from 1998 to 2000 was analyzed. 4 relevant quality indicators of newborn outcome -- a) severe intraventricular hemorrhage in preterm infants 2500 g and d) hypoxic-ischemic encephalopathy -- were targeted to find out specific risk predictors by considering 26 risk factors. A logistic regression model was used to develop the risk predictors. Risk predictors for the 4 quality indicators could be described by 3 - 9 out of 26 analyzed risk factors. The AUC (ROC)-values for these quality indicators were 82, 89, 89 and 89 %, what signifies their reliability. Using the new specific predictors for calculation the risk adjusted incidence rates of quality indicator yielded in some remarkable changes. The apparent differences in the outcome criteria of analyzed hospitals were found to be much less pronounced. The application of the proposed method for risk adjustment of quality indicators makes it possible to perform a more objective comparison of neonatal outcome criteria between different hospitals or regions.

  1. Behavioral Risk Factor Surveillance System (BRFSS) Age-Adjusted Prevalence Data (2011 to present)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011 to present. BRFSS combined land line and cell phone age-adjusted prevalence data. The BRFSS is a continuous, state-based surveillance system that collects...

  2. Identifying risk factors for brain metastasis in breast cancer patients: Implication for a vigorous surveillance program

    Directory of Open Access Journals (Sweden)

    Lorraine Chow

    2015-10-01

    Conclusion: Chinese breast cancer patients with brain metastasis were more likely to have high-grade tumors and negative estrogen receptor status. A more vigorous surveillance program for the central nervous system should be considered for this group of patients.

  3. Behavioral Risk Factor Surveillance System (BRFSS) Prevalence Data (2011 to present)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011 to present. BRFSS combined land line and cell phone prevalence data. BRFSS is a continuous, state-based surveillance system that collects information about...

  4. The World Health Organization STEPwise Approach to Noncommunicable Disease Risk-Factor Surveillance: Methods, Challenges, and Opportunities.

    Science.gov (United States)

    Riley, Leanne; Guthold, Regina; Cowan, Melanie; Savin, Stefan; Bhatti, Lubna; Armstrong, Timothy; Bonita, Ruth

    2016-01-01

    We sought to outline the framework and methods used by the World Health Organization (WHO) STEPwise approach to noncommunicable disease (NCD) surveillance (STEPS), describe the development and current status, and discuss strengths, limitations, and future directions of STEPS surveillance. STEPS is a WHO-developed, standardized but flexible framework for countries to monitor the main NCD risk factors through questionnaire assessment and physical and biochemical measurements. It is coordinated by national authorities of the implementing country. The STEPS surveys are generally household-based and interviewer-administered, with scientifically selected samples of around 5000 participants. To date, 122 countries across all 6 WHO regions have completed data collection for STEPS or STEPS-aligned surveys. STEPS data are being used to inform NCD policies and track risk-factor trends. Future priorities include strengthening these linkages from data to action on NCDs at the country level, and continuing to develop STEPS' capacities to enable a regular and continuous cycle of risk-factor surveillance worldwide.

  5. Examining lung cancer risks across different industries and occupations in Ontario, Canada: the establishment of the Occupational Disease Surveillance System.

    Science.gov (United States)

    Jung, James K H; Feinstein, Saul G; Palma Lazgare, Luis; Macleod, Jill S; Arrandale, Victoria H; McLeod, Christopher B; Peter, Alice; Demers, Paul A

    2018-05-07

    The Occupational Disease Surveillance System (ODSS) was established in Ontario, Canada by linking a cohort of workers with data created from Workplace Safety and Insurance Board (WSIB) claims to administrative health databases. The aim of this study was to use ODSS to identify high-risk industry and occupation groups for lung cancer in Ontario. Workers in the WSIB lost time claims database were linked to the Ontario Cancer Registry using subjects' health insurance numbers, name, sex, birthdate and death date (if applicable). Several occupations and industries known to be at increased risk were outlined a priori to examine whether ODSS could replicate these associations. Age-adjusted, sex-stratified Cox proportional hazard models compared the risk of lung cancer within one industry/occupation versus all other groups in the cohort. Workers with a lung cancer diagnosis prior to cohort entry were excluded for analysis, leaving 2 187 762 workers for analysis. During the 1983 to 2014 follow-up, 34 661 workers in the cohort were diagnosed with lung cancer. Among expected high-risk industries, elevated risks were observed among workers in quarries/sand pits and construction industries for both sexes, and among males in metal mines, iron foundries, non-metallic mineral products industries and transportation industries. Excess risk was also observed among occupations in drilling/blasting, other mining/quarrying, mineral ore treating, excavating/grading/paving, truck driving, painting, bus driving and construction. This current surveillance system identified several established high-risk groups for lung cancer and could be used for ongoing surveillance of occupational lung cancer in Ontario. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Incorporation of Novel MRI and Biomarkers into Prostate Cancer Active Surveillance Risk Assessment

    Science.gov (United States)

    2016-09-01

    outside the formal programs. Population-based data suggest limited lifestyle modifications after diagnosis and potentially a reduction in exercise ...periodic surveillance prostate biopsies. There were no lifestyle or behavioral components as part of the protocol. 1Department of Urology, University of...management strategy. Our broad objective is two-fold: [1] to improve the ability to select candidates who safely choose active surveillance as a

  7. Estimates of lifetime infertility from three states: the behavioral risk factor surveillance system.

    Science.gov (United States)

    Crawford, Sara; Fussman, Chris; Bailey, Marie; Bernson, Dana; Jamieson, Denise J; Murray-Jordan, Melissa; Kissin, Dmitry M

    2015-07-01

    Knowledge of state-specific infertility is limited. The objectives of this study were to explore state-specific estimates of lifetime prevalence of having ever experienced infertility, sought treatment for infertility, types of treatments sought, and treatment outcomes. Male and female adult residents aged 18-50 years from three states involved in the States Monitoring Assisted Reproductive Technology Collaborative (Florida, Massachusetts, and Michigan) were asked state-added infertility questions as part of the 2012 Behavioral Risk Factor Surveillance System, a state-based, health-related telephone survey. Analysis involved estimation of lifetime prevalence of infertility. The estimated lifetime prevalence of infertility among 1,285 adults in Florida, 1,302 in Massachusetts, and 3,360 in Michigan was 9.7%, 6.0%, and 4.2%, respectively. Among 736 adults in Florida, 1,246 in Massachusetts, and 2,742 in Michigan that have ever tried to get pregnant, the lifetime infertility prevalence was 25.3% in Florida, 9.9% in Massachusetts, and 5.8% in Michigan. Among those with a history of infertility, over half sought treatment (60.7% in Florida, 70.6% in Massachusetts, and 51.6% in Michigan), the most common being non-assisted reproductive technology fertility treatments (61.3% in Florida, 66.0% in Massachusetts, and 75.9% in Michigan). State-specific estimates of lifetime infertility prevalence in Florida, Massachusetts, and Michigan varied. Variations across states are difficult to interpret, as they likely reflect both true differences in prevalence and differences in data collection questionnaires. State-specific estimates are needed for the prevention, detection, and management of infertility, but estimates should be based on a common set of questions appropriate for these goals.

  8. An on-line pressurizer surveillance system design to prevent small-break loss-of-coolant accidents through power-operated relief valves using a microcomputer

    International Nuclear Information System (INIS)

    Lee, J.H.; Chang, S.H.

    1987-01-01

    A small-break loss-of-coolant accident (LOCA) caused by a stuck-open power-operated relief valve is one of the important contributors to nuclear power plant risk. A pressurizer surveillance system was designed to use a microcomputer to prevent the malfunction of the system; the effect of this improvement has been assessed through probabilistic risk assessment. The microcomputer diagnoses the malfunction of the system by a process-checking method and automatically performs the backup action related to each malfunction. This improvement means that we can correctly diagnose ''spurious opening,'' ''failure to reclose,'' and ''small-break LOCA,'' which are difficult for operators to diagnose quickly and correctly, and by taking automatic backup action one can reduce the probability of human error

  9. Annual surveillance by CA125 and transvaginal ultrasound for ovarian cancer in both high-risk and population risk women is ineffective

    DEFF Research Database (Denmark)

    Woodward, E R; Sleightholme, H V; Considine, A M

    2007-01-01

    OBJECTIVE: To assess the efficacy of annual CA125 and transvaginal ultrasound (TVU) scan as surveillance for ovarian cancer. DESIGN: Retrospective audit. SETTING: NHS Trust. POPULATION: Three hundred and forty-one asymptomatic women enrolled for ovarian cancer screening: 179 were in a high...... and local cancer registry data. MAIN OUTCOME MEASURES: Ovarian cancers occurring in study population. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TVU, and CA125 as a screening tool for ovarian cancer. RESULTS: Four ovarian cancers and one endometrial...... cancer occurred. One ovarian cancer was detected at surveillance, three occurred in women who presented symptomatically between screenings. Thirty women underwent exploratory surgery because of abnormal findings at surveillance. Two women had cancer (PPV = 6.7%); one had ovarian cancer and the other...

  10. Patients with Testicular Cancer Undergoing CT Surveillance Demonstrate a Pitfall of Radiation-induced Cancer Risk Estimates: The Timing Paradox

    Science.gov (United States)

    Eisenberg, Jonathan D.; Lee, Richard J.; Gilmore, Michael E.; Turan, Ekin A.; Singh, Sarabjeet; Kalra, Mannudeep K.; Liu, Bob; Kong, Chung Yin; Gazelle, G. Scott

    2013-01-01

    Purpose: To demonstrate a limitation of lifetime radiation-induced cancer risk metrics in the setting of testicular cancer surveillance—in particular, their failure to capture the delayed timing of radiation-induced cancers over the course of a patient’s lifetime. Materials and Methods: Institutional review board approval was obtained for the use of computed tomographic (CT) dosimetry data in this study. Informed consent was waived. This study was HIPAA compliant. A Markov model was developed to project outcomes in patients with testicular cancer who were undergoing CT surveillance in the decade after orchiectomy. To quantify effects of early versus delayed risks, life expectancy losses and lifetime mortality risks due to testicular cancer were compared with life expectancy losses and lifetime mortality risks due to radiation-induced cancers from CT. Projections of life expectancy loss, unlike lifetime risk estimates, account for the timing of risks over the course of a lifetime, which enabled evaluation of the described limitation of lifetime risk estimates. Markov chain Monte Carlo methods were used to estimate the uncertainty of the results. Results: As an example of evidence yielded, 33-year-old men with stage I seminoma who were undergoing CT surveillance were projected to incur a slightly higher lifetime mortality risk from testicular cancer (598 per 100 000; 95% uncertainty interval [UI]: 302, 894) than from radiation-induced cancers (505 per 100 000; 95% UI: 280, 730). However, life expectancy loss attributable to testicular cancer (83 days; 95% UI: 42, 124) was more than three times greater than life expectancy loss attributable to radiation-induced cancers (24 days; 95% UI: 13, 35). Trends were consistent across modeled scenarios. Conclusion: Lifetime radiation risk estimates, when used for decision making, may overemphasize radiation-induced cancer risks relative to short-term health risks. © RSNA, 2012 Supplemental material: http

  11. Documentation design for probabilistic risk assessment

    International Nuclear Information System (INIS)

    Parkinson, W.J.; von Herrmann, J.L.

    1985-01-01

    This paper describes a framework for documentation design of probabilistic risk assessment (PRA) and is based on the EPRI document NP-3470 ''Documentation Design for Probabilistic Risk Assessment''. The goals for PRA documentation are stated. Four audiences are identified which PRA documentation must satisfy, and the documentation consistent with the needs of the various audiences are discussed, i.e., the Summary Report, the Executive Summary, the Main Report, and Appendices. The authors recommend the documentation specifications discussed herein as guides rather than rigid definitions

  12. Surveillance of surgical site infections at a tertiary care hospital in Greece: incidence, risk factors, microbiology, and impact.

    Science.gov (United States)

    Roumbelaki, Maria; Kritsotakis, Evangelos I; Tsioutis, Constantinos; Tzilepi, Penelope; Gikas, Achilleas

    2008-12-01

    In this first attempt to implement a standardized surveillance system of surgical site infections (SSI) in a Greek hospital, our objective was to identify areas for improvement by comparing main epidemiologic and microbiologic features of SSI with international data. The National Nosocomial Infections Surveillance (NNIS) system protocols were employed to prospectively collect data for patients in 8 surgical wards who underwent surgery during a 9-month period. SSI rates were benchmarked with international data using standardized infection ratios. Risk factors were evaluated by multivariate logistic regression. A total of 129 SSI was identified in 2420 operations (5.3%), of which 47.3% developed after discharge. SSI rates were higher for 2 of 20 operation categories compared with Spanish and Italian data and for 12 of 20 categories compared with NNIS data. Gram-positive microorganisms accounted for 52.1% of SSI isolates, and Enterococci were predominant. Alarming resistance patterns for Enterococcus faecium and Acinetobacter baumannii were recorded. Potentially modifiable risk factors for SSI included multiple procedures, extended duration of operation, and antibiotic prophylaxis. SSI was associated with prolongation of postoperative stay but not with mortality. Comparisons of surveillance data in our hospital with international benchmarks provided useful information for infection control interventions to reduce the incidence of SSI.

  13. The perception of the relationship between environment and health according to data from Italian Behavioural Risk Factor Surveillance System (PASSI).

    Science.gov (United States)

    Sampaolo, Letizia; Tommaso, Giulia; Gherardi, Bianca; Carrozzi, Giuliano; Freni Sterrantino, Anna; Ottone, Marta; Goldoni, Carlo Alberto; Bertozzi, Nicoletta; Scaringi, Meri; Bolognesi, Lara; Masocco, Maria; Salmaso, Stefania; Lauriola, Paolo

    2017-01-01

    "OBJECTIVES: to identify groups of people in relation to the perception of environmental risk and to assess the main characteristics using data collected in the environmental module of the surveillance network Italian Behavioral Risk Factor Surveillance System (PASSI). perceptive profiles were identified using a latent class analysis; later they were included as outcome in multinomial logistic regression models to assess the association between environmental risk perception and demographic, health, socio-economic and behavioural variables. the latent class analysis allowed to split the sample in "worried", "indifferent", and "positive" people. The multinomial logistic regression model showed that the "worried" profile typically includes people of Italian nationality, living in highly urbanized areas, with a high level of education, and with economic difficulties; they pay special attention to their own health and fitness, but they have a negative perception of their own psychophysical state. the application of advanced statistical analysis enable to appraise PASSI data in order to characterize the perception of environmental risk, making the planning of interventions related to risk communication possible. ".

  14. Quantifying the Transition from Active Surveillance to Watchful Waiting Among Men with Very Low-risk Prostate Cancer.

    Science.gov (United States)

    Van Hemelrijck, Mieke; Garmo, Hans; Lindhagen, Lars; Bratt, Ola; Stattin, Pär; Adolfsson, Jan

    2017-10-01

    Active surveillance (AS) is commonly used for men with low-risk prostate cancer (PCa). When life expectancy becomes too short for curative treatment to be beneficial, a change from AS to watchful waiting (WW) follows. Little is known about this change since it is rarely documented in medical records. To model transition from AS to WW and how this is affected by age and comorbidity among men with very low-risk PCa. National population-based healthcare registers were used for analysis. Using data on PCa characteristics, age, and comorbidity, a state transition model was created to estimate the probability of changes between predefined treatments to estimate transition from AS to WW. Our estimates indicate that 48% of men with very low-risk PCa starting AS eventually changed to WW over a life course. This proportion increased with age at time of AS initiation. Within 10 yr from start of AS, 10% of men aged 55 yr and 50% of men aged 70 yr with no comorbidity at initiation changed to WW. Our prevalence simulation suggests that the number of men on WW who were previously on AS will eventually stabilise after 30 yr. A limitation is the limited information from clinical follow-up visits (eg, repeat biopsies). We estimated that changes from AS to WW become common among men with very low-risk PCa who are elderly. This potential change to WW should be discussed with men starting on AS. Moreover, our estimates may help in planning health care resources allocated to men on AS, as the transition to WW is associated with lower demands on outpatient resources. Changes from active surveillance to watchful waiting will become more common among men with very low-risk prostate cancer. These observations suggest that patients need to be informed about this potential change before they start on active surveillance. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  15. Contract Design: Risk Management and Evaluation.

    Science.gov (United States)

    Mühlbacher, Axel C; Amelung, Volker E; Juhnke, Christin

    2018-01-12

    Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The risk structure of the providers plays a vital role in Pay for Performance. A prerequisite for optimal incentive-based service models is a (partial) dependence of the agent's returns on the provider's gain level. Integrated care systems as well as accountable care organisations (ACOs) in the US and similar concepts in other countries are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality metrics. By this the total costs of care shall be reduced. Little is known about the contractual design and the main challenges of delegating "accountability" to these new kinds of organisations and/or contracts. The costs of market utilisation are highly relevant for the conception of healthcare contracts; furthermore information asymmetries and contract-specific investments are an obstacle to the efficient operation of ACOs. A comprehensive literature review on methods of designing contracts in Integrated Care was conducted. The research question in this article focuses on how reimbursement strategies, evaluation of measures and methods of risk adjustment can best be integrated in healthcare contracting. Each integrated care contract includes challenges for both payers and providers without having sufficient empirical data on both sides. These challenges are clinical, administrative or financial nature. Risk adjusted contracts ensure that the reimbursement roughly matches the true costs resulting from the morbidity of a population. If reimbursement of care provider corresponds to the actual expenses for an individual/population the problem of risk selection is greatly reduced. The currently used methods of risk adjustment have widely differing model and forecast

  16. Contract Design: Risk Management and Evaluation

    Directory of Open Access Journals (Sweden)

    Axel C. Mühlbacher

    2018-01-01

    Full Text Available Introduction: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The risk structure of the providers plays a vital role in Pay for Performance. A prerequisite for optimal incentive-based service models is a (partial dependence of the agent’s returns on the provider’s gain level. Integrated care systems as well as accountable care organisations (ACOs in the US and similar concepts in other countries are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality metrics. By this the total costs of care shall be reduced.  Methods: Little is known about the contractual design and the main challenges of delegating “accountability” to these new kinds of organisations and/or contracts. The costs of market utilisation are highly relevant for the conception of healthcare contracts; furthermore information asymmetries and contract-specific investments are an obstacle to the efficient operation of ACOs. A comprehensive literature review on methods of designing contracts in Integrated Care was conducted. The research question in this article focuses on how reimbursement strategies, evaluation of measures and methods of risk adjustment can best be integrated in healthcare contracting.  Results: Each integrated care contract includes challenges for both payers and providers without having sufficient empirical data on both sides. These challenges are clinical, administrative or financial nature. Risk adjusted contracts ensure that the reimbursement roughly matches the true costs resulting from the morbidity of a population. If reimbursement of care provider corresponds to the actual expenses for an individual/population the problem of risk selection is greatly reduced. The currently used methods

  17. Wallops Ship Surveillance System

    Science.gov (United States)

    Smith, Donna C.

    2011-01-01

    Approved as a Wallops control center backup system, the Wallops Ship Surveillance Software is a day-of-launch risk analysis tool for spaceport activities. The system calculates impact probabilities and displays ship locations relative to boundary lines. It enables rapid analysis of possible flight paths to preclude the need to cancel launches and allow execution of launches in a timely manner. Its design is based on low-cost, large-customer- base elements including personal computers, the Windows operating system, C/C++ object-oriented software, and network interfaces. In conformance with the NASA software safety standard, the system is designed to ensure that it does not falsely report a safe-for-launch condition. To improve the current ship surveillance method, the system is designed to prevent delay of launch under a safe-for-launch condition. A single workstation is designated the controller of the official ship information and the official risk analysis. Copies of this information are shared with other networked workstations. The program design is divided into five subsystems areas: 1. Communication Link -- threads that control the networking of workstations; 2. Contact List -- a thread that controls a list of protected item (ocean vessel) information; 3. Hazard List -- threads that control a list of hazardous item (debris) information and associated risk calculation information; 4. Display -- threads that control operator inputs and screen display outputs; and 5. Archive -- a thread that controls archive file read and write access. Currently, most of the hazard list thread and parts of other threads are being reused as part of a new ship surveillance system, under the SureTrak project.

  18. Role of prostate specific antigen and immediate confirmatory biopsy in predicting progression during active surveillance for low risk prostate cancer.

    Science.gov (United States)

    Adamy, Ari; Yee, David S; Matsushita, Kazuhito; Maschino, Alexandra; Cronin, Angel; Vickers, Andrew; Guillonneau, Bertrand; Scardino, Peter T; Eastham, James A

    2011-02-01

    We evaluated predictors of progression after starting active surveillance, especially the role of prostate specific antigen and immediate confirmatory prostate biopsy. A total of 238 men with prostate cancer met active surveillance eligibility criteria and were analyzed for progression with time. Cox proportional hazards regression was used to evaluate predictors of progression. Progression was evaluated using 2 definitions, including no longer meeting 1) full and 2) modified criteria, excluding prostate specific antigen greater than 10 ng/ml as a criterion. Using full criteria 61 patients progressed during followup. The 2 and 5-year progression-free probability was 80% and 60%, respectively. With prostate specific antigen included in progression criteria prostate specific antigen at confirmatory biopsy (HR 1.29, 95% CI 1.14-1.46, p <0.0005) and positive confirmatory biopsy (HR 1.75, 95% CI 1.01-3.04, p = 0.047) were independent predictors of progression. Of the 61 cases 34 failed due to increased prostate specific antigen, including only 5 with subsequent progression by biopsy criteria. When prostate specific antigen was excluded from progression criteria, only 32 cases progressed, and 2 and 5-year progression-free probability was 91% and 76%, respectively. Using modified criteria as an end point positive confirmatory biopsy was the only independent predictor of progression (HR 3.16, 95% CI 1.41-7.09, p = 0.005). Active surveillance is feasible in patients with low risk prostate cancer and most patients show little evidence of progression within 5 years. There is no clear justification for treating patients in whom prostate specific antigen increases above 10 ng/ml in the absence of other indications of tumor progression. Patients considering active surveillance should undergo confirmatory biopsy to better assess the risk of progression. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  19. MHC class I dowregulation, tumour escape from immune surveillance and design of therapeutic strategies

    Czech Academy of Sciences Publication Activity Database

    Bubeník, Jan

    2005-01-01

    Roč. 51, č. 1 (2005), s. 1-2 ISSN 0015-5500 R&D Projects: GA ČR GA301/04/0492; GA MZd NR7807 Institutional research plan: CEZ:AV0Z50520514 Keywords : MHC class I * immune surveillance * immunotherapy Subject RIV: EC - Immunology Impact factor: 0.719, year: 2005

  20. Acceptable risk as a basis for design

    International Nuclear Information System (INIS)

    Vrijling, J.K.; Hengel, W. van; Houben, R.J.

    1998-01-01

    Historically, human civilisations have striven to protect themselves against natural and man-made hazards. The degree of protection is a matter of political choice. Today this choice should be expressed in terms of risk and acceptable probability of failure to form the basis of the probabilistic design of the protection. It is additionally argued that the choice for a certain technology and the connected risk is made in a cost-benefit framework. The benefits and the costs including risk are weighed in the decision process. A set of rules for the evaluation of risk is proposed and tested in cases. The set of rules leads to technical advice in a question that has to be decided politically

  1. [The surveillance of occupational risks. Problems and perspectives of the recent legislative framework after the national preliminary survey].

    Science.gov (United States)

    Marinaccio, A; Di Marzio, D; Binazzi, Alessandra; Napoli, G; Businelli, A; Crema, M; di Leone, G; Ferrari, D; Ferraris, F; Galli, P; Latini, L; Masucci, A; Quercia, A; Stopponi, Roberta; Vianello, L; Scarselli, A; Massari, Stefania; Iavicoli, S

    2010-01-01

    Legislation in Italy concerning health, safety and prevention at the workplace recently established a new data communication standard The findings are reported of a specific survey on 18 Local Health Units (ASL) over the entire Italian territory, aimed at identifying the critical points in data management and analyze the available information. The occupational health physician for each company must collect and transmit information on the number of workers submitted to health surveillance protocols to the Local Health Unit. Information must be divided by risk factor and gender Local health Units then transmit the data to the Regions and finally to the Italian National Institute for Occupational Safety and Prevention (ISPESL). A sample of 22.977 companies was studied, providing information on about 410,009 workers undergoing health surveillance protocols. Carrying or moving heavy loads, exposure to noise, VDU and chemical substances were the most frequent risk factors. The difference between genders was significant in risk allocation, with exposures to VDU and biological agents prevalently among females. The information thus collected suffered from a lack of data organization and completeness in the sample under study, but nevertheless provides preliminary evidence of a map of occupational risks on a national basis, confirming the potential for the new law (D.Lgs 81/2008) to investigate health safety and prevention at the workplace.

  2. Evaluation of sanitary consequences of Chernobylsk accident in France. Epidemiological surveillance plan, state of knowledge, risks evaluation and perspectives

    International Nuclear Information System (INIS)

    Verger, P.; Cherie-Challine, L.

    2000-12-01

    This report jointly written by IPSN and InVS, reviews the sanitary consequences in France of the Chernobyl accident, which occurred in 1986. The first point is dedicated to a short presentation of the knowledge relative to the sanitary consequences of the Chernobyl accident in the high contaminated countries and to the risk factors of the thyroid cancer. Secondly, this report describes the main systems of epidemiological surveillance of health implemented in France in 1986 and in 1999, as well as the data of the incidence and mortality of thyroid cancer observed in France since 1975. In addition, this report presents an analysis of the risk of thyroid cancer related to radioactive contamination in France, for young people of less than 15 years of age who where living in 1986 in the highest contaminated areas of France (Eastern territories). For this purpose, the theoretical number of thyroid cancers in excess is evaluated for this population, on the basis of different available risk model. Finally starting from the results of risk assessment, there is a discussion about the relevance and the feasibility of different epidemiological methods in view of answering the questions related to the sanitary consequences of the Chernobyl accident. In conclusion, this report recommends to reinforce the surveillance of thyroid cancer in France. (author)

  3. Novel public health risk assessment process developed to support syndromic surveillance for the 2012 Olympic and Paralympic Games.

    Science.gov (United States)

    Smith, Gillian E; Elliot, Alex J; Ibbotson, Sue; Morbey, Roger; Edeghere, Obaghe; Hawker, Jeremy; Catchpole, Mike; Endericks, Tina; Fisher, Paul; McCloskey, Brian

    2017-09-01

    Syndromic surveillance aims to provide early warning and real time estimates of the extent of incidents; and reassurance about lack of impact of mass gatherings. We describe a novel public health risk assessment process to ensure those leading the response to the 2012 Olympic Games were alerted to unusual activity that was of potential public health importance, and not inundated with multiple statistical 'alarms'. Statistical alarms were assessed to identify those which needed to result in 'alerts' as reliably as possible. There was no previously developed method for this. We identified factors that increased our concern about an alarm suggesting that an 'alert' should be made. Between 2 July and 12 September 2012, 350 674 signals were analysed resulting in 4118 statistical alarms. Using the risk assessment process, 122 'alerts' were communicated to Olympic incident directors. Use of a novel risk assessment process enabled the interpretation of large number of statistical alarms in a manageable way for the period of a sustained mass gathering. This risk assessment process guided the prioritization and could be readily adapted to other surveillance systems. The process, which is novel to our knowledge, continues as a legacy of the Games. © Crown copyright 2016.

  4. A Smart Card-Based Electronic School Absenteeism System for Influenza-Like Illness Surveillance in Hong Kong: Design, Implementation, and Feasibility Assessment.

    Science.gov (United States)

    Ip, Dennis Km; Lau, Eric Hy; So, Hau Chi; Xiao, Jingyi; Lam, Chi Kin; Fang, Vicky J; Tam, Yat Hung; Leung, Gabriel M; Cowling, Benjamin J

    2017-10-06

    School-aged children have the highest incidence of respiratory virus infections each year, and transmission of respiratory viruses such as influenza virus can be a major concern in school settings. School absenteeism data have been employed as a component of influenza surveillance systems in some locations. Data timeliness and system acceptance remain as key determinants affecting the usefulness of a prospective surveillance system. The aim of this study was to assess the feasibility of implementing an electronic school absenteeism surveillance system using smart card-based technology for influenza-like illness (ILI) surveillance among a representative network of local primary and secondary schools in Hong Kong. We designed and implemented a surveillance system according to the Protocol for a Standardized information infrastructure for Pandemic and Emerging infectious disease Response (PROSPER). We employed an existing smart card-based education and school administration platform for data capture, customized the user interface, and used additional back end systems built for other downstream surveillance steps. We invited local schools to participate and collected absenteeism data by the implemented system. We compared temporal trend of the absenteeism data with data from existing community sentinel and laboratory surveillance data. We designed and implemented an ILI surveillance system utilizing smart card-based attendance tracking approach for data capture. We implemented the surveillance system in a total of 107 schools (including 66 primary schools and 41 secondary schools), covering a total of 75,052 children. The system successfully captured information on absences for 2 consecutive academic years (2012-2013 and 2013-2014). The absenteeism data we collected from the system reflected ILI activity in the community, with an upsurge in disease activity detected up to 1 to 2 weeks preceding other existing surveillance systems. We designed and implemented a novel

  5. Influenza surveillance

    Directory of Open Access Journals (Sweden)

    Karolina Bednarska

    2016-04-01

    Full Text Available Influenza surveillance was established in 1947. From this moment WHO (World Health Organization has been coordinating international cooperation, with a goal of monitoring influenza virus activity, effective diagnostic of the circulating viruses and informing society about epidemics or pandemics, as well as about emergence of new subtypes of influenza virus type A. Influenza surveillance is an important task, because it enables people to prepare themselves for battle with the virus that is constantly mutating, what leads to circulation of new and often more virulent strains of influenza in human population. As vaccination is the most effective method of fighting the virus, one of the major tasks of GISRS is developing an optimal antigenic composition of the vaccine for the current epidemic season. European Influenza Surveillance Network (EISN has also developed over the years. EISN is running integrated epidemiological and virological influenza surveillance, to provide appropriate data to public health experts in member countries, to enable them undertaking relevant activities based on the current information about influenza activity. In close cooperation with GISRS and EISN are National Influenza Centres - national institutions designated by the Ministry of Health in each country.

  6. Contract Design: Financial Options and Risk.

    Science.gov (United States)

    Mühlbacher, Axel C; Amelung, Volker E; Juhnke, Christin

    2018-01-12

    Integrated care systems as well as accountable care organisations (ACOs) in the US and similar concepts in other countries are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality metrics. By this the total costs of care shall be reduced. When designing healthcare options contractors are faced with a variety of financial options. The costs of market utilisation are highly relevant for the conception of healthcare contracts; furthermore contract-specific investments are an obstacle to the efficient operation of ACOs. A comprehensive literature review on methods of designing contracts in Integrated Care was conducted. This article is the second in a row of three that are all published in this issue and contribute to a specific issue in designing healthcare contracts. The first dealt with the organisation of contracts and information asymmetries, while part 3 concludes with the question of risk management and evaluation. The specific research question of this second article focusses on the financial options and reimbursement schemes that are available to define healthcare contracts. A healthcare contract is a relational contract, which determines the level of reimbursement, the scope of services and the quality between service providers and payers, taking account of the risks relating to population and performance. A relational contract is an agreement based upon assumption of a longer timeframe. A major obstacle to the practical implementation of healthcare contracts is the prognosis of the inflows and outflows due to the actuarial risks of the insured population. Financing conditions and reimbursement arrangements that are based on a prospectively determined fixed price, have a significant drawback: it is very difficult to take the differences in health status and the utilisation of distinct insured clientele

  7. {sup 18}F-FDG PET/contrast enhanced CT in the standard surveillance of high risk colorectal cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Jiménez Londoño, Germán Andrés, E-mail: gjimenez91@yahoo.com [Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); García Vicente, Ana María [Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Sánchez Pérez, Victoria [Department of Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Jiménez Aragón, Fátima [Department of Radiology, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); León Martin, Alberto [Investigation Unit, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Cano Cano, Juana María [Department of Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Domínguez Ferreras, Esther [Department of Radiology, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Gómez López, Ober Van [Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Espinosa Arranz, Javier [Department of Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain); Soriano Castrejón, Ángel María [Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real (Spain)

    2014-12-15

    Highlights: • We assessed the accuracy of FDG-PET/contrast enhanced CT (FDG-PET/ceCT) in the detection of unsuspected recurrence of colorectal cancer. In regard to our knowledge, no previous experience has been reported about the combined acquisition and interpretation of a FDG-PET/ceCT in the surveillance of colorectal cancer. • We designed a prospective study and performed an individual and combined assessment of both techniques (PET and ceCT), in a patient-based analysis and a lesion-based analysis. • The value of PET and ceCT was found to be similar in the detection of unsuspected recurrence of CRC in a patient-based analysis. The most interesting of our result, is that the combined assessment of PET/ceCT improves the accuracy in the lesion-based analysis. - Abstract: Objective: To assess the accuracy of FDG-PET/contrast enhanced CT (FDG-PET/ceCT) in the detection of unsuspected recurrence of colorectal cancer (CRC) in patients with high risk of relapse. Methods: Thirty-three patients (14 females and 19 males, mean age: 62, range: 41–78), with CRC in complete remission, were prospectively included. All patients underwent FDG-PET/ceCT (58 studies). FDG-PET/ceCT was requested in the surveillance setting, and performed following a standardized protocol. A portal venous phase CT scan was performed after the injection of iodinated contrast agent. An individual and combined assessment of both techniques (PET and ceCT) was performed. Concordant and discordant findings of PET, ceCT and FDG-PET/ceCT were compared in a patient-based and a lesion-based analysis. The final diagnosis, recurrence or disease free status (DFS), were established by histopathology or clinical/radiological follow-up of at least 6 months. Results: Seven out of 33 patients had a confirmed recurrence and the rest of patients had a DFS. In a patient-based analysis the sensitivity and specificity of PET, ceCT and PET/ceCT was of 86% and 88%, 86% and 92%, 86% and 85%, respectively. Attending to

  8. Design and development of correlation techniques to maintain a space surveillance system catalogue

    Science.gov (United States)

    Olmedo, E.; Sánchez Ortiz, Noelia; Lerate, Mercedes; Belló-Mora, Miguel; Klinkrad, H.

    2009-10-01

    A growing interest exists in a future, autonomous European Space Surveillance System (ESSS). Currently, most of the knowledge about Earth-orbiting space objects is based on information provided by the USASPACECOM. This paper presents the required initial orbit determination (IOD) and correlation techniques to process optical measurements. Former studies were focused on the handling of radar measurements, which are summarised with the aim of describing a global procedure for processing hybrid measurement types (combination of radar and optic data for catalogue maintenance). The introduction of manoeuvres are presented due to their importance in the space object catalogue maintenance. The detection of uncatalogued objects and the successful correlation of already catalogued objects involve two different tasks for telescopes: survey and tasking. Assumptions for both strategies are developed on the basis of the previous work developed at the University of Berne (see [T. Flohrer, T. Schildknecht, R. Musci, E. Stöveken, Performance estimation for GEO space surveillance, Advances in Space Research 35 (2005). [1]; T. Flohrer, T. Schildknecht, R. Musci, Proposed strategies for optical observations in a future European Space Surveillance Network, presented in the 36th COSPAR Scientific Assembly (2006). [2]; R. Musci, T. Schildknecht, M. Ploner, Orbit improvement for GEO objects using follow-up observations, Advances in Space Research 34 (2004). [3]; R. Musci, T. Schildknecht, M. Ploner, G. Beutler, Orbit improvement for GTO objects using follow-up observations, Advances in Space Research 35 (2005). [4]; R. Musci, T. Schildknecht, T. Flohrer, G. Beutler, Concept for a catalogue of space debris in GEO, Proceedings of the Fourth European Conference on Space Debris, (ESA SP-587, 2005). [5

  9. Health Characteristics of Solo Grandparent Caregivers and Single Parents: A Comparative Profile Using the Behavior Risk Factor Surveillance Survey.

    Science.gov (United States)

    Whitley, Deborah M; Fuller-Thomson, Esme; Brennenstuhl, Sarah

    2015-01-01

    Objectives. To describe the health characteristics of solo grandparents raising grandchildren compared with single parents. Methods. Using the 2012 Behavioral Risk Factor Surveillance System, respondents identified as a single grandparent raising a grandchild were categorized as a solo grandparent; grandparent responses were compared with single parents. Descriptive analysis compared health characteristics of 925 solo grandparents with 7,786 single parents. Results. Compared to single parents, grandparents have a higher prevalence of physical health problems (e.g., arthritis). Both parent groups have a high prevalence of lifetime depression. A larger share of grandparents actively smoke and did no recreational physical exercise in the last month. However, grandparents appear to have better access to health services in comparison with single parents. Conclusion. Solo grandparents may be at risk for diminished physical capacity and heightened prevalence of depression. Health professionals can be an important resource to increase grandparents' physical and emotional capacities.

  10. Health Characteristics of Solo Grandparent Caregivers and Single Parents: A Comparative Profile Using the Behavior Risk Factor Surveillance Survey

    Directory of Open Access Journals (Sweden)

    Deborah M. Whitley

    2015-01-01

    Full Text Available Objectives. To describe the health characteristics of solo grandparents raising grandchildren compared with single parents. Methods. Using the 2012 Behavioral Risk Factor Surveillance System, respondents identified as a single grandparent raising a grandchild were categorized as a solo grandparent; grandparent responses were compared with single parents. Descriptive analysis compared health characteristics of 925 solo grandparents with 7,786 single parents. Results. Compared to single parents, grandparents have a higher prevalence of physical health problems (e.g., arthritis. Both parent groups have a high prevalence of lifetime depression. A larger share of grandparents actively smoke and did no recreational physical exercise in the last month. However, grandparents appear to have better access to health services in comparison with single parents. Conclusion. Solo grandparents may be at risk for diminished physical capacity and heightened prevalence of depression. Health professionals can be an important resource to increase grandparents’ physical and emotional capacities.

  11. Risk indicators affecting honeybee colony survival in Europe: one year of surveillance

    DEFF Research Database (Denmark)

    Jacques, Antoine; Laurent, Marion; Bougeard, Stéphanie

    2016-01-01

    The first pan-European harmonized active epidemiological surveillance program on honeybee colony mortality (EPILOBEE) was set up across 17 European Member States to estimate honeybee colony mortality over winter and during the beekeeping season. In nine Member States, overwinter losses were higher...... and statistically different from the empirical level of 10 % under which the level of overwinter mortality was considered as acceptable with usual beekeeping conditions. In four other countries, these losses were lower. Using multivariable Poisson regression models, it was showed that the size of the operation...

  12. Surveillance of STI risk behaviour among young people attending a music festival in Australia, 2005-08.

    Science.gov (United States)

    Lim, Megan S C; Hellard, Margaret E; Aitken, Campbell K; Hocking, Jane S

    2009-10-01

    To explain rising rates of sexually transmitted infections it is necessary to monitor trends among high risk groups, such as youth. Surveillance of risk behaviours and testing among a variety of populations in different settings is required. We monitored self-reported sexual behaviour among music festival attendees. Cross-sectional studies of young people's behaviour were conducted annually at a music festival between 2005 and 2008 using self-administered questionnaires. Logistic regression, adjusted for age and gender, determined trends in risk behaviours. More than 5,000 questionnaires were completed. The proportion reporting multiple sexual partners in the past year remained stable from 2005 to 2008 and condom use with these partners increased. Reporting a new sexual partner in the past three months decreased, while condom use with new partners increased. Reporting a casual sexual partner increased and condom use with casual partners remained stable. Reporting a recent STI test increased from 23% in 2006 to 32% in 2008. Despite increases in STI notifications, most risk behaviours are decreasing in this group, possibly as a function of increased STI testing. Music festivals are a useful setting for monitoring behaviour trends within a sub-population of young people at relatively high risk of STIs.

  13. Deployment Design of Wireless Sensor Network for Simple Multi-Point Surveillance of a Moving Target

    Science.gov (United States)

    Tsukamoto, Kazuya; Ueda, Hirofumi; Tamura, Hitomi; Kawahara, Kenji; Oie, Yuji

    2009-01-01

    In this paper, we focus on the problem of tracking a moving target in a wireless sensor network (WSN), in which the capability of each sensor is relatively limited, to construct large-scale WSNs at a reasonable cost. We first propose two simple multi-point surveillance schemes for a moving target in a WSN and demonstrate that one of the schemes can achieve high tracking probability with low power consumption. In addition, we examine the relationship between tracking probability and sensor density through simulations, and then derive an approximate expression representing the relationship. As the results, we present guidelines for sensor density, tracking probability, and the number of monitoring sensors that satisfy a variety of application demands. PMID:22412326

  14. Validity and design of environmental surveillance systems for operating nuclear power plants. Final report

    International Nuclear Information System (INIS)

    Eichholz, G.G.

    1977-12-01

    The composition and procedures of environmental surveillance programs at completed and operating nuclear power plants have been examined with respect to their validity, continuing significance and cost. It was found that many programs contain components that are mainly an extension of preoperational baseline measurements that need not be continued indefinitely and that others lack the statistical validity to make their continued application meaningful. To identify the practical limits imposed by counting statistics and realistic equipment capacity measurements were done on iodine-131 and cesium-137 containing samples to establish detectability limits and proportionate costs for sample preparation and counting. It was found that under commercial conditions effective detectability limits and expected confidence limits were substantially higher than those mentioned in NRC Regulatory Guides. This imposes a need for either selecting fewer samples and counting them for longer times or accepting a lesser accuracy on more samples, within the bounds of reasonable cost per sample

  15. A quantitative method for groundwater surveillance monitoring network design at the Hanford Site

    International Nuclear Information System (INIS)

    Meyer, P.D.

    1993-12-01

    As part of the Environmental Surveillance Program at the Hanford Site, mandated by the US Department of Energy, hundreds of groundwater wells are sampled each year, with each sample typically analyzed for a variety of constituents. The groundwater sampling program must satisfy several broad objectives. These objectives include an integrated assessment of the condition of groundwater and the identification and quantification of existing, emerging, or potential groundwater problems. Several quantitative network desip objectives are proposed and a mathematical optimization model is developed from these objectives. The model attempts to find minimum cost network alternatives that maximize the amount of information generated by the network. Information is measured both by the rats of change with respect to time of the contaminant concentration and the uncertainty in contaminant concentration. In an application to tritium monitoring at the Hanford Site, both information measures were derived from historical data using time series analysis

  16. Ski and snowboard school programs: Injury surveillance and risk factors for grade-specific injury.

    Science.gov (United States)

    Sran, R; Djerboua, M; Romanow, N; Mitra, T; Russell, K; White, K; Goulet, C; Emery, C; Hagel, B

    2018-05-01

    The objective of our study was to evaluate incidence rates and profile of school program ski and snowboard-related injuries by school grade group using a historical cohort design. Injuries were identified via Accident Report Forms completed by ski patrollers. Severe injury was defined as those with ambulance evacuation or recommending patient transport to hospital. Poisson regression analysis was used to examine the school grade group-specific injury rates adjusting for risk factors (sex, activity, ability, and socioeconomic status) and accounting for the effect of clustering by school. Forty of 107 (37%) injuries reported were severe. Adolescents (grades 7-12) had higher crude injury rates (91 of 10 000 student-days) than children (grades 1-3: 25 of 10 000 student-days; grades 4-6: 65 of 10 000 student-days). Those in grades 1-3 had no severe injuries. Although the rate of injury was lower in grades 1-3, there were no statistically significant grade group differences in adjusted analyses. Snowboarders had a higher rate of injury compared with skiers, while higher ability level was protective. Participants in grades 1-3 had the lowest crude and adjusted injury rates. Students in grades 7-12 had the highest rate of overall and severe injuries. These results will inform evidence-based guidelines for school ski/snowboard program participation by school-aged children. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Risk, innovation and change : design propositions for implementing risk management in organizations

    NARCIS (Netherlands)

    van Staveren, Martinus Theodorus

    2009-01-01

    This Ph.D. research generated unique design propositions for implementing existing risk management methodologies in organizations. The resulting design propositions incorporate a synthesis of risk management, innovation management and change management. True implementation of risk management is

  18. Social support and employment status modify the effect of intimate partner violence on depression symptom severity in women: results from the 2006 Behavioral Risk Factor Surveillance System Survey.

    Science.gov (United States)

    Dougé, Nathalie; Lehman, Erik B; McCall-Hosenfeld, Jennifer S

    2014-01-01

    Depression and intimate partner violence (IPV) are significant health issues for U.S. women. Interaction effects between IPV and other psychosocial factors on the severity of depressive symptoms have not been fully explored. This study assessed effect modification, that is, how IPV interacts with sociodemographics, psychosocial factors and health risk behaviors, on the severity of depressive symptoms in women. We utilized cross-sectional data from female respondents (n = 16,106) of the 2006 Behavioral Risk Factors Surveillance Survey. Sociodemographics, psychosocial variables, and health risk behaviors determined to be significantly associated with depression were tested for interaction effects with IPV. Weighted ordinal logistic regression and predicted probabilities illustrated the effect of IPV status on depressive symptom severity, stratified by interaction effects. Recent and lifetime IPV exposure were associated with more severe depressive symptoms compared with no IPV exposure. IPV history interacted with employment status and social support on the severity of depressive symptoms in women. Overall, any IPV exposure was associated with more severe depressive symptoms among women with low social support and unemployment, although the effect of recent (versus lifetime) IPV was most pronounced among women with high social support or employed women. Social support and employment status interact with IPV on the severity of depressive symptoms in women. Therefore, social support or workplace interventions designed to improve depressive symptoms should examine IPV history. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  19. A new paradigm in low-risk papillary microcarcinoma: active surveillance

    Directory of Open Access Journals (Sweden)

    Alex González Bóssolo

    2017-09-01

    Full Text Available Classical papillary thyroid microcarcinoma (PTMC is a variant of papillary thyroid carcinoma (PTC known to have excellent prognosis. It has a mortality of 0.3%, even in the presence of distance metastasis. The latest American Thyroid Association guidelines state that although lobectomy is acceptable, active surveillance can be considered in the appropriate setting. We present the case of a 37-year-old female with a history of PTMC who underwent surgical management consisting of a total thyroidectomy. Although she has remained disease-free, her quality of life has been greatly affected by the sequelae of this procedure. This case serves as an excellent example of how first-line surgical treatment may result more harmful than the disease itself.

  20. Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel): changes in weighting methodology.

    Science.gov (United States)

    Bernal, Regina Tomie Ivata; Iser, Betine Pinto Moehlecke; Malta, Deborah Carvalho; Claro, Rafael Moreira

    2017-01-01

    to introduce the methodology used to calculate post-stratification weights of the 2012 Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) and to compare the trends of indicators estimated by cell-by-cell weighting and raking methods. in this panel of cross-sectional studies, the prevalences of smokers, overweight, and intake of fruits and vegetables from 2006 to 2012 were estimated using the cell-by-cell weighting and raking methods. there were no differences in time trends of the indicators estimated by both methods, but the prevalence of smokers estimated by the raking method was lower than the estimated by cell-by-cell weighting, whilst the prevalence of fruit and vegetable intake was higher; for overweight, there was no difference between the methods. raking method presented higher accuracy of the estimates when compared to cell-by-cell weighting method, proving to be most convenient, although it presents register coverage bias.

  1. Forging process design for risk reduction

    Science.gov (United States)

    Mao, Yongning

    In this dissertation, forging process design has been investigated with the primary concern on risk reduction. Different forged components have been studied, especially those ones that could cause catastrophic loss if failure occurs. As an effective modeling methodology, finite element analysis is applied extensively in this work. Three examples, titanium compressor disk, superalloy turbine disk, and titanium hip prosthesis, have been discussed to demonstrate this approach. Discrete defects such as hard alpha anomalies are known to cause disastrous failure if they are present in those stress critical components. In this research, hard-alpha inclusion movement during forging of titanium compressor disk is studied by finite element analysis. By combining the results from Finite Element Method (FEM), regression modeling and Monte Carlo simulation, it is shown that changing the forging path is able to mitigate the failure risk of the components during the service. The second example goes with a turbine disk made of superalloy IN 718. The effect of forging on microstructure is the main consideration in this study. Microstructure defines the as-forged disk properties. Considering specific forging conditions, preform has its own effect on the microstructure. Through a sensitivity study it is found that forging temperature and speed have significant influence on the microstructure. In order to choose the processing parameters to optimize the microstructure, the dependence of microstructure on die speed and temperature is thoroughly studied using design of numerical experiments. For various desired goals, optimal solutions are determined. The narrow processing window of titanium alloy makes the isothermal forging a preferred way to produce forged parts without forging defects. However, the cost of isothermal forging (dies at the same temperature as the workpiece) limits its wide application. In this research, it has been demonstrated that with proper process design, the die

  2. Designs for Risk Evaluation and Management

    Energy Technology Data Exchange (ETDEWEB)

    2015-12-01

    The Designs for Risk Evaluation and Management (DREAM) tool was developed as part of the effort to quantify the risk of geologic storage of carbon dioxide (CO2) under the U.S. Department of Energy's National Risk Assessment Partnership (NRAP). DREAM is an optimization tool created to identify optimal monitoring schemes that minimize the time to first detection of CO2 leakage from a subsurface storage formation. DREAM acts as a post-processer on user-provided output from subsurface leakage simulations. While DREAM was developed for CO2 leakage scenarios, it is applicable to any subsurface leakage simulation of the same output format. The DREAM tool is comprised of three main components: (1) a Java wizard used to configure and execute the simulations, (2) a visualization tool to view the domain space and optimization results, and (3) a plotting tool used to analyze the results. A secondary Java application is provided to aid users in converting common American Standard Code for Information Interchange (ASCII) output data to the standard DREAM hierarchical data format (HDF5). DREAM employs a simulated annealing approach that searches the solution space by iteratively mutating potential monitoring schemes built of various configurations of monitoring locations and leak detection parameters. This approach has proven to be orders of magnitude faster than an exhaustive search of the entire solution space. The user's manual illustrates the program graphical user interface (GUI), describes the tool inputs, and includes an example application.

  3. Epidemiological HIV infection surveillance among subjects with risk behaviours in the city of Messina (Sicily) from 1992 to 2015.

    Science.gov (United States)

    Visalli, G; Avventuroso, E; Laganà, P; Spataro, P; Di Pietro, A; Bertuccio, M P; Picerno, I

    2017-09-01

    Epidemiological studies are a key element in determining the evolution and spread of HIV infection among the world population. Knowledge of the epidemiological dynamics improves strategies for prevention and monitoring. We examined 2,272 subjects who voluntarily underwent HIV testing from January 1992 to December 2015. For each subject, an anonymous form was completed to obtain information on personal data, sexual habits and exposure to risk factors. The number of subjects undergoing the screening test has increased over the years and the average age of the tested subjects has decreased over time. The main motivation for undergoing HIV testing is unprotected sex. Although heterosexual subjects taking the test were more numerous than homosexuals in this study, an increase in the latter over time should be highlighted. Although the number of tests performed has increased over the years, the persistence of unprotected sex shows an inadequate perception of risk. Therefore, it is necessary to implement programmes to increase the general awareness of HIV infection. It is also essential to undertake constant monitoring of behaviour, risk perception and the application of the screening test via surveillance systems in order to implement effective and efficient prevention.

  4. What is the optimal definition of misclassification in patients with very low-risk prostate cancer eligible for active surveillance? Results from a multi-institutional series.

    NARCIS (Netherlands)

    Gandaglia, G.; Ploussard, G.; Isbarn, H.; Suardi, N.; Visschere, P.J. De; Futterer, J.J.; Ghadjar, P.; Massard, C.; Ost, P.; Sooriakumaran, P.; Surcel, C.I.; Bergh, R.C. van den; Montorsi, F.; Ficarra, V.; Giannarini, G.; Briganti, A.

    2015-01-01

    BACKGROUND: The risk of unfavorable prostate cancer in active surveillance (AS) candidates is nonnegligible. However, what represents an adverse pathologic outcome in this setting is unknown. We aimed at assessing the optimal definition of misclassification and its effect on recurrence in AS

  5. Value of cyclin A immunohistochemistry for cancer risk stratification in Barrett esophagus surveillance: A multicenter case-control study.

