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Sample records for targeted at-risk middle

  1. Overweight and obesity among children at risk of intellectual disability in 20 low and middle income countries.

    Science.gov (United States)

    Savage, A; Emerson, E

    2016-11-01

    Children with intellectual disability (ID) in high income countries are at significantly greater risk of obesity than their non-disabled peers. We aimed to estimate the prevalence of overweight and obesity in 3 to 4-year-old children who are/are not at risk of ID in low and middle income countries. Secondary analysis of Round 4 and 5 UNICEF Multiple Indicator Cluster Surveys (MICS) from 20 low and middle income countries that included a total of 83 597 3 to 4-year-old children. Few differences in risk of overweight or obesity were apparent between 3 and 4-year-old children identified as being at risk/not at risk of ID in 20 low and middle income countries. In the two countries where statistically significant differences were observed, prevalence of overweight/obesity was lower among children at risk of ID. These results stand in stark contrast to evidence from high income countries which suggest that children with ID are at significantly increased risk of obesity when compared to their non-intellectually disabled peers. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  2. At-Risk Programs for Middle School and High School: Essential Components and Recommendations for Administrators and Teachers.

    Science.gov (United States)

    Bateman, Susan; Karr-Kidwell, PJ

    This paper provides an extensive literature review concerning at-risk students and their needs, identifies the essential components necessary for effective at-risk programming, and describes successful at-risk programs and recommendations for administrators and teachers at the middle- and high-school levels. The literature review presents research…

  3. Valuing a Lifestyle Intervention for Middle Eastern Immigrants at Risk of Diabetes.

    Science.gov (United States)

    Saha, Sanjib; Gerdtham, Ulf-G; Siddiqui, Faiza; Bennet, Louise

    2018-02-27

    Willingness-to-pay (WTP) techniques are increasingly being used in the healthcare sector for assessing the value of interventions. The objective of this study was to estimate WTP and its predictors in a randomized controlled trial of a lifestyle intervention exclusively targeting Middle Eastern immigrants living in Malmö, Sweden, who are at high risk of type 2 diabetes. We used the contingent valuation method to evaluate WTP. The questionnaire was designed following the payment-scale approach, and administered at the end of the trial, giving an ex-post perspective. We performed logistic regression and linear regression techniques to identify the factors associated with zero WTP value and positive WTP values. The intervention group had significantly higher average WTP than the control group (216 SEK vs. 127 SEK; p = 0.035; 1 U.S.$ = 8.52 SEK, 2015 price year) per month. The regression models demonstrated that being in the intervention group, acculturation, and self-employment were significant factors associated with positive WTP values. Male participants and lower-educated participants had a significantly higher likelihood of zero WTP. In this era of increased migration, our findings can help policy makers to take informed decisions to implement lifestyle interventions for immigrant populations.

  4. Valuing a Lifestyle Intervention for Middle Eastern Immigrants at Risk of Diabetes

    Directory of Open Access Journals (Sweden)

    Sanjib Saha

    2018-02-01

    Full Text Available Willingness-to-pay (WTP techniques are increasingly being used in the healthcare sector for assessing the value of interventions. The objective of this study was to estimate WTP and its predictors in a randomized controlled trial of a lifestyle intervention exclusively targeting Middle Eastern immigrants living in Malmö, Sweden, who are at high risk of type 2 diabetes. We used the contingent valuation method to evaluate WTP. The questionnaire was designed following the payment-scale approach, and administered at the end of the trial, giving an ex-post perspective. We performed logistic regression and linear regression techniques to identify the factors associated with zero WTP value and positive WTP values. The intervention group had significantly higher average WTP than the control group (216 SEK vs. 127 SEK; p = 0.035; 1 U.S.$ = 8.52 SEK, 2015 price year per month. The regression models demonstrated that being in the intervention group, acculturation, and self-employment were significant factors associated with positive WTP values. Male participants and lower-educated participants had a significantly higher likelihood of zero WTP. In this era of increased migration, our findings can help policy makers to take informed decisions to implement lifestyle interventions for immigrant populations.

  5. Mentoring At-risk Youth: Improving Academic Achievement in Middle School Students

    Directory of Open Access Journals (Sweden)

    Kellie C. Johnson

    2010-01-01

    Full Text Available Research supports the implementation of mentoring programs as potentially successful approaches to meeting the needs of at-risk students. This study examined a mentoring program entitled: LISTEN (Linking Individual Students To Educational Needs. The LISTEN mentoring program was a district-sponsored, school-based program in which at-risk, middle school students were identified by the school system and mentors were recruited specifically to assist these students with school performance or related issues. Mentors, in this study, were classroom teachers, school counselors, administrators, custodians, librarians, teaching assistants, retired teachers, and cafeteria employees. Archival data from the 2003–04 and 2004–05 academic years were analyzed. A statistically significant difference was found for all three of the study’s criterion variables (GPAs, discipline referrals, and attendance records between those measured in the 2003–04 academic year (pre-intervention and those measured in the 2004–05 academic year (post-intervention. Forty-nine of the fifty-four LISTEN participants experienced academic achievement gains in all three areas of the study.

  6. Polygenic Risk, Appetite Traits, and Weight Gain in Middle Childhood

    Science.gov (United States)

    Steinsbekk, Silje; Belsky, Daniel; Guzey, Ismail Cuneyt; Wardle, Jane; Wichstrøm, Lars

    2018-01-01

    weight and fat mass more rapidly during follow-up. Each SD increase in genetic risk score was associated with a 0.22-point increase in BMI at age-4 baseline (for the intercept, unstandardized path coefficient B = 0.22 [95%CI, 0.06–0.38]; P = .008. Children with higher genetic risk scores also gained BMI points more rapidly from ages 4 to 6 years (B = 0.11 [95% CI, 0.03–0.20]; P = .01 ; β = 0.12) and from 6 to 8 years (B = 0.09 [95%CI, 0.00–0.19]; P = .05; β = 0.10), compared with their lower genetic risk peers. Children at higher genetic risk had higher levels of alleged obesogenic appetite traits than peers with lower genetic risk at age 6 years, but appetite traits did not mediate genetic associations with weight gain. The sum of the 5 indirect effects was B = −0.001 (95%CI, −0.02 –0.01); P = .86; β = 0.00. CONCLUSIONS AND RELEVANCE Genetic risk for obesity is associated with accelerated childhood weight gain. Interventions targeting childhood weight gain may provide one path to mitigating genetic risk. However, middle childhood appetite traits may not be a promising target for such interventions. Studies of early-childhood samples are needed to test whether appetite traits explain how genetic risks accelerate growth earlier in development. PMID:26830872

  7. Toxicity risk of non-target organs at risk receiving low-dose radiation: case report

    International Nuclear Information System (INIS)

    Shueng, Pei-Wei; Lin, Shih-Chiang; Chang, Hou-Tai; Chong, Ngot-Swan; Chen, Yu-Jen; Wang, Li-Ying; Hsieh, Yen-Ping; Hsieh, Chen-Hsi

    2009-01-01

    The spine is the most common site for bone metastases. Radiation therapy is a common treatment for palliation of pain and for prevention or treatment of spinal cord compression. Helical tomotherapy (HT), a new image-guided intensity modulated radiotherapy (IMRT), delivers highly conformal dose distributions and provides an impressive ability to spare adjacent organs at risk, thus increasing the local control of spinal column metastases and decreasing the potential risk of critical organs under treatment. However, there are a lot of non-target organs at risk (OARs) occupied by low dose with underestimate in this modern rotational IMRT treatment. Herein, we report a case of a pathologic compression fracture of the T9 vertebra in a 55-year-old patient with cholangiocarcinoma. The patient underwent HT at a dose of 30 Gy/10 fractions delivered to T8-T10 for symptom relief. Two weeks after the radiotherapy had been completed, the first course of chemotherapy comprising gemcitabine, fluorouracil, and leucovorin was administered. After two weeks of chemotherapy, however, the patient developed progressive dyspnea. A computed tomography scan of the chest revealed an interstitial pattern with traction bronchiectasis, diffuse ground-glass opacities, and cystic change with fibrosis. Acute radiation pneumonitis was diagnosed. Oncologists should be alert to the potential risk of radiation toxicities caused by low dose off-targets and abscopal effects even with highly conformal radiotherapy

  8. [Risk sharing methods in middle income countries].

    Science.gov (United States)

    Inotai, András; Kaló, Zoltán

    2012-01-01

    The pricing strategy of innovative medicines is based on the therapeutic value in the largest pharmaceutical markets. The cost-effectiveness of new medicines with value based ex-factory price is justifiable. Due to the international price referencing and parallel trade the ex-factory price corridor of new medicines has been narrowed in recent years. Middle income countries have less negotiation power to change the narrow drug pricing corridor, although their fair intention is to buy pharmaceuticals at lower price from their scarce public resources compared to higher income countries. Therefore the reimbursement of new medicines at prices of Western-European countries may not be justifiable in Central-Eastern European countries. Confidential pricing agreements (i.e. confidential price discounts, claw-back or rebate) in lower income countries of the European Union can alleviate this problem, as prices of new medicines can be adjusted to local purchasing power without influencing the published ex-factory price and so the accessibility of patients to these drugs in other countries. In order to control the drug budget payers tend to apply financial risk sharing agreements for new medicines in more and more countries to shift the consequences of potential overspending to pharmaceutical manufacturers. The major paradox of financial risk-sharing schemes is that increased mortality, poor persistence of patients, reduced access to healthcare providers, and no treatment reduce pharmaceutical spending. Consequently, payers have started to apply outcome based risk sharing agreements for new medicines recently to improve the quality of health care provision. Our paper aims to review and assess the published financial and outcome based risk sharing methods. Introduction of outcome based risk-sharing schemes can be a major advancement in the drug reimbursement strategy of payers in middle income countries. These schemes can help to reduce the medical uncertainty in coverage

  9. Temperamental Influences on Risk-taking during Middle Childhood

    OpenAIRE

    Nyström, Beatrice

    2017-01-01

    This thesis concerns temperamental qualities and their influence on risk-taking behavior during middle childhood (7–11 years of age). Contemporary research generally agrees upon the notion that temperament constitutes two motivational systems, sensitive to punishment and reward respectively, together with a third system that is responsible for regulating the motivational systems. Risk-taking is generally regarded as the tendency to engage in potentially harmful or dangerous behaviors that at ...

  10. Polygenic Risk, Appetite Traits, and Weight Gain in Middle Childhood: A Longitudinal Study.

    Science.gov (United States)

    Steinsbekk, Silje; Belsky, Daniel; Guzey, Ismail Cuneyt; Wardle, Jane; Wichstrøm, Lars

    2016-02-01

    associated with a 0.22-point increase in BMI at age-4 baseline (for the intercept, unstandardized path coefficient B = 0.22 [95% CI, 0.06-0.38]; P = .008. Children with higher genetic risk scores also gained BMI points more rapidly from ages 4 to 6 years (B = 0.11 [95% CI, 0.03-0.20]; P = .01 ; β = 0.12) and from 6 to 8 years (B = 0.09 [95% CI, 0.00-0.19]; P = .05; β = 0.10), compared with their lower genetic risk peers. Children at higher genetic risk had higher levels of alleged obesogenic appetite traits than peers with lower genetic risk at age 6 years, but appetite traits did not mediate genetic associations with weight gain. The sum of the 5 indirect effects was B = -0.001 (95% CI, -0.02 -0.01); P = .86; β = 0.00. Genetic risk for obesity is associated with accelerated childhood weight gain. Interventions targeting childhood weight gain may provide one path to mitigating genetic risk. However, middle childhood appetite traits may not be a promising target for such interventions. Studies of early-childhood samples are needed to test whether appetite traits explain how genetic risks accelerate growth earlier in development.

  11. Educating Urban African American Children Placed at Risk: A Comparison of Two Types of Catholic Middle Schools

    Science.gov (United States)

    Fenzel, L. Mickey; Domingues, Janine

    2009-01-01

    Although the number of urban Catholic schools has declined in recent years, Nativity model middle schools, first developed by the Jesuits over 35 years ago, have appeared throughout the nation to address the need for effective alternative education for urban children placed at risk. The present study compares the effectiveness of two types of…

  12. Can older "at risk" adults benefit from psychoeducation targeting healthy brain aging?

    Science.gov (United States)

    Norrie, Louisa M; Diamond, Keri; Hickie, Ian B; Rogers, Naomi L; Fearns, Samantha; Naismith, Sharon L

    2011-04-01

    Multifactorial strategies that prevent or delay the onset or progress of cognitive decline and dementia are needed, and should include education regarding recognized risk factors. The current study sought to investigate whether older adults "at risk" of cognitive decline benefit from psychoeducation targeting healthy brain aging. 65 participants (mean age 64.8 years, SD 9.6) with a lifetime history of major depression; vascular risk as evidenced by at least one vascular risk factor; and/or subjective or objective memory impairment were allocated to weekly psychoeducation sessions or a waitlist control group. The small group sessions were conducted over ten weeks by a team of medical and allied health professionals with expertise in late-life depression and cognition. Sessions focused on modifiable risk factors for cognitive decline including vascular risk, diet, exercise, depression, anxiety and sleep disturbance, as well as providing practical strategies for memory and cognition. Both the psychoeducation and waitlist group completed a 20-item knowledge test at baseline and follow-up. Participants in the psychoeducation group were asked to complete follow-up self-report satisfaction questionnaires. Repeated measures ANOVA showed a significant interaction effect depicting improvements in knowledge associated with psychoeducation, corresponding to an improvement of 15% from baseline. Satisfaction data additionally showed that 92.3% of participants rated the program as "good" to "excellent", and over 90% suggested they would recommend it to others. A group-based psychoeducation program targeting healthy brain aging is effective in improving knowledge. Additionally, it is acceptable and rated highly by participants.

  13. Does age of onset of risk behaviors mediate the relationship between child abuse and neglect and outcomes in middle adulthood?

    Science.gov (United States)

    Horan, Jacqueline M; Widom, Cathy Spatz

    2015-03-01

    Child maltreatment has been linked with a number of risk behaviors that are associated with long-lasting maladaptive outcomes across multiple domains of functioning. This study examines whether the ages of onset of four risk behaviors-sexual intercourse, alcohol use, drug use, and criminal behavior-mediate the relationship between child maltreatment and outcomes in middle adulthood among a sample of court-documented victims of child abuse/neglect and matched controls (N = 1,196; 51.7% female; 66.2% White, 32.6% Black). Adult outcomes included employment status, welfare receipt, internalizing symptoms of anxiety and depressive symptoms, substance use problems, and criminal arrests. The results indicated gender differences in these relationships. For females, age of onset of sexual intercourse mediated the relationship between child abuse/neglect and both internalizing symptoms and substance use problems in middle adulthood. For males, age at first criminal arrest mediated the relationship between child abuse/neglect and extensive involvement in the justice system in middle adulthood. Age of onset of alcohol use and drug use did not mediate the relationship between child abuse/neglect and middle adult outcomes. This study expands current knowledge by identifying associations between early initiation of risk behavior in one domain and later, continuing problems in different domains. Thus, early initiation of specific risk behaviors may have more wide-ranging negative consequences than are typically considered during intervention or treatment and strategies may need to target multiple domains of functioning.

  14. Does targeting children with hygiene promotion messages work? The effect of handwashing promotion targeted at children, on diarrhoea, soil-transmitted helminth infections and behaviour change, in low- and middle-income countries.

    Science.gov (United States)

    Watson, Julie A; Ensink, Jeroen H J; Ramos, Monica; Benelli, Prisca; Holdsworth, Elizabeth; Dreibelbis, Robert; Cumming, Oliver

    2017-05-01

    To synthesise evidence on the effect of handwashing promotion interventions targeting children, on diarrhoea, soil-transmitted helminth infection and handwashing behaviour, in low- and middle-income country settings. A systematic review of the literature was performed by searching eight databases, and reference lists were hand-searched for additional articles. Studies were reviewed for inclusion according to pre-defined inclusion criteria and the quality of all studies was assessed. Eight studies were included in this review: seven cluster-randomised controlled trials and one cluster non-randomised controlled trial. All eight studies targeted children aged 5-12 attending primary school but were heterogeneous for both the type of intervention and the reported outcomes so results were synthesised qualitatively. None of the studies were of high quality and the large majority were at high risk of bias. The reported effect of child-targeted handwashing interventions on our outcomes of interest varied between studies. Of the different interventions reported, no one approach to promoting handwashing among children appeared most effective. Our review found very few studies that evaluated handwashing interventions targeting children and all had various methodological limitations. It is plausible that interventions which succeed in changing children's handwashing practices will lead to significant health impacts given that much of the attributable disease burden is concentrated in that age group. The current paucity of evidence in this area, however, does not permit any recommendations to be made as to the most effective route to increasing handwashing with soap practice among children in LMIC. © 2017 John Wiley & Sons Ltd.

  15. Habitual physical activity and vascular aging in a young to middle-age population at low cardiovascular risk

    DEFF Research Database (Denmark)

    Kozakova, Michaela; Palombo, Carlo; Mhamdi, Leila

    2007-01-01

    BACKGROUND AND PURPOSE: Regular endurance exercise has been shown to reduce the age-related increase in arterial stiffness that is thought to contribute to cardiovascular risk. The aim of this study was to evaluate the influence of age and habitual physical activity on carotid artery wall thickness...... physical activity was negatively related to indices of carotid stiffness (r from -0.20 to -0.25, Page...... and physical activity were independently related to carotid stiffness. CONCLUSIONS: This study provides cross-sectional evidence that habitual physical activity is inversely related to the age-dependent increase in carotid wall stiffness in a young to middle-age population at low risk...

  16. Risk-targeted maps for Romania

    Science.gov (United States)

    Vacareanu, Radu; Pavel, Florin; Craciun, Ionut; Coliba, Veronica; Arion, Cristian; Aldea, Alexandru; Neagu, Cristian

    2018-03-01

    Romania has one of the highest seismic hazard levels in Europe. The seismic hazard is due to a combination of local crustal seismic sources, situated mainly in the western part of the country and the Vrancea intermediate-depth seismic source, which can be found at the bend of the Carpathian Mountains. Recent seismic hazard studies have shown that there are consistent differences between the slopes of the seismic hazard curves for sites situated in the fore-arc and back-arc of the Carpathian Mountains. Consequently, in this study we extend this finding to the evaluation of the probability of collapse of buildings and finally to the development of uniform risk-targeted maps. The main advantage of uniform risk approach is that the target probability of collapse will be uniform throughout the country. Finally, the results obtained are discussed in the light of a recent study with the same focus performed at European level using the hazard data from SHARE project. The analyses performed in this study have pointed out to a dominant influence of the quantile of peak ground acceleration used for anchoring the fragility function. This parameter basically alters the shape of the risk-targeted maps shifting the areas which have higher collapse probabilities from eastern Romania to western Romania, as its exceedance probability increases. Consequently, a uniform procedure for deriving risk-targeted maps appears as more than necessary.

  17. Children at risk: the association between perceived weight status and suicidal thoughts and attempts in middle school youth.

    Science.gov (United States)

    Whetstone, Lauren M; Morrissey, Susan L; Cummings, Doyle M

    2007-02-01

    Suicide is one of the most common causes of death among young people. A report from the US Surgeon General called for strategies to prevent suicide, including increasing public awareness of suicide and risks factors, and enhancing research to understand risk and protective factors. Weight perception has been linked to depression and poor self-esteem in adolescents. The purpose of this study was to examine the relationship between perceived weight status and suicidal thoughts and actions by gender in middle school youth. All public middle school students in 4 eastern North Carolina counties presented, and with parental permission (n = 5174), completed the Youth Risk Behavior Survey: Middle School Questionnaire. The 3 dependent variables were self-reported thinking, planning, and attempting suicide. Bivariate analyses describe suicidal thoughts and actions; multiple logistic regression models examined the relationship between weight description and suicidal thoughts and actions controlling for age, race, household composition, grades on report cards, and parents' education. Significantly more females than males reported thinking (26% vs 19%), planning (12% vs 9%), and attempting (11% vs 8%) suicide. For females, those who perceived themselves as overweight were significantly more likely to report suicidal thoughts and actions; while for males, perceptions of overweight and underweight were significantly associated with suicidal thoughts and actions. Controlling for personal and family characteristics, perceived weight status was significantly associated with suicidal thoughts and actions in middle school boys and girls.

  18. Sedimentary features and exploration targets of Middle Permian reservoirs in the SW Sichuan Basin

    Directory of Open Access Journals (Sweden)

    Guoming Xu

    2015-11-01

    Full Text Available The exploration direction and targets for the large-scale Middle Permian gas reservoirs in the Sichuan Basin are hot spots and challenges in current exploration researches. The exploration successes of large gas field of Cambrian Longwangmiao Formation in Gaoshiti-Moxi region, Central Sichuan Basin, indicated that prospective sedimentary facies belt was the basis for the formation of large gas fields. In this paper, based on seismic data, outcrop data and drilling data, the tectonic framework and sedimentary features of the Middle Permian in the SW Sichuan Basin were comprehensively studied. The following conclusions were reached from the perspective of sedimentary facies control: (1 during the Middle Permian, this region was in shallow water gentle slope belts with high energy, where thick reef flat facies were deposited; (2 the basement was uplifted during Middle Permian, resulting in the unconformity weathering crust at the top of Maokou Formation due to erosion; the SW Sichuan Basin was located in the karst slope belt, where epigenic karstification was intense; and (3 reef flat deposits superimposed by karst weathering crust was favorable for the formation of large-scale reef flat karst reservoirs. Based on the combination of the resources conditions and hydrocarbon accumulation conditions in this region, it was pointed out that the Middle Permian has great potential of large-scale reef flat karst gas reservoir due to its advantageous geological conditions; the Middle Permian traps with good hydrocarbon accumulation conditions were developed in the Longmen Mountain front closed structural belt in the SW Sichuan Basin and Western Sichuan Basin depression slope belt, which are favorable targets for large-scale reef flat karst reservoirs.

  19. Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level

    Science.gov (United States)

    Lu, Chunling; Black, Maureen M; Richter, Linda M

    2018-01-01

    Summary Background A 2007 study published in The Lancet estimated that approximately 219 million children aged younger than 5 years were exposed to stunting or extreme poverty in 2004. We updated the 2004 estimates with the use of improved data and methods and generated estimates for 2010. Methods We used country-level prevalence of stunting in children younger than 5 years based on the 2006 Growth Standards proposed by WHO and poverty ratios from the World Bank to estimate children who were either stunted or lived in extreme poverty for 141 low-income and middle-income countries in 2004 and 2010. To avoid counting the same children twice, we excluded children jointly exposed to stunting and extreme poverty from children living in extreme poverty. To examine the robustness of estimates, we also used moderate poverty measures. Findings The 2007 study underestimated children at risk of poor development. The estimated number of children exposed to the two risk factors in low-income and middle-income countries decreased from 279·1 million (95% CI 250·4 million–307·4 million) in 2004 to 249·4 million (209·3 million–292·6 million) in 2010; prevalence of children at risk fell from 51% (95% CI 46–56) to 43% (36–51). The decline occurred in all income groups and regions with south Asia experiencing the largest drop. Sub-Saharan Africa had the highest prevalence in both years. These findings were robust to variations in poverty measures. Interpretation Progress has been made in reducing the number of children exposed to stunting or poverty between 2004 and 2010, but this is still not enough. Scaling up of effective interventions targeting the most vulnerable children is urgently needed. Funding National Institutes of Health, Bill & Melinda Gates Foundation, Hilton Foundation, and WHO. PMID:27717632

  20. Measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis

    DEFF Research Database (Denmark)

    Kroman, S L; Roos, Ewa M.; Bennell, K L

    2014-01-01

    To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA).......To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA)....

  1. A Feature Analysis of Risk Factors for Stroke in the Middle-Aged Adults

    OpenAIRE

    Haewon Byeon; Hyeung Woo Koh

    2015-01-01

    In order to maintain health during middle age and achieve successful aging, it is important to elucidate and prevent risk factors of middle-age stroke. This study investigated high risk groups of stroke in middle age population of Korea and provides basic material for establishment of stroke prevention policy by analyzing sudden perception of speech/language problems and clusters of multiple risk factors. This study analyzed 2,751 persons (1,191 males and 1,560 females) aged 40–59 who partici...

  2. Ecological risk assessment of heavy metals in sediment and human health risk assessment of heavy metals in fishes in the middle and lower reaches of the Yangtze River basin

    Energy Technology Data Exchange (ETDEWEB)

    Yi Yujun [State Key Laboratory of Water Environment Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing 100875 (China); Yang Zhifeng, E-mail: zfyang@bnu.edu.cn [State Key Laboratory of Water Environment Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing 100875 (China); Zhang Shanghong [Renewable Energy School, North China Electric Power University, Beijing 102206 (China)

    2011-10-15

    The concentrations of heavy metals (Cr, Cd, Hg, Cu, Zn, Pb and As) in the water, sediment, and fish were investigated in the middle and lower reaches of the Yangtze River, China. Potential ecological risk analysis of sediment heavy metal concentrations indicated that six sites in the middle reach, half of the sites in the lower reach, and two sites in lakes, posed moderate or considerable ecological risk. Health risk analysis of individual heavy metals in fish tissue indicated safe levels for the general population and for fisherman but, in combination, there was a possible risk in terms of total target hazard quotients. Correlation analysis and PCA found that heavy metals (Hg, Cd, Pb, Cr, Cu, and Zn) may be mainly derived from metal processing, electroplating industries, industrial wastewater, and domestic sewage. Hg may also originate from coal combustion. Significant positive correlations between TN and As were observed. - Highlights: > Field survey, test and relationship of the concentrations of heavy metals in the water, sediment, and fish. > Potential ecological risk assessment of heavy metals in sediment. > Non-cancer health risk assessment of heavy metals in fish tissue. > Possible pollution source of heavy metals analyzed. - Possible ecological risk of sediment and slight non-cancer health risk of eating fish were found in the middle and lower reaches of the Yangtze River.

  3. Ecological risk assessment of heavy metals in sediment and human health risk assessment of heavy metals in fishes in the middle and lower reaches of the Yangtze River basin

    International Nuclear Information System (INIS)

    Yi Yujun; Yang Zhifeng; Zhang Shanghong

    2011-01-01

    The concentrations of heavy metals (Cr, Cd, Hg, Cu, Zn, Pb and As) in the water, sediment, and fish were investigated in the middle and lower reaches of the Yangtze River, China. Potential ecological risk analysis of sediment heavy metal concentrations indicated that six sites in the middle reach, half of the sites in the lower reach, and two sites in lakes, posed moderate or considerable ecological risk. Health risk analysis of individual heavy metals in fish tissue indicated safe levels for the general population and for fisherman but, in combination, there was a possible risk in terms of total target hazard quotients. Correlation analysis and PCA found that heavy metals (Hg, Cd, Pb, Cr, Cu, and Zn) may be mainly derived from metal processing, electroplating industries, industrial wastewater, and domestic sewage. Hg may also originate from coal combustion. Significant positive correlations between TN and As were observed. - Highlights: → Field survey, test and relationship of the concentrations of heavy metals in the water, sediment, and fish. → Potential ecological risk assessment of heavy metals in sediment. → Non-cancer health risk assessment of heavy metals in fish tissue. → Possible pollution source of heavy metals analyzed. - Possible ecological risk of sediment and slight non-cancer health risk of eating fish were found in the middle and lower reaches of the Yangtze River.

  4. Adult and Middle School Girls' Perceptions of Risk-Taking Behavior: Implications for School Practitioners

    Science.gov (United States)

    Solomon, Brett Johnson; Garibaldi, Mark

    2013-01-01

    There is an overwhelming disconnect between young adolescent girls and adults, in relationship to perceptions of middle schoolgirl risk taking. This mixed-methods study investigates the differences between adult practitioners and middle school girls' perceptions of risk taking, understanding of consequences, and needs among middle school girls.…

  5. Prevalence of Teen Dating Violence and Co-occurring Risk Factors Among Middle School Youth in High-Risk Urban Communities

    Science.gov (United States)

    Niolon, Phyllis Holditch; Vivolo-Kantor, Alana M.; Latzman, Natasha E.; Valle, Linda Anne; Kuoh, Henrietta; Burton, Tessa; Taylor, Bruce G.; Tharp, Andra T.

    2018-01-01

    Purpose This study describes the lifetime prevalence of teen dating violence (TDV) perpetration in a sample of middle school students from high-risk urban communities and examines the relation between TDV and related cognitive and behavioral risk factors. Methods Surveys were administered to 2,895 middle school students in four U.S. cities; 1,673 students (58%) reported having dated and were included in analyses. The sample was 52.3% female, 48.2% non-Hispanic black/African-American, 38.2% Hispanic, 4.8% non-Hispanic white, and 7.6% other race. Six types of TDV perpetration were assessed: threatening behaviors, verbal/emotional abuse, relational abuse, physical abuse, sexual abuse, and stalking. Results Of the students who had dated, 77% reported perpetrating verbal/emotional abuse, 32% reported perpetrating physical abuse, 20% reported threatening a partner, 15% reported perpetrating sexual abuse, 13% reported perpetrating relational abuse, and 6% reported stalking. Girls were more likely than boys to report perpetrating threatening behaviors, verbal/emotional abuse, and physical abuse, and boys were more likely to report perpetrating sexual abuse. Involvement in bullying positively predicted perpetration of TDV, albeit, in different ways for boys and girls. Other risk factors differed by sex. For instance, alcohol use and sex initiation predicted multiple forms of TDV perpetration for boys, whereas weapon carrying and emotional symptoms predicted several forms of TDV perpetration for girls. Conclusions The prevalence of TDV was high in our sample. Important sex differences in rates of perpetration and risk factors emerged. Comprehensive prevention programs that target TDV and related risk factors, such as bullying and other risk factors, seem warranted. PMID:25620454

  6. Academic Achievement and Transcendental Meditation: A Study with At-Risk Urban Middle School Students

    Science.gov (United States)

    Nidich, Sanford; Mjasiri, Shujaa; Nidich, Randi; Rainforth, Maxwell; Grant, James; Valosek, Laurent; Chang, Walter; Zigler, Ronald L.

    2011-01-01

    The middle school level is of particular concern to educators because of poor standardized test performance. This study evaluated change in academic achievement in public middle school students practicing the Transcendental Meditation[R] program compared to controls. A total of 189 students who were below proficiency level at baseline in English…

  7. Cardiovascular Risk and Events in 17 Low-, Middle-, and High-Income Countries.

    OpenAIRE

    Yusuf, S; Rangarajan, S; Teo, K; Islam, S; Li, W; Liu, L; Bo, J; Lou, Q; Lu, F; Liu, T; Yu, L; Zhang, S; Mony, P; Swaminathan, S; Mohan, V

    2014-01-01

    : More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. : We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater r...

  8. Nanotechnology Awareness, Opinions and Risk Perceptions among Middle School Students

    Science.gov (United States)

    Sahin, Nurettin; Ekli, Emel

    2013-01-01

    The present study investigates awareness, factual knowledge, opinions, and risk perceptions of students from Turkish middle schools with regard to nanotechnology in a very general sense. The study was carried out among 1,396 middle school 6th, 7th, and 8th grade students. The students' perceptions of and opinions about nanotechnology were elicited…

  9. Physical activity in middle-aged women and hip fracture risk: the UFO study.

    Science.gov (United States)

    Englund, U; Nordström, P; Nilsson, J; Bucht, G; Björnstig, U; Hallmans, G; Svensson, O; Pettersson, U

    2011-02-01

    In a population-based case-control study, we demonstrate that middle-aged women who were active with walking or in different physical spare time activities were at lower risk of later sustaining a hip fracture compared to more sedentary women. In middle-aged women participating in the Umeå Fracture and Osteoporosis (UFO) study, we investigated whether physical activity is associated with a subsequent decreased risk of sustaining a hip fracture. The UFO study is a nested case-control study investigating associations between bone markers, lifestyle, and osteoporotic fractures. We identified 81 female hip fracture cases that had reported lifestyle data before they sustained their fracture. Each case was compared with two female controls who were identified from the same cohort and matched for age and week of reporting data, yielding a total cohort of 237 subjects. Mean age at baseline was 57.2 ± 5.0 years, and mean age at fracture was 65.4 ± 6.4 years. Conditional logistic regression analysis with adjustments for height, weight, smoking, and menopausal status showed that subjects who were regularly active with walking or had a moderate or high frequency of physical spare time activities (i.e. berry/mushroom picking and snow shovelling) were at reduced risk of sustaining a hip fracture (OR 0.14; 95% CI; 0.05-0.53 for walking and OR 0.19; 95% CI; 0.08-0.46, OR 0.17, 95% CI; 0.05-0.64 for moderate and high frequency of spare time activities, respectively) compared to more sedentary women. An active lifestyle in middle age seems to reduce the risk of future hip fracture. Possible mechanisms may include improved muscle strength, coordination, and balance resulting in a decreased risk of falling and perhaps also direct skeletal benefits.

  10. Active commuting reduces the risk of wrist fractures in middle-aged women-the UFO study.

    Science.gov (United States)

    Englund, U; Nordström, P; Nilsson, J; Hallmans, G; Svensson, O; Bergström, U; Pettersson-Kymmer, U

    2013-02-01

    Middle-aged women with active commuting had significantly lower risk for wrist fracture than women commuting by car/bus. Our purpose was to investigate whether a physically active lifestyle in middle-aged women was associated with a reduced risk of later sustaining a low-trauma wrist fracture. The Umeå Fracture and Osteoporosis (UFO) study is a population-based nested case-control study investigating associations between lifestyle and fragility fractures. From a cohort of ~35,000 subjects, we identified 376 female wrist fracture cases who had reported data regarding their commuting habits, occupational, and leisure physical activity, before they sustained their fracture. Each fracture case was compared with at least one control drawn from the same cohort and matched for age and week of reporting data, yielding a total of 778 subjects. Mean age at baseline was 54.3 ± 5.8 years, and mean age at fracture was 60.3 ± 5.8 years. Conditional logistic regression analysis with adjustments for height, body mass index, smoking, and menopausal status showed that subjects with active commuting (especially walking) were at significantly lower risk of sustaining a wrist fracture (OR 0.48; 95 % CI 0.27-0.88) compared with those who commuted by car or bus. Leisure time activities such as dancing and snow shoveling were also associated with a lower fracture risk, whereas occupational activity, training, and leisure walking or cycling were unrelated to fracture risk. This study suggests that active commuting is associated with a lower wrist fracture risk, in middle-aged women.

  11. Mentoring At-Risk Middle School Students to Reduce Communication Apprehension

    Science.gov (United States)

    Jones, Kevin T.; Procopio, Claire H.

    2017-01-01

    Research has demonstrated the efficacy of mentoring at-risk students in a number of fields from physical education to math and science. While separate research has found that many at-risk students lack effective communication skills, little research has explored the potential of communication mentoring in improving at-risk students' communication…

  12. Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level.

    Science.gov (United States)

    Lu, Chunling; Black, Maureen M; Richter, Linda M

    2016-12-01

    A 2007 study published in The Lancet estimated that approximately 219 million children aged younger than 5 years were exposed to stunting or extreme poverty in 2004. We updated the 2004 estimates with the use of improved data and methods and generated estimates for 2010. We used country-level prevalence of stunting in children younger than 5 years based on the 2006 Growth Standards proposed by WHO and poverty ratios from the World Bank to estimate children who were either stunted or lived in extreme poverty for 141 low-income and middle-income countries in 2004 and 2010. To avoid counting the same children twice, we excluded children jointly exposed to stunting and extreme poverty from children living in extreme poverty. To examine the robustness of estimates, we also used moderate poverty measures. The 2007 study underestimated children at risk of poor development. The estimated number of children exposed to the two risk factors in low-income and middle-income countries decreased from 279·1 million (95% CI 250·4 million-307·4 million) in 2004 to 249·4 million (209·3 million-292·6 million) in 2010; prevalence of children at risk fell from 51% (95% CI 46-56) to 43% (36-51). The decline occurred in all income groups and regions with south Asia experiencing the largest drop. Sub-Saharan Africa had the highest prevalence in both years. These findings were robust to variations in poverty measures. Progress has been made in reducing the number of children exposed to stunting or poverty between 2004 and 2010, but this is still not enough. Scaling up of effective interventions targeting the most vulnerable children is urgently needed. National Institutes of Health, Bill & Melinda Gates Foundation, Hilton Foundation, and WHO. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license. Published by Elsevier Ltd.. All rights reserved.

  13. 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...

  14. Middle East respiratory syndrome risk perception among students at a university in South Korea, 2015.

    Science.gov (United States)

    Yang, Seongwoo; Cho, Sung-Il

    2017-06-01

    The 2015 Middle East respiratory syndrome (MERS) outbreak in South Korea was a serious threat to public health, and was exacerbated by the inappropriate responses of major institutions and the public. This study examined the sources of confusion during the MERS outbreak and identified the factors that can affect people's behavior. An online survey of the risk perception of university students in South Korea was performed after the epidemic had peaked. The questionnaire addressed the major social determinants in South Korea during the MERS epidemic. The analysis included data from 1,470 subjects who provided complete answers. The students had 53.5% of the essential knowledge about MERS. Women showed higher risk perception than men, and trust in the media was positively associated with risk perception (P level of risk led to overreaction. Risk perception was associated with most of the social factors examined and overreaction by the public. Therefore, providing accurate information and data to the public, establishing trust, and facilitating the development of an attitude will all be important in future crises. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  15. Early childhood risk and resilience factors for behavioural and emotional problems in middle childhood.

    Science.gov (United States)

    Cabaj, Jason L; McDonald, Sheila W; Tough, Suzanne C

    2014-07-01

    Mental disorders in childhood have a considerable health and societal impact but the associated negative consequences may be ameliorated through early identification of risk and protective factors that can guide health promoting and preventive interventions. The objective of this study was to inform health policy and practice through identification of demographic, familial and environmental factors associated with emotional or behavioural problems in middle childhood, and the predictors of resilience in the presence of identified risk factors. A cohort of 706 mothers followed from early pregnancy was surveyed at six to eight years post-partum by a mail-out questionnaire, which included questions on demographics, children's health, development, activities, media and technology, family, friends, community, school life, and mother's health. Although most children do well in middle childhood, of 450 respondents (64% response rate), 29.5% and 25.6% of children were found to have internalising and externalising behaviour problem scores in the lowest quintile on the NSCLY Child Behaviour Scales. Independent predictors for problem behaviours identified through multivariable logistic regression modelling included being male, demographic risk, maternal mental health risk, poor parenting interactions, and low parenting morale. Among children at high risk for behaviour problems, protective factors included high maternal and child self-esteem, good maternal emotional health, adequate social support, good academic performance, and adequate quality parenting time. These findings demonstrate that several individual and social resilience factors can counter the influence of early adversities on the likelihood of developing problem behaviours in middle childhood, thus informing enhanced public health interventions for this understudied life course phase.

  16. Validation of a Dietary Screening Tool in a Middle-Aged Appalachian Population

    Directory of Open Access Journals (Sweden)

    Melissa Ventura Marra

    2018-03-01

    Full Text Available Proactive nutrition screening is an effective public health strategy for identifying and targeting individuals who could benefit from making dietary improvements for primary and secondary prevention of disease. The Dietary Screening Tool (DST was developed and validated to assess nutritional risk among rural older adults. The purpose of this study was to evaluate the utility and validity of the DST to identify nutritional risk in middle-aged adults. This cross-sectional study in middle-aged adults (45–64 year olds, n = 87 who reside in Appalachia, examined nutritional status using an online health survey, biochemical measures, anthropometry, and three representative 24-h dietary recalls. The Healthy Eating Index (HEI was calculated to describe overall diet quality. Adults identified by the DST with a nutrition risk had lower HEI scores (50 vs. 64, p < 0.001 and were much more likely to also be considered at dietary risk by the HEI (OR 11.6; 3.2–42.6 when compared to those not at risk. Those at risk had higher energy-adjusted total fat, saturated fat, and added sugar intakes and lower intakes of dietary fiber, and several micronutrients than those classified as not at risk by the DST. Similarly, the at-risk group had significantly lower serum levels of α-carotene, β-carotene, cryptoxanthin, lutein, and zeaxanthin but did not differ in retinol or methylmalonic acid compared with those not at risk. The DST is a valid tool to identify middle-aged adults with nutritional risk.

  17. Which behavioral, emotional and school problems in middle-childhood predict early sexual behavior?

    Science.gov (United States)

    Parkes, Alison; Waylen, Andrea; Sayal, Kapil; Heron, Jon; Henderson, Marion; Wight, Daniel; Macleod, John

    2014-04-01

    Mental health and school adjustment problems are thought to distinguish early sexual behavior from normative timing (16-18 years), but little is known about how early sexual behavior originates from these problems in middle-childhood. Existing studies do not allow for co-occurring problems, differences in onset and persistence, and there is no information on middle-childhood school adjustment in relationship to early sexual activity. This study examined associations between several middle-childhood problems and early sexual behavior, using a subsample (N = 4,739, 53 % female, 98 % white, mean age 15 years 6 months) from a birth cohort study, the Avon Longitudinal Study of Parents and Children. Adolescents provided information at age 15 on early sexual behavior (oral sex and/or intercourse) and sexual risk-taking, and at age 13 on prior risk involvement (sexual behavior, antisocial behavior and substance use). Information on hyperactivity/inattention, conduct problems, depressive symptoms, peer relationship problems, school dislike and school performance was collected in middle-childhood at Time 1 (6-8 years) and Time 2 (10-11 years). In agreement with previous research, conduct problems predicted early sexual behavior, although this was found only for persistent early problems. In addition, Time 2 school dislike predicted early sexual behavior, while peer relationship problems were protective. Persistent early school dislike further characterized higher-risk groups (early sexual behavior preceded by age 13 risk, or accompanied by higher sexual risk-taking). The study establishes middle-childhood school dislike as a novel risk factor for early sexual behavior and higher-risk groups, and the importance of persistent conduct problems. Implications for the identification of children at risk and targeted intervention are discussed, as well as suggestions for further research.

  18. Tissue at risk in the deep middle cerebral artery territory is critical to stroke outcome

    Energy Technology Data Exchange (ETDEWEB)

    Rosso, Charlotte; Samson, Yves [Pitie-Salpetriere Hospital, AP-HP, Urgences Cerebro-Vasculaires, Paris (France); UPMC, Univ Paris 06, Paris (France); Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, ICM, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, COGIMAGE, Paris (France); Colliot, Olivier [UPMC, Univ Paris 06, Paris (France); Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, ICM, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, COGIMAGE, Paris (France); Valabregue, Romain [UPMC, Univ Paris 06, Paris (France); Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, ICM, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Centre for NeuroImaging Research (CENIR), Paris (France); Crozier, Sophie [Pitie-Salpetriere Hospital, AP-HP, Urgences Cerebro-Vasculaires, Paris (France); Dormont, Didier [UPMC, Univ Paris 06, Paris (France); Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, ICM, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, COGIMAGE, Paris (France); Pitie-Salpetriere Hospital, AP-HP, Department of Neuroradiology, Paris (France); Lehericy, Stephane [UPMC, Univ Paris 06, Paris (France); Centre de Recherche de l' Institut du Cerveau et de la Moelle epiniere, ICM, UPMC Paris 6, Inserm, U975, CNRS, UMR 7225, Centre for NeuroImaging Research (CENIR), Paris (France); Pitie-Salpetriere Hospital, AP-HP, Department of Neuroradiology, Paris (France)

    2011-10-15

    The clinical efficacy of thrombolysis in stroke patients is explained by the increased rate of recanalization, which limits infarct growth. However, the efficacy could also be explained by the protection of specific sites of the brain. Here, we investigate where is this outcome-related tissue at risk using voxel-based analysis. We included 68 acute stroke patients with middle cerebral artery (MCA) occlusion on the admission MRI performed within 6 h of symptoms onset (H6) and 16 controls. MCA recanalization was assessed using the magnetic resonance angiography performed at day 1 (D1). Apparent diffusion coefficient (ADC) changes were analyzed using a voxel-based method between patients vs. controls group at admission (H6) in non-recanalized vs. recanalized and in 3-month poor vs. good outcome patients at D1. Complete or partial MCA recanalization was observed in 52 of 68 patients. Good outcome at 3 months occurred in 40 patients (59%). In non-recanalized patients, ADC was decreased in the deep MCA and watershed arterial territory (the lenticular nucleus, internal capsule, and the overlying periventricular white matter). This decrease was not observed in recanalized patients at D1 or patients at H6. Fiber tracking suggested that the area is crossed by the cortico-spinal, cerebellar, and intra-hemispheric association tracts. Finally, this area almost co-localized with the area associated with poor outcome. A clinically relevant area of tissue at risk may occur in patients with MCA infarcts at the level of deep white matter fiber tracts. These findings suggest that neuroprotection research should be refocused on white matter. (orig.)

  19. Tissue at risk in the deep middle cerebral artery territory is critical to stroke outcome

    International Nuclear Information System (INIS)

    Rosso, Charlotte; Samson, Yves; Colliot, Olivier; Valabregue, Romain; Crozier, Sophie; Dormont, Didier; Lehericy, Stephane

    2011-01-01

    The clinical efficacy of thrombolysis in stroke patients is explained by the increased rate of recanalization, which limits infarct growth. However, the efficacy could also be explained by the protection of specific sites of the brain. Here, we investigate where is this outcome-related tissue at risk using voxel-based analysis. We included 68 acute stroke patients with middle cerebral artery (MCA) occlusion on the admission MRI performed within 6 h of symptoms onset (H6) and 16 controls. MCA recanalization was assessed using the magnetic resonance angiography performed at day 1 (D1). Apparent diffusion coefficient (ADC) changes were analyzed using a voxel-based method between patients vs. controls group at admission (H6) in non-recanalized vs. recanalized and in 3-month poor vs. good outcome patients at D1. Complete or partial MCA recanalization was observed in 52 of 68 patients. Good outcome at 3 months occurred in 40 patients (59%). In non-recanalized patients, ADC was decreased in the deep MCA and watershed arterial territory (the lenticular nucleus, internal capsule, and the overlying periventricular white matter). This decrease was not observed in recanalized patients at D1 or patients at H6. Fiber tracking suggested that the area is crossed by the cortico-spinal, cerebellar, and intra-hemispheric association tracts. Finally, this area almost co-localized with the area associated with poor outcome. A clinically relevant area of tissue at risk may occur in patients with MCA infarcts at the level of deep white matter fiber tracts. These findings suggest that neuroprotection research should be refocused on white matter. (orig.)

  20. Association of Insulin Resistance With Cerebral Glucose Uptake in Late Middle-Aged Adults at Risk for Alzheimer Disease.

    Science.gov (United States)

    Willette, Auriel A; Bendlin, Barbara B; Starks, Erika J; Birdsill, Alex C; Johnson, Sterling C; Christian, Bradley T; Okonkwo, Ozioma C; La Rue, Asenath; Hermann, Bruce P; Koscik, Rebecca L; Jonaitis, Erin M; Sager, Mark A; Asthana, Sanjay

    2015-09-01

    Converging evidence suggests that Alzheimer disease (AD) involves insulin signaling impairment. Patients with AD and individuals at risk for AD show reduced glucose metabolism, as indexed by fludeoxyglucose F 18-labeled positron emission tomography (FDG-PET). To determine whether insulin resistance predicts AD-like global and regional glucose metabolism deficits in late middle-aged participants at risk for AD and to examine whether insulin resistance-predicted variation in regional glucose metabolism is associated with worse cognitive performance. This population-based, cross-sectional study included 150 cognitively normal, late middle-aged (mean [SD] age, 60.7 [5.8] years) adults from the Wisconsin Registry for Alzheimer's Prevention (WRAP) study, a general community sample enriched for AD parental history. Participants underwent cognitive testing, fasting blood draw, and FDG-PET at baseline. We used the homeostatic model assessment of peripheral insulin resistance (HOMA-IR). Regression analysis tested the statistical effect of HOMA-IR on global glucose metabolism. We used a voxelwise analysis to determine whether HOMA-IR predicted regional glucose metabolism. Finally, predicted variation in regional glucose metabolism was regressed against cognitive factors. Covariates included age, sex, body mass index, apolipoprotein E ε4 genotype, AD parental history status, and a reference region used to normalize regional uptake. Regional glucose uptake determined using FDG-PET and neuropsychological factors. Higher HOMA-IR was associated with lower global glucose metabolism (β = -0.29; P factor scores. Our results show that insulin resistance, a prevalent and increasingly common condition in developed countries, is associated with significantly lower regional cerebral glucose metabolism, which in turn may predict worse memory performance. Midlife may be a critical period for initiating treatments to lower peripheral insulin resistance to maintain neural metabolism

  1. Academic Achievement and Risk Factors for Adolescents with Attention-Deficit Hyperactivity Disorder in Middle School and Early High School.

    Science.gov (United States)

    Zendarski, Nardia; Sciberras, Emma; Mensah, Fiona; Hiscock, Harriet

    Examine academic achievement of students with attention-deficit hyperactivity disorder (ADHD) during the early high school period and identify potentially modifiable risk factors for low achievement. Data were collected through surveys (adolescent, parent, and teacher) and direct assessment of Australian adolescents (12-15 yr; n = 130) with ADHD in early high school (i.e., US middle and high school grades). Academic achievement outcomes were measured by linking to individual performance on the National Assessment Program-Literacy and Numeracy (NAPLAN) tests, direct assessment of reading and math, and teacher report of academic competence. Linear regression models examined associations between adolescent, parent/family, and school factors and NAPLAN domain scores. Students with ADHD had lower NAPLAN scores on all domains and fewer met minimum academic standards in comparison with state benchmarks. The poorest results were for persuasive writing. Poor achievement was associated with lower intelligence quotient across all academic domains. Adolescent inattention, bullying, poor family management, male sex, and attending a low socioeconomic status school were associated with lower achievement on specific domains. Students with ADHD are at increased academic risk during the middle school and early high school period. In addition to academic support, interventions targeting modifiable factors including inattention, bullying, and poor family management may improve academic achievement across this critical period.

  2. Healthy lifestyle through young adulthood and the presence of low cardiovascular disease risk profile in middle age: the Coronary Artery Risk Development in (Young) Adults (CARDIA) study.

    Science.gov (United States)

    Liu, Kiang; Daviglus, Martha L; Loria, Catherine M; Colangelo, Laura A; Spring, Bonnie; Moller, Arlen C; Lloyd-Jones, Donald M

    2012-02-28

    A low cardiovascular disease risk profile (untreated cholesterol risk profile. We examined whether adopting a healthy lifestyle throughout young adulthood is associated with the presence of the low cardiovascular disease risk profile in middle age. The Coronary Artery Risk Development in (Young) Adults (CARDIA) study sample consisted of 3154 black and white participants 18 to 30 years of age at year 0 (1985-1986) who attended the year 0, 7, and 20 examinations. Healthy lifestyle factors defined at years 0, 7, and 20 included average body mass index risk profile at year 20 were 3.0%, 14.6%, 29.5%, 39.2%, and 60.7% for people with 0 or 1, 2, 3, 4, and 5 healthy lifestyle factors, respectively (P for trend risk profile in middle age. Public health and individual efforts are needed to improve the adoption and maintenance of healthy lifestyles in young adults.

  3. Targeted cardiopulmonary resuscitation training focused on the family members of high-risk patients at a regional medical center: A comparison between family members of high-risk and no-risk patients.

    Science.gov (United States)

    Han, Kap Su; Lee, Ji Sung; Kim, Su Jin; Lee, Sung Woo

    2018-05-01

    We developed a hospital-based cardiopulmonary resuscitation (CPR) training model focused on the target population (family members of patients with potential risks for cardiac arrest) and compared the outcome of CPR training between target and non-target populations for validity. Family members of patients in training were divided into three groups on the basis of patients' diseases, as follows: 1) the cardio-specific (CS) risk group, including family members of patients with cardiac disease at risk of cardiac arrest; 2) the cardiovascular (CV) risk group, including family members of patients with risk factors for cardiovascular disease; and 3) the no-risk group. Pre- and posttraining surveys and skill tests as well as a post-training 3-month telephone survey were conducted. Educational outcomes were analyzed. A total of 203 family members were enrolled into 21 CPR training classes. The CS group (n=88) included elderly persons and housewives with a lower level of education compared with the CV (n=79) and no-risk groups (n=36). The CS group was motivated by healthcare professionals and participated in the training course. The CS, CV, and no-risk groups showed improvements in knowledge, willingness to perform CPR, and skills. Despite the older age and lower level of education in the CS group, the effects of education were similar to those in the other groups. A high rate of response and secondary propagation of CPR training were observed in the CS group. Family members of patients with heart disease could be an appropriate target population for CPR training, particularly in terms of recruitment and secondary propagation. Targeted intervention may be an effective training strategy to improve bystander CPR rates.

  4. Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East.

    Science.gov (United States)

    Al Sayed, Nasreen; Al Waili, Khalid; Alawadi, Fatheya; Al-Ghamdi, Saeed; Al Mahmeed, Wael; Al-Nouri, Fahad; Al Rukhaimi, Mona; Al-Rasadi, Khalid; Awan, Zuhier; Farghaly, Mohamed; Hassanein, Mohamed; Sabbour, Hani; Zubaid, Mohammad; Barter, Philip

    2016-12-15

    Plasma lipid disorders are key risk factors for the development of atherosclerotic cardiovascular disease (ASCVD) and are prevalent in the Middle East, with rates increasing in recent decades. Despite this, no region-specific guidelines for managing plasma lipids exist and there is a lack of use of guidelines developed in other regions. A multidisciplinary panel of regional experts was convened to develop consensus clinical recommendations for the management of plasma lipids in the Middle East. The panel considered existing international guidelines and regional clinical experience to develop recommendations. The panel's recommendations include plasma lipid screening, ASCVD risk calculation and treatment considerations. The panel recommend that plasma lipid levels should be measured in all at-risk patients and at regular intervals in all adults from the age of 20years. A scoring system should be used to calculate ASCVD risk that includes known lipid and non-lipid risk factors. Primary treatment targets include low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol. Lifestyle modifications should be first-line treatment for all patients; the first-line pharmacological treatment targeting plasma lipids in patients at moderate-to-high risk of ASCVD is statin therapy, with a number of adjunctive or second-line agents available. Guidance is also provided on the management of underlying conditions and special populations; of particular pertinence in the region are familial hypercholesterolaemia, diabetes and metabolic dyslipidaemia. These consensus clinical recommendations provide practicing clinicians with comprehensive, region-specific guidance to improve the detection and management of plasma lipid disorders in patients in the Middle East. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  5. Disparities in Prevalence of Cardiometablic Risk Factors in Rural, Urban-Poor, and Urban-Middle Class Women in India.