    Science.gov (United States)

    van Olphen, Sophie H; Ten Kate, Fiebo J C; Doukas, Michail; Kastelein, Florine; Steyerberg, Ewout W; Stoop, Hans A; Spaander, Manon C; Looijenga, Leendert H J; Bruno, Marco J; Biermann, Katharina

    2016-11-01

    The value of endoscopic Barrett esophagus (BE) surveillance based on histological diagnosis of low-grade dysplasia (LGD) remains debated given the lack of adequate risk stratification. The aim of this study was to evaluate the predictive value of cyclin A expression and to combine these results with our previously reported immunohistochemical p53, AMACR, and SOX2 data, to identify a panel of biomarkers predicting neoplastic progression in BE.We conducted a case-control study within a prospective cohort of 720 BE patients. BE patients who progressed to high-grade dysplasia (HGD, n = 37) or esophageal adenocarcinoma (EAC, n = 13), defined as neoplastic progression, were classified as cases and patients without neoplastic progression were classified as controls (n = 575). Cyclin A expression was determined by immunohistochemistry in all 625 patients; these results were combined with the histological diagnosis and our previous p53, AMACR, and SOX2 data in loglinear regression models. Differences in discriminatory ability were quantified as changes in area under the ROC curve (AUC) for predicting neoplastic progression.Cyclin A surface positivity significantly increased throughout the metaplasia-dysplasia-carcinoma sequences and was seen in 10% (107/1050) of biopsy series without dysplasia, 33% (109/335) in LGD, and 69% (34/50) in HGD/EAC. Positive cyclin A expression was associated with an increased risk of neoplastic progression (adjusted relative risk (RR) 2.4; 95% CI: 1.7-3.4). Increases in AUC were substantial for P53 (+0.05), smaller for SOX2 (+0.014), minor for cyclin A (+0.003), and none for AMARC (0.00).Cyclin A immunopositivity was associated with an increased progression risk in BE patients. However, compared to p53 and SOX2, the incremental value of cyclin A was limited. The use of biomarkers has the potential to significantly improve risk stratification in BE.

  6. Assessment of Doppler velocimetry versus nonstress test in antepartum surveillance of high risk pregnancy

    OpenAIRE

    Nishi Choudhury; Barun Kumar Sharma; Bikram Kishor Kanungo; Ruby Yadav; Hafizur Rahman

    2017-01-01

    Background: High risk pregnancies increase the maternal and fetal morbidity and mortality; and there is a need for appropriate investigation which can diagnose it early and predicts the morbidity and mortality. The objectives of this study were to compare the efficacy of Doppler velocimetry studies and NST in predicting fetal compromise in utero and compare their ability in predicting the perinatal outcome in cases of high risk pregnancies. Methods: It was a prospective cross-sectional ho...

  7. Non-Rhabdomyosarcoma Soft Tissue Sarcomas in Children: A Surveillance, Epidemiology, and End Results Analysis Validating COG Risk Stratifications

    Energy Technology Data Exchange (ETDEWEB)

    Waxweiler, Timothy V., E-mail: timothy.waxweiler@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Rusthoven, Chad G. [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Proper, Michelle S. [Department of Radiation Oncology, Billings Clinic, Billings, Montana (United States); Cost, Carrye R. [Division of Hematology and Oncology, Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, Colorado (United States); Cost, Nicholas G. [Division of Urology, Department of Surgery, University of Colorado Denver School of Medicine, Aurora, Colorado (United States); Donaldson, Nathan [Department of Orthopedics, University of Colorado Denver School of Medicine, Aurora, Colorado (United States); Garrington, Timothy; Greffe, Brian S. [Division of Hematology and Oncology, Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, Colorado (United States); Heare, Travis [Department of Orthopedics, University of Colorado Denver School of Medicine, Aurora, Colorado (United States); Macy, Margaret E. [Division of Hematology and Oncology, Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, Colorado (United States); Liu, Arthur K. [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)

    2015-06-01

    Purpose: Non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) are a heterogeneous group of sarcomas that encompass over 35 histologies. With an incidence of ∼500 cases per year in the United States in those <20 years of age, NRSTS are rare and therefore difficult to study in pediatric populations. We used the large Surveillance, Epidemiology, and End Results (SEER) database to validate the prognostic ability of the Children's Oncology Group (COG) risk classification system and to define patient, tumor, and treatment characteristics. Methods and Materials: From SEER data from 1988 to 2007, we identified patients ≤18 years of age with NRSTS. Data for age, sex, year of diagnosis, race, registry, histology, grade, primary size, primary site, stage, radiation therapy, and survival outcomes were analyzed. Patients with nonmetastatic grossly resected low-grade tumors of any size or high-grade tumors ≤5 cm were considered low risk. Cases of nonmetastatic tumors that were high grade, >5 cm, or unresectable were considered intermediate risk. Patients with nodal or distant metastases were considered high risk. Results: A total of 941 patients met the review criteria. On univariate analysis, black race, malignant peripheral nerve sheath (MPNST) histology, tumors >5 cm, nonextremity primary, lymph node involvement, radiation therapy, and higher risk group were associated with significantly worse overall survival (OS) and cancer-specific survival (CSS). On multivariate analysis, MPNST histology, chemotherapy-resistant histology, and higher risk group were significantly poor prognostic factors for OS and CSS. Compared to low-risk patients, intermediate patients showed poorer OS (hazard ratio [HR]: 6.08, 95% confidence interval [CI]: 3.53-10.47, P<.001) and CSS (HR: 6.27; 95% CI: 3.44-11.43, P<.001), and high-risk patients had the worst OS (HR: 13.35, 95% CI: 8.18-21.76, P<.001) and CSS (HR: 14.65, 95% CI: 8.49-25.28, P<.001). Conclusions: The current COG risk group

  8. Automating risk analysis of software design models.

    Science.gov (United States)

    Frydman, Maxime; Ruiz, Guifré; Heymann, Elisa; César, Eduardo; Miller, Barton P

    2014-01-01

    The growth of the internet and networked systems has exposed software to an increased amount of security threats. One of the responses from software developers to these threats is the introduction of security activities in the software development lifecycle. This paper describes an approach to reduce the need for costly human expertise to perform risk analysis in software, which is common in secure development methodologies, by automating threat modeling. Reducing the dependency on security experts aims at reducing the cost of secure development by allowing non-security-aware developers to apply secure development with little to no additional cost, making secure development more accessible. To automate threat modeling two data structures are introduced, identification trees and mitigation trees, to identify threats in software designs and advise mitigation techniques, while taking into account specification requirements and cost concerns. These are the components of our model for automated threat modeling, AutSEC. We validated AutSEC by implementing it in a tool based on data flow diagrams, from the Microsoft security development methodology, and applying it to VOMS, a grid middleware component, to evaluate our model's performance.

  9. Risk-based evaluation of allowed outage time and surveillance test interval extensions for nuclear power plants

    International Nuclear Information System (INIS)

    Gibelli, Sonia Maria Orlando

    2008-03-01

    The main goal of this work is, through the use of Probabilistic Safety Analysis (PSA), to evaluate Technical Specification (TS) Allowed Outage Times (AOT) and Surveillance Test Intervals (STI) extensions for Angra 1 nuclear power plant. PSA has been incorporated as an additional tool, required as part of NPP licensing process. The risk measure used in this work is the Core Damage Frequency (CDF), obtained from the Angra 1 PSA Level 1. AOT and STI extensions are calculated for the Safety Injection System (SIS), Service water System (SAS) and Auxiliary Feedwater System (AFS) through the use of SAPHIRE code. In order to compensate for the risk increase caused by the extensions, compensatory measures as test of redundant train prior to entering maintenance and staggered test strategy are proposed. Results have shown that the proposed AOT extensions are acceptable for the SIS and SAS with the implementation of compensatory measures. The proposed AOT extension is not acceptable for the AFS. The STI extensions are acceptable for all three systems. (author)

  10. Extending in-competition Athletics injury and illness surveillance with pre-participation risk factor screening: A pilot study.

    Science.gov (United States)

    Edouard, Pascal; Jacobsson, Jenny; Timpka, Toomas; Alonso, Juan-Manuel; Kowalski, Jan; Nilsson, Sverker; Karlsson, David; Depiesse, Frédéric; Branco, Pedro

    2015-05-01

    To explore the performance of retrospective health data collected from athletes before Athletics championships for the analysis of risk factors for in-competition injury and illness (I&I). For the 2013 European Athletics Indoor Championships, a self-report questionnaire (PHQ) was developed to record the health status of 127 athletes during the 4 weeks prior to the championship. Physician-based surveillance of in-competition I&I among all 577 athletes registered to compete was pursued during the championships. 74 athletes (58.3%) from the sample submitted a complete PHQ. 21 (28%) of these athletes sustained at least one injury and/or illness during the championships. Training more than 12 h/week predisposed for sustaining an in-competition injury, and a recent health problem for in-competition illness. Among the 577 registered athletes, 60 injuries (104/1000 registered athletes) were reported. 31% of injuries were caused by the track, and 29% by overuse. 29 illnesses were reported (50/1000 registered athletes); upper respiratory tract infection and gastro-enteritis/diarrhoea were the most reported diagnoses. Pre-participation screening using athletes' self-report PHQ showed promising results with regard to identification of individuals at risk. Indoor injury types could be attributed to extrinsic factors, such as small track size, track inclination, and race tactics. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Risk Informed Design as Part of the Systems Engineering Process

    Science.gov (United States)

    Deckert, George

    2010-01-01

    This slide presentation reviews the importance of Risk Informed Design (RID) as an important feature of the systems engineering process. RID is based on the principle that risk is a design commodity such as mass, volume, cost or power. It also reviews Probabilistic Risk Assessment (PRA) as it is used in the product life cycle in the development of NASA's Constellation Program.

  12. Low Risk of Cervical Cancer/Precancer Among Most Women Under Surveillance Postcolposcopy.

    Science.gov (United States)

    Demarco, Maria; Cheung, Li C; Kinney, Walter K; Wentzensen, Nicolas; Lorey, Thomas S; Fetterman, Barbara; Poitras, Nancy E; Befano, Brian; Castle, Philip E; Schiffman, Mark

    2018-04-01

    To inform impending postcolposcopy guidelines, this analysis examined the subsequent risk of CIN 3+ among women with a grade lower than CIN 2 (< CIN 2) colposcopy results, taking into account the referring results that brought them to colposcopy and cotest results postcolposcopy. We analyzed 107,005 women from 25 to 65 years old, recommended for colposcopy at Kaiser Permanente Northern California. We estimated absolute risks of CIN 3+ among women: (1) recommended for colposcopy (precolposcopy), (2) following colposcopy and with histology results < CIN 2 (postcolposcopy), and (3) with cotest results 12 months after a < CIN 2 colposcopy (return cotest). After colposcopy showing < CIN 2 (n = 69,790; 87% of the women at colposcopy), the 1-year risk of CIN 3+ was 1.2%, compared with 6.3% at the time of colposcopy recommendation. Negative cotest results 1 year after colposcopy identified a large group (37.1%) of women whose risk of CIN 3+ (i.e., <0.2% at 3 years after postcolposcopy cotest) was comparable with women with normal cytology in the screening population. These risks are consistent with current guidelines recommending repeat cotesting 12 months after colposcopy < CIN 2 and a 3-year return for women with a negative postcolposcopy cotest. Most women are at low risk of subsequent CIN 3+ after a colposcopy showing < CIN 2, especially those who are human papillomavirus-negative postcolposcopy, consistent with current management guidelines for repeat testing intervals. Before the finalizing the upcoming guidelines, we will consider additional rounds of postcolposcopy cotesting.

  13. Risk factors for changing test classification in the Danish surveillance program for Salmonella in dairy herds

    DEFF Research Database (Denmark)

    Nielsen, Lennarth Ravn; Warnick, L. D.; Greiner, M.

    2007-01-01

    test positive to negative, whereas the breed and neighbor factors were not found to be important for small herds. Organic production was associated with remaining test positive, but not with becoming test positive. The results emphasize the importance of external and internal biosecurity measures....... The objective of this study was to evaluate risk factors for changing from test negative to positive, which was indicative of herds becoming infected from one quarter of the year to the next, and risk factors for changing from test positive to negative, which was indicative of herds recovering from infection...

  14. Nutritional surveillance.

    Science.gov (United States)

    Mason, J B; Mitchell, J T

    1983-01-01

    The concept of nutritional surveillance is derived from disease surveillance, and means "to watch over nutrition, in order to make decisions that lead to improvements in nutrition in populations". Three distinct objectives have been defined for surveillance systems, primarily in relation to problems of malnutrition in developing countries: to aid long-term planning in health and development; to provide input for programme management and evaluation; and to give timely warning of the need for intervention to prevent critical deteriorations in food consumption. Decisions affecting nutrition are made at various administrative levels, and the uses of different types of nutritional surveillance information can be related to national policies, development programmes, public health and nutrition programmes, and timely warning and intervention programmes. The information should answer specific questions, for example concerning the nutritional status and trends of particular population groups.Defining the uses and users of the information is the first essential step in designing a system; this is illustrated with reference to agricultural and rural development planning, the health sector, and nutrition and social welfare programmes. The most usual data outputs are nutritional outcome indicators (e.g., prevalence of malnutrition among preschool children), disaggregated by descriptive or classifying variables, of which the commonest is simply administrative area. Often, additional "status" indicators, such as quality of housing or water supply, are presented at the same time. On the other hand, timely warning requires earlier indicators of the possibility of nutritional deterioration, and agricultural indicators are often the most appropriate.DATA COME FROM TWO MAIN TYPES OF SOURCE: administrative (e.g., clinics and schools) and household sample surveys. Each source has its own advantages and disadvantages: for example, administrative data often already exist, and can be

  15. The Use of Student Self-Report Screening Data for Mental Health Risk Surveillance

    Science.gov (United States)

    Dever, B. V.; Raines, T. C.

    2013-01-01

    Child and adolescent mental health disorders are known to increase the risk for numerous poor school and life outcomes for children and adolescents including suicidal ideation and attempts, academic underachievement and school dropout, substance use and disorders, and physical fighting or victimization by a weapon (Bradley, Doolittle, &…

  16. Tuberculosis in Kazakhstan: analysis of risk determinants in national surveillance data

    Science.gov (United States)

    2012-01-01

    Background Development of tuberculosis (TB) is determined by various risk factors and the interactions of temporal and spatial distributions. The aim of this study was to identify the most salient risk factors for TB disease as well as multidrug resistant TB (MDR-TB) at the oblast (provincial) level in Kazakhstan. Methods Correlational and descriptive analyses were conducted at the oblast and national level using data provided by the country’s National Institute of Geography (NIG) and the National Tuberculosis Program (NTP). Reported incident case notification rates (CNRs) and prevalence vary by oblast, thus the study investigated which determinants contributed to this regional variation and compared burdens among oblasts. Results The results showed that while tuberculosis CNRs decreased over the study period, MDR-TB conversely increased. Two oblasts -Atyrauskaya and Mangystauskaya - presented especially significant anomalies with large decreases in TB incident CNRs coupled with comparatively large increases in MDR-TB incident CNRs. Conclusion Understanding the distribution of TB and MDR-TB cases and associated risk factors, especially the “unknown risk factor” categorization points to the need for future research. PMID:23075260

  17. Validation of a model for ranking aquaculture facilities for risk-based disease surveillance.

    Science.gov (United States)

    Diserens, Nicolas; Falzon, Laura Cristina; von Siebenthal, Beat; Schüpbach-Regula, Gertraud; Wahli, Thomas

    2017-09-15

    A semi-quantitative model for risk ranking of aquaculture facilities in Switzerland with regard to the introduction and spread of Viral Haemorrhagic Septicaemia (VHS) and Infectious Haematopoietic Necrosis (IHN) was developed in a previous study (Diserens et al., 2013). The objective of the present study was to validate this model using data collected during field visits on aquaculture sites in four Swiss cantons compared to data collected through a questionnaire in the previous study. A discrepancy between the values obtained with the two different methods was found in 32.8% of the parameters, resulting in a significant difference (pranking of Swiss aquaculture facilities according to their risk of getting infected with or spreading of VHS and IHN, as the five facilities that tested positive for these diseases in the last ten years were ranked as medium or high risk. Moreover, because the seven fish farms that were infected with Infectious Pancreatic Necrosis (IPN) during the same period also belonged to the risk categories medium and high, the classification appeared to correlate with the occurrence of this third viral fish disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. A risk assessment approach to evaluating food safety based on product surveillance

    NARCIS (Netherlands)

    Notermans, S.; Nauta, M.J.; Jansen, J.; Jouve, J.L.; Mead, G.C.

    1998-01-01

    This paper outlines a risk assessment approach to food safety evaluation, which is based on testing a particular type of food, or group of similar foods, for relevant microbial pathogens. The results obtained are related to possible adverse effects on the health of consumers. The paper also gives an

  19. 522 Postmarket Surveillance Studies

    Data.gov (United States)

    U.S. Department of Health & Human Services — The 522 Postmarket Surveillance Studies Program encompasses design, tracking, oversight, and review responsibilities for studies mandated under section 522 of the...

  20. Design of the Dutch prevention of influenza, surveillance and management (PRISMA) study

    NARCIS (Netherlands)

    Hak, E; van Loon, S; Buskens, E; van Essen, G A; de Bakker, D; Tacken, M A J B; van Hout, B A; Grobbee, D E; Verheij, Th J M

    2003-01-01

    Rationale and design of a study on the cost-effectiveness of the Dutch influenza vaccination campaign are described. During two influenza epidemics, about 75,000 primary care patients recommended for influenza vaccination are included. Cases have fatal or non-fatal influenza, pneumonia, otitis

  1. Risk allocation approach to reactor safety design and evaluation

    International Nuclear Information System (INIS)

    Gokcek, O.; Temme, M.I.; Derby, S.L.

    1978-01-01

    This paper describes a risk allocation technique used for determining nuclear power plant design reliability requirements. The concept of risk allocation-optimum choice of safety function reliabilities under a maximum risk constraint - is described. An example of risk allocation is presented to demonstrate the application of the methodology

  2. Insights from a Systematic Search for Information on Designs, Costs, and Effectiveness of Poliovirus Environmental Surveillance Systems.

    Science.gov (United States)

    Duintjer Tebbens, Radboud J; Zimmermann, Marita; Pallansch, Mark A; Thompson, Kimberly M

    2017-12-01

    Poliovirus surveillance plays a critical role in achieving and certifying eradication and will play a key role in the polio endgame. Environmental surveillance can provide an opportunity to detect circulating polioviruses prior to the observation of any acute flaccid paralysis cases. We completed a systematic review of peer-reviewed publications on environmental surveillance for polio including the search terms "environmental surveillance" or "sewage," and "polio," "poliovirus," or "poliomyelitis," and compared characteristics of the resulting studies. The review included 146 studies representing 101 environmental surveillance activities from 48 countries published between 1975 and 2016. Studies reported taking samples from sewage treatment facilities, surface waters, and various other environmental sources, although they generally did not present sufficient details to thoroughly evaluate the sewage systems and catchment areas. When reported, catchment areas varied from 50 to over 7.3 million people (median of 500,000 for the 25% of activities that reported catchment areas, notably with 60% of the studies not reporting this information and 16% reporting insufficient information to estimate the catchment area population size). While numerous studies reported the ability of environmental surveillance to detect polioviruses in the absence of clinical cases, the review revealed very limited information about the costs and limited information to support quantitative population effectiveness of conducting environmental surveillance. This review motivates future studies to better characterize poliovirus environmental surveillance systems and the potential value of information that they may provide in the polio endgame.

  3. Spatial analysis of under-5 mortality and potential risk factors in the Basse Health and Demographic Surveillance System, the Gambia.

    Science.gov (United States)

    Quattrochi, John; Jasseh, Momodou; Mackenzie, Grant; Castro, Marcia C

    2015-07-01

    To describe the spatial pattern in under-5 mortality rates in the Basse Health and Demographic Surveillance System (BHDSS) and to test for associations between under-5 deaths and biodemographic and socio-economic risk factors. Using data on child survival from 2007 to 2011 in the BHDSS, we mapped under-5 mortality by km(2) . We tested for spatial clustering of high or low death rates using Kulldorff's spatial scan statistic. Associations between child death and a variety of biodemographic and socio-economic factors were assessed with Cox proportional hazards models, and deviance residuals from the best-fitting model were tested for spatial clustering. The overall death rate among children under 5 was 0.0195 deaths per child-year. We found two spatial clusters of high death rates and one spatial cluster of low death rates; children in the two high clusters died at a rate of 0.0264 and 0.0292 deaths per child-year, while in the low cluster, the rate was 0.0144 deaths per child-year. We also found that children born to Fula mothers experienced, on average, a higher hazard of death, whereas children born in the households in the upper two quintiles of asset ownership experienced, on average, a lower hazard of death. After accounting for the spatial distribution of biodemographic and socio-economic characteristics, we found no residual spatial pattern in child mortality risk. This study demonstrates that significant inequality in under-5 death rates can occur within a relatively small area (1100 km(2) ). Risks of under-5 mortality were associated with mother's ethnicity and household wealth. If high mortality clusters persist, then equity concerns may require additional public health efforts in those areas. © 2015 John Wiley & Sons Ltd.

  4. Risk management and post-marketing surveillance for the abuse of medications acting on the central nervous system: expert panel report.

    Science.gov (United States)

    Johanson, Chris-Ellyn; Balster, Robert L; Henningfield, Jack E; Schuster, Charles R; Anthony, James C; Barthwell, Andrea G; Coleman, John J; Dart, Richard C; Gorodetzky, Charles W; O'Keeffe, Charles; Sellers, Edward M; Vocci, Frank; Walsh, Sharon L

    2009-12-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and 11 recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized.

  5. [Company occupational physician and work related stress: from risk assessment to health surveillance].

    Science.gov (United States)

    Buselli, R; Cristaudo, A

    2009-01-01

    In Italy the recent safety legislation requires a new committment for the company occupational physician. His duty is a balance between legal requirements and the state of art of prevention. There are many tools to tackle stress at work as a general preventive intervention. The hard challenge of the company physician is to keep all the garantees in terms of prevention and social security for the worker at risk of stress. This paper examines some of the difficulties with current approaches and looks at possible solutions.

  6. HTGR containment design options: an application of probabilistic risk assessment

    International Nuclear Information System (INIS)

    1977-08-01

    Through the use of probabilistic risk assessment (PRA), it is possible to quantitatively evaluate the radiological risk associated with a given reactor design and to place such risk into perspective with alternative designs. The merits are discussed for several containment alternatives for the HTGR from the viewpoints of economics and licensability, as well as public risk. The quantification of cost savings and public risk indicates that presently acceptable public risk can be maintained and cost savings of $40 million can result from use of a vented confinement for the HTGR

  7. Design and Evaluation of Novel Textile Wearable Systems for the Surveillance of Vital Signals

    Directory of Open Access Journals (Sweden)

    Isabel G. Trindade

    2016-09-01

    Full Text Available This article addresses the design, development, and evaluation of T-shirt prototypes that embed novel textile sensors for the capture of cardio and respiratory signals. The sensors are connected through textile interconnects to either an embedded custom-designed data acquisition and transmission unit or to snap fastener terminals for connection to external monitoring devices. The performance of the T-shirt prototype is evaluated in terms of signal-to-noise ratio amplitude and signal interference caused by baseline wander and motion artefacts, through laboratory tests with subjects in standing and walking conditions. Performance tests were also conducted in a hospital environment using a T-shirt prototype connected to a commercial three-channel Holter monitoring device. The textile sensors and interconnects were realized with the assistance of an industrial six-needle digital embroidery tool and their resistance to wear addressed with normalized tests of laundering and abrasion. The performance of these wearable systems is discussed, and pathways and methods for their optimization are highlighted.

  8. Design and Evaluation of Novel Textile Wearable Systems for the Surveillance of Vital Signals.

    Science.gov (United States)

    Trindade, Isabel G; Machado da Silva, José; Miguel, Rui; Pereira, Madalena; Lucas, José; Oliveira, Luís; Valentim, Bruno; Barreto, Jorge; Santos Silva, Manuel

    2016-09-24

    This article addresses the design, development, and evaluation of T-shirt prototypes that embed novel textile sensors for the capture of cardio and respiratory signals. The sensors are connected through textile interconnects to either an embedded custom-designed data acquisition and transmission unit or to snap fastener terminals for connection to external monitoring devices. The performance of the T-shirt prototype is evaluated in terms of signal-to-noise ratio amplitude and signal interference caused by baseline wander and motion artefacts, through laboratory tests with subjects in standing and walking conditions. Performance tests were also conducted in a hospital environment using a T-shirt prototype connected to a commercial three-channel Holter monitoring device. The textile sensors and interconnects were realized with the assistance of an industrial six-needle digital embroidery tool and their resistance to wear addressed with normalized tests of laundering and abrasion. The performance of these wearable systems is discussed, and pathways and methods for their optimization are highlighted.

  9. Late renal toxicity of treatment for childhood malignancy: risk factors, long-term outcomes, and surveillance.

    Science.gov (United States)

    Skinner, Roderick

    2018-02-01

    Chronic glomerular and tubular nephrotoxicity is reported in 20-50% and 20-25%, respectively, of children and adolescents treated with ifosfamide and 60-80% and 10-30%, respectively, of those given cisplatin. Up to 20% of children display evidence of chronic glomerular damage after unilateral nephrectomy for a renal tumour. Overall, childhood cancer survivors have a ninefold higher risk of developing renal failure compared with their siblings. Such chronic nephrotoxicity may have multiple causes, including chemotherapy, radiotherapy exposure to kidneys, renal surgery, supportive care drugs and tumour-related factors. These cause a wide range of chronic glomerular and tubular toxicities, often with potentially severe clinical sequelae. Many risk factors for developing nephrotoxicity, mostly patient and treatment related, have been described, but we remain unable to predict all episodes of renal damage. This implies that other factors may be involved, such as genetic polymorphisms influencing drug metabolism. Although our knowledge of the long-term outcomes of chronic nephrotoxicity is increasing, there is still much to learn, including how we can optimally predict or achieve early detection of nephrotoxicity. Greater understanding of the pathogenesis of nephrotoxicity is needed before its occurrence can be prevented.

  10. The importance of continuing surveillance of risk factors for prevention of cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Gaetano Lanza

    2007-06-01

    Full Text Available After peaking in the 1960s’, cardiovascular diseases (CVDs have shown a consistent decline in western countries in recent decades [1].Despite this,CVDs remain the major cause of mortality and morbidity in industrialized populations, with relevant associated socio-economical issues, while their incidence is increasing in developing countries. Several factors have likely contributed to the reduced incidence of CVDs in industrialized societies, including an increase in education and attention to health issues, lifestyle changes and improvement in diagnostic facilities and therapeutic tools. Epidemiologic studies have played an outstanding role in the decline of CVDs. Indeed, they have allowed for the identification of habits and conditions which expose healthy subjects to an increased risk of development of atherosclerosis and its complications They have also led to the implementation of appropriate programs and campaigns aimed at fighting the identified risk factors by means of changes in diet and lifestyle and the use of specific drug treatments. In particular, tight control and prevention of hypertension, smoking and hypercholesterolemia has largely contributed to the reduction of CVDs, accounting for more than 50% of the reduction of mortality from the 1960s’ to the 1990s’ [2].This approach was also crucial in improving the clinical outcomes of secondary prevention for CVDs.

  11. Creutzfeldt-Jakob disease lookback study: 21 years of surveillance for transfusion transmission risk.

    Science.gov (United States)

    Crowder, Lauren A; Schonberger, Lawrence B; Dodd, Roger Y; Steele, Whitney R

    2017-08-01

    Transfusion transmission of human prion diseases has been observed for variant Creutzfeldt-Jakob disease (vCJD), but not for the classic forms of prion disease (CJD: sporadic, genetic, and iatrogenic). Although the presence of prions or misfolded prion proteins in blood has been documented in some patients with the most common form of CJD, sporadic CJD, no transfusion-transmitted cases of CJD have been recognized. Since 1995, the American Red Cross has conducted a lookback study of the recipients of blood products from donors who develop CJD to assess the risk of blood-borne CJD transmission in the United States. Blood donors subsequently diagnosed with confirmed or probable CJD were enrolled and the consignees were asked to identify the recipients of their blood products. These donors' transfusion recipients are traced annually with the National Death Index to see if they subsequently die of CJD. To date, 65 CJD donors have been enrolled along with 826 of their blood recipients. These recipients have contributed 3934 person-years of follow-up and no transfusion-transmitted cases of CJD have been recognized. From this study, as well as other epidemiologic studies, there is no evidence of CJD transfusion transmission; this risk remains theoretical. © 2017 AABB.

  12. Association between perceived insufficient sleep, frequent mental distress, obesity and chronic diseases among US adults, 2009 behavioral risk factor surveillance system

    Directory of Open Access Journals (Sweden)

    Liu Yong

    2013-01-01

    Full Text Available Abstract Background Although evidence suggests that poor sleep is associated with chronic disease, little research has been conducted to assess the relationships between insufficient sleep, frequent mental distress (FMD ≥14 days during the past 30 days, obesity, and chronic disease including diabetes mellitus, coronary heart disease, stroke, high blood pressure, asthma, and arthritis. Methods Data from 375,653 US adults aged ≥ 18 years in the 2009 Behavioral Risk Factor Surveillance System were used to assess the relationships between insufficient sleep and chronic disease. The relationships were further examined using a multivariate logistic regression model after controlling for age, sex, race/ethnicity, education, and potential mediators (FMD and obesity. Results The overall prevalence of insufficient sleep during the past 30 days was 10.4% for all 30 days, 17.0% for 14–29 days, 42.0% for 1–13 days, and 30.6% for zero day. The positive relationships between insufficient sleep and each of the six chronic disease were significant (p  Conclusions Assessment of sleep quantity and quality and additional efforts to encourage optimal sleep and sleep health should be considered in routine medical examinations. Ongoing research designed to test treatments for obesity, mental distress, or various chronic diseases should also consider assessing the impact of these treatments on sleep health.

  13. Prevalence and associated factors of diabetes mellitus in Puerto Rican adults: behavioral risk factor surveillance system, 1999.

    Science.gov (United States)

    Pérez-Cardona, C; Pérez-Perdomo, R

    2001-06-01

    To estimate the self-reported weighted prevalence of diabetes mellitus among different population subgroups and determine associated factors in Puerto Rico. Data gathered from the Behavioral Risk Factor Surveillance Survey (BRFSS) during 1999 was analyzed. The weighted prevalence in Puerto Rico in 1999 was 9.6% (95% CI: 8.5%-10.7%), highest than reported nationally. It was higher among individuals with increasing age, female sex, decreasing annual income, decreasing educational attainment, being non-employed, having a health care coverage, high blood pressure, high blood cholesterol, and increasing body mass index. Health behaviors and co-morbid conditions significantly associated with diabetes among individuals aged less than 65 years were high blood pressure, high blood cholesterol, obesity and low educational attainment. However, the only significant characteristic associated with diabetes in individuals aged 65 years or more was female sex. Analysis of the data gathered in the diabetes module revealed that nearly 35% were using insulin, 57.4% were using insulin once a day, 14.4% self-monitored their blood glucose one to three times per day, 18.3% reported they have heard of the glycosylated hemoglobin test, and of these, 71.8% had their test performed between one and six times within the past year. Nearly 42% reported their feet were checked and 54.1% had a dilated eye examination last year. The high prevalence of diabetes in Puerto Rico underscores the need for developing integrated management strategies for improving quality of diabetes care.

  14. The relationship between employment and veteran status, disability and gender from 2004-2011 Behavioral Risk Factor Surveillance System (BRFSS).

    Science.gov (United States)

    Smith, Diane L

    2014-01-01

    In 2011, about 1.8 million or 8 percent of the 22.2 million veterans were women in the US. The unemployment rate for female veterans of the wars in Iraq and Afghanistan rose to 13.5%, above the 8.4% for non-veteran adult women. To examine data from the Behavioral Risk Factor Surveillance System (BRFSS), from 2004-2011 to determine the relationship between employment and veteran status, disability and gender. Chi square analysis was used to determine if significant differences existed between the employment rate of female veterans with disabilities and female veterans without disabilities, female non-veterans with disabilities and male veterans with disabilities. Binomial logistic regression analysis was used to determine how veteran status, disability and gender affected the likelihood of not being employed. Significant differences were found in employment rate between female veterans with disabilities and female veterans without disabilities, but not when compared to female non-veterans with disabilities or male veterans with disabilities. Disability was the strongest factor increasing the likelihood of not being employed, though veteran status and female gender were also predictive. Female veterans with disabilities experience low levels of employment. Policies and programs are needed to address the unique needs of these veterans.

  15. A pilot study on the reproductive risks of maternal exposure to magnetic fields from electronic article surveillance systems.

    Science.gov (United States)

    Khan, Muhammad Waseem; Roivainen, Päivi; Herrala, Mikko; Tiikkaja, Maria; Sallmén, Markku; Hietanen, Maila; Juutilainen, Jukka

    2018-02-26

    We investigated the feasibility of a large-scale epidemiological study on reproductive effects of intermediate frequency (IF) magnetic field (MF) exposure among cashiers working near electronic article surveillance (EAS) systems. The study cohort included 4157 women who had worked as cashiers in supermarkets with EAS devices (considered as exposed) or grocery stores without EAS devices (considered as unexposed) between 2008 and 2015. 536 births and 38 miscarriages occurred among these women during the study period, based on information from nationwide health registries. Measurements were also performed to characterize the MF exposure of cashiers. Cashiers were found to be exposed to 8.2 MHz MFs only when passing by the gates at short distance. Static fields of about 0.1 mT were observed at cashier's seat. Extremely low frequency MFs were higher at stores without EAS devices. No differences on the risk of miscarriage, reduced birth weight or preterm birth were observed between cashiers in different store types. Any further studies should attempt to include study subjects working near EAS systems that produce stronger IF MFs at kHz frequencies. Exposure to ELF MFs should be assessed as a possible confounding factor.

  16. Do obese adults have a higher risk of asthma attack when exposed to indoor mold? A study based on the 2005 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Wen, Xiao-Jun; Balluz, Lina; Mokdad, Ali

    2009-01-01

    Some studies show an association between asthma and obesity, but it is unknown whether exposure to mold will increase the risk of asthma attacks among obese people. This study examined whether obese adults have a higher risk of asthma attacks than non-obese adults when exposed to indoor mold. We used data from the 2005 Behavioral Risk Factor Surveillance System to conduct a cross-sectional analysis among 9,668 respondents who reported exposure to indoor mold. With exposure to indoor mold, weighted prevalence of asthma attacks among obese respondents was 11.4% (95% confidence interval [CI] 6.0, 20.6], which was 2.3 times as high as among the exposed non-obese respondents (5.0%, 95% CI 2.8, 8.8). This ratio was almost the same as the ratio of 2.0:1 between the obese respondents (5.7%, 95% CI 4.6, 7.2) and the non-obese respondents (2.8%, 95% CI 2.3, 3.9) when neither group had exposure to mold. The odds ratio of asthma attack among obese people was 3.10 (95% CI 1.10, 8.67) for those with exposure to mold and 2.21 (95% CI 1.54, 3.17) for those without exposure to mold after adjusting for age, sex, race/ethnicity, and smoking status. Our study suggests that obese adults who have been exposed to indoor mold may not necessarily have a higher risk of asthma attack than obese adults who have not been exposed, even though obesity and exposure to indoor mold are both major risk factors for asthma attack. Medical professionals should not only incorporate weight-control or weight-reduction measures as the components of asthma treatment plans, but also advise asthma patients to avoid exposure to indoor mold.

  17. Urban-Rural Differences in the Prevalence of Self-Reported Diabetes and its Risk Factors: The WHO STEPS Iranian Noncommunicable Disease Risk Factor Surveillance in 2011

    Directory of Open Access Journals (Sweden)

    Zahra Khorrami

    2017-09-01

    Full Text Available The high prevalence of diabetes in Iran and other developing countries is chiefly attributed to urbanization. The objectives of the present study were to assess the prevalence of self-reported diabetes and to determine its associated risk factors. This study is a part of the national noncommunicable disease risk factor surveillance, conducted in 31 provinces of Iran in 2011. First, 10069 individuals, between 20 and 70 years old (3036 individuals from rural and 7033 from urban areas, were recruited. The major risk factors were studied using a modified WHO STEPS approach. Diabetes was considered based on self-reported diabetes. The prevalence of self-reported diabetes was 10% overall. The prevalence in the rural and urban settings was 7.4% and 11.1%, respectively. Moderate physical activity (OR=0.45, 95% CI=0.29–0.71 and family history of diabetesOR=6.53, 95% CI=4.29–9.93 were the most important risk factors among the rural residents and systolic blood pressure (OR=1.01, 95% CI=1–1.02, waist circumference (OR=1.02, 95% CI=1.01–1.03, and overweight (OR=1.36, 95% CI= 1–1.84 were significantly associated with self-reported diabetes in the urban residents. The prevalence of self-reported diabetes in the urban setting was higher than that in the rural setting. Physical inactivity, abdominal obesity, and high blood pressure were the most important risk factors associated with self-reported diabetes in Iran.

  18. Design of quality assurance surveillance of geotechnical investigation in evaluation of nuclear power plants siting

    International Nuclear Information System (INIS)

    Made Pramayuni; Haendra Subekti

    2011-01-01

    System of building Nuclear Power Plants (NPP) is built above ground surface and rocks. Therefore, the geotechnical aspects evaluation of NPP siting in particular must be implemented properly and accurately. The successful of the design and construction of the building system is influenced by geotechnical conditions in the vicinity of NPP will be built. To be able to perform geotechnical analysis is good and true; it's required data of surface/underground completely. These data can be obtained directly not only from the geotechnical field investigations, but also can be obtained from the laboratory tests results. To ensure that geotechnical investigations are conducted effectively and efficiently, produce accurate data, as well as meeting the requirements of safety, health, safety, environmental, quality and economic, then the Quality Assurance Program (QAP) should be established and implemented. Supervision of the QAP implementation is required to ensure the work is done according to QAP that have been established and applicable requirement. (author)

  19. Identifying areas at risk of low birth weight using spatial epidemiology: A small area surveillance study.

    Science.gov (United States)

    Insaf, Tabassum Z; Talbot, Thomas

    2016-07-01

    To assess the geographic distribution of Low Birth Weight (LBW) in New York State among singleton births using a spatial regression approach in order to identify priority areas for public health actions. LBW was defined as birth weight less than 2500g. Geocoded data from 562,586 birth certificates in New York State (years 2008-2012) were merged with 2010 census data at the tract level. To provide stable estimates and maintain confidentiality, data were aggregated to yield 1268 areas of analysis. LBW prevalence among singleton births was related with area-level behavioral, socioeconomic and demographic characteristics using a Poisson mixed effects spatial error regression model. Observed low birth weight showed statistically significant auto-correlation in our study area (Moran's I 0.16 p value 0.0005). After over-dispersion correction and accounting for fixed effects for selected social determinants, spatial autocorrelation was fully accounted for (Moran's I-0.007 p value 0.241). The proportion of LBW was higher in areas with larger Hispanic or Black populations and high smoking prevalence. Smoothed maps with predicted prevalence were developed to identify areas at high risk of LBW. Spatial patterns of residual variation were analyzed to identify unique risk factors. Neighborhood racial composition contributes to disparities in LBW prevalence beyond differences in behavioral and socioeconomic factors. Small-area analyses of LBW can identify areas for targeted interventions and display unique local patterns that should be accounted for in prevention strategies. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Mitigating construction safety risks using prevention through design.

    Science.gov (United States)

    Gangolells, Marta; Casals, Miquel; Forcada, Núria; Roca, Xavier; Fuertes, Alba

    2010-04-01

    Research and practice have demonstrated that decisions made prior to work at construction sites can influence construction worker safety. However, it has also been argued that most architects and design engineers possess neither the knowledge of construction safety nor the knowledge of construction processes necessary to effectively perform Construction Hazards Prevention through Design (CHPtD). This paper introduces a quantitative methodology that supports designers by providing a way to evaluate the safety-related performance of residential construction designs using a risk analysis-based approach. The methodology compares the overall safety risk level of various construction designs and ranks the significance of the various safety risks of each of these designs. The methodology also compares the absolute importance of a particular safety risk in various construction designs. Because the methodology identifies the relevance of each safety risk at a particular site prior to the construction stage, significant risks are highlighted in advance. Thus, a range of measures for mitigating safety risks can then be implemented during on-site construction. The methodology is specially worthwhile for designers, who can compare construction techniques and systems during the design phase and determine the corresponding level of safety risk without their creative talents being restricted. By using this methodology, construction companies can improve their on-site safety performance. Copyright 2010 Elsevier Ltd. All rights reserved.

  1. Injury risk is low among world-class volleyball players: 4-year data from the FIVB Injury Surveillance System.

    Science.gov (United States)

    Bere, Tone; Kruczynski, Jacek; Veintimilla, Nadège; Hamu, Yuichiro; Bahr, Roald

    2015-09-01

    Little is known about the rate and pattern of injuries in international volleyball competition. To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation (FIVB) Injury Surveillance System (ISS) (junior and senior, male and female). The FIVB ISS is based on prospective registration of injuries by team medical staff during all major FIVB tournaments (World Championships, World Cup, World Grand Prix, World League, Olympic Games). This paper is based on 4-year data (September 2010 to November 2014) obtained through the FIVB ISS during 32 major FIVB events (23 senior and 9 junior). The incidence of time-loss injuries during match play was 3.8/1000 player hours (95% CI 3.0 to 4.5); this was greater for senior players than for junior players (relative risk: 2.04, 1.29 to 3.21), while there was no difference between males and females (1.04, 0.70 to 1.55). Across all age and sex groups, the ankle was the most commonly injured body part (25.9%), followed by the knee (15.2%), fingers/thumb (10.7%) and lower back (8.9%). Injury incidence was greater for centre players and lower for liberos than for other player functions; injury patterns also differed between player functions. Volleyball is a very safe sport, even at the highest levels of play. Preventive measures should focus on acute ankle and finger sprains, and overuse injuries in the knee, lower back and shoulder. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Surveillance study of vector species on board passenger ships, Risk factors related to infestations

    Directory of Open Access Journals (Sweden)

    Hatzoglou Chrissi

    2008-03-01

    Full Text Available Abstract Background Passenger ships provide conditions suitable for the survival and growth of pest populations. Arthropods and rodents can gain access directly from the ships' open spaces, can be carried in shiploads, or can be found on humans or animals as ectoparasites. Vectors on board ships may contaminate stored foods, transmit illness on board, or, introduce diseases in new areas. Pest species, ship areas facilitating infestations, and different risk factors related to infestations were identified in 21 ferries. Methods 486 traps for insects and rodents were placed in 21 ferries. Archives of Public Health Authorities were reviewed to identify complaints regarding the presence of pest species on board ferries from 1994 to 2004. A detail questionnaire was used to collect data on ship characteristics and pest control practices. Results Eighteen ferries were infested with flies (85.7%, 11 with cockroaches (52.3%, three with bedbugs, and one with fleas. Other species had been found on board were ants, spiders, butterflies, beetles, and a lizard. A total of 431 Blattella germanica species were captured in 28 (9.96% traps, and 84.2% of them were nymphs. One ship was highly infested. Cockroach infestation was negatively associated with ferries in which Hazard Analysis Critical Control Point system was applied to ensure food safety on board (Relative Risk, RR = 0.23, p = 0.03, and positively associated with ferries in which cockroaches were observed by crew (RR = 4.09, p = 0.007, no cockroach monitoring log was kept (RR = 5.00, p = 0.02, and pesticide sprays for domestic use were applied by crew (RR = 4.00, p = 0.05. Cockroach infested ships had higher age (p = 0.03. Neither rats nor mice were found on any ship, but three ferries had been infested with a rodent in the past. Conclusion Integrated pest control programs should include continuing monitoring for a variety of pest species in different ship locations; pest control measures should be more

  3. The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals

    OpenAIRE

    Gärtner, Fania R; Ketelaar, Sarah M; Smeets, Odile; Bolier, Linda; Fischer, Eva; van Dijk, Frank JH; Nieuwenhuijsen, Karen; Sluiter, Judith K

    2011-01-01

    Abstract Background Employees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions are necessary. A Workers' Health Surveillance (WHS) mental module may be an effective strategy to monitor and promote good (mental) health and work performance. The objective o...

  4. Healthcare workers mobile phone usage: A potential risk for viral contamination. Surveillance pilot study.

    Science.gov (United States)

    Cavari, Yuval; Kaplan, Or; Zander, Aviva; Hazan, Guy; Shemer-Avni, Yonat; Borer, Abraham

    2016-01-01

    Mobile phones are commonly used by healthcare workers (HCW) in the working environment, as they allow instant communication and endless resource utilisation. Studies suggest that mobile phones have been implicated as reservoirs of bacterial pathogens, with the potential to cause nosocomial infection. This study aimed to investigate the presence of Respiratory Syncytial Virus, Adenovirus and Influenza Virus on HCWs mobile phones and to identify risk factors implied by HCWs practice of mobile phones in a clinical paediatric environment. Fifty HCWs' mobile phones were swabbed over both sides of the mobile phone, for testing of viral contamination during 8 days in January 2015. During the same period, a questionnaire investigating usage of mobile phones was given to 101 HCWs. Ten per cent of sampled phones were contaminated with viral pathogens tested for. A total of 91% of sampled individuals by questionnaire used their mobile phone within the workplace, where 37% used their phone at least every hour. Eighty-nine (88%) responders were aware that mobile phones could be a source of contamination, yet only 13 (13%) disinfect their cell phone regularly. Mobile phones in clinical practice may be contaminated with viral pathogenic viruses. HCWs use their mobile phone regularly while working and, although the majority are aware of contamination, they do not disinfect their phones.

  5. Surveillance for Certain Health Behaviors, Chronic Diseases, and Conditions, Access to Health Care, and Use of Preventive Health Services Among States and Selected Local Areas
- Behavioral Risk Factor Surveillance System, United States, 2012.

    Science.gov (United States)

    Chowdhury, Pranesh P; Mawokomatanda, Tebitha; Xu, Fang; Gamble, Sonya; Flegel, David; Pierannunzi, Carol; Garvin, William; Town, Machell

    2016-04-29

    Chronic diseases (e.g., heart diseases, cancer, chronic lower respiratory disease, stroke, diabetes, and arthritis) and unintentional injuries are the leading causes of morbidity and mortality in the United States. Behavioral risk factors (e.g., tobacco use, poor diet, physical inactivity, excessive alcohol consumption, failure to use seat belts, and insufficient sleep) are linked to the leading causes of death. Modifying these behavioral risk factors and using preventive health services (e.g., cancer screenings and influenza and pneumococcal vaccination of adults aged ≥65 years) can substantially reduce morbidity and mortality in the U.S. Continuous monitoring of these health-risk behaviors, chronic conditions, and use of preventive services are essential to the development of health promotion strategies, intervention programs, and health policies at the state, city, and county level. January-December 2012. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health-risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services related to the leading causes of death and disability. This report presents results for all 50 states, the District of Columbia, participating U.S. territories that include the Commonwealth of Puerto Rico (Puerto Rico) and Guam, 187 Metropolitan/Micropolitan Statistical Areas (MMSAs), and 210 counties (n = 475,687 survey respondents) for the year 2012. In 2012, the estimated prevalence of health-risk behaviors, chronic diseases or conditions, access to health care, and use of preventive health services substantially varied by state and territory, MMSA, and county. The following portion of the abstract lists a summary of results by selected BRFSS measures. Each set of proportions refers to the range of

  6. Co-variations and clustering of chronic disease behavioral risk factors in China: China Chronic Disease and Risk Factor Surveillance, 2007.

    Directory of Open Access Journals (Sweden)

    Yichong Li

    Full Text Available BACKGROUND: Chronic diseases have become the leading causes of mortality in China and related behavioral risk factors (BRFs changed dramatically in past decades. We aimed to examine the prevalence, co-variations, clustering and the independent correlates of five BRFs at the national level. METHODOLOGY/PRINCIPAL FINDINGS: We used data from the 2007 China Chronic Disease and Risk Factor Surveillance, in which multistage clustering sampling was adopted to collect a nationally representative sample of 49,247 Chinese aged 15 to 69 years. We estimated the prevalence and clustering (mean number of BRFs of five BRFs: tobacco use, excessive alcohol drinking, insufficient intake of vegetable and fruit, physical inactivity, and overweight or obesity. We conducted binary logistic regression models to examine the co-variations among five BRFs with adjustment of demographic and socioeconomic factors, chronic conditions and other BRFs. Ordinal logistic regression was constructed to investigate the independent associations between each covariate and the clustering of BRFs within individuals. Overall, 57.0% of Chinese population had at least two BRFs and the mean number of BRFs is 1.80 (95% confidence interval: 1.78-1.83. Eight of the ten pairs of bivariate associations between the five BRFs were found statistically significant. Chinese with older age, being a male, living in rural areas, having lower education level and lower yearly household income experienced increased likelihood of having more BRFs. CONCLUSIONS/SIGNIFICANCE: Current BRFs place the majority of Chinese aged 15 to 69 years at risk for the future development of chronic disease, which calls for urgent public health programs to reduce these risk factors. Prominent correlations between BRFs imply that a combined package of interventions targeting multiple BRFs might be appropriate. These interventions should target elder population, men, and rural residents, especially those with lower SES.

  7. The systems engineering design of a smart Forward Operating Base surveillance system for forward operating base protection

    OpenAIRE

    Craft, Timothy L.

    2013-01-01

    Approved for public release; distribution is unlimited Forward operating bases are vulnerable to terrorist activity due to their location and limited resources. Threat awareness under these conditions is paramount to the safety of the personnel and to mission accomplishment. In the absence of the manpower required to maintain complete and continuous monitoring of the FOBs surroundings, an automated surveillance system is needed. The Smart FOB Surveillance System (SFSS) employs a multi-agen...

  8. Tornado risk model for transmission line design

    CSIR Research Space (South Africa)

    Milford, RV

    1997-11-01

    Full Text Available is in combination with ice loading. The wind load used in most codes of practice and design recommendations for transmission line design have until recently been based almost exclusively on large-scale wind storms, which may include severe storms such as hurricanes...

  9. Designing cellular manufacturing system under risk conditions ...

    African Journals Online (AJOL)

    This paper develops a mathematical modeling to design a cellular manufacturing system. In addition some of the total or portion of the demand of the part types can be subcontracted.. In order to designing the optimal CMS, we needs to detrmined a plan to produce and subcontract parts at a minimum cost and to mitigate the ...

  10. Designing a flood-risk education program in the Netherlands

    NARCIS (Netherlands)

    Bosschaert, A.; van der Schee, J.; Kuiper, W.

    2016-01-01

    This study focused on designing a flood-risk education program to enhance 15-year-old students’ flood-risk perception. In the flood-risk education program, learning processes were modeled in such a way that the arousal of moderate levels of fear should prompt experiential and analytical information

  11. Prospective multicenter surveillance and risk factor analysis of deep surgical site infection after posterior thoracic and/or lumbar spinal surgery in adults.

    Science.gov (United States)

    Ogihara, Satoshi; Yamazaki, Takashi; Maruyama, Toru; Oka, Hiroyuki; Miyoshi, Kota; Azuma, Seiichi; Yamada, Takashi; Murakami, Motoaki; Kawamura, Naohiro; Hara, Nobuhiro; Terayama, Sei; Morii, Jiro; Kato, So; Tanaka, Sakae

    2015-01-01

    Surgical site infection is a serious and significant complication after spinal surgery and is associated with high morbidity rates, high healthcare costs and poor patient outcomes. Accurate identification of risk factors is essential for developing strategies to prevent devastating infections. The purpose of this study was to identify independent risk factors for surgical site infection among posterior thoracic and/or lumbar spinal surgery in adult patients using a prospective multicenter surveillance research method. From July 2010 to June 2012, we performed a prospective surveillance study in adult patients who had developed surgical site infection after undergoing thoracic and/or lumbar posterior spinal surgery at 11 participating hospitals. Detailed preoperative and operative patient characteristics were prospectively recorded using a standardized data collection format. Surgical site infection was based on the definition established by the Centers for Disease Control and Prevention. A total of 2,736 consecutive adult patients were enrolled, of which 24 (0.9%) developed postoperative deep surgical site infection. Multivariate regression analysis indicated four independent risk factors. Preoperative steroid therapy (P = 0.001), spinal trauma (P = 0.048) and gender (male) (P = 0.02) were statistically significant independent patient-related risk factors, whereas an operating time ≥3 h (P operating time ≥3 h were independent risk factors for deep surgical site infection after thoracic and/or lumbar spinal surgery in adult patients. Identification of these risk factors can be used to develop protocols aimed at decreasing the risk of surgical site infection.