    Directory of Open Access Journals (Sweden)

    Indu Mohan

    Full Text Available Urbanization is an important determinant of cardiovascular disease (CVD risk. To determine location-based differences in CVD risk factors in India we performed studies among women in rural, urban-poor and urban middle-class locations.Population-based cross-sectional studies in rural, urban-poor, and urban-middle class women (35-70 y were performed at multiple sites. We evaluated 6853 women (rural 2616, 5 sites; urban-poor 2008, 4 sites; urban middle-class 2229, 11 sites for socioeconomic, lifestyle, anthropometric and biochemical risk factors. Descriptive statistics are reported.Mean levels of body mass index (BMI, waist circumference, waist-hip ratio (WHR, systolic BP, fasting glucose and cholesterol in rural, urban-poor and urban-middle class women showed significantly increasing trends (ANOVAtrend, p 80 cm (28.3, 63.4, 61.9%, waist >90 cm (8.4, 31.4, 38.2%, waist hip ratio (WHR >0.8 (60.4, 90.7, 88.5, WHR>0.9 (13.0, 44.3, 56.1%, hypertension (31.6, 48.2, 59.0% and hypercholesterolemia (13.5, 27.7, 37.4% (Mantel Haenszel X2 ptrend <0.01. Inverse trend was observed for tobacco use (41.6, 19.6, 9.4%. There was significant association of hypertension, hypercholesterolemia and diabetes with overweight and obesity (adjusted R2 0.89-0.99.There are significant location based differences in cardiometabolic risk factors in India. The urban-middle class women have the highest risk compared to urban-poor and rural.

  6. Psychosocial Stress at Work Doubles the Risk of Type 2 Diabetes in Middle-Aged Women Evidence from the Whitehall II Study

    DEFF Research Database (Denmark)

    Heraclides, A.; Chandola, T.; Witte, Daniel Rinse

    2009-01-01

    OBJECTIVE - To investigate the effect of psychosocial stress at work on risk of type 2 diabetes, adjusting for conventional risk factors, among a sample of British, white-collar, middle-aged men and women. RESEARCH DESIGN AND METHODS - This was a prospective analysis (19912004) from the Whitehall...... phases. The job strain and iso-strain models were used to assess psychosocial work stress. RESULTS - iso-strain in the workplace was associated with a twofold higher risk of type 2 diabetes in age-adjusted analysis in women but not in men (hazard ratio 1.94 [95% CI 1.17-3.21]). This effect remained...... robust to adjustment for socioeconomic position and outside work stressors and was only attenuated by 20% after adjustment for health behaviors, obesity, and other type 2 diabetes risk factors. CONCLUSIONS - Psychosocial work stress was an independent predictor of type 2 diabetes among women after a 15...

  7. Knee extensor strength and body weight in adolescent men and the risk of knee osteoarthritis by middle age

    DEFF Research Database (Denmark)

    Turkiewicz, Aleksandra; Timpka, Simon; Thorlund, Jonas Bloch

    2017-01-01

    be attributed to knee injury and adult occupation. CONCLUSION: Higher knee extensor strength in adolescent men was associated with increased risk of knee OA by middle age, challenging the current tenet of low muscle strength being a risk factor for OA. We confirmed higher weight to be a strong risk factor......OBJECTIVES: To assess the extent to which knee extensor strength and weight in adolescence are associated with knee osteoarthritis (OA) by middle age. METHODS: We studied a cohort of 40 121 men who at age 18 years in 1969/1970 underwent mandatory conscription in Sweden. We retrieved data...

  8. Behavioral inhibition in preschool children at risk is a specific predictor of middle childhood social anxiety: a five-year follow-up.

    Science.gov (United States)

    Hirshfeld-Becker, Dina R; Biederman, Joseph; Henin, Aude; Faraone, Stephen V; Davis, Stephanie; Harrington, Kara; Rosenbaum, Jerrold F

    2007-06-01

    Behavioral inhibition (BI) to the unfamiliar represents the temperamental tendency to exhibit fearfulness, reticence, or restraint when faced with unfamiliar people or situations. It has been hypothesized to be a risk factor for anxiety disorders. In this prospective longitudinal study, we compared the psychiatric outcomes in middle childhood of children evaluated at preschool age for BI. The baseline sample consisted of 284 children ages 21 months to 6 years, including offspring at risk for anxiety (children of parents with panic disorder and/or major depression) and comparison offspring of parents without mood or major anxiety disorders. They had been assessed for BI using age-specific laboratory protocols. We reassessed 215 of the children (76.5%) at 5-year follow-up at a mean age of 9.6 years using structured diagnostic interviews. BI specifically predicted onset of social anxiety. The rate of lifetime social anxiety (DSM-IV social phobia or DSM-III-R avoidant disorder) was 28% versus 14% (odds ratio [OR] = 2.37; 95% confidence interval [CI]: 1.10-5.10) in inhibited versus noninhibited children. BI significantly predicted new onset of social phobia among children unaffected at baseline (22.2% vs 8.0% in inhibited versus noninhibited children (OR = 3.15, 95% CI: 1.16-8.57). No other anxiety disorders were associated with BI. BI appears to be a temperamental antecedent to subsequent social anxiety in middle childhood. Children presenting with BI should be monitored for symptoms of social anxiety and may be good candidates for preventive cognitive behavioral strategies.

  9. Healthy Lifestyle through Young Adulthood and Presence of Low Cardiovascular Disease Risk Profile in Middle Age: The Coronary Artery Risk Development in (Young) Adults (CARDIA) Study

    Science.gov (United States)

    Liu, Kiang; Daviglus, Martha L.; Loria, Catherine M.; Colangelo, Laura A.; Spring, Bonnie; Moller, Arlen C.; Lloyd-Jones, Donald M.

    2012-01-01

    Background A low cardiovascular disease (CVD) risk profile (untreated cholesterol risk profile. We examined whether adopting a healthy lifestyle throughout young adulthood is associated with presence of the low CVD risk profile in middle age. Methods and Results The CARDIA study sample consisted of 3,154 black and white participants aged 18 to 30 years at Year 0 (Y0, 1985-86) who attended the Year 0, 7 and 20 (Y0, Y7 and Y20) examinations. Healthy lifestyle factors (HLFs) defined at Y0, Y7 and Y20 included: 1) Average BMI risk profile at Y20 were 3.0%, 14.6%, 29.5%, 39.2% and 60.7% for people with 0 or 1, 2, 3, 4, and 5 HLFs, respectively (p-trend risk profile in middle age. Public health and individual efforts are needed to improve adoption and maintenance of healthy lifestyles in young adults. PMID:22291127

  10. Is Privacy at Risk when Commercial Websites Target Primary School Children? A Case Study in Korea

    Science.gov (United States)

    Kim, Sora; Yi, Soon-Hyung

    2010-01-01

    This study discusses privacy risk factors when commercial web sites target primary school children in Korea. Specifically, the authors examined types of personal information required for membership subscriptions and whether privacy policies at commercial sites for children abide by privacy guidelines. A total of 159 commercial sites targeting…

  11. Socioeconomic position and risk of short-term weight gain: Prospective study of 14,619 middle-aged men and women

    Directory of Open Access Journals (Sweden)

    Luben Robert N

    2008-04-01

    Full Text Available Abstract Background The association between socioeconomic position in middle age and risk of subsequent, short-term weight gain is unknown. We therefore assessed this association in a prospective population based cohort study in Norfolk, UK. Methods We analysed data on 14,619 middle-aged men and women (aged between 40–75 at baseline with repeated objective measures of weight and height at baseline (1993–1997 and follow up (1998–2000. Results During follow up 5,064 people gained more than 2.5 kg. Compared with the highest social class, individuals in the lowest social class had around a 30% greater risk of gaining more than 2.5 kg (OR 1.29; 95% CI 1.11–1.51; p for trend = 0.002. This association remained statistically significant following adjustment for sex, age, baseline BMI, smoking, and follow up time (OR 1.25; CI 1.07–1.46; p for trend Conclusion Individuals of low socioeconomic position are at greatest risk of gaining weight during middle age, which is not explained by classical correlates of socioeconomic position and risk factors for obesity.

  12. Early identification of pneumonia patients at increased risk of Middle East respiratory syndrome coronavirus infection in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Anwar E. Ahmed

    2018-05-01

    Full Text Available Background: The rapid and accurate identification of individuals who are at high risk of Middle East respiratory syndrome coronavirus (MERS-CoV infection remains a major challenge for the medical and scientific communities. The aim of this study was to develop and validate a risk prediction model for the screening of suspected cases of MERS-CoV infection in patients who have developed pneumonia. Methods: A two-center, retrospective case–control study was performed. A total of 360 patients with confirmed pneumonia who were evaluated for MERS-CoV infection by real-time reverse transcription polymerase chain reaction (rRT-PCR between September 1, 2012 and June 1, 2016 at King Abdulaziz Medical City in Riyadh and King Fahad General Hospital in Jeddah, were included. According to the rRT-PCR results, 135 patients were positive for MERS-CoV and 225 were negative. Demographic characteristics, clinical presentations, and radiological and laboratory findings were collected for each subject. Results: A risk prediction model to identify pneumonia patients at increased risk of MERS-CoV was developed. The model included male sex, contact with a sick patient or camel, diabetes, severe illness, low white blood cell (WBC count, low alanine aminotransferase (ALT, and high aspartate aminotransferase (AST. The model performed well in predicting MERS-CoV infection (area under the receiver operating characteristics curves (AUC 0.8162, on internal validation (AUC 0.8037, and on a goodness-of-fit test (p = 0.592. The risk prediction model, which produced an optimal probability cut-off of 0.33, had a sensitivity of 0.716 and specificity of 0.783. Conclusions: This study provides a simple, practical, and valid algorithm to identify pneumonia patients at increased risk of MERS-CoV infection. This risk prediction model could be useful for the early identification of patients at the highest risk of MERS-CoV infection. Further validation of the prediction model on a

  13. Prevalence and Risk Factors for Toxoplasmosis in Middle Java, Indonesia.

    Science.gov (United States)

    Retmanasari, Annisa; Widartono, Barandi Sapta; Wijayanti, Mahardika Agus; Artama, Wayan Tunas

    2017-03-01

    Toxoplasmosis is a zoonosis caused by Toxoplasma gondii. Risk factors include consumption of undercooked meat, raw vegetables, and unfiltered water. This study aims to determine the seroprevalence and spatial distribution of toxoplasmosis in Middle Java, Indonesia, using an EcoHealth approach, combined with geographic information system (GIS). A total of 630 participants were randomly selected from seven districts. Each participant completed a questionnaire and provided a blood sample. The seroprevalence of toxoplasmosis was 62.5%. Of those who were seropositive, 90.1% were IgG+, and 9.9% were IgG+ and IgM+. Several risk factors were identified, including living at elevations of ≤200 m, compared with >200 m (OR = 56.2; P Java has a high prevalence of toxoplasmosis and identified some important environmental, ecological, and demographic risk factors. When researching diseases, such as toxoplasmosis, where animal hosts, human lifestyle, and environmental factors are involved in transmission, an EcoHealth method is essential to ensure a fully collaborative approach to developing interventions to reduce the risk of transmission in high-risk populations.

  14. Early Risk Factors of Overweight Developmental Trajectories during Middle Childhood.

    Directory of Open Access Journals (Sweden)

    Laura E Pryor

    Full Text Available Research is needed to identify early life risk factors associated with different developmental paths leading to overweight by adolescence.To model heterogeneity in overweight development during middle childhood and identify factors associated with differing overweight trajectories.Data was drawn from the Quebec Longitudinal Study of Child Development (QLSCD; 1998-2010. Trained research assistants measured height and weight according to a standardized protocol and conducted yearly home interviews with the child's caregiver (mother in 98% of cases. Information on several putative early life risk factors for the development of overweight were obtained, including factors related to the child's perinatal, early behavioral family and social environment. Group-based trajectories of the probability of overweight (6-12 years were identified with a semiparametric method (n=1678. Logistic regression analyses were used to identify early risk factors (5 months- 5 years associated with each trajectory.Three trajectories of overweight were identified: "early-onset overweight" (11.0 %, "late-onset overweight" (16.6% and "never overweight" (72.5%. Multinomial analyses indicated that children in the early and late-onset group, compared to the never overweight group, had 3 common types of risk factors: parental overweight, preschool overweight history, and large size for gestational age. Maternal overprotection (OR= 1.12, CI: 1.01-1.25, short nighttime sleep duration (OR=1.66, CI: 1.07-2.57, and immigrant status (OR=2.01, CI: 1.05-3.84 were factors specific to the early-onset group. Finally, family food insufficiency (OR=1.81, CI: 1.00-3.28 was weakly associated with membership in the late-onset trajectory group.The development of overweight in childhood follows two different trajectories, which have common and distinct risk factors that could be the target of early preventive interventions.

  15. Early Risk Factors of Overweight Developmental Trajectories during Middle Childhood

    Science.gov (United States)

    Pryor, Laura E.; Brendgen, Mara; Tremblay, Richard E.; Pingault, Jean-Baptiste; Liu, Xuecheng; Dubois, Lise; Touchette, Evelyne; Falissard, Bruno; Boivin, Michel; Côté, Sylvana M.

    2015-01-01

    Background Research is needed to identify early life risk factors associated with different developmental paths leading to overweight by adolescence. Objectives To model heterogeneity in overweight development during middle childhood and identify factors associated with differing overweight trajectories. Methods Data was drawn from the Quebec Longitudinal Study of Child Development (QLSCD; 1998-2010). Trained research assistants measured height and weight according to a standardized protocol and conducted yearly home interviews with the child’s caregiver (mother in 98% of cases). Information on several putative early life risk factors for the development of overweight were obtained, including factors related to the child’s perinatal, early behavioral family and social environment. Group-based trajectories of the probability of overweight (6-12 years) were identified with a semiparametric method (n=1678). Logistic regression analyses were used to identify early risk factors (5 months- 5 years) associated with each trajectory. Results Three trajectories of overweight were identified: “early-onset overweight” (11.0 %), “late-onset overweight” (16.6%) and “never overweight” (72.5%). Multinomial analyses indicated that children in the early and late-onset group, compared to the never overweight group, had 3 common types of risk factors: parental overweight, preschool overweight history, and large size for gestational age. Maternal overprotection (OR= 1.12, CI: 1.01-1.25), short nighttime sleep duration (OR=1.66, CI: 1.07-2.57), and immigrant status (OR=2.01, CI: 1.05-3.84) were factors specific to the early-onset group. Finally, family food insufficiency (OR=1.81, CI: 1.00-3.28) was weakly associated with membership in the late-onset trajectory group. Conclusions The development of overweight in childhood follows two different trajectories, which have common and distinct risk factors that could be the target of early preventive interventions. PMID

  16. Exposure to Violence and Sexual Risk among Early Adolescents in Urban Middle Schools

    Science.gov (United States)

    Coyle, Karin K.; Guinosso, Stephanie A.; Glassman, Jill R.; Anderson, Pamela M.; Wilson, Helen W.

    2017-01-01

    This article examines the relationship between exposure to violence, fear of exposure to violence, and sexual risk among a sample of urban middle school youth. The sample included 911 seventh-grade students who completed self-report surveys. Approximately 20% of the sample reported at least one direct threat or injury with a weapon in the past 3…

  17. Observed changes in cardiovascular risk factors among high-risk middle-aged men who received lifestyle counselling: a 5-year follow-up.

    Science.gov (United States)

    Siren, Reijo; Eriksson, Johan G; Vanhanen, Hannu

    2016-12-01

    To examine the long-term impact of health counselling among middle-aged men at high risk of CVD. An observational study with a 5-year follow-up. All men aged 40 years in Helsinki have been invited to a visit to evaluate CVD risk from 2006 onwards. A modified version of the North Karelia project risk tool (CVD risk score) served to assess the risk. High-risk men received lifestyle counselling based on their individual risk profile in 2006 and were invited to a follow-up visit in 2011. Of the 389 originally high-risk men, 159 participated in the follow-up visits in 2011. Based on their follow-up in relation the further risk communication, we divided the participants into three groups: primary health care, occupational health care and no control visits. Lifestyle and CVD risk score change. All groups showed improvements in lifestyles. The CVD risk score decreased the most in the group that continued the risk communication visits in their primary health care centre (6.1 to 4.8 [95% CI -1.6 to -0.6]) compared to those who continued risk communication visits in their occupational health care (6.0 to 5.4 [95% CI -1.3 to 0.3]), and to those with no risk communication visits (6.0 to 5.9 [95% CI -0.5 to 0.4]). These findings indicate that individualized lifestyle counselling improves health behaviour and reduces total CVD risk among middle-aged men at high risk of CVD. Sustained improvement in risk factor status requires ongoing risk communication with health care providers. KEY POINTS Studies of short duration have shown that lifestyle changes reduce the risk of cardiovascular disease among high-risk individuals. Sustaining these lifestyle changes and maintaining the lower disease risk attained can prove challenging. Cardiovascular disease (CVD) risk assessment and individualized health counselling for high-risk men, when implemented in primary health care, have the potential to initiate lifestyle changes that support risk reduction. Attaining a sustainable reduction in CVD

  18. Feasibility of the Positive Thoughts and Actions Prevention Program for Middle Schoolers at Risk for Depression

    Directory of Open Access Journals (Sweden)

    Carolyn A. McCarty

    2011-01-01

    Full Text Available Despite the importance of adolescent depression, few school-based prevention programs have been developed and tested in the United States with middle school populations. This study examined the acceptability and changes in targeted outcomes for a new preventative program, Positive Thoughts and Actions (PTA. Sixty-seven 7th grade students with elevated depressive symptoms were recruited from public schools and randomized to the 12-week PTA program with a parent-component or to a school-as-usual control group. The PTA prevention program was well received by students and parents, yielding high rates of participation and satisfaction among those randomized to receive the intervention. However, analyses of the efficacy of the program in changing depressive symptoms were not significant. In terms of our proximal program targets, most differences were not statistically significant, though effect sizes suggested advantage of PTA over control group in coping, cognitive style, and parent-child communication. This preliminary research highlights a need for further testing of programs for school-based prevention of depression and promotion of positive emotional health.

  19. [Targeting high-risk drugs to optimize clinical pharmacists' intervention].

    Science.gov (United States)

    Mouterde, Anne-Laure; Bourdelin, Magali; Maison, Ophélie; Coursier, Sandra; Bontemps, Hervé

    2016-12-01

    By the Order of 6 April 2011, the pharmacist must validate all the prescriptions containing "high-risk drugs" or those of "patients at risk". To optimize this clinical pharmacy activity, we identified high-risk drugs. A list of high-risk drugs has been established using literature, pharmacists' interventions (PI) performed in our hospital and a survey sent to hospital pharmacists. In a prospective study (analysis of 100 prescriptions for each high-risk drug selected), we have identified the most relevant to target. We obtained a statistically significant PI rate (P<0.05) for digoxin, oral anticoagulants direct, oral methotrexate and colchicine. This method of targeted pharmaceutical validation based on high-risk drugs is relevant to detect patients with high risk of medicine-related illness. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  20. Improving Deficient Listening Skills in the Language Arts Program at the Middle Grades.

    Science.gov (United States)

    Alonso, Laura

    A project developed a program for improving deficient student-to-student listening skills. The targeted population consisted of 18 seventh-grade middle school students in a culturally diverse, lower middle class community in a near-western suburb of Chicago. The problem of deficient listening skills was evident through teacher observation and…

  1. World Health Organization cardiovascular risk stratification and target organ damage.

    Science.gov (United States)

    Piskorz, D; Bongarzoni, L; Citta, L; Citta, N; Citta, P; Keller, L; Mata, L; Tommasi, A

    2016-01-01

    Prediction charts allow treatment to be targeted according to simple markers of cardiovascular risk; many algorithms do not recommend screening asymptomatic target organ damage which could change dramatically the assessment. To demonstrate that target organ damage is present in low cardiovascular risk hypertensive patients and it is more frequent and severe as global cardiovascular risk increases. Consecutive hypertensive patients treated at a single Latin American center. Cardiovascular risk stratified according to 2013 WHO/ISH risk prediction chart America B. Left ventricular mass assessed by Devereux method, left ventricular hypertrophy considered >95g/m(2) in women and >115g/m(2) in men. Transmitral diastolic peak early flow velocity to average septal/lateral peak early diastolic relaxation velocity (E/e' ratio) measured cut off value >13. Systolic function assessed by tissue Doppler average interventricular septum/lateral wall mitral annulus rate systolic excursion (s wave). A total of 292 patients were included of whom 159 patients (54.5%) had cardiovascular risk of 20%. Left ventricular hypertrophy was detected in 17.6% low risk patients, 27.8% in medium risk and 23.3% in high risk (p<0.05), abnormal E/e' ratio was found in 13.8%, 31.1% and 27.9%, respectively (p<0.05). Mean s wave was 8.03+8, 8.1+9 and 8.7+1cm/s for low, intermediate and high risk patients, respectively (p<0.025). Target organ damage is more frequent and severe in high risk; one over four subjects was misclassified due to the presence of asymptomatic target organ damage. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

  2. Risk factors for Staphylococcus aureus nasal colonization in Danish middle-aged and elderly twins

    DEFF Research Database (Denmark)

    Andersen, P S; Larsen, Lisbeth Aagaard; Fowler, V G

    2013-01-01

    on S. aureus carriage in Danish middle-aged and elderly twins, which indicated no significant heritability that could account for the observed S. aureus carriage. In the present study, we performed a questionnaire-based study of S. aureus colonization on the same cohort of 2,196 Danish middle......-aged and elderly twins to identify specific risk factors for S. aureus nasal colonization, including analyzing the paired twins (n = 478) that were discordant for S. aureus colonization. We found associations between risk factors and S. aureus nasal colonization among middle-aged and elderly twins, including age......, male gender, psoriasis, and atopic diseases. Also, present living on a farm is clearly associated with S. aureus colonization, while smoking had a borderline statistically significant protective effect....

  3. Resourceful or At Risk

    DEFF Research Database (Denmark)

    Højen-Sørensen, Anna-Katharina

    Introduction: Social categories are used to determine which individuals are at an increased risk of unfavorable outcomes and they are a vital tool for the development of targeted interventions. This presentation takes a critical look at the Resourceful and At Risk categories, that are often emplo...... employed in research and social work, and investigate the possible consequences of the preconceptions born out of these categories....

  4. Differences in neural and cognitive response to emotional faces in middle-aged dizygotic twins at familial risk of depression

    DEFF Research Database (Denmark)

    Miskowiak, K W; Svendsen, A M B; Harmer, C J

    2017-01-01

    -twin history of depression (high-risk) and 20 were without co-twin history of depression (low-risk). During fMRI, participants viewed fearful and happy faces while performing a gender discrimination task. After the scan, they were given a faces dot-probe task, a facial expression recognition task......BACKGROUND: Negative bias and aberrant neural processing of emotional faces are trait-marks of depression but findings in healthy high-risk groups are conflicting. METHODS: Healthy middle-aged dizygotic twins (N = 42) underwent functional magnetic resonance imaging (fMRI): 22 twins had a co...... the amygdala and ventral prefrontal cortex and pregenual anterior cingulate. This was accompanied by greater fear-specific fronto-temporal response and reduced fronto-occipital response to all emotional faces relative to baseline. The risk groups showed no differences in mood, subjective state or coping...

  5. Suicide Interventions Targeted toward At-Risk Youth

    Science.gov (United States)

    Langhinrichsen-Rohling, Jennifer; Lamis, Dorian A.; McCullars, Adrianne

    2012-01-01

    Suicide is currently the third leading cause of death among youth; it has been named a public health concern. A number of programs have been developed to prevent suicide; many of these involve intervening with youth who are known to be at-risk because of their depression, expressed suicide ideation, or previous suicide attempts. This paper serves…

  6. Risk factors for coronary heart disease in middle-aged men in Crete in 1982.

    NARCIS (Netherlands)

    Aravanis, C.; Mensink, R.P.; Corcondilas, A.; Ioanidis, P.; Feskens, E.J.M.; Katan, M.B.

    1988-01-01

    Risk factors for coronary heart disease were studied in healthy middle- aged Cretan men in order to compare them with the middle-aged men of a previous generation studied in 1960 as the Cretan cohort of the Seven Countries Study (1960). In the present cohort mean values for total cholesterol were

  7. [Ecological risk assessment of dam construction for terrestrial plant species in middle reach of Lancangjiang River, Southwest China].

    Science.gov (United States)

    Li, Xiao-Yan; Dong, Shi-Kui; Liu, Shi-Liang; Peng, Ming-Chun; Li, Jin-Peng; Zhao, Qing-He; Zhang, Zhao-Ling

    2012-08-01

    Taking the surrounding areas of Xiaowan Reservoir in the middle reach of Lancangjiang River as study area, and based on the vegetation investigation at three sites including electricity transmission area (site 1), electricity-transfer substation and roadsides to the substation (site 2), and emigration area (site 3) in 1997 (before dam construction), another investigation was conducted on the vegetation composition, plant coverage, and dominant species at the same sites in 2010 (after dam construction), aimed to evaluate the ecological risk of the dam construction for the terrestrial plant species in middle reach of Lancangjiang River. There was an obvious difference in the summed dominance ratio of dominant species at the three sites before and after the dam construction. According the types of species (dominant and non-dominant species) and the changes of plant dominance, the ecological risk (ER) for the plant species was categorized into 0 to IV, i.e., no or extremely low ecological risk (0), low ecological risk (I), medium ecological risk (II), high ecological risk (III), and extremely high ecological risk (IV). As affected by the dam construction, the majority of the species were at ER III, and a few species were at ER IV. The percentage of the plant species at ER III and ER IV at site 3 was higher than that at sites 1 and 2. The decrease or loss of native plants and the increase of alien or invasive plants were the major ecological risks caused by the dam construction. Effective protection strategies should be adopted to mitigate the ecological risk of the dam construction for the terrestrial plants at species level.

  8. Surveillane of Middle and High School Mental Health Risk by Student Self-Report Screener

    Directory of Open Access Journals (Sweden)

    Bridget V Dever

    2013-08-01

    Full Text Available Introduction: A 2009 National Academies of Sciences report on child mental health prevention and treatment concluded that screening for mental health risk is an essential component of service delivery. To date, however, there are few practical assessments available or practices in place that measure individual child risk, or risk aggregated at the school or community level. This study examined the utility of a 30-item paper and pencil student self-report screener of behavioral and emotional risk (BER for surveying community risk among 7 schools. Methods: In 2010, 2,222 students in 3 middle and 4 high schools in a medium-sized school district in Georgia were administered the Behavioral and Emotional Screening System Self-Report Child/Adolescent form (BESS Student. The BESS is designed to measure 4 sub-syndromal BER factors for developing mental health disorders: inattention/hyperactivity, internalizing, school problems, and personal adjustment. Analysis of Variance and Chi Square analyses were used to assess the association between adolescent self-reported BER as an indicator of school BER, grade level, child ethnic identification and gender, socioeconomic status, and special education placement status.Results: BESS scores differentiated well between schools for overall BER and special education status, as well as between grade levels, ethnicity, and gender groups. One high school, known by the school administration to have numerous incidents of student behavior problems, had the most deviant 4 BER domain scores of all 7 schools. Girls rated themselves as having a higher prevalence of BER (14% than boys (12%; middle school students reported fewer difficulties than high school students.Conclusion: Middle and high school students were capable of identifying significant differences in their own BER across schools, suggesting that universal mental health risk screening viastudent self-report is potentially useful for identifying aggregated community

  9. Risk scores for diabetes and impaired glycaemia in the Middle East and North Africa

    DEFF Research Database (Denmark)

    Handlos, Line Neerup; Witte, Daniel Rinse; Almdal, Thomas Peter

    2013-01-01

    AIMS: To develop risk scores for diabetes and diabetes or impaired glycaemia for individuals living in the Middle East and North Africa region. In addition, to derive national risk scores for Algeria, Saudi Arabia and the United Arab Emirates and to compare the performance of the regional risk...