  12. Problems and prospects for maintaining the register of sanitary and epidemiological objects of surveillance for the tasks of the transition to risk-oriented model of activity

    Directory of Open Access Journals (Sweden)

    N.V. Zaitseva

    2015-03-01

    Full Text Available The article describes the approaches to the formation of regional databases of the objects of sanitary-epidemiological surveillance for the tasks of sequential evaluation of each object having the potential risk to the citizens of the affected areas of these objects, e.g. workers, consumers of products or services. The basic structure of the information system is demonstrated. The system is oriented to be used together with the DBMS MS Access. The system performs the manual quiding function for the register and implements the calculation algorithm of the health risk indicators and classification of the objects of surveillance. Approaches to the formation of the system have been tested in Perm, Lipetsk, Kaluga, Omsk regions as part of a pilot project of the Federal Service on Surveillance for Consumer rights protection and human well-being. The problems of the registers’ formation are in the fact of scares operational entering of the significant amount of information, that has been accumulated in Administration offices of Rospotrebnadzor, but do not exist in the form of electronic databases. The relevant issue is the development of guidance documents to ensure unified approaches to the registers’ formation and risk calculation in relation to population census under the influence of various activities.

  13. Introduction to surveillance studies

    CERN Document Server

    Petersen, JK

    2012-01-01

    Introduction & OverviewIntroduction Brief History of Surveillance Technologies & TechniquesOptical SurveillanceAerial Surveillance Audio Surveillance Radio-Wave SurveillanceGlobal Positioning Systems Sensors Computers & the Internet Data Cards Biochemical Surveillance Animal Surveillance Biometrics Genetics Practical ConsiderationsPrevalence of Surveillance Effectiveness of Surveillance Freedom & Privacy IssuesConstitutional Freedoms Privacy Safeguards & Intrusions ResourcesReferences Glossary Index

  14. Systèmes de surveillance de la fièvre jaune en Afrique : rôle des centres OMS et place de la surveillance entomologique

    OpenAIRE

    Thonnon, J.; Mathiot, C.; Fontenille, Didier

    1998-01-01

    WHO Collaborating Centers, or (by default) designated national laboratories, intervene at two levels in the surveillance of yellow fever : (1) upstream, through knowledge and analysis of risk factors linked to vectors and populations, including : collection of entomological data (surveillance of the sylvatic cycle, Kédougou, Senegal), measuring the risk of an outbreak in urban areas (quantity of larvae of #Aedes aegypti$), measuring the national immunity to yellow fever among human population...

  15. MRI and mammography surveillance of women at increased risk for breast cancer: recommendations using an evidence-based approach.

    Science.gov (United States)

    Granader, Elon J; Dwamena, Ben; Carlos, Ruth C

    2008-12-01

    To evaluate breast cancer screening with mammography and magnetic resonance imaging (MRI) in high-risk populations, including women with the BRCA mutation, using an evidence-based approach. The MEDLINE, PubMed, EBM Reviews, ACP Journal Club, Cochrane Database MEDSEARCH, and SCOPUS databases were accessed and searched for articles up to August 2007. Articles were collected using the following terms and medical subject headings (MeSH) that applied to the focused clinical question: "BRCA1" and "BRCA2" with "mammography," "MRI," "prevention," "screening," and "surveillance." References from retrieved articles were also used to identify relevant papers. Abstracts were screened and relevant papers retrieved. Retrieved papers were graded for quality. Summary performance measures were obtained by random effects modeling of study-specific performance estimates and standard errors derived from the multiple 2 x 2 tables. Additionally, studies meeting the Centre for Evidence-Based Medicine level 2b quality were reviewed. In women with an increased risk without the BRCA gene, cancer detection rates by MRI were 0.011 (95% confidence interval [CI] 0.003-0.019), by mammography 0.005 (95% CI 0.002-0.008), and by a combination of both, 0.012 (95% CI 0.004-0.020). False-positive rates by MRI, mammography, or a combination of both were 0.10 (95% CI 0.03-0.18), 0.05 (95% CI 0.03-0.06), and 0.14 (95% CI 0.04-0.24). In BRCA positive women, cancer detection rates by MRI were 0.027 (95% CI 0.015-0.040), by mammography 0.010 (95% CI 0.005-0.016), and by a combination of both 0.031 (95% CI 0.018-0.045). False-positive rates by MRI, mammography, or a combination of both were 0.10 (95% CI 0.01-0.19), 0.05 (95% CI 0.03-0.07), and 0.14 (95% CI 0.04-0.24), respectively. The data support an essential role for screening MRI in women with an increased risk for breast cancer.

  16. Prostate MRI findings in patients treated for testosterone deficiency while on active surveillance for low-risk prostate cancer

    Science.gov (United States)

    Hashimoto, Takeshi; Rahul, Krishnan; Takeda, Toshikazu; Benfante, Nicole; Mulhall, John P.; Hricak, Hedvig; Eastham, James A.; Vargas, Hebert Alberto

    2017-01-01

    Objective To investigate the multiparametric prostate magnetic resonance imaging (mpMRI) findings in patients treated with testosterone replacement therapy (TRT) while on active surveillance (AS) for low-risk prostate cancer. Methods We retrospectively reviewed 12 patients who underwent mpMRI before and after TRT while on AS. Changes in serum testosterone level, prostate specific antigen (PSA), prostate biopsy findings, prostate volume and Prostate Imaging Reporting and Data System Version 2 (PI-RADSv2) score before and after TRT were summarized. Results Following TRT, there was a significant increase in serum testosterone (516.5 ng/dl vs. 203.0 ng/dl), PSA (4.2 ng/ml vs. 3.3 ng/ml) and prostate volume (55.2 cm3 vs. 39.4 cm3). Two patients had biopsy progression during the study periods. The PI-RADSv2 scores before and after TRT were unchanged in 10/12 patients; none of these demonstrated biopsy progression on post TRT. The PI-RADSv2 scores increased after TRT in 2/12 patients; both showed Gleason score upgrade on follow-up biopsy. One of these two patients underwent radical treatment due to clinical progression. The area under the curve calculated from PI-RADSv2 score after TRT was 0.90, which was better than that calculated from post TRT PSA level (0.48). Conclusions After TRT, mpMRI findings remained stable in patients without biopsy progression, while PI-RADSv2 score increase was identified in patients with Gleason score upgrade on follow-up biopsy. PMID:27665357

  17. Trends and Predictors of Participation in Cardiac Rehabilitation Following Acute Myocardial Infarction: Data From the Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Peters, Anthony E; Keeley, Ellen C

    2017-12-29

    Participation in cardiac rehabilitation (CR) after acute myocardial infarction has been proven to significantly reduce morbidity and mortality. Historically, participation rates have been low, and although recent efforts have increased referral rates, current data on CR participation are limited. Utilizing data from the Behavioral Risk Factor Surveillance System conducted by Centers for Disease Control and Prevention, we performed a population-based, cross-sectional analysis of CR post-acute myocardial infarction. Unadjusted participation from 2005 to 2015 was evaluated by univariable logistic regression. Multivariable logistic regression was performed with patient characteristic variables to determine adjusted trends and associations with participation in CR in more recent years from 2011 to 2015. Among the 32 792 survey respondents between 2005 and 2015, participation ranged from 35% in 2005 to 39% in 2009 ( P =0.005) and from 38% in 2011 to 32% in 2015 ( P =0.066). Between 2011 and 2015, participants were less likely to be female (odds ratio [OR] 0.763, 95% confidence interval [CI] 0.646-0.903), black (OR 0.700, 95% CI 0.526-0.931), uninsured (OR 0.528, 95% CI 0.372-0.751), less educated (OR 0.471, 95% CI 0.367-0.605), current smokers (OR 0.758, 95% CI 0.576-0.999), and were more likely to be retired or self-employed (OR 1.393, 95% CI 1.124-1.726). Only one third of patients participate in CR following acute myocardial infarction despite the known health benefits. Participants are less likely to be female, black, and uneducated. Future studies should focus on methods to maximize the proportion of CR referrals converted into CR participation. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  18. Autonomous Military Robotics: Risk, Ethics, and Design

    Science.gov (United States)

    2008-12-20

    close scrutiny of the robotics industry with respect to those ethical issues, e.g., the book Love and Sex with Robots published late last year that...thank and credit Wendell Wallach and Colin Allen for their contribution to many of the discussions here, drawn from their new book Moral Machines... secondhand smoke is more objectionable than firsthand, because the passive smoker did not consent to the risk even if ▌64 A u t o n o m o

  19. Surveillance Culture

    DEFF Research Database (Denmark)

    2017-01-01

    What does it mean to live in a world full of surveillance? In this documentary film, we take a look at everyday life in Denmark and how surveillance technologies and practices influence our norms and social behaviour. Researched and directed by Btihaj Ajana and Anders Albrechtslund....

  20. Recognizing Risk-of-Failure in Communication Design Projects

    Science.gov (United States)

    Yee, Joyce; Lievesley, Matthew; Taylor, Louise

    2009-01-01

    The pace of commercial graphic design practice presents very few opportunities to conduct user research after a project's launch. This makes the design team's ability to anticipate and address risks during the design development phase even more important, recognized in the astute observation from Tim Brown, CEO of leading international design…

  1. Food insecurity and self-reported hypertension among Hispanic, black, and white adults in 12 states, Behavioral Risk Factor Surveillance System, 2009.

    Science.gov (United States)

    Irving, Shalon M; Njai, Rashid S; Siegel, Paul Z

    2014-09-18

    Food insecurity is positively linked to risk of hypertension; however, it is not known whether this relationship persists after adjustment for socioeconomic position (SEP). We examined the association between food insecurity and self-reported hypertension among adults aged 35 or older (N = 58,677) in 12 states that asked the food insecurity question in their 2009 Behavioral Risk Factor Surveillance System questionnaire. After adjusting for SEP, hypertension was more common among adults reporting food insecurity (adjusted prevalence ratio, 1.27; 95% confidence interval, 1.19-1.36). Our study found a positive relationship between food insecurity and hypertension after adjusting for SEP and other characteristics.

  2. A Holistic Approach for Risk Management During Design

    Science.gov (United States)

    Meshkat, Leila

    2006-01-01

    In this paper, an approach for the identification, assessment, mitigation and continuous management of risks during the process of designing a space mission is presented. This approach has been developed by observing the risk patterns that occur at the Project Design Center of the Jet Propulsion Laboratory (TeamX) which develops conceptual, concurrent design of Space Missions. TeamX develops an end-to-end conceptual design of a Space Mission in a matter of one or two weeks. As the risk chair in TeamX, the author has had the opportunity to observe the risk patterns that occur during design over the course of many design sessions. This paper introduces an abstraction and generalization of those patterns. Risk is defined as anything that can go wrong, along with its approximate likelihood and consequence. The indicators, and causes, and effects of these risks are cross cutting across the multiple levels of people and processes involved in the design, and the actual design product itself.

  3. Monitoring the introduction of pneumococcal conjugate vaccines into West Africa: design and implementation of a population-based surveillance system.

    Directory of Open Access Journals (Sweden)

    Grant A Mackenzie

    2012-01-01

    Full Text Available Routine use of pneumococcal conjugate vaccines (PCVs in developing countries is expected to lead to a significant reduction in childhood deaths. However, PCVs have been associated with replacement disease with non-vaccine serotypes. We established a population-based surveillance system to document the direct and indirect impact of PCVs on the incidence of invasive pneumococcal disease (IPD and radiological pneumonia in those aged 2 months and older in The Gambia, and to monitor changes in serotype-specific IPD. Here we describe how this surveillance system was set up and is being operated as a partnership between the Medical Research Council Unit and the Gambian Government. This surveillance system is expected to provide crucial information for immunisation policy and serves as a potential model for those introducing routine PCV vaccination in diverse settings.

  4. Incidence of surgical-site infections and the validity of the National Nosocomial Infections Surveillance System risk index in a general surgical ward in Santa Cruz, Bolivia.

    Science.gov (United States)

    Soleto, Lorena; Pirard, Marianne; Boelaert, Marleen; Peredo, Remberto; Vargas, Reinerio; Gianella, Alberto; Van der Stuyft, Patrick

    2003-01-01

    To estimate the frequency of and risk factors for surgical-site infections (SSIs) in Bolivia, and to study the performance of the National Nosocomial Infections Surveillance (NNIS) System risk index in a developing country. A prospective study with patient follow-up until the 30th postoperative day. A general surgical ward of a public hospital in Santa Cruz, Bolivia. Patients admitted to the ward between July 1998 and June 1999 on whom surgical procedures were performed. Follow-up was complete for 91.5% of 376 surgical procedures. The overall SSI rate was 12%. Thirty-four (75.6%) of the 45 SSIs were culture positive. A logistic regression model retained an American Society of Anesthesiologists score of more than 1 (odds ratio [OR], 1.87), a not-clean wound class (OR, 2.28), a procedure duration of more than 1 hour (OR, 1.81), and drain (OR, 1.98) as independent risk factors for SSI. There was no significant association between the NNIS System risk index and SSI rates. However, a "local" risk index constructed with the above cutoff points showed a linear trend with SSI (P < .001) and a relative risk of 3.18 for risk class 3 versus a class of less than 3. SSIs cause considerable morbidity in Santa Cruz. Appropriate nosocomial infection surveillance and control should be introduced. The NNIS System risk index did not discriminate between patients at low and high risk for SSI in this hospital setting, but a risk score based on local cutoff points performed substantially better.

  5. Electricity market design and risk management

    International Nuclear Information System (INIS)

    Boschi, Federico; Cervigni, Guido

    2005-01-01

    We show that each wholesale electricity market design trades-off between efficiency and liquidity. Efficiency requires that the product traded in the wholesale market closely reflect the physical features of electricity. Liquidity requires standardization of the products that ore traded on the wholesale market. We stress that Iiquidity comes at a cost since an excessive degree of standardization may lead to significant inefficiencies and forge wealth transfers among market participants [it

  6. Risk-informed design of IRIS using a level-1 probabilistic risk assessment from its conceptual design phase

    International Nuclear Information System (INIS)

    Mizuno, Yuko; Ninokata, Hisashi; Finnicum, David J.

    2005-01-01

    In this study, a probabilistic risk assessment (PRA) for the International Reactor Innovative and Secure (IRIS) has been generated to address two key areas as a part of the effort for the pre-application licensing of the IRIS design. First, the IRIS PRA is supporting the evaluation of IRIS design by providing design insights as well as a solid risk basis for the pre-licensing evaluation of the IRIS design. Second, the current PRA task is beginning the preparation of the more complete PRA analyses and documentation that will be required for Design Certification. The initial IRIS PRA is an at-power, Level-1 PRA for internal events that focuses on the evaluation of the IRIS design features to support the risk-informed design of IRIS by application of the PRA insights and the risk information to the design. To accomplish the evaluation, a reasonably complete Level-1 PRA model has been developed. The use of PRA in the early stages of the design has allowed a selection of design and performance features and an optimization of the design of several systems to reduce the potential for events that could lead to core damage via both enhanced prevention and mitigation of challenges. As a result, the total core damage frequency for internal events for the IRIS design has been calculated as 1.2x10 -8 per year

  7. Distributed data processing for public health surveillance

    Directory of Open Access Journals (Sweden)

    Yih Katherine

    2006-09-01

    Full Text Available Abstract Background Many systems for routine public health surveillance rely on centralized collection of potentially identifiable, individual, identifiable personal health information (PHI records. Although individual, identifiable patient records are essential for conditions for which there is mandated reporting, such as tuberculosis or sexually transmitted diseases, they are not routinely required for effective syndromic surveillance. Public concern about the routine collection of large quantities of PHI to support non-traditional public health functions may make alternative surveillance methods that do not rely on centralized identifiable PHI databases increasingly desirable. Methods The National Bioterrorism Syndromic Surveillance Demonstration Program (NDP is an example of one alternative model. All PHI in this system is initially processed within the secured infrastructure of the health care provider that collects and holds the data, using uniform software distributed and supported by the NDP. Only highly aggregated count data is transferred to the datacenter for statistical processing and display. Results Detailed, patient level information is readily available to the health care provider to elucidate signals observed in the aggregated data, or for ad hoc queries. We briefly describe the benefits and disadvantages associated with this distributed processing model for routine automated syndromic surveillance. Conclusion For well-defined surveillance requirements, the model can be successfully deployed with very low risk of inadvertent disclosure of PHI – a feature that may make participation in surveillance systems more feasible for organizations and more appealing to the individuals whose PHI they hold. It is possible to design and implement distributed systems to support non-routine public health needs if required.

  8. Active animal health surveillance in European Union Member States: gaps and opportunities.

    Science.gov (United States)

    Bisdorff, B; Schauer, B; Taylor, N; Rodríguez-Prieto, V; Comin, A; Brouwer, A; Dórea, F; Drewe, J; Hoinville, L; Lindberg, A; Martinez Avilés, M; Martínez-López, B; Peyre, M; Pinto Ferreira, J; Rushton, J; VAN Schaik, G; Stärk, K D C; Staubach, C; Vicente-Rubiano, M; Witteveen, G; Pfeiffer, D; Häsler, B

    2017-03-01

    Animal health surveillance enables the detection and control of animal diseases including zoonoses. Under the EU-FP7 project RISKSUR, a survey was conducted in 11 EU Member States and Switzerland to describe active surveillance components in 2011 managed by the public or private sector and identify gaps and opportunities. Information was collected about hazard, target population, geographical focus, legal obligation, management, surveillance design, risk-based sampling, and multi-hazard surveillance. Two countries were excluded due to incompleteness of data. Most of the 664 components targeted cattle (26·7%), pigs (17·5%) or poultry (16·0%). The most common surveillance objectives were demonstrating freedom from disease (43·8%) and case detection (26·8%). Over half of components applied risk-based sampling (57·1%), but mainly focused on a single population stratum (targeted risk-based) rather than differentiating between risk levels of different strata (stratified risk-based). About a third of components were multi-hazard (37·3%). Both risk-based sampling and multi-hazard surveillance were used more frequently in privately funded components. The study identified several gaps (e.g. lack of systematic documentation, inconsistent application of terminology) and opportunities (e.g. stratified risk-based sampling). The greater flexibility provided by the new EU Animal Health Law means that systematic evaluation of surveillance alternatives will be required to optimize cost-effectiveness.

  9. Methodology for Designing Operational Banking Risks Monitoring System

    Science.gov (United States)

    Kostjunina, T. N.

    2018-05-01

    The research looks at principles of designing an information system for monitoring operational banking risks. A proposed design methodology enables one to automate processes of collecting data on information security incidents in the banking network, serving as the basis for an integrated approach to the creation of an operational risk management system. The system can operate remotely ensuring tracking and forecasting of various operational events in the bank network. A structure of a content management system is described.

  10. Risk based rulemaking and design - Proceed with caution

    DEFF Research Database (Denmark)

    Zachariadis, Panos; Psaraftis, Harilaos N.; Kontovas, Christos A.

    2007-01-01

    The trend towards a risk based regulatory framework at IMO and within classification societies is expanding while some voices claim that a full ship risk based scantlings design approach can be immediately implementable. This paper attempts to clarify some widely used, but confusing to many, noti...

  11. Inherent risk and organisational design in European tort law

    NARCIS (Netherlands)

    W.H. van Boom (Willem)

    2009-01-01

    textabstractThis paper is devoted to a complex set of issues relating to the functions of tort law in distinguishing acceptable and unacceptable risks. Often, such risks are brought about by deliberate organisational design choice. On many occasions, legislators and courts are called upon to assess

  12. Surveillance Pleasures

    DEFF Research Database (Denmark)

    Albrechtslund, Anders

    The notorious intensification and digitalization of surveillance technologies and practices in today’s society has brought about numerous changes. These changes have been widely noticed, described and discussed across many academic disciplines. However, the contexts of entertainment, play...

  13. ANALYSIS OF LEGAL AND METHODOLOGICAL GROUNDS FOR RISK-ORIENTED SURVEILLANCE OVER CONSUMER PRODUCTS: TASKS AND DEVELOPMENT PROSPECTS IN THE EURASIAN ECONOMIC UNION

    Directory of Open Access Journals (Sweden)

    N.V. Zaitseva

    2017-12-01

    Full Text Available The paper dwells on basic legal and sub-legislative documents issued in the EU, the USA, Canada, by the WTO and Codex Alimentarius Commission which provide control of consumer products safety on the basis of assessing risks for consumers' life and health. Risk-oriented surveillance is shown as a system which makes for lower loads on business but still provides systemic control over most hazardous products. The EU legislation fixes the right to perform supranational control over state control systems existing in the EU member states in terms of their relevance and legitimacy. This supranational control is supported by organizational structures and regulatory and methodological documents. National control systems are systematically reviewed and analyzed in order to secure their conformity to supranational regulatory acts, to detect any cases of non-compliance, and to spread the best practices. Risk analysis reviews and results are open and discussable. As a result of products hazards assessment their turnover can be limited, or they can be withdrawn from the market, or additional information on hazards or risks they may cause is to be provided for consumers. Public and constantly operating systems of informing about hazardous goods are well-developed. International experience and practices in the sphere of risk-oriented surveillance over consumer products can be and should be applied in the Eurasian Economic Union (EEU countries. The Eurasian Economic Union countries fix orientation at observing consumer goods safety principles in their legislation. There are also legal grounds for and practices in the sphere of risk-oriented approach to products manufactures. But it is necessary to further develop a products classification system as per consumer health risk parameters. And this task requires working out unified approaches to classification of both eatable and non-eatable products. It seems relevant to develop a public analytical database of risk

  14. Study on risk factors of PWR accidents beyond design basis

    International Nuclear Information System (INIS)

    Ahn, Seung Hoon; Nah, W. J.; Bang, Y. S.; Oh, D. Y.; Oh, S. H.

    2005-01-01

    Development of the regulatory guidelines for Beyond Design Basis Accidents (BDBA) with high risk requires a detailed investigation of major factors contributing to the event risk. In this study, each event was classified by the level of risk, based on the probabilistic safety assessment results, so that BDBA with high risk could be selected, with consideration of foreign and domestic regulations, and operating experiences. The regulatory requirements and technical backgrounds for the selected accidents were investigated, and effective regulatory approaches for risk reduction of the accidents. The following conclusions were drawn from this study: - Selected high risk BDBA is station blackout, anticipated without scram, total loss of feedwater. - Major contributors to the risk of selected events were investigated, and appropriate assessment of them was recommended for development of the regulatory guidelines

  15. Trends and risk factors of hyperglycemia and diabetes among Kuwaiti adults: National Nutrition Surveillance Data from 2002 to 2009

    Directory of Open Access Journals (Sweden)

    Ahmed Faruk

    2013-02-01

    Full Text Available Abstract Background Current prevalence estimates for diabetes in Arabian Gulf countries are some of the world’s highest, yet regional trends and contributing factors are poorly documented. The present study was designed to determine temporal changes in the prevalence of impaired fasting glucose (IFG and diabetes and associated factors in Kuwaiti adults. Methods Data analysis from the nationally representative cross-sectional Kuwait National Nutrition Surveillance System. 2745 males and 3611 females, aged 20–69 years, attending registration for employment or pensions and Hajj Pilgrimage health check-ups or accompanying children for immunizations from 2002 through 2009 were participated. Socio-demographic and lifestyle information, height and weight, and blood samples were collected. Results During the 8 years (2002–09, prevalences of IFG in males and females decreased by 7.4% and 6.8% and of diabetes by 9.8% and 8.9% in males and females, respectively. Linear regression for blood glucose level with time, adjusted for age, BMI, blood cholesterol and education level, showed a greater decrease in males than females (1.12 vs 0.93 mmol/L; males also showed an increase in 2002–2003 followed by a marked decrease in 2006–2007 while females showed a significant decrease in 2008–2009. Both males and females showed the largest decrease in the 2nd half of the study accounting for the majority of the overall decrease (1.13 mmol/L for males and 0.87 mmol/l for females for the 4 years. Compared with 2002–03, the OR for IFG in males decreased with time, and becoming significantly lower (OR=0.32; 95% CI: 0.21-0.49 for 2008–09. In females, the OR for IFG decreased significantly with time, except in 2006–07. Similarly, the OR for diabetes in males decreased to 0.34 (95% CI: 0.24-0.49 and in females to 0.33 (95% CI: 0.22-0.50 in 2008–09. For both genders, age and BMI were independently positively associated with IFG and diabetes, while education

  16. Recommendations on the use and design of risk matrices

    DEFF Research Database (Denmark)

    Duijm, Nijs Jan

    2015-01-01

    of the risk matrix. The objective of this paper is to explore these weaknesses, and provide recommendations for the use and design of risk matrices. The paper reviews the few relevant publications and adds some observations of its own in order to emphasize existing recommendations and add some suggestions...... of its own. The recommendations cover a range of issues, among them: the relation between coloring the risk matrix and the definition of risk and major hazard aversion; the qualitative, subjective assessment of likelihood and consequence; the scaling of the discrete likelihood and consequence categories...

  17. Development of a self-report questionnaire designed for population-based surveillance of gingivitis in adolescents: assessment of content validity and reliability

    Science.gov (United States)

    QUIROZ, Viviana; REINERO, Daniela; HERNÁNDEZ, Patricia; CONTRERAS, Johanna; VERNAL, Rolando; CARVAJAL, Paola

    2017-01-01

    Abstract The major infectious diseases in Chile encompass the periodontal diseases, with a combined prevalence that rises up to 90% of the population. Thus, the population-based surveillance of periodontal diseases plays a central role for assessing their prevalence and for planning, implementing, and evaluating preventive and control programs. Self-report questionnaires have been proposed for the surveillance of periodontal diseases in adult populations world-wide. Objective This study aimed to develop and assess the content validity and reliability of a cognitively adapted self-report questionnaire designed for surveillance of gingivitis in adolescents. Material and Methods Ten predetermined self-report questions evaluating early signs and symptoms of gingivitis were preliminary assessed by a panel of clinical experts. Eight questions were selected and cognitively tested in 20 adolescents aged 12 to 18 years from Santiago de Chile. The questionnaire was then conducted and answered by 178 Chilean adolescents. Internal consistency was measured using the Cronbach’s alpha and temporal stability was calculated using the Kappa-index. Results A reliable final self-report questionnaire consisting of 5 questions was obtained, with a total Cronbach’s alpha of 0.73 and a Kappa-index ranging from 0.41 to 0.77 between the different questions. Conclusions The proposed questionnaire is reliable, with an acceptable internal consistency and a temporal stability from moderate to substantial, and it is promising for estimating the prevalence of gingivitis in adolescents. PMID:28877279

  18. Development of a self-report questionnaire designed for population-based surveillance of gingivitis in adolescents: assessment of content validity and reliability

    Directory of Open Access Journals (Sweden)

    Viviana QUIROZ

    Full Text Available Abstract The major infectious diseases in Chile encompass the periodontal diseases, with a combined prevalence that rises up to 90% of the population. Thus, the population-based surveillance of periodontal diseases plays a central role for assessing their prevalence and for planning, implementing, and evaluating preventive and control programs. Self-report questionnaires have been proposed for the surveillance of periodontal diseases in adult populations world-wide. Objective This study aimed to develop and assess the content validity and reliability of a cognitively adapted self-report questionnaire designed for surveillance of gingivitis in adolescents. Material and Methods Ten predetermined self-report questions evaluating early signs and symptoms of gingivitis were preliminary assessed by a panel of clinical experts. Eight questions were selected and cognitively tested in 20 adolescents aged 12 to 18 years from Santiago de Chile. The questionnaire was then conducted and answered by 178 Chilean adolescents. Internal consistency was measured using the Cronbach’s alpha and temporal stability was calculated using the Kappa-index. Results A reliable final self-report questionnaire consisting of 5 questions was obtained, with a total Cronbach’s alpha of 0.73 and a Kappa-index ranging from 0.41 to 0.77 between the different questions. Conclusions The proposed questionnaire is reliable, with an acceptable internal consistency and a temporal stability from moderate to substantial, and it is promising for estimating the prevalence of gingivitis in adolescents.

  19. Risk-informed design of a pebble bed gas reactor

    International Nuclear Information System (INIS)

    Ritterbusch, Stanley; Dimitrijevic, Vesna; Simic Zdenko; Savkina Marina

    2003-01-01

    One of the major challenges to the successful deployment of new nuclear plants in the United States is the regulatory process, which is largely based on water-reactor design technology and operating experience. While ongoing and expected efforts to license new LWR designs are based primarily on current regulations, guidance, and past experience, the pre-application review of the gas-cooled Pebble Bed Modular Reactor (PBMR) has shown that efforts are being made to provide additional 'risk-informed' improvements to the licensing process. These improvements are aimed at resolving new design and regulatory issues using a plant-wide integrated evaluation method - state-of-the-art Probabilistic Risk Assessment - which addresses all significant design features and operating modes. The integrated PRA evaluation is supported by the usual deterministic design analyses, engineering judgments, and margins added to address uncertainties (i.e., defense-in-depth). The work performed for this paper was completed as part of the United States Department of Energy's Nuclear Energy Research Initiative. The purpose of this particular project was to develop the methods for a new 'highly risk-informed' design and regulatory process. In this work. PRA techniques were applied in order to provide an integrated and systematic analysis of the plant design, to quantify uncertainties and explicitly account for defense-in-depth features. This work concentrates on the application of the risk-informed principles to a new plant design such as the PBMR. The implementation example completed for this project included specification of the design configuration, use of the PRA to evaluate the design, and iterations to identify design changes that improve the overall level of safety and system reliability. This paper summarizes the new 'highly risk-informed' design process, the design of the PBMR, and the results obtained. These results, consistent with the known inherent safety features of a pebble

  20. Secure Video Surveillance System (SVSS) for unannounced safeguards inspections

    International Nuclear Information System (INIS)

    Galdoz, Erwin G.; Pinkalla, Mark

    2010-01-01

    The Secure Video Surveillance System (SVSS) is a collaborative effort between the U.S. Department of Energy (DOE), Sandia National Laboratories (SNL), and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC). The joint project addresses specific requirements of redundant surveillance systems installed in two South American nuclear facilities as a tool to support unannounced inspections conducted by ABACC and the International Atomic Energy Agency (IAEA). The surveillance covers the critical time (as much as a few hours) between the notification of an inspection and the access of inspectors to the location in facility where surveillance equipment is installed. ABACC and the IAEA currently use the EURATOM Multiple Optical Surveillance System (EMOSS). This outdated system is no longer available or supported by the manufacturer. The current EMOSS system has met the project objective; however, the lack of available replacement parts and system support has made this system unsustainable and has increased the risk of an inoperable system. A new system that utilizes current technology and is maintainable is required to replace the aging EMOSS system. ABACC intends to replace one of the existing ABACC EMOSS systems by the Secure Video Surveillance System. SVSS utilizes commercial off-the shelf (COTS) technologies for all individual components. Sandia National Laboratories supported the system design for SVSS to meet Safeguards requirements, i.e. tamper indication, data authentication, etc. The SVSS consists of two video surveillance cameras linked securely to a data collection unit. The collection unit is capable of retaining historical surveillance data for at least three hours with picture intervals as short as 1sec. Images in .jpg format are available to inspectors using various software review tools. SNL has delivered two SVSS systems for test and evaluation at the ABACC Safeguards Laboratory. An additional 'proto-type' system remains

  1. The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals.

    Science.gov (United States)

    Gärtner, Fania R; Ketelaar, Sarah M; Smeets, Odile; Bolier, Linda; Fischer, Eva; van Dijk, Frank J H; Nieuwenhuijsen, Karen; Sluiter, Judith K

    2011-05-10

    Employees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions are necessary. A Workers' Health Surveillance (WHS) mental module may be an effective strategy to monitor and promote good (mental) health and work performance. The objective of this paper is to describe the design of a three arm cluster randomized controlled trial on the effectiveness of a WHS mental module for nurses and allied health professionals. Two strategies for this WHS mental module will be compared along with data from a control group. Additionally, the cost effectiveness of the approaches will be evaluated from a societal perspective. The study is designed as a cluster randomized controlled trial consisting of three arms (two intervention groups, 1 control group) with randomization at ward level. The study population consists of 86 departments in one Dutch academic medical center with a total of 1731 nurses and allied health professionals. At baseline, after three months and after six months of follow-up, outcomes will be assessed by online questionnaires. In both intervention arms, participants will complete a screening to detect problems in mental health and work functioning and receive feedback on their screening results. In cases of impairments in mental health or work functioning in the first intervention arm, a consultation with an occupational physician will be offered. The second intervention arm offers a choice of self-help e-mental health interventions, which will be tailored based on each individual's mental health state and work functioning. The primary outcomes will be help-seeking behavior and work functioning. Secondary outcomes will be mental health and wellbeing. Furthermore, cost-effectiveness in both intervention arms will be assessed, and

  2. The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers' health surveillance mental module for nurses and allied health professionals

    Directory of Open Access Journals (Sweden)

    van Dijk Frank JH

    2011-05-01

    Full Text Available Abstract Background Employees in health care service are at high risk for developing mental health complaints. The effects of mental health complaints on work can have serious consequences for the quality of care provided by these workers. To help health service workers remain healthy and productive, preventive actions are necessary. A Workers' Health Surveillance (WHS mental module may be an effective strategy to monitor and promote good (mental health and work performance. The objective of this paper is to describe the design of a three arm cluster randomized controlled trial on the effectiveness of a WHS mental module for nurses and allied health professionals. Two strategies for this WHS mental module will be compared along with data from a control group. Additionally, the cost effectiveness of the approaches will be evaluated from a societal perspective. Methods The study is designed as a cluster randomized controlled trial consisting of three arms (two intervention groups, 1 control group with randomization at ward level. The study population consists of 86 departments in one Dutch academic medical center with a total of 1731 nurses and allied health professionals. At baseline, after three months and after six months of follow-up, outcomes will be assessed by online questionnaires. In both intervention arms, participants will complete a screening to detect problems in mental health and work functioning and receive feedback on their screening results. In cases of impairments in mental health or work functioning in the first intervention arm, a consultation with an occupational physician will be offered. The second intervention arm offers a choice of self-help e-mental health interventions, which will be tailored based on each individual's mental health state and work functioning. The primary outcomes will be help-seeking behavior and work functioning. Secondary outcomes will be mental health and wellbeing. Furthermore, cost-effectiveness in

  3. A Modified Behavior Risk Factor Surveillance System to Assess Diabetes Self-management Behaviors and Diabetes Care in Monterrey Mexico: A Cross-sectional Study

    Directory of Open Access Journals (Sweden)

    Francisco González-Salazar

    2017-05-01

    Full Text Available Type 2 diabetes mellitus (T2DM is one of the leading causes of death from worldwide non-communicable diseases. The prevalence of diabetes in the Mexico (MX–United States border states exceeds the national rate in both countries. The economic burden of diabetes, due to decreased productivity, disability, and medical costs, is staggering and increases significantly when T2DM-related complications occur. The purpose of this study was to use a modified behavioral risk factor surveillance system (BRFSS to describe the T2DM self-management behaviors, diabetes care, and health perception of a convenience sample of adults with T2DM in Monterrey, MX. This cross-sectional study design, with convenience sampling, was conducted with a convenience sample (n = 351 of adults in the metropolitan area of Monterrey, MX who self-reported a diagnosis of T2DM. Potential participants were recruited from local supermarkets. Twenty-six diabetes and health-related items were selected from the BRFSS and administered in face-to-face interviews by trained data collectors. Data analysis was conducted using descriptive statistics. The mean age was 47 years, and the mean length of time with T2DM was 12 years. The majority was taking oral medication and 34% required insulin. Daily self-monitoring of feet was performed by 56% of the participants; however, only 8.8% engaged in blood glucose self-monitoring. The mean number of health-care provider visits was 9.09 per year, and glycated hemoglobin level (HbA1c was assessed 2.6 times per year. Finally, only 40.5% of the participants recalled having a dilated eye exam. We conclude the modified BRFSS survey administered in a face-to-face interview format is an appropriate tool for assessing engagement in T2DM self-management behaviors, diabetes care, and health perception. Extension of the use of this survey in a more rigorous design with a larger scale survey is encouraged.

  4. Delayed radical prostatectomy for intermediate-risk prostate cancer is associated with biochemical recurrence: possible implications for active surveillance from the SEARCH database.

    Science.gov (United States)

    Abern, Michael R; Aronson, William J; Terris, Martha K; Kane, Christopher J; Presti, Joseph C; Amling, Christopher L; Freedland, Stephen J

    2013-03-01

    Active surveillance (AS) is increasingly accepted as appropriate management for low-risk prostate cancer (PC) patients. It is unknown whether delaying radical prostatectomy (RP) is associated with increased risk of biochemical recurrence (BCR) for men with intermediate-risk PC. We performed a retrospective analysis of 1,561 low and intermediate-risk men from the Shared Equal Access Regional Cancer Hospital (SEARCH) database treated with RP between 1988 and 2011. Patients were stratified by interval between diagnosis and RP (≤ 3, 3-6, 6-9, or >9 months) and by risk using the D'Amico classification. Cox proportional hazard models were used to analyze BCR. Logistic regression was used to analyze positive surgical margins (PSM), extracapsular extension (ECE), and pathologic upgrading. Overall, 813 (52%) men were low-risk, and 748 (48%) intermediate-risk. Median follow-up among men without recurrence was 52.9 months, during which 437 men (38.9%) recurred. For low-risk men, RP delays were unrelated to BCR, ECE, PSM, or upgrading (all P > 0.05). For intermediate-risk men, however, delays >9 months were significantly related to BCR (HR: 2.10, P = 0.01) and PSM (OR: 4.08, P 9 months were associated with BCR in subsets of intermediate-risk men with biopsy Gleason score ≤ 3 + 4 (HR: 2.51, P 9 months predicted greater BCR and PSM risk. If confirmed in future studies, this suggests delayed RP for intermediate-risk PC may compromise outcomes. Copyright © 2012 Wiley Periodicals, Inc.

  5. EpiContactTrace: an R-package for contact tracing during livestock disease outbreaks and for risk-based surveillance.

    Science.gov (United States)

    Nöremark, Maria; Widgren, Stefan

    2014-03-17

    During outbreak of livestock diseases, contact tracing can be an important part of disease control. Animal movements can also be of relevance for risk-based surveillance and sampling, i.e. both when assessing consequences of introduction or likelihood of introduction. In many countries, animal movement data are collected with one of the major objectives to enable contact tracing. However, often an analytical step is needed to retrieve appropriate information for contact tracing or surveillance. In this study, an open source tool was developed to structure livestock movement data to facilitate contact-tracing in real time during disease outbreaks and for input in risk-based surveillance and sampling. The tool, EpiContactTrace, was written in the R-language and uses the network parameters in-degree, out-degree, ingoing contact chain and outgoing contact chain (also called infection chain), which are relevant for forward and backward tracing respectively. The time-frames for backward and forward tracing can be specified independently and search can be done on one farm at a time or for all farms within the dataset. Different outputs are available; datasets with network measures, contacts visualised in a map and automatically generated reports for each farm either in HTML or PDF-format intended for the end-users, i.e. the veterinary authorities, regional disease control officers and field-veterinarians. EpiContactTrace is available as an R-package at the R-project website (http://cran.r-project.org/web/packages/EpiContactTrace/). We believe this tool can help in disease control since it rapidly can structure essential contact information from large datasets. The reproducible reports make this tool robust and independent of manual compilation of data. The open source makes it accessible and easily adaptable for different needs.

  6. Issues in risk analysis of passive LWR designs

    International Nuclear Information System (INIS)

    Youngblood, R.W.; Pratt, W.T.; Amico, P.J.; Gallagher, D.

    1992-01-01

    This paper discusses issues which bear on the question of how safety is to be demonstrated for ''simplified passive'' light water reactor (LWR) designs. First, a very simplified comparison is made between certain systems in today's plants. comparable systems in evolutionary designs, and comparable systems in the simplified passives. in order to introduce the issues. This discussion is not intended to describe the designs comprehensively, but is offered only to show why certain issues seem to be important in these particular designs. Next, an important class of accident sequences is described; finally, based on this discussion, some priorities in risk analysis are presented and discussed

  7. Site investigations, design, construction, operation, shutdown and surveillance of repositories for low- and intermediate-level radioactive wastes in rock cavities

    International Nuclear Information System (INIS)

    1984-01-01

    The report provides an overview and technical guidelines for considerations and for activities to be undertaken for safety assessment, site investigations, design, construction, operation, shutdown and surveillance of repositories for the disposal of low- and intermediate-level radioactive wastes in rock cavities. A generalized sequence of investigations is introduced which proceeds through region and site selection to the stage where the site is confirmed by detailed geoscientific investigations as being suitable for a waste repository. The different procedures and somewhat specific investigative needs with respect to existing mines are dealt with separately. General design, as well as specific requirements with respect to the different stages of design and construction, are dealt with. A review of activities related to the operational and post-operational stages of repositories in rock cavities is presented. The report describes in general terms the procedures related to different stages of disposal operation; also the conditions for shutdown together with essential shutdown and sealing activities and the related safety assessment requirements. Guidance is also given on the surveillance programme which will allow for inspection, testing, maintenance and security of a disposal facility during the operational phase, as well as for the post-operational stage for periods determined as necessary by the national authorities

  8. Implementing risk-informed life-cycle design

    International Nuclear Information System (INIS)

    Hill, Ralph S. III

    2007-01-01

    This paper describes a design process based on risk-informed probabilistic methodologies that cover a facility's life-cycle from start of conceptual design through decontamination and decommissioning. The concept uses probabilistic risk assessments to identify target reliabilities for facility systems and components. Target reliabilities are used in system and subsystem simulation analyses to determine the optimum combination of initial system and component construction reliability, maintenance frequency, and inspection frequency for both active and passive components. The target reliabilities are also used for system based code margin exchange to reduce excessive level of margins to appropriate levels resulting in a more flexible structure of codes and standards that improves facility reliability and cost. The paper includes a description of a risk informed life-cycle design process, a summary of work being done, and a discussion of work needed to implement the process. (author)

  9. Smart Meter Tariff Design to Minimise Wholesale Risk

    OpenAIRE

    Rogers, William; Carroll, Paula

    2016-01-01

    Smart metering in electricity markets offers an opportunity to explore more diversetariff structures. In this article a Genetic Algorithm (GA) is used to design Time ofUse tariffs that minimise the wholesale risk to the supplier in residential markets.Residential demand and the System Marginal Price of Ireland's Single ElectricityMarket are simulated to estimate the wholesale risk associated with each tariff.

  10. Game Theory and Risk-Based Levee System Design

    Science.gov (United States)

    Hui, R.; Lund, J. R.; Madani, K.

    2014-12-01

    Risk-based analysis has been developed for optimal levee design for economic efficiency. Along many rivers, two levees on opposite riverbanks act as a simple levee system. Being rational and self-interested, land owners on each river bank would tend to independently optimize their levees with risk-based analysis, resulting in a Pareto-inefficient levee system design from the social planner's perspective. Game theory is applied in this study to analyze decision making process in a simple levee system in which the land owners on each river bank develop their design strategies using risk-based economic optimization. For each land owner, the annual expected total cost includes expected annual damage cost and annualized construction cost. The non-cooperative Nash equilibrium is identified and compared to the social planner's optimal distribution of flood risk and damage cost throughout the system which results in the minimum total flood cost for the system. The social planner's optimal solution is not feasible without appropriate level of compensation for the transferred flood risk to guarantee and improve conditions for all parties. Therefore, cooperative game theory is then employed to develop an economically optimal design that can be implemented in practice. By examining the game in the reversible and irreversible decision making modes, the cost of decision making myopia is calculated to underline the significance of considering the externalities and evolution path of dynamic water resource problems for optimal decision making.

  11. Enhancing capacity for risk factor surveillance at the regional/local level: a follow-up review of the findings of the Canadian Think Tank Forum after 4 years.

    Science.gov (United States)

    Choi, Bernard Ck; Decou, Mary Lou; Rasali, Drona; Martens, Patricia J; Mancuso, Michelina; Plotnikoff, Ronald C; Neudorf, Cory; Thanos, Joanne; Svenson, Lawrence W; Denny, Keith; Orpana, Heather; Stewart, Paula; King, Michael; Griffith, Jane; Erickson, Tannis; van Dorp, Renate; White, Deanna; Ali, Amira

    2014-01-22

    National health surveys are sometimes used to provide estimates on risk factors for policy and program development at the regional/local level. However, as regional/local needs may differ from national ones, an important question is how to also enhance capacity for risk factor surveillance regionally/locally. A Think Tank Forum was convened in Canada to discuss the needs, characteristics, coordination, tools and next steps to build capacity for regional/local risk factor surveillance. A series of follow up activities to review the relevant issues pertaining to needs, characteristics and capacity of risk factor surveillance were conducted. Results confirmed the need for a regional/local risk factor surveillance system that is flexible, timely, of good quality, having a communication plan, and responsive to local needs. It is important to conduct an environmental scan and a gap analysis, to develop a common vision, to build central and local coordination and leadership, to build on existing tools and resources, and to use innovation. Findings of the Think Tank Forum are important for building surveillance capacity at the local/county level, both in Canada and globally. This paper provides a follow-up review of the findings based on progress over the last 4 years.

  12. Applying Statistical Design to Control the Risk of Over-Design with Stochastic Simulation

    Directory of Open Access Journals (Sweden)

    Yi Wu

    2010-02-01

    Full Text Available By comparing a hard real-time system and a soft real-time system, this article elicits the risk of over-design in soft real-time system designing. To deal with this risk, a novel concept of statistical design is proposed. The statistical design is the process accurately accounting for and mitigating the effects of variation in part geometry and other environmental conditions, while at the same time optimizing a target performance factor. However, statistical design can be a very difficult and complex task when using clas-sical mathematical methods. Thus, a simulation methodology to optimize the design is proposed in order to bridge the gap between real-time analysis and optimization for robust and reliable system design.

  13. Decision Support and Shared Decision Making About Active Surveillance Versus Active Treatment Among Men Diagnosed with Low-Risk Prostate Cancer: a Pilot Study.

    Science.gov (United States)

    Myers, Ronald E; Leader, Amy E; Censits, Jean Hoffman; Trabulsi, Edouard J; Keith, Scott W; Petrich, Anett M; Quinn, Anna M; Den, Robert B; Hurwitz, Mark D; Lallas, Costas D; Hegarty, Sarah E; Dicker, Adam P; Zeigler-Johnson, Charnita M; Giri, Veda N; Ayaz, Hasan; Gomella, Leonard G

    2018-02-01

    This study aimed to explore the effects of a decision support intervention (DSI) and shared decision making (SDM) on knowledge, perceptions about treatment, and treatment choice among men diagnosed with localized low-risk prostate cancer (PCa). At a multidisciplinary clinic visit, 30 consenting men with localized low-risk PCa completed a baseline survey, had a nurse-mediated online DS session to clarify preference for active surveillance (AS) or active treatment (AT), and met with clinicians for SDM. Participants also completed a follow-up survey at 30 days. We assessed change in treatment knowledge, decisional conflict, and perceptions and identified predictors of AS. At follow-up, participants exhibited increased knowledge (p decision. Perceived support of the decision facilitated patient choice of AS.

  14. Implementing risk-informed life-cycle design

    International Nuclear Information System (INIS)

    Hill, Ralph S.

    2009-01-01

    This paper describes a design process based on risk-informed probabilistic design methodologies that cover a facility's life-cycle from start of conceptual design through decontamination and decommissioning. The concept embodies use of probabilistic risk assessments to establish target reliabilities for facility systems and components. The target reliabilities are used for system based code margin exchange and performance simulation analyses to optimize design over all phases (design, construction, operation and decommissioning) of a facility's life-cycle. System based code margin exchange reduces excessive level of construction margins for passive components to appropriate levels resulting in a more flexible structure of codes and standards that improves facility reliability and cost. System and subsystem simulation analyses determine the optimum combination of initial system and component construction reliability, maintenance frequency, and inspection frequency for both active and passive components. The paper includes a description of these risk-informed life-cycle design processes, a summary of work being done, and a discussion of additional work needed to implement the process.

  15. Surveillance Angels

    NARCIS (Netherlands)

    Rothkrantz, L.J.M.

    2014-01-01

    The use of sensor networks has been proposed for military surveillance and environmental monitoring applications. Those systems are composed of a heterogeneous set of sensors to observe the environment. In centralised systems the observed data will be conveyed to the control room to process the

  16. Design Life Level: Quantifying risk in a changing climate

    Science.gov (United States)

    Rootzén, Holger; Katz, Richard W.

    2013-09-01

    In the past, the concepts of return levels and return periods have been standard and important tools for engineering design. However, these concepts are based on the assumption of a stationary climate and do not apply to a changing climate, whether local or global. In this paper, we propose a refined concept, Design Life Level, which quantifies risk in a nonstationary climate and can serve as the basis for communication. In current practice, typical hydrologic risk management focuses on a standard (e.g., in terms of a high quantile corresponding to the specified probability of failure for a single year). Nevertheless, the basic information needed for engineering design should consist of (i) the design life period (e.g., the next 50 years, say 2015-2064); and (ii) the probability (e.g., 5% chance) of a hazardous event (typically, in the form of the hydrologic variable exceeding a high level) occurring during the design life period. Capturing both of these design characteristics, the Design Life Level is defined as an upper quantile (e.g., 5%) of the distribution of the maximum value of the hydrologic variable (e.g., water level) over the design life period. We relate this concept and variants of it to existing literature and illustrate how they, and some useful complementary plots, may be computed and used. One practically important consideration concerns quantifying the statistical uncertainty in estimating a high quantile under nonstationarity.

  17. Causes of death and competing risk analysis of the associated factors for non-small cell lung cancer using the Surveillance, Epidemiology, and End Results database.

    Science.gov (United States)

    Wei, Shenhai; Tian, Jintao; Song, Xiaoping; Wu, Bingqun; Liu, Limin

    2018-01-01

    To investigate the probability of death (POD) from any causes by time after diagnosis of non-small cell lung cancer (NSCLC) and the factors associated with survival for NSCLC patients. A total of 202,914 patients with NSCLC from 2004 to 2013 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The overall survival (OS) and lung cancer-specific survival (LCSS) were calculated and POD from any causes at different time periods after diagnosis was explored. The predictive factors for OS, LCSS and survival from non-lung cancer deaths were investigated using multivariate analysis with Cox proportional hazards regression and competing risk regression analysis. The 5- and 10-year OS were 20.4% and 11.5%, accordingly that for LCSS were 25.5% and 18.4%, respectively. Lung cancer contributed 88.3% (n = 128,402) of the deaths. The POD from lung cancer decreased with time after diagnosis. In multivariate analysis, advanced age and advanced stage of NSCLC were associated with decreased OS and LCSS. Comparing to no surgery, any kind of resection conferred lower risk of death from lung cancer and higher risk of dying from non-lung cancer conditions except lobectomy or bilobectomy, which was associated with lower risk of death from both lung cancer and non-lung cancer conditions. Most of the patients with NSCLC died from lung cancer. Rational surveillance and treatment policies should be made for them. Early stage and lobectomy or bilobectomy were associated with improved OS and LCSS. It is reasonable to focus on early detection and optimal surgical treatment for NSCLC.

  18. Adherence to the breast cancer surveillance program for women at risk for familial breast and ovarian cancer versus overscreening: a monocenter study in Germany.

    Science.gov (United States)

    Vetter, Lisa; Keller, Monika; Bruckner, Thomas; Golatta, Michael; Eismann, Sabine; Evers, Christina; Dikow, Nicola; Sohn, Christof; Heil, Jörg; Schott, Sarah

    2016-04-01

    Breast cancer (BC) is the leading cancer among women worldwide and in 5-10 % of cases is of hereditary origin, mainly due to BRCA1/2 mutations. Therefore, the German Consortium for Familial Breast and Ovarian Cancer (HBOC) with its 15 specialized academic centers offers families at high risk for familial/hereditary cancer a multimodal breast cancer surveillance program (MBCS) with regular breast MRI, mammography, ultrasound, and palpation. So far, we know a lot about the psychological effects of genetic testing, but we know little about risk-correlated adherence to MBCS or prophylactic surgery over time. The aim of this study was to investigate counselees' adherence to recommendations for MBCS in order to adjust the care supply and define predictors for incompliance. All counselees, who attended HBOC consultation at the University Hospital Heidelberg between July 01, 2009 and July 01, 2011 were eligible to participate. A tripartite questionnaire containing sociodemographic information, psychological parameters, behavioral questions, and medical data collection from the German consortium were used. A high participation rate was achieved among the study population, with 72 % returning the questionnaire. This study showed a rate of 59 % of full-adherers to the MBCS. Significant predictors for partial or full adherence were having children (p = 0.0221), younger daughters (p = 0.01795), a higher awareness of the topic HBOC (p = 0.01795, p breast cancer risk (p breast cancer surveillance program for women at risk for familial breast and ovarian cancer versus overscreening-a monocenter study in Germany.

  19. Design of Process Displays based on Risk Analysis Techniques

    DEFF Research Database (Denmark)

    Paulsen, Jette Lundtang

    -tions. On the basis of her experience with the design of display systems; with risk analysis methods and from 8 years, as an engi-neer-on-shift at a research reactor, the author developed a method to elicit necessary information to the operator. The method, a combination of a Goal-Tree and a Fault-Tree, is described...

  20. What Could Be Future Scenarios?-Lessons from the History of Public Health Surveillance for the Future: --A keynote address presented at the 8th World Alliance for Risk Factor Surveillance (WARFS) Global Conference on October 30, 2013, Beijing, China.

    Science.gov (United States)

    Choi, Bernard C K

    2015-01-01

    This article provides insights into the future based on a review of the past and present of public health surveillance-the ongoing systematic collection, analysis, interpretation, and dissemination of health data for the planning, implementation, and evaluation of public health action. Public health surveillance dates back to the first recorded epidemic in 3180 BC in Egypt. A number of lessons and items of interest are summarised from a review of historical perspectives in the past 5,000 years and the current practice of surveillance. Some future scenarios are presented: exploring new frontiers; enhancing computer technology; improving epidemic investigations; improving data collection, analysis, dissemination and use; building on lessons from the past; building capacity; and enhancing global surveillance. It is concluded that learning from the past, reflecting on the present, and planning for the future can further enhance public health surveillance.

  1. Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance: first report from the prospective Lynch syndrome database

    OpenAIRE

    Moller, Pal; Seppala, Toni; Bernstein, Inge; Holinski-Feder, Elke; Sala, Paola; Evans, D. Gareth; Lindblom, Annika; Macrae, Finlay; Blanco, Ignacio; Sijmons, Rolf; Jeffries, Jacqueline; Vasen, Hans; Burn, John; Nakken, Sigve; Hovig, Eivind

    2017-01-01

    Objective Estimates of cancer risk and the effects of surveillance in Lynch syndrome have been subject to bias, partly through reliance on retrospective studies. We sought to establish more robust estimates in patients undergoing prospective cancer surveillance.\\ud \\ud Design We undertook a multicentre study of patients carrying Lynch syndrome-associated mutations affecting MLH1, MSH2, MSH6 or PMS2. Standardised information on surveillance, cancers and outcomes were collated in an Oracle rela...

  2. Risk assessment data bank design at the Savannah River Site

    International Nuclear Information System (INIS)

    Townsend, C.S.; Johnson, K.B.

    1992-01-01

    The Savannah River Site has designed and implemented a database system containing a series of compilations of incidents used primarily for risk assessment. Four databases have been designed and implemented using advanced database management system computer software. These databases exist for reprocessing, fuel fabrication, waste management, and the Savannah River Technology Center. They are combined into one system caged the Risk Assessment Methodology (RAM) Fault Tree Data Banks. This paper will discuss the logical design of the data, the menus, and the operating platform. Built-in updating features, such as batch and on-line data entry; data validation methods; automatic update features; and expert system programs, will also be discussed. User functions, such as on-line search/view/report and statistical functions, will be presented. Security features and backup and recovery methods will also be covered

  3. Risk-informed design guidance for future reactor systems

    International Nuclear Information System (INIS)

    Delaney, Michael J.; Apostolakis, George E.; Driscoll, Michael J.

    2005-01-01

    Future reactor designs face an uncertain regulatory environment. It is anticipated that there will be some level of probabilistic insights in the regulations and supporting regulatory documents for Generation-IV nuclear reactors. Central to current regulations are design basis accidents (DBAs) and the general design criteria (GDC), which were established before probabilistic risk assessments (PRAs) were developed. These regulations implement a structuralist approach to safety through traditional defense in depth and large safety margins. In a rationalist approach to safety, accident frequencies are quantified and protective measures are introduced to make these frequencies acceptably low. Both approaches have advantages and disadvantages and future reactor design and licensing processes will have to implement a hybrid approach. This paper presents an iterative four-step risk-informed methodology to guide the design of future-reactor systems using a gas-cooled fast reactor emergency core cooling system as an example. This methodology helps designers to analyze alternative designs under potential risk-informed regulations and to anticipate design justifications the regulator may require during the licensing process. The analysis demonstrated the importance of common-cause failures and the need for guidance on how to change the quantitative impact of these potential failures on the frequency of accident sequences as the design changes. Deliberation is an important part of the four-step methodology because it supplements the quantitative results by allowing the inclusion in the design choice of elements such as best design practices and ease of online maintenance, which usually cannot be quantified. The case study showed that, in some instances, the structuralist and the rationalist approaches were inconsistent. In particular, GDC 35 treats the double-ended break of the largest pipe in the reactor coolant system with concurrent loss of offsite power and a single

  4. Development of risk-informed assessment (RIA) design methodology

    International Nuclear Information System (INIS)

    Ji, S. K.; Park, S. J.; Park, B. R.; Kim, M. R.; Choi, C. J.

    2001-01-01

    It has been assessed that the capital cost for future nuclear power plants needs to be reduced on the order of 35% to 40% for Advanced Light Water Reactors such as KNGR and System 80+. Such reduction in the capital cost will require a fundamental re-evaluation of the industry standards and regulatory basis under which nuclear plants are designed and licensed. The objective of this study is to develop the risk-informed assessment (RIA) design methodology for future nuclear power plants. In order to meet this objective, the design simplification method is developed and RIA design methodology exercised for conceptual system. For the methodology verification, simplified conceptual ECCS and feedwater system are developed, then LOCA sensitivity analyses and agressive secondary cooldown analyses for these systems are performed. In addition, the probability safety assessment (PSA) model for LOCA is developed and the validation of RIA design methodology is demonstrated

  5. Reactor Vessel Surveillance Program for Advanced Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Kyeong-Hoon; Kim, Tae-Wan; Lee, Gyu-Mahn; Kim, Jong-Wook; Park, Keun-Bae; Kim, Keung-Koo

    2008-10-15

    This report provides the design requirements of an integral type reactor vessel surveillance program for an integral type reactor in accordance with the requirements of Korean MEST (Ministry of Education, Science and Technology Development) Notice 2008-18. This report covers the requirements for the design of surveillance capsule assemblies including their test specimens, test block materials, handling tools, and monitors of the surveillance capsule neutron fluence and temperature. In addition, this report provides design requirements for the program for irradiation surveillance of reactor vessel materials, a layout of specimens and monitors in the surveillance capsule, procedures of installation and retrieval of the surveillance capsule assemblies, and the layout of the surveillance capsule assemblies in the reactor.

  6. Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance : first report from the prospective Lynch syndrome database

    NARCIS (Netherlands)

    Moller, Pal; Seppala, Toni; Bernstein, Inge; Holinski-Feder, Elke; Sala, Paola; Evans, D. Gareth; Lindblom, Annika; Macrae, Finlay; Blanco, Ignacio; Sijmons, Rolf; Jeffries, Jacqueline; Vasen, Hans; Burn, John; Nakken, Sigve; Hovig, Eivind; Rodland, Einar Andreas; Tharmaratnam, Kukatharmini; Cappel, Wouter H. de Vos Tot Nederveen; Hill, James; Wijnen, Juul; Green, Kate; Lalloo, Fiona; Sunde, Lone; Mints, Miriam; Bertario, Lucio; Pineda, Marta; Navarro, Matilde; Morak, Monika; Renkonen-Sinisalo, Laura; Frayling, Ian M.; Plazzer, John-Paul; Pylvanainen, Kirsi; Sampson, Julian R.; Capella, Gabriel; Mecklin, Jukka-Pekka; Moslein, Gabriela

    Objective Estimates of cancer risk and the effects of surveillance in Lynch syndrome have been subject to bias, partly through reliance on retrospective studies. We sought to establish more robust estimates in patients undergoing prospective cancer surveillance. Design We undertook a multicentre

  7. Attitudes toward mental illness in adults by mental illness-related factors and chronic disease status: 2007 and 2009 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Kobau, Rosemarie; Zack, Matthew M

    2013-11-01

    We examined how attitudes toward mental illness treatment and its course differ by serious psychological distress, mental illness treatment, chronic disease, and sociodemographic factors using representative state-based data. Using data from jurisdictions supporting the Behavioral Risk Factor Surveillance System's Mental Illness and Stigma Module (35 states, the District of Columbia, and Puerto Rico), we compared adjusted proportions of adults agreeing that "Treatment can help people with mental illness lead normal lives" (treatment effectiveness) and that "People are generally caring and sympathetic to people with mental illness" (supportive environment), by demographic characteristics, serious psychological distress, chronic disease status, and mental illness treatment. Attitudes regarding treatment effectiveness and a supportive environment for people with mental illness varied within and between groups. Most adults receiving mental illness treatment agreed that treatment is effective. Fewer adults with serious psychological distress than those without such distress agreed that treatment is effective. Fewer of those receiving treatment, those with psychological distress, and those with chronic disease perceived the environment as supportive. These data can be used to target interventions for population subgroups with less favorable attitudes and for surveillance.

  8. Air surveillance

    International Nuclear Information System (INIS)

    Patton, G.W.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the air surveillance and monitoring programs currently in operation at that Hanford Site. Atmospheric releases of pollutants from Hanford to the surrounding region are a potential source of human exposure. For that reason, both radioactive and nonradioactive materials in air are monitored at a number of locations. The influence of Hanford emissions on local radionuclide concentrations was evaluated by comparing concentrations measured at distant locations within the region to concentrations measured at the Site perimeter. This section discusses sample collection, analytical methods, and the results of the Hanford air surveillance program. A complete listing of all analytical results summarized in this section is reported separately by Bisping (1995)

  9. Air surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Patton, G.W.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the air surveillance and monitoring programs currently in operation at that Hanford Site. Atmospheric releases of pollutants from Hanford to the surrounding region are a potential source of human exposure. For that reason, both radioactive and nonradioactive materials in air are monitored at a number of locations. The influence of Hanford emissions on local radionuclide concentrations was evaluated by comparing concentrations measured at distant locations within the region to concentrations measured at the Site perimeter. This section discusses sample collection, analytical methods, and the results of the Hanford air surveillance program. A complete listing of all analytical results summarized in this section is reported separately by Bisping (1995).

  10. Modeling risk and uncertainty in designing reverse logistics problem

    Directory of Open Access Journals (Sweden)

    Aida Nazari Gooran

    2018-01-01

    Full Text Available Increasing attention to environmental problems and social responsibility lead to appear reverse logistic (RL issues in designing supply chain which, in most recently, has received considerable attention from both academicians and practitioners. In this paper, a multi-product reverse logistic network design model is developed; then a hybrid method including Chance-constrained programming, Genetic algorithm and Monte Carlo simulation, are proposed to solve the developed model. The proposed model is solved for risk-averse and risk-seeking decision makers by conditional value at risk, sum of the excepted value and standard deviation, respectively. Comparisons of the results show that minimizing the costs had no direct relation with the kind of decision makers; however, in the most cases, risk-seeking decision maker gained more return products than risk-averse ones. It is clear that by increasing returned products to the chain, production costs of new products and material will be reduced and also by this act, environmental benefits will be created.

  11. Managing geotechnical risk on US design-build transport projects

    Directory of Open Access Journals (Sweden)

    Kevin McLain

    2014-03-01

    Full Text Available Awarding design-build (DB contracts before a complete subsurface investigation is completed, makes mitigating the risk of differing site conditions difficult, if not impossible. The purpose of the study was to identify effective practices for managing geotechnical risk in DB projects, and it reports the results of a survey that included responses from 42 of 50 US state departments of transportation and a content analysis of DB requests for proposals from 26 states to gauge the client’s perspective, as well as 11 structured interviews with DB contractors to obtain the perspective from the other side of the DB contract.  A suite of DB geotechnical risk manage tools is presented based on the results of the analysis. Effective practices were found in three areas: enhancing communications on geotechnical issues before final proposals are submitted; the use of project-specific differing site conditions clauses; and expediting geotechnical design reviews after award. The major finding is that contract verbiage alone is not sufficient to transfer the risk of changed site conditions. The agency must actively communicate all the geotechnical information on hand at the time of the DB procurement and develop a contract strategy that reduces/retires the risk of geotechnical uncertainty as expeditiously as possible after award.

  12. Designing and operating infrastructure for nonstationary flood risk management

    Science.gov (United States)

    Doss-Gollin, J.; Farnham, D. J.; Lall, U.

    2017-12-01

    Climate exhibits organized low-frequency and regime-like variability at multiple time scales, causing the risk associated with climate extremes such as floods and droughts to vary in time. Despite broad recognition of this nonstationarity, there has been little theoretical development of ideas for the design and operation of infrastructure considering the regime structure of such changes and their potential predictability. We use paleo streamflow reconstructions to illustrate an approach to the design and operation of infrastructure to address nonstationary flood and drought risk. Specifically, we consider the tradeoff between flood control and conservation storage, and develop design and operation principles for allocating these storage volumes considering both a m-year project planning period and a n-year historical sampling record. As n increases, the potential uncertainty in probabilistic estimates of the return periods associated with the T-year extreme event decreases. As the duration m of the future operation period decreases, the uncertainty associated with the occurrence of the T-year event also increases. Finally, given the quasi-periodic nature of the system it may be possible to offer probabilistic predictions of the conditions in the m-year future period, especially if m is small. In the context of such predictions, one can consider that a m-year prediction may have lower bias, but higher variance, than would be associated with using a stationary estimate from the preceding n years. This bias-variance trade-off, and the potential for considering risk management for multiple values of m, provides an interesting system design challenge. We use wavelet-based simulation models in a Bayesian framework to estimate these biases and uncertainty distributions and devise a risk-optimized decision rule for the allocation of flood and conservation storage. The associated theoretical development also provides a methodology for the sizing of storage for new

  13. Rinderpest surveillance

    International Nuclear Information System (INIS)

    2003-01-01

    Rinderpest is probably the most lethal virus disease of cattle and buffalo and can destroy whole populations; damaging economies; undermining food security and ruining the livelihood of farmers and pastoralists. The disease can be eradicated by vaccination and control of livestock movement. The Department of Technical Co-operation is sponsoring a programme, with technical support from the Joint FAO/IAEA Division to provide advice, training and materials to thirteen states through the 'Support for Rinderpest Surveillance in West Asia' project. (IAEA)

  14. Health surveillance

    International Nuclear Information System (INIS)

    1981-01-01

    The Code includes a number of requirements for the health surveillance of employees associated with the mining and milling of radioactive ores. This guideline is particularly directed at determining the level of fitness of employees and prospective employees, detecting any symptom which might contraindicate exposure to the environment encountered in mine/mill situations, examination of any employee who may have been exposed to radiation in excess of defined limits and the accumulation and provision of data on the health of employees

  15. Using QA classification to guide design and manage risk

    International Nuclear Information System (INIS)

    Lathrop, J.; DeKlever, R.; Petrie, E.H.

    1993-01-01

    Raytheon Services Nevada has developed a classification process based on probabilistic risk assessment, using accident/impact scenarios for each system classified. Initial classification analyses were performed for the 20 systems of Package IA of the Exploratory Studies Facility (ESF). The analyses demonstrated a solid, defensible methodological basis for classification which minimizes the use of direct engineering judgment. They provide guidance for ESF design and risk management through the identification of: The critical characteristics of each system that need to be controlled; and the parts of the information base that most need to be further developed through performance assessment or other efforts

  16. Societal risk approach to safeguards design and evaluation

    International Nuclear Information System (INIS)

    Murphey, W.M.; Sherr, T.S.; Bennett, C.A.

    1975-01-01

    A comprehensive rationale for safeguards design and evaluation, and a framework for continuing systematic assessment of the system's effectiveness and efficient allocation of available safeguards resources for balanced protection, were developed. The societal risk approach employed considers the likelihood of successful destructive acts involving nuclear materials or facilities and the magnitude of the effects on society. The safeguards problem is described in terms of events affecting societal risk and adversary actions. Structure of the safeguards system and the evaluation of its adequacy are discussed. Adversary characteristics are also discussed

  17. The Toxic Exposure Surveillance System (TESS): Risk assessment and real-time toxicovigilance across United States poison centers

    International Nuclear Information System (INIS)

    Watson, William A.; Litovitz, Toby L.; Belson, Martin G.; Funk Wolkin, Amy B.; Patel, Manish; Schier, Joshua G.; Reid, Nicole E.; Kilbourne, Edwin; Rubin, Carol

    2005-01-01

    The Toxic Exposure Surveillance System (TESS) is a uniform data set of US poison centers cases. Categories of information include the patient, the caller, the exposure, the substance(s), clinical toxicity, treatment, and medical outcome. The TESS database was initiated in 1985, and provides a baseline of more than 36.2 million cases through 2003. The database has been utilized for a number of safety evaluations. Consideration of the strengths and limitations of TESS data must be incorporated into data interpretation. Real-time toxicovigilance was initiated in 2003 with continuous uploading of new cases from all poison centers to a central database. Real-time toxicovigilance utilizing general and specific approaches is systematically run against TESS, further increasing the potential utility of poison center experiences as a means of early identification of potential public health threats

  18. The Toxic Exposure Surveillance System (TESS): risk assessment and real-time toxicovigilance across United States poison centers.

    Science.gov (United States)

    Watson, William A; Litovitz, Toby L; Belson, Martin G; Wolkin, Amy B Funk; Patel, Manish; Schier, Joshua G; Reid, Nicole E; Kilbourne, Edwin; Rubin, Carol

    2005-09-01

    The Toxic Exposure Surveillance System (TESS) is a uniform data set of US poison centers cases. Categories of information include the patient, the caller, the exposure, the substance(s), clinical toxicity, treatment, and medical outcome. The TESS database was initiated in 1985, and provides a baseline of more than 36.2 million cases through 2003. The database has been utilized for a number of safety evaluations. Consideration of the strengths and limitations of TESS data must be incorporated into data interpretation. Real-time toxicovigilance was initiated in 2003 with continuous uploading of new cases from all poison centers to a central database. Real-time toxicovigilance utilizing general and specific approaches is systematically run against TESS, further increasing the potential utility of poison center experiences as a means of early identification of potential public health threats.

  19. Surveillance of avian influenza in the Caribbean through the Caribbean Animal Health Network: surveillance tools and epidemiologic studies.

    Science.gov (United States)

    Lefrançois, T; Hendrikx, P; Ehrhardt, N; Millien, M; Gomez, L; Gouyet, L; Gaidet, N; Gerbier, G; Vachiéry, N; Petitclerc, F; Carasco-Lacombe, C; Pinarello, V; Ahoussou, S; Levesque, A; Gongora, H V; Trotman, M

    2010-03-01

    The Caribbean region is considered to be at risk for avian influenza (AI) due to a large backyard poultry system, an important commercial poultry production system, the presence of migratory birds, and disparities in the surveillance systems. The Caribbean Animal Health Network (CaribVET) has developed tools to implement AI surveillance in the region with the goals to have 1) a regionally harmonized surveillance protocol and specific web pages for AI surveillance on www.caribvet.net, and 2) an active and passive surveillance for AI in domestic and wild birds. A diagnostic network for the Caribbean, including technology transfer and AI virus molecular diagnostic capability in Guadeloupe (real-time reverse transcription-polymerase chain reaction for the AI virus matrix gene), was developed. Between 2006 and 2009, 627 samples from four Caribbean countries were tested for three circumstances: importation purposes, following a clinical suspicion of AI, or through an active survey of wild birds (mainly waders) during the southward and northward migration periods in Guadeloupe. None of the samples tested were positive, suggesting a limited role of these species in the AI virus ecology in the Caribbean. Following low pathogenic H5N2 outbreaks in the Dominican Republic in 2007, a questionnaire was developed to collect data for a risk analysis of AI spread in the region through fighting cocks. The infection pathway of the Martinique commercial poultry sector by AI, through introduction of infected cocks, was designed, and recommendations were provided to the Caribbean Veterinary Services to improve cock movement control and biosecurity measures. The CaribVET and its organization allowed interaction between diagnostic and surveillance tools on the one hand and epidemiologic studies on the other, both of them developed in congruence with regional strategies. Together, these CaribVET activities contribute to strengthening surveillance of avian influenza virus (AIV) in the

  20. Risk of leukemia associated with the first course of cancer treatment: an analysis of the Surveillance, Epidemiology, and End Results Program experience

    International Nuclear Information System (INIS)

    Curtis, R.E.; Hankey, B.F.; Myers, M.H.; Young, J.L. Jr.

    1984-01-01

    The risk of leukemia associated with the first course of cancer treatment was evaluated in over 440,000 patients diagnosed during 1973-80 (average follow-up . 1.91 yr) from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Although the reporting of the first course of therapy probably was incomplete, 34 acute nonlymphocytic leukemias (ANLL) developed compared with 7.6 expected among 70,674 patients known to receive initial chemotherapy [relative risk (RR) . 4.5, 95% confidence interval (Cl) . 3.1-6.3]. Significant ANLL excesses were observed following chemotherapy for breast cancer (RR . 8.1), ovarian cancer (RR . 22.2), and multiple myeloma (RR . 9.5). Patients initially treated with radiation (with no record of chemotherapy) also had a significantly increased ANLL risk; 45 leukemias occurred versus 17.9 expected (RR . 2.5, 95% Cl . 1.8-3.4). In this group, excess ANLL were found following irradiation for uterine corpus cancer (RR . 4.0). Kidney and renal pelvis cancer patients had a twofold leukemia risk (all types) that was unrelated to treatment (RR . 2.2)

  1. Selection of low-risk design guidelines for energetic events

    International Nuclear Information System (INIS)

    Ferguson, D.; Marchaterre, J.; Graham, J.

    1982-01-01

    This paper recommends the establishment of specific design guidelines for protection against potential, but low-probability, energetic events. These guidelines recognize the plant protective features incorporated to prevent such events, as well as the inherent capability of the plant to accommodate a certain level of energy release. Further, their application is recommended within the context of necessary standardized and agreed-upon acceptance criteria which are less restrictive than ASME code requirements. The paper provides the background upon which the selection of the design is made, including the characterization of energetic events dependent on various core-design parameters, and including the necessity of a low-risk design balanced between prevention of accidents and the mitigation of consequences

  2. The Design and Risk Management of Structured Finance Vehicles

    Directory of Open Access Journals (Sweden)

    Sanjiv Das

    2016-10-01

    Full Text Available Special investment vehicles (SIVs, extremely popular financial structures for the creation of highly-rated tranched securities, experienced spectacular demise in the 2007-2008 financial crisis. These financial vehicles epitomize the shadow banking sector, characterized by high leverage, undiversified asset pools, and long-dated assets supported by short-term debt, thus bearing material rollover risk on their liabilities which led to defeasance. This paper models these vehicles, and shows that imposing leverage risk control triggers can be optimal for all capital providers, though they may not always be appropriate. The efficacy of these risk controls varies depending on anticipated asset volatility and fire-sale discounts on defeasance. Despite risk management controls, we show that a high failure rate is inherent in the design of these vehicles, and may be mitigated to some extent by including contingent capital provisions in the ex-ante covenants. Post the recent subprime financial crisis, we inform the creation of safer SIVs in structured finance, and propose avenues of mitigating risks faced by senior debt through deleveraging policies in the form of leverage risk controls and contingent capital.

  3. To estimation of health risks of workers during classification of objects of sanitary and epidemiological surveillance and planning of state control (by the example of Moscow

    Directory of Open Access Journals (Sweden)

    E.E. Andreeva

    2016-06-01

    Full Text Available When estimating of health risks of workers for planning tasks of audits of compliance with health legislation on facilities of Moscow, it is found that most often non-compliances with requirements for working conditions are registered in industrial enterprises, among other, on wood-shaving material production facilities; air and water transport facilities, and in a number of communication facilities. The most serious consequences of breach of statutory requirements for working conditions are typical for activity in the sphere of motor transport and industrial production. It is defined by the structure of the types of deterioration of health among which there are traumas, diseases of a cardiovascular and nervous system. Analysis of more than 35.5 thousand facilities of sanitary and epidemiological supervision showed that the highest levels of health risks for workers are formed on industrial facilities (the risks are classified as “average”, “significant” and “high”, in construction («significant» or «moderate», on a number of manufacturing activities and in energy engineering. For the mentioned facilities the risks to workers can define the main class of an object based on the risk of infliction of harm, in general, the audits must be based on profound analysis of working conditions and include a complete complex of laboratory researches. When checking of legal entities and individual entrepreneurs, carrying out such kinds of activity as chain retailing, provision of services health care, education, etc., the highest risks are formed for consumers of goods and services. On these facilities the control in the sphere of occupational hygiene can occupy a smaller share in a total volume of a scheduled activity. Relevant direction of further perfection of the risk-based surveillance is formation of an exhaustive list of the statutory requirements for working conditions with differentiation of these requirements on levels of severity

  4. The Nordic Obstetric Surveillance Study

    DEFF Research Database (Denmark)

    Colmorn, Lotte B.; Petersen, Kathrine B; Jakobsson, Maija

    2015-01-01

    by using International Classification of Diseases, 10th revision codes on diagnoses and the Nordic Medico-Statistical Committee Classification of Surgical Procedure codes. MAIN OUTCOME MEASURES: Rates of the studied complications and possible risk factors among parturients in the Nordic countries. RESULTS......OBJECTIVE: To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. DESIGN: Prospective, Nordic collaboration. SETTING: The Nordic Obstetric Surveillance Study...... (NOSS) collected cases of severe obstetric complications in the Nordic countries from April 2009 to August 2012. SAMPLE AND METHODS: Cases were reported by clinicians at the Nordic maternity units and retrieved from medical birth registers, hospital discharge registers, and transfusion databases...

  5. The concept of risk in the design basis threat

    International Nuclear Information System (INIS)

    Reynolds, J.M.

    2001-01-01

    Full text: Mathematically defined, risk is a product of one or more probability factors and one or more consequences. Actuarial analysis of risk requires the creation of a numeric algorithm that reflects the interaction of different probability factors, where probability data usually draws on direct measurements of incidence. For physical protection purposes, the algorithms take the general form: Risk = Probability of successful attack x Consequence where the overall probability of a successful attack will be determined by the product of, amongst other things, the probability of there being sufficient intent, the probability of there being available hostile resources, the probability of deterrence, and the probability that a hostile act will be detected and prevented. Deliberate, malevolent acts against nuclear facilities are rare. In so far as it is possible to make an actuarial type of judgement, the probability of malevolent activity against a nuclear facility is almost zero. This creates a problem for a numerical assessment of risk for nuclear facilities where the value (consequence) term could be almost infinite. As can be seen from the general equation above, a numerical algorithm of risk of malevolent activity affecting nuclear facilities could only yield a zero or infinite result. In such circumstances, intelligence-based threat assessments are sometimes thought of as a substitute for historic data in the determination of probability. However, if the paucity of historic data reflects the actual threat - which by and large it should - no amount of intelligence is likely to yield a substantially different conclusion. This mathematical approach to analysing risk appears to lead us either to no risk and no protection or to an infinite risk demanding every conceivable protective measure. The Design Basis Threat (DBT) approach offers a way out of the dilemma. Firstly, it allows us to eliminate from further consideration all zero or near zero probabilities

  6. Perceived discrimination, psychological distress, and current smoking status: results from the Behavioral Risk Factor Surveillance System Reactions to Race module, 2004-2008.

    Science.gov (United States)

    Purnell, Jason Q; Peppone, Luke J; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J; Carroll, Jennifer K; Shacham, Enbal; Morrow, Gary R

    2012-05-01

    We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination-smoking association. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment.

  7. Perceived Discrimination, Psychological Distress, and Current Smoking Status: Results From the Behavioral Risk Factor Surveillance System Reactions to Race Module, 2004–2008

    Science.gov (United States)

    Peppone, Luke J.; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J.; Carroll, Jennifer K.; Shacham, Enbal; Morrow, Gary R.

    2012-01-01

    Objectives. We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. Methods. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Results. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination–smoking association. Conclusions. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment. PMID:22420821

  8. Field application of a combined pig and poultry market chain and risk pathway analysis within the Pacific Islands region as a tool for targeted disease surveillance and biosecurity.

    Science.gov (United States)

    Brioudes, Aurélie; Gummow, Bruce

    2016-07-01

    Limited resources are one of the major constraints in effective disease monitoring and control in developing countries. This paper examines the pig and poultry market chains of four targeted Pacific Island countries and territories (PICTs): Fiji, Papua New Guinea, Solomon Islands and Vanuatu and combines them with a risk pathway analysis to identify the highest risk areas (risk hotspots) and risky practices and behaviours (risk factors) of animal disease introduction and/or spread, using highly pathogenic avian influenza (HPAI) and foot-and-mouth disease (FMD) as model diseases because of their importance in the region. The results show that combining a market chain analysis with risk pathways is a practical way of communicating risk to animal health officials and improving biosecurity. It provides a participatory approach that helps officials to better understand the trading regulations in place in their country and to better evaluate their role as part of the control system. Common risk patterns were found to play a role in all four PICTs. Legal trade pathways rely essentially on preventive measures put in place in the exporting countries while no or only limited control measures are undertaken by the importing countries. Legal importations of animals and animal products are done mainly by commercial farms which then supply local smallholders. Targeting surveillance on these potential hotspots would limit the risk of introduction and spread of animal diseases within the pig and poultry industry and better rationalize use of skilled manpower. Swill feeding is identified as a common practice in the region that represents a recognized risk factor for dissemination of pathogens to susceptible species. Illegal introduction of animals and animal products is suspected, but appears restricted to small holder farms in remote areas, limiting the risk of spread of transboundary animal diseases along the market chain. Introduction of undeclared goods hidden within a legal

  9. Avian Cholera emergence in Arctic-nesting northern Common Eiders: using community-based, participatory surveillance to delineate disease outbreak patterns and predict transmission risk

    Directory of Open Access Journals (Sweden)

    Samuel A. Iverson

    2016-12-01

    Full Text Available Emerging infectious diseases are a growing concern in wildlife conservation. Documenting outbreak patterns and determining the ecological drivers of transmission risk are fundamental to predicting disease spread and assessing potential impacts on population viability. However, evaluating disease in wildlife populations requires expansive surveillance networks that often do not exist in remote and developing areas. Here, we describe the results of a community-based research initiative conducted in collaboration with indigenous harvesters, the Inuit, in response to a new series of Avian Cholera outbreaks affecting Common Eiders (Somateria mollissima and other comingling species in the Canadian Arctic. Avian Cholera is a virulent disease of birds caused by the bacterium Pasteurella multocida. Common Eiders are a valuable subsistence resource for Inuit, who hunt the birds for meat and visit breeding colonies during the summer to collect eggs and feather down for use in clothing and blankets. We compiled the observations of harvesters about the growing epidemic and with their assistance undertook field investigation of 131 colonies distributed over >1200 km of coastline in the affected region. Thirteen locations were identified where Avian Cholera outbreaks have occurred since 2004. Mortality rates ranged from 1% to 43% of the local breeding population at these locations. Using a species-habitat model (Maxent, we determined that the distribution of outbreak events has not been random within the study area and that colony size, vegetation cover, and a measure of host crowding in shared wetlands were significantly correlated to outbreak risk. In addition, outbreak locations have been spatially structured with respect to hypothesized introduction foci and clustered along the migration corridor linking Arctic breeding areas with wintering areas in Atlantic Canada. At present, Avian Cholera remains a localized threat to Common Eider populations in the

  10. Seismic hazard, risk, and design for South America

    Science.gov (United States)

    Petersen, Mark D.; Harmsen, Stephen; Jaiswal, Kishor; Rukstales, Kenneth S.; Luco, Nicolas; Haller, Kathleen; Mueller, Charles; Shumway, Allison

    2018-01-01

    We calculate seismic hazard, risk, and design criteria across South America using the latest data, models, and methods to support public officials, scientists, and engineers in earthquake risk mitigation efforts. Updated continental scale seismic hazard models are based on a new seismicity catalog, seismicity rate models, evaluation of earthquake sizes, fault geometry and rate parameters, and ground‐motion models. Resulting probabilistic seismic hazard maps show peak ground acceleration, modified Mercalli intensity, and spectral accelerations at 0.2 and 1 s periods for 2%, 10%, and 50% probabilities of exceedance in 50 yrs. Ground shaking soil amplification at each site is calculated by considering uniform soil that is applied in modern building codes or by applying site‐specific factors based on VS30">VS30 shear‐wave velocities determined through a simple topographic proxy technique. We use these hazard models in conjunction with the Prompt Assessment of Global Earthquakes for Response (PAGER) model to calculate economic and casualty risk. Risk is computed by incorporating the new hazard values amplified by soil, PAGER fragility/vulnerability equations, and LandScan 2012 estimates of population exposure. We also calculate building design values using the guidelines established in the building code provisions. Resulting hazard and associated risk is high along the northern and western coasts of South America, reaching damaging levels of ground shaking in Chile, western Argentina, western Bolivia, Peru, Ecuador, Colombia, Venezuela, and in localized areas distributed across the rest of the continent where historical earthquakes have occurred. Constructing buildings and other structures to account for strong shaking in these regions of high hazard and risk should mitigate losses and reduce casualties from effects of future earthquake strong ground shaking. National models should be developed by scientists and engineers in each country using the best

  11. Increasing resilience through participative flood risk map design

    Science.gov (United States)

    Fuchs, Sven; Spira, Yvonne; Stickler, Therese

    2013-04-01

    regarding participation was not the methods used for participation but the involvement of concerned lay persons not only in the design of the hazard and risk maps or the risk assessments itself but the cooperative elaboration of the risk assessment approach especially for the harbour area. Following these principles, flood risk maps were created in the underlying EU-project DANUBE FLOODRISK. In this ETC SEE project "DANUBE FLOODRISK - Stakeholder Oriented Assessment of the Danube Floodplains" (2009-2012), hazard and risk maps harmonized across borders for the Danube main stream were produced. This way the overall DANUBE FLOODRISK project contributed to Article 6 of the EU Floods Directive, the hazard and risk maps for international river basins, and provides with the involvement of the national and regional stakeholders the first step to the implementation of Article 7, the Flood Risk Management Plans. By testing the involvement of the broad public and local stakeholders, first exemplary steps were taken for local flood risk management planning. A first set of maps was created for an underlying hazard scenario of a 1-in-100 year flood affecting the city of Krems assuming a failure of the temporal flood protection due to the impact of a ship in the area of the pier. Moreover, both, hazard scenarios with and without a second line of defence were visualised. The set of maps includes (a) an evaluative risk map showing the risk qualitatively aggregated for each building exposed and the number of affected citizens, (b) an evaluative risk map showing the risk qualitatively aggregated per square footage for each building exposed and the number of affected citizens, (c) an evaluative risk map showing the risk quantitatively in monetary units per square footage for each building exposed and the number of affected citizens, and (d) as well as (e) risk maps according to (a) and (b) without the second line of defence in order to communicate the effectiveness of temporal flood protection

  12. Ebola virus disease surveillance and response preparedness in northern Ghana

    Directory of Open Access Journals (Sweden)

    Martin N. Adokiya

    2016-05-01

    Full Text Available Background: The recent Ebola virus disease (EVD outbreak has been described as unprecedented in terms of morbidity, mortality, and geographical extension. It also revealed many weaknesses and inadequacies for disease surveillance and response systems in Africa due to underqualified staff, cultural beliefs, and lack of trust for the formal health care sector. In 2014, Ghana had high risk of importation of EVD cases. Objective: The objective of this study was to assess the EVD surveillance and response system in northern Ghana. Design: This was an observational study conducted among 47 health workers (district directors, medical, disease control, and laboratory officers in all 13 districts of the Upper East Region representing public, mission, and private health services. A semi-structured questionnaire with focus on core and support functions (e.g. detection, confirmation was administered to the informants. Their responses were recorded according to specific themes. In addition, 34 weekly Integrated Disease Surveillance and Response reports (August 2014 to March 2015 were collated from each district. Results: In 2014 and 2015, a total of 10 suspected Ebola cases were clinically diagnosed from four districts. Out of the suspected cases, eight died and the cause of death was unexplained. All the 10 suspected cases were reported, none was confirmed. The informants had knowledge on EVD surveillance and data reporting. However, there were gaps such as delayed reporting, low quality protective equipment (e.g. gloves, aprons, inadequate staff, and lack of laboratory capacity. The majority (38/47 of the respondents were not satisfied with EVD surveillance system and response preparedness due to lack of infrared thermometers, ineffective screening, and lack of isolation centres. Conclusion: EVD surveillance and response preparedness is insufficient and the epidemic is a wake-up call for early detection and response preparedness. Ebola surveillance remains

  13. The Tobacco Pack Surveillance System: A Protocol for Assessing Health Warning Compliance, Design Features, and Appeals of Tobacco Packs Sold in Low- and Middle-Income Countries.

    Science.gov (United States)

    Smith, Katherine; Washington, Carmen; Brown, Jennifer; Vadnais, Alison; Kroart, Laura; Ferguson, Jacqueline; Cohen, Joanna

    2015-01-01

    Tobacco remains the world's leading preventable cause of death, with the majority of tobacco-caused deaths occurring in low- and middle-income countries. The first global health treaty, the Framework Convention on Tobacco Control (FCTC), outlines a set of policy initiatives that have been demonstrated as effective in reducing tobacco use. Article 11 of the FCTC focuses on using the tobacco package to communicate tobacco-caused harms; it also seeks to restrict the delivery of misleading information about the product on the pack. The objective of this study was to establish a surveillance system for tobacco packs in the 14 low- and middle-income countries with the greatest number of smokers. The Tobacco Pack Surveillance System (TPackSS) monitors whether required health warnings on tobacco packages are being implemented as intended, and identifies pack designs and appeals that might violate or detract from the communication of harm-related information and undermine the impact of a country's tobacco packaging laws. The protocol outlined is intended to be applicable or adaptable for surveillance efforts in other countries. Tobacco packs were collected in 14 countries during 2013. The intention was, to the extent possible, to construct a census of "unique" pack presentations available for purchase in each country. The TPackSS team partnered with in-country field staff to implement a standardized protocol for acquiring packs from 36 diverse neighborhoods across three cities in each country. At the time of purchase, data on price and place of acquisition of each pack was recorded. The field staff, according to a standardized protocol, then photographed packs before they were shipped to the United States for coding and archiving. Each pack was coded for compliance with the country-specific health warning label laws, as well as for key design features of the pack and appeals of the branding elements. The coding protocols were developed based upon prior research, expert

  14. The surveillance error grid.

    Science.gov (United States)

    Klonoff, David C; Lias, Courtney; Vigersky, Robert; Clarke, William; Parkes, Joan Lee; Sacks, David B; Kirkman, M Sue; Kovatchev, Boris

    2014-07-01

    Currently used error grids for assessing clinical accuracy of blood glucose monitors are based on out-of-date medical practices. Error grids have not been widely embraced by regulatory agencies for clearance of monitors, but this type of tool could be useful for surveillance of the performance of cleared products. Diabetes Technology Society together with representatives from the Food and Drug Administration, the American Diabetes Association, the Endocrine Society, and the Association for the Advancement of Medical Instrumentation, and representatives of academia, industry, and government, have developed a new error grid, called the surveillance error grid (SEG) as a tool to assess the degree of clinical risk from inaccurate blood glucose (BG) monitors. A total of 206 diabetes clinicians were surveyed about the clinical risk of errors of measured BG levels by a monitor. The impact of such errors on 4 patient scenarios was surveyed. Each monitor/reference data pair was scored and color-coded on a graph per its average risk rating. Using modeled data representative of the accuracy of contemporary meters, the relationships between clinical risk and monitor error were calculated for the Clarke error grid (CEG), Parkes error grid (PEG), and SEG. SEG action boundaries were consistent across scenarios, regardless of whether the patient was type 1 or type 2 or using insulin or not. No significant differences were noted between responses of adult/pediatric or 4 types of clinicians. Although small specific differences in risk boundaries between US and non-US clinicians were noted, the panel felt they did not justify separate grids for these 2 types of clinicians. The data points of the SEG were classified in 15 zones according to their assigned level of risk, which allowed for comparisons with the classic CEG and PEG. Modeled glucose monitor data with realistic self-monitoring of blood glucose errors derived from meter testing experiments plotted on the SEG when compared to

  15. Multiparametric Magnetic-Resonance to Confirm Eligibility to an Active Surveillance Program for Low-Risk Prostate Cancer: Intermediate Time Results of a Third Referral High Volume Centre Active Surveillance Protocol.

    Science.gov (United States)

    Luzzago, Stefano; Musi, Gennaro; Catellani, Michele; Russo, Andrea; Di Trapani, Ettore; Mistretta, Francesco Alessandro; Bianchi, Roberto; Cozzi, Gabriele; Conti, Andrea; Pricolo, Paola; Ferro, Matteo; Matei, Deliu-Victor; Mirone, Vincenzo; Petralia, Giuseppe; de Cobelli, Ottavio

    2018-05-07

    To evaluate the role of confirmatory multiparametric magnetic resonance imaging (mpMRI) of the prostate at the time of Active Surveillance (AS) enrollment to reduce disease misclassification. From 2012 to 2016, 383 patients with low-risk disease respecting Prostate Cancer Research International AS criteria underwent confirmatory 1.5-T mpMRI. AS was proposed to patients with Prostate Imaging and Report and Data System (PI-RADS) score ≤3 and no extraprostatic extension (EPE), whereas patients with PI-RADS score ≥4 and/or EPE were treated actively. Kaplan-Meier analyses quantified progression-free survival (PFS) in patients enrolled in the AS program. Logistic regression analyses tested the association between confirmatory mpMRI and clinically significant prostate cancer (csPCa) at radical prostatectomy (RP). Diagnostic performance of mpMRI was calculated in patients submitted to immediate RP. PFS rate was 99, 90 and 86% at 1, 2 and 3 years respectively. At multivariable analysis, PI-RADS 3, PI-RADS 4, PI-RADS 5 and EPE increased the probability of having csPCa at immediate RP (PI-RADS 3 [OR] 1.2, p = 0.26; PI-RADS 4 [OR] 5.1, p = 0.02; PI-RADS 5 [OR] 6.7; p = 0.009; EPE [OR] 11.8, p < 0.001). Confirmatory mpMRI showed sensibility, specificity, positive predictive value and negative predictive value of 85, 55, 68 and 76% respectively. MpMRI at the time of AS enrollment reduces the misclassification rate of csPCa. We suggest to perform target biopsies in patients with PI-RADS score 3 and 4 lesions. © 2018 S. Karger AG, Basel.

  16. Commentary: Risk Management and Reliability Design for Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Berry, Dennis L.; Cranwell, Robert M.; Hunter, Regina L.

    1999-05-28

    Where there is a significant actuarial basis for decision making (e.g., the occurrence of fires in single-family dwellings), there is little incentive for formal risk management. Formal risk assessments are most useful in those cases where the value of the structure is high, many people may be affected, the societal perception of risk is high, consequences of a mishap would be severe, and the actuarial uncertainty is large. For these cases, there is little opportunity to obtain the necessary experiential data to make informed decisions, and the consequences in terms of money, lives, and societal confidence are severe enough to warrant a formal risk assessment. Other important factors include the symbolic value of the structure and vulnerability to single point failures. It is unlikely that formal risk management and assessment practices will or should replace the proven institutions of building codes and engineering practices. Nevertheless, formal risk assessment can provide valuable insights into the hazards threatening high-value and high-risk (perceived or actual) buildings and structures, which can in turn be translated into improved public health, safety, and security. The key is to choose and apply the right assessment tool to match the structure in question. Design-for-reliability concepts can be applied to buildings, bridges, transportation sys- tems, dams, and other structures. The use of these concepts could have the dual benefits of lowering life-cycle costs by reducing the necessity for maintenance and repair and of enhancing the saiiety and security of the structure's users.

  17. Surveillance test interval optimization

    International Nuclear Information System (INIS)

    Cepin, M.; Mavko, B.

    1995-01-01

    Technical specifications have been developed on the bases of deterministic analyses, engineering judgment, and expert opinion. This paper introduces our risk-based approach to surveillance test interval (STI) optimization. This approach consists of three main levels. The first level is the component level, which serves as a rough estimation of the optimal STI and can be calculated analytically by a differentiating equation for mean unavailability. The second and third levels give more representative results. They take into account the results of probabilistic risk assessment (PRA) calculated by a personal computer (PC) based code and are based on system unavailability at the system level and on core damage frequency at the plant level

  18. The association of lifetime education with the prevalence of myocardial infarction: an analysis of the 2006 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Kelly, Michael J; Weitzen, Sherry

    2010-02-01

    Socioeconomic status is likely an independent risk factor for coronary heart disease but little research has been done in the United States to study this association in a nationally representative sample. We sought to determine the association between lifetime education and the prevalence of myocardial infarction (MI) among adults over the age of 39 in the US. A cross sectional study was conducted using the 2006 Behavioral Risk Factor Surveillance System (BRFSS). A multivariable logistic regression was performed. The analysis was conducted in 2008. Among respondents aged 40 years and older to the 2006 BRFSS survey those with less than a high school education had 3.09 (95% CI: 2.79-3.43) times the odds of having had an MI compared to college graduates. After adjusting for confounders, respondents with less than a high school education had 1.61 (95% CI: 1.41-1.83) times the odds of having had an MI compared to college graduates. Both those with a high school education and those who completed some college or technical school had 1.22 times the odds of having had an MI compared to college graduates after adjusting for confounders. This study suggests that education is a risk factor for MI. More national prospective studies are needed in the US to better understand the link between socioeconomic status and coronary heart disease.

  19. Prevention and surveillance of public health risks during extended mass gatherings in rural areas: the experience of the Tamworth Country Music Festival, Australia.

    Science.gov (United States)

    Polkinghorne, B G; Massey, P D; Durrheim, D N; Byrnes, T; MacIntyre, C R

    2013-01-01

    To describe and evaluate the public health response to the Tamworth Country Music Festival, an annual extended mass gathering in rural New South Wales, Australia; and to propose a framework for responding to similar rural mass gatherings. Process evaluation by direct observation, archival analysis and focus group discussion. The various components of the public health response to the 2011 Tamworth Country Music Festival were actively recorded. An archival review of documentation from 2007 to 2010 was performed to provide context. A focus group was also conducted to discuss the evolution of the public health response and the consequences of public health involvement. Public health risks increased with increasing duration of the rural mass gathering. Major events held within the rural mass gathering further strained resources. The prevention, preparedness, response and recovery principles provided a useful framework for public health actions. Particular risks included inadequately trained food preparation volunteers functioning in poorly equipped temporary facilities, heat-related ailments and arboviral disease. Extended mass gatherings in rural areas pose particular public health challenges; surge capacity is limited and local infrastructure may be overwhelmed in the event of an acute incident or outbreak. There is value in proactive public health surveillance and monitoring. Annual mass gatherings provide opportunities for continual systems improvement. Early multi-agency planning can identify key risks and identify opportunities for partnership. Special consideration is required for major events within mass gatherings. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Cross-sectional STEPwise Approach to Surveillance (STEPS) Population Survey of Noncommunicable Diseases (NCDs) and Risk Factors in Brunei Darussalam 2016.

    Science.gov (United States)

    Ong, Sok King; Lai, Daphne Teck Ching; Wong, Justin Yun Yaw; Si-Ramlee, Khairil Azhar; Razak, Lubna Abdul; Kassim, Norhayati; Kamis, Zakaria; Koh, David

    2017-11-01

    This article provides a cross-sectional weighted measurement of noncommunicable diseases (NCDs) and risk factors prevalence among Brunei adult population using WHO STEPS methodology. A 2-staged randomized sampling was conducted during August 2015 to April 2016. Three-step surveillance included (1) interview using standardized questionnaire, (2) blood pressure and anthropometric measurements, and (3) biochemistry tests. Data weighting was applied. A total of 3808 adults aged 18 to 69 years participated in step 1; 2082 completed steps 2 and 3 measurements. Adult smoking prevalence was 19.9%, obesity 28.2%, hypertension 28.0%, diabetes 9.7%, prediabetes 2.1%, and 51.3% had fasting cholesterol level ≥5 mmol/L. Inadequate consumption of fruits and vegetables prevalence was high at 91.7%. Among those aged 40 to 69 years, 8.9% had a 10-year cardiovascular disease (CVD) risk ≥30%, or with existing CVD. Population strategies and targeted group interventions are required to control the NCD risk factors and morbidities.

  1. Lifestyles in Brazilian capitals according to the National Health Survey and the Surveillance System for Protective and Risk Factors for Chronic Diseases by Telephone Survey (Vigitel), 2013.

    Science.gov (United States)

    Malta, Deborah Carvalho; Iser, Betine Pinto Moehlecke; Santos, Maria Aline Siqueira; Andrade, Silvânia Suely de Araújo; Stopa, Sheila Rizzato; Bernal, Regina Tomie Ivata; Claro, Rafael Moreira

    2015-12-01

    To describe risk and protective factors for chronic diseases, in Brazilian capitals and the Federal District, collected by the National Health Survey (PNS) and by the Surveillance System for Protective and Risk Factors for Chronic Diseases by Telephone Survey (Vigitel) in 2013. Data analysis of the studies conducted by the PNS and Vigitel in 2013 was performed. Indicators analyzed were: smoking, alcohol consumption, diet, and physical activity, according to sex, with a 95% confidence interval. The prevalences found were: current cigarette smokers: PNS, 12.5% and Vigitel, 11.3%; abuse of alcoholic beverages: PNS, 14.9% and Vigitel, 16.4%; recommended intake of fruits and vegetables: PNS, 41.8% and Vigitel, 23.6%; and physical activity in leisure time: PNS, 26.6% and Vigitel, 35.8%. In the majority of indicators, the results were similar, especially when the questions and response options were equal. Surveys are useful for the monitoring of risk and protective factors of noncommunicable diseases and can support health promotion programs.

  2. Design of process displays based on risk analysis techniques

    International Nuclear Information System (INIS)

    Lundtang Paulsen, J.

    2004-05-01

    This thesis deals with the problems of designing display systems for process plants. We state the reasons why it is important to discuss information systems for operators in a control room, especially in view of the enormous amount of information available in computer-based supervision systems. The state of the art is discussed: How are supervision systems designed today and why? Which strategies are used? What kind of research is going on? Four different plants and their display systems, designed by the author, are described and discussed. Next we outline different methods for eliciting knowledge of a plant, particularly the risks, which is necessary information for the display designer. A chapter presents an overview of the various types of operation references: constitutive equations, set points, design parameters, component characteristics etc., and their validity in different situations. On the basis of her experience with the design of display systems; with risk analysis methods and from 8 years, as an engineer-on-shift at a research reactor, the author developed a method to elicit necessary information to the operator. The method, a combination of a Goal-Tree and a Fault-Tree, is described in some detail. Finally we address the problem of where to put the dot and the lines: when all information is on the table, how should it be presented most adequately. Included, as an appendix is a paper concerning the analysis of maintenance reports and visualization of their information. The purpose was to develop a software tool for maintenance supervision of components in a nuclear power plant. (au)

  3. Body mass index was associated with upstaging and upgrading in patients with low-risk prostate cancer who met the inclusion criteria for active surveillance.