  10. Dependency of cardiovascular risk on reproductive stages and on age among middle-aged Chinese women.

    Science.gov (United States)

    Sun, Y; Ruan, X; Mueck, A O

    2017-10-01

    To assess the 10-year cardiovascular risk in middle-aged Chinese women living in the same community and the impact of reproductive aging and age. This was a cross-sectional study in the Yuetan Community of Beijing. Data on lifestyle habits, prevalence and treatment of chronic diseases with significance for cardiovascular disease (CVD) development were collected by interview. CVD risk factors were assessed by physical examination and laboratory tests. The 10-year cardiovascular risk was calculated using the Framingham 10-year risk score. STRAW +10 criteria were used for the stages of reproductive aging. A total of 536 women, aged 40-60 years, were enrolled. The incidences of hypertension, dyslipidemia, abdominal obesity, glucose intolerance and diabetes were 32.6%, 45.7%, 65.5%, 37.9% and 10.1%, respectively. After adjustment, the incidence of hypertension and diabetes increased with age and with reproductive aging. Dyslipidemia and glucose intolerance were only associated with age. Abdominal obesity was related neither to age nor to reproductive aging. The 10-year cardiovascular risk ranged from 1% to 24.8%; 11.6% of women had a moderate or high Framingham 10-year risk score. CVD risk factors were frequent and more than 10% of the women were at moderate or high risk of developing cardiovascular disease within the next 10 years. To our knowledge, this was demonstrated for the first time in middle-aged Chinese women. Thus, women should maintain a healthy lifestyle and physicians should monitor them to prevent CVD.

  11. Fatherhood and Men's Lives at Middle Age

    Science.gov (United States)

    Eggebeen, David J.; Dew, Jeffrey; Knoester, Chris

    2010-01-01

    This article uses data on 2,024 men who were followed through the third wave of the National Survey of Families and Households to examine the implications of fatherhood experiences for men's involvement in altruistic social activities at middle age. We find that middle-aged men (ages 45-65) who at some point in their lives become fathers are…

  12. A retrospective study of recurrent chlamydia infection in men and women: is there a role for targeted screening for those at risk?

    Science.gov (United States)

    Evans, C; Das, C; Kinghorn, G

    2009-03-01

    Chalmydia trachomatis remains the commonest sexually transmitted infection (STI) in the UK. This study identifies those at risk of recurrent infection (RI) attending a central genitourinary clinic, time to subsequent reinfection and duration of at-risk behaviour for the consideration of targeted chlamydia screening. From 1995 to 2005, a total of 14,011 patients' were diagnosed with chlamydia and 1743 (12.4%) had RI, classified as a repeat infection greater than three months after initial diagnosis. Individual risk factors for both sexes include young age TOC) and previous STI. Men of non-White ethnicity, symptoms and those self-referred were also at risk. Combined risk factors for both sexes were non-White ethnicity, symptoms, young age, previous STI and two or more partners. Attendance for TOC considerably reduced RI rates in men (odds ratio [OR] = 0.549; 95% confidence interval [CI] 0.359-0.840). Mean time to first and last reinfection in men was 1.91 and 2.49 years, in women 1.76 and 1.92 years. One in eight individuals with chlamydia infection are at risk of RI, the majority of which will occur within two years of initial presentation. These individuals have identifiable risk factors facilitating targeted re-screening, enhanced follow-up and support for behavioural change.

  13. Does corporate social responsibility put reputation at risk by inviting activist targeting? An empirical test among European SMEs.

    NARCIS (Netherlands)

    Graafland, Johan

    Corporate social responsibility (CSR) is believed to improve a company’s reputation. However,CSR may also put reputation at risk by making the company a more attractive target for activists’campaigns. We test this effect on a sample of 1355 European small and medium-sized enterprises(SMEs). We find

  14. Identifying HIV most-at-risk groups in Malawi for targeted interventions. A classification tree model.

    Science.gov (United States)

    Emina, Jacques B O; Madise, Nyovani; Kuepie, Mathias; Zulu, Eliya M; Ye, Yazoume

    2013-05-28

    To identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi. A cross-sectional survey. Malawi The study used a sample of 6395 women aged 15-49 years from the 2010 Malawi Health and Demographic Surveys. Individual HIV status: positive or not. Findings from the Pearson χ(2) and χ(2) Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15-24) never married or in union and living in rural areas. In the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25-49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30-49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment.

  15. Lower early postnatal oxygen saturation target and risk of ductus arteriosus closure failure.

    Science.gov (United States)

    Inomata, Kei; Taniguchi, Shinji; Yonemoto, Hiroki; Inoue, Takeshi; Kawase, Akihiko; Kondo, Yuichi

    2016-11-01

    Early postnatal hyperoxia is a major risk factor for retinopathy of prematurity (ROP) in extremely premature infants. To reduce the occurrence of ROP, we adopted a lower early postnatal oxygen saturation (SpO 2 ) target range (85-92%) from April 2011. Lower SpO 2 target range, however, may lead to hypoxemia and an increase in the risk of ductus arteriosus (DA) closure failure. The aim of this study was therefore to determine whether a lower SpO 2 target range, during the early postnatal stage, increases the risk of DA closure failure. Infants born at closure failure in period 2 (21%) was significantly higher than that in period 1 (1%). On multivariate logistic regression analysis, the lower oxygen saturation target range was an independent risk factor for DA closure failure. Lower early postnatal oxygen saturation target range increases the risk of DA closure failure. © 2016 Japan Pediatric Society.

  16. A Data-Driven Evaluation of the Stop TB Global Partnership Strategy of Targeting Key Populations at Greater Risk for Tuberculosis.

    Science.gov (United States)

    McLaren, Zoë M; Schnippel, Kathryn; Sharp, Alana

    2016-01-01

    Identifying those infected with tuberculosis (TB) is an important component of any strategy for reducing TB transmission and population prevalence. The Stop TB Global Partnership recently launched an initiative with a focus on key populations at greater risk for TB infection or poor clinical outcomes, due to housing and working conditions, incarceration, low household income, malnutrition, co-morbidities, exposure to tobacco and silica dust, or barriers to accessing medical care. To achieve operational targets, the global health community needs effective, low cost, and large-scale strategies for identifying key populations. Using South Africa as a test case, we assess the feasibility and effectiveness of targeting active case finding to populations with TB risk factors identified from regularly collected sources of data. Our approach is applicable to all countries with TB testing and census data. It allows countries to tailor their outreach activities to the particular risk factors of greatest significance in their national context. We use a national database of TB test results to estimate municipality-level TB infection prevalence, and link it to Census data to measure population risk factors for TB including rates of urban households, informal settlements, household income, unemployment, and mobile phone ownership. To examine the relationship between TB prevalence and risk factors, we perform linear regression analysis and plot the set of population characteristics against TB prevalence and TB testing rate by municipality. We overlay lines of best fit and smoothed curves of best fit from locally weighted scatter plot smoothing. Higher TB prevalence is statistically significantly associated with more urban municipalities (slope coefficient β1 = 0.129, p informal settlement households (β1 = 0.021, p = 0.136, R2 = 0.014). These analyses reveal that the set of characteristics identified by the Global Plan as defining key populations do not adequately predict

  17. Suicide risk in a representative sample of people receiving HIV care: Time to target most-at-risk populations (ANRS VESPA2 French national survey).

    Science.gov (United States)

    Carrieri, Maria Patrizia; Marcellin, Fabienne; Fressard, Lisa; Préau, Marie; Sagaon-Teyssier, Luis; Suzan-Monti, Marie; Guagliardo, Valérie; Mora, Marion; Roux, Perrine; Dray-Spira, Rosemary; Spire, Bruno

    2017-01-01

    Suicide risk is high among people living with HIV (PLHIV). This study aimed to identify major correlates of suicide risk in a representative sample of PLHIV in France, in order to help target individuals who would benefit from suicide risk screening and psychiatric care. The ANRS VESPA2 cross-sectional survey (April 2011-January 2012) collected socio-demographic, medical and behavioral data from 3,022 PLHIV recruited in 73 French HIV hospital departments. The study sample comprised the 2,973 participants with available self-reported data on suicide risk (defined as having either thought about and planned to commit suicide during the previous 12 months or attempted suicide during the same period of time) and medical data on comorbidities. Weighted Poisson models adjusted for HCV co-infection and significant clinical variables were used to estimate the relationship between suicide risk and HIV transmission groups, experience with HIV disease and other psychosocial factors. Suicide risk was reported by 6.3% of PLHIV in the study sample. After adjustment for HIV immunological status and HCV co-infection, women (IRR [95%CI]:1.93 [1.17; 3.19]) and men who have sex with men (MSM) (1.97 [1.22; 3.19]) had a higher suicide risk than the rest of the sample. Moreover, the number of discrimination-related social contexts reported (1.39 [1.19; 1.61]), homelessness (4.87 [1.82; 13.02]), and reporting a feeling of loneliness (4.62 [3.06; 6.97]) were major predictors of suicide risk. Reducing the burden of precarious social conditions and discrimination is an important lever for preventing suicide risk among PLHIV in France. Comprehensive care models involving peer/community social interventions targeted at women and MSM need to be implemented to lower the risk of suicide in these specific subgroups of PLHIV.

  18. Suicide risk in a representative sample of people receiving HIV care: Time to target most-at-risk populations (ANRS VESPA2 French national survey.

    Directory of Open Access Journals (Sweden)

    Maria Patrizia Carrieri

    Full Text Available Suicide risk is high among people living with HIV (PLHIV. This study aimed to identify major correlates of suicide risk in a representative sample of PLHIV in France, in order to help target individuals who would benefit from suicide risk screening and psychiatric care.The ANRS VESPA2 cross-sectional survey (April 2011-January 2012 collected socio-demographic, medical and behavioral data from 3,022 PLHIV recruited in 73 French HIV hospital departments. The study sample comprised the 2,973 participants with available self-reported data on suicide risk (defined as having either thought about and planned to commit suicide during the previous 12 months or attempted suicide during the same period of time and medical data on comorbidities. Weighted Poisson models adjusted for HCV co-infection and significant clinical variables were used to estimate the relationship between suicide risk and HIV transmission groups, experience with HIV disease and other psychosocial factors.Suicide risk was reported by 6.3% of PLHIV in the study sample. After adjustment for HIV immunological status and HCV co-infection, women (IRR [95%CI]:1.93 [1.17; 3.19] and men who have sex with men (MSM (1.97 [1.22; 3.19] had a higher suicide risk than the rest of the sample. Moreover, the number of discrimination-related social contexts reported (1.39 [1.19; 1.61], homelessness (4.87 [1.82; 13.02], and reporting a feeling of loneliness (4.62 [3.06; 6.97] were major predictors of suicide risk.Reducing the burden of precarious social conditions and discrimination is an important lever for preventing suicide risk among PLHIV in France. Comprehensive care models involving peer/community social interventions targeted at women and MSM need to be implemented to lower the risk of suicide in these specific subgroups of PLHIV.

  19. School as a risk factor for psychoactive substance use by middle school students

    Science.gov (United States)

    Okulicz-Kozaryn, Katarzyna

    2010-01-01

    For the majority of Polish students school is a source of negative experiences and therefore may increase the risk of adolescent problem behaviors. The results of the study conducted in Warsaw middle schools (N=2244, 54% girls) indicated that changes for worse (between 7 and 8 grade) in students' behavior increase the risk of drug use. However, changes for better in students' perception of school value and school achievements are risk factors, too (even when family and peer risk factors are controlled). PMID:21152104

  20. Targeted In-service Inspections Using Risk Insights

    International Nuclear Information System (INIS)

    Kulat, S.; Montgomery, B.; Robin Graybeal, M.

    2012-01-01

    This paper includes a discussion of the historical background and rationale for development of a targeted In-service Inspection (ISI) program using risk insights, known as Risk-Informed In-service Inspection (RI-ISI). RI-ISI programs are optimized inspection programs which target specific welds for inspection based upon potential degradation mechanisms and consequences of failure. Inspections are performed on those welds that are the highest contributors to plant risk. Additionally the inspections are tailored to detect the specific postulated degradation mechanisms. As a result, the numbers of inspections are reduced along with the associated cost and radiation exposure, while maintaining or improving the level of quality and safety. Provided in this paper are the basic principles of RI-ISI program development, and a summary of the impact of the implementation of such programs. For example, implementation of a Risk-Informed In-service Inspection program results in a reduction of both cost and radiation exposure. Cost savings are estimated at between USD 1,000,000 and USD 2,300,000 per unit per ten year interval for a Class 1 and2 RI-ISI application. Cost savings are estimated based on average cost per weld of USD 7600 for examination, including the following activities: erection and removal of scaffolding, removal and replacement of insulation, removal and replacement of interferences, weld preparation, examination, documentation, craft support. Reduction in radiation exposure is estimated at 75% to 90% for a Class 1 and2 RI-ISI application. Reduction in radiation exposure is due to the following factors: number of welds selected for examination decreases by 60% to 75%, surface examinations essentially eliminated, within a given risk category, welds can be selected for examination based on additional factors such as the minimization of radiation exposure.(author).

  1. Multi-targeted and aggressive treatment of patients with type 2 diabetes at high risk

    DEFF Research Database (Denmark)

    Gaede, P; Pedersen, O

    2005-01-01

    Results from many single risk factor intervention trials and the multi-targeted Steno-2 trial in the last few years have provided a strong case that management of type 2 diabetes in all age groups requires a structured and intensified approach that is far more than just glucocentric, an approach...... addressing additional cardiovascular risk factors including hypertension, dyslipidaemia, sedentary behaviour, smoking and dietary habits causing insulin resistance and pro-inflammation. This type of integrated therapy applied for almost 8 years to high-risk type 2 diabetic patients has cut the relative risk......-driven polypharmacy and simple but focused behaviour modelling with continuous education, motivation and trouble-shooting for treatment barriers identified for the patient and the care giver. It is high time we transfer these experiences and major health benefits gained in the 'green house' of controlled clinical...

  2. Prevalence of cardiovascular risk factors in a middle-income country and estimated cost of a treatment strategy

    Directory of Open Access Journals (Sweden)

    Gabriel Anne

    2006-01-01

    Full Text Available Abstract Background We assessed the prevalence of risk factors for cardiovascular disease (CVD in a middle-income country in rapid epidemiological transition and estimated direct costs for treating all individuals at increased cardiovascular risk, i.e. following the so-called "high risk strategy". Methods Survey of risk factors using an age- and sex-stratified random sample of the population of Seychelles aged 25–64 in 2004. Assessment of CVD risk and treatment modalities were in line with international guidelines. Costs are expressed as US$ per capita per year. Results 1255 persons took part in the survey (participation rate of 80.2%. Prevalence of main risk factors was: 39.6% for high blood pressure (≥140/90 mmHg or treatment of which 59% were under treatment; 24.2% for high cholesterol (≥6.2 mmol/l; 20.8% for low HDL-cholesterol (2 and 22.1% for the metabolic syndrome. Overall, 43% had HBP, high cholesterol or diabetes and substantially increased CVD risk. The cost for medications needed to treat all high-risk individuals amounted to US $45.6, i.e. $11.2 for high blood pressure, $3.8 for diabetes, and $30.6 for dyslipidemia (using generic drugs except for hypercholesterolemia. Cost for minimal follow-up medical care and laboratory tests amounted to $22.6. Conclusion High prevalence of major risk factors was found in a rapidly developing country and costs for treatment needed to reduce risk factors in all high-risk individuals exceeded resources generally available in low or middle income countries. Our findings emphasize the need for affordable cost-effective treatment strategies and the critical importance of population strategies aimed at reducing risk factors in the entire population.

  3. [Relationship between body weight status in early adulthood and body weight change at middle age in adults and type 2 diabetes mellitus].

    Science.gov (United States)

    Zhou, Long; Zhao, Liancheng; Li, Ying; Guo, Min; Wu, Yangfeng

    2016-03-01

    To explore the relationship between weight status in early adulthood and body weight change at middle age in adults and type 2 diabetes mellitus (T2DM). The data of 14 population samples from China Multicenter Collaborative Study of Cardiovascular Epidemiology conducted in 1998 were used. Approximately 1 000 men and women in each sample were surveyed for cardiovascular disease risk factors, including body weight at age 25 years. The body mass index (BMI) at the age 25 years was calculated. The association between body weight in early adulthood and body weight change at middle age and T2DM was examined by using logistic regression model. The incidence of T2DM in low weight group (BMIweight group (BMI: 18.5-23.9 kg/m(2)), overweight group (BMI: 24.0-27.9 kg/m(2)) and obese group (BMI:≥28.0 kg/m(2)) at 25 years old were 2.4%(30/1263), 2.8%(266/9562), 4.0%(70/1739) and 6.4% (7/110), respectively (P value for trendincidence of T2DM for adults with weight change 12.5 kg at middle age were 2.5% (18/712), 1.3%(21/1629), 2.1%(48/2330), 2.3%(59/2585), 3.7%(94/2518), and 4.6% (133/2900) respectively. (P value for trend weight gain were positively correlated with T2DM after adjusted other risk factors (all P values for trend weight gain at middle age were both independently associated with the increased risk of T2DM in middle-aged men and women.

  4. Targeting condom distribution at high risk places increases condom utilization-evidence from an intervention study in Livingstone, Zambia

    Directory of Open Access Journals (Sweden)

    Sandøy Ingvild

    2012-01-01

    Full Text Available Abstract Background The PLACE-method presumes that targeting HIV preventive activities at high risk places is effective in settings with major epidemics. Livingstone, Zambia, has a major HIV epidemic despite many preventive efforts in the city. A baseline survey conducted in 2005 in places where people meet new sexual partners found high partner turnover and unprotected sex to be common among guests. In addition, there were major gaps in on-site condom availability. This study aimed to assess the impact of a condom distribution and peer education intervention targeting places where people meet new sexual partners on condom use and sexual risk taking among people socializing there. Methods The 2005 baseline survey assessed the presence of HIV preventive activities and sexual risk taking in places where people meet new sexual partners in Livingstone. One township was selected for a non-randomised intervention study on condom distribution and peer education in high risk venues in 2009. The presence of HIV preventive activities in the venues during the intervention was monitored by an external person. The intervention was evaluated after one year with a follow-up survey in the intervention township and a comparison township. In addition, qualitative interviews and focus group discussions were conducted. Results Young people between 17-32 years of age were recruited as peer educators, and 40% were females. Out of 72 persons trained before the intervention, 38 quit, and another 11 had to be recruited. The percentage of venues where condoms were reported to always be available at least doubled in both townships, but was significantly higher in the intervention vs. the control venues in both surveys (84% vs. 33% in the follow-up. There was a reduction in reported sexual risk taking among guests socializing in the venues in both areas, but reporting of recent condom use increased more among people interviewed in the intervention (57% to 84% than in the

  5. Targeting condom distribution at high risk places increases condom utilization-evidence from an intervention study in Livingstone, Zambia.

    Science.gov (United States)

    Sandøy, Ingvild Fossgard; Zyaambo, Cosmas; Michelo, Charles; Fylkesnes, Knut

    2012-01-05

    The PLACE-method presumes that targeting HIV preventive activities at high risk places is effective in settings with major epidemics. Livingstone, Zambia, has a major HIV epidemic despite many preventive efforts in the city. A baseline survey conducted in 2005 in places where people meet new sexual partners found high partner turnover and unprotected sex to be common among guests. In addition, there were major gaps in on-site condom availability. This study aimed to assess the impact of a condom distribution and peer education intervention targeting places where people meet new sexual partners on condom use and sexual risk taking among people socializing there. The 2005 baseline survey assessed the presence of HIV preventive activities and sexual risk taking in places where people meet new sexual partners in Livingstone. One township was selected for a non-randomised intervention study on condom distribution and peer education in high risk venues in 2009. The presence of HIV preventive activities in the venues during the intervention was monitored by an external person. The intervention was evaluated after one year with a follow-up survey in the intervention township and a comparison township. In addition, qualitative interviews and focus group discussions were conducted. Young people between 17-32 years of age were recruited as peer educators, and 40% were females. Out of 72 persons trained before the intervention, 38 quit, and another 11 had to be recruited. The percentage of venues where condoms were reported to always be available at least doubled in both townships, but was significantly higher in the intervention vs. the control venues in both surveys (84% vs. 33% in the follow-up). There was a reduction in reported sexual risk taking among guests socializing in the venues in both areas, but reporting of recent condom use increased more among people interviewed in the intervention (57% to 84%) than in the control community (55% to 68%). It is likely that the

  6. School-Based Interventions to Reduce Obesity Risk in Children in High- and Middle-Income Countries.

    Science.gov (United States)

    Evans, Charlotte E L; Albar, Salwa Ali; Vargas-Garcia, Elisa J; Xu, Fei

    2015-01-01

    School-based interventions are relatively new and were first introduced in the United States in the 1990s. Early programs were mainly education based with many of the findings now embedded in school policy in the form of a healthy eating curriculum. More recent school programs have taken education outside the classroom and attempted to engage parents as well as teachers. Environmental changes such as improving the quality of foods available at lunchtime and at other times during the school day are now common. Reviews of evaluations of school-based programs have demonstrated that they are effective and successfully improve dietary quality such as increasing fruit and vegetable intake and decreasing sweet and savory snacks and sweetened drinks; not just in school but over the whole day and particularly in younger school children. School-based interventions are also effective at reducing obesity if components to increase physical activity and reduce sedentary behaviors are also targeted but not if only dietary behaviors are tackled. Most of the high-quality evaluation studies using randomized controlled trials have been carried out in high-income countries as they are costly to run. However, middle-income countries have benefitted from the information available from these evaluation studies and many are now starting to fund and evaluate school-based programs themselves, resulting in unique problems such as concomitant under- and overnutrition being addressed. Action for the future demands more focus on populations most at risk of poor dietary quality and obesity in order to reduce inequalities in health and on adolescents who have not benefited as much as younger children from school-based interventions. This will involve innovative solutions within schools as well as targeting the food environment outside schools such as reducing the density of fast-food outlets and marketing of sweet and savory snacks and drinks. © 2015 Elsevier Inc. All rights reserved.

  7. Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

    Energy Technology Data Exchange (ETDEWEB)

    Baldini, Elizabeth H., E-mail: ebaldini@partners.org [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Bosch, Walter [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Roberge, David [Department of Radiation Oncology, Centre Hospitalier de l' Universite de Montreal, Montreal, Quebec (Canada); Haas, Rick L.M. [Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam (Netherlands); Catton, Charles N. [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Olsen, Jeffrey R. [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Deville, Curtiland [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Chen, Yen-Lin [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Finkelstein, Steven E. [Translational Research Consortium, 21st Century Oncology, Scottsdale, Arizona (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Wang, Dian [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States)

    2015-08-01

    Purpose: The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials: Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions: For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed.

  8. Retroperitoneal Sarcoma Target Volume and Organ at Risk Contour Delineation Agreement Among NRG Sarcoma Radiation Oncologists

    International Nuclear Information System (INIS)

    Baldini, Elizabeth H.; Abrams, Ross A.; Bosch, Walter; Roberge, David; Haas, Rick L.M.; Catton, Charles N.; Indelicato, Daniel J.; Olsen, Jeffrey R.; Deville, Curtiland; Chen, Yen-Lin; Finkelstein, Steven E.; DeLaney, Thomas F.; Wang, Dian

    2015-01-01

    Purpose: The purpose of this study was to evaluate the variability in target volume and organ at risk (OAR) contour delineation for retroperitoneal sarcoma (RPS) among 12 sarcoma radiation oncologists. Methods and Materials: Radiation planning computed tomography (CT) scans for 2 cases of RPS were distributed among 12 sarcoma radiation oncologists with instructions for contouring gross tumor volume (GTV), clinical target volume (CTV), high-risk CTV (HR CTV: area judged to be at high risk of resulting in positive margins after resection), and OARs: bowel bag, small bowel, colon, stomach, and duodenum. Analysis of contour agreement was performed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: Ten radiation oncologists contoured both RPS cases, 1 contoured only RPS1, and 1 contoured only RPS2 such that each case was contoured by 11 radiation oncologists. The first case (RPS 1) was a patient with a de-differentiated (DD) liposarcoma (LPS) with a predominant well-differentiated (WD) component, and the second case (RPS 2) was a patient with DD LPS made up almost entirely of a DD component. Contouring agreement for GTV and CTV contours was high. However, the agreement for HR CTVs was only moderate. For OARs, agreement for stomach, bowel bag, small bowel, and colon was high, but agreement for duodenum (distorted by tumor in one of these cases) was fair to moderate. Conclusions: For preoperative treatment of RPS, sarcoma radiation oncologists contoured GTV, CTV, and most OARs with a high level of agreement. HR CTV contours were more variable. Further clarification of this volume with the help of sarcoma surgical oncologists is necessary to reach consensus. More attention to delineation of the duodenum is also needed

  9. A Collaborative Approach To Health Promotion Targeting People With Mental Illness At Risk Of Diabetes

    DEFF Research Database (Denmark)

    Folmann Hempler, Nana; Saurbrey Pals, Regitze; Oest, Lone

    People with mental illness (users) have a notable higher risk of developing type 2 diabetes than the general population. Recent studies show that traditional lifestyle interventions focusing solely on exercise and diet targeting users have small effect. Studies suggest that collaborative approaches...

  10. [Use of tobacco smoke: approach and risk perception by middle-school students in Catania (Italy)].

    Science.gov (United States)

    Modonutti, G B; Altobello, A; Fiore, M; Garascia, C; Leon, L

    2009-01-01

    The aim of this study was to investigate the approach and behaviour of middle school students in Catania, towards the risks associated with tobacco smoke. This study is part of a multicentric project evaluating the lifestyles of middle school students (grades 6-8), carried out by the Research and Health Education Group (GRES) and was performed during the 2006/2007 school year. In total 432 students participated in the study by completing a self-administered questionnaire. Data was analysed by using the Statistical Package for the Social Sciences (SPSS). Results show an increasing trend in the number of smokers from grades 6 to 8. In grades 6 and 8 most smokers are female while in grade 7 male smokers outnumber female smokers. Three percent of the student population reports smoking occasionally and 3% are regular smokers. In light of these results families, schools and institutions should take charge of programming and implementing health promotion interventions aimed at reducing risks and improving the quality of life of students in Catania.

  11. WTS - Risk Based Resource Targeting (RBRT) -

    Data.gov (United States)

    Department of Transportation — The Risk Based Resource Targeting (RBRT) application supports a new SMS-structured process designed to focus on safety oversight of systems and processes rather than...