    Science.gov (United States)

    de Cobelli, Ottavio; Terracciano, Daniela; Tagliabue, Elena; Raimondi, Sara; Galasso, Giacomo; Cioffi, Antonio; Cordima, Giovanni; Musi, Gennaro; Damiano, Rocco; Cantiello, Francesco; Detti, Serena; Victor Matei, Deliu; Bottero, Danilo; Renne, Giuseppe; Ferro, Matteo

    2015-05-01

    Obesity is associated with an increased risk of high-grade prostate cancer (PCa). The effect of body mass index (BMI) as a predictor of progression in men with low-risk PCa has been only poorly assessed. In this study, we evaluated the association of BMI with progression in patients with low-risk PCa who met the inclusion criteria for the active surveillance (AS) protocol. We assessed 311 patients who underwent radical prostatectomy and were eligible for AS according to the following criteria: clinical stage T2a or less, prostate-specific antigen level pT2) and upgraded (Gleason score ≥ 7; primary Gleason pattern 4) disease. Seminal vesicle invasion, positive lymph nodes, and tumor volume ≥ 0.5 ml were also recorded. We found that high BMI was significantly associated with upgrading, upstaging, and seminal vesicle invasion, whereas it was not associated with positive lymph nodes or large tumor volume. At multivariate analysis, 1 unit increase of BMI significantly increased the risk of upgrading, upstaging, seminal vesicle invasion, and any outcome by 21%, 23%, 27%, and 20%, respectively. The differences between areas under the receiver operating characteristics curves comparing models with and without BMI were statistically significant for upgrading (P = 0.0002), upstaging (P = 0.0007), and any outcome (P = 0.0001). BMI should be a selection criterion for inclusion of patients with low-risk PCa in AS programs. Our results support the idea that obesity is associated with worse prognosis and suggest that a close AS program is an appropriate treatment option for obese subjects. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Body mass index, falls, and injurious falls among U.S. adults: Findings from the 2014 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Ylitalo, Kelly R; Karvonen-Gutierrez, Carrie A

    2016-10-01

    Falls are an important health concern because they are associated with loss of independence and disability, particularly among women. We determined the age- and sex-specific prevalence of injurious falls among adults in the United States and examined the impact of obesity on fall risk. Self-reported falls, injurious falls, and health histories were obtained from 280,035 adults aged 45-79years in the 2014 Behavioral Risk Factor Surveillance System. Body mass index was categorized as underweight (fall in the previous 12months. Mid-life women 55-59years reported the highest prevalence of injurious falls (15.4%). Among mid-life women, overweight was associated with injurious falls (RR=1.17; 95% CI: 1.08, 1.28), but overweight was not associated with falling among other age-sex groups. Class II/III obesity was associated with injurious falls among all age-sex groups. After considering the mediators like health conditions (depression, cardiovascular disease, diabetes, arthritis) and behaviors (physical activity, sleep), the association of class II/III obesity and injurious fall risk persisted only among mid-life women (RR=1.23; 95% CI: 1.12, 1.36). Not only are mid-life women at high risk for falls, but the class II/III obesity is a risk factor for injurious falls. Targeting mid-life women for fall and injury prevention is an important aim for practitioners, particularly given unique correlates of falling for this group. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Early versus late percutaneous revascularization in patients hospitalized with non ST-segment elevation myocardial infarction: The atherosclerosis risk in communities surveillance study.

    Science.gov (United States)

    Arora, Sameer; Matsushita, Kunihiro; Qamar, Arman; Stacey, R Brandon; Caughey, Melissa C

    2018-02-01

    Current guidelines recommend early invasive intervention (<24 hr) for high risk patients with non-ST-segment elevation myocardial infarction (NSTEMI). A delayed invasive strategy (24-72 hr) is considered reasonable for low risk patients. The real-world effectiveness of this strategy is unknown. The ARIC Study has conducted hospital surveillance of acute myocardial infarction (MI) since 1987. NSTEMI was classified using a validated algorithm. We limited our study to patients undergoing early (<24 hr of the event onset), or late (≥24 hr) percutaneous coronary intervention (PCI). Patients were stratified into low (TIMI score 2-4), and high risk (TIMI score 5-7, or presence of cardiogenic shock, ventricular fibrillation, or cardiac arrest). Associations between early versus late PCI and mortality were analyzed using multivariable logistic regression adjusted for demographics, hospitalization year, TIMI score, and comorbidities. From 1987 to 2012, 6,746 patients were hospitalized with NSTEMI and underwent PCI. Most were white (79%), male (68%), with mean age 61 years. The 28-day and 1-year mortality were 2% and 5%, respectively. Most revascularizations (65%) were late. After accounting for potential confounders, early PCI was associated with a 58% reduced 28-day mortality (OR = 0.42; 95% CI: 0.21-0.84) for the entire population, and 57% reduced mortality (OR = 0.43; 95% CI: 0.21-0.88) for high risk patients. By 1-year of follow up, there was no significant difference in mortality with respect to early vs. late PCI. In hospitalized NSTEMI patients with high risk of clinical events, early PCI is associated with improved 28-day survival. © 2017 Wiley Periodicals, Inc.

  6. Pathological and Biochemical Outcomes among African-American and Caucasian Men with Low Risk Prostate Cancer in the SEARCH Database: Implications for Active Surveillance Candidacy.

    Science.gov (United States)

    Leapman, Michael S; Freedland, Stephen J; Aronson, William J; Kane, Christopher J; Terris, Martha K; Walker, Kelly; Amling, Christopher L; Carroll, Peter R; Cooperberg, Matthew R

    2016-11-01

    Racial disparities in the incidence and risk profile of prostate cancer at diagnosis among African-American men are well reported. However, it remains unclear whether African-American race is independently associated with adverse outcomes in men with clinical low risk disease. We retrospectively analyzed the records of 895 men in the SEARCH (Shared Equal Access Regional Cancer Hospital) database in whom clinical low risk prostate cancer was treated with radical prostatectomy. Associations of African-American and Caucasian race with pathological biochemical recurrence outcomes were examined using chi-square, logistic regression, log rank and Cox proportional hazards analyses. We identified 355 African-American and 540 Caucasian men with low risk tumors in the SEARCH cohort who were followed a median of 6.3 years. Following adjustment for relevant covariates African-American race was not significantly associated with pathological upgrading (OR 1.33, p = 0.12), major upgrading (OR 0.58, p = 0.10), up-staging (OR 1.09, p = 0.73) or positive surgical margins (OR 1.04, p = 0.81). Five-year recurrence-free survival rates were 73.4% in African-American men and 78.4% in Caucasian men (log rank p = 0.18). In a Cox proportional hazards analysis model African-American race was not significantly associated with biochemical recurrence (HR 1.11, p = 0.52). In a cohort of patients at clinical low risk who were treated with prostatectomy in an equal access health system with a high representation of African-American men we observed no significant differences in the rates of pathological upgrading, up-staging or biochemical recurrence. These data support continued use of active surveillance in African-American men. Upgrading and up-staging remain concerning possibilities for all men regardless of race. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  7. Propositions for the implementation and reinforcement of surveillance activities of exposure and risks associated to radon inhalation

    International Nuclear Information System (INIS)

    2003-10-01

    This report treats exclusively of exposure by inhalation. It expresses the propositions relative to the implantation and the development of an information network allowing to characterize the radon exposures by inhalation and associated risks. (N.C.)

  8. Market Mechanism Design for Renewable Energy based on Risk Theory

    Science.gov (United States)

    Yang, Wu; Bo, Wang; Jichun, Liu; Wenjiao, Zai; Pingliang, Zeng; Haobo, Shi

    2018-02-01

    Generation trading between renewable energy and thermal power is an efficient market means for transforming supply structure of electric power into sustainable development pattern. But the trading is hampered by the output fluctuations of renewable energy and the cost differences between renewable energy and thermal power at present. In this paper, the external environmental cost (EEC) is defined and the EEC is introduced into the generation cost. At same time, the incentive functions of renewable energy and low-emission thermal power are designed, which are decreasing functions of EEC. On these bases, for the market risks caused by the random variability of EEC, the decision-making model of generation trading between renewable energy and thermal power is constructed according to the risk theory. The feasibility and effectiveness of the proposed model are verified by simulation results.

  9. Public involvement in environmental surveillance at Hanford

    International Nuclear Information System (INIS)

    Hanf, R.W. Jr.; Patton, G.W.; Woodruff, R.K.; Poston, T.M.

    1994-08-01

    Environmental surveillance at the Hanford Site began during the mid-1940s following the construction and start-up of the nation's first plutonium production reactor. Over the past approximately 45 years, surveillance operations on and off the Site have continued, with virtually all sampling being conducted by Hanford Site workers. Recently, the US Department of Energy Richland Operations Office directed that public involvement in Hanford environmental surveillance operations be initiated. Accordingly, three special radiological air monitoring stations were constructed offsite, near hanford's perimeter. Each station is managed and operated by two local school teaches. These three stations are the beginning of a community-operated environmental surveillance program that will ultimately involve the public in most surveillance operations around the Site. The program was designed to stimulate interest in Hanford environmental surveillance operations, and to help the public better understand surveillance results. The program has also been used to enhance educational opportunities at local schools

  10. Tuberculosis and mass gatherings-opportunities for defining burden, transmission risk, and the optimal surveillance, prevention, and control measures at the annual Hajj pilgrimage.

    Science.gov (United States)

    Zumla, Alimuddin; Saeed, Abdulaziz Bin; Alotaibi, Badriah; Yezli, Saber; Dar, Osman; Bieh, Kingsley; Bates, Matthew; Tayeb, Tamara; Mwaba, Peter; Shafi, Shuja; McCloskey, Brian; Petersen, Eskild; Azhar, Esam I

    2016-06-01

    Tuberculosis (TB) is now the most common infectious cause of death worldwide. In 2014, an estimated 9.6 million people developed active TB. There were an estimated three million people with active TB including 360000 with multidrug-resistant TB (MDR-TB) who were not diagnosed, and such people continue to fuel TB transmission in the community. Accurate data on the actual burden of TB and the transmission risk associated with mass gatherings are scarce and unreliable due to the small numbers studied and methodological issues. Every year, an estimated 10 million pilgrims from 184 countries travel to the Kingdom of Saudi Arabia (KSA) to perform the Hajj and Umrah pilgrimages. A large majority of pilgrims come from high TB burden and MDR-TB endemic areas and thus many may have undiagnosed active TB, sub-clinical TB, and latent TB infection. The Hajj pilgrimage provides unique opportunities for the KSA and the 184 countries from which pilgrims originate, to conduct high quality priority research studies on TB under the remit of the Global Centre for Mass Gatherings Medicine. Research opportunities are discussed, including those related to the definition of the TB burden, transmission risk, and the optimal surveillance, prevention, and control measures at the annual Hajj pilgrimage. The associated data are required to develop international recommendations and guidelines for TB management and control at mass gathering events. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Profiles of circulating inflammatory cytokines in colorectal cancer (CRC), high cancer risk conditions, and health are distinct. Possible implications for CRC screening and surveillance.

    Science.gov (United States)

    Krzystek-Korpacka, Malgorzata; Diakowska, Dorota; Kapturkiewicz, Bartosz; Bębenek, Marek; Gamian, Andrzej

    2013-08-28

    Alternate colorectal cancer (CRC) screening and surveillance strategies are needed to pre-select candidates for invasive methods. We compared systemic inflammatory profiles in CRC (n=99), health (n=98), high CRC-risk conditions (n=48) and overt inflammation (n=69) by multiplexed analysis of IL-1β, IL-6, IL-8, FGF-2, G-CSF, GM-CSF, MCP-1, MIP-1α, TNF-α, VEGF-A, and PDGF-B and CEA. Cytokines corresponded with CRC advancement. FGF2, GM-CSF, IL-1β, IL-6, MIP-1α, PDGF-BB, TNF-α, and VEGF-A were higher than in controls already in stage I CRC with FGF2, IL1-β, and MIP-1α higher than in high CRC-risk individuals as well. Cytokine panels devised to differentiate early CRC from controls, adenomas, or inflammatory bowel disease patients (IBD) had good accuracy but only IBD panel had promising specificity at 95% sensitivity. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. Active surveillance for low-risk prostate cancer in Austria: the online registry of the Qualitätspartnerschaft Urologie (QuapU).

    Science.gov (United States)

    Eredics, Klaus; Dorfinger, Karl; Kramer, Gero; Ponholzer, Anton; Madersbacher, Stephan

    2017-06-01

    Active surveillance (AS) is a well-recognized strategy to reduce the risk of overtreatment in men with low-risk prostate cancer. No data on this approach are available from Austria. The Qualitätspartnerschaft Urologie (QuapU) developed an online database for patients managed with AS in Austria. Principal inclusion/exclusion criteria corresponded to those of the S3 prostate cancer guideline of German urologists: prostate-specific antigen (PSA) 4-10 ng/ml: 85%). The prostate volume averaged 39 ml. The mean time under AS was 17.5 months (12 months: 40%). The AS adherence at 12 months was 85% and at 24 months 76%. To date, a total of 23 patients (17.6%) stopped AS. The most frequent reasons for discontinuing AS were patient wish for active treatment (43.5%) and PSA progression (30.4%). A histological progression was rarely seen (6.1%) and the control biopsy rate was low (19.8%). This study is the first description of AS in Austria and documents the feasibility of an online registry for AS. The data confirm the international experience with this approach with acceptable adherence rates.

  13. Non-Communicable Disease Mortality and Risk Factors in Formal and Informal Neighborhoods, Ouagadougou, Burkina Faso: Evidence from a Health and Demographic Surveillance System.

    Directory of Open Access Journals (Sweden)

    Clémentine Rossier

    Full Text Available The expected growth in NCDs in cities is one of the most important health challenges of the coming decades in Sub-Saharan countries. This paper aims to fill the gap in our understanding of socio-economic differentials in NCD mortality and risk in low and middle income neighborhoods in urban Africa. We use data collected in the Ouagadougou Health and Demographic Surveillance System. 409 deaths were recorded between 2009-2011 among 20,836 individuals aged 35 years and older; verbal autopsies and the InterVA program were used to determine the probable cause of death. A random survey asked in 2011 1,039 adults aged 35 and over about tobacco use, heavy alcohol consumption, lack of physical activity and measured their weight, height, and blood pressure. These data reveal a high level of premature mortality due to NCDs in all neighborhoods: NCD mortality increases substantially by age 50. NCD mortality is greater in formal neighborhoods, while adult communicable disease mortality remains high, especially in informal neighborhoods. There is a high prevalence of risk factors for NCDs in the studied neighborhoods, with over one-fourth of the adults being overweight and over one-fourth having hypertension. Better-off residents are more prone to physical inactivity and excessive weight, while vulnerable populations such as widows/divorced individuals and migrants suffer more from higher blood pressure. Females have a significantly lower risk of being smokers or heavy drinkers, while they are more likely to be physically inactive or overweight, especially when married. Muslim individuals are less likely to be smokers or heavy drinkers, but have a higher blood pressure. Everything else being constant, individuals living in formal neighborhoods are more often overweight. The data presented make clear the pressing need to develop effective programs to reduce NCD risk across all types of neighborhoods in African cities, and suggest several entry points for

  14. Long term risk factors for coronary heart disease and stroke: influence of duration of follow-up over four decades of mortality surveillance.

    Science.gov (United States)

    Batty, G David; Shipley, Martin; Smith, George Davey; Kivimaki, Mika

    2015-09-01

    While cohort studies have revealed a range of risk factors for coronary heart disease and stroke, the extent to which the strength of these associations varies according to duration of follow-up in studies with extended disease surveillance is unclear. This was the aim of the present study. Initiated in 1967/70, the original Whitehall study is an on-going cohort study of 15,402 male UK government workers free of coronary heart disease when they took part in a baseline medical examination during which a range of standard risk factors was measured. In analyses in which we stratified by duration of follow-up, there was evidence of time-dependency for most risk factor-disease relationships. Thus, the associations of systolic and diastolic blood pressure, total cholesterol and cigarette smoking with coronary heart disease and stroke diminished in strength with increasing duration of follow-up, whereas the magnitude of the body mass index-coronary heart disease relation was unchanged. For example, the age-adjusted hazard ratios (95% confidence interval) for cigarette smoking (versus never smoked) in relation to coronary heart disease were: 2.49 (1.80, 3.44), 1.65 (1.34, 2.03), 1.36 (1.15, 1.61) and 1.32 (1.10, 1.58) for follow-up periods 0-10, 10-20, 20-30 and 30+ years, respectively. Despite a general diminution in the strength of effect over time, even in the fourth decade of follow-up, classic risk factors retained some predictive capacity for coronary heart disease and, to a lesser degree, stroke. © The European Society of Cardiology 2014.

  15. Designing a Supply Chain Network under the Risk of Disruptions

    Directory of Open Access Journals (Sweden)

    Armin Jabbarzadeh

    2012-01-01

    Full Text Available This paper studies a supply chain design problem with the risk of disruptions at facilities. At any point of time, the facilities are subject to various types of disruptions caused by natural disasters, man-made defections, and equipment breakdowns. We formulate the problem as a mixed-integer nonlinear program which maximizes the total profit for the whole system. The model simultaneously determines the number and location of facilities, the subset of customers to serve, the assignment of customers to facilities, and the cycle-order quantities at facilities. In order to obtain near-optimal solutions with reasonable computational requirements for large problem instances, two solution methods based on Lagrangian relaxation and genetic algorithm are developed. The effectiveness of the proposed solution approaches is shown using numerical experiments. The computational results, in addition, demonstrate that the benefits of considering disruptions in the supply chain design model can be significant.

  16. Evaluation of the cost-effectiveness of bovine brucellosis surveillance in a disease-free country using stochastic scenario tree modelling.

    Science.gov (United States)

    Hénaux, Viviane; Calavas, Didier

    2017-01-01

    Surveillance systems of exotic infectious diseases aim to ensure transparency about the country-specific animal disease situation (i.e. demonstrate disease freedom) and to identify any introductions. In a context of decreasing resources, evaluation of surveillance efficiency is essential to help stakeholders make relevant decisions about prioritization of measures and funding allocation. This study evaluated the efficiency (sensitivity related to cost) of the French bovine brucellosis surveillance system using stochastic scenario tree models. Cattle herds were categorized into three risk groups based on the annual number of purchases, given that trading is considered as the main route of brucellosis introduction in cattle herds. The sensitivity in detecting the disease and the costs of the current surveillance system, which includes clinical (abortion) surveillance, programmed serological testing and introduction controls, were compared to those of 19 alternative surveillance scenarios. Surveillance costs included veterinary fees and laboratory analyses. The sensitivity over a year of the current surveillance system was predicted to be 91±7% at a design prevalence of 0.01% for a total cost of 14.9±1.8 million €. Several alternative surveillance scenarios, based on clinical surveillance and random or risk-based serological screening in a sample (20%) of the population, were predicted to be at least as sensitive but for a lower cost. Such changes would reduce whole surveillance costs by 20 to 61% annually, and the costs for farmers only would be decreased from about 12.0 million € presently to 5.3-9.0 million € (i.e. 25-56% decrease). Besides, fostering the evolution of the surveillance system in one of these directions would be in agreement with the European regulations and farmers perceptions on brucellosis risk and surveillance.

  17. Evaluation of the cost-effectiveness of bovine brucellosis surveillance in a disease-free country using stochastic scenario tree modelling.

    Directory of Open Access Journals (Sweden)

    Viviane Hénaux

    Full Text Available Surveillance systems of exotic infectious diseases aim to ensure transparency about the country-specific animal disease situation (i.e. demonstrate disease freedom and to identify any introductions. In a context of decreasing resources, evaluation of surveillance efficiency is essential to help stakeholders make relevant decisions about prioritization of measures and funding allocation. This study evaluated the efficiency (sensitivity related to cost of the French bovine brucellosis surveillance system using stochastic scenario tree models. Cattle herds were categorized into three risk groups based on the annual number of purchases, given that trading is considered as the main route of brucellosis introduction in cattle herds. The sensitivity in detecting the disease and the costs of the current surveillance system, which includes clinical (abortion surveillance, programmed serological testing and introduction controls, were compared to those of 19 alternative surveillance scenarios. Surveillance costs included veterinary fees and laboratory analyses. The sensitivity over a year of the current surveillance system was predicted to be 91±7% at a design prevalence of 0.01% for a total cost of 14.9±1.8 million €. Several alternative surveillance scenarios, based on clinical surveillance and random or risk-based serological screening in a sample (20% of the population, were predicted to be at least as sensitive but for a lower cost. Such changes would reduce whole surveillance costs by 20 to 61% annually, and the costs for farmers only would be decreased from about 12.0 million € presently to 5.3-9.0 million € (i.e. 25-56% decrease. Besides, fostering the evolution of the surveillance system in one of these directions would be in agreement with the European regulations and farmers perceptions on brucellosis risk and surveillance.

  18. Surveillance and Critical Theory

    Directory of Open Access Journals (Sweden)

    Christian Fuchs

    2015-09-01

    Full Text Available In this comment, the author reflects on surveillance from a critical theory approach, his involvement in surveillance research and projects, and the status of the study of surveillance. The comment ascertains a lack of critical thinking about surveillance, questions the existence of something called “surveillance studies” as opposed to a critical theory of society, and reflects on issues such as Edward Snowden’s revelations, and Foucault and Marx in the context of surveillance.

  19. Cancer risk in hereditary nonpolyposis colorectal cancer due to MSH6 mutations: impact on counseling and surveillance

    NARCIS (Netherlands)

    Hendriks, Yvonne M. C.; Wagner, Anja; Morreau, Hans; Menko, Fred; Stormorken, Astrid; Quehenberger, Franz; Sandkuijl, Lodewijk; Møller, Pal; Genuardi, Maurizio; van Houwelingen, Hans; Tops, Carli; van Puijenbroek, Marjo; Verkuijlen, Paul; Kenter, Gemma; van Mil, Anneke; Meijers-Heijboer, Hanne; Tan, Gita B.; Breuning, Martijn H.; Fodde, Riccardo; Wijnen, Juul Th; Bröcker-Vriends, Annette H. J. T.; Vasen, Hans

    2004-01-01

    BACKGROUND & AIMS: Hereditary nonpolyposis colorectal carcinoma (HNPCC) is caused by a mutated mismatch repair (MMR) gene. The aim of our study was to determine the cumulative risk of developing cancer in a large series of MSH6 mutation carriers. METHODS: Mutation analysis was performed in 20

  20. Risk based surveillance for vector-borne diseases in horses : combining multiple sources of evidence to improve decision making

    NARCIS (Netherlands)

    Faverjon, Céline

    2017-01-01

    Emerging vector-borne diseases are a growing concern, especially for horse populations, which are at particular risk for disease spread. In general, horses travel widely and frequently and, despite the health and economic impacts of equine diseases, effective health regulations and biosecurity

  1. Risk Factor Detection as a Metric of STARHS Performance for HIV Incidence Surveillance Among Female Sex Workers in Kigali, Rwanda

    NARCIS (Netherlands)

    Braunstein, Sarah L.; van de Wijgert, Janneke H.; Vyankandondera, Joseph; Kestelyn, Evelyne; Ntirushwa, Justin; Nash, Denis

    2012-01-01

    The epidemiologic utility of STARHS hinges not only on producing accurate estimates of HIV incidence, but also on identifying risk factors for recent HIV infection. As part of an HIV seroincidence study, 800 Rwandan female sex workers (FSW) were HIV tested, with those testing positive further tested

  2. Uptake of tamoxifen in consecutive premenopausal women under surveillance in a high-risk breast cancer clinic.

    Science.gov (United States)

    Donnelly, L S; Evans, D G; Wiseman, J; Fox, J; Greenhalgh, R; Affen, J; Juraskova, I; Stavrinos, P; Dawe, S; Cuzick, J; Howell, A

    2014-04-02

    Randomised trials of tamoxifen versus placebo indicate that tamoxifen reduces breast cancer risk by approximately 33%, yet uptake is low. Approximately 10% of women in our clinic entered the IBIS-I prevention trial. We assess the uptake of tamoxifen in a consecutive series of premenopausal women not in a trial and explore the reasons for uptake through interviews. All eligible women between 33 and 46 years at ≥17% lifetime risk of breast cancer and undergoing annual mammography in our service were invited to take a 5-year course of tamoxifen. Reasons for accepting (n=15) or declining (n=15) were explored using semi-structured interviews. Of 1279 eligible women, 136 (10.6%) decided to take tamoxifen. Women >40 years (74 out of 553 (13.4%)) and those at higher non-BRCA-associated risk were more likely to accept tamoxifen (129 out of 1109 (11.6%)). Interviews highlighted four themes surrounding decision making: perceived impact of side effects, the impact of others' experience on beliefs about tamoxifen, tamoxifen as a 'cancer drug', and daily reminder of cancer risk. Tamoxifen uptake was similar to previously ascertained uptake in a randomised controlled trial (IBIS-I). Concerns were similar in women who did or did not accept tamoxifen. Decision making appeared to be embedded in the experience of significant others.

  3. Analyses of Helsinki 2012 European Athletics Championships injury and illness surveillance to discuss elite athletes risk factors.

    Science.gov (United States)

    Edouard, Pascal; Depiesse, Frédéric; Branco, Pedro; Alonso, Juan-Manuel

    2014-09-01

    To further analyze newly incurred injuries and illnesses (I&Is) during Athletics International Championships to discuss risk factors. Prospective recording of newly occurred injuries and illnesses. The 2012 European Athletics (EA) Championships in Helsinki, Finland. National team and local organizing committee physicians and physiotherapists and 1342 registered athletes. Incidence and characteristics of new injuries and illnesses. Ninety-three percent of athletes were covered by medical teams, with a response rate of 91%. One hundred thirty-three injuries were reported (incidence of 98.4 injuries per 1000 registered athletes). Sixty-two injuries (47%) resulted in time loss from sport. The most common diagnosis was hamstring strain (11.4% of injuries and 21% of time-loss injuries). Injury risk was higher in males and increased with age. The highest incidences of injuries were found in combined events and middle- and long-distance events. Twenty-seven illnesses were reported (4.0 illnesses per 1000 athlete days). The most common diagnoses were upper respiratory tract infection (33.3%) and gastroenteritis/diarrhea (25.9%). During outdoor EA Championships, injury and illness incidences were slightly lower and injury characteristics were comparable with those during outdoor World Athletics Championships. During elite athletics Championships, gender (male), age (older than 30 years), finals, and some events (combined events and middle- and long-distance races) seem to be injury risk factors. Illness risk factors remain unclear. As in previous recommendations, preventive interventions should focus on overuse injuries, hamstring strains, and adequate rehabilitation of previous injuries, decreasing risk of infectious diseases transmission, appropriate event scheduling, sports clothes, and heat acclimatization.

  4. Child development in primary care: a surveillance proposal.

    Science.gov (United States)

    Coelho, Renato; Ferreira, José Paulo; Sukiennik, Ricardo; Halpern, Ricardo

    2016-01-01

    To evaluate a child development surveillance tool proposal to be used in primary care, with simultaneous use of the Denver II scale. This was a cross-sectional study of 282 infants aged up to 36 months, enrolled in a public daycare in a countryside community in Rio Grande do Sul/Brazil. Child development was assessed using the surveillance tool and the Denver II scale. The prevalence of probable developmental delay was 53%; most of these cases were in the alert group and 24% had normal development, but with risk factors. At the Denver scale, the prevalence of suspected developmental delay was 32%. When risk factors and sociodemographic variables were assessed, no significant difference was observed. The evaluation of this surveillance tool resulted in objective and comparable data, which were adequate for a screening test. It is easily applicable as a screening tool, even though it was originally designed as a surveillance tool. The inclusion of risk factors to the scoring system is an innovation that allows for the identification of children with suspected delay in addition to developmental milestones, although the definition of parameters and choice of indicators should be thoroughly studied. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. Privacy Implications of Surveillance Systems

    DEFF Research Database (Denmark)

    Thommesen, Jacob; Andersen, Henning Boje

    2009-01-01

    This paper presents a model for assessing the privacy „cost‟ of a surveillance system. Surveillance systems collect and provide personal information or observations of people by means of surveillance technologies such as databases, video or location tracking. Such systems can be designed for vari......This paper presents a model for assessing the privacy „cost‟ of a surveillance system. Surveillance systems collect and provide personal information or observations of people by means of surveillance technologies such as databases, video or location tracking. Such systems can be designed...... for various purposes, even as a service for those being observed, but in any case they will to some degree invade their privacy. The model provided here can indicate how invasive any particular system may be – and be used to compare the invasiveness of different systems. Applying a functional approach......, the model is established by first considering the social function of privacy in everyday life, which in turn lets us determine which different domains will be considered as private, and finally identify the different types of privacy invasion. This underlying model (function – domain – invasion) then serves...

  6. Nanosafety by design: risks from nanocomposite/nanowaste combustion

    Science.gov (United States)

    Bouillard, Jacques X.; R'Mili, Badr; Moranviller, Daniel; Vignes, Alexis; Le Bihan, Olivier; Ustache, Aurelien; Bomfim, Joao A. S.; Frejafon, Emeric; Fleury, Dominique

    2013-04-01

    Risks associated with the end-of-life of nanomaterials are an issue that needs to be addressed so that the public perception and opinion, with regard to these emerging technological products, can effectively be supported by experimental evidences. In order to find new ecological ways to treat nanoproducts at their end-of-life, a new home-made demonstrator system was setup at INERIS, specifically designed to perform burning tests, coupled to a differential thermal analyzer to monitor the combustion kinetics. To assess nanoobject release during combustion, a high-performance nanocomposite polymer commonly used in the automotive industry, namely the polymeric compound acrylonitrile butadiene styrene matrix mixed with 3 wt% of multiwalled carbon nanotubes (MWCNTs) was tested. To assess the potential release of carbon nanotubes (CNTs) during the combustion with this tool, the particle size distribution in the fumes was measured using an electrical low pressure impactor, and CNTs were collected using an aspiration-based transmission electron microscopy grid sampler. One of primary objective of these preliminary tests described in this study consisted in validating whether CNT fibers can be released in the gas phase during the combustion of a polymeric matrix filled with CNTs. It was found indeed that MWCNT of about 12-nm diameter and 600-nm length can be released in the ambient environment during combustion of 3 % MWCNT ABS. Such information is critical to assess whether a nanoproduct can be deemed to be considered as "nanosafe by design" in its risk assessment.

  7. Probabilistic framework for product design optimization and risk management

    Science.gov (United States)

    Keski-Rahkonen, J. K.

    2018-05-01

    Probabilistic methods have gradually gained ground within engineering practices but currently it is still the industry standard to use deterministic safety margin approaches to dimensioning components and qualitative methods to manage product risks. These methods are suitable for baseline design work but quantitative risk management and product reliability optimization require more advanced predictive approaches. Ample research has been published on how to predict failure probabilities for mechanical components and furthermore to optimize reliability through life cycle cost analysis. This paper reviews the literature for existing methods and tries to harness their best features and simplify the process to be applicable in practical engineering work. Recommended process applies Monte Carlo method on top of load-resistance models to estimate failure probabilities. Furthermore, it adds on existing literature by introducing a practical framework to use probabilistic models in quantitative risk management and product life cycle costs optimization. The main focus is on mechanical failure modes due to the well-developed methods used to predict these types of failures. However, the same framework can be applied on any type of failure mode as long as predictive models can be developed.

  8. Risk-taking related to drug use: an application of the shift-to-risk design.

    Science.gov (United States)

    Deren, S; Des Jarlais, D C

    1977-01-01

    The utility of the shift-to-risk design for studying the influence of peer groups on drug taking was investigated. Two studies using this design with drug content were conducted, varying the level of information provided about a drug. Subjects were from two college classes consisting of 26 and 28 students. Results indicated that the specification of possible harmful drug effects which are somewhat minimal lead to a significantly greater willingness to recommend trying the drug. In addition, a tendency for a shift-to-caution was found. It was concluded that the shift-to-risk designwas useful for studying decision-making regarding drug use, and that both users and nonusers of drugs should be included in future research.

  9. Gender Disparity in Structured Physical Activity and Overall Activity Level in Adolescence: Evaluation of Youth Risk Behavior Surveillance Data

    OpenAIRE

    Lenhart, Clare M.; Hanlon, Alexandra; Kang, Youjeong; Daly, Brian P.; Brown, Michael D.; Patterson, Freda

    2012-01-01

    Background. Adolescent girls are less likely to meet physical activity recommendations than boys. This study examined the relative contribution of structured physical activity opportunities including physical education (PE) class and sports teams to overall activity levels for girls and boys. Methods. Data from 591 9th–12th grade students who completed the 2009 Philadelphia Youth Risk Behavior Survey were examined. Logistic regression was used to estimate the relationship between PE and sport...

  10. Financial risk analysis in the synthesis and design of processing networks: Balancing risk and return

    DEFF Research Database (Denmark)

    Quaglia, Alberto; Sin, Gürkan; Gani, Rafiqul

    2014-01-01

    The construction of a processing network is a corporate investment, that processing companies make with the goal of creating the conditions to increase their value. In a previous work, a computer-aided framework supporting the design of processing network under uncertainty has been presented (Qua...... and financial risk models. Through the solution of a small benchmark problem, the impact of financial factors on the optimal network configuration is presented and discussed....

  11. Identification of Barriers to Influenza Vaccination in Patients with Chronic Obstructive Pulmonary Disease: Analysis of the 2012 Behavioral Risk Factors Surveillance System.

    Science.gov (United States)

    Hsu, Douglas J; North, Crystal M; Brode, Sarah K; Celli, Bartolome R

    2016-01-01

    Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for influenza-related morbidity and mortality. Influenza vaccination is known to decrease influenza incidence, severity, hospitalizations, and mortality. Identification of barriers to influenza vaccination among patients with COPD may aid in efforts to increase vaccination rates. This study aims to identify predictors of influenza vaccination in COPD patients. This study used data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS). Participants with self-reported COPD and receiving an influenza vaccination in the prior 12 months were identified. Independent predictors of the exposure were identified by estimating a parsimonious logistic regression model of influenza vaccination. All analyses were performed using weighted data. The final study sample consisted of 36,811 COPD participants, with 48.5% of COPD patients reporting having been vaccinated and 51.5% reporting being unvaccinated. A total of 15 independent predictors of influenza vaccination in COPD patients were identified. Negative predictors included predisposing factors (younger age, male gender, household children, black or non-white/non-Hispanic/non-black race/ethnicity, lower education level, heavy alcohol use, current tobacco use) and enabling factors that reflect access to medical care (insurance status, ability to afford care, having a recent check-up). Positive predictors of influenza vaccination included need factors (chronic comorbidities), being a military veteran, or being a former smoker. This analysis identifies multiple predictors of influenza vaccination in persons with COPD. Identification of at risk-groups provides the foundation for development of focused efforts to improve influenza vaccination rates in patients with COPD.

  12. Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active-surveillance report.

    Science.gov (United States)

    Gómez-Reino, Juan J; Carmona, Loreto; Valverde, Vicente Rodríguez; Mola, Emilio Martín; Montero, Maria Dolores

    2003-08-01

    The long-term safety of therapeutic agents that neutralize tumor necrosis factor (TNF) is uncertain. Recent evidence based on spontaneous reporting shows an association with active tuberculosis (TB). We undertook this study to determine and describe the long-term safety of 2 of these agents, infliximab and etanercept, in rheumatic diseases based on a national active-surveillance system following the commercialization of the drugs. We analyzed the safety data actively collected in the BIOBADASER (Base de Datos de Productos Biológicos de la Sociedad Española de Reumatología) database, which was launched in February 2000 by the Spanish Society of Rheumatology. For the estimation of TB risk, the annual incidence rate in patients treated with these agents was compared with the background rate and with the rate in a cohort of patients with rheumatoid arthritis (RA) assembled before the era of anti-TNF treatment. Seventy-one participating centers sent data on 1,578 treatments with infliximab (86%) or etanercept (14%) in 1,540 patients. Drug survival rates (reported as the cumulative percentage of patients still receiving medication) for infliximab and etanercept pooled together were 85% and 81% at 1 year and 2 years, respectively. Instances of discontinuation were essentially due to adverse events. Seventeen cases of TB were found in patients treated with infliximab. The estimated incidence of TB associated with infliximab in RA patients was 1,893 per 100,000 in the year 2000 and 1,113 per 100,000 in the year 2001. These findings represent a significant increased risk compared with background rates. In the first 5 months of 2002, after official guidelines were established for TB prevention in patients treated with biologics, only 1 new TB case was registered (in January). Therapy with infliximab is associated with an increased risk of active TB. Proper measures are needed to prevent and manage this adverse event.

  13. Co-Prime Frequency and Aperture Design for HF Surveillance, Wideband Radar Imaging, and Nonstationary Array Processing

    Science.gov (United States)

    2018-03-01

    to develop novel co-prime sampling and array design strategies that achieve high-resolution estimation of spectral power distributions and signal...by the array geometry and the frequency offset. We overcome this limitation by introducing a novel sparsity-based multi-target localization approach...estimation using a sparse uniform linear array with two CW signals of co-prime frequencies,” IEEE International Workshop on Computational Advances

  14. Survival analysis of factors affecting incidence risk of Salmonella Dublin in Danish dairy herds during a 7-year surveillance period

    DEFF Research Database (Denmark)

    Nielsen, Liza Rosenbaum; Dohoo, Ian

    2012-01-01

    , proportional hazard model allowing for recurrence within herds. During October to December the hazard of failures was higher (hazard ratio HR=3.4, P=0.0005) than the rest of the year. Accounting for the delay in bulk-tank milk antibody responses to S. Dublin infection, this indicates that introduction......-quarters (YQs), either at the start of the study period or after recovery from infection. Survival analysis was performed on a dataset including 6931 dairy herds with 118969 YQs at risk, in which 1523 failures (new infection events) occurred. Predictors obtained from register data were tested in a multivariable...

  15. Disparities in eye care utilization among the United States adults with visual impairment: findings from the behavioral risk factor surveillance system 2006-2009.

    Science.gov (United States)

    Chou, Chiu-Fang; Barker, Lawrence E; Crews, John E; Primo, Susan A; Zhang, Xinzhi; Elliott, Amanda F; McKeever Bullard, Kai; Geiss, Linda S; Saaddine, Jinan B

    2012-12-01

    To estimate the prevalence of annual eye care among visually impaired United States residents aged 40 years or older, by state, race/ethnicity, education, and annual income. Cross-sectional study. In analyses of 2006-2009 Behavioral Risk Factor Surveillance System data from 21 states, we used multivariate regression to estimate the state-level prevalence of yearly eye doctor visit in the study population by race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and other), annual income (≥$35,000 and education ( high school). The age-adjusted state-level prevalence of yearly eye doctor visits ranged from 48% (Missouri) to 69% (Maryland). In Alabama, Colorado, Indiana, Iowa, New Mexico, and North Carolina, the prevalence was significantly higher among respondents with more than a high school education than among those with a high school education or less (P education, and income, we also found significant disparities in the prevalence of yearly eye doctor visits among states. Among visually impaired US residents aged 40 or older, the prevalence of yearly eye examinations varied significantly by race/ethnicity, income, and education, both overall and within states. Continued and possibly enhanced collection of eye care utilization data, such as we analyzed here, may help states address disparities in vision health and identify population groups most in need of intervention programs. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Improvement of risk informed surveillance test interval for the safety related instrument and control system of Ulchin units 3 and 4

    International Nuclear Information System (INIS)

    Jang, Seung Cheol; Lee, Yun Hwan; Lee, Seung Joon; Han, Sang Hoon

    2012-05-01

    The purpose of this research is the development of various methodologies necessary for the licensing of the risk informed surveillance test interval(STI) improvement for the safety related I and C systems in UCN 3 and 4, for instance, reactor protection system (RPS), engineered safety features actuation system (ESFAS), ESF auxiliary relay cabinet (ARC), and core protection calculator (CPC). The technical adequacy of the methodology was sufficiently verified through the application to the following STI changes. o CPC channel functional test (change from 1 month to 3 months including safety channel and log power test) o RPS channel functional test (change from 1 month to 3 months) o RPS logic and trip channel test (change from 1 month to 3 months. 1 month for RPS manual actuation test) o ESFAS channel functional test (change from 1 month to 3 months) o ESFAS logic and trip channel test (change from 1 month to 3 months) o ESF auxiliary relay test (change from 1 month to 3 months with staggered test. Manual actuation at the ESF ARC is added as a backup of ESF actuation signals during emergency operation

  17. Improvement of risk informed surveillance test interval for the safety related instrumentation and control system of Yonggwang units 3 and 4

    International Nuclear Information System (INIS)

    Jang, Seung Cheol; Lee, Yun Hwan; Lee, Seung Joon; Han, Sang Hoon

    2012-05-01

    The purpose of this research is the development of various methodologies necessary for the licensing of the risk informed surveillance test interval(STI) improvement for the safety related I and C systems in YGN 3 and 4, for instance, reactor protection system (RPS), engineered safety features actuation system (ESFAS), ESF auxiliary relay cabinet (ARC), and core protection calculator (CPC). The technical adequacy of the methodology was sufficiently verified through the application to the following STI changes. o CPC channel functional test (change from 1 month to 3 months including safety channel and log power test) o RPS channel functional test (change from 1 month to 3 months) o RPS logic and trip channel test (change from 1 month to 3 months. 1 month for RPS manual actuation test) o ESFAS channel functional test (change from 1 month to 3 months) o ESFAS logic and trip channel test (change from 1 month to 3 months) o ESF auxiliary relay test (change from 1 month to 3 months with staggered test. Manual actuation at the ESF ARC is added as a backup of ESF actuation signals during emergency operation

  18. Associations Between Minimum Wage Policy and Access to Health Care: Evidence From the Behavioral Risk Factor Surveillance System, 1996–2007

    Science.gov (United States)

    Zimmerman, Frederick J.; Ralston, James D.; Martin, Diane P.

    2011-01-01

    Objectives. We examined whether minimum wage policy is associated with access to medical care among low-skilled workers in the United States. Methods. We used multilevel logistic regression to analyze a data set consisting of individual-level indicators of uninsurance and unmet medical need from the Behavioral Risk Factor Surveillance System and state-level ecological controls from the US Census, Bureau of Labor Statistics, and several other sources in all 50 states and the District of Columbia between 1996 and 2007. Results. Higher state-level minimum wage rates were associated with significantly reduced odds of reporting unmet medical need after control for the ecological covariates, substate region fixed effects, and individual demographic and health characteristics (odds ratio = 0.853; 95% confidence interval = 0.750, 0.971). Minimum wage rates were not significantly associated with being uninsured. Conclusions. Higher minimum wages may be associated with a reduced likelihood of experiencing unmet medical need among low-skilled workers, and do not appear to be associated with uninsurance. These findings appear to refute the suggestion that minimum wage laws have detrimental effects on access to health care, as opponents of the policies have suggested. PMID:21164102

  19. Associations between minimum wage policy and access to health care: evidence from the Behavioral Risk Factor Surveillance System, 1996-2007.

    Science.gov (United States)

    McCarrier, Kelly P; Zimmerman, Frederick J; Ralston, James D; Martin, Diane P

    2011-02-01

    We examined whether minimum wage policy is associated with access to medical care among low-skilled workers in the United States. We used multilevel logistic regression to analyze a data set consisting of individual-level indicators of uninsurance and unmet medical need from the Behavioral Risk Factor Surveillance System and state-level ecological controls from the US Census, Bureau of Labor Statistics, and several other sources in all 50 states and the District of Columbia between 1996 and 2007. Higher state-level minimum wage rates were associated with significantly reduced odds of reporting unmet medical need after control for the ecological covariates, substate region fixed effects, and individual demographic and health characteristics (odds ratio = 0.853; 95% confidence interval = 0.750, 0.971). Minimum wage rates were not significantly associated with being uninsured. Higher minimum wages may be associated with a reduced likelihood of experiencing unmet medical need among low-skilled workers, and do not appear to be associated with uninsurance. These findings appear to refute the suggestion that minimum wage laws have detrimental effects on access to health care, as opponents of the policies have suggested.

  20. The Effects of Weight Perception on Adolescents’ Weight-Loss Intentions and Behaviors: Evidence from the Youth Risk Behavior Surveillance Survey

    Directory of Open Access Journals (Sweden)

    Maoyong Fan

    2015-11-01

    Full Text Available The objective of this study was to examine the correlation between self-perception of being overweight and weight loss intentions, eating and exercise behaviors, as well as extreme weight-loss strategies for U.S. adolescents. This study uses 50,241 observations from the Youth Risk Behavior Surveillance Survey (YRBSS 2001–2009, which were nationally representative sample of 9th- through 12th-grade students in both public and private schools in the US. This study finds that, irrespective of the weight status base on self-reported weight and height, adolescents who perceive themselves as overweight have a stronger intention to lose weight, but do not develop better eating and exercise habits, compared with their counterparts of same gender and reported weight status. Normal-weight adolescents, if they perceive themselves as overweight, are more likely to engage in health-compromising weight-loss methods. This study shows that it is critical to transform weight-loss intentions into actual behaviors among overweight/obese adolescents and improve the efficacy of behavioral interventions against childhood obesity. It also highlights the need of establishing a correct perception of body weight among normal weight adolescents to curb extreme weight-loss methods.

  1. Who is Surveilling Whom?

    DEFF Research Database (Denmark)

    Mortensen, Mette

    2014-01-01

    This article concerns the particular form of counter-surveillance termed “sousveillance”, which aims to turn surveillance at the institutions responsible for surveillance. Drawing on the theoretical perspectives “mediatization” and “aerial surveillance,” the article studies WikiLeaks’ publication...

  2. A new risk-informed design and regulatory process

    International Nuclear Information System (INIS)

    Apostolakis, George E.; Golay, Michael W.; Camp, Allen L.; Duran, Felicia A.; Finnicum, David; Ritterbusch, Stanley E.

    2001-01-01

    The overall purpose of the new approach, termed Risk-Informed Regulation, is to formulate a method of regulation that is logically consistent and devised so that both the reactor designer and regulator can work together in obtaining systems able to produce economical electricity safely. In this new system the traditional tools (deterministic and probabilistic analyses, tests and expert judgement) and treatments (defense-in-depth, conservatism) of safety regulation would still be employed, but the logic governing their use would be reversed from the current treatment. In the new treatment, probabilistic risk analysis (PRA) would be used as the paramount decision support tool, taking advantage of its ability to integrate all of the elements of system performance and to represent the uncertainties in the results. The latter is the most important reason for this choice, as the most difficult part of safety regulation is the treatment of uncertainties, not the assurance of expected performance. The scope of the PRA would be made as large as that of the reactor system, including all of its performance phenomena. The models and data of the PRA would be supported by deterministic analytical results, and data to the extent feasible. However, as in the current regulatory system, the models and data of the PRA would require being complemented by subjective judgements where the former were inadequate. All of these elements play important roles in the current decision-making structure; the main departure from current practice would be making all of these treatments explicit within the PRA, therefore, decreasing the frequency of sometimes arbitrary judgments. In the intended sense the PRA would be used as a vehicle for stating the beliefs of the designer and regulatory decision-maker; the foundation of their decisions. Thus, the PRA should be viewed as a Bayesian decision tool, and be used in order to take advantage of its capabilities in integration and inclusion of

  3. Nanosafety by design: risks from nanocomposite/nanowaste combustion

    International Nuclear Information System (INIS)

    Bouillard, Jacques X.; R’Mili, Badr; Moranviller, Daniel; Vignes, Alexis; Le Bihan, Olivier; Ustache, Aurelien; Bomfim, Joao A. S.; Frejafon, Emeric; Fleury, Dominique

    2013-01-01

    Risks associated with the end-of-life of nanomaterials are an issue that needs to be addressed so that the public perception and opinion, with regard to these emerging technological products, can effectively be supported by experimental evidences. In order to find new ecological ways to treat nanoproducts at their end-of-life, a new home-made demonstrator system was setup at INERIS, specifically designed to perform burning tests, coupled to a differential thermal analyzer to monitor the combustion kinetics. To assess nanoobject release during combustion, a high-performance nanocomposite polymer commonly used in the automotive industry, namely the polymeric compound acrylonitrile butadiene styrene matrix mixed with 3 wt% of multiwalled carbon nanotubes (MWCNTs) was tested. To assess the potential release of carbon nanotubes (CNTs) during the combustion with this tool, the particle size distribution in the fumes was measured using an electrical low pressure impactor, and CNTs were collected using an aspiration-based transmission electron microscopy grid sampler. One of primary objective of these preliminary tests described in this study consisted in validating whether CNT fibers can be released in the gas phase during the combustion of a polymeric matrix filled with CNTs. It was found indeed that MWCNT of about 12-nm diameter and 600-nm length can be released in the ambient environment during combustion of 3 % MWCNT ABS. Such information is critical to assess whether a nanoproduct can be deemed to be considered as “nanosafe by design” in its risk assessment.

  4. Application of geographically-weighted regression analysis to assess risk factors for malaria hotspots in Keur Soce health and demographic surveillance site.

    Science.gov (United States)

    Ndiath, Mansour M; Cisse, Badara; Ndiaye, Jean Louis; Gomis, Jules F; Bathiery, Ousmane; Dia, Anta Tal; Gaye, Oumar; Faye, Babacar

    2015-11-18

    In Senegal, considerable efforts have been made to reduce malaria morbidity and mortality during the last decade. This resulted in a marked decrease of malaria cases. With the decline of malaria cases, transmission has become sparse in most Senegalese health districts. This study investigated malaria hotspots in Keur Soce sites by using geographically-weighted regression. Because of the occurrence of hotspots, spatial modelling of malaria cases could have a considerable effect in disease surveillance. This study explored and analysed the spatial relationships between malaria occurrence and socio-economic and environmental factors in small communities in Keur Soce, Senegal, using 6 months passive surveillance. Geographically-weighted regression was used to explore the spatial variability of relationships between malaria incidence or persistence and the selected socio-economic, and human predictors. A model comparison of between ordinary least square and geographically-weighted regression was also explored. Vector dataset (spatial) of the study area by village levels and statistical data (non-spatial) on malaria confirmed cases, socio-economic status (bed net use), population data (size of the household) and environmental factors (temperature, rain fall) were used in this exploratory analysis. ArcMap 10.2 and Stata 11 were used to perform malaria hotspots analysis. From Jun to December, a total of 408 confirmed malaria cases were notified. The explanatory variables-household size, housing materials, sleeping rooms, sheep and distance to breeding site returned significant t values of -0.25, 2.3, 4.39, 1.25 and 2.36, respectively. The OLS global model revealed that it explained about 70 % (adjusted R(2) = 0.70) of the variation in malaria occurrence with AIC = 756.23. The geographically-weighted regression of malaria hotspots resulted in coefficient intercept ranging from 1.89 to 6.22 with a median of 3.5. Large positive values are distributed mainly in the southeast

  5. Development of a self-report questionnaire designed for population-based surveillance of gingivitis in adolescents: assessment of content validity and reliability.

    Science.gov (United States)

    Quiroz, Viviana; Reinero, Daniela; Hernández, Patricia; Contreras, Johanna; Vernal, Rolando; Carvajal, Paola

    2017-01-01

    This study aimed to develop and assess the content validity and reliability of a cognitively adapted self-report questionnaire designed for surveillance of gingivitis in adolescents. Ten predetermined self-report questions evaluating early signs and symptoms of gingivitis were preliminary assessed by a panel of clinical experts. Eight questions were selected and cognitively tested in 20 adolescents aged 12 to 18 years from Santiago de Chile. The questionnaire was then conducted and answered by 178 Chilean adolescents. Internal consistency was measured using the Cronbach's alpha and temporal stability was calculated using the Kappa-index. A reliable final self-report questionnaire consisting of 5 questions was obtained, with a total Cronbach's alpha of 0.73 and a Kappa-index ranging from 0.41 to 0.77 between the different questions. The proposed questionnaire is reliable, with an acceptable internal consistency and a temporal stability from moderate to substantial, and it is promising for estimating the prevalence of gingivitis in adolescents.

  6. Risk Factor for Diabetes Mellitus and High Blood Glucose With HMG-CoA Reductase Inhibitors Using a Postmarketing Surveillance Database in Japan.

    Science.gov (United States)

    Hashiguchi, Masayuki; Maruyama, Junya; Shimizu, Mikiko; Takahashi, Daichi; Shiga, Tsuyoshi

    2018-02-20

    To investigate whether 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor (statin) use is associated with an increased risk of diabetes mellitus and hyperglycemia, we performed a nested case-control study using a postmarketing surveillance database in Japan. The database cohort included 26,849 cases of statin use and 5308 cases of other lipid-lowering drug use in patients with hyperlipidemia. Participants received at least 1 type of statin, had a clear medication history of statin use, and had no complications of diabetes mellitus. Cases were defined as onset of diabetes mellitus or hyperglycemia during statin intake. For each case, 20 controls were randomly selected and matched by time point. The factors associated with an increased risk of diabetes mellitus and hyperglycemia during statin intake examined included sex, age, body mass index, statin use duration, complications, concomitant medication, and clinical laboratory tests. Statin-associated diabetes mellitus or hyperglycemia was identified based on abnormal elevation of blood glucose concentrations beyond the reference range. A total of 19,868 patients met the inclusion criteria, of whom 24 were patients in the case group. Two complicating factors, fatty liver (adjusted odds ratio 16.10) and hyperuricemia (adjusted odds ratio 28.96), were extracted for onset of diabetes mellitus or hyperglycemia. Nonalcoholic fatty liver was associated with diabetes mellitus, obesity, and insulin resistance, and hyperuricemia was associated with lifestyle. This study suggested that the onset of diabetes mellitus or hyperglycemia might be increased with statin use in patients with complications of fatty liver and hyperuricemia. © 2018, The American College of Clinical Pharmacology.

  7. Housing and Food Insecurity, Care Access, and Health Status Among the Chronically Ill: An Analysis of the Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Charkhchi, Paniz; Fazeli Dehkordy, Soudabeh; Carlos, Ruth C

    2018-05-01

    The proportion of the United States population with chronic illness continues to rise. Understanding the determinants of quality of care-particularly social determinants-is critical to the provision of care in this population. To estimate the prevalence of housing and food insecurity among persons with common chronic conditions and to assess the independent effects of chronic illness and sociodemographic characteristics on (1) housing and food insecurity, and (2) health care access hardship and health status. Cross-sectional study. We used data from the 11 states and one territory that completed the social context module of the 2015 Behavioral Risk Factor Surveillance System (BRFSS). We estimated the prevalence of housing and food insecurity among patients with cancer, stroke, cardiovascular disease, and chronic lung disease. Logistic regression models were used to assess the independent effects of housing and food insecurity, chronic conditions, and demographics on health care access and health status. Among the chronically ill, 36.71% (95% CI: 35.54-37.88) experienced housing insecurity and 30.60% (95% CI: 29.49-31.71) experienced food insecurity. Cardiovascular and lung disease increased the likelihood of housing (OR 1.69, 95% CI: 1.07-2.66 and OR 1.71, 95% CI: 1.12-2.60, respectively) and food insecurity (OR 1.75, 95% CI: 1.12-2.73 and OR 1.78, 95% CI: 1.20-2.63, respectively). Housing and food insecurity significantly increased the risk of health care access hardship. Being insured or having an income level above 200% of the federal poverty level significantly reduced the likelihood of access hardship, while female gender significantly increased the likelihood. Chronic illness independently affects housing and food insecurity. In turn, food and housing anxiety leads to reduced access to care, likely due to cost concerns, and correlates with poorer health. A more complete understanding of the pathways by which chronic illness influences social determinants and

  8. Differences in Mental, Cognitive, and Functional Health by Sexual Orientation Among Older Women: Analysis of the 2015 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    Seelman, Kristie L

    2018-02-01

    This study addresses a gap in the knowledge base regarding whether there are differences in mental, cognitive, and functional health between sexual minority women aged 65 and older and their heterosexual counterparts, as well as whether disparities are moderated by age, socioeconomic status, and race/ethnicity. This study analyzes 2015 Behavioral Risk Factor Surveillance System data from 21 states. Multivariate logistic regression is used to test the hypotheses. Compared to heterosexual women, lesbian/gay women aged 65 and older report worse functional health and bisexual women report worse cognitive health and more difficulties with instrumental activities of daily living. Disparities are particularly present for women in their late 60s and those in their 70s. While the likelihood of a depression diagnosis tends to be lower for heterosexual women with higher income, the inverse is true of sexual minority women. Additionally, sexual minority women with less education have lower odds of frequent mental distress and activity limitations than those with some college education. Sexual minority women of color have significantly lower odds of frequent mental distress, activity limitations, and use of special equipment compared to white sexual minority women. Findings indicate a need for gerontological services that provide support to older sexual minority women, particularly in relation to cognitive and functional health. Future research is needed to understand risk and protective factors contributing to these disparities, including forms of resilience that occur among older sexual minority women of color. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Sustainable and Resilient Supply Chain Network Design under Disruption Risks

    Directory of Open Access Journals (Sweden)

    Sonia Irshad Mari

    2014-09-01

    Full Text Available Sustainable supply chain network design is a rich area for academic research that is still in its infancy and has potential to affect supply chain performance. Increasing regulations for carbon and waste management are forcing firms to consider their supply chains from ecological and social objectives, but in reality, however, facilities and the links connecting them are disrupted from time to time, due to poor weather, natural or manmade disasters or a combination of any other factors. Supply chain systems drop their sustainability objectives while coping with these unexpected disruptions. Hence, the new challenges for supply chain managers are to design an efficient and effective supply chain network that will be resilient enough to bounce back from any disruption and that also should have sufficient vigilance to offer same sustainability under a disruption state. This paper focuses on ecological sustainability, because an environmental focus in a supply chain system is more important and also links with other pillars of sustainability, as the products need to be produced, packed and transported in an ethical way, which should not harm social balance and the environment. Owing to importance of the considered issue, this paper attempts to introduce a network optimization model for a sustainable and resilient supply chain network by incorporating (1 sustainability via carbon emissions and embodied carbon footprints and (2 resilience by incorporating location-specific risks. The proposed goal programming (GP model optimizes the total cost, while considering the resilience and sustainability of the supply chain network.

  10. GSFC Supplier Surveillance

    Science.gov (United States)

    Kelly, Michael P.

    2011-01-01

    Topics covered include: Develop Program/Project Quality Assurance Surveillance Plans The work activities performed by the developer and/or his suppliers are subject to evaluation and audit by government-designated representatives. CSO supports project by selecting on-site supplier representative s by one of several methods: (1) a Defense Contract Management Agency (DCMA) person via a Letter Of Delegation (LOD), (2) an independent assurance contractor (IAC) via a contract Audits, Assessments, and Assurance (A3) Contract Code 300 Mission Assurance Support Contract (MASC)

  11. HIV testing and intimate partner violence among non-pregnant women in 15 US states/territories: findings from behavioral risk factor surveillance system survey data.

    Science.gov (United States)

    Nasrullah, Muazzam; Oraka, Emeka; Breiding, Mathew J; Chavez, Pollyanna R

    2013-09-01

    Intimate partner violence (IPV) has been shown to be associated with higher rates of HIV infection among women, underscoring the importance of encouraging IPV victims to receive HIV testing. However, we do not know how much HIV testing behavior is influenced by IPV victimization. The current study characterized the association between individual types of IPV and HIV testing in a large sample of non-pregnant women in 15 US states/territories. The 2005 Behavioral Risk Factor Surveillance System data were analyzed after restricting the sample to non-pregnant women. The dependent variable, whether a woman ever had an HIV test, was examined in relation to individual types of IPV victimization (threatened physical violence; attempted physical violence; completed physical violence; and unwanted sex). Associations between HIV testing and types of IPV were assessed using adjusted risk ratios (aRR) that controlled for demographics and HIV-related risk factors (intravenous drug use, sexually transmitted diseases, exchange sex, unprotected anal sex). Approximately 28.6 % of women reported ever having experienced IPV, and 52.8 % of these women reported being tested for HIV. Among women who had not experienced IPV, 32.9 % reported ever having been tested for HIV. HIV testing was associated with lifetime experience of threatened violence (aRR = 1.43; 95 % CI = 1.24-1.65), attempted violence (aRR = 1.43; 95 % CI = 1.20-1.69), completed physical violence (aRR = 1.30; 95 % CI = 1.13-1.48), and unwanted sex (aRR = 1.66; 95 % CI = 1.48-1.86). Women who experienced each type of IPV were more likely to have been ever tested for HIV compared to women with no IPV history. However, nearly half of those reporting IPV, even though at greater risk for HIV infection, had never been tested. Additional efforts are needed to address barriers to testing in this group.

  12. Tenaga Nasional Berhad dam safety and surveillance program

    International Nuclear Information System (INIS)

    Jansen Luis; Zulkhairi Abd Talib

    2006-01-01

    This paper discusses the current practice of dam surveillance, which includes dam monitoring which is a process of visual inspections, measuring, processing, compiling and analyzing dam instrumentation data to determine the performance of a dam. The prime objective of the dam surveillance system is to ensure that any occurrence and development of safety deficiencies and problems are quickly detected, identified, analyzed and the required remedial actions are determined and consequently carried out in due time. In brief, the section is responsible to ensure that the dam monitoring and surveillance works are implemented as per scheduled and in accordance with the requirement and guidelines prepared by the dam designers and in accordance with international commission on large dams, ICOLD. The paper also illustrates and recommends an alternative approach for dam surveillance program using risk management approach, which is currently being actively adopted by some countries like USA, Canada, Australia and etc, towards improving the dam safety management and the decision making process. The approach provides a wider area of opportunity, improvements and benefits particular in the evaluation and modifications to the dam performance and safety. The process provides an effective and efficient tool for the decision makers and engineers through a comprehensive evaluation and a good understanding of the hazards, risks and consequences in relation to dam safety investigations. (Author)

  13. Final report : mobile surveillance and wireless communication systems field operational test. Volume 2, FOT objectives, organization, system design, results, conclusions, and recommendations

    Science.gov (United States)

    1999-03-01

    The Mobile Surveillance and Wireless Communication Systems Field Operational Test (FOT) evaluated the performance of wireless traffic detection and communications systems in areas where permanent detectors, electrical power, and landline communicatio...

  14. Decreasing prevalence of no known major risk factors for cardiovascular disease among Mississippi adults, Mississippi Behavioral Risk Factor Surveillance System, 2001 and 2009

    Directory of Open Access Journals (Sweden)

    Vincent L. Mendy

    2016-12-01

    Full Text Available Abstract Background Cardiovascular disease (CVD is the leading cause of death in Mississippi. However, the prevalence of no known CVD risk factors among Mississippi adults and the change of prevalence in the past 9 years have not been described. We assess changes in prevalence of no known CVD risk factors during 2001 and 2009. Methods Prevalence of high blood pressure, high cholesterol, diabetes, physical inactivity, smoking, and obesity were investigated. Survey respondents who reported having none of these factors were defined as having no known CVD risk factors. Differences in prevalence and 95% confidence intervals were determined using t-test analysis. Results Overall, age-standardized prevalence of having no known CVD risk factors significantly decreased from 17.3% in 2001 to 14.5% in 2009 (p = 0.0091. The age-standardized prevalence of no known CVD risk factors were significantly lower in 2009 than in 2001 among blacks (8.9% vs. 13.2%, p = 0.008; males (13.5% vs. 17.9%, p = 0.0073; individuals with a college degree (25.2%, vs. 30.8%, p = 0.0483; and those with an annual household income of $20,000–$34,999 (11.6% vs. 16.9%, p = 0.0147; and $35,000–$49,999 (15.2% vs. 23.3%, p = 0.0135. Conclusion The prevalence of no known CVD risk factors among Mississippi adults significantly decreased from 2001 to 2009 with observed differences by race, age group, sex, and annual household income.

  15. Negotiating privacy in surveillant welfare relations

    DEFF Research Database (Denmark)

    Andersen, Lars Bo; Lauritsen, Peter; Bøge, Ask Risom

    . However, while privacy is central to debates of surveillance, it has proven less productive as an analytical resource for studying surveillance in practice. Consequently, this paper reviews different conceptualisations of privacy in relation to welfare and surveillance and argues for strengthening...... the analytical capacity of the concept by rendering it a situated and relational concept. The argument is developed through a research and design project called Teledialogue meant to improve the relation between case managers and children placed at institutions or in foster families. Privacy in Teledialogue...... notion of privacy are discussed in relation to both research- and public debates on surveillance in a welfare setting....

  16. Risk factors for readmission to hospital in patients with tuberculosis in Tehran, Iran: three-year surveillance.

    Science.gov (United States)

    Shamaei, Masoud; Samiei-Nejad, Mozhgan; Nadernejad, Masoumeh; Baghaei, Parvaneh

    2017-10-01

    Tuberculosis (TB) is still a major health problem and TB hospital readmission could increase health system costs. In a retrospective study in a tertiary referral hospital for TB in Tehran, Iran, TB patients with readmission were evaluated. These TB patients in the index year who were then readmitted were compared with TB patients in the same year who were not readmitted during the follow-up period. One hundred and forty-six patients had hospital readmission within three-year follow-up with mean age of 51.6 years old of whom 78 patients (53.5%) were men. Univariate analysis revealed married status, smoking, opium smoking, and medical comorbidities (chronic obstructive pulmonary disease [COPD], hypertension, and human immunodeficiency virus [HIV] infection) as risk factors. Final logistic regression model revealed married status and smoking values of (0.478 odds ratio [OR], 0.310-0.737; 95% confidence interval [CI], P = 0.001) and (1.932 OR, 1.269-2.941; 95% CI, P = 0.002), respectively. Readmission predicted probability was 37% for married patients and 31% for active smokers. The most common medical comorbidities in the first readmission were COPD and HIV infection. Dyspnea and anti-TB drug-induced hepatitis were a common cause of early readmission, while failure and default of treatment were more frequent causes of late readmission. Admission and discharge guidelines, outpatient follow-up, and smoking cessation intervention were proposed as important factors in decreasing the readmission rate.

  17. Managing research and surveillance projects in real-time with a novel open-source eManagement tool designed for under-resourced countries.

    Science.gov (United States)

    Steiner, Andreas; Hella, Jerry; Grüninger, Servan; Mhalu, Grace; Mhimbira, Francis; Cercamondi, Colin I; Doulla, Basra; Maire, Nicolas; Fenner, Lukas

    2016-09-01

    A software tool is developed to facilitate data entry and to monitor research projects in under-resourced countries in real-time. The eManagement tool "odk_planner" is written in the scripting languages PHP and Python. The odk_planner is lightweight and uses minimal internet resources. It was designed to be used with the open source software Open Data Kit (ODK). The users can easily configure odk_planner to meet their needs, and the online interface displays data collected from ODK forms in a graphically informative way. The odk_planner also allows users to upload pictures and laboratory results and sends text messages automatically. User-defined access rights protect data and privacy. We present examples from four field applications in Tanzania successfully using the eManagement tool: 1) clinical trial; 2) longitudinal Tuberculosis (TB) Cohort Study with a complex visit schedule, where it was used to graphically display missing case report forms, upload digitalized X-rays, and send text message reminders to patients; 3) intervention study to improve TB case detection, carried out at pharmacies: a tablet-based electronic referral system monitored referred patients, and sent automated messages to remind pharmacy clients to visit a TB Clinic; and 4) TB retreatment case monitoring designed to improve drug resistance surveillance: clinicians at four public TB clinics and lab technicians at the TB reference laboratory used a smartphone-based application that tracked sputum samples, and collected clinical and laboratory data. The user friendly, open source odk_planner is a simple, but multi-functional, Web-based eManagement tool with add-ons that helps researchers conduct studies in under-resourced countries. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Sero-surveillance and risk factors for avian influenza and Newcastle disease virus in backyard poultry in Oman.

    Science.gov (United States)

    Shekaili, Thunai Al; Clough, Helen; Ganapathy, Kannan; Baylis, Matthew

    2015-11-01

    Avian Influenza (AI) and Newcastle disease (ND) are the most important reportable poultry diseases worldwide. Low pathogenic AI (H9N2) and ND viruses are known to have been circulating in the Middle East, including in Oman, for many decades. However, detailed information on the occurrence of these pathogens is almost completely lacking in Oman. As backyard poultry are not vaccinated against either virus in Oman, this sector is likely to be the most affected poultry production sector for both diseases. Here, in the first survey of AI and ND viruses in backyard poultry in Oman, we report high flock-level seroprevalences of both viruses. Serum and oropharyngeal swabs were taken from 2350 birds in 243 backyard flocks from all regions and governorates of Oman. Information was recorded on location, type of bird and housing type for each sampled farm. Individual bird serum samples were tested using commercial indirect antibody detection ELISA kits. Pooled oropharyngeal samples from each flock were inoculated onto FTA cards and tested by RT-PCR. Samples came from chickens (90.5%), turkeys (2.1%), ducks (6.2%), guinea fowl (0.8%) and geese (0.4%). The bird-level seroprevalence of antibody to AI and ND viruses was 37.5% and 42.1% respectively, and at the flock level it was 84% and 90% respectively. There were statistically significant differences between some different regions of Oman in the seroprevalence of both viruses. Flock-level NDV seropositivity in chickens was significantly associated with AIV seropositivity, and marginally negatively associated with flock size. AIV seropositivity in chickens was marginally negatively associated with altitude. All oropharyngeal samples were negative for both viruses by RT-PCR, consistent with a short duration of infection. This study demonstrates that eight or nine out of ten backyard poultry flocks in Oman are exposed to AI and ND viruses, and may present a risk for infection for the commercial poultry sector in Oman, or wild birds

  19. Ideology, Critique and Surveillance

    Directory of Open Access Journals (Sweden)

    Heidi Herzogenrath-Amelung

    2013-11-01

    Full Text Available The 2013 revelations concerning global surveillance programmes demonstrate in unprecedented clarity the need for Critical Theory of information and communication technologies (ICTs to address the mechanisms and implications of increasingly global, ubiquitous surveillance. This is all the more urgent because of the dominance of the “surveillance ideology” (the promise of security through surveillance that supports the political economy of surveillance. This paper asks which theoretical arguments and concepts can be useful for philosophically grounding a critique of this surveillance ideology. It begins by examining how the surveillance ideology works through language and introduces the concept of the ‘ideological packaging’ of ICTs to show how rhetoric surrounding the implementation of surveillance technologies reinforces the surveillance ideology. It then raises the problem of how ideology-critique can work if it relies on language itself and argues that Martin Heidegger’s philosophy can make a useful contribution to existing critical approaches to language.

  20. SAVY-4000 Field Surveillance Plan Update for 2017

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, Elizabeth J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Stone, Timothy Amos [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Smith, Paul Herrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Reeves, Kirk Patrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Veirs, Douglas Kirk [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Prochnow, David Adrian [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-03-20

    The Packaging Surveillance Program section of the Department of Energy (DOE) Manual 441.1-­1, Nuclear Material Packaging Manual (DOE 2008), requires DOE contractors to “ensure that a surveillance program is established and implemented to ensure the nuclear material storage package continues to meet its design criteria.”This 2017 update reflects changes to the surveillance plan resulting from surveillance findings as documented in Reeves et al. 2016. These findings include observations of corrosion in SAVY and Hagan containers and the indication (in one SAVY container) of possible filter membrane thermal degradation. This surveillance plan update documents the rationale for selecting surveillance containers, specifies the containers for 2017 surveillance, and identifies a minimum set of containers for 2018 surveillance. This update contains important changes to the previous surveillance plans.

  1. Societal risk approach to safeguards design and evaluation

    International Nuclear Information System (INIS)

    Bennett, C.A.; Murphey, W.M.; Sherr, T.S.

    1975-06-01

    There has been much discussion and public debate concerning the effectiveness of the national system of safeguards against malevolent acts involving nuclear materials. Useful dialogue on this subject has been hampered by the lack of well-defined objectives, system parameters and boundary conditions as a framework for communication. This study provides such a framework. Expressing the safeguards objective in terms of societal risk represents a change in focus, rather than intent, from the earlier view of safeguards as a system for protecting nuclear material against theft or diversion. The study defines both the safeguards problem and the safeguards system in terms that can be related to the general safeguards objective. It is axiomatic that the first step to an effective solution is a careful definition of the problem. The significant and immediate value of this study lies in the rigorous definition and systematic organization of recognized elements into a coherent and comprehensive pattern. Although the title specifically addresses design and evaluation, the framework provided by the study will be a useful management tool for safeguards implementation and administration as well. (U.S.)

  2. Effects of Disruption Risks on Biorefinery Location Design

    Directory of Open Access Journals (Sweden)

    Yun Bai

    2015-02-01

    Full Text Available While ever-growing bio-ethanol production poses considerable challenges to the bioenergy supply chain, the risk of refinery operation disruptions further compromises the efficiency and reliability of the energy supply system. This paper applies discrete and continuous reliable facility location models to the design of reliable bio-ethanol supply chains so that the system can hedge against potential operational disruptions. The discrete model is shown to be suitable for obtaining the exact optimality for small or moderate instances, while the continuous model has superior computational tractability for large-scale applications. The impacts of both site-independent and dependent disruptions (i.e., due to flooding are analyzed in empirical case study for the State of Illinois (one of the main biomass supply states in the U.S.. The reliable solution is compared with a deterministic solution under the same setting. It is found that refinery disruptions, especially those site-dependent ones, affect both optimal refinery deployment and the supply chain cost. Sensitivity analysis is also conducted to show how refinery failure probability and fixed cost (for building biorefineries affect optimal supply chain configuration and the total expected system cost.

  3. The impact of state-level nutrition-education program funding on BMI: evidence from the behavioral risk factor surveillance system.

    Science.gov (United States)

    McGeary, Kerry Anne

    2013-04-01

    Currently, there is insufficient evidence regarding which policies will improve nutrition, reduce BMI levels and the prevalence of obesity and overweight nationwide. This preliminary study investigates the impact of a nutrition-education policy relative to price policy as a means to reduce BMI in the United States (US). Model estimations use pooled cross-sectional data at the individual-level from the Centers for Disease Control's (CDC), Behavioral Risk Factor Surveillance System (BRFSS), state-level food prices from the American Chamber of Commerce Research Association (ACCRA) and funding for state-specific nutrition-education programs from the United States Department of Agriculture (USDA) from 1992 to 2006. The total number of observations for the study is 2,249,713 over 15 years. During this period, federal funding for state-specific nutrition-education programs rose from approximately $660 thousand for seven states to nearly $248 million for all fifty-two states. In 2011, federal funding for nutrition-education programs reached $375 million. After controlling for state-fixed effects, year effects and state specific linear and quadratic time trends, we find that nutrition education spending has the intended effect on BMI, obese and overweight in aggregate. However, we find heterogeneity as individuals from certain, but not all, income and education levels respond to nutrition-education funding. The results regarding nutrition-education programs suggest that large scale funding of nutrition-education programs may improve BMI levels and reduce obesity and overweight. However, more study is required to determine if these funds are able make the requisite dietary improvements that may ultimately improve BMI for individuals from low income and education-levels. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Postauthorization safety surveillance of ADVATE [antihaemophilic factor (recombinant), plasma/albumin-free method] demonstrates efficacy, safety and low-risk for immunogenicity in routine clinical practice.

    Science.gov (United States)

    Oldenburg, J; Goudemand, J; Valentino, L; Richards, M; Luu, H; Kriukov, A; Gajek, H; Spotts, G; Ewenstein, B

    2010-11-01

      Postauthorization safety surveillance of factor VIII (FVIII) concentrates is essential for assessing rare adverse event incidence. We determined safety and efficacy of ADVATE [antihaemophilic factor (recombinant), plasma/albumin-free method, (rAHF-PFM)] during routine clinical practice. Subjects with differing haemophilia A severities and medical histories were monitored during 12 months of prophylactic and/or on-demand therapy. Among 408 evaluable subjects, 386 (95%) received excellent/good efficacy ratings for all on-demand assessments; the corresponding number for subjects with previous FVIII inhibitors was 36/41 (88%). Among 276 evaluable subjects receiving prophylaxis continuously in the study, 255 (92%) had excellent/good ratings for all prophylactic assessments; the corresponding number for subjects with previous FVIII inhibitors was 41/46 (89%). Efficacy of surgical prophylaxis was excellent/good in 16/16 evaluable procedures. Among previously treated patients (PTPs) with >50 exposure days (EDs) and FVIII≤2%, three (0.75%) developed low-titre inhibitors. Two of these subjects had a positive inhibitor history; thus, the incidence of de novo inhibitor formation in PTPs with FVIII≤2% and no inhibitor history was 1/348 (0.29%; 95% CI, 0.01-1.59%). A PTP with moderate haemophilia developed a low-titre inhibitor. High-titre inhibitors were reported in a PTP with mild disease (following surgery), a previously untreated patient (PUP) with moderate disease (following surgery) and a PUP with severe disease. The favourable benefit/risk profile of rAHF-PFM previously documented in prospective clinical trials has been extended to include a broader range of haemophilia patients, many of whom would have been ineligible for registration studies. © 2010 Blackwell Publishing Ltd.

  5. Diseño y puesta en marcha de un sistema de vigilancia epidemiológica en salud mental Design and implementation of an epidemiological surveillance system for mental health

    Directory of Open Access Journals (Sweden)

    Judith Scharager Goldenberg

    2002-02-01

    a surveillance system to detect and rank the most significant mental health problems in a community and to establish their association with the living conditions in that community. Methods. The system was designed and tested at a primary health care center in the community of La Florida, which is in the metropolitan region of Santiago, the capital of Chile. The health problems that were under surveillance, with monthly monitoring, were: addiction (to alcohol, tobacco, and benzodiazepines or other drugs, violence (domestic violence and sexual abuse, real or suspected, and disorders in children (attention deficit and behavioral disorders. By means of a computerized geographical information system (GIS, those surveillance data were combined with other data. These other data included sociodemographic information on the persons who went to the health center for care as well as data on local risk factors and protective factors for health problems, some of which are indicators of the local residents' living conditions. Results. The proposed epidemiological surveillance system, which takes into account local living conditions and environmental variables, is a good tool for health action. The proposed system also complements the incomplete perspective of monitoring systems, which do not include variables describing the local context and that focus only on health problems. The information synthesized in the GIS maps makes it possible to simultaneously display different layers of information on factors related to the health problems studied, linked to a specific area and all its environmental variables, in an easy-to-read, self-explanatory format. Conclusions. These results and the concurring opinions of the participating physicians show that the experimental system effectively met the basic requirements of an epidemiological surveillance system of this kind.

  6. Containment and Surveillance Equipment Compendium

    International Nuclear Information System (INIS)

    Luetters, F.O.

    1980-02-01

    The Containment and Surveillance Equipment Compendium contains information sections describing the application and status of seals, optical surveillance systems, and monitors for international safeguards systems. The Compendium is a collection of information on equipment in use (generally by the IAEA) or under development in the US in diverse programs being conducted at numerous facilities under different sponsors. The Compendium establishes a baseline for the status and applications of C/S equipment and is a tool to assist in the planning of future C/S hardware development activities. The Appendix contains design concepts which can be developed to meet future goals

  7. Evaluation of sanitary consequences of Chernobylsk accident in France. Epidemiological surveillance plan, state of knowledge, risks evaluation and perspectives; Evaluation des consequences sanitaires de l'accident de Tchernobyl en France. Dispositif de surveillance epidemiologique, etat des connaissances, evaluation des risques et perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Verger, P.; Cherie-Challine, L

    2000-12-15

    This report jointly written by IPSN and InVS, reviews the sanitary consequences in France of the Chernobyl accident, which occurred in 1986. The first point is dedicated to a short presentation of the knowledge relative to the sanitary consequences of the Chernobyl accident in the high contaminated countries and to the risk factors of the thyroid cancer. Secondly, this report describes the main systems of epidemiological surveillance of health implemented in France in 1986 and in 1999, as well as the data of the incidence and mortality of thyroid cancer observed in France since 1975. In addition, this report presents an analysis of the risk of thyroid cancer related to radioactive contamination in France, for young people of less than 15 years of age who where living in 1986 in the highest contaminated areas of France (Eastern territories). For this purpose, the theoretical number of thyroid cancers in excess is evaluated for this population, on the basis of different available risk model. Finally starting from the results of risk assessment, there is a discussion about the relevance and the feasibility of different epidemiological methods in view of answering the questions related to the sanitary consequences of the Chernobyl accident. In conclusion, this report recommends to reinforce the surveillance of thyroid cancer in France. (author)

  8. Comparing national infectious disease surveillance systems: China and the Netherlands.

    Science.gov (United States)

    Vlieg, Willemijn L; Fanoy, Ewout B; van Asten, Liselotte; Liu, Xiaobo; Yang, Jun; Pilot, Eva; Bijkerk, Paul; van der Hoek, Wim; Krafft, Thomas; van der Sande, Marianne A; Liu, Qi-Yong

    2017-05-08

    Risk assessment and early warning (RAEW) are essential components of any infectious disease surveillance system. In light of the International Health Regulations (IHR)(2005), this study compares the organisation of RAEW in China and the Netherlands. The respective approaches towards surveillance of arboviral disease and unexplained pneumonia were analysed to gain a better understanding of the RAEW mode of operation. This study may be used to explore options for further strengthening of global collaboration and timely detection and surveillance of infectious disease outbreaks. A qualitative study design was used, combining data retrieved from the literature and from semi-structured interviews with Chinese (5 national-level and 6 provincial-level) and Dutch (5 national-level) experts. The results show that some differences exist such as in the use of automated electronic components of the early warning system in China ('CIDARS'), compared to a more limited automated component in the Netherlands ('barometer'). Moreover, RAEW units in the Netherlands focus exclusively on infectious diseases, while China has a broader 'all hazard' approach (including for example chemical incidents). In the Netherlands, veterinary specialists take part at the RAEW meetings, to enable a structured exchange/assessment of zoonotic signals. Despite these differences, the main conclusion is that for the two infections studied, the early warning system in China and the Netherlands are remarkably similar considering their large differences in infectious disease history, population size and geographical setting. Our main recommendations are continued emphasis on international corporation that requires insight into national infectious disease surveillance systems, the usage of a One Health approach in infectious disease surveillance, and further exploration/strengthening of a combined syndromic and laboratory surveillance system.

  9. Design and implementation of an online risk monitor

    International Nuclear Information System (INIS)

    Majdara, A.; Nematollah, M. R.; Haddad, K.; Sepanloo, K.

    2006-01-01

    Probabilistic Safety Assessment is a powerful method for evaluating the safety of nuclear facilities. Probabilistic Safety Assessment models are the basis of online risk monitors, which can be utilized for monitoring the online risk. In this paper a newly developed risk monitor called Safety Assessment Tool is presented, and its main features and capabilities are introduced. Some of these features are: graphical event/fault tree developing interface, a 30-day risk profile, performing importance analysis, different administrative levels, and handling time dependent failure data. Safety Assessment Tool can be utilized in nuclear power plants, research reactors, etc. as an online assistant to manage safety issues and prevent high-risk configurations

  10. The association between race/ethnicity and the prevalence of stroke among United States adults in 2015: a secondary analysis study using Behavioural Risk Factor Surveillance System (BRFSS).

    Science.gov (United States)

    Aldayel, Abdulrahman Yousef; Alharbi, Muteb Mousa; Shadid, Asem Mustafa; Zevallos, Juan Carlos

    2017-12-01

    Worldwide, stroke is considered the second leading cause of death, accounting for 11.8% of all deaths in 2013. In the Unites States (US), approximately 795,000 people have a stroke every year. Stroke has many different risk factors that vary by race/ethnicity. There is limited contemporary published literature about the prevalence of stroke among racial/ethnic groups in the US adult population. This study aimed to determine the association between race/ethnicity and the prevalence of stroke among US adults in 2015. This study was an observational, non-concurrent prospective of the Behavioural Risk Factor Surveillance System (BRFSS) in 2015 to assess the association between race/ethnicity and the prevalence of stroke. The final study sample was 432,814 US adults ≥ 18 years old. Variables were excluded from the model if there were missing, refused, or did not know responses to the variables of interest. A binary logistic regression analysis was used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the association between race/ethnicity and stroke. The Chi-square test was used to study bivariate associations between categorical variables. The collinearity was assessed. A p-value of <0.05 was considered statistically significant. Statistical analysis was completed using STATA version 14 (Stata Corp, College Station, TX). The highest proportion of participants (43%) were ≥ 44 years old with a balanced distribution of males and females. The highest proportion of stroke was found among Hispanics (4.2%) and non-Hispanic Blacks (4.1%) as compared to 3.2% among non-Hispanic Whites (p<0.001). Furthermore, Hispanics and Blacks were significantly more likely to develop stroke (OR=1.57, 95% CI=1.28-1.91; and OR=1.30, 95% CI=1.16-1.45, respectively) after adjusting for confounding variables. Hispanics and Blacks had a higher prevalence of stroke in comparison with non-Hispanic Whites. Further studies are needed to verify these findings and to determine which

  11. Health surveillance of radiological work

    International Nuclear Information System (INIS)

    Pauw, H.; Vliet, J.V.D.; Zuidema, H.

    1988-01-01

    Shielding x-ray devices and issuing film badges to radiological workers in 1936 can be considered the start of radiological protection in the Philips enterprises in the Netherlands. Shielding and equipment were constantly improved based upon the dosimetry results of the filmbadges. The problem of radioactive waste led to the foundation of a central Philips committee for radiological protection in 1956, which in 1960 also issued an internal license system in order to regulate the proper precautions to be taken : workplace design and layout, technological provisions and working procedures. An evaluation of all radiological work in 1971 learnt that a stricter health surveillance program was needed to follow up the precautions issued by the license. On one hand a health surveillance program was established and on the other hand all types of radiological work were classified. In this way an obligatory and optimal health surveillance program was issued for each type of radiological work

  12. Preferential sampling in veterinary parasitological surveillance

    Directory of Open Access Journals (Sweden)

    Lorenzo Cecconi

    2016-04-01

    Full Text Available In parasitological surveillance of livestock, prevalence surveys are conducted on a sample of farms using several sampling designs. For example, opportunistic surveys or informative sampling designs are very common. Preferential sampling refers to any situation in which the spatial process and the sampling locations are not independent. Most examples of preferential sampling in the spatial statistics literature are in environmental statistics with focus on pollutant monitors, and it has been shown that, if preferential sampling is present and is not accounted for in the statistical modelling and data analysis, statistical inference can be misleading. In this paper, working in the context of veterinary parasitology, we propose and use geostatistical models to predict the continuous and spatially-varying risk of a parasite infection. Specifically, breaking with the common practice in veterinary parasitological surveillance to ignore preferential sampling even though informative or opportunistic samples are very common, we specify a two-stage hierarchical Bayesian model that adjusts for preferential sampling and we apply it to data on Fasciola hepatica infection in sheep farms in Campania region (Southern Italy in the years 2013-2014.

  13. Project Surveillance and Maintenance Plan

    International Nuclear Information System (INIS)

    1985-09-01

    The Project Surveillance and Maintenance Plan (PSMP) describes the procedures that will be used by the US Department of Energy (DOE), or other agency as designated by the President to verify that inactive uranium tailings disposal facilities remain in compliance with licensing requirements and US Environmental Protection Agency (EPA) standards for remedial actions. The PSMP will be used as a guide for the development of individual Site Surveillance and Maintenance Plans (part of a license application) for each of the UMTRA Project sites. The PSMP is not intended to provide minimum requirements but rather to provide guidance in the selection of surveillance measures. For example, the plan acknowledges that ground-water monitoring may or may not be required and provides the [guidance] to make this decision. The Site Surveillance and Maintenance Plans (SSMPs) will form the basis for the licensing of the long-term surveillance and maintenance of each UMTRA Project site by the NRC. Therefore, the PSMP is a key milestone in the licensing process of all UMTRA Project sites. The Project Licensing Plan (DOE, 1984a) describes the licensing process. 11 refs., 22 figs., 8 tabs

  14. SOA-surveillance Nederland

    NARCIS (Netherlands)

    Rijlaarsdam J; Bosman A; Laar MJW van de; CIE

    2000-01-01

    In May 1999 a working group was started to evaluate the current surveillance systems for sexually transmitted diseases (STD) and to make suggestions for a renewed effective and efficient STD surveillance system in the Netherlands. The surveillance system has to provide insight into the prevalence

  15. Containment and surveillance devices

    International Nuclear Information System (INIS)

    Campbell, J.W.; Johnson, C.S.; Stieff, L.R.

    The growing acceptance of containment and surveillance as a means to increase safeguards effectiveness has provided impetus to the development of improved surveillance and containment devices. Five recently developed devices are described. The devices include one photographic and two television surveillance systems and two high security seals that can be verified while installed

  16. Microbiological Food Safety Surveillance in China

    Directory of Open Access Journals (Sweden)

    Xiaoyan Pei

    2015-08-01

    Full Text Available Microbiological food safety surveillance is a system that collects data regarding food contamination by foodborne pathogens, parasites, viruses, and other harmful microbiological factors. It helps to understand the spectrum of food safety, timely detect food safety hazards, and provide relevant data for food safety supervision, risk assessment, and standards-setting. The study discusses the microbiological surveillance of food safety in China, and introduces the policies and history of the national microbiological surveillance system. In addition, the function and duties of different organizations and institutions are provided in this work, as well as the generation and content of the surveillance plan, quality control, database, and achievement of the microbiological surveillance of food safety in China.

  17. Towards a standardised surveillance for Trichinella in the European Union

    DEFF Research Database (Denmark)

    Alban, L.; Pozio, E.; Boes, J.

    2011-01-01

    a specified design prevalence which we set to 1 per million pigs. A simple and transparent method is proposed to estimate this confidence, based on the sensitivity of the surveillance system, taking into account the sensitivity of testing and the design prevalence. The probability of detecting a positive case......, if present, must be high (>95 or >99%) to ensure that there is a low or negligible risk of transmission to humans through the food chain. In MS where the probability of a positive pig is demonstrated to be negligible, testing of fattening pigs from a sub-population consisting of pigs from controlled housing...

  18. Surveillance study for creating the national clinical database relating to ECG-gated myocardial perfusion SPECT of asymptomatic ischemic heart disease in patients with type-2 diabetes mellitus. J-ACCESS 2 study design

    International Nuclear Information System (INIS)

    Kusuoka, Hideo; Yamasaki, Yoshimitsu; Izumi, Tohru; Kashiwagi, Atsunori; Kawamori, Ryuzo; Shimamoto, Kazuaki; Yamada, Nobuhiro; Nishimura, Tsunehiko

    2008-01-01

    Diabetes mellitus is an independent risk factor for acute myocardial infarction. Thus, a surveillance study was conducted as part of studies to create a national database related to electrocardiogram (ECG)-gated myocardial perfusion single-photon emission computed tomography (SPECT) of ischemic heart disease. Single-photon emission computed tomography was conducted in patients with type 2 diabetes mellitus and their prognoses will be followed for 3 years, stratified by patients' clinical background and SPECT findings. A total of 513 patients from 50 institutions were enrolled in this study, 297 of whom were men (age 66.2±0.4 years, mean±standard error of the mean (SEM)) and 261 women (age 67.8±0.5 years). They have a history of retinopathy (25.3%), neuropathy (19.9%), cerebrovascular disorder, chronic obstructive pulmonary disease, and photocoagulation. Major risk factors for present disease were hypertension (82.3%) and hyperlipidemia (79.7%). In 244 patients (129 men and 115 women), body mass index (BMI) was 25 or more. Fifty-two of them (10.1%) underwent coronary angiography; of these, 26 (50.0%) had no coronary artery lesions with 75% or more stenosis, and only 1 (1.9%) had a left main trunk with 50% or more stenosis. An overwhelming majority of patients (94.3%) underwent SPECT imaging by a 1-day stress-followed-by-rest procedure. Stress procedure was exercise in most (70.8%) patients, followed by dipyridamole infusion in 14.6%, adenosine infusion in 6.6%, and adenosine triphosphate infusion in 5.7%. Endpoint of stress examination was most often fatigue in lower limbs (40.7%), followed by completion of pharmacological stress protocol (28.7%), and achievement of target heart rate (26.3%). The largest number of patients (198, 38.6%) received 99m Tc-tetrofosmin at an initial dosage of 200-300 MBq (mean 331±3 MBq) followed by a second dosage of 700-800 MBq (mean 748±8 MBq). Among them, 491 (95.7%) received some kind of therapeutic drug: hypoglycemic drugs were

  19. Not in Traffic Surveillance (NiTS)

    Data.gov (United States)

    Department of Transportation — The Not-in-Traffic Surveillance (NiTS) system is a virtual data collection system designed to provide counts and details regarding fatalities and injuries that occur...

  20. Sonoma Persistent Surveillance System

    Energy Technology Data Exchange (ETDEWEB)

    Pennington, D M

    2006-03-24

    Sonoma offers the first cost-effective, broad-area, high-resolution, real-time motion imagery system for surveillance applications. Sonoma is unique in its ability to provide continuous, real-time video imagery of an area the size of a small city with resolutions sufficient to track 8,000 moving objects in the field of view. At higher resolutions and over smaller areas, Sonoma can even track the movement of individual people. The visual impact of the data available from Sonoma is already causing a paradigm shift in the architecture and operation of other surveillance systems. Sonoma is expected to cost just one-tenth the price of comparably sized sensor systems. Cameras mounted on an airborne platform constantly monitor an area, feeding data to the ground for real-time analysis. Sonoma was designed to provide real-time data for actionable intelligence in situations such as monitoring traffic, special events, border security, and harbors. If a Sonoma system had been available in the aftermath of the Katrina and Rita hurricanes, emergency responders would have had real-time information on roads, water levels, and traffic conditions, perhaps saving many lives.

  1. A bootstrap based space-time surveillance model with an application to crime occurrences

    Science.gov (United States)

    Kim, Youngho; O'Kelly, Morton

    2008-06-01

    This study proposes a bootstrap-based space-time surveillance model. Designed to find emerging hotspots in near-real time, the bootstrap based model is characterized by its use of past occurrence information and bootstrap permutations. Many existing space-time surveillance methods, using population at risk data to generate expected values, have resulting hotspots bounded by administrative area units and are of limited use for near-real time applications because of the population data needed. However, this study generates expected values for local hotspots from past occurrences rather than population at risk. Also, bootstrap permutations of previous occurrences are used for significant tests. Consequently, the bootstrap-based model, without the requirement of population at risk data, (1) is free from administrative area restriction, (2) enables more frequent surveillance for continuously updated registry database, and (3) is readily applicable to criminology and epidemiology surveillance. The bootstrap-based model performs better for space-time surveillance than the space-time scan statistic. This is shown by means of simulations and an application to residential crime occurrences in Columbus, OH, year 2000.

  2. Bilirubin and Stroke Risk Using a Mendelian Randomization Design.

    Science.gov (United States)

    Lee, Sun Ju; Jee, Yon Ho; Jung, Keum Ji; Hong, Seri; Shin, Eun Soon; Jee, Sun Ha

    2017-05-01

    Circulating bilirubin, a natural antioxidant, is associated with decreased risk of stroke. However, the nature of the relationship between the two remains unknown. We used a Mendelian randomization analysis to assess the causal effect of serum bilirubin on stroke risk in Koreans. The 14 single-nucleotide polymorphisms (SNPs) (bilirubin level in the KCPS-II (Korean Cancer Prevention Study-II) Biobank subcohort consisting of 4793 healthy Korean and 806 stroke cases. Weighted genetic risk score was calculated using 14 SNPs selected from the top SNPs. Both rs6742078 (F statistics=138) and weighted genetic risk score with 14 SNPs (F statistics=187) were strongly associated with bilirubin levels. Simultaneously, serum bilirubin level was associated with decreased risk of stroke in an ordinary least-squares analysis. However, in 2-stage least-squares Mendelian randomization analysis, no causal relationship between serum bilirubin and stroke risk was found. There is no evidence that bilirubin level is causally associated with risk of stroke in Koreans. Therefore, bilirubin level is not a risk determinant of stroke. © 2017 American Heart Association, Inc.

  3. [Entomological surveillance in Mauritius].

    Science.gov (United States)

    Gopaul, R

    1995-01-01

    The entomological surveillance is an essential link in the fight against malaria in Mauritius. Because of the large number of malaria-infected travellers in Mauritius and the presence of the vector Anopheles arabiensis, the risk of local transmission is very real. The medical entomology division together with the malaria control unit and the health appointees exert a rigorous entomological surveillance of malaria. Field agents make entomological investigations of pilot villages and around the harbor and airport, where there have been cases of malaria, in addition to a few randomly chosen regions. All of the inhabited regions are accessible because of a good highway infrastructure, which enables a complete coverage for the entomological prospectives. Entomological controls are also conducted in the airplanes and the ships. All of the captured mosquitos and the harvested larva are transferred to a laboratory for identification, dissection or sensibility tests, etc. The larva of A. arabiensis have not yet developed resistance to Temephos and the adults are still sensitive to DDT. Thus, the larval habitats are treated with Temephos and DDT is sprayed in the residences where there have been native cases of malaria. The entomology division studies the ecology and the evolution of the larval habitats, as well as the impact of the anti-larval fight on the anophelene density. In addition to the chemical fight, a biological control is being tried with larva-eating fish such as Lebistes and Tilapia. In general, the anophelene density in Mauritius is low, but after the big summer rains, especially during a period of cyclones, there is a considerable increase of larval habitats and consequently a higher number of A. arabiensis. Therefore during this season, it is necessary to make an even more rigorous entomological surveillance. A. arabiensis has a strong exophile tendency even if it is endophage and exophage. This mosquito is zoophile, mostly towards cattle, and the

  4. Current Management Strategy for Active Surveillance in Prostate Cancer.

    Science.gov (United States)

    Syed, Jamil S; Javier-Desloges, Juan; Tatzel, Stephanie; Bhagat, Ansh; Nguyen, Kevin A; Hwang, Kevin; Kim, Sarah; Sprenkle, Preston C

    2017-02-01

    Active surveillance has been increasingly utilized as a strategy for the management of favorable-risk, localized prostate cancer. In this review, we describe contemporary management strategies of active surveillance, with a focus on traditional stratification schemes, new prognostic tools, and patient outcomes. Patient selection, follow-up strategy, and indication for delayed intervention for active surveillance remain centered around PSA, digital rectal exam, and biopsy findings. Novel tools which include imaging, biomarkers, and genetic assays have been investigated as potential prognostic adjuncts; however, their role in active surveillance remains institutionally dependent. Although 30-50% of patients on active surveillance ultimately undergo delayed treatment, the vast majority will remain free of metastasis with a low risk of dying from prostate cancer. The optimal method for patient selection into active surveillance is unknown; however, cancer-specific mortality rates remain excellent. New prognostication tools are promising, and long-term prospective, randomized data regarding their use in active surveillance will be beneficial.

  5. Risk management in architectural design control of uncertainty over building use and maintenance

    CERN Document Server

    Martani, Claudio

    2015-01-01

    This book analyzes the risk management process in relation to building design and operation and on this basis proposes a method and a set of tools that will improve the planning and evaluation of design solutions in order to control risks in the operation and management phase. Particular attention is paid to the relationship between design choices and the long-term performance of buildings in meeting requirements expressing user and client needs. A risk dashboard is presented as a risk measurement framework that identifies and addresses areas of uncertainty surrounding the satisfaction of particularly relevant requirements over time. This risk dashboard will assist both designers and clients. It will support designers by enabling them to improve the maintainability of project performance and will aid clients both in devising a brief that emphasizes the most relevant aspects of maintainability and in evaluating project proposals according to long-term risks. The results of assessment of the proposed method and...

  6. A Methodology for Modeling Nuclear Power Plant Passive Component Aging in Probabilistic Risk Assessment under the Impact of Operating Conditions, Surveillance and Maintenance Activities

    Science.gov (United States)

    Guler Yigitoglu, Askin

    In the context of long operation of nuclear power plants (NPPs) (i.e., 60-80 years, and beyond), investigation of the aging of passive systems, structures and components (SSCs) is important to assess safety margins and to decide on reactor life extension as indicated within the U.S. Department of Energy (DOE) Light Water Reactor Sustainability (LWRS) Program. In the traditional probabilistic risk assessment (PRA) methodology, evaluating the potential significance of aging of passive SSCs on plant risk is challenging. Although passive SSC failure rates can be added as initiating event frequencies or basic event failure rates in the traditional event-tree/fault-tree methodology, these failure rates are generally based on generic plant failure data which means that the true state of a specific plant is not reflected in a realistic manner on aging effects. Dynamic PRA methodologies have gained attention recently due to their capability to account for the plant state and thus address the difficulties in the traditional PRA modeling of aging effects of passive components using physics-based models (and also in the modeling of digital instrumentation and control systems). Physics-based models can capture the impact of complex aging processes (e.g., fatigue, stress corrosion cracking, flow-accelerated corrosion, etc.) on SSCs and can be utilized to estimate passive SSC failure rates using realistic NPP data from reactor simulation, as well as considering effects of surveillance and maintenance activities. The objectives of this dissertation are twofold: The development of a methodology for the incorporation of aging modeling of passive SSC into a reactor simulation environment to provide a framework for evaluation of their risk contribution in both the dynamic and traditional PRA; and the demonstration of the methodology through its application to pressurizer surge line pipe weld and steam generator tubes in commercial nuclear power plants. In the proposed methodology, a

  7. Mining Surveillance and Maintenance Dollars

    International Nuclear Information System (INIS)

    MARTINEZ, R.

    2000-01-01

    Accelerating site cleanup to reduce facility risks to the workers, the public and the environment during a time of declining federal budgets represents a significant technical and economic challenge to U.S. Department of Energy (DOE) Operations Offices and their respective contractors. A significant portion of a facility's recurring annual expenses are associated with routine, long-term surveillance and maintenance (S and M) activities. However, ongoing S and M activities do nothing to reduce risks and basically spend money that could be reallocated towards facility deactivation. This paper discusses the background around DOE efforts to reduce surveillance and maintenance costs, one approach used to perform cost reviews, lessons learned from field implementation and what assistance is available to assist DOE sites in performing these evaluations

  8. Random effect modelling of patient-related risk factors in orthopaedic procedures: results from the Dutch nosocomial infection surveillance network 'PREZIES'.

    NARCIS (Netherlands)

    Muilwijk, J; Walenkamp, G H I M; Voss, Andreas; Wille, Jan C; Hof, Susan van den

    2006-01-01

    In the Dutch surveillance for surgical site infections (SSIs), data from 70277 orthopaedic procedures with 1895 SSIs were collected between 1996 and 2003. The aims of this study were: (1) to analyse the trends in SSIs associated with Gram-positive and Gram-negative bacteria; (2) to estimate

  9. Risk Informed Design Using Integrated Vehicle Rapid Assessment Tools

    Data.gov (United States)

    National Aeronautics and Space Administration — A successful proof of concept was performed in FY 2012 integrating the Envision tool for parametric estimates of vehicle mass and the Rapid Response Risk Assessment...