  12. Enhanced clinical pharmacy service targeting tools: risk-predictive algorithms.

    Science.gov (United States)

    El Hajji, Feras W D; Scullin, Claire; Scott, Michael G; McElnay, James C

    2015-04-01

    This study aimed to determine the value of using a mix of clinical pharmacy data and routine hospital admission spell data in the development of predictive algorithms. Exploration of risk factors in hospitalized patients, together with the targeting strategies devised, will enable the prioritization of clinical pharmacy services to optimize patient outcomes. Predictive algorithms were developed using a number of detailed steps using a 75% sample of integrated medicines management (IMM) patients, and validated using the remaining 25%. IMM patients receive targeted clinical pharmacy input throughout their hospital stay. The algorithms were applied to the validation sample, and predicted risk probability was generated for each patient from the coefficients. Risk threshold for the algorithms were determined by identifying the cut-off points of risk scores at which the algorithm would have the highest discriminative performance. Clinical pharmacy staffing levels were obtained from the pharmacy department staffing database. Numbers of previous emergency admissions and admission medicines together with age-adjusted co-morbidity and diuretic receipt formed a 12-month post-discharge and/or readmission risk algorithm. Age-adjusted co-morbidity proved to be the best index to predict mortality. Increased numbers of clinical pharmacy staff at ward level was correlated with a reduction in risk-adjusted mortality index (RAMI). Algorithms created were valid in predicting risk of in-hospital and post-discharge mortality and risk of hospital readmission 3, 6 and 12 months post-discharge. The provision of ward-based clinical pharmacy services is a key component to reducing RAMI and enabling the full benefits of pharmacy input to patient care to be realized. © 2014 John Wiley & Sons, Ltd.

  13. An Evaluation of Supplemental Reading Instruction for At-Risk Middle School Readers

    Science.gov (United States)

    Berkeley, Sheri; Lindstrom, Jennifer H.; Regan, Kelley; Nealy, Allison; Southall, Candice; Stagliano, Christina

    2012-01-01

    One middle school's implementation of corrective reading was evaluated for student reading outcomes and treatment fidelity. Findings indicated that sixth-, seventh-, and eighth-grade students made progress in decoding and oral reading fluency over the school year; however, students did not demonstrate greater gains during the semester enrolled in…

  14. Cardiovascular risk factors in a Mexican middle-class urban population. The Lindavista Study. Baseline data.

    Science.gov (United States)

    Meaney, Alejandra; Ceballos-Reyes, Guillermo; Gutiérrez-Salmean, Gabriela; Samaniego-Méndez, Virginia; Vela-Huerta, Agustín; Alcocer, Luis; Zárate-Chavarría, Elisa; Mendoza-Castelán, Emma; Olivares-Corichi, Ivonne; García-Sánchez, Rubén; Martínez-Marroquín, Yolanda; Ramírez-Sánchez, Israel; Meaney, Eduardo

    2013-01-01

    The aim of this communication is to describe the cardiovascular risk factors affecting a Mexican urban middle-class population. A convenience sample of 2602 middle class urban subjects composed the cohort of the Lindavista Study, a prospective study aimed to determine if conventional cardiovascular risks factors have the same prognosis impact as in other populations. For the baseline data, several measurements were done: obesity indexes, smoking, blood pressure, fasting serum glucose, total cholesterol, HDL-c, LDL-c and triglycerides. This paper presents the basal values of this population, which represents a sample of the Mexican growing urban middle-class. The mean age in the sample was 50 years; 59% were females. Around 50% of the entire group were overweighed, while around 24% were obese. 32% smoked; 32% were hypertensive with a 20% rate of controlled pressure. 6% had diabetes, and 14% had impaired fasting glucose; 66% had total cholesterol ≥ 200 mg/dL; 62% showed HDL-c levels150 mg/dL, and 34% levels of LDL-c ≥ 160 mg/dL. Half of the population studied had the metabolic syndrome. These data show a population with a high-risk profile, secondary to the agglomeration of several cardiovascular risk factors. Copyright © 2012 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  15. Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study

    DEFF Research Database (Denmark)

    Emaus, Marleen J; van Gils, Carla H; Bakker, Marije F

    2014-01-01

    .3 years. Annual weight change was categorized using quintiles taking quintile 2 and 3 as the reference category (-0.44 to 0.36 kg/year). Multivariable Cox proportional hazards regression analysis was used to examine the association. 205,723 women were included and 4,663 incident breast cancer cases were......Long-term weight gain (i.e., weight gain since age 20) has been related to higher risk of postmenopausal breast cancer, but a lower risk of premenopausal breast cancer. The effect of weight change in middle adulthood is unclear. We investigated the association between weight change in middle...... diagnosed during a median follow-up of 7.5 years (from second weight assessment onward). High weight gain (Q5: 0.83-4.98 kg/year) was related to a slightly, but significantly higher breast cancer risk (HRQ5_versus_Q2/3 : 1.09, 95% CI: 1.01-1.18). The association was more pronounced for breast cancer...

  16. Protocol for Targeted School-Based Interventions for Improving Reading and Mathematics for Students With or At-Risk of Academic Difficulties in Grade 7 to 12

    DEFF Research Database (Denmark)

    Dietrichson, Jens; Bøg, Martin; Filges, Trine

    2016-01-01

    This systematic review will examine the effects of targeted interventions to students with or at-risk of academic difficulties in grades 7 to 12 on standardized tests in reading and mathematics. We will examine interventions such as for example tutoring, cooperative learning, computer-assisted in......This systematic review will examine the effects of targeted interventions to students with or at-risk of academic difficulties in grades 7 to 12 on standardized tests in reading and mathematics. We will examine interventions such as for example tutoring, cooperative learning, computer...

  17. A new hereditary colorectal cancer network in the Middle East and eastern mediterranean countries to improve care for high-risk families.

    Science.gov (United States)

    Ghorbanoghli, Zeinab; Jabari, Carol; Sweidan, Walid; Hammoudeh, Wail; Cortas, George; Sharara, Ala I; Abedrabbo, Amal; Hourani, Ijad; Mahjoubi, Bahareh; Majidzadeh, Keivan; Tözün, Nurdan; Ziada-Bouchaar, Hadia; Hamoudi, Waseem; Diab, Osama; Khorshid, Hamid Reza Khorram; Lynch, Henry; Vasen, Hans

    2018-04-01

    Colorectal cancer (CRC) has a very high incidence in the western world. Data from registries in the Middle East showed that the incidence of CRC is relatively low in these countries. However, these data also showed that CRC incidence has increased substantially over the past three decades and that a high proportion of cases are diagnosed at an early age (Middle East was discussed and the idea was conceived to establish a network on hereditary colorectal cancer (HCCN-ME) with the goal of improving care for high-risk groups in the Middle East and (Eastern) Mediterranean Countries.

  18. Development and Validation of a Risk Score Predicting Substantial Weight Gain over 5 Years in Middle-Aged European Men and Women

    DEFF Research Database (Denmark)

    Steffen, Annika; Sørensen, Thorkild I.A.; Knüppel, Sven

    2013-01-01

    Identifying individuals at high risk of excess weight gain may help targeting prevention efforts at those at risk of various metabolic diseases associated with weight gain. Our aim was to develop a risk score to identify these individuals and validate it in an external population.......Identifying individuals at high risk of excess weight gain may help targeting prevention efforts at those at risk of various metabolic diseases associated with weight gain. Our aim was to develop a risk score to identify these individuals and validate it in an external population....

  19. Middle Man Concept for In-Orbit Collision Risks Mitigation, CAESAR and CARA Examples

    Science.gov (United States)

    Moury, Monique; Newman, Lauri K.; Laporte, Francois

    2014-01-01

    This paper describes the conjunction analysis which has to be performed using data provided by JSpOC. This description not only demonstrates that Collision Avoidance is a 2- step process (close approach detection followed by risk evaluation for collision avoidance decision) but also leads to the conclusion that there is a need for a Middle Man role. After describing the Middle Man concept, this paper introduces two examples with their similarities and particularities: the American civil space effort delivered by the NASA CARA team (Conjunction Assessment Risk Analysis) and the French response CAESAR (Conjunction Assessment and Evaluation Service: Alerts and Recommendations). For both, statistics are presented and feedbacks discussed. All together, around 80 satellites are served by CARA and/or CAESAR. Both processes regularly evolve in order either to follow JSpOC upgrades or to improve analysis according to experience acquired during the past years.

  20. Youth at risk of physical inactivity may benefit more from activity-related support than youth not at risk

    Directory of Open Access Journals (Sweden)

    Schmalz Dorothy L

    2006-03-01

    Full Text Available Background This study examines whether associations between activity-related support and adolescents' physical activity differ for adolescents at high versus low risk of physical inactivity. Methods: Participants included 202 middle-school-aged girls (N = 92 and boys (N = 110. Physical activity was assessed using three self-report questionnaires. Activity-related support from mothers, fathers, siblings, and peers was assessed using the Activity Support Scale. Perceived sport competence was assessed using the Physical Activity Self Description Questionnaire. Participants' height and weight were measured and used to calculate their age- and sex-adjusted Body Mass Index percentile. Participants were classified as being at high risk for physical inactivity if they fulfilled two of the following three criteria: (1 overweight; (2 female; or (3 having low perceived sport competence. Results: Activity-related support from all sources was associated with higher levels of physical activity among adolescents. A stronger association between activity support and physical activity was found for adolescents at high risk for physical inactivity in comparison to adolescents at low risk. Conclusions: Findings from this study suggest that the activity-related support from family and friends may be an effective tool in promoting physical activity among youth at risk of physical inactivity.

  1. Role of renal function in risk assessment of target non-attainment after standard dosing of meropenem in critically ill patients: a prospective observational study.

    Science.gov (United States)

    Ehmann, Lisa; Zoller, Michael; Minichmayr, Iris K; Scharf, Christina; Maier, Barbara; Schmitt, Maximilian V; Hartung, Niklas; Huisinga, Wilhelm; Vogeser, Michael; Frey, Lorenz; Zander, Johannes; Kloft, Charlotte

    2017-10-21

    Severe bacterial infections remain a major challenge in intensive care units because of their high prevalence and mortality. Adequate antibiotic exposure has been associated with clinical success in critically ill patients. The objective of this study was to investigate the target attainment of standard meropenem dosing in a heterogeneous critically ill population, to quantify the impact of the full renal function spectrum on meropenem exposure and target attainment, and ultimately to translate the findings into a tool for practical application. A prospective observational single-centre study was performed with critically ill patients with severe infections receiving standard dosing of meropenem. Serial blood samples were drawn over 4 study days to determine meropenem serum concentrations. Renal function was assessed by creatinine clearance according to the Cockcroft and Gault equation (CLCR CG ). Variability in meropenem serum concentrations was quantified at the middle and end of each monitored dosing interval. The attainment of two pharmacokinetic/pharmacodynamic targets (100%T >MIC , 50%T >4×MIC ) was evaluated for minimum inhibitory concentration (MIC) values of 2 mg/L and 8 mg/L and standard meropenem dosing (1000 mg, 30-minute infusion, every 8 h). Furthermore, we assessed the impact of CLCR CG on meropenem concentrations and target attainment and developed a tool for risk assessment of target non-attainment. Large inter- and intra-patient variability in meropenem concentrations was observed in the critically ill population (n = 48). Attainment of the target 100%T >MIC was merely 48.4% and 20.6%, given MIC values of 2 mg/L and 8 mg/L, respectively, and similar for the target 50%T >4×MIC . A hyperbolic relationship between CLCR CG (25-255 ml/minute) and meropenem serum concentrations at the end of the dosing interval (C 8h ) was derived. For infections with pathogens of MIC 2 mg/L, mild renal impairment up to augmented renal function was

  2. Socioeconomic inequalities in risk factors for non communicable diseases in low-income and middle-income countries: results from the World Health Survey.

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kunst, Anton; Harper, Sam; Guthold, Regina; Rekve, Dag; d'Espaignet, Edouard Tursan; Naidoo, Nirmala; Chatterji, Somnath

    2012-10-28

    Monitoring inequalities in non communicable disease risk factor prevalence can help to inform and target effective interventions. The prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking were quantified and compared across wealth and education levels in low- and middle-income country groups. This study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002-2004 World Health Survey. Data were stratified by sex and low- or middle-income country status. The main outcome measurements were risk factor prevalence rates reported by wealth quintile and five levels of educational attainment. Socioeconomic inequalities were measured using the slope index of inequality, reflecting differences in prevalence rates, and the relative index of inequality, reflecting the prevalence ratio between the two extremes of wealth or education accounting for the entire distribution. Data were adjusted for confounding factors: sex, age, marital status, area of residence, and country of residence. Smoking and low fruit and vegetable consumption were significantly higher among lower socioeconomic groups. The highest wealth-related absolute inequality was seen in smoking among men of low- income country group (slope index of inequality 23.0 percentage points; 95% confidence interval 19.6, 26.4). The slope index of inequality for low fruit and vegetable consumption across the entire distribution of education was around 8 percentage points in both sexes and both country income groups. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries (relative index of inequality: (men) 0.46, 95% confidence interval 0.33, 0.64; (women) 0.52, 95% confidence interval 0.42, 0.65). Mixed patterns were found for heavy drinking. Disaggregated analysis of the prevalence of non-communicable disease risk factors demonstrated different

  3. Alcohol Intake and Risk of Coronary Heart Disease in Younger, Middle-Aged, and Older Adults

    DEFF Research Database (Denmark)

    Hvidtfeldt, Ulla A; Tolstrup, Janne S; Jakobsen, Marianne U

    2010-01-01

    prospective studies from North America and Europe including 192 067 women and 74 919 men free of cardiovascular diseases, diabetes, and cancers at baseline, average daily alcohol intake was assessed at baseline with a food frequency or diet history questionnaire. An inverse association between alcohol......BACKGROUND: -Light to moderate alcohol consumption is associated with a reduced risk of coronary heart disease. This protective effect of alcohol, however, may be confined to middle-aged or older individuals. Coronary heart disease incidence is low in men ... of age; for this reason, study cohorts rarely have the power to investigate the effects of alcohol on coronary heart disease risk in younger adults. This study examined whether the beneficial effect of alcohol on coronary heart disease depends on age. Methods and Results-In this pooled analysis of 8...

  4. The Expected Cardiovascular Benefit of Plasma Cholesterol Lowering with or Without LDL-C Targets in Healthy Individuals at Higher Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Fernando Henpin Yue Cesena

    Full Text Available Abstract Background: There is controversy whether management of blood cholesterol should be based or not on LDL-cholesterol (LDL-c target concentrations. Objectives: To compare the estimated impact of different lipid-lowering strategies, based or not on LDL-c targets, on the risk of major cardiovascular events in a population with higher cardiovascular risk. Methods: We included consecutive individuals undergoing a routine health screening in a single center who had a 10-year risk for atherosclerotic cardiovascular disease (ASCVD ≥ 7.5% (pooled cohort equations, ACC/AHA, 2013. For each individual, we simulated two strategies based on LDL-c target (≤ 100 mg/dL [Starget-100] or ≤ 70 mg/dL [Starget-70] and two strategies based on percent LDL-c reduction (30% [S30%] or 50% [S50%]. Results: In 1,897 subjects (57 ± 7 years, 96% men, 10-year ASCVD risk 13.7 ± 7.1%, LDL-c would be lowered from 141 ± 33 mg/dL to 99 ± 23 mg/dL in S30%, 71 ± 16 mg/dL in S50%, 98 ± 9 mg/dL in Starget-100, and 70 ± 2 mg/dL in Starget-70. Ten-year ASCVD risk would be reduced to 8.8 ± 4.8% in S50% and 8.9 ± 5.2 in Starget-70. The number of major cardiovascular events prevented in 10 years per 1,000 individuals would be 32 in S30%, 31 in Starget-100, 49 in S50%, and 48 in Starget-70. Compared with Starget-70, S50% would prevent more events in the lower LDL-c tertile and fewer events in the higher LDL-c tertile. Conclusions: The more aggressive lipid-lowering approaches simulated in this study, based on LDL-c target or percent reduction, may potentially prevent approximately 50% more hard cardiovascular events in the population compared with the less intensive treatments. Baseline LDL-c determines which strategy (based or not on LDL-c target is more appropriate at the individual level.

  5. A Data-Driven Evaluation of the Stop TB Global Partnership Strategy of Targeting Key Populations at Greater Risk for Tuberculosis.

    Directory of Open Access Journals (Sweden)

    Zoë M McLaren

    Full Text Available Identifying those infected with tuberculosis (TB is an important component of any strategy for reducing TB transmission and population prevalence. The Stop TB Global Partnership recently launched an initiative with a focus on key populations at greater risk for TB infection or poor clinical outcomes, due to housing and working conditions, incarceration, low household income, malnutrition, co-morbidities, exposure to tobacco and silica dust, or barriers to accessing medical care. To achieve operational targets, the global health community needs effective, low cost, and large-scale strategies for identifying key populations. Using South Africa as a test case, we assess the feasibility and effectiveness of targeting active case finding to populations with TB risk factors identified from regularly collected sources of data. Our approach is applicable to all countries with TB testing and census data. It allows countries to tailor their outreach activities to the particular risk factors of greatest significance in their national context.We use a national database of TB test results to estimate municipality-level TB infection prevalence, and link it to Census data to measure population risk factors for TB including rates of urban households, informal settlements, household income, unemployment, and mobile phone ownership. To examine the relationship between TB prevalence and risk factors, we perform linear regression analysis and plot the set of population characteristics against TB prevalence and TB testing rate by municipality. We overlay lines of best fit and smoothed curves of best fit from locally weighted scatter plot smoothing.Higher TB prevalence is statistically significantly associated with more urban municipalities (slope coefficient β1 = 0.129, p < 0.0001, R2 = 0.133, lower mobile phone access (β1 = -0.053, p < 0.001, R2 = 0.089, lower unemployment rates (β1 = -0.020, p = 0.003, R2 = 0.048, and a lower proportion of low-income households

  6. Weighing in on risk factors for body dissatisfaction: a one-year prospective study of middle-adolescent girls.

    Science.gov (United States)

    Wojtowicz, Amy E; von Ranson, Kristin M

    2012-01-01

    Body dissatisfaction is a common problem among adolescent girls that is linked to serious outcomes, including the development of eating disorders. This study tested to what degree five theorized risk factors (weight-related teasing, thin-ideal internalization, body mass index [BMI], self-esteem, and perfectionism) predicted prospective changes in body dissatisfaction. At baseline, 393 10th and 11th grade girls (M=15.8 years) completed questionnaires and had their height and weight measured. One year later, 316 participants' body dissatisfaction was reassessed (80.4% retention). Results suggested that self-esteem was the most potent risk factor, followed by BMI, when used to categorize girls into high- and low-risk groups for body dissatisfaction at follow-up. However, weight-related teasing, thin-ideal internalization, and perfectionism did not prove to be risk factors. These results suggest self-esteem and BMI are relevant variables for helping to identify middle-adolescent girls who may be at risk for subsequent increases in body dissatisfaction. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Multimedia approach to estimating target cleanup levels for soils at hazardous waste sites

    International Nuclear Information System (INIS)

    Hwang, S.T.

    1990-04-01

    Contaminated soils at hazardous and nuclear waste sites pose a potential threat to human health via transport through environmental media and subsequent human intake. To minimize health risks, it is necessary to identify those risks and ensure that appropriate actions are taken to protect public health. The regulatory process may typically include identification of target cleanup levels and evaluation of the effectiveness of remedial alternatives and the corresponding reduction in risks at a site. The US Environmental Protection Agency (EPA) recommends that exposure assessments be combined with toxicity information to quantify the health risk posed by a specific site. This recommendation then forms the basis for establishing target cleanup levels. An exposure assessment must first identify the chemical concentration in a specific medium (soil, water, air, or food), estimate the exposure potential based on human intake from that media, and then combined with health criteria to estimate the upperbound health risks for noncarcinogens and carcinogens. Estimation of target cleanup levels involves the use of these same principles but can occur in reverse order. The procedure starts from establishing a permissible health effect level and ends with an estimated target cleanup level through an exposure assessment process. 17 refs

  8. Pathways from Childhood Abuse and Neglect to HIV-Risk Sexual Behavior in Middle Adulthood

    Science.gov (United States)

    Wilson, Helen W.; Widom, Cathy Spatz

    2011-01-01

    Objective: This study examines the relationship between childhood abuse and neglect and sexual risk behavior in middle adulthood and whether psychosocial factors (risky romantic relationships, affective symptoms, drug and alcohol use, and delinquent and criminal behavior) mediate this relationship. Method: Children with documented cases of…

  9. History Repeats Itself at Yorktown Middle.

    Science.gov (United States)

    Haskin, Teresa T.

    1999-01-01

    Describes two interdisciplinary units that can be used in most middle school classrooms, one on the sinking of the "Titanic" and one on Pickett's charge at Gettysburg during the Civil War. Describes how each unit involves English, math, social studies, and science classes and activities. (SR)

  10. Risk factors and characteristics of youth living with, or at high risk for, HIV

    NARCIS (Netherlands)

    Huba, GJ; Melchior, LA; Panter, AT; Trevithick, L; Woods, ER; Wright, E; Feudo, R; Tierney, S; Schneir, A; Tenner, A; Remafedi, G; Greenberg, B; Sturdevant, M; Goodman, E; Hodgins, A; Wallace, M; Brady, RE; Singer, B

    2000-01-01

    Over 8,000 adolescents and young adults (4,111 males; 4,085 females) reported on several HIV-related risk behaviors during enrollment into 10 service demonstration projects targeted to youth living with, or at risk for, HIV. Distinct risk patterns emerged by gender when predicting HIV serostatus

  11. Orthostatic Hypotension in Middle-Age and Risk of Falls.

    Science.gov (United States)

    Juraschek, Stephen P; Daya, Natalie; Appel, Lawrence J; Miller, Edgar R; Windham, Beverly Gwen; Pompeii, Lisa; Griswold, Michael E; Kucharska-Newton, Anna; Selvin, Elizabeth

    2017-02-01

    One-third of older adults fall each year. Orthostatic hypotension (OH) has been hypothesized as an important risk factor for falls, but findings from prior studies have been inconsistent. We conducted a prospective study of the association between baseline OH (1987-1989) and risk of falls in the Atherosclerosis Risk in Communities (ARIC) Study. Falls were ascertained during follow-up via ICD-9 hospital discharge codes or Centers for Medicare & Medicaid Services claims data. OH was defined as a drop in systolic blood pressure (SBP) ≥20mm Hg or diastolic blood pressure (DBP) ≥10mm Hg within 2 minutes of moving from the supine to standing position. Changes in SBP or DBP during OH assessments were also examined as continuous variables. During a median follow-up of 23 years, there were 2,384 falls among 12,661 participants (mean age 54 years, 55% women, 26% black). OH was associated with risk of falls even after adjustment for demographic characteristics and other risk factors (hazard ratio (HR): 1.30; 95% confidence interval (CI): 1.10, 1.54; P = 0.002). Postural change in DBP was more significantly associated with risk of falls (HR 1.09 per -5mm Hg change in DBP; 95% CI: 1.05, 1.13; P postural change in SBP (HR 1.03 per -5mm Hg change in SBP; 95% CI: 1.01, 1.05; P = 0.002). In a community-based, middle-aged population, OH, and in particular, postural change in DBP, were independent risk factors for falls over 2 decades of follow-up. Future studies are needed to examine OH thresholds associated with increased risk of falls. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. The NPT and the Middle East

    International Nuclear Information System (INIS)

    Freier, S.

    1987-01-01

    Written by an Israeli, this article looks at the nuclear proliferation risks in the Middle Eastern area. It firsts sets the Middle Eastern political scene, then discusses the Non-Proliferation Treaty as perceived in Israel. The nuclear capabilities and intentions of the Middle Eastern Countries are examined and an assessment made of the prospects for non-proliferation. The author is not optimistic as it is felt that Iraq, Iran and possibly Egypt will all want to develop a nuclear weapon capability in spite of their formal commitment to the NPT. (U.K.)

  13. [Study on the detection rate and risk factors regarding non-suicidal self-injurious behavior in middle school students].

    Science.gov (United States)

    Yan, Jing; Zhu, Cui-zhen; Situ, Ming-jing; DU, Na; Huang, Yi

    2012-01-01

    To understand the prevalence and risk factors of non-suicidal self-injury in middle school students. 1312 middle school students of Pengzhou and Santai were selected to fill in a Risky Behavior Questionnaire for Adolescence (RBQ-A), Family Environment Scale (FES), Center for Epidemiological Survey, Depression Scale (CES-D), Adolescent Self-Rating Life Events Check List (ASLEC), Social Support Scale for Adolescents (SSSA) and self-administered questionnaire. In all the research subjects, 1288 were qualified for the study in April 2011 before the risk factors for non-suicidal self-injury were identified by logistic regression. In 1288 middle school students, 22.67% had a history of non-suicidal self-injury, with 22.70% in boys and 22.64% in girls. 63.36% of students had injured themselves through variously ways, more seen in boys (26.88%) than in girls (11.36%) who cut or burnt themselves. The scores of ASLEC and CES-D in non-suicidal self-injury group appeared higher than that in the control group and the score of SSSA was found higher in the control group. The main risk factors for non-suicidal self-injuries were family conflict, depressive emotion, negative life events and receiving less social support. The prevalence of non-suicidal self-injury among middle school students in Pengzhou was high, which called for more attention.

  14. Cancer risk in different generations of Middle Eastern immigrants to California, 1988-2013.

    Science.gov (United States)

    Ziadeh, Clara; Ziogas, Argyrios; Anton-Culver, Hoda

    2017-12-01

    The objective of this study is to compare cancer risk among different generations of Middle Eastern immigrants (ME) and non-Hispanic whites (NHW) in California between 1988 and 2013. We used data from the California Cancer Registry to identify invasive primary incident cancer cases in three population groups: (i) first-generation ME immigrants, (ii) second- or subsequent-generations ME immigrants, and (iii) NHW. Proportional incidence ratio (PIR) was used to compare cancer risk of the 15 selected most common cancers in the 3 population groups taking into consideration time since immigration for first-generation ME immigrants. First generation ME immigrants were more likely to be at increased risk of stomach (PIR= 3.13) and hepatobiliary (PIR = 2.27) cancers in females and thyroid (PIR = 2.19) and stomach (PIR = 2.13) cancers in males in comparison with NHW. Second- or subsequent-generations ME immigrants were at increased risk of thyroid cancer (PIR = 1.43 in females and 2.00 in males) in comparison with NHW, and malignant melanoma cancer (PIR = 4.53 in females and 4.61 in males) in comparison with first-generation ME immigrants. The risk levels of breast, thyroid and bladder cancers in ME first generation were significantly higher compared to NHW regardless of time spent in the United States suggesting the role of genetic predisposition, and/or cultural characteristics associated with these cancers. The results suggest that differences in cancer risk between ME first-generation immigrants and NHW change in second or subsequent generations, approaching the risk level of NHW and indicating the impact of acculturation in this immigrant population. © 2017 UICC.

  15. Gender differences in risk profile and outcome of Middle Eastern patients undergoing percutaneous coronary intervention.