  10. Reflecting Societal Values in Designing Flood Risk Management Strategies

    Directory of Open Access Journals (Sweden)

    Adamson Mark

    2016-01-01

    Full Text Available In 2006, the Office of Public Works (OPW began the National Catchment-based Flood Risk Assessment and Management (CFRAM Programme through a series of pilot studies. A Multi-Criteria Analysis (MCA Framework was developed through the pilot studies that integrated a number of objectives related to a wide range of potential impacts and benefits into the core of process of appraising and selecting suitable flood risk management measures for a given area or location, and then for prioritising national investments for different schemes and projects. This MCA Framework, that provides a systematic process of developing a non-monetised but numerical indicator of benefit and impact, has since been implemented nationally in the preparation of the Flood Risk Management Plans (FRMPs. A key feature of the MCA is that it should represent societal values. To this end, nationally representative quantitative research was undertaken to determine global weights that reflect the perceived importance of each of the objectives for reducing economic, social and environmental / cultural risks in flood management strategies. Saaty’s Analytical Hierarchy Process (AHP, in conjunction with a pair-wise comparison of criteria relating to these risks, was utilised to determine weights. In excess of 1,000 structured interviews were completed where the relative importance of these objectives were assessed using a seven-point scale. The weighting given to each of the 13 specific objectives identified broadly followed expectations, with risk to people followed by risk to homes and properties being respectively the first and second most important, although some were given greater or less weighting than expected. The national application of the MCA Framework, using the weighted objectives based on this process, through the CFRAM Programme has generally lead to the identification of appropriate and, based on local consultation, acceptable options for each community.

  11. Does the response to alcohol taxes differ across racial/ethnic groups? Some evidence from 1984-2009 Behavioral Risk Factor Surveillance System.

    Science.gov (United States)

    An, Ruopeng; Sturm, Roland

    2011-03-01

    Excessive alcohol use remains an important lifestyle-related contributor to morbidity and mortality in the U.S. and worldwide. It is well documented that drinking patterns differ across racial/ethnic groups, but not how those different consumption patterns would respond to tax changes. Therefore, policy makers are not informed on whether the effects of tax increases on alcohol abuse are shared equally by the whole population, or policies in addition to taxation should be pursued to reach certain sociodemographic groups. To estimate differential demand responses to alcohol excise taxes across racial/ethnic groups in the U.S. Individual data from the Behavioral Risk Factor Surveillance System 1984-2009 waves (N= 3,921,943, 39.3% male; 81.3% White, 7.8% African American, 5.8% Hispanic, 1.9% Asian or Pacific Islander, 1.4% Native American, and 1.8% other race/multi-race) are merged with tax data by residential state and interview month. Dependent variables include consumption of any alcohol and number of drinks consumed per month. Demand responses to alcohol taxes are estimated for each race/ethnicity in separate regressions conditional on individual characteristics, state and time fixed effects, and state-specific secular trends. The null hypothesis on the identical tax effects among all races/ethnicities is strongly rejected (P ethnicities, the estimated tax effects on consumption are large and significant among light drinkers (1-40 drinks per month), but shrink substantially for moderate (41-99) and heavy drinkers (≥ 100). Extensive research has been conducted on overall demand responses to alcohol excise taxes, but not on heterogeneity across various racial/ethnic groups. Only one similar prior study exists, but used a much smaller dataset. The authors did not identify differential effects. With this much larger dataset, we found some evidence for different responses across races/ethnicities to alcohol taxes, although we lack precision for individual group

  12. EDRP public local inquiry, UKAEA/BNFL precognition on: Risk targets and EDRP design

    International Nuclear Information System (INIS)

    Brown, M.L.

    1986-06-01

    A full description is presented of the extent to which risk is controlled by the targets to be implemented in the proposed EDRP design, including a discussion of a particular accident sequence. Risk expressions and the usefulness of risk criteria are reviewed. Details are given of the accident consequence modelling as used by the UKAEA. Terrorist attack and sabotage are briefly discussed. (UK)

  13. The adoption and design of Enterprise Risk Management practices : An empirical study

    NARCIS (Netherlands)

    Paape, L.; Speklé, R.F.

    2012-01-01

    We examine (1) the extent of enterprise risk management (ERM) implementation and the factors that are associated with cross-sectional differences in the level of ERM adoption, and (2) specific risk management design choices and their effect on perceived risk management effectiveness. Broadly

  14. Computed tomography in children: multicenter cohort study design for the evaluation of cancer risk

    International Nuclear Information System (INIS)

    Krille, L.; Jahnen, A.; Mildenberger, P.; Schneider, K.; Weisser, G.; Zeeb, H.; Blettner, M.

    2011-01-01

    Exposure to ionizing radiation is a known risk factor for cancer. Cancer risk is highest after exposure in childhood. The computed tomography is the major contributor to the average, individual radiation exposure. Until now the association has been addressed only in statistical modeling. We present the first feasible study design on childhood cancer risk after exposure to computed tomography.

  15. Applications of probabilistic risk analysis in nuclear criticality safety design

    International Nuclear Information System (INIS)

    Chang, J.K.

    1992-01-01

    Many documents have been prepared that try to define the scope of the criticality analysis and that suggest adding probabilistic risk analysis (PRA) to the deterministic safety analysis. The report of the US Department of Energy (DOE) AL 5481.1B suggested that an accident is credible if the occurrence probability is >1 x 10 -6 /yr. The draft DOE 5480 safety analysis report suggested that safety analyses should include the application of methods such as deterministic safety analysis, risk assessment, reliability engineering, common-cause failure analysis, human reliability analysis, and human factor safety analysis techniques. The US Nuclear Regulatory Commission (NRC) report NRC SG830.110 suggested that major safety analysis methods should include but not be limited to risk assessment, reliability engineering, and human factor safety analysis. All of these suggestions have recommended including PRA in the traditional criticality analysis

  16. Evaluation of risk factors associated with congenital malformations in the surveillance program of birth defects based on the methodology ECLAMC in Bogotá during the period 2001 to 2010

    OpenAIRE

    Zarate, Ana María; Pontificia Universidad Javeriana; García, Gloria; Secretaría Distrital de Salud; Zarante, Ignacio; Pontificia Universidad Javeriana

    2016-01-01

    Introduction: Birth defects are a cause of morbidity and mortality in our country, so the Institute of Human Genetics and the Health Secretary of Bogotá developed a surveillance program based on the methodology of the Latin American Collaborative Study of Congenital Malformations (ECLAMC).Methods: We collected data on births monitored in the case-control and monitor modes. Maternal and newborn risk factors were evaluated.Results: 121,674 births were monitored, 1,81% had congenital malformatio...

  17. Mental, social, and physical well-being in New Hampshire, Oregon, and Washington, 2010 Behavioral Risk Factor Surveillance System: implications for public health research and practice related to Healthy People 2020 foundation health measures on well-being

    OpenAIRE

    Kobau, Rosemarie; Bann, Carla; Lewis, Megan; Zack, Matthew M; Boardman, Angela M; Boyd, Renee; Lim, Kim C; Holder, Tommy; Hoff, Anastacia KL; Luncheon, Cecily; Thompson, William; Horner-Johnson, Willi; Lucas, Richard E

    2013-01-01

    Background Well-being is now accepted as one of four cross-cutting measures in gauging progress for Healthy People 2020. This shift to population indicators of well-being redresses notions of health that have focused on absence of illness (negative health) as a primary or sufficient indicator of positive functioning. The purpose of this study was to estimate mental, social, and physical well-being in three US states using new measures piloted on the 2010 Behavioral Risk Factor Surveillance Su...

  18. A review of zoonotic disease surveillance supported by the Armed Forces Health Surveillance Center.

    Science.gov (United States)

    Burke, R L; Kronmann, K C; Daniels, C C; Meyers, M; Byarugaba, D K; Dueger, E; Klein, T A; Evans, B P; Vest, K G

    2012-05-01

    The Armed Forces Health Surveillance Center (AFHSC), Division of Global Emerging Infections Surveillance and Response System conducts disease surveillance through a global network of US Department of Defense research laboratories and partnerships with foreign ministries of agriculture, health and livestock development in over 90 countries worldwide. In 2010, AFHSC supported zoonosis survey efforts were organized into four main categories: (i) development of field assays for animal disease surveillance during deployments and in resource limited environments, (ii) determining zoonotic disease prevalence in high-contact species which may serve as important reservoirs of diseases and sources of transmission, (iii) surveillance in high-risk human populations which are more likely to become exposed and subsequently infected with zoonotic pathogens and (iv) surveillance at the human-animal interface examining zoonotic disease prevalence and transmission within and between human and animal populations. These efforts have aided in the detection, identification and quantification of the burden of zoonotic diseases such as anthrax, brucellosis, Crimean Congo haemorrhagic fever, dengue fever, Hantaan virus, influenza, Lassa fever, leptospirosis, melioidosis, Q fever, Rift Valley fever, sandfly fever Sicilian virus, sandfly fever Naples virus, tuberculosis and West Nile virus, which are of military and public health importance. Future zoonotic surveillance efforts will seek to develop local capacity for zoonotic surveillance focusing on high risk populations at the human-animal interface. © 2011 Blackwell Verlag GmbH.

  19. CoCo design as a risk preventive tool

    NARCIS (Netherlands)

    Perotti, E.; Flannery, M.

    2011-01-01

    Contingent Convertible (CoCo) bonds have been suggested as a way to ensure that banks keep aside enough capital to help them through financial crises. This column proposes a market-triggered CoCo buffer to maintain risk incentives during periods of high leverage. It argues that this will also

  20. Experimental designs and risk assessment in combination toxicology: Panel discussion

    NARCIS (Netherlands)

    Henschler, D.; Bolt, H.M.; Jonker, D.; Pieters, M.N.; Groten, J.P.

    1996-01-01

    Advancing our knowledge on the toxicology of combined exposures to chemicals and implementation of this knowledge in guidelines for health risk assessment of such combined exposures are necessities dictated by the simple fact that humans are continuously exposed to a multitude of chemicals. A

  1. An Introduction to Risk with a Focus on Design Diversity in the Stockpile

    Energy Technology Data Exchange (ETDEWEB)

    Noone, Bailey C [Los Alamos National Laboratory

    2012-08-13

    The maintenance and security of nuclear weapons in the stockpile involves decisions based on risk analysis and quantitative measures of risk. Risk is a factor in all decisions, a particularly important factor in decisions of a large scale. One example of high-risk decisions we will discuss is the risk involved in design diversity within the stockpile of nuclear weapons arsenal. Risk is defined as 'possibility of loss or injury' and the 'degree of probability of such loss' (Kaplan and Garrick 12). To introduce the risk involved with maintaining the weapons stockpile we will draw a parallel to the design and maintenance of Southwest Airlines fleet of Boeing 737 planes. The clear benefits for cost savings in maintenance of having a uniform fleet are what historically drove Southwest to have only Boeing 737s in their fleet. Less money and resources are need for maintenance, training, and materials. Naturally, risk accompanies those benefits. A defect in a part of the plane indicates a potential defect in that same part in all the planes of the fleet. As a result, safety, business, and credibility are at risk. How much variety or diversity does the fleet need to mitigate that risk? With that question in mind, a balance is needed to accommodate the different risks and benefits of the situation. In a similar way, risk is analyzed for the design and maintenance of nuclear weapons in the stockpile. In conclusion, risk must be as low as possible when it comes to the nuclear weapons stockpile. Design and care to keep the stockpile healthy involves all aspects of risk management. Design diversity is a method that helps to mitigate risk, and to help balance options in stockpile stewardship.

  2. Smart sensing surveillance system

    Science.gov (United States)

    Hsu, Charles; Chu, Kai-Dee; O'Looney, James; Blake, Michael; Rutar, Colleen

    2010-04-01

    An effective public safety sensor system for heavily-populated applications requires sophisticated and geographically-distributed infrastructures, centralized supervision, and deployment of large-scale security and surveillance networks. Artificial intelligence in sensor systems is a critical design to raise awareness levels, improve the performance of the system and adapt to a changing scenario and environment. In this paper, a highly-distributed, fault-tolerant, and energy-efficient Smart Sensing Surveillance System (S4) is presented to efficiently provide a 24/7 and all weather security operation in crowded environments or restricted areas. Technically, the S4 consists of a number of distributed sensor nodes integrated with specific passive sensors to rapidly collect, process, and disseminate heterogeneous sensor data from near omni-directions. These distributed sensor nodes can cooperatively work to send immediate security information when new objects appear. When the new objects are detected, the S4 will smartly select the available node with a Pan- Tilt- Zoom- (PTZ) Electro-Optics EO/IR camera to track the objects and capture associated imagery. The S4 provides applicable advanced on-board digital image processing capabilities to detect and track the specific objects. The imaging detection operations include unattended object detection, human feature and behavior detection, and configurable alert triggers, etc. Other imaging processes can be updated to meet specific requirements and operations. In the S4, all the sensor nodes are connected with a robust, reconfigurable, LPI/LPD (Low Probability of Intercept/ Low Probability of Detect) wireless mesh network using Ultra-wide band (UWB) RF technology. This UWB RF technology can provide an ad-hoc, secure mesh network and capability to relay network information, communicate and pass situational awareness and messages. The Service Oriented Architecture of S4 enables remote applications to interact with the S4

  3. Redefining syndromic surveillance

    Directory of Open Access Journals (Sweden)

    Rebecca Katz

    2011-12-01

    Full Text Available With growing concerns about international spread of disease and expanding use of early disease detection surveillance methods, the field of syndromic surveillance has received increased attention over the last decade. The purpose of this article is to clarify the various meanings that have been assigned to the term syndromic surveillance and to propose a refined categorization of the characteristics of these systems. Existing literature and conference proceedings were examined on syndromic surveillance from 1998 to 2010, focusing on low- and middle-income settings. Based on the 36 unique definitions of syndromic surveillance found in the literature, five commonly accepted principles of syndromic surveillance systems were identified, as well as two fundamental categories: specific and non-specific disease detection. Ultimately, the proposed categorization of syndromic surveillance distinguishes between systems that focus on detecting defined syndromes or outcomes of interest and those that aim to uncover non-specific trends that suggest an outbreak may be occurring. By providing an accurate and comprehensive picture of this field’s capabilities, and differentiating among system types, a unified understanding of the syndromic surveillance field can be developed, encouraging the adoption, investment in, and implementation of these systems in settings that need bolstered surveillance capacity, particularly low- and middle-income countries.

  4. Airborne Video Surveillance

    National Research Council Canada - National Science Library

    Blask, Steven

    2002-01-01

    The DARPA Airborne Video Surveillance (AVS) program was established to develop and promote technologies to make airborne video more useful, providing capabilities that achieve a UAV force multiplier...

  5. Handbook of surveillance technologies

    CERN Document Server

    Petersen, JK

    2012-01-01

    From officially sanctioned, high-tech operations to budget spy cameras and cell phone video, this updated and expanded edition of a bestselling handbook reflects the rapid and significant growth of the surveillance industry. The Handbook of Surveillance Technologies, Third Edition is the only comprehensive work to chronicle the background and current applications of the full-range of surveillance technologies--offering the latest in surveillance and privacy issues.Cutting-Edge--updates its bestselling predecessor with discussions on social media, GPS circuits in cell phones and PDAs, new GIS s

  6. Secure surveillance videotapes

    International Nuclear Information System (INIS)

    Resnik, W.M.; Kadner, S.P.; Olsen, R.; Chitumbo, K.; Pepper, S.

    1995-01-01

    With assistance from the US Program for Technical Assistance to IAEA Safeguards (POTAS), Aquila Technologies Group developed the Tamper-Resistant Analog Media (TRAM-1000) system to provide standard VHS surveillance video tapes with an enhanced tamper-indicating capability. This project represents further implementation of the partnership approach in facilities including light water reactors with MOX facilities. These facilities use Uniplex Digiquad system video tapes. The partnership approach ensures that one organization can exchange the tapes in a machine without the presence of the other, without losing continuity of information. The TRAM-1000 system development project was accomplished in two stages. In the first stage of the project, the original system delivered to the IAEA, consists of three parts: (1) the tamper detection unit, (2) a specially augmented VHS video tape, and (3) an HP-95 reader. The tamper detection unit houses a VACOSS active fiber-optic seal and an electronic identification tag (E-TAG) reader. In the second stage of the project, the original TRAM-1000 was modified to its current design based on agency input. After delivery of the original TRAM-1000 system to the IAEA, it was reviewed by inspectors. The inspectors felt that the initial system's tape storage/transport method could be simplified. Rather than threading the fiber through the tape spindles, the inspectors suggested that the tape be placed in a bag capable of being sealed. Also, a more flexible fiber-optic cable was recommended. As a result of these suggestions, Aquila developed a tamper-proof bag specifically for holding a surveillance video tape and sealable with a VACOSS fiber optical seal

  7. Cost effectiveness of surveillance for GI cancers.

    Science.gov (United States)

    Omidvari, Amir-Houshang; Meester, Reinier G S; Lansdorp-Vogelaar, Iris

    2016-12-01

    Gastrointestinal (GI) diseases are among the leading causes of death in the world. To reduce the burden of GI diseases, surveillance is recommended for some diseases, including for patients with inflammatory bowel diseases, Barrett's oesophagus, precancerous gastric lesions, colorectal adenoma, and pancreatic neoplasms. This review aims to provide an overview of the evidence on cost-effectiveness of surveillance of individuals with GI conditions predisposing them to cancer, specifically focussing on the aforementioned conditions. We searched the literature and reviewed 21 studies. Despite heterogeneity of studies in terms of settings, study populations, surveillance strategies and outcomes, most reviewed studies suggested at least some surveillance of patients with these GI conditions to be cost-effective. For some high-risk conditions frequent surveillance with 3-month intervals was warranted, while for other conditions, surveillance may only be cost-effective every 10 years. Further studies based on more robust effectiveness evidence are needed to inform and optimise surveillance programmes for GI cancers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Second Generation of HIV Surveillance System: A Pattern for Iran

    OpenAIRE

    Nematollahi, M; Khalesi, N; Moghaddasi, H; Askarian, M

    2012-01-01

    Background For the purpose of minimizing the HIV/AIDS epidemic effects, one of the programs is the promotion of scientific methods and setting of the suitable surveillance systems. The present research was conducted to design the HIV/AIDS surveillance system in Iran applying WHO recommendations and the experience of some countries. Methods In 2009, based on the country's requirements, the HIV/AIDS surveillance system was proposed and designed for Iran. The Delphi technique was utilized to fin...

  9. HIV surveillance in complex emergencies.

    Science.gov (United States)

    Salama, P; Dondero, T J

    2001-04-01

    Many studies have shown a positive association between both migration and temporary expatriation and HIV risk. This association is likely to be similar or even more pronounced for forced migrants. In general, HIV transmission in host-migrant or host-forced-migrant interactions depends on the maturity of the HIV epidemic in both the host and the migrant population, the relative seroprevalence of HIV in the host and the migrant population, the prevalence of other sexually transmitted infections (STIs) that may facilitate transmission, and the level of sexual interaction between the two communities. Complex emergencies are the major cause of mass population movement today. In complex emergencies, additional factors such as sexual interaction between forced-migrant populations and the military; sexual violence; increasing commercial sex work; psychological trauma; and disruption of preventive and curative health services may increase the risk for HIV transmission. Despite recent success in preventing HIV infection in stable populations in selected developing countries, internally displaced persons and refugees (or forced migrants) have not been systematically included in HIV surveillance systems, nor consequently in prevention activities. Standard surveillance systems that rely on functioning health services may not provide useful data in many complex emergency settings. Secondary sources can provide some information in these settings. Little attempt has been made, however, to develop innovative HIV surveillance systems in countries affected by complex emergencies. Consequently, data on the HIV epidemic in these countries are scarce and HIV prevention programs are either not implemented or interventions are not effectively targeted. Second generation surveillance methods such as cross-sectional, population-based surveys can provide rapid information on HIV, STIs, and sexual behavior. The risks for stigmatization and breaches of confidentiality must be recognized

  10. Environmental surveillance master sampling schedule

    International Nuclear Information System (INIS)

    Bisping, L.E.

    1995-02-01

    Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the U.S. Department of Energy (DOE). This document contains the planned 1994 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project. Samples are routinely collected for the SESP and analyzed to determine the quality of air, surface water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. The responsibility for monitoring onsite drinking water falls outside the scope of the SESP. PNL conducts the drinking water monitoring project concurrent with the SESP to promote efficiency and consistency, utilize expertise developed over the years, and reduce costs associated with management, procedure development, data management, quality control, and reporting. The ground-water sampling schedule identifies ground-water sampling .events used by PNL for environmental surveillance of the Hanford Site. Sampling is indicated as annual, semi-annual, quarterly, or monthly in the sampling schedule. Some samples are collected and analyzed as part of ground-water monitoring and characterization programs at Hanford (e.g. Resources Conservation and Recovery Act (RCRA), Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), or Operational). The number of samples planned by other programs are identified in the sampling schedule by a number in the analysis column and a project designation in the Cosample column. Well sampling events may be merged to avoid redundancy in cases where sampling is planned by both-environmental surveillance and another program

  11. Environmental surveillance master sampling schedule

    Energy Technology Data Exchange (ETDEWEB)

    Bisping, L.E.

    1995-02-01

    Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the U.S. Department of Energy (DOE). This document contains the planned 1994 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project. Samples are routinely collected for the SESP and analyzed to determine the quality of air, surface water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. The responsibility for monitoring onsite drinking water falls outside the scope of the SESP. PNL conducts the drinking water monitoring project concurrent with the SESP to promote efficiency and consistency, utilize expertise developed over the years, and reduce costs associated with management, procedure development, data management, quality control, and reporting. The ground-water sampling schedule identifies ground-water sampling .events used by PNL for environmental surveillance of the Hanford Site. Sampling is indicated as annual, semi-annual, quarterly, or monthly in the sampling schedule. Some samples are collected and analyzed as part of ground-water monitoring and characterization programs at Hanford (e.g. Resources Conservation and Recovery Act (RCRA), Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), or Operational). The number of samples planned by other programs are identified in the sampling schedule by a number in the analysis column and a project designation in the Cosample column. Well sampling events may be merged to avoid redundancy in cases where sampling is planned by both-environmental surveillance and another program.

  12. Late Relapses in Stage I Testicular Cancer Patients on Surveillance

    DEFF Research Database (Denmark)

    Mortensen, Mette Saksø; Lauritsen, Jakob; Kier, Maria Gry Gundgaard

    2016-01-01

    Cancer (DaTeCa) database. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We estimated survival and relapse probabilities and compared the results using log-rank tests and Cox regression analyses. We compared differences in patient characteristics by using χ(2), Fisher exact, and Mann-Whitney tests...... no significant differences in patient characteristics at orchiectomy or relapse. Limitations include retrospective design and exclusion of patients who had been offered adjuvant therapy. CONCLUSIONS: The risk of VLR is minimal, and the patients carry a good prognosis. Patient characteristics of CS-1 surveillance...

  13. Significando o risco sanitário: modos de atuação sobre o risco na vigilância sanitária / Meaning the health risk: modes of action on the risk in health surveillance

    Directory of Open Access Journals (Sweden)

    Ana Valesca Fernandes GIlson Silva

    2014-05-01

    Full Text Available Este estudo qualitativo, que utiliza o Interacionismo Simbólico como referencial teórico e a Teoria Fundamentada nos Dados como método, buscou compreender os modos de atuação sobre o risco. Sintetiza os significados do risco para os profissionais da Vigilância Sanitária (VISA e analisa os modos de atuação para o seu controle. A síntese é a sistematização das interpretações e significados do risco. A análise apresenta a existência de dois modos de atuação, permitindo empreender a aplicação do significado de risco no âmbito do domínio de um saber específico. Entre a identificação do risco e a intervenção existem processos que mesclam a racionalidade à subjetividade, a autoridade ao controle, a experiência ao conhecimento formal adquirido. O agir do profissional da VISA é constituído por conhecimentos, pela experiência adquirida, pelos contextos socioculturais e pelas interações que definem e redefinem os modos de atuar. As ações são baseadas nos significados do risco que se deslocam no plano da objetividade e da subjetividade, e a legislação é um importante instrumento de decisão e de persuasão. Embora ocorra um deslocamento para o uso do conhecimento e da experiência, é o arcabouço legal que imprime o que deve ou não ser controlado. ------------------------------------------------------------------------- This qualitative study that utilizes Symbolic Interactionism as a theoretical background and Grounded Theory as a method, sought to understand the modes of action about risk. It summarizes the meanings of risk to the professionals of Health Surveillance (HS, and analyses the modes of action to control it. The summary is the systematization of the in-terpretations and meanings of risk. The analysis shows the existence of two modes of ac-tion, allowing to undertake the application of the meaning of risk in the scope of domain of an specific knowledge. Between the risk identification and the

  14. Probabilistic risk criteria and their application to nuclear chemical plant design

    International Nuclear Information System (INIS)

    Arthur, T.; Barnes, D.S.; Brown, M.L.; Taig, A.R.; Johnston, B.D.; Hayns, M.

    1989-01-01

    A nuclear chemical plant safety strategy is presented. The use of risk criteria in design is demonstrated by reference to a particular area of the plant. This involves the application of Probabilistic Risk Assessment (PRA) techniques. Computer programs developed by the UK Atomic Energy Authority (UKAEA) at its Safety and Reliability Directorate (SRD) are used toe valuate and analyze the resultant fault trees. the magnitude of releases are estimated and individual and societal risks determined. The paper concludes that the application of PRA to a nuclear chemical plant can be structured in such a way as to allow a designer to work to quantitative risk targets

  15. The impacts of product design changes on supply chain risk: a case study

    OpenAIRE

    Lin, Yong; Zhou, Li

    2011-01-01

    Purpose: The main purpose of this paper is to address the impact of product design changes on supply chain risk, and to identify the supply chain risk dimensions in the Chinese special-purpose vehicle (SPV) industry in the context of product design change.\\ud \\ud Design/methodology/approach: Case study methodology is adopted to describe the current situation of supply chain risk management in the Chinese SPV industry. Data are mainly collected from in-depth semi-structured interviews, and a c...

  16. Development of risk benefit structural design method for innovative reactor plants

    International Nuclear Information System (INIS)

    Yoshio Kamishima; Tai Asayama; Yukio Takahashi; Masanori Tashimo; Hideo Machida; Yomomi Otani; Yasuharu Chuman

    2005-01-01

    The development of innovative nuclear plants where the energy in the future is carried out in Japan. The design method based on a risk benefit of having maintained mitigation of a risk and the improvement in economy is called for, in order to realize the national innovative nuclear plants. Main key technologies of the risk benefit structural design method are crack propagation evaluation technology and structural reliability evaluation technology. This research aims at pulling up these two technologies on an engineering practical use level. In this paper, requirements from the design of typical innovative nuclear plants and research plan are shown.(authors)

  17. On the optimal design of risk retention in securitisation

    Directory of Open Access Journals (Sweden)

    Metin Kaptan

    2011-09-01

    Full Text Available This paper examines the optimal design of retention in securitisation, in order to maximize welfare of screening per unit of retention, assuming that screening is costly and that the bank intends to securitise its loans. In contrast to the focus of previous literature on tranche retention, we deviate from the constitutional mechanisms of tranche retention to present a pareto-optimal method of tranche retention. Unlike the current ad-hoc-regulations, we derive the optimal design of retention from a utility maximization problem. We show that the level of retention per tranche should be dependent on the rate of credit default, i.e. the higher the rate of default, the higher the optimal rate of retention required to provide an incentive to screen carefully. From this approach, it follows that the rate of retention per tranche should be higher, the higher the position within the ranking order of subordination. Accordingly, the efficiency of tranche retention can be enhanced, reducing the level of retention required to maintain a given level of screening-effort. This retention design entails a recovery of the bank’s equity capital, thereby increasing liquidity and lending capacities.

  18. Occupational health and safety: Designing and building with MACBETH a value risk-matrix for evaluating health and safety risks

    Science.gov (United States)

    Lopes, D. F.; Oliveira, M. D.; Costa, C. A. Bana e.

    2015-05-01

    Risk matrices (RMs) are commonly used to evaluate health and safety risks. Nonetheless, they violate some theoretical principles that compromise their feasibility and use. This study describes how multiple criteria decision analysis methods have been used to improve the design and the deployment of RMs to evaluate health and safety risks at the Occupational Health and Safety Unit (OHSU) of the Regional Health Administration of Lisbon and Tagus Valley. ‘Value risk-matrices’ (VRMs) are built with the MACBETH approach in four modelling steps: a) structuring risk impacts, involving the construction of descriptors of impact that link risk events with health impacts and are informed by scientific evidence; b) generating a value measurement scale of risk impacts, by applying the MACBETH-Choquet procedure; c) building a system for eliciting subjective probabilities that makes use of a numerical probability scale that was constructed with MACBETH qualitative judgments on likelihood; d) and defining a classification colouring scheme for the VRM. A VRM built with OHSU members was implemented in a decision support system which will be used by OHSU members to evaluate health and safety risks and to identify risk mitigation actions.

  19. Remote container monitoring and surveillance systems

    International Nuclear Information System (INIS)

    Resnik, W.M.; Kadner, S.P.

    1995-01-01

    Aquila Technologies Group is developing a monitoring and surveillance system to monitor containers of nuclear materials. The system will both visually and physically monitor the containers. The system is based on the combination of Aquila's Gemini All-Digital Surveillance System and on Aquila's AssetLAN trademark asset tracking technology. This paper discusses the Gemini Digital Surveillance system as well as AssetLAN technology. The Gemini architecture with emphasis on anti-tamper security features is also described. The importance of all-digital surveillance versus other surveillance methods is also discussed. AssetLAN trademark technology is described, emphasizing the ability to continually track containers (as assets) by location utilizing touch memory technology. Touch memory technology provides unique container identification, as well as the ability to store and retrieve digital information on the container. This information may relate to container maintenance, inspection schedules, and other information. Finally, this paper describes the combination of the Gemini system with AssetLAN technology, yielding a self contained, container monitoring and area/container surveillance system. Secure container fixture design considerations are discussed. Basic surveillance review functions are also discussed

  20. Soil and vegetation surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Antonio, E.J.

    1995-06-01

    Soil sampling and analysis evaluates long-term contamination trends and monitors environmental radionuclide inventories. This section of the 1994 Hanford Site Environmental Report summarizes the soil and vegetation surveillance programs which were conducted during 1994. Vegetation surveillance is conducted offsite to monitor atmospheric deposition of radioactive materials in areas not under cultivation and onsite at locations adjacent to potential sources of radioactivity.

  1. Between visibility and surveillance

    DEFF Research Database (Denmark)

    Uldam, Julie

    As activists move from alternative media platforms to commercial social media platforms they face increasing challenges in protecting their online security and privacy. While government surveillance of activists is well-documented in both scholarly research and the media, corporate surveillance...

  2. Reassembling Surveillance Creep

    DEFF Research Database (Denmark)

    Bøge, Ask Risom; Lauritsen, Peter

    2017-01-01

    We live in societies in which surveillance technologies are constantly introduced, are transformed, and spread to new practices for new purposes. How and why does this happen? In other words, why does surveillance “creep”? This question has received little attention either in theoretical developm......We live in societies in which surveillance technologies are constantly introduced, are transformed, and spread to new practices for new purposes. How and why does this happen? In other words, why does surveillance “creep”? This question has received little attention either in theoretical...... development or in empirical analyses. Accordingly, this article contributes to this special issue on the usefulness of Actor-Network Theory (ANT) by suggesting that ANT can advance our understanding of ‘surveillance creep’. Based on ANT’s model of translation and a historical study of the Danish DNA database......, we argue that surveillance creep involves reassembling the relations in surveillance networks between heterogeneous actors such as the watchers, the watched, laws, and technologies. Second, surveillance creeps only when these heterogeneous actors are adequately interested and aligned. However...

  3. Validation of an automated surveillance approach for drain-related meningitis : A multicenter study

    NARCIS (Netherlands)

    Van Mourik, Maaike S M; Troelstra, Annet; Van Der Sprenkel, Jan Willem Berkelbach; Van Der Jagt-Zwetsloot, Marischka C E; Nelson, Jolande H.; Vos, Piet; Arts, Mark P.; Dennesen, Paul J W; Moons, K. (Carl) G.M.; Bonten, Marc J M

    2015-01-01

    Objective. Manual surveillance of healthcare-associated infections is cumbersome and vulnerable to subjective interpretation. Automated systems are under development to improve efficiency and reliability of surveillance, for example by selecting high-risk patients requiring manual chart review. In

  4. Surveillance and epidemiology of surgical site infections after cardiothoracic surgery in The Netherlands, 2002-2007

    NARCIS (Netherlands)

    Manniën, Judith; Wille, Jan C.; Kloek, Jaap J.; van Benthem, Birgit H. B.

    2011-01-01

    Surgical site infections after cardiothoracic surgery substantially increase the risk for illness, mortality, and costs. Surveillance of surgical site infections might assist in the prevention of these infections. This study describes the Dutch surveillance methods and results of data collected

  5. Environmental and ground-water surveillance at Hanford

    International Nuclear Information System (INIS)

    Dirkes, R.L.; Luttrell, S.P.

    1995-01-01

    Environmental and ground-water surveillance of the Hanford Site and surrounding region is conducted to demonstrate compliance with environmental regulations, confirm adherence to DOE environmental protection policies, support DOE environmental management decisions, and provide information to the public. Environmental surveillance encompasses sampling and analyzing for potential radiological and nonradiological chemical contaminants on and off the Hanford Site. Emphasis is placed on surveillance of exposure pathways and chemical constituents that pose the greatest risk to human health and the environment

  6. Environmental and ground-water surveillance at Hanford

    Energy Technology Data Exchange (ETDEWEB)

    Dirkes, R.L.; Luttrell, S.P.

    1995-06-01

    Environmental and ground-water surveillance of the Hanford Site and surrounding region is conducted to demonstrate compliance with environmental regulations, confirm adherence to DOE environmental protection policies, support DOE environmental management decisions, and provide information to the public. Environmental surveillance encompasses sampling and analyzing for potential radiological and nonradiological chemical contaminants on and off the Hanford Site. Emphasis is placed on surveillance of exposure pathways and chemical constituents that pose the greatest risk to human health and the environment.

  7. Health-related quality of life among people aged ≥65 years with self-reported visual impairment: findings from the 2006-2010 behavioral risk factor surveillance system.

    Science.gov (United States)

    Crews, John E; Chou, Chiu-Fang; Zhang, Xinzhi; Zack, Matthew M; Saaddine, Jinan B

    2014-10-01

    To examine the association between health-related quality of life (HRQoL) and visual impairment among people aged ≥65 years. We used cross-sectional data from the 2006-2010 Behavioral Risk Factor Surveillance System to examine six HRQoL measures: self-reported health, physically unhealthy days, mentally unhealthy days, activity limitation days, life satisfaction, and disability. Visual impairment was categorized as no, a little, and moderate/severe. We examined the association between self-reported visual impairment and HRQoL using logistic regression accounting for the survey's complex design. People with self-reported moderate/severe visual impairment had more frequent (≥14) physically unhealthy days, mentally unhealthy days, and activity limitation days in the last 30 days compared to those reporting a little or no visual impairment. After controlling for all covariates (age, sex, marital status, race/ethnicity, education, income, diabetes, heart disease, stroke, heart attack, body mass index, leisure time activity, smoking, and medical care cost concerns) and comparing to those with no self-reported visual impairment, people reporting a little visual impairment were more likely to have fair/poor health (odds ratio, OR, 1.2, 95% confidence interval, CI, 1.1-1.3), life dissatisfaction (OR 1.6, 95% CI 1.3-2.0), and disability (OR 1.5, 95% CI 1.3-1.6), and those with self-reported moderate/severe visual impairment had more fair/poor health (OR 1.8, 95% CI 1.6-2.0), life dissatisfaction (OR 2.3, 95% CI 1.8-2.9), and disability (OR 2.0, 95% CI 1.8-2.2). They also had more frequent physically unhealthy days (OR 1.9, 95% CI 1.7-2.1), mentally unhealthy days (OR 1.8, 95% CI 1.5-2.1), and activity limitations days (OR 1.9, 95% CI 1.6-2.2). Poor HRQoL is strongly associated with the severity of self-reported visual impairment among people aged ≥65 years.

  8. The Association of Health-Related Quality of Life with Severity of Visual Impairment among People Aged 40–64 Years: Findings from the 2006–2010 Behavioral Risk Factor Surveillance System

    Science.gov (United States)

    Crews, John E.; Chou, Chiu-Fang; Zack, Matthew M.; Zhang, Xinzhi; Bullard, Kai McKeever; Morse, Alan R.; Saaddine, Jinan B.

    2016-01-01

    Purpose To examine the association of health-related quality of life (HRQoL) with severity of visual impairment among people aged 40–64 years. Methods We used cross-sectional data from the 2006–2010 Behavioral Risk Factor Surveillance System to examine six measures of HRQoL: self-reported health, physically unhealthy days, mentally unhealthy days, activity limitation days, life satisfaction, and disability. Visual impairment was categorized as no, a little, or moderate/severe. We examined the association between visual impairment and HRQoL using logistic regression accounting for the survey’s complex design. Results Overall, 23.0% of the participants reported a little difficult seeing, while 16.8% reported moderate/severe difficulty seeing. People aged 40–64 years with moderate/severe visual impairment had more frequent (≥14) physically unhealthy days, mentally unhealthy days, and activity limitation days in the last 30 days, as well as greater life dissatisfaction, greater disability, and poorer health compared to people reporting no or a little visual impairment. After controlling for covariates (age, sex, marital status, race/ethnicity, education, income, state, year, health insurance, heart disease, stroke, heart attack, body mass index, leisure-time activity, smoking, and medical care costs), and compared to people with no visual impairment, those with moderate/severe visual impairment were more likely to have fair/poor health (odds ratio, OR, 2.01, 95% confidence interval, CI, 1.82–2.23), life dissatisfaction (OR 2.06, 95% CI 1.80–2.35), disability (OR 1.95, 95% CI 1.80–2.13), and frequent physically unhealthy days (OR 1.69, 95% CI 1.52–1.88), mentally unhealthy days (OR 1.84, 95% CI 1.66–2.05), and activity limitation days (OR 1.94, 95% CI 1.71–2.20; all p visual impairment among people aged 40–64 years. PMID:27159347

  9. Health-Related Quality of Life Among People Aged ≥65 Years with Self-reported Visual Impairment: Findings from the 2006–2010 Behavioral Risk Factor Surveillance System

    Science.gov (United States)

    Crews, John E.; Chou, Chiu-Fang; Zhang, Xinzhi; Zack, Matthew M.; Saaddine, Jinan B.

    2016-01-01

    Purpose To examine the association between health-related quality of life (HRQoL) and visual impairment among people aged ≥65 years. Methods We used cross-sectional data from the 2006–2010 Behavioral Risk Factor Surveillance System to examine six HRQoL measures: self-reported health, physically unhealthy days, mentally unhealthy days, activity limitation days, life satisfaction, and disability. Visual impairment was categorized as no, a little, and moderate/severe. We examined the association between self-reported visual impairment and HRQoL using logistic regression accounting for the survey’s complex design. Results People with self-reported moderate/severe visual impairment had more frequent (≥14) physically unhealthy days, mentally unhealthy days, and activity limitation days in the last 30 days compared to those reporting a little or no visual impairment. After controlling for all covariates (age, sex, marital status, race/ethnicity, education, income, diabetes, heart disease, stroke, heart attack, body mass index, leisure time activity, smoking, and medical care cost concerns) and comparing to those with no self-reported visual impairment, people reporting a little visual impairment were more likely to have fair/poor health (odds ratio, OR, 1.2, 95% confidence interval, CI, 1.1–1.3), life dissatisfaction (OR 1.6, 95% CI 1.3–2.0), and disability (OR 1.5, 95% CI 1.3–1.6), and those with self-reported moderate/severe visual impairment had more fair/poor health (OR 1.8, 95% CI 1.6–2.0), life dissatisfaction (OR 2.3, 95% CI 1.8–2.9), and disability (OR 2.0, 95% CI 1.8–2.2). They also had more frequent physically unhealthy days (OR 1.9, 95% CI 1.7–2.1), mentally unhealthy days (OR 1.8, 95% CI 1.5–2.1), and activity limitations days (OR 1.9, 95% CI 1.6–2.2). Conclusion Poor HRQoL is strongly associated with the severity of self-reported visual impairment among people aged ≥65 years. PMID:24955821

  10. Diabetes, obesity, and recommended fruit and vegetable consumption in relation to food environment sub-types: a cross-sectional analysis of Behavioral Risk Factor Surveillance System, United States Census, and food establishment data.

    Science.gov (United States)

    Frankenfeld, Cara L; Leslie, Timothy F; Makara, Matthew A

    2015-05-14

    Social and spatial factors are an important part of individual and community health. The objectives were to identify food establishment sub-types and evaluate prevalence of diabetes, obesity, and recommended fruit and vegetable consumption in relation to these sub-types in the Washington DC metropolitan area. A cross-sectional study design was used. A measure of retail food environment was calculated as the ratio of number of sources of unhealthier food options (fast food, convenience stores, and pharmacies) to healthier food options (grocery stores and specialty food stores). Two categories were created: ≤ 1.0 (healthier options) and > 1.0 (unhealthier options). k-means clustering was used to identify clusters based on proportions of grocery stores, restaurants, specialty food, fast food, convenience stores, and pharmacies. Prevalence data for county-level diabetes, obesity, and consumption of five or more fruits or vegetables per day (FV5) was obtained from the Behavioral Risk Factor Surveillance System. Multiple imputation was used to predict block-group level health outcomes with US Census demographic and economic variables as the inputs. The healthier options category clustered into three sub-types: 1) specialty food, 2) grocery stores, and 3) restaurants. The unhealthier options category clustered into two sub-types: 1) convenience stores, and 2) restaurants and fast food. Within the healthier options category, diabetes prevalence in the sub-types with high restaurants (5.9 %, p = 0.002) and high specialty food (6.1 %, p = 0.002) was lower than the grocery stores sub-type (7.1 %). The high restaurants sub-type compared to the high grocery stores sub-type had significantly lower obesity prevalence (28.6 % vs. 31.2 %, p restaurants (including fast food) sub-type was significantly associated with lower diabetes and obesity, and higher FV prevalence compared to grocery store sub-type. These results suggest that there are sub-types within larger categories of

  11. Structural analysis of 177-FA redesigned surveillance specimen holder tube

    International Nuclear Information System (INIS)

    Pryor, C.W.; Thoren, D.E.; Vames, G.J.; Harris, R.J.

    1976-08-01

    Because of in-service operational problems, the surveillance specimen holder tubes described in B and W topical report BAW-10051 have been redesigned. This report describes the new design and structural analysis for normal operation and upset loading conditions. The results of the analysis demonstrate the adequacy of the new surveillance specimen holder tubes for their design life of 40 years

  12. A risk-informed framework for establishing a beyond design basis safety basis for external hazards

    Energy Technology Data Exchange (ETDEWEB)

    Amico, P. [Hughes Associates, Inc, Baltimore, MD (United States); Anoba, R. [Hughes Associates, Inc, Raleigh, NC (United States); Najafi, B. [Hughes Associates, Inc., Los Gatos, CA (United States)

    2014-07-01

    The events at Fukushima Daiichi taught us that meeting a deterministic design basis requirement for external hazards does not assure that the risk is low. As observed at the plant, the two primary reasons for this are failure cliffs above the design basis event and that combined hazard effects are not considered in design. Because the possible combinations of design basis exceedences and external hazard combinations are very large and complex, an approach focusing only on the most important ones is needed. For this reason, a risk informed approach is the most effective approach, which is discussed in this paper. (author)

  13. Needs assessment and design of the intervention for high risk sex offenders social reintegration

    OpenAIRE

    García Díez, César; Soler Iglesias, Carles

    2014-01-01

    Executive report of the adaptation study "Needs assessment and design of the intervention for high risk sex offenders social reintegration: Adaptation of the Circles of Support and Accountability to the Penal Enforcement System of Catalonia".

  14. Uncertainty and Risk Assessment in the Design Process for Wind

    Energy Technology Data Exchange (ETDEWEB)

    Damiani, Rick R. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2018-02-09

    This report summarizes the concepts and opinions that emerged from an initial study on the subject of uncertainty in wind design that included expert elicitation during a workshop held at the National Wind Technology Center at the National Renewable Energy Laboratory July 12-13, 2016. In this paper, five major categories of uncertainties are identified. The first category is associated with direct impacts on turbine loads, (i.e., the inflow including extreme events, aero-hydro-servo-elastic response, soil-structure inter- action, and load extrapolation). The second category encompasses material behavior and strength. Site suitability and due-diligence aspects pertain to the third category. Calibration of partial safety factors and optimal reliability levels make up the fourth one. And last but not least, is the category associated with uncertainties in computational modeling. The main sections of this paper follow this organization.

  15. Psychosocial Risks Generated By Assets Specific Design Software

    Science.gov (United States)

    Remus, Furtună; Angela, Domnariu; Petru, Lazăr

    2015-07-01

    The human activity concerning an occupation is resultant from the interaction between the psycho-biological, socio-cultural and organizational-occupational factors. Tehnological development, automation and computerization that are to be found in all the branches of activity, the level of speed in which things develop, as well as reaching their complexity, require less and less physical aptitudes and more cognitive qualifications. The person included in the work process is bound in most of the cases to come in line with the organizational-occupational situations that are specific to the demands of the job. The role of the programmer is essencial in the process of execution of ordered softwares, thus the truly brilliant ideas can only come from well-rested minds, concentrated on their tasks. The actual requirements of the jobs, besides the high number of benefits and opportunities, also create a series of psycho-social risks, which can increase the level of stress during work activity, especially for those who work under pressure.

  16. Designing Visual Aids That Promote Risk Literacy: A Systematic Review of Health Research and Evidence-Based Design Heuristics.

    Science.gov (United States)

    Garcia-Retamero, Rocio; Cokely, Edward T

    2017-06-01

    Background Effective risk communication is essential for informed decision making. Unfortunately, many people struggle to understand typical risk communications because they lack essential decision-making skills. Objective The aim of this study was to review the literature on the effect of numeracy on risk literacy, decision making, and health outcomes, and to evaluate the benefits of visual aids in risk communication. Method We present a conceptual framework describing the influence of numeracy on risk literacy, decision making, and health outcomes, followed by a systematic review of the benefits of visual aids in risk communication for people with different levels of numeracy and graph literacy. The systematic review covers scientific research published between January 1995 and April 2016, drawn from the following databases: Web of Science, PubMed, PsycINFO, ERIC, Medline, and Google Scholar. Inclusion criteria were investigation of the effect of numeracy and/or graph literacy, and investigation of the effect of visual aids or comparison of their effect with that of numerical information. Thirty-six publications met the criteria, providing data on 27,885 diverse participants from 60 countries. Results Transparent visual aids robustly improved risk understanding in diverse individuals by encouraging thorough deliberation, enhancing cognitive self-assessment, and reducing conceptual biases in memory. Improvements in risk understanding consistently produced beneficial changes in attitudes, behavioral intentions, trust, and healthy behaviors. Visual aids were found to be particularly beneficial for vulnerable and less skilled individuals. Conclusion Well-designed visual aids tend to be highly effective tools for improving informed decision making among diverse decision makers. We identify five categories of practical, evidence-based guidelines for heuristic evaluation and design of effective visual aids.

  17. Interaction between research and diagnosis and surveillance of avian influenza within the Caribbean animal health network (CaribVET).

    Science.gov (United States)

    Lefrançois, T; Hendrikx, P; Vachiéry, N; Ehrhardt, N; Millien, M; Gomez, L; Gouyet, L; Gerbier, G; Gongora, V; Shaw, J; Trotman, M

    2010-04-01

    The Caribbean region is considered to be at risk for avian influenza (AI) because of predominance of the backyard poultry system, important commercial poultry production, migratory birds and disparities in the surveillance systems. The Caribbean animal health network (CaribVET) has developed tools to implement AI surveillance in the region: (i) a regionally harmonized surveillance protocol, (ii) specific web pages for AI surveillance on http://www.caribvet.net, and (iii) a diagnostic network for the Caribbean including AI virus molecular diagnostic capability in Guadeloupe and technology transfer. Altogether 303 samples from four Caribbean countries were tested between June 2006 and March 2009 by real time PCR either for importation purposes or following clinical suspicion. Following AI H5N2 outbreaks in the Dominican Republic in 2007, a questionnaire was developed to collect data for risk analysis of AI spread in the region through fighting cocks. The infection pathway of Martinique commercial poultry sector by AI through introduction of infected cocks was designed and recommendations were provided to the Caribbean veterinary services to improve fighting cock movement controls and biosecurity measures. Altogether, these CaribVET activities contribute to strengthen surveillance of AI in the Caribbean region and may allow the development of research studies on AI risk analysis.

  18. Mammographic surveillance in the follow up of early primary breast cancer in England: A cross-sectional survey

    International Nuclear Information System (INIS)

    Greenwood-Haigh, Lesley

    2009-01-01

    Purpose: The aim of this study was to determine current practice in the clinical setting at national and regional level of the use of mammographic surveillance in the follow up of patients surgically treated for early breast cancer. Method: A cross-sectional survey method was employed. Self-administered questionnaires were sent to a random selection of symptomatic breast imaging units representing all the cancer networks in England nationally, and all symptomatic breast imaging units in one cancer network regionally. Questions were designed to determine frequency and duration of mammographic surveillance for patients aged < 50 years and ≥50 years surgically treated by mastectomy or breast conserving surgery and the number of units with protocols based on the risk of local recurrence or development of a new primary breast cancer. Results: The protocols demonstrated a striking diversity in both the frequency and duration of mammographic surveillance; however the variation was less marked regionally. The duration of mammography for patient's aged ≥70 years surgically treated by mastectomy, demonstrated the greatest diversity (range: 0-15 years). Four protocols had regimes tailored to risk. Conclusion: The introduction of protocols based on risk of development of a local recurrence or new primary could prove cost effective by targeting mammographic surveillance to those who would benefit the most. The survey has demonstrated that a 'post-code lottery' exists for both the frequency and duration of mammographic surveillance in this patient group indicating an urgent need for evidence based national guidance.

  19. Concept Design and Risk Assessment of Nuclear Propulsion Ship

    International Nuclear Information System (INIS)

    Gil, Youngmi; Yoo, Seongjin; Kim, Yeontae; Oh, June; Byun, Yoonchul; Woo, Ilguk; Kim, Jiho; Choi, Suhn

    2014-01-01

    The nuclear propulsion ships (hereinafter referred to as 'nuclear ships') have been considered as an eco-friendly ship. There have historically been warship and submarine with the source of nuclear power. The use of nuclear ships has been recently extending to the icebreaker, the deep-water exploration ship, and the floating nuclear power plant. Prior to developing the new ship, we evaluated the economics of various types of ships and concluded that the container ship could be appropriate for the nuclear propulsion. In order to verify its safety, we performed the ship calculation based on the optimal arrangement of the nuclear reactor. Finally, we verified its safety by the HAZID. In the former research, we confirmed the applicability of the nuclear propulsion system for the large container ship. In this study, we verified the safety of the nuclear ships according to the HAZID analysis. We expect that this research will lead to safe design of the nuclear ships

  20. Concept Design and Risk Assessment of Nuclear Propulsion Ship

    Energy Technology Data Exchange (ETDEWEB)

    Gil, Youngmi; Yoo, Seongjin; Kim, Yeontae; Oh, June; Byun, Yoonchul; Woo, Ilguk [Daewoo Shipbuilding and Marine Engineering Co. Ltd., Seoul (Korea, Republic of); Kim, Jiho; Choi, Suhn [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-05-15

    The nuclear propulsion ships (hereinafter referred to as 'nuclear ships') have been considered as an eco-friendly ship. There have historically been warship and submarine with the source of nuclear power. The use of nuclear ships has been recently extending to the icebreaker, the deep-water exploration ship, and the floating nuclear power plant. Prior to developing the new ship, we evaluated the economics of various types of ships and concluded that the container ship could be appropriate for the nuclear propulsion. In order to verify its safety, we performed the ship calculation based on the optimal arrangement of the nuclear reactor. Finally, we verified its safety by the HAZID. In the former research, we confirmed the applicability of the nuclear propulsion system for the large container ship. In this study, we verified the safety of the nuclear ships according to the HAZID analysis. We expect that this research will lead to safe design of the nuclear ships.

  1. Designing reliable supply chain network with disruption risk

    Directory of Open Access Journals (Sweden)

    Ali Bozorgi Amiri

    2013-01-01

    Full Text Available Although supply chains disruptions rarely occur, their negative effects are prolonged and severe. In this paper, we propose a reliable capacitated supply chain network design (RSCND model by considering random disruptions in both distribution centers and suppliers. The proposed model determines the optimal location of distribution centers (DC with the highest reliability, the best plan to assign customers to opened DCs and assigns opened DCs to suitable suppliers with lowest transportation cost. In this study, random disruption occurs at the location, capacity of the distribution centers (DCs and suppliers. It is assumed that a disrupted DC and a disrupted supplier may lose a portion of their capacities, and the rest of the disrupted DC's demand can be supplied by other DCs. In addition, we consider shortage in DCs, which can occur in either normal or disruption conditions and DCs, can support each other in such circumstances. Unlike other studies in the extent of literature, we use new approach to model the reliability of DCs; we consider a range of reliability instead of using binary variables. In order to solve the proposed model for real-world instances, a Non-dominated Sorting Genetic Algorithm-II (NSGA-II is applied. Preliminary results of testing the proposed model of this paper on several problems with different sizes provide seem to be promising.

  2. REMOTE SURVEILLANCE OF FACILITIES AWAITING D AND D

    International Nuclear Information System (INIS)

    Ebadian, M.A.; Weger, Hans; Roelant, Dave; Ade, Rodrigue; Duran, Celso

    2001-01-01

    A remote surveillance system was designed, tested and will be deployed at INEEL that will monitor the TAN-616 facility for water in sumps, tanks, and on the floor. The presence of water is an indication that the facility is not contained and that the risk of contamination escaping is increased. This system replaces the need to send inspectors into the facility with radiation control personnel to check for water. Some of the areas that would be checked by the inspectors have a high radiation field and little space for maneuvering. Therefore, this system also decreases the radiation exposure and increases the safety of these personnel. A remote surveillance system has a higher initial capital cost for the equipment than the baseline method, which is to send inspectors into the building to obtain samples and perform measurements. However, the cost of operating and maintaining the system is negligible compared to the continuing cost of sending inspectors and radiation control technicians into the facility. The remote surveillance system has a lower cost in the long term when compared to the baseline method

  3. Urine Telomerase for Diagnosis and Surveillance of Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Angela Lamarca

    2012-01-01

    Full Text Available Bladder cancer has increased incidence during last decades. For those patients with nonmuscle involved tumors, noninvasive diagnosis test and surveillance methods must be designed to avoid current cystoscopies that nowadays are done regularly in a lot of patients. Novel urine biomarkers have been developed during last years. Telomerase is important in cancer biology, improving the division capacity of cancer cells. Even urinary telomerase could be a potentially useful urinary tumor marker; its use for diagnosis of asymptomatic and symptomatic patients or its impact during surveillance is still unknown. Moreover, there will need to be uniformity and standardization in the assays before it can become useful in clinical practice. It does not seem to exist a real difference between the most classical assays for the detection of urine telomerase (TRAP and hTERT. However, the new detection methods with modified TeloTAGGG telomerase or with gold nanoparticles must also be taken into consideration for the correct development of this diagnosis method. Maybe the target population would be the high-risk groups within screening programs. To date there is no enough evidence to use it alone and to eliminate cystoscopies from the diagnosis and surveillance of these patients. The combination with cytology or FISH is still preferred.

  4. The Need for European Surveillance of CDI.

    Science.gov (United States)

    Wiuff, Camilla; Banks, A-Lan; Fitzpatrick, Fidelma; Cottom, Laura

    2018-01-01

    Since the turn of the millennium, the epidemiology of Clostridium difficile infection (CDI) has continued to challenge. Over the last decade there has been a growing awareness that improvements to surveillance are needed. The increasing rate of CDI and emergence of ribotype 027 precipitated the implementation of mandatory national surveillance of CDI in the UK. Changes in clinical presentation, severity of disease, descriptions of new risk factors and the occurrence of outbreaks all emphasised the importance of early diagnosis and surveillance.However a lack of consensus on case definitions, clinical guidelines and optimal laboratory diagnostics across Europe has lead to the underestimation of CDI and impeded comparison between countries. These inconsistencies have prevented the true burden of disease from being appreciated.Acceptance that a multi-country surveillance programme and optimised diagnostic strategies are required not only to detect and control CDI in Europe, but for a better understanding of the epidemiology, has built the foundations for a more robust, unified surveillance. The concerted efforts of the European Centre for Disease Prevention and Control (ECDC) CDI networks, has lead to the development of an over-arching long-term CDI surveillance strategy for 2014-2020. Fulfilment of the ECDC priorities and targets will no doubt be challenging and will require significant investment however the hope is that both a national and Europe-wide picture of CDI will finally be realised.

  5. Designing SQCRA as a Software to Semi-quantitative Chemical Risk Assessment in Workplace

    Directory of Open Access Journals (Sweden)

    Ali Karimi

    2014-06-01

    Full Text Available Background & Objectives : The aim of chemical risk assessment is to identify and evaluate risks originated from chemicals usages. This study aims to design a practical tool for facilitating chemical risk assessment. Methods: The proposed software was derived from chemical risk assessment method which was recommended by Ministry of Human Resources of Malaysia. All of the processes in question are designed in operating system software. Based on some revisions, this software was developed using Visual Basic (VB titled as SQCRA. The developed software was used for chemical risk assessment in Narges Vegetale Oil Company in Shiraz (center of Iran. Result: The output of software showed that the level of risk derived from sulfuric acid, phosphoric acid, aluminum sulphate, nickel catalyst, acetic acid used as a raw material were 2.4, 2.84, 2.3, 3.5 and 2.66, respectively. Moreover, risk rank and proposed control methods for each of these materials were determined. Conclusions : The developed software calculates the health risk level based on the degree of hazard and exposure in shorttime and without using risk matrix and chemical formula. After determining the risk rank, the software proposes the control procedures to reduce occupational exposure.

  6. Comparing national infectious disease surveillance systems: China and the Netherlands.

    NARCIS (Netherlands)

    Vlieg, Willemijn L; Fanoy, Ewout B; van Asten, Liselotte; Liu, Xiaobo; Yang, Jun; Pilot, Eva; Bijkerk, Paul; van der Hoek, Wim; Krafft, Thomas; van der Sande, Marianne A; Liu, Qi-Yong

    2017-01-01

    Risk assessment and early warning (RAEW) are essential components of any infectious disease surveillance system. In light of the International Health Regulations (IHR)(2005), this study compares the organisation of RAEW in China and the Netherlands. The respective approaches towards surveillance of

  7. Surveillance System for Infectious Diseases of Pets, Santiago, Chile

    Science.gov (United States)

    López, Javier; Abarca, Katia; Valenzuela, Berta; Lorca, Lilia; Olea, Andrea; Aguilera, Ximena

    2009-01-01

    Pet diseases may pose risks to human health but are rarely included in surveillance systems. A pilot surveillance system of pet infectious diseases in Santiago, Chile, found that 4 canine and 3 feline diseases accounted for 90.1% and 98.4% of notifications, respectively. Data also suggested association between poverty and pet diseases. PMID:19861073

  8. Review of Qualitative Approaches for the Construction Industry: Designing a Risk Management Toolbox

    Science.gov (United States)

    Spee, Ton; Gillen, Matt; Lentz, Thomas J.; Garrod, Andrew; Evans, Paul; Swuste, Paul

    2011-01-01

    Objectives This paper presents the framework and protocol design for a construction industry risk management toolbox. The construction industry needs a comprehensive, systematic approach to assess and control occupational risks. These risks span several professional health and safety disciplines, emphasized by multiple international occupational research agenda projects including: falls, electrocution, noise, silica, welding fumes, and musculoskeletal disorders. Yet, the International Social Security Association says, "whereas progress has been made in safety and health, the construction industry is still a high risk sector." Methods Small- and medium-sized enterprises (SMEs) employ about 80% of the world's construction workers. In recent years a strategy for qualitative occupational risk management, known as Control Banding (CB) has gained international attention as a simplified approach for reducing work-related risks. CB groups hazards into stratified risk 'bands', identifying commensurate controls to reduce the level of risk and promote worker health and safety. We review these qualitative solutions-based approaches and identify strengths and weaknesses toward designing a simplified CB 'toolbox' approach for use by SMEs in construction trades. Results This toolbox design proposal includes international input on multidisciplinary approaches for performing a qualitative risk assessment determining a risk 'band' for a given project. Risk bands are used to identify the appropriate level of training to oversee construction work, leading to commensurate and appropriate control methods to perform the work safely. Conclusion The Construction Toolbox presents a review-generated format to harness multiple solutions-based national programs and publications for controlling construction-related risks with simplified approaches across the occupational safety, health and hygiene professions. PMID:22953194

  9. Review of qualitative approaches for the construction industry: designing a risk management toolbox.

    Science.gov (United States)

    Zalk, David M; Spee, Ton; Gillen, Matt; Lentz, Thomas J; Garrod, Andrew; Evans, Paul; Swuste, Paul

    2011-06-01

    This paper presents the framework and protocol design for a construction industry risk management toolbox. The construction industry needs a comprehensive, systematic approach to assess and control occupational risks. These risks span several professional health and safety disciplines, emphasized by multiple international occupational research agenda projects including: falls, electrocution, noise, silica, welding fumes, and musculoskeletal disorders. Yet, the International Social Security Association says, "whereas progress has been made in safety and health, the construction industry is still a high risk sector." Small- and medium-sized enterprises (SMEs) employ about 80% of the world's construction workers. In recent years a strategy for qualitative occupational risk management, known as Control Banding (CB) has gained international attention as a simplified approach for reducing work-related risks. CB groups hazards into stratified risk 'bands', identifying commensurate controls to reduce the level of risk and promote worker health and safety. We review these qualitative solutions-based approaches and identify strengths and weaknesses toward designing a simplified CB 'toolbox' approach for use by SMEs in construction trades. This toolbox design proposal includes international input on multidisciplinary approaches for performing a qualitative risk assessment determining a risk 'band' for a given project. Risk bands are used to identify the appropriate level of training to oversee construction work, leading to commensurate and appropriate control methods to perform the work safely. The Construction Toolbox presents a review-generated format to harness multiple solutions-based national programs and publications for controlling construction-related risks with simplified approaches across the occupational safety, health and hygiene professions.

  10. Gestión del riesgo de asma por haba de soja: monitorización y vigilancia Risk management of soybean-related asthma: monitoring and surveillance

    Directory of Open Access Journals (Sweden)

    Joan R. Villalbí

    2011-12-01

    Full Text Available Objetivos: Las emisiones de alérgeno durante la descarga de haba de soja en el puerto de Barcelona han sido causa de asma epidémica. Este trabajo describe las acciones de vigilancia y control de los servicios de salud pública. Métodos: Los datos se extraen del dispositivo de control durante el periodo de 1999 a 2009, detallando el sistema de vigilancia de emisiones y concentraciones ambientales de alérgeno (para las que se han fijado empíricamente niveles guía, y de salud. Resultados: De los 95 estudios de emisión, cuatro superaron los valores de alarma, con probables causas en los filtros. Las concentraciones ambientales medias son bajas, pero superaron el nivel de alarma 13 días; se relacionan con meteorología adversa e incidencias en las instalaciones. No se detectaron efectos en los pacientes del panel de vigilancia, ni días de asma epidémica. Conclusiones: El sistema detecta incidencias y ha mostrado su utilidad para preservar la salud pública.Objectives: Allergen emissions during soybean unloading operations in the Barcelona harbor have caused asthma epidemics. The present article aimed to describe the surveillance and control measures carried out by the public health services. Methods: Data were extracted from control systems from 1999 to 2009, with description of the surveillance schemes for allergen emissions, environmental concentrations (with defined reference levels and for health. Results: Of 95 studies of plant emission, four were above the reference levels, and filters were found to be the most likely cause. Mean environmental concentrations were low but were above the reference levels on 13 days; these levels were related to adverse meteorological conditions and incidents in the plants. No health effects were detected in the panel of patients nor epidemic asthma days. Conclusions: The system detects incidents and has shown its usefulness in protecting public health.

  11. Doppler ultrasound for detection of renal transplant artery stenosis - Threshold peak systolic velocity needs to be higher in a low-risk or surveillance population

    International Nuclear Information System (INIS)

    Patel, U.; Khaw, K.K.; Hughes, N.C.

    2003-01-01

    AIMS: To establish the ideal threshold arterial velocity for the diagnosis of renal transplant artery stenosis in a surveillance population with a low pre-test probability of stenosis. METHODS: Retrospective review of Doppler ultrasound, angiographic and clinical outcome data of patients transplanted over a 3-year period. Data used to calculate sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for various threshold peak systolic velocity values. RESULTS: Of 144 patients transplanted, full data were available in 117 cases. Five cases had renal transplant artery stenosis--incidence 4.2% [stenosis identified at a mean of 6.5 months (range 2-10 months)]. All five cases had a significant arterial pressure gradient across the narrowing and underwent angioplasty. Threshold peak systolic velocity of ≥2.5 m/s is not ideal [specificity=79% (CI 65-82%), PPV=18% (CI 6-32%), NPV=100% (CI 94-100%)], subjecting many patients to unnecessary angiography--8/117 (6%) in our population. Comparable values if the threshold is set at ≥3.0 m/s are 93% (CI 77-96%), 33% (CI 7-44%) and 99% (CI 93-100%), respectively. The clinical outcome of all patients was satisfactory, with no unexplained graft failures or loss. CONCLUSIONS: In a surveillance population with a low pre-test probability of stenosis, absolute renal artery velocity ≥2.5 m/s is a limited surrogate marker for significant renal artery stenosis. The false-positive rate is high, and ≥3.0 m/s is a better choice which will halve the number of patients enduring unnecessary angiography. Close clinical follow-up of patients in the 2.5-3.0 m/s range, with repeat Doppler ultrasound if necessary, will identify the test false-negatives

  12. The Copyright Surveillance Industry

    Directory of Open Access Journals (Sweden)

    Mike Zajko

    2015-09-01

    Full Text Available Creative works are now increasingly distributed as digital “content” through the internet, and copyright law has created powerful incentives to monitor and control these flows. This paper analyzes the surveillance industry that has emerged as a result. Copyright surveillance systems identify copyright infringement online and identify persons to hold responsible for infringing acts. These practices have raised fundamental questions about the nature of identification and attribution on the internet, as well as the increasing use of algorithms to make legal distinctions. New technologies have threatened the profits of some media industries through copyright infringement, but also enabled profitable forms of mass copyright surveillance and enforcement. Rather than a system of perfect control, copyright enforcement continues to be selective and uneven, but its broad reach results in systemic harm and provides opportunities for exploitation. It is only by scrutinizing copyright surveillance practices and copyright enforcement measures that we can evaluate these consequences.

  13. Deployment Health Surveillance

    National Research Council Canada - National Science Library

    DeNicola, Anthony D

    2004-01-01

    ... of stress in causing chronic illness. The lack of comprehensive deployment health surveillance has made it difficult to determine possible causes of adverse health effects reported by Gulf War veterans...

  14. Sanitary surveillance and bioethics

    Directory of Open Access Journals (Sweden)

    Volnei Garrafa

    2017-08-01

    Full Text Available Regulatory practices in the field of health surveillance are indispensable. The aim of this study is to show ‒ taking the Brazilian National Surveillance Agency, governing body of sanitary surveillance in Brazil as a reference ‒ that bioethics provides public bodies a series of theoretical tools from the field of applied ethics for the proper exercise and control of these practices. To that end, the work uses two references of bioethics for the development of a comparative and supportive analysis to regulatory activities in the field of health surveillance: the Universal Declaration on Bioethics and Human Rights of Unesco and the theory of intervention bioethics. We conclude that organizations and staff working with regulatory activities can take advantage of the principles and frameworks proposed by bioethics, especially those related to the Declaration and the theory of intervention bioethics, the latter being set by the observation and use of the principles of prudence, precaution, protection and prevention.

  15. A Survey of Colonoscopic Surveillance After Polypectomy

    Science.gov (United States)

    2014-01-01

    Purpose Several guidelines have been proposed for surveillance colonoscopy after polypectomy. However, some discrepancies still exist between the guidelines and clinical practice. This study was conducted to identify Korean doctors' recommendations for the colonoscopic surveillance interval after polypectomy. Methods A survey of the attendees at the symposium of the 64th Annual Congress of the Korean Surgical Society was conducted. When the prepared clinical scenarios were given, attendees answered using a wireless radio-frequency audience response system. All responders' results were automatically counted immediately. Frequencies of different answers to each question were calculated, and our results were compared with those of previous surveys performed using the same questionnaire in the United States or Japan. Results The number of responder varied from 38 to 41. About 50% of valid responders selected 'follow-up in 3 years' for low-risk lesions, such as a 6-mm hyperplastic polyp, a 6-mm tubular adenoma, or two 6-mm tubular adenomas. Responders most-commonly selected 'follow-up in 1 year' for high-risk lesions, such as a 12-mm tubular adenoma with high grade dysplasia or a 12-mm tubulovillous adenoma. The majority of Korean doctors recommend postpolypectomy colonoscopic surveillance more frequently than American physicians did. Conclusion A discrepancy between the guidelines and clinical practice for the surveillance after polypectomy still exists in Korea. A surveillance program that can be easily and widely applied in clinical practice needs to be established. PMID:24851219

  16. Wireless sensor network for mobile surveillance systems; 2005BU1-TRSP

    NARCIS (Netherlands)

    Maris, M.G.; Dijk, G.J.A. van

    2005-01-01

    Guarding safety and security within industrial, commercial and military areas is an important issue nowadays. A specific challenge lies in the design of portable surveillance systems that can be rapidly deployed, installed and easily operated. Conventional surveillance systems typically employ

  17. A scenario tree model for the Canadian Notifiable Avian Influenza Surveillance System and its application to estimation of probability of freedom and sample size determination.

    Science.gov (United States)

    Christensen, Jette; Stryhn, Henrik; Vallières, André; El Allaki, Farouk

    2011-05-01

    In 2008, Canada designed and implemented the Canadian Notifiable Avian Influenza Surveillance System (CanNAISS) with six surveillance activities in a phased-in approach. CanNAISS was a surveillance system because it had more than one surveillance activity or component in 2008: passive surveillance; pre-slaughter surveillance; and voluntary enhanced notifiable avian influenza surveillance. Our objectives were to give a short overview of two active surveillance components in CanNAISS; describe the CanNAISS scenario tree model and its application to estimation of probability of populations being free of NAI virus infection and sample size determination. Our data from the pre-slaughter surveillance component included diagnostic test results from 6296 serum samples representing 601 commercial chicken and turkey farms collected from 25 August 2008 to 29 January 2009. In addition, we included data from a sub-population of farms with high biosecurity standards: 36,164 samples from 55 farms sampled repeatedly over the 24 months study period from January 2007 to December 2008. All submissions were negative for Notifiable Avian Influenza (NAI) virus infection. We developed the CanNAISS scenario tree model, so that it will estimate the surveillance component sensitivity and the probability of a population being free of NAI at the 0.01 farm-level and 0.3 within-farm-level prevalences. We propose that a general model, such as the CanNAISS scenario tree model, may have a broader application than more detailed models that require disease specific input parameters, such as relative risk estimates. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

  18. A Global Cancer Surveillance Framework Within Noncommunicable Disease Surveillance: Making the Case for Population-Based Cancer Registries.

    Science.gov (United States)

    Piñeros, Marion; Znaor, Ariana; Mery, Les; Bray, Freddie

    2017-01-01

    The growing burden of cancer among several major noncommunicable diseases (NCDs) requires national implementation of tailored public health surveillance. For many emerging economies where emphasis has traditionally been placed on the surveillance of communicable diseases, it is critical to understand the specificities of NCD surveillance and, within it, of cancer surveillance. We propose a general framework for cancer surveillance that permits monitoring the core components of cancer control. We examine communalities in approaches to the surveillance of other major NCDs as well as communicable diseases, illustrating key differences in the function, coverage, and reporting in each system. Although risk factor surveys and vital statistics registration are the foundation of surveillance of NCDs, population-based cancer registries play a unique fundamental role specific to cancer surveillance, providing indicators of population-based incidence and survival. With an onus now placed on governments to collect these data as part of the monitoring of NCD targets, the integration of cancer registries into existing and future NCD surveillance strategies is a vital requirement in all countries worldwide. The Global Initiative for Cancer Registry Development, endorsed by the World Health Organization, provides a means to enhance cancer surveillance capacity in low- and middle-income countries. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Including test errors in evaluating surveillance test intervals

    International Nuclear Information System (INIS)

    Kim, I.S.; Samanta, P.K.; Martorell, S.; Vesely, W.E.

    1991-01-01

    Technical Specifications require surveillance testing to assure that the standby systems important to safety will start and perform their intended functions in the event of plant abnormality. However, as evidenced by operating experience, the surveillance tests may be adversely impact safety because of their undesirable side effects, such as initiation of plant transients during testing or wearing-out of safety systems due to testing. This paper first defines the concerns, i.e., the potential adverse effects of surveillance testing, from a risk perspective. Then, we present a methodology to evaluate the risk impact of those adverse effects, focusing on two important kinds of adverse impacts of surveillance testing: (1) risk impact of test-caused trips and (2) risk impact of test-caused equipment wear. The quantitative risk methodology is demonstrated with several surveillance tests conducted at boiling water reactors, such as the tests of the main steam isolation valves, the turbine overspeed protection system, and the emergency diesel generators. We present the results of the risk-effectiveness evaluation of surveillance test intervals, which compares the adverse risk impact with the beneficial risk impact of testing from potential failure detection, along with insights from sensitivity studies

  20. Reactor surveillance by noise analysis

    International Nuclear Information System (INIS)

    Ciftcioglu, Ozer

    1988-01-01

    A real-time noise analysis system is designed for the TRIGA reactor at Istanbul Technical University. By means of the noise techniques, reactor surveillance is performed together with failure diagnosis. The fast data processing is carried out by FFT in real-time so that malfunction or non-stationary operation of the reactor in long term can be identified by comparing the noise power spectra with the corresponding reference patterns while the decision making procedure is accomplished by the method of hypothesis testing. The system being computer based safety instrumentation involves CAMAC in conjunction with the RT-11 (PDP-11) single user dedicated environment. (author)

  1. HIV surveillance in MENA: recent developments and results.

    Science.gov (United States)

    Bozicevic, Ivana; Riedner, Gabriele; Calleja, Jesus Maria Garcia

    2013-11-01

    To provide an overview of the current level of development and results from the national HIV surveillance systems of the 23 countries of the Middle East and North Africa (MENA), and to assess the quality of HIV surveillance systems in the period 2007-2011. A questionnaire was used to collect the information about the structure, activities and the results of HIV surveillance systems from the National AIDS Programmes. Assessment of the quality was based on four indicators: timeliness of data collection, appropriateness of populations under surveillance, consistency of the surveillance sites and groups measured over time, and coverage of the surveillance system. Only in four countries did surveillance systems enable assessment of epidemic trends in the same populations and locations over time, such as in pregnant women (Morocco, Iran), injecting drug users (Iran, Pakistan), female sex workers (Djibouti, Morocco) and male sex workers (Pakistan). There is increasing evidence of HIV infection being firmly established in at least one of the populations most at risk of HIV in nine MENA countries, while lower risk populations show elevated HIV prevalence in South Sudan, Djibouti and some parts of Somalia. The performance of HIV surveillance systems in several of the MENA countries has improved in recent years. The extent of HIV epidemics in the populations most at risk of HIV is still largely unknown in 10 countries. Multiple data sources that most of the countries still lack would enable indirectly estimation not only of the patterns of HIV epidemics but also the effectiveness of HIV responses.

  2. Risk-based design of process plants with regard to domino effects and land use planning

    Energy Technology Data Exchange (ETDEWEB)

    Khakzad, Nima, E-mail: nkhakzad@gmail.com [Safety and Security Science Group (S3G), Faculty of Technology, Policy and Management, TU Delft, Delft (Netherlands); Reniers, Genserik [Safety and Security Science Group (S3G), Faculty of Technology, Policy and Management, TU Delft, Delft (Netherlands); Antwerp Research Group on Safety and Security (ARGoSS), Faculty of Applied Economics, Universiteit Antwerpen, Antwerp (Belgium); Research Group CEDON, Campus Brussels, KULeuven, Brussels (Belgium)

    2015-12-15

    Highlights: • A Bayesian network methodology has been developed to estimate the total probability of major accidents in chemical plants. • Total probability of accidents includes the probability of individual accidents and potential domino effects. • The methodology has been extended to calculate on-site and off-site risks. • The results of the risk analysis have been used in a multi-criteria decision analysis technique to risk-based design of chemical plants. - Abstract: Land use planning (LUP) as an effective and crucial safety measure has widely been employed by safety experts and decision makers to mitigate off-site risks posed by major accidents. Accordingly, the concept of LUP in chemical plants has traditionally been considered from two perspectives: (i) land developments around existing chemical plants considering potential off-site risks posed by major accidents and (ii) development of existing chemical plants considering nearby land developments and the level of additional off-site risks the land developments would be exposed to. However, the attempts made to design chemical plants with regard to LUP requirements have been few, most of which have neglected the role of domino effects in risk analysis of major accidents. To overcome the limitations of previous work, first, we developed a Bayesian network methodology to calculate both on-site and off-site risks of major accidents while taking domino effects into account. Second, we combined the results of risk analysis with Analytic Hierarchical Process to design an optimal layout for which the levels of on-site and off-site risks would be minimum.

  3. Groundwater surveillance plan for the Oak Ridge Reservation

    International Nuclear Information System (INIS)

    Forstrom, J.M.; Smith, E.D.; Winters, S.L.; McMaster, W.M.

    1994-07-01

    US Department of Energy (DOE) Order 5400.1 requires the preparation of environmental monitoring plans and implementation of environmental monitoring programs for all DOE facilities. The order identifies two distinct components of environmental monitoring, namely effluent monitoring and environmental surveillance. In general, effluent monitoring has the objectives of characterizing contaminants and demonstrating compliance with applicable standards and permit requirements, whereas environmental surveillance has the broader objective of monitoring the effects of DOE activities on on- and off-site environmental and natural resources. The purpose of this document is to support the Environmental Monitoring Plan for the Oak Ridge Reservation (ORR) by describing the groundwater component of the environmental surveillance program for the DOE facilities on the ORR. The distinctions between groundwater effluent monitoring and groundwater surveillance have been defined in the Martin Marietta Energy Systems, Inc., Groundwater Surveillance Strategy. As defined in the strategy, a groundwater surveillance program consists of two parts, plant perimeter surveillance and off-site water well surveillance. This document identifies the sampling locations, parameters, and monitoring frequencies for both of these activities on and around the ORR and describes the rationale for the program design. The program was developed to meet the objectives of DOE Order 5400.1 and related requirements in DOE Order 5400.5 and to conform with DOE guidance on environmental surveillance and the Energy Systems Groundwater Surveillance Strategy

  4. Enfermedad de Chagas en Argentina: herramientas para que los escolares vigilen y determinen la presencia de factores de riesgo en sus viviendas Chagas disease in Argentina: tools for schoolchildren to exercise vector surveillance and identify household risk factors

    Directory of Open Access Journals (Sweden)

    Liliana Crocco

    2005-04-01

    Full Text Available El objetivo de este trabajo fue validar herramientas para que escolares puedan vigilar sus viviendas. Se desarrollaron dos tipos de planillas, una sobre la presencia de factores de riesgos y otra para registrar la presencia de vinchucas en las viviendas. Estas planillas fueron puestas a prueba en campo por 100 escolares de escuelas de áreas endémicas de Argentina y validadas en campo por personal técnico. Los resultados obtenidos por los escolares sobre porcentajes de viviendas que presentan factores de riesgos y viviendas positivas fueron similares a los obtenidos por el personal técnico. La información recabada permitió a los docentes caracterizar las viviendas como "con mucho riesgo", "de riesgo" o "sin riesgo". Esta información sobre nivel de riesgo de las viviendas puede ser una importante ayuda para los agentes primarios de salud. Por lo tanto, se recomienda incluir estas estrategias educativas en los programas de control, en especial para la fase de vigilancia.The objective of this paper was to validate tools for schoolchildren to help control Chagas disease vectors in their own homes. Two types of tables were produced, one reporting on the presence of risk factors in residences and the other to record the presence of triatomines. The materials were tested in the field by 100 students from an endemic area in Argentina and validated by technical personnel. The results obtained by students concerning the percentage of households with risk factors and vector-positive residences were similar to those obtained by the technical personnel. This information allowed teachers to classify the risk levels in the residences as at "high-risk", "risk", or "no risk". The information provides an important aid for health workers, and it is therefore recommended to include this educational strategy in the surveillance phase of the Chagas disease control program.

  5. Methodology of life cycle cost with risk expenditure for offshore process at conceptual design stage

    International Nuclear Information System (INIS)

    Nam, Kiil; Chang, Daejun; Chang, Kwangpil; Rhee, Taejin; Lee, In-Beum

    2011-01-01

    This study proposed a new LCC (life cycle cost) methodology with the risk expenditure taken into account for comparative evaluation of offshore process options at their conceptual design stage. The risk expenditure consisted of the failure risk expenditure and the accident risk expenditure. The former accounted for the production loss and the maintenance expense due to equipment failures while the latter reflected the asset damage and the fatality worth caused by disastrous accidents such as fire and explosion. It was demonstrated that the new LCC methodology was capable of playing the role of a process selection basis in choosing the best of the liquefaction process options including the power generation systems for a floating LNG (Liquefied natural gas) production facility. Without the risk expenditure, a simple economic comparison apparently favored the mixed refrigerant cycle which had the better efficiency. The new methodology with the risk expenditure, however, indicated that the nitrogen expansion cycle driven by steam turbines should be the optimum choice, mainly due to its better availability and safety. -- Highlights: → The study presented the methodology of the LCC with the risk expenditure for the conceptual design of offshore processes. → The proposed methodology demonstrated the applicability of the liquefaction unit with the power generation system of LNG FPSO. → Without the risk expenditure, a simple economic comparison apparently favored the mixed refrigerant cycle which had the better efficiency. → The new methodology indicated that the nitrogen expansion cycle driven by steam turbines is the optimum choice due to its better availability and safety.

  6. Quality surveillance experience of PHWR fuel

    International Nuclear Information System (INIS)

    Kulkarni, P.G.; Bandyopadhyay, A.K.; Shah, B.K.

    1997-01-01

    Quality Surveillance activities are being carried out for PHWR fuel for over 25 years in India. A large number of fuel bundles of 19 element design have been produced and successfully irradiated. The quality surveillance practices follow the guidelines given in various Quality Assurance Codes and Guides. An independent third party surveillance is provided to cover major manufacturing and quality control operations. A system of design basis review periodic quality audit and regulatory safety review is in place. Over the years there have been modifications in the quality assurance procedures to comply with changing requirements. Also many innovative improvements have been introduced in the manufacturing procedures. Similarly quality control activities are also modified. Developments in fuel has remained a continuous activity. The paper summarizes the experience gathered over many years in this exciting process of innovation and improvement. (author)

  7. MARGINAL EXPENSE OIL WELL WIRELESS SURVEILLANCE MEOWS

    Energy Technology Data Exchange (ETDEWEB)

    Mason M. Medizade; John R. Ridgely; Donald G. Nelson

    2004-11-01

    A marginal expense oil well wireless surveillance system to monitor system performance and production from rod-pumped wells in real time from wells operated by Vaquero Energy in the Edison Field, Main Area of Kern County in California has been successfully designed and field tested. The surveillance system includes a proprietary flow sensor, a programmable transmitting unit, a base receiver and receiving antenna, and a base station computer equipped with software to interpret the data. First, the system design is presented. Second, field data obtained from three wells is shown. Results of the study show that an effective, cost competitive, real-time wireless surveillance system can be introduced to oil fields across the United States and the world.

  8. Laser surveillance system for spent fuel

    International Nuclear Information System (INIS)

    Fiarman, S.; Zucker, M.S.; Bieber, A.M. Jr.

    1980-01-01

    A laser surveillance system installed at spent fuel storage pools (SFSP's) will provide the safeguard inspector with specific knowledge of spent fuel movement that cannot be obtained with current surveillance systems. The laser system will allow for the division of the pool's spent fuel inventory into two populations - those assemblies which have been moved and those which haven't - which is essential for maximizing the efficiency and effectiveness of the inspection effort. We have designed, constructed, and tested a full size laser system operating in air and have used an array of 6 zircaloy BWR tubes to simulate an assembly. The reflective signal from the zircaloy rods is a strong function of position of the assembly, but in all cases is easily discernable from the reference scan of the background with no assembly. A design for a SFSP laser surveillance system incorporating laser ranging is discussed. 10 figures

  9. Organization of surveillance in GI practice.

    Science.gov (United States)

    Senore, Carlo; Bellisario, Cristina; Hassan, Cesare

    2016-12-01

    Several reports documented an inefficient utilisation of available resources, as well as a suboptimal compliance with surveillance recommendations. Although, evidence suggests that organisational issues can influence the quality of care delivered, surveillance protocols are usually based on non-organized approaches. We conducted a literature search (publication date: 01/2000-06/2016) on PubMed and Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and Cochrane Central Register of Controlled Trials for guidelines, or consensus statements, for surveys of practice, reporting information about patients, or providers attitudes and behaviours, for intervention studies to enhance compliance with guidelines. Related articles were also scrutinised. Based on the clinical relevance and burden on endoscopy services this review was focused on surveillance for Barrett's oesophagus, IBD and post-polypectomy surveillance of colonic adenomas. Existing guidelines are generally recognising structure and process requirements influencing delivery of surveillance interventions, while less attention had been devoted to transitions and interfaces in the care process. Available evidence from practice surveys is suggesting the need to design organizational strategies aimed to enable patients to attend and providers to deliver timely and appropriate care. Well designed studies assessing the effectiveness of specific interventions in this setting are however lacking. Indirect evidence from screening settings would suggest that the implementation of automated standardized recall systems, utilisation of clinical registries, removing financial barriers, could improve appropriateness of use and compliance with recommendations. Lack of sound evidence regarding utility and methodology of surveillance can contribute to explain the observed variability in providers and patients attitudes and in compliance with the recommended surveillance. Copyright © 2016 Elsevier

  10. The role of risk management in the design of diagnostics for fusion reactors

    Energy Technology Data Exchange (ETDEWEB)

    Ingesson, L. C. [Fusion for Energy, Josep Pla 2, Torres Diagonal Litoral B3, 08019 Barcelona (Spain); Collaboration: F4E Diagnostic Project Team

    2014-08-21

    A project-oriented approach is beneficial for the selection and design of viable diagnostics for fusion reactors because of the associated complex physical and organizational environment. The project-oriented approach includes rigorous risk management. The nature and impact of risks related to technical, organizational and commercial aspects in relation to the development of ITER diagnostics under EU responsibility are analyzed. The majority of risks are related to organizational aspects and technical feasibility issues. The experience with ITER is extrapolated to DEMO and beyond. It should not be taken for granted that technical solutions will be found, while a risk analysis of various diagnostic techniques with quantitative assessments undertaken early in the design of DEMO would be beneficial.

  11. Surveillance of hepatic late adverse effects in a large cohort of long-term survivors of childhood cancer: prevalence and risk factors

    NARCIS (Netherlands)

    Mulder, Renée L.; Kremer, Leontien C. M.; Koot, Bart G. P.; Benninga, Marc A.; Knijnenburg, Sebastiaan L.; van der Pal, Helena J. H.; Koning, Caro C. E.; Oldenburger, Foppe; Wilde, James C. H.; Taminiau, Jan A. J. M.; Caron, Huib N.; van Dalen, Elvira C.

    2013-01-01

    Childhood cancer survivors (CCS) are a growing group of young individuals with a high risk of morbidity and mortality. We evaluated the prevalence and risk factors of hepatic late adverse effects, defined as elevated liver enzymes, in a large cohort of CCS. The cohort consisted of all five-year CCS

  12. Incidence of Interval Colorectal Cancer Among Inflammatory Bowel Disease Patients Undergoing Regular Colonoscopic Surveillance

    NARCIS (Netherlands)

    Mooiweer, Erik; van der Meulen-de Jong, Andrea E.; Ponsioen, Cyriel Y.; van der Woude, C. Janneke; van Bodegraven, Ad A.; Jansen, Jeroen M.; Mahmmod, Nofel; Kremer, Willemijn; Siersema, Peter D.; Oldenburg, Bas

    2015-01-01

    Surveillance is recommended for patients with long-term inflammatory bowel disease because they have an increased risk of colorectal cancer (CRC). To study the effectiveness of surveillance, we determined the incidence of CRC after negative findings from surveillance colonoscopies (interval CRC). We

  13. Incidence of Interval Colorectal Cancer Among Inflammatory Bowel Disease Patients Undergoing Regular Colonoscopic Surveillance

    NARCIS (Netherlands)

    Mooiweer, Erik; van der Meulen-de Jong, Andrea E.; Ponsioen, Cyriel Y.; van der Woude, C. Janneke; van Bodegraven, Ad A.; Jansen, Jeroen M.; Mahmmod, Nofel; Kremer, Willemijn; Siersema, Peter D.; Oldenburg, Bas

    2015-01-01

    Surveillance is recommended for patients with long-term inflammatory bowel disease because they have an increased risk of colorectal cancer (CRC). To study the effectiveness of surveillance, we determined the incidence of CRC after negative findings from surveillance colonoscopies (interval CRC).

  14. Incidence of Interval Colorectal Cancer Among Inflammatory Bowel Disease Patients Undergoing Regular Colonoscopic Surveillance

    NARCIS (Netherlands)

    Mooiweer, E.; Maulen- de Jong, A.E. van der; Ponsioen, C.Y.; Woude, C.J. van der; Bodegraven, A.A. van; Jansen, J.M.; Mahmmod, N.; Kremer, W.; Siersema, P.D.; Oldenburg, B.

    2015-01-01

    BACKGROUND & AIMS: Surveillance is recommended for patients with long-term inflammatory bowel disease because they have an increased risk of colorectal cancer (CRC). To study the effectiveness of surveillance, we determined the incidence of CRC after negative findings from surveillance colonoscopies

  15. Steam generator tube rupture risk impact on design and operation of French PWR plants

    International Nuclear Information System (INIS)

    Depond, G.; Sureau, H.

    1984-01-01

    The experience of steam generator tube leaks incidents in PWR plants has resulted in an increase of EDF analysis leading to improvements in design and post-accidental operation for new projects and operating plants. The accident consequences are minimized for each of the NSSS three barriers: first barrier: safeguard systems design and operating procedures relying upon core safety allow to maintain a low level of primary radioactivity, second barrier: steam generator design and periodic inspection allow to reduce tube ruptures risks and third barrier: atmospheric releases are reduced as a result of optimal recovery procedures, detection improvements and atmospheric steam valves design improvements. (orig.)

  16. The control, at the design stage, of risks related to buildings management over time

    Directory of Open Access Journals (Sweden)

    Claudio Martani

    2013-10-01

    Full Text Available In the present paper an apparatus of tools and methods is presented to evaluate, at the design stage, the risks over a set of objectives through buildings lifetime. To this purpose a tool is first presented to relate technological requirements of each technical elements to the pertinent maintenance interventions. Then a process is also proposed to estimate the risks on user requirements runningMonte Carlo simulations. The risk management process proposed in the present work aims to support designers and promoters in making predictions on the outcomes of long, not standardized, multivariable dependent processes – as the building process is – in order to indicate the attitude of a designed building to meet a framework of important objectives through its lifetime.

  17. Surveillance of wild birds for avian influenza virus.

    Science.gov (United States)

    Hoye, Bethany J; Munster, Vincent J; Nishiura, Hiroshi; Klaassen, Marcel; Fouchier, Ron A M

    2010-12-01

    Recent demand for increased understanding of avian influenza virus in its natural hosts, together with the development of high-throughput diagnostics, has heralded a new era in wildlife disease surveillance. However, survey design, sampling, and interpretation in the context of host populations still present major challenges. We critically reviewed current surveillance to distill a series of considerations pertinent to avian influenza virus surveillance in wild birds, including consideration of what, when, where, and how many to sample in the context of survey objectives. Recognizing that wildlife disease surveillance is logistically and financially constrained, we discuss pragmatic alternatives for achieving probability-based sampling schemes that capture this host-pathogen system. We recommend hypothesis-driven surveillance through standardized, local surveys that are, in turn, strategically compiled over broad geographic areas. Rethinking the use of existing surveillance infrastructure can thereby greatly enhance our global understanding of avian influenza and other zoonotic diseases.

  18. Implementing hospital-based surveillance for severe acute respiratory infections caused by influenza and other respiratory pathogens in New Zealand

    Directory of Open Access Journals (Sweden)

    Q Sue Huang

    2014-05-01

    Full Text Available Background: Recent experience with pandemic influenza A(H1N1pdm09 highlighted the importance of global surveillance for severe respiratory disease to support pandemic preparedness and seasonal influenza control. Improved surveillance in the southern hemisphere is needed to provide critical data on influenza epidemiology, disease burden, circulating strains and effectiveness of influenza prevention and control measures. Hospital-based surveillance for severe acute respiratory infection (SARI cases was established in New Zealand on 30 April 2012. The aims were to measure incidence, prevalence, risk factors, clinical spectrum and outcomes for SARI and associated influenza and other respiratory pathogen cases as well as to understand influenza contribution to patients not meeting SARI case definition. Methods/Design: All inpatients with suspected respiratory infections who were admitted overnight to the study hospitals were screened daily. If a patient met the World Health Organization’s SARI case definition, a respiratory specimen was tested for influenza and other respiratory pathogens. A case report form captured demographics, history of presenting illness, co-morbidities, disease course and outcome and risk factors. These data were supplemented from electronic clinical records and other linked data sources. Discussion: Hospital-based SARI surveillance has been implemented and is fully functioning in New Zealand. Active, prospective, continuous, hospital-based SARI surveillance is useful in supporting pandemic preparedness for emerging influenza A(H7N9 virus infections and seasonal influenza prevention and control.

  19. Risk-informed approach in US-APWR technical specifications

    International Nuclear Information System (INIS)

    Saji, Etsuro; Tanaka, Futoshi; Kuroiwa, Katsuya; Kawai, Katsunori

    2009-01-01

    The Risk-Managed Technical Specifications and the Surveillance Frequency Control Program have been adopted in the US-APWR Technical Specifications. These risk-informed approaches are unique among the technical specifications for the advanced light water reactor designs adopted by planned nuclear power stations in the United States. (author)

  20. The design of reliability data bases, part II: competing risk and data compression

    International Nuclear Information System (INIS)

    Cooke, Roger M.

    1996-01-01

    Models for analyzing dependent competing risk data are presented. These models are designed to represent interactions of critical failure and maintenance mechanisms responsible for intercepting incipient and degraded failures, and they are fashioned such that the (constant) critical failure rate is identifiable from dependent competing risk data. Uncertainty bounds for the critical failure rate which take modeling uncertainty and statistical fluctuations into account are given

  1. Probabilistic Modeling of Seismic Risk Based Design for a Dual System Structure

    OpenAIRE

    Sidi, Indra Djati

    2017-01-01

    The dual system structure concept has gained popularity in the construction of high-rise buildings over the last decades. Meanwhile, earthquake engineering design provisions for buildings have moved from the uniform hazard concept to the uniform risk concept upon recognizing the uncertainties involved in the earthquake resistance of concrete structures. In this study, a probabilistic model for the evaluation of such risk is proposed for a dual system structure consisting of shear walls or cor...

  2. Medical surveillance program for uranium workers in Grants, New Mexico

    International Nuclear Information System (INIS)

    Valdivia, A.A.

    1981-01-01

    A medical surveillance program at the Grants Clinic in Grants, New Mexico designed for early detection of pre-invasive and invasive lung neoplasms is discussed. The parameters of the surveillance profile are: age, race, mining history, smoking history, radiation exposure, chest x-rays, and sputum cytology. The best tool is the cytological examination of the sputum

  3. Increasing Breast Cancer Surveillance among African American Breast Cancer Survivors

    National Research Council Canada - National Science Library

    Thompson, Hayley

    2005-01-01

    ...; they also are at considerable risk for breast cancer recurrence. According to the American Society of Clinical Oncology, survivors should undergo careful breast cancer surveillance, including annual mammography and breast self-exam...

  4. Transition to CCTV surveillance for safeguards

    International Nuclear Information System (INIS)

    Gaertner, K.J.; Heaysman, B.; Kerr, R.E.; Rundquist, D.E.

    1987-01-01

    After many years of development effort and as a result of regular maintenance the Agency's most important optical surveillance system, the Twin Minolta, has matured to a highly reliable, economic and user friendly equipment. In 1986 its reliability was 95.7%, including human failures. However, because they are no longer available, the Agency is forced to replace the Minolta Super 8 cameras by adequate Closed Circuit Television systems. Ten years of experience with television systems clearly indicate that they must work actively to improve the overall reliability of CCTV systems. The recording units, from the authors experience, are the most critical components. Therefore new systems - already existing or under development - focus on this aspect. The Multiplex TV Surveillance System (MUX), uses redundant time lapse recorders, which are specifically designed for surveillance applications. The Compact Surveillance Monitoring System (COSMOS) will be using low speed time lapse recorders which are specifically developed for still-picture recording surveillance applications. The Modular Integrated Video System (MIVS) will use two redundant 8 mm video recorders to achieve the goal of high reliability. It is their understanding that this intensive consideration of reliability aspects in the design phase will also result in a decrease in maintenance and operational costs for the Agency in the future

  5. Design and implementation of a risk assessment module in a spatial decision support system

    Science.gov (United States)

    Zhang, Kaixi; van Westen, Cees; Bakker, Wim

    2014-05-01

    The spatial decision support system named 'Changes SDSS' is currently under development. The goal of this system is to analyze changing hydro-meteorological hazards and the effect of risk reduction alternatives to support decision makers in choosing the best alternatives. The risk assessment module within the system is to assess the current risk, analyze the risk after implementations of risk reduction alternatives, and analyze the risk in different future years when considering scenarios such as climate change, land use change and population growth. The objective of this work is to present the detailed design and implementation plan of the risk assessment module. The main challenges faced consist of how to shift the risk assessment from traditional desktop software to an open source web-based platform, the availability of input data and the inclusion of uncertainties in the risk analysis. The risk assessment module is developed using Ext JS library for the implementation of user interface on the client side, using Python for scripting, as well as PostGIS spatial functions for complex computations on the server side. The comprehensive consideration of the underlying uncertainties in input data can lead to a better quantification of risk assessment and a more reliable Changes SDSS, since the outputs of risk assessment module are the basis for decision making module within the system. The implementation of this module will contribute to the development of open source web-based modules for multi-hazard risk assessment in the future. This work is part of the "CHANGES SDSS" project, funded by the European Community's 7th Framework Program.

  6. Effectiveness of community participation in a surveillance system initiative to prevent drowning in Thailand.

    Science.gov (United States)

    Sansiritaweesook, Getsara; Muangsom, Niramon; Kanato, Manop; Ratanasiri, Amornrat

    2015-03-01

    This study had a 2-group pre-post quasiexperimental design and was conducted in 2 selected areas of Ubon Ratchathani province, Thailand. The objective was to evaluate the extent to which the surveillance system that was developed helped in drowning prevention. The development process involved extensive participation from the community. System efficiency was evaluated, and the drowning rates were compared. The system demonstrated 82.8% system sensitivity and 87% positive-predictive value. There were 90.0% rescues with no injury during the study period. The relative risk of drowning injury suggests that the control area was at 5.6 times more at risk for drowning injury than the intervention area (95% CI = 1.58, 20.12). Local knowledge and participation from the community were found to be key issues in the success of the surveillance system, and such systems can be applied to other areas with similar problems. © 2013 APJPH.

  7. Designing a Physical Security System for Risk Reduction in a Hypothetical Nuclear Facility

    International Nuclear Information System (INIS)

    Saleh, A.A.; Abd Elaziz, M.

    2017-01-01

    Physical security in a nuclear facility means detection, prevention and response to threat, the ft, sabotage, unauthorized access and illegal transfer involving radioactive and nuclear material. This paper proposes a physical security system designing concepts to reduce the risk associated with variant threats to a nuclear facility. This paper presents a study of the unauthorized removal and sabotage in a hypothetical nuclear facility considering deter, delay and response layers. More over, the study involves performing any required upgrading to the security system by investigating the nuclear facility layout and considering all physical security layers design to enhance the weakness for risk reduction

  8. Incorporating risk measures in closed-loop supply chain network design

    DEFF Research Database (Denmark)

    Soleimani, H.; Seyyed-Esfahani, M.; Govindan, Kannan

    2014-01-01

    This paper considers a location-allocation problem in a closed-loop supply chain (CLSC) with two extensions: first, demand and prices of new and return products are regarded as non-deterministic parameters and second, the objective function is developed from expected profit to three types of mean......-risk ones. Indeed, design and planning an integrated CLSC in real-world volatile markets is an important and necessary issue. Further, risk-neutral approaches, which are considered expected values, are not efficient for such uncertain conditions. Hence, this paper, copes with the design and planning problem...

  9. Surveillance of antibiotic resistance

    Science.gov (United States)

    Johnson, Alan P.

    2015-01-01

    Surveillance involves the collection and analysis of data for the detection and monitoring of threats to public health. Surveillance should also inform as to the epidemiology of the threat and its burden in the population. A further key component of surveillance is the timely feedback of data to stakeholders with a view to generating action aimed at reducing or preventing the public health threat being monitored. Surveillance of antibiotic resistance involves the collection of antibiotic susceptibility test results undertaken by microbiology laboratories on bacteria isolated from clinical samples sent for investigation. Correlation of these data with demographic and clinical data for the patient populations from whom the pathogens were isolated gives insight into the underlying epidemiology and facilitates the formulation of rational interventions aimed at reducing the burden of resistance. This article describes a range of surveillance activities that have been undertaken in the UK over a number of years, together with current interventions being implemented. These activities are not only of national importance but form part of the international response to the global threat posed by antibiotic resistance. PMID:25918439

  10. Practical experience applied to the design of injection and sample manifolds to perform in-place surveillance tests according to ANSI/ASME N-510

    Energy Technology Data Exchange (ETDEWEB)

    Banks, E.M.; Wikoff, W.O.; Shaffer, L.L. [NUCON International, Inc., Columbus, OH (United States)

    1997-08-01

    At the current level of maturity and experience in the nuclear industry, regarding testing of air treatment systems, it is now possible to design and qualify injection and sample manifolds for most applications. While the qualification of sample manifolds is still in its infancy, injection manifolds have reached a mature stage that helps to eliminate the {open_quotes}hit or miss{close_quotes} type of design. During the design phase, manifolds can be adjusted to compensate for poor airflow distribution, laminar flow conditions, and to take advantage of any system attributes. Experience has shown that knowing the system attributes before the design phase begins is an essential element to a successful manifold design. The use of a spreadsheet type program commonly found on most personal computers can afford a greater flexibility and a reduction in time spent in the design phase. The experience gained from several generations of manifold design has culminated in a set of general design guidelines. Use of these guidelines, along with a good understanding of the type of testing (theoretical and practical), can result in a good manifold design requiring little or no field modification. The requirements for manifolds came about because of the use of multiple banks of components and unconventional housing inlet configurations. Multiple banks of adsorbers and pre and post HEPA`s required that each bank be tested to insure that each one does not exceed a specific allowable leakage criterion. 5 refs., 5 figs., 1 tab.

  11. Assessment of the Fire Risk Levels in an Office Building and a Nightclub with Prescriptive Designs

    DEFF Research Database (Denmark)

    Yilmaz, D.; Steffensen, F.B.; Jomaas, Grunde

    2014-01-01

    A comparison of the risk level of an office building and a nightclub with code compliant prescriptive designs was conducted in order to evaluate whether an uniform safety level of the two occupancy types can be established. A risk assessment method using Monte Carlo simulations and 1- and 2-zone......-movement time and the movement time were adjusted for the required safe egress time (RSET) of the nightclub. The number of simulations required in order to obtain reliable results was considered sufficient at 20,000. The comparison of the risk profiles of the nightclub and the office building showed significant...... difference in risk levels, with that of the nightclub being substantially higher. The higher risk level in the nightclub is caused by a relatively fast mean value of the fire g