    Science.gov (United States)

    Jarrah, Mohamad I; Hammoudeh, Ayman J; Al-Natour, Dalal B; Khader, Yousef S; Tabbalat, Ramzi A; Alhaddad, Imad A; Kullab, Susan M

    2017-02-01

    To determine the gender differences in cardiovascular risk profile and outcomes among patients undergoing percutaneous coronary intervention (PCI). Methods: In a prospective multicenter study of consecutive Middle Eastern patients managed with PCI from January 2013 to February 2014 in 12 tertiary care centers in Amman and Irbid, Jordan. Clinical and coronary angiographic features, and major cardiovascular events were assessed for both genders from hospital stay to 1 year. Results: Women comprised 20.6% of 2426 enrolled patients, were older (mean age 62.9 years versus 57.2 years), had higher prevalence of hypertension (81% versus 57%), diabetes (66% versus 44%), dyslipidemia (58% versus 46%), and obesity (44% versus 25%) compared with men, p less than 0.001. The PCI for ST-segment elevation myocardial infarction was indicated for fewer women than men (23% versus 33%; p=0.001). Prevalence of single or multi-vessel coronary artery disease was similar in women and men. More women than men had major bleeding during hospitalization (2.2% versus 0.6%; p=0.003) and at one year (2.5% versus 0.9%; p=0.007). There were no significant differences between women and men in mortality (3.1% versus 1.7%) or stent thrombosis (2.1% versus 1.8%) at 1 year. Conclusion: Middle Eastern women undergoing PCI had worse baseline risk profile compared with men.Except for major bleeding, no gender differences in the incidence of major adverse cardiovascular events were demonstrated.

  16. Flood risk control of dams and dykes in middle reach of Huaihe River

    Directory of Open Access Journals (Sweden)

    Zhen-kun MA

    2014-01-01

    Full Text Available Three stochastic mathematical models for calculation of the reservoir flood regulation process, river course flood release, and flood risk rate under flood control were established based on the theory of stochastic differential equations and features of flood control systems in the middle reach of the Huaihe River from Xixian to the Bengbu floodgate, comprehensively considering uncertain factors of hydrology, hydraulics, and engineering control. They were used to calculate the flood risk rate with flood regulation of five key reservoirs, including the Meishan, Xianghongdian, Nianyushan, Mozitan, and Foziling reservoirs in the middle reach of the Huaihe River under different flood frequencies, the flood risk rate with river course flood release under design and check floods for the trunk of the Huaihe River in conjunction with relevant flood storage areas, and the flood risk rate with operation of the Linhuaigang Project under design and check floods. The calculated results show that (1 the five reservoirs can withstand design floods, but the Xianghongdian and Foziling reservoirs will suffer overtopping accidents under check floods; (2 considering the service of flood storage areas under the design flood conditions of the Huaihe River, the mean flood risk rate with flood regulation of dykes and dams from Xixian to the Bengbu floodgate is about 0.2, and the trunk of the Huaihe River can generally withstand design floods; and (3 under a check flood with the flood return period of 1 000 years, the risk rate of overtopping accidents of the Linhuaigang Project is not larger than 0.15, indicating that it has a high flood regulation capacity. Through regulation and application of the flood control system of the Linhuigang Project, the Huaihe River Basin can withstand large floods, and the safety of the protected area can be ensured.

  17. Ageism and sexism at work: the middle-aged women of Hong Kong.

    Science.gov (United States)

    Tang, K L

    2000-01-01

    Employment discrimination against middle-aged women has recently captured public attention in Hong Kong. One reason is the economic slowdown and increasing unemployment since the 1993-94 and the 1997-to date economic downturns. This paper looks at sex and age discrimination against middle-aged women in colonial Hong Kong where they faced such problems as low labor force participation, occupational and industrial segregation and wage differentials, which in turn left them vulnerable to unemployment and poverty. Rampant age and sex discrimination in the workplace is due to a number of factors: traditional values and cultural devaluation of women's work and need for education, economic restructuring and labor importation, a legal vacuum, inefficient retraining policy, and the weak position of women in the labor movement. The postcolonial government under Tung Chee Hwa is heavily influenced by business interests. Women in the age group of 30-39 and above are hardest hit. They are not targeted as special groups of trainees who require special assistance. Given the limited concern for gender development on the part of the new government, the prospect for women workers does not look good.

  18. Identifying Children in Middle Childhood Who Are at Risk for Reading Problems.

    Science.gov (United States)

    Speece, Deborah L; Ritchey, Kristen D; Silverman, Rebecca; Schatschneider, Christopher; Walker, Caroline Y; Andrusik, Katryna N

    2010-06-01

    The purpose of this study was to identify and evaluate a universal screening battery for reading that is appropriate for older elementary students in a response to intervention model. Multiple measures of reading and reading correlates were administered to 230 fourth-grade children. Teachers rated children's reading skills, academic competence, and attention. Children were classified as not-at-risk or at-risk readers based on a three-factor model reflecting reading comprehension, word recognition/decoding, and word fluency. Predictors of reading status included group-administered tests of reading comprehension, silent word reading fluency, and teacher ratings of reading problems. Inclusion of individually administered tests and growth estimates did not add substantial variance. The receiver-operator characteristic curve analysis yielded an area under the curve index of 0.90, suggesting this model may both accurately and efficiently screen older elementary students with reading problems.

  19. Mediating Mechanisms of Theory-Based Psychosocial Determinants on Behavioral Changes in a Middle School Obesity Risk Reduction Curriculum Intervention, Choice, Control, and Change.

    Science.gov (United States)

    Gray, Heewon Lee; Contento, Isobel R; Koch, Pamela A; Noia, Jennifer Di

    2016-10-01

    A limited number of school-based intervention studies have explored mediating mechanisms of theory-based psychosocial variables on obesity risk behavior changes. The current study investigated how theory-based psychosocial determinants mediated changes in energy balance-related behaviors (EBRBs) among urban youth. A secondary analysis study was conducted using data from a cluster randomized controlled trial. Data from students at 10 middle schools in New York City (n = 1136) were used. The intervention, Choice, Control, and Change curriculum, was based on social cognitive and self-determination theories. Theory-based psychosocial determinants (goal intention, cognitive outcome expectations, affective outcome expectations, self-efficacy, perceived barriers, and autonomous motivation) and EBRBs were measured with self-report questionnaires. Mediation mechanisms were examined using structural equation modeling, Results: Mediating mechanisms for daily sugar-sweetened beverage (SSB) consumption and purposeful stair climbing were identified. Models with best fit indices (root mean square error of approximation = 0.039/0.045, normed fit index = 0.916/0.882; comparative fit index = 0.945/0.932; Tucker-Lewis index = 0.896/0.882, respectively) suggested that goal intention and reduced perceived barriers were significant proximal mediators for reducing SSB consumption among both boys and girls or increasing physical activity by stair climbing among boys. Cognitive outcome expectations, affective outcome expectations, self-efficacy, and autonomous motivation indirectly mediated behavioral changes through goal intention or perceived barriers (p behavioral outcome variances. Theory-based psychosocial determinants targeted in Choice, Control, and Change in fact mediated behavior changes in middle school students. Strategies targeting these mediators might benefit future success of behavioral interventions. Further studies are needed to determine other

  20. Calculation for laser-produced plasmas conditions of thin middle-Z targets: Pt.I

    International Nuclear Information System (INIS)

    Peng Huimin; Zhang Guoping; Sheng Jiatian; Shao Yunfeng; Zhang Yinchun

    1988-01-01

    An one-dimentional non-LTE laser irradiated code was used to simulate the laser-produced plasmas conditions of thin middle Z targets with high intensities (about 10 13 W/cm 2 ) irradiation. Following physical processes are considered: bremsstrahlung, radiative ionization, collisional ionization by electrons and their inverse processes, Compton scattering. Fokker-Planck approximtaion is used in Compton scattering; the thermal flux limits are taken for electrons and ions in the calculating, and the multigroup flux-limited diffusion approximation is taken for the radiative transport equations. The average-atom model is used to calculate the population probabilities of atoms. Laser absorption via inverse bremsstrahlung is considered to be the most important in the simulation. Using laser beams with intensities 5 x 10 13 W/cm 2 and 1 x 10 14 W/cm 2 , λ L = 0.53 μm, τ = 450 ps to irradiate thin Se target from single-side and double-sides separately, the computational results for laser-produced plasmas conditions are well agree with experimental results

  1. Management of Noncommunicable Disease in Low- and Middle-Income Countries

    Science.gov (United States)

    Checkley, William; Ghannem, Hassen; Irazola, Vilma; Kimaiyo, Sylvester; Levitt, Naomi S.; Miranda, J. Jaime; Niessen, Louis; Prabhakaran, Dorairaj; Rabadán-Diehl, Cristina; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Sigamani, Alben; Smith, Richard; Tandon, Nikhil; Wu, Yangfeng; Xavier, Denis; Yan, Lijing L.

    2014-01-01

    Noncommunicable disease (NCD), comprising cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing in incidence rapidly in low- and middle-income countries (LMICs). Some patients have access to the same treatments available in high-income countries, but most do not, and different strategies are needed. Most research on noncommunicable diseases has been conducted in high-income countries, but the need for research in LMICs has been recognized. LMICs can learn from high-income countries, but they need to devise their own systems that emphasize primary care, the use of community health workers, and sometimes the use of mobile technology. The World Health Organization has identified “best buys” it advocates as interventions in LMICs. Non-laboratory-based risk scores can be used to identify those at high risk. Targeting interventions to those at high risk for developing diabetes has been shown to work in LMICs. Indoor cooking with biomass fuels is an important cause of chronic obstructive pulmonary disease in LMICs, and improved cookstoves with chimneys may be effective in the prevention of chronic diseases. PMID:25592798

  2. Vaccine supply chains need to be better funded and strengthened, or lives will be at risk.

    Science.gov (United States)

    Kaufmann, Judith R; Miller, Roger; Cheyne, James

    2011-06-01

    In the next decade, at least twelve additional vaccines that target such diseases as typhoid, malaria, and dengue will become available to lower- and middle-income countries. These vaccines must travel along what are called supply chains, which include all personnel, systems, equipment, and activities involved in ensuring that vaccines are effectively delivered from the point of production to the people who need them. But for various reasons, supply chains are already strained in many developing countries, and the potential inability to distribute new vaccines will place lives at risk. Among the many steps needed to strengthen the global vaccine supply chain, we suggest that the international community pursue improved coordination between organizations that donate and ship vaccines and the host-country officials who receive and distribute the vaccines, as well as better training for supply-chain managers.

  3. Pneumococcal vaccine targeting strategy for older adults: customized risk profiling.

    Science.gov (United States)

    Balicer, Ran D; Cohen, Chandra J; Leibowitz, Morton; Feldman, Becca S; Brufman, Ilan; Roberts, Craig; Hoshen, Moshe

    2014-02-12

    Current pneumococcal vaccine campaigns take a broad, primarily age-based approach to immunization targeting, overlooking many clinical and administrative considerations necessary in disease prevention and resource planning for specific patient populations. We aim to demonstrate the utility of a population-specific predictive model for hospital-treated pneumonia to direct effective vaccine targeting. Data was extracted for 1,053,435 members of an Israeli HMO, age 50 and older, during the study period 2008-2010. We developed and validated a logistic regression model to predict hospital-treated pneumonia using training and test samples, including a set of standard and population-specific risk factors. The model's predictive value was tested for prospectively identifying cases of pneumonia and invasive pneumococcal disease (IPD), and was compared to the existing international paradigm for patient immunization targeting. In a multivariate regression, age, co-morbidity burden and previous pneumonia events were most strongly positively associated with hospital-treated pneumonia. The model predicting hospital-treated pneumonia yielded a c-statistic of 0.80. Utilizing the predictive model, the top 17% highest-risk within the study validation population were targeted to detect 54% of those members who were subsequently treated for hospitalized pneumonia in the follow up period. The high-risk population identified through this model included 46% of the follow-up year's IPD cases, and 27% of community-treated pneumonia cases. These outcomes were compared with international guidelines for risk for pneumococcal diseases that accurately identified only 35% of hospitalized pneumonia, 41% of IPD cases and 21% of community-treated pneumonia. We demonstrate that a customized model for vaccine targeting performs better than international guidelines, and therefore, risk modeling may allow for more precise vaccine targeting and resource allocation than current national and international

  4. Cross-gender Social Normative Effects for Violence in Middle School: Do Girls Carry a Social Multiplier Effect for At-risk Boys?

    Science.gov (United States)

    Pasch, Keryn E.; Brown, H. Shelton; Perry, Cheryl L.; Komro, Kelli A.

    2014-01-01

    A social multiplier effect is a social interaction in which the behavior of a person in a social network varies with the normative behavior of others in the network, also known as an endogenous interaction. Policies and intervention efforts can harness social multiplier effects because, in theory, interventions on a subset of individuals will have “spillover effects” on other individuals in the network. This study investigates potential social multiplier effects for violence in middle schools, and whether there is evidence for a social multiplier effect transmitted from girls to boys. Three years of longitudinal data (2003–2005) from Project Northland Chicago (PNC) were used to investigate this question, with a sample consisting of youth in Grades 6 through 8 in 61 Chicago Public Schools (N = 4233 at Grade 6, N = 3771 at Grade 7, and N = 3793 at Grade 8). The sample was 49.3% female, and primarily African American (41.9%) and Latino/a (28.7%), with smaller proportions of whites (12.9%), Asians (5.2%) and other ethnicities. Results from two sets of regression models estimating the effects of 20th (low), 50th (average), and 80th (high) percentile scores for girls and boys on levels of violence in each gender group revealed evidence for social multiplier effects. Specifically, boys and girls were both influenced by social multiplier effects within their own gender group, and boys were also affected by normative violence scores among girls, typically those of the best-behaved (20th percentile) girls. The finding that girls may have positive social influence on boys’ levels of violent behavior extends prior findings of beneficial social effects of girls on boys in the domains of education and risky driving. Further, this social normative effect presents a potential opportunity to improve school-based intervention efforts for reducing violence among youth by leveraging girls as carriers of a social multiplier effect for reduced violence in the middle school

  5. Cross-gender social normative effects for violence in middle school: do girls carry a social multiplier effect for at-risk boys?

    Science.gov (United States)

    Yarnell, Lisa M; Pasch, Keryn E; Brown, H Shelton; Perry, Cheryl L; Komro, Kelli A

    2014-09-01

    A social multiplier effect is a social interaction in which the behavior of a person in a social network varies with the normative behavior of others in the network, also known as an endogenous interaction. Policies and intervention efforts can harness social multiplier effects because, in theory, interventions on a subset of individuals will have "spillover effects" on other individuals in the network. This study investigates potential social multiplier effects for violence in middle schools, and whether there is evidence for a social multiplier effect transmitted from girls to boys. Three years of longitudinal data (2003-2005) from Project Northland Chicago were used to investigate this question, with a sample consisting of youth in Grades 6 through 8 in 61 Chicago Public Schools (N = 4,233 at Grade 6, N = 3,771 at Grade 7, and N = 3,793 at Grade 8). The sample was 49.3% female, and primarily African American (41.9%) and Latino/a (28.7%), with smaller proportions of whites (12.9%), Asians (5.2%) and other ethnicities. Results from two sets of regression models estimating the effects of 20th (low), 50th (average), and 80th (high) percentile scores for girls and boys on levels of violence in each gender group revealed evidence for social multiplier effects. Specifically, boys and girls were both influenced by social multiplier effects within their own gender group, and boys were also affected by normative violence scores among girls, typically those of the best-behaved (20th percentile) girls. The finding that girls may have positive social influence on boys' levels of violent behavior extends prior findings of beneficial social effects of girls on boys in the domains of education and risky driving. Further, this social normative effect presents a potential opportunity to improve school-based intervention efforts for reducing violence among youth by leveraging girls as carriers of a social multiplier effect for reduced violence in the middle school environmental

  6. IQ in late adolescence/early adulthood, risk factors in middle age, and later cancer mortality in men: the Vietnam Experience Study

    DEFF Research Database (Denmark)

    Batty, G David; Mortensen, Laust Hvas; Gale, Catharine R

    2009-01-01

    (i) examine the relation, if any, of pre-morbid IQ scores at 20 years of age with the risk of later cancer mortality; and (ii) explore the role, if any, of potential mediating factors (e.g. smoking, obesity), assessed in middle age, in explaining the IQ-cancer relation....

  7. Assessment of Total Risk on Non-Target Organisms in Fungicide Application for Agricultural Sustainability

    Directory of Open Access Journals (Sweden)

    Ali Musa Bozdogan

    2014-02-01

    Full Text Available In Turkey, in 2010, the amount of pesticide (active ingredient; a.i. used in agriculture was about 23,000 metric tons, of which approximately 32% was fungicides. In 2012, 14 a.i. were used for fungus control in wheat cultivation areas in Adana province, Turkey. These a.i. were: azoxystrobin, carbendazim, difenoconazole, epoxiconazole, fluquinconazole, prochloraz, propiconazole, prothioconazole, pyraclostrobin, spiroxamine, tebuconazole, thiophanate-methyl, triadimenol, and trifloxystrobin. In this study, the potential risk of a.i. on non-target organisms in fungicide application of wheat cultivation was assessed by The Pesticide Occupational and Environmental Risk (POCER indicators. In this study, the highest human health risk was for fluquinconazole (Exceedence Factor (EF 1.798 for human health, whereas the fungicide with the highest environmental risk was propiconazole (EF 2.000 for the environment. For non-target organisms, the highest potential risk was determined for propiconazole when applied at 0.1250 kg a.i. ha-1 (EF 2.897. The lowest total risk was for azoxystrobin when applied at  0.0650 kg a.i. ha-1 (EF 0.625.

  8. Education on radiation risk in primary and middle schools in Japan

    International Nuclear Information System (INIS)

    Tada, Junichiro

    1999-01-01

    The (ionizing) radiation appears in the text of social studies in primary and middle school curriculums. The radiation is almost not involved in the text of science. Consequently, pupils know only the examples of disasters caused by the excessive radiation and have no chance to learn real natures and characters of the radiation after the compulsory education course. This situation means difficulties to give a lesson on the radiation risk. Erupting volcanoes, earthquakes and lightning are similar in danger of the excessive radiations. However, few pupils have a supernatural threat for these phenomena that ancient people do, because they have the adequate knowledge for theses after primary and middle school curriculums. This situation is a full of contrast to the case of the radiation on the major sensitivity that they have. The point is to let pupils learn that the radiation is one of the natural phenomena like heat and electricity, those exist before a birth of human being. Natural ionizing radiation sources are recommended for the first teaching material. Pupils know that the radiation is one of commonplace events, then. Radiation is one of the universe elements. Consequently, they will know that human being is evolving with the radiation exposures. The general perception on safety and danger is a kind of antinomy in Japan. A person who is following antinomy accepts only zero risk. Preschool educations will be needed to grow out of an antinomy concept on safety and danger, and to recognize the reality. A comprehensive knowledge should be provided with a full balance for the perception of risk. For an example, prejudices against HIV patients still remain in Japan, due to many belated campaigns on weak infection. People remember danger, and they do not remember the fact that is not dangerous. (Y. Tanaka)

  9. Education on radiation risk in primary and middle schools in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Tada, Junichiro [Japan Synchrotron Radiation Research Institute (SPring-8), Mikaduki, Hyogo (Japan)

    1999-09-01

    The (ionizing) radiation appears in the text of social studies in primary and middle school curriculums. The radiation is almost not involved in the text of science. Consequently, pupils know only the examples of disasters caused by the excessive radiation and have no chance to learn real natures and characters of the radiation after the compulsory education course. This situation means difficulties to give a lesson on the radiation risk. Erupting volcanoes, earthquakes and lightning are similar in danger of the excessive radiations. However, few pupils have a supernatural threat for these phenomena that ancient people do, because they have the adequate knowledge for theses after primary and middle school curriculums. This situation is a full of contrast to the case of the radiation on the major sensitivity that they have. The point is to let pupils learn that the radiation is one of the natural phenomena like heat and electricity, those exist before a birth of human being. Natural ionizing radiation sources are recommended for the first teaching material. Pupils know that the radiation is one of commonplace events, then. Radiation is one of the universe elements. Consequently, they will know that human being is evolving with the radiation exposures. The general perception on safety and danger is a kind of antinomy in Japan. A person who is following antinomy accepts only zero risk. Preschool educations will be needed to grow out of an antinomy concept on safety and danger, and to recognize the reality. A comprehensive knowledge should be provided with a full balance for the perception of risk. For an example, prejudices against HIV patients still remain in Japan, due to many belated campaigns on weak infection. People remember danger, and they do not remember the fact that is not dangerous. (Y. Tanaka)

  10. Stability and change in autism spectrum disorder diagnosis from age 3 to middle childhood in a high-risk sibling cohort.

    Science.gov (United States)

    Brian, Jessica; Bryson, Susan E; Smith, Isabel M; Roberts, Wendy; Roncadin, Caroline; Szatmari, Peter; Zwaigenbaum, Lonnie

    2016-10-01

    Considerable evidence on autism spectrum disorder emergence comes from longitudinal high-risk samples (i.e. younger siblings of children with autism spectrum disorder). Diagnostic stability to age 3 is very good when diagnosed as early as 18-24 months, but sensitivity is weaker, and relatively little is known beyond toddlerhood. We examined stability and change in blinded, clinical best-estimate diagnosis from age 3 to middle childhood (mean age = 9.5 years) in 67 high-risk siblings enrolled in infancy. Good agreement emerged for clinical best-estimate diagnoses (89.6% overall; kappa = 0.76, p autism spectrum disorder": 17 retained their autism spectrum disorder diagnosis (94.4%; 13 boys, 4 girls) and 1 no longer met autism spectrum disorder criteria at follow-up. Among "non-autism spectrum disorder" cases at age 3, 43/49 remained non-autism spectrum disorder at follow-up (87.8%; 22 boys, 21 girls) and 6/49 met lower autism symptomatology criteria ("Later-Diagnosed"; 3 boys, 3 girls). Later-diagnosed cases had significantly lower autism spectrum disorder symptomatology and higher receptive language at age 3 and trends toward lower autism symptoms and higher cognitive abilities at follow-up. Emerging developmental concerns were noted in all later-diagnosed cases, by age 3 or 5. High-risk children need to be followed up into middle childhood, particularly when showing differences in autism-related domains. © The Author(s) 2015.

  11. Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study

    OpenAIRE

    Coutinho, Evandro SF; Fletcher, Astrid; Bloch, Katia V; Rodrigues, Laura C

    2008-01-01

    Abstract Background Fracture after falling has been identified as an important problem in public health. Most studies of risk factors for fractures due to falls have been carried out in developed countries, although the size of the elderly population is increasing fast in middle income countries. The objective of this paper is to identify risk factors for fall related to severe fractures in those aged 60 or more in a middle-income country. Methods A case-control study was carried out in Rio d...

  12. Sweet Preference Associated with the Risk of Hypercholesterolemia Among Middle-Aged Women in Korea.

    Science.gov (United States)

    Shin, Yoonjin; Lee, Soojin; Kim, Yangha

    2018-04-05

    Sweet preference has been reported to be associated with various health problems. This study examined the influence of sweet taste preference on the risk of dyslipidemia in Korean middle-aged women. The study selected 3,609 middle-aged women from the Korean Genome and Epidemiology Study (KoGES) and classified them into two groups on the basis of whether or not they preferred sweet taste. Dietary intake was analyzed using a semiquantitative food frequency questionnaire. Serum lipid profiles and anthropometric variables were measured. Subjects who preferred the sweet taste had significantly higher intakes of sugar products and sweet drink than those who did not prefer the sweet taste. Subjects who preferred the sweet taste showed higher carbohydrate and fat intake and less fiber intake than those who did not prefer the sweet taste. The serum concentrations of total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly higher in subjects who preferred the sweet taste than those who did not prefer. Furthermore, subjects who preferred the sweet taste showed a significantly higher odds ratio (OR) for hypercholesterolemia (OR 1.22; 95% CI (1.01-1.45)) and hyper-LDL cholesterolemia (OR 1.33; 95% CI (1.11-1.60)) than those who did not prefer the sweet taste. Our results suggested that preference for sweet taste may increase the consumption of sugar products and sweet drinks, which is partially linked to the risk of hypercholesterolemia and hyper-LDL cholesterolemia in Korean middle-aged women.

  13. The Effects of a Rational-Emotive Affective Education Program for High-Risk Middle School Students.

    Science.gov (United States)

    LaConte, Michael A.; And Others

    1993-01-01

    Investigated effects of participation in developmentally appropriate affective education program. Middle school students (n=23), identified as high risk for dropping out and also as learning disabled or emotionally disturbed, were assigned to experimental and control conditions. Participants in affective education group met for 15 weeks.…

  14. Direct behavior rating as a school-based behavior screener for elementary and middle grades.

    Science.gov (United States)

    Chafouleas, Sandra M; Kilgus, Stephen P; Jaffery, Rose; Riley-Tillman, T Chris; Welsh, Megan; Christ, Theodore J

    2013-06-01

    The purpose of this study was to investigate how Direct Behavior Rating Single Item Scales (DBR-SIS) involving targets of academically engaged, disruptive, and respectful behaviors function in school-based screening assessment. Participants included 831 students in kindergarten through eighth grades who attended schools in the northeastern United States. Teachers provided behavior ratings for a sample of students in their classrooms on the DBR-SIS, the Behavioral and Emotional Screening System (Kamphaus & Reynolds, 2007), and the Student Risk Screening Scale (Drummond, 1994). Given variations in rating procedures to accommodate scheduling differences across grades, analysis was conducted separately for elementary school and middle school grade levels. Results suggested that the recommended cut scores, the combination of behavior targets, and the resulting conditional probability indices varied depending on grade level grouping (lower elementary, upper elementary, middle). For example, for the lower elementary grade level grouping, a combination of disruptive behavior (cut score=2) and academically engaged behavior (cut score=8) was considered to offer the best balance among indices of diagnostic accuracy, whereas a cut score of 1 for disruptive behavior and 8 for academically engaged behavior were recommended for the upper elementary school grade level grouping and cut scores of 1 and 9, respectively, were suggested for middle school grade level grouping. Generally, DBR-SIS cut scores considered optimal for screening using single or combined targets including academically engaged behavior and disruptive behavior by offering a reasonable balance of indices for sensitivity (.51-.90), specificity (.47-.83), negative predictive power (.94-.98), and positive predictive power (.14-.41). The single target of respectful behavior performed poorly across all grade level groups, and performance of DBR-SIS targets was relatively better in the elementary school than middle

  15. Inequalities in the prevalence of diabetes mellitus and its risk factors in Sri Lanka: a lower middle income country.

    Science.gov (United States)

    De Silva, Ambepitiyawaduge Pubudu; De Silva, Sudirikku Hennadige Padmal; Haniffa, Rashan; Liyanage, Isurujith Kongala; Jayasinghe, Saroj; Katulanda, Prasad; Wijeratne, Chandrika Neelakanthi; Wijeratne, Sumedha; Rajapaksa, Lalini Chandika

    2018-04-17

    Explorations into quantifying the inequalities for diabetes mellitus (DM) and its risk factors are scarce in low and lower middle income countries (LICs/LMICs). The aims of this study were to assess the inequalities of DM and its risk factors in a suburban district of Sri Lanka. A sample of 1300 participants, (aged 35-64 years) randomly selected using a stratified multi-stage cluster sampling method, were studied employing a cross sectional descriptive design. The socioeconomic indicators (SEIs) of the individual were education level and occupational category, and at the household level, the household income, social status level and area deprivation level. DM was diagnosed if the fasting plasma glucose was ≥126 and a body mass index (BMI) of > 27.5 kg/m 2 was considered high. Asian cut-off values were used for high waist circumference (WC). Validated tools were used to assess the diet and level of physical activity. The slope index of inequality (SII), relative index of inequality (RII) and concentration index (CI) were used to assess inequalities. The prevalence of DM and its risk factors (at individual or household level) showed no consistent relationship with the three measures of inequality (SII, RII and CI) of the different indices of socio economic status (education, occupation, household income, social status index or area unsatisfactory basic needs index). The prevalence of diabetes showed a more consistent pro-rich distribution in females compared to males. Of the risk factors in males and females, the most consistent and significant pro-rich relationship was for high BMI and WC. In males, the significant positive relationship with high BMI for SII ranged from 0.18 to 0.35, and RII from 1.56 to 2.25. For high WC, the values were: SII from 0.13 to 0.27 and RII from 1.9 to 3.97. In females the significant positive relationship with high BMI in SII ranged from 0.13 to 0.29, and RII from 2.3 to 4.98. For high WC the values were: SII from 028 to 0.4 and

  16. The burden of mortality of obesity at middle and old age is small: a life table analysis of the US Health and Retirement Survey

    NARCIS (Netherlands)

    Reuser, M.; Bonneux, L.G.A.; Willekens, F.J.C.

    2008-01-01

    The evidence of effect of overweight and obesity on mortality at middle and old age is conflicting. The increased relative risk of cardiovascular disease and diabetes for overweight and obese individuals compared to normal weight is well documented, but the absolute risk of cardiovascular death has

  17. The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey

    NARCIS (Netherlands)

    Reuser, Mieke; Bonneux, Luc; Willekens, Frans

    The evidence of effect of overweight and obesity on mortality at middle and old age is conflicting. The increased relative risk of cardiovascular disease and diabetes for overweight and obese individuals compared to normal weight is well documented, but the absolute risk of cardiovascular death has

  18. Targeting LDL Cholesterol: Beyond Absolute Goals Toward Personalized Risk.

    Science.gov (United States)

    Leibowitz, Morton; Cohen-Stavi, Chandra; Basu, Sanjay; Balicer, Ran D

    2017-06-01

    The aim of this study was to review and assess the evidence for low-density lipoprotein cholesterol (LDL-C) treatment goals as presented in current guidelines for primary and secondary prevention of cardiovascular disease. Different sets of guidelines and clinical studies for secondary prevention have centered on lower absolute LDL-C targets [achieve greater reductions in cardiovascular risk. Population-based risk models serve as the basis for statin initiation in primary prevention. Reviews of current population risk models for primary prevention show moderate ability to discriminate [with c-statistics ranging from 0.67 to 0.77 (95% CIs from 0.62 to 0.83) for men and women] with poor calibration and overestimation of risk. Individual clinical trial data are not compelling to support specific LDL-C targets and percent reductions in secondary prevention. Increasing utilization of electronic health records and data analytics will enable the development of individualized treatment goals in both primary and secondary prevention.

  19. 'A low risk is still a risk': exploring women's attitudes towards genetic testing for breast cancer susceptibility in order to target disease prevention

    NARCIS (Netherlands)

    Henneman, L.; Timmermans, D. R.; Bouwman, C. M.; Cornel, M. C.; Meijers-Heijboer, H.

    2011-01-01

    Population breast cancer screening programs by mammography are offered to women based on age. It has been suggested that a screening program based on genetic risk profile could be more effective by targeting interventions at those at higher genetic risk. This study explores women's attitudes towards

  20. Targeting strategies of mHealth interventions for maternal health in low and middle-income countries: a systematic review protocol.

    Science.gov (United States)

    Ilozumba, Onaedo; Abejirinde, Ibukun-Oluwa Omolade; Dieleman, Marjolein; Bardají, Azucena; Broerse, Jacqueline E W; Van Belle, Sara

    2018-02-24

    Recently, there has been a steady increase in mobile health (mHealth) interventions aimed at improving maternal health of women in low-income and middle-income countries. While there is evidence indicating that these interventions contribute to improvements in maternal health outcomes, other studies indicate inconclusive results. This uncertainty has raised additional questions, one of which pertains to the role of targeting strategies in implementing mHealth interventions and the focus on pregnant women and health workers as target groups. This review aims to assess who is targeted in different mHealth interventions and the importance of targeting strategies in maternal mHealth interventions. We will search for peer-reviewed, English-language literature published between 1999 and July 2017 in PubMed, Web of Knowledge (Science Direct, EMBASE) and Cochrane Central Registers of Controlled Trials. The study scope is defined by the Population, Intervention, Comparison and Outcomes framework: P, community members with maternal or reproductive needs; I, electronic health or mHealth programmes geared at improving maternal or reproductive health; C, other non-electronic health or mHealth-based interventions; O, maternal health measures including family planning, antenatal care attendance, health facility delivery and postnatal care attendance. This study is a review of already published or publicly available data and needs no ethical approval. Review results will be published in a peer-reviewed journal and presented at international conferences. CRD42017072280. © 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.

  1. A Research on the Middle East Market within the Context of Turkey

    Directory of Open Access Journals (Sweden)

    Yaşar Sarı

    2015-03-01

    Full Text Available In this study, it is aimed to reveal Middle Eastern tourists' place among the target market of local tourism establishments at Ayder tourism center in the province of Rize and local tourism establishments’ perceptions of Middle Eastern tourists based on the growth in the number of tourists from the Middle East. The study also aims to find out whether there is sufficient diversity of products and services for the target market and how local tourism establishments segment the market. As a method of data collection, semi-structured interviews were used. 16 different types of hospitality businesses representatives and 3 restaurants / fast food representatives located in the researegion have been interviewed. Deductive thematic analysis technique was usedin the analysis of data. In this regard, tourism establishments interviewed could group the tourists based on 13 market segmentation variables except gender. Different answers were received regarding the target market of tourism establishments and none of the tourism operators mentioned Middle Eastern tourists as the target market. Finally, it was found out that the vast majority of tourism establishments have been applying undifferentiated marketing strategy

  2. Religiosity and Health Risk Behaviour Among University Students in 26 Low, Middle and High Income Countries.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa; Amuleru-Marshall, Omowale; Mufune, Pempelani; Zeid, Alaa Abou

    2016-12-01

    The aim of this study was to assess religiosity and health risk behaviours among university students from 26 low, middle and high income countries. Using anonymous questionnaires, data were collected from 20,222 undergraduate university students (mean age 20.8, SD = 2. 8) from 27 universities in 26 countries across Asia, Africa and the Americas. Among all students, 41.1 % engaged at least once a week in organized religious activity, 35.8 % practised a non-organized religious activity daily or more than once daily, and more or less two-thirds of the students agreed to the three different statements on intrinsic of subjective religiosity. In multivariate logistic regression analysis, higher reported involvement in organized religious activity was associated with addictive, injury, sexual and oral health risk behaviour, while lower reported involvement in organized religious activity was associated with physical inactivity and oral health risk behaviour. Lower reported involvement in non-organized religious activity was associated with addictive, nutrition risk, injury, sexual and oral health risk behaviour, while higher reported involvement in non-organized religious activity was associated with physical inactivity. Finally, lower reported intrinsic religiosity was associated with addictive and sexual risk behaviour, while higher reported intrinsic religiosity was associated with nutrition risk behaviour, physical inactivity and oral health risk behaviour.

  3. Effectiveness of exercise intervention and health promotion on cardiovascular risk factors in middle-aged men: a protocol of a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Although cardiovascular disease has decreased, there is still potential for prevention as obesity and diabetes increase. Exercise has a positive effect on many cardiovascular risk factors, and it can significantly reduce the components of metabolic syndrome. The main challenge with exercise in primary care is how to succeed in motivating the patients at risk to change and increase their exercise habits. The objective of this study is to modify the cardiovascular risk in middle-aged men, either through a health promotion intervention alone or combined with an exercise intervention. Methods/design During a two-year period we recruit 300 men aged from 35 to 45 years with elevated cardiovascular risk (> two traditional risk factors). The men are randomized into three arms: 1) a health promotion intervention alone, 2) both health promotion and exercise intervention, or 3) control with usual community care and delayed health promotion (these men receive the intervention after one year). The main outcome measures will be the existence of metabolic syndrome and physical activity frequency (times per week). The participants are assessed at baseline, and at 3, 6, and 12 months. The follow-up of the study will last 12 months. Discussion This pragmatic trial in primary health care aimed to assess the effect of a health promotion programme with or without exercise intervention on cardiovascular risk and physical activity in middle-aged men. The results of this study may help to plan the primary care interventions to further reduce cardiovascular mortality. The study was registered at the Controlled Trials ( http://www.controlled-trials.com). Trial number: ISRCTN80672011. The study received ethics approval from the Coordinating Ethics Committee at Helsinki University Hospital on 8 June 2009 (ref: 4/13/03/00/09). PMID:23398957

  4. Risk as a target of safety research

    International Nuclear Information System (INIS)

    Krueger, W.

    1986-01-01

    Job creation is not the idea behind the demand for risk studies to be intensified in safety research. Risks are not only a target safety research should investigate, they are a subject that actually can be most adequately investigated by safety research. Assuming a neutral position between irrational fears and interest-minded problem minimization, that is the central approach and the ethics of a safety scientist. The Babylonian confusion of terminology experienced after the Chernobyl accident is a good example proving the necessity of fostering the neutral professionalism in safety research. (orig./DG) [de

  5. Neuroanatomical Predictors of Functional Outcome in Individuals at Ultra-High Risk for Psychosis.

    Science.gov (United States)

    Reniers, Renate L E P; Lin, Ashleigh; Yung, Alison R; Koutsouleris, Nikolaos; Nelson, Barnaby; Cropley, Vanessa L; Velakoulis, Dennis; McGorry, Patrick D; Pantelis, Christos; Wood, Stephen J

    2017-03-01

    Most individuals at ultra-high risk (UHR) for psychosis do not transition to frank illness. Nevertheless, many have poor clinical outcomes and impaired psychosocial functioning. This study used voxel-based morphometry to investigate if baseline grey and white matter brain densities at identification as UHR were associated with functional outcome at medium- to long-term follow-up. Participants were help-seeking UHR individuals (n = 109, 54M:55F) who underwent magnetic resonance imaging at baseline; functional outcome was assessed an average of 9.2 years later. Primary analysis showed that lower baseline grey matter density, but not white matter density, in bilateral frontal and limbic areas, and left cerebellar declive were associated with poorer functional outcome (Social and Occupational Functioning Assessment Scale [SOFAS]). These findings were independent of transition to psychosis or persistence of the at-risk mental state. Similar regions were significantly associated with lower self-reported levels of social functioning and increased negative symptoms at follow-up. Exploratory analyses showed that lower baseline grey matter densities in middle and inferior frontal gyri were significantly associated with decline in Global Assessment of Functioning (GAF) score over follow-up. There was no association between baseline grey matter density and IQ or positive symptoms at follow-up. The current findings provide novel evidence that those with the poorest functional outcomes have the lowest grey matter densities at identification as UHR, regardless of transition status or persistence of the at-risk mental state. Replication and validation of these findings may allow for early identification of poor functional outcome and targeted interventions. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  6. Alternative Education Programmes and Middle School Dropout in Honduras

    Science.gov (United States)

    Marshall, Jeffery H.; Aguilar, Claudia R.; Alas, Mario; Castellanos, Renán Rápalo; Castro, Levi; Enamorado, Ramón; Fonseca, Esther

    2014-01-01

    Honduras has made steady progress in expanding post-primary school coverage in recent years, but many rural communities still do not provide a middle (lower secondary) school. As a result, Honduras has implemented a number of middle school alternative programmes designed to meet the needs of at-risk populations throughout the country. This article…

  7. Fatherhood and Men’s Lives at Middle Age

    Science.gov (United States)

    Eggebeen, David J.; Dew, Jeffrey; Knoester, Chris

    2014-01-01

    This paper uses data on 2,024 men who were followed through the third wave of the National Survey of Families and Households to examine the implications of fatherhood experiences for men’s involvement in altruistic social activities at middle age. We find that middle-aged men (ages 45–65) who at some point in their lives become fathers are significantly more likely to have altruistically oriented social relationships and be involved in service organizations compared to men who have never become fathers. Furthermore, it appears that the defining aspect of the effect of fatherhood is the level of engagement with children while they are growing up. Neither current residential status nor whether current non-residence occurs because of nest leaving is found to distinguish men’s altruistic ties. PMID:25620831

  8. A Promise Unfulfilled: Social Skills Training with At-Risk and Antisocial Children and Youth.

    Science.gov (United States)

    Bullis, Michael; Walker, Hill M.; Sprague, Jeffrey R.

    2001-01-01

    This article reviews the social skills training knowledge base and describes social skills training considerations for children who are at-risk and/or display antisocial behavior at three grade levels: preschool and elementary, middle schools, and high school. Characteristics of students, composition of model social skills interventions, and…

  9. Does Head Start differentially benefit children with risks targeted by the program's service model?

    Science.gov (United States)

    Miller, Elizabeth B; Farkas, George; Duncan, Greg J

    Data from the Head Start Impact Study ( N = 3540) were used to test for differential benefits of Head Start after one program year and after kindergarten on pre-academic and behavior outcomes for children at risk in the domains targeted by the program's comprehensive services. Although random assignment to Head Start produced positive treatment main effects on children's pre-academic skills and behavior problems, residualized growth models showed that random assignment to Head Start did not differentially benefit the pre-academic skills of children with risk factors targeted by the Head Start service model. The models showed detrimental impacts of Head Start for maternal-reported behavior problems of high-risk children, but slightly more positive impacts for teacher-reported behavior. Policy implications for Head Start are discussed.

  10. Protocol for Targeted School-Based Interventions for Improving Reading and Mathematics for Students With or At-Risk of Academic Difficulties in Grade K to 6

    DEFF Research Database (Denmark)

    Dietrichson, Jens; Bøg, Martin; Eiberg, Misja

    2016-01-01

    This systematic review will examine the effects of targeted interventions to students with or at-risk of academic difficulties in Kindergarten to grade 6 on standardized tests in reading and mathematics. We will examine interventions such as for example tutoring, cooperative learning, computer...

  11. Risk factors that affect reproductive target achievement in fertile dairy cows.

    Science.gov (United States)

    Aungier, S P M; Roche, J F; Diskin, M G; Crowe, M A

    2014-01-01

    The aims of the present study were to investigate (1) the risk factors that influence the achievement of reproductive targets postpartum (pp) and (2) the key factors that influence pregnancy rate following first artificial insemination (AI) in dairy cows. Ninety-eight Holstein-Friesian pp cows were blood sampled from wk 1 to 4 pp for hematology and biochemistry. Reproductive tract health was assessed weekly by ultrasonography and vaginal mucus scoring. Body condition score (BCS), lameness score, and milk yield were assessed every 2 wk. Milk samples for progesterone assay were collected twice weekly and on d 4, 5, and 7 after AI. Risk factors associated with achieving reproductive targets depended on (1) increased metabolic activity of the liver (increased glutamate dehydrogenase at calving and increased γ-glutamyl transpeptidase in wk 4), (2) a competent immune system (increased neutrophils in wk 1; decreased α1-acid glycoprotein in wk 1, 2, and 3), (3) an endocrine system that was capable of responding by producing sufficient triiodothyronine in wk 2 and increased insulin-like growth factor I in wk 3 and 4, (4) a lower negative energy balance status (decreased nonesterified fatty acid concentration in wk 1; decreased β-hydroxybutyrate concentration in wk 2; BCS loss between calving and d 28 pp mucus discharge at first ovulation and at d 45 pp; resumed ovarian cyclicity by the end of the voluntary waiting period (≥ d 35 pp)], and (6) adequate diet (to ensure increased glutathione peroxidase in wk 2 and 3 and increased magnesium in wk 4). Risk factors that increased the odds of a successful first AI were previous ovulation(s) (odds ratio=3.17 per ovulation), BCS >2.5 at AI (odds ratio=3.01), and clear vaginal mucus (score=0) compared with purulent mucus (score >0) 4 d after first AI (odds ratio=2.99). In conclusion, this study identified key risk factors in the early pp period that give a higher probability of cows achieving their reproductive targets and of

  12. Knee extensor strength and body weight in adolescent men and the risk of knee osteoarthritis by middle age.

    Science.gov (United States)

    Turkiewicz, Aleksandra; Timpka, Simon; Thorlund, Jonas Bloch; Ageberg, Eva; Englund, Martin

    2017-10-01

    To assess the extent to which knee extensor strength and weight in adolescence are associated with knee osteoarthritis (OA) by middle age. We studied a cohort of 40 121 men who at age 18 years in 1969/1970 underwent mandatory conscription in Sweden. We retrieved data on isometric knee extensor strength, weight, height, smoking, alcohol consumption, parental education and adult occupation from Swedish registries. We identified participants diagnosed with knee OA or knee injury from 1987 to 2010 through the National Patient Register. We estimated the HR of knee OA using multivariable-adjusted Cox proportional regression model. To assess the influence of adult knee injury and occupation, we performed a formal mediation analysis. The mean (SD) knee extensor strength was 234 (47) Nm, the mean (SD) weight was 66 (9.3) kg. During 24 years (median) of follow-up starting at the age of 35 years, 2049 persons were diagnosed with knee OA. The adjusted HR (95% CI) of incident knee OA was 1.12 (1.06 to 1.18) for each SD of knee extensor strength and 1.18 (1.15 to 1.21) per 5 kg of body weight. Fifteen per cent of the increase in OA risk due to higher knee extensor strength could be attributed to knee injury and adult occupation. Higher knee extensor strength in adolescent men was associated with increased risk of knee OA by middle age, challenging the current tenet of low muscle strength being a risk factor for OA. We confirmed higher weight to be a strong risk factor for knee OA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Medical Geology in the Middle East: Potential Health Risks from Mineralized Dust Exposure

    Science.gov (United States)

    Lyles, M. B.; Fredrickson, H. L.; Bednar, A. J.; Fannin, H. B.; Griffin, D. W.; Sobecki, T. M.

    2012-04-01

    In the Middle East, dust and sand storms are a persistent problem delivering significant amounts of mineralized particulates via inhalation into the mouth, nasal pharynx, and lungs. The health risks of this dust inhalation are presently being studied but accurate characterization as to the potential health effects is still lacking. Experiments were designed to study the chemical composition, mineral content, and microbial flora of Kuwaiti and Iraqi dust particles for the potential to cause adverse human health effects both acute and chronic. Multiple site samples were collected and chemical and physical characterization including particle size distribution and inorganic analysis was conducted, followed by analysis and identification of biologic flora to include bacteria, fungi and viruses. Additionally, PM10 exposure data was collected hourly over a 12 day period (>10,000 ug/m3). Data indicates that the mineralized dust is composed of calcium carbonate and magnesium sulfate coating over a precipitated matrix of metallic silicate nanocrystals of various forms containing a variety of trace and heavy metals constituting ~3 % of the particles by weight. This includes ~ 1% by weight bioaccessible aluminum and reactive iron with the remaining 1% a mixture of bioaccessible trace and heavy metals. Microbial analysis reveals a significant biodiversity of bacteria of which ~25 % are known pathogens. Of the microbes identified, several have hemolytic properties and most have significant antibiotic resistance. Viral analysis indicates a tremendous amount of virons with a large percent of RNA viruses. The level of total suspended particle mass at PM10 constitutes an excessive exposure micro-particulates including PM 2.5 (~1,0000 ug/m3). Reported data on cell culture and animal studies have indicated a high level of toxicity to these dust particles. Taken together, these data suggest that at the level of dust exposure commonly found in the Middle East (i.e., Iraq, Kuwait, and

  14. Risk maps for targeting exotic plant pest detection programs in the United States

    Science.gov (United States)

    R.D. Magarey; D.M. Borchert; J.S. Engle; M Garcia-Colunga; Frank H. Koch; et al

    2011-01-01

    In the United States, pest risk maps are used by the Cooperative Agricultural Pest Survey for spatial and temporal targeting of exotic plant pest detection programs. Methods are described to create standardized host distribution, climate and pathway risk maps for the top nationally ranked exotic pest targets. Two examples are provided to illustrate the risk mapping...

  15. Oral hygiene practices among middle-school students in 44 low- and middle-income countries.

    Science.gov (United States)

    McKittrick, Terence R; Jacobsen, Kathryn H

    2014-06-01

    To examine the frequency of toothbrushing or cleaning among middle school students from 44 low- and middle-income countries. Secondary analysis of nationally representative data from 146,462 middle school students who participated in the Global School-based Student Health Survey (GSHS) between 2003 and 2010. In 39 of the 44 countries, more than 80% of students reported brushing or cleaning their teeth at least once each day. In 23 countries, more than 5% of participants reported brushing their teeth less than once a day or never. In 37 countries, boys reported a significantly lower frequency of toothbrushing or cleaning than did girls. Countries where miswak (chewing stick) use is common reported lower toothbrushing or cleaning frequency, perhaps because the questionnaire item did not clarify that this counts as a form of tooth cleaning. School-based dental health education programmes that target early adolescents may help students to develop habits that improve their immediate and long-term health. © 2014 FDI World Dental Federation.

  16. Women Who Have Sex with Women Living in Low- and Middle-Income Countries: A Systematic Review of Sexual Health and Risk Behaviors

    OpenAIRE

    Tat, Susana A.; Marrazzo, Jeanne M.; Graham, Susan M.

    2015-01-01

    Women who have sex with women (WSW) have long been considered at low risk of acquiring and transmitting HIV and other sexually transmitted infections (STIs). However, limited research has been conducted on WSW, especially those living in low-and middle-income countries (LMICs). We reviewed available research on sexual health and risk behaviors of WSW in LMICs. We searched CINAHL, Embase, and PubMed for studies of WSW in LMICs published between January 1, 1980, and December 31, 2013. Studies o...

  17. Middle East Desert Dust Exposure: Health Risks from Metals and Microbial Pathogens

    Science.gov (United States)

    Lyles, M. B.

    2014-12-01

    In the Middle East, dust and sand storms are a persistent problem and can deliver significant amounts of micro-particulates via inhalation into the mouth, nasal pharynx, & lungs due to the fine size and abundance of these micro-particulates. The chronic and acute health risks of this dust inhalation have not been well studied nor has the dust been effectively characterized as to its chemical composition, mineral content, or microbial flora. Scientific experiments were designed to study the Kuwaiti and Iraqi dust as to its physical, chemical, and biological characteristics and for its potential to cause adverse health effects. First, dust samples from different locations were collected and processed and exposure data collected. Initial chemical and physical characterization of each sample including particle size distribution and inorganic analysis was conducted, followed by characterization of biologic flora of the dust, including bacteria, fungi and viruses. Data indicates that the mineralized dust is composed of calcium carbonate over a matrix of metallic silicate nanocrystals containing a variety of trace and heavy metals constituting ~3 % of the PM10 particles by weight, of which ~1% is bioaccessible aluminum and reactive iron, each. The particles also consist of ~1% bioavailable aluminum and reactive iron each. Microbial analysis reveals a significant biodiversity of bacterial, fungi, and viruses of which ~30% are known pathogens. Of the microbes identified, several have hemolytic properties and most have significant antibiotic resistance. Viral analysis indicates a tremendous amount of virons with a large percent of RNA viruses. The level of total suspended particle mass at PM 10 along with environmental & physiological conditions present constitute an excessive exposure to micro-particulates including PM 2.5 and the potential for adverse health effects. Reported data on cell culture and animal studies have indicated a high level of toxicity to these dust

  18. Comprehensively Assessing Cognitive and Behavioral Risks for HIV Infection among Middle-Aged and Older Adults

    Science.gov (United States)

    Paniagua, Freddy A.; O'Boyle, Michael

    2008-01-01

    A comprehensive survey of HIV/AIDS with middle-aged and older adults should include six domains (e.g., factual knowledge regarding the acquisition and transmission of HIV, traditionally-accepted behavioral risks for HIV infection). A sample of 23 women (54.8%) and 19 men (45.2%), ranging in age from 51 to 85 were surveyed across such domains.…

  19. Diffusion tensor imaging, intracranial vascular resistance and cognition in middle-aged asymptomatic subjects.

    Science.gov (United States)

    López-Olóriz, Jorge; López-Cancio, Elena; Arenillas, Juan F; Hernández, María; Dorado, Laura; Dacosta-Aguayo, Rosalía; Barrios, Maite; Soriano-Raya, Juan José; Miralbell, Júlia; Bargalló, Núria; Cáceres, Cynthia; Torán, Pere; Alzamora, Maite; Dávalos, Antonio; Mataró, Maria

    2014-01-01

    The contribution of traditional vascular risk factors to cognitive impairment and dementia is well known. However, in order to obtain possible targets for prevention of vascular cognitive impairment (VCI), it may be important to identify other early and noninvasive markers in asymptomatic middle-aged adults. The calculation of middle cerebral artery-pulsatility index (MCA-PI) is an ultrasonologic, noninvasive, validated and easily reproducible technique to assess increased distal resistance to blood flow. This study aims to assess the relationship between MCA-PI, microstructural white matter (WM) integrity and cognition in a middle-aged asymptomatic population. Ninety-five participants from the Barcelona-Asymptomatic Intracranial Atherosclerosis (AsIA) neuropsychology study were included. Subjects were 50-65 years old, free from dementia and without history of vascular disease. Transcranial color-coded duplex ultrasound examination was performed to assess MCA-PI as a measure of vascular resistance. WM integrity was evaluated by fractional anisotropy (FA) measurements of diffusion tensor images (DTI) acquired on a 3T-MRI. The neuropsychological battery was specifically selected to be sensitive to VCI, and included tests that were grouped into six cognitive domains: executive functioning, attention, verbal fluency, memory, visuospatial skills and psychomotor speed. A multivariate linear regression model adjusted for age, gender, years of education, diabetes and hypertension was performed. MCA-PI was significantly associated with WM disintegration in different tracts (fornix, corticospinal and anterior thalamic), all p gender, years of education, and vascular risk factors (all p cognitive domains, except for visuospatial skills. Our data suggest that MCA-PI may be related to WM disintegration and early vascular cognitive impairment in middle-aged subjects. Although further prospective studies are needed to provide evidence for its validity in longitudinal studies, our

  20. Demonstration of the Military Ecological Risk Assessment Framework (MERAF): Apache Longbow - Hell Missile Test at Yuma Proving Ground

    Energy Technology Data Exchange (ETDEWEB)

    Efroymson, R.A.

    2002-05-09

    This ecological risk assessment for a testing program at Yuma Proving Ground, Arizona, is a demonstration of the Military Ecological Risk Assessment Framework (MERAF; Suter et al. 2001). The demonstration is intended to illustrate how risk assessment guidance concerning-generic military training and testing activities and guidance concerning a specific type of activity (e.g., low-altitude aircraft overflights) may be implemented at a military installation. MERAF was developed with funding from the Strategic Research and Development Program (SERDP) of the Department of Defense. Novel aspects of MERAF include: (1) the assessment of risks from physical stressors using an ecological risk assessment framework, (2) the consideration of contingent or indirect effects of stressors (e.g., population-level effects that are derived from habitat or hydrological changes), (3) the integration of risks associated with different component activities or stressors, (4) the emphasis on quantitative risk estimates and estimates of uncertainty, and (5) the modularity of design, permitting components of the framework to be used in various military risk assessments that include similar activities. The particular subject of this report is the assessment of ecological risks associated with a testing program at Cibola Range of Yuma Proving Ground, Arizona. The program involves an Apache Longbow helicopter firing Hellfire missiles at moving targets, i.e., M60-A1 tanks. Thus, the three component activities of the Apache-Hellfire test were: (1) helicopter overflight, (2) missile firing, and (3) tracked vehicle movement. The demonstration was limited, to two ecological endpoint entities (i.e., potentially susceptible and valued populations or communities): woody desert wash communities and mule deer populations. The core assessment area is composed of about 126 km{sup 2} between the Chocolate and Middle Mountains. The core time of the program is a three-week period, including fourteen days of

  1. Demonstration of the Military Ecological Risk Assessment Framework (MERAF): Apache Longbow - Hell Missile Test at Yuma Proving Ground

    International Nuclear Information System (INIS)

    Efroymson, R.A.

    2002-01-01

    This ecological risk assessment for a testing program at Yuma Proving Ground, Arizona, is a demonstration of the Military Ecological Risk Assessment Framework (MERAF; Suter et al. 2001). The demonstration is intended to illustrate how risk assessment guidance concerning-generic military training and testing activities and guidance concerning a specific type of activity (e.g., low-altitude aircraft overflights) may be implemented at a military installation. MERAF was developed with funding from the Strategic Research and Development Program (SERDP) of the Department of Defense. Novel aspects of MERAF include: (1) the assessment of risks from physical stressors using an ecological risk assessment framework, (2) the consideration of contingent or indirect effects of stressors (e.g., population-level effects that are derived from habitat or hydrological changes), (3) the integration of risks associated with different component activities or stressors, (4) the emphasis on quantitative risk estimates and estimates of uncertainty, and (5) the modularity of design, permitting components of the framework to be used in various military risk assessments that include similar activities. The particular subject of this report is the assessment of ecological risks associated with a testing program at Cibola Range of Yuma Proving Ground, Arizona. The program involves an Apache Longbow helicopter firing Hellfire missiles at moving targets, i.e., M60-A1 tanks. Thus, the three component activities of the Apache-Hellfire test were: (1) helicopter overflight, (2) missile firing, and (3) tracked vehicle movement. The demonstration was limited, to two ecological endpoint entities (i.e., potentially susceptible and valued populations or communities): woody desert wash communities and mule deer populations. The core assessment area is composed of about 126 km 2 between the Chocolate and Middle Mountains. The core time of the program is a three-week period, including fourteen days of

  2. Dating Violence among Urban, Minority, Middle School Youth and Associated Sexual Risk Behaviors and Substance Use

    Science.gov (United States)

    Lormand, Donna K.; Markham, Christine M.; Peskin, Melissa F.; Byrd, Theresa L.; Addy, Robert C.; Baumler, Elizabeth; Tortolero, Susan R.

    2013-01-01

    Background: Whereas dating violence among high school students has been linked with sexual risk-taking and substance use, this association has been understudied among early adolescents. We estimated the prevalence of physical and nonphysical dating violence in a sample of middle school students and examined associations between dating violence,…

  3. Smoking and its risk factors in Chinese elementary and middle school students: a nationally representative sample study.

    Science.gov (United States)

    Zhang, Xinghui; Li, Yajun; Zhang, Qin; Lu, Furong; Wang, Yun

    2014-05-01

    The purpose of this study was to examine the prevalence of smoking in a nationally representative sample of Chinese elementary and middle school students and to investigate its risk factors from families and schools. The data were from the National Children's Study of China (NCSC), in which 24,013 fourth- to ninth-grade students were recruited from 100 counties in 31 provinces in China. Chi-square tests and one-way ANOVAs were used to analyze the relationships between smoking and the risk factors. Logistic regressions were used to calculate odds ratios. The prevalence of ever smokers and current smokers were 19.0% and 5.4%. Focusing on current smokers, boys, middle school students, rural students, boarding students, non-only children and those owning parents with low educational levels reported smoking significantly more than girls, elementary school students, urban students, non-boarding students, only children and those owning parents with high educational levels. Lower trust and support from teachers and higher parent-child conflict positively predicted both smoking and smoking frequency. Lower trust and support from classmates was associated with higher possibility of smoking. However, higher trust and support from classmates was associated with higher smoking frequency. Teacher smoking and friend smoking were only predictive of smoking, but not of smoking frequency. Boys, middle school students, rural students, boarding students, non-only children and those owning parents with low educational levels need special attention. The most risk factors for smoking and smoking frequency were lower trust and support from teachers and higher parent-child conflict. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Dynamic Ecological Risk Assessment and Management of Land Use in the Middle Reaches of the Heihe River Based on Landscape Patterns and Spatial Statistics

    Directory of Open Access Journals (Sweden)

    Jiahui Fan

    2016-06-01

    Full Text Available Land use profoundly changes the terrestrial ecosystem and landscape patterns, and these changes reveal the extent and scope of the ecological influence of land use on the terrestrial ecosystem. The study area selected for this research was the middle reaches of the Heihe River. Based on land use data (1986, 2000, and 2014, we proposed an ecological risk index of land use by combining a landscape disturbance index with a landscape fragility index. An exponential model was selected to perform kriging interpolation, as well as spatial autocorrelations and semivariance analyses which could reveal the spatial aggregation patterns. The results indicated that the ecological risk of the middle reaches of the Heihe River was generally high, and higher in the northwest. The high values of the ecological risk index (ERI tended to decrease, and the low ERI values tended to increase. Positive spatial autocorrelations and a prominent scale-dependence were observed among the ERI values. The main hot areas with High-High local autocorrelations were located in the north, and the cold areas with low-low local autocorrelations were primarily located in the middle corridor plain and Qilian Mountains. From 1986 to 2014, low and relatively low ecological risk areas decreased while relatively high risk areas expanded. A middle level of ecological risk was observed in Ganzhou and Minle counties. Shandan County presented a serious polarization, with high ecological risk areas observed in the north and low ecological risk areas observed in the southern Shandan horse farm. In order to lower the eco-risk and achieve the sustainability of land use, these results suggest policies to strictly control the oasis expansion and the occupation of farmland for urbanization. Some inefficient farmland should transform into grassland in appropriate cases.

  5. Higher Intake of Fruit, but Not Vegetables or Fiber, at Baseline Is Associated with Lower Risk of Becoming Overweight or Obese in Middle-Aged and Older Women of Normal BMI at Baseline.

    Science.gov (United States)

    Rautiainen, Susanne; Wang, Lu; Lee, I-Min; Manson, JoAnn E; Buring, Julie E; Sesso, Howard D

    2015-05-01

    Fruit, vegetable, and dietary fiber intake have been associated with lower risk of cardiovascular disease (CVD); however, little is known about their role in obesity prevention. Our goal was to investigate whether intake of fruits, vegetables, and dietary fiber is associated with weight change and the risk of becoming overweight and obese. We studied 18,146 women aged ≥45 y from the Women's Health Study free of CVD and cancer with an initial body mass index (BMI) of 18.5 to Fruit, vegetable, and dietary fiber intakes were assessed at baseline through a 131-item food-frequency questionnaire, along with obesity-related risk factors. Women self-reported body weight on annual questionnaires. During a mean follow-up of 15.9 y, 8125 women became overweight or obese (BMI ≥25 kg/m²). Intakes of total fruits and vegetables, fruits, and dietary fiber were not associated with the longitudinal changes in body weight, whereas higher vegetable intake was associated with greater weight gain (P-trend: 0.02). In multivariable analyses, controlling for total energy intake and physical activity along with other lifestyle, clinical, and dietary factors, women in the highest vs. lowest quintile of fruit intake had an HR of 0.87 (95% CI: 0.80, 0.94; P-trend: 0.01) of becoming overweight or obese. No association was observed for vegetable or dietary fiber intake. The association between fruit intake and risk of becoming overweight or obese was modified by baseline BMI (P-interaction: fruit, but not vegetables or fiber, by middle-aged and older women with a normal BMI at baseline is associated with lower risk of becoming overweight or obese. © 2015 American Society for Nutrition.

  6. Enrichment of putative PAX8 target genes at serous epithelial ovarian cancer susceptibility loci

    DEFF Research Database (Denmark)

    Kar, Siddhartha P; Adler, Emily; Tyrer, Jonathan

    2017-01-01

    BACKGROUND: Genome-wide association studies (GWAS) have identified 18 loci associated with serous ovarian cancer (SOC) susceptibility but the biological mechanisms driving these findings remain poorly characterised. Germline cancer risk loci may be enriched for target genes of transcription factors...... (TFs) critical to somatic tumorigenesis. METHODS: All 615 TF-target sets from the Molecular Signatures Database were evaluated using gene set enrichment analysis (GSEA) and three GWAS for SOC risk: discovery (2196 cases/4396 controls), replication (7035 cases/21 693 controls; independent from discovery...... to interact with PAX8 in the literature to the PAX8-target set and applying an alternative to GSEA, interval enrichment, further confirmed this association (P=0.006). Fifteen of the 157 genes from this expanded PAX8 pathway were near eight loci associated with SOC risk at P

  7. Assessing risks to non-target species during poison baiting programs for feral cats.

    Directory of Open Access Journals (Sweden)

    Tony Buckmaster

    Full Text Available Poison baiting is used frequently to reduce the impacts of pest species of mammals on agricultural and biodiversity interests. However, baiting may not be appropriate if non-target species are at risk of poisoning. Here we use a desktop decision tree approach to assess the risks to non-target vertebrate species in Australia that arise from using poison baits developed to control feral house cats (Felis catus. These baits are presented in the form of sausages with toxicant implanted in the bait medium within an acid-soluble polymer capsule (hard shell delivery vehicle, or HSDV that disintegrates after ingestion. Using criteria based on body size, diet and feeding behaviour, we assessed 221 of Australia's 3,769 native vertebrate species as likely to consume cat-baits, with 47 of these likely to ingest implanted HSDVs too. Carnivorous marsupials were judged most likely to consume both the baits and HSDVs, with some large-bodied and ground-active birds and reptiles also consuming them. If criteria were relaxed, a further 269 species were assessed as possibly able to consume baits and 343 as possibly able to consume HSDVs; most of these consumers were birds. One threatened species, the Tasmanian devil (Sarcophilus harrisii was judged as definitely able to consume baits with implanted HSDVs, whereas five threatened species of birds and 21 species of threatened mammals were rated as possible consumers. Amphibia were not considered to be at risk. We conclude that most species of native Australian vertebrates would not consume surface-laid baits during feral cat control programs, and that significantly fewer would be exposed to poisoning if HSDVs were employed. However, risks to susceptible species should be quantified in field or pen trials prior to the implementation of a control program, and minimized further by applying baits at times and in places where non-target species have little access.

  8. Assessing risks to non-target species during poison baiting programs for feral cats.

    Science.gov (United States)

    Buckmaster, Tony; Dickman, Christopher R; Johnston, Michael J

    2014-01-01

    Poison baiting is used frequently to reduce the impacts of pest species of mammals on agricultural and biodiversity interests. However, baiting may not be appropriate if non-target species are at risk of poisoning. Here we use a desktop decision tree approach to assess the risks to non-target vertebrate species in Australia that arise from using poison baits developed to control feral house cats (Felis catus). These baits are presented in the form of sausages with toxicant implanted in the bait medium within an acid-soluble polymer capsule (hard shell delivery vehicle, or HSDV) that disintegrates after ingestion. Using criteria based on body size, diet and feeding behaviour, we assessed 221 of Australia's 3,769 native vertebrate species as likely to consume cat-baits, with 47 of these likely to ingest implanted HSDVs too. Carnivorous marsupials were judged most likely to consume both the baits and HSDVs, with some large-bodied and ground-active birds and reptiles also consuming them. If criteria were relaxed, a further 269 species were assessed as possibly able to consume baits and 343 as possibly able to consume HSDVs; most of these consumers were birds. One threatened species, the Tasmanian devil (Sarcophilus harrisii) was judged as definitely able to consume baits with implanted HSDVs, whereas five threatened species of birds and 21 species of threatened mammals were rated as possible consumers. Amphibia were not considered to be at risk. We conclude that most species of native Australian vertebrates would not consume surface-laid baits during feral cat control programs, and that significantly fewer would be exposed to poisoning if HSDVs were employed. However, risks to susceptible species should be quantified in field or pen trials prior to the implementation of a control program, and minimized further by applying baits at times and in places where non-target species have little access.

  9. Informing early intervention: preschool predictors of anxiety disorders in middle childhood.

    Directory of Open Access Journals (Sweden)

    Jennifer L Hudson

    Full Text Available BACKGROUND: To inform early intervention practice, the present research examines how child anxiety, behavioural inhibition, maternal overinvolvement, maternal negativity, mother-child attachment and maternal anxiety, as assessed at age four, predict anxiety at age nine. METHOD: 202 children (102 behaviourally inhibited and 100 behaviourally uninhibited aged 3-4 years were initially recruited and the predictors outlined above were assessed. Diagnostic assessments, using the Anxiety Disorders Interview Schedule, were then conducted five years later. RESULTS: Behavioural inhibition, maternal anxiety, and maternal overinvolvement were significant predictors of clinical anxiety, even after controlling for baseline anxiety (p.1. CONCLUSIONS: Preschool children who show anxiety, are inhibited, have overinvolved mothers and mothers with anxiety disorders are at increased risk for anxiety in middle childhood. These factors can be used to identify suitable participants for early intervention and can be targeted within intervention programs.

  10. Addressing diabetes at the crossroads of global pandemic and regional culture: Comment on "The curse of wealth - Middle Eastern countries need to address the rapidly rising burden of diabetes".

    Science.gov (United States)

    Hsu, William C; Gabbay, Robert A

    2014-07-01

    As diabetes and obesity rates continue to climb at astronomical rates in the Middle East, future generations are at an even greater risk for diabetes and the associated complications. Many factors are at play and it is clear that creative solutions are needed to retool provider resources in the Middle East towards prevention of diabetes and its complications while leveraging technology to maximize outreach within the accepted cultural norms. Only by building the capacity to address the current diabetes burden as well focusing on prevention for the future, can Middle East countries create a strong infrastructure for a successful future.

  11. The target volume concept at the recording of external beam radiotherapy

    International Nuclear Information System (INIS)

    Quast, U.; Glaeser, L.

    1981-01-01

    With the aim of complete, exact and reproducible manual recording and documentation of external beam radiotherapy a concept is proposed providing treatment planning and recording related to space and time for target volumes of different order corresponding to Ist, IInd or IIIrd part of treatment course, regarding all dose limiting organs at risk. The record consists of the dosage plan for medical treatment planning, the treatment plan for physical dose distribution planning and the treatment record of absorbed doses delivered as well as a checklist for patient and machine set-up, and labels for intended actions during treatment development. A clear arrangement of the record form in logical order was found, demanding exact specification of target(s) and beam(s) and their relation in space and time; asking for verbal and graphical description of target volumes, organs at risk, patient positioning, beam portals and dose reference points in terms of patients' anatomy; emphasizing the most important medical data by marked areas and leaving enough empty space for additional data, remarks or comments. During several years of clinical use these record forms proved to be suitable for all cases of external beam therapy, for complex situations of target volumes and treatment-scheduling, for all treatment techniques and radiation qualities and for all ways of physical treatment planning. They can be extended to automatic treatment verification, monitoring and recording as well as to the application of in-vivo-measurements of absorbed doses. (orig.) [de

  12. Single-Isocenter Multiple-Target Stereotactic Radiosurgery: Risk of Compromised Coverage

    International Nuclear Information System (INIS)

    Roper, Justin; Chanyavanich, Vorakarn; Betzel, Gregory; Switchenko, Jeffrey; Dhabaan, Anees

    2015-01-01

    Purpose: To determine the dosimetric effects of rotational errors on target coverage using volumetric modulated arc therapy (VMAT) for multitarget stereotactic radiosurgery (SRS). Methods and Materials: This retrospective study included 50 SRS cases, each with 2 intracranial planning target volumes (PTVs). Both PTVs were planned for simultaneous treatment to 21 Gy using a single-isocenter, noncoplanar VMAT SRS technique. Rotational errors of 0.5°, 1.0°, and 2.0° were simulated about all axes. The dose to 95% of the PTV (D95) and the volume covered by 95% of the prescribed dose (V95) were evaluated using multivariate analysis to determine how PTV coverage was related to PTV volume, PTV separation, and rotational error. Results: At 0.5° rotational error, D95 values and V95 coverage rates were ≥95% in all cases. For rotational errors of 1.0°, 7% of targets had D95 and V95 values 95% for only 63% of the targets. Multivariate analysis showed that PTV volume and distance to isocenter were strong predictors of target coverage. Conclusions: The effects of rotational errors on target coverage were studied across a broad range of SRS cases. In general, the risk of compromised coverage increased with decreasing target volume, increasing rotational error and increasing distance between targets. Multivariate regression models from this study may be used to quantify the dosimetric effects of rotational errors on target coverage given patient-specific input parameters of PTV volume and distance to isocenter.

  13. Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control.

    Science.gov (United States)

    Gilbert, Clare

    2008-02-01

    Globally at least 50,000 children are blind from retinopathy of prematurity (ROP) which is now a significant cause of blindness in many middle income countries in Latin American and Eastern Europe. Retinopathy of prematurity is also being reported from the emerging economies of India and China. The characteristics of babies developing severe disease varies, with babies in middle and low income countries having a much wider range of birth weights and gestational ages than is currently the case in industrialized countries. Rates of disease requiring treatment also tend to be higher in middle and low income countries suggesting that babies are being exposed to risk factors which are, to a large extent, being controlled in industrialised countries. The reasons for this "third epidemic" of ROP are discussed as well as strategies for control, including the need for locally relevant, evidence based criteria which ensure that all babies at risk are examined.

  14. Atrial fibrillation in the Middle East: unmapped, underdiagnosed, undertreated.

    Science.gov (United States)

    Al-Shamkhani, Warkaa; Ayetey, Harold; Lip, Gregory Y H

    2018-05-01

    Atrial fibrillation (AF) is the commonest persistent cardiac arrhythmia with an estimated incidence rate of between 1.5-2% and an important cause of strokes. Few epidemiological studies and clinical trials on the management of AF have been conducted outside Europe and North America. These gaps in our understanding of AF likely lead to sub-optimal management of patients with AF in the rest of the world. Areas covered: We discuss the epidemiology, treatment and clinical outcomes for AF in the Middle East after systematic review of published work for AF from the Middle East. We also discuss important clinical trials on AF conducted in the West in the same period to help contextualize our findings. Expert commentary: The few available Middle East studies suggest important epidemiological differences between Middle Eastern and Western AF populations. In particular, the Middle Eastern AF population is younger and have more co-morbidities than patients in the West. We find that significant numbers of moderate to high risk patients with AF are either undertreated or untreated placing them at increased risk of complications such as stroke. More studies in the Middle Eastern population are required to aid the development of region-specific clinical guidelines to improve patient care.

  15. [Factors that influence sexual intercourse among middle school students: using data from the 8th (2012) Korea Youth Risk Behavior Web-based Survey].

    Science.gov (United States)

    Gwon, Seok Hyun; Lee, Chung Yul

    2015-02-01

    The purpose of this study was to investigate factors that influence sexual intercourse among middle school students in South Korea. Using statistics from the 8th (2012) Korea Youth Risk Behavior Web-based Survey, hierarchical logistic regression analysis was conducted. The study sample comprised 37,297 middle school students aged primarily 12 to 15. The significant predictors of sexual intercourse were grade, ever smoking, ever drinking, habitual or purposeful drug use, economic status, weekly allowance, cohabitation with family, and type of school. The results suggest that intensified sex education is needed not only in the 1st grade of middle school, but also in the upper grades of elementary school. Sexual health interventions for high-risk groups may be needed, given the factors predicting sexual intercourse.

  16. The penetration of Middle east gas in Europe will be limited at middle term

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    The European gas demand has progressed about 4% by year from 1985 to 1994. A growth of 3% is expected for future. So, it seems that Middle East could take a place on gas European market. But with competition of North Africa or ex-USSR, the price of transport or the investment for a gas pipeline, the contribution of Middle East gas to European supply will stay limited in a middle term. Perspectives could be very different if political stability of Algeria or ex-USSR was no more assured

  17. The impact of a private sector living wage intervention on consumption and cardiovascular disease risk factors in a middle income country.

    Science.gov (United States)

    Rehkopf, David H; Burmaster, Katharine; Landefeld, John C; Adler-Milstein, Sarah; Flynn, Emily P; Acevedo, Maria Cecilia; Jones-Smith, Jessica C; Adler, Nancy; Fernald, Lia C H

    2018-01-25

    A positive association of socioeconomic position and health is well established in high-income countries. In poorer nations, however, higher income individuals often have more cardiovascular risk factors (including obesity) than do those with less income. Our study goal was to estimate the effects of receiving a living wage (340% higher income) on short-term changes in consumption and cardiovascular risk factors among low-wage workers in a middle-income country. This cross-sectional study matched workers at an apparel factory (n=105) in the Dominican Republic with those at a similar factory (n=99) nearby, 15 months after the intervention factory introduced a substantially higher living wage. Statistical matching on non-time varying individual characteristics (childhood health, childhood living conditions, work experience, demographic factors) strengthened causal inference. Primary outcomes were blood pressure (systolic and diastolic), pulse rate, body mass index and waist circumference. Secondary outcomes were dietary consumption and spending on services, consumables and durable goods. Receiving the living wage was associated with increased consumption of protein, dairy, soda and juice and sugars, but not with cardiovascular risk factors. Intervention factory workers spent more on grocery items and household durable goods. While having a higher income in a middle-income country might be expected to increase obesity and its associated health risks, the current study found no short-term negative associations. There may be possible longer-term negative health consequences of increases in consumption of soda, juice and sugars, however. It is important to consider complementary interventions to support healthy dietary intake in areas with increasing wages.

  18. Prevalence of pressure ulcer and associated risk factors in middle- and older-aged medical inpatients in Norway.

    Science.gov (United States)

    Børsting, Tove E; Tvedt, Christine R; Skogestad, Ingrid J; Granheim, Tove I; Gay, Caryl L; Lerdal, Anners

    2018-02-01

    To describe the prevalence of pressure ulcers among middle- and older-aged patients in a general medical hospital in Norway and to describe the associations between pressure ulcers and potential risk factors additional to the Braden risk score. Degrees of mobility, activity, perfusion and skin status are risk factors for development of pressure ulcer. Nurses' clinical judgements combined with risk assessment tools are effective to detect pressure ulcer risk. Cross-sectional study. The study was performed as part of a research project conducted between September 2012-May 2014 in a general hospital in the capital of Norway. Registered nurses and nursing students collected data from all eligible patients on 10 days during the students' clinical practice studies. The Braden scale was used to measure pressure ulcer risk, and skin examinations were performed to classify the skin area as normal or as indicative of pressure ulcer according to the definitions by the National Pressure Ulcer Advisory Panel. Comorbidities were collected by patient's self-report. This analysis focused on the 255 inpatients at the medical wards ≥52 years of age, most of whom had more than one comorbidity. The prevalence of pressure ulcers was 14.9% in this sample. Higher age, underweight, diabetes and worse Braden scores were factors associated with pressure ulcer, and pressure ulcer was most frequently sited at the sacrum or heel. Adding age, weight and diabetes status to pressure ulcer risk assessment scales may improve identification of patients at risk for pressure ulcers. Knowledge about strengths and limitations of risk assessment tools is important for clinical practice. Age, weight and diabetes status should be considered for inclusion in risk assessment tools for pressure ulcers in medical wards. © 2017 John Wiley & Sons Ltd.

  19. Postoperative Intensity-Modulated Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: Treatment Outcomes, Marginal Misses, and Perspective on Target Delineation

    International Nuclear Information System (INIS)

    Chen, Wan-Yu; Kuo, Sung-Hsin; Chen, Yu-Hsuan; Lu, Szu-Huai; Tsai, Chiao-Ling; Chia-Hsien Cheng, Jason; Hong, Ruey-Long; Chen, Ya-Fang; Hsu, Chuan-Jen; Lin, Kai-Nan; Ko, Jenq-Yuh; Lou, Pei-Jen; Wang, Cheng-Ping; Chong, Fok-Ching; Wang, Chun-Wei

    2012-01-01

    Purpose: To report outcomes of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated with surgery and postoperative intensity-modulated radiotherapy (IMRT). Failure patterns related to spatial dose distribution were also analyzed to provide insight into target delineation. Methods and Materials: A retrospective review was conducted of the records of 11 consecutive patients with SCC of the EAC and middle ear who were treated with curative surgery and postoperative IMRT at one institution between January 2007 and February 2010. The prescribed IMRT dose was 60 to 66 Gy at 2 Gy per fraction. Three patients also received concurrent cisplatin-based chemotherapy, and 1 patient received concurrent oral tegafur/uracil. The median follow-up time was 19 months (range, 6–33 months). Results: Four patients had locoregional recurrence, yielding an estimated 2-year locoregional control rate of 70.7%. Among them, 1 patient had persistent disease after treatment, and 3 had marginal recurrence. Distant metastasis occurred in 1 patient after extensive locoregional recurrence, yielding an estimated 2-year distant control rate of 85.7%. The estimated 2-year overall survival was 67.5%. The three cases of marginal recurrence were near the preauricular space and glenoid fossa of the temporomandibular joint, adjacent to the apex of the ear canal and glenoid fossa of the temporomandibular joint, and in the postauricular subcutaneous area and ipsilateral parotid nodes, respectively. Conclusions: Marginal misses should be recognized to improve target delineation. When treating SCC of the EAC and middle ear, care should be taken to cover the glenoid fossa of the temporomandibular joint and periauricular soft tissue. Elective ipsilateral parotid irradiation should be considered. The treatment planning procedure should also be refined to balance subcutaneous soft-tissue dosimetry and toxicity.

  20. Postoperative Intensity-Modulated Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: Treatment Outcomes, Marginal Misses, and Perspective on Target Delineation

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Wan-Yu [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Kuo, Sung-Hsin [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (China); Chen, Yu-Hsuan; Lu, Szu-Huai; Tsai, Chiao-Ling [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Chia-Hsien Cheng, Jason [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (China); Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Hong, Ruey-Long [Division of Medical Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Chen, Ya-Fang [Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan (China); Hsu, Chuan-Jen; Lin, Kai-Nan; Ko, Jenq-Yuh; Lou, Pei-Jen; Wang, Cheng-Ping [Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan (China); Chong, Fok-Ching [Graduate Institute of Electrical Engineering, National Taiwan University, Taipei, Taiwan (China); Wang, Chun-Wei, E-mail: cwwang@ntuh.gov.tw [Graduate Institute of Electrical Engineering, National Taiwan University, Taipei, Taiwan (China)

    2012-03-15

    Purpose: To report outcomes of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated with surgery and postoperative intensity-modulated radiotherapy (IMRT). Failure patterns related to spatial dose distribution were also analyzed to provide insight into target delineation. Methods and Materials: A retrospective review was conducted of the records of 11 consecutive patients with SCC of the EAC and middle ear who were treated with curative surgery and postoperative IMRT at one institution between January 2007 and February 2010. The prescribed IMRT dose was 60 to 66 Gy at 2 Gy per fraction. Three patients also received concurrent cisplatin-based chemotherapy, and 1 patient received concurrent oral tegafur/uracil. The median follow-up time was 19 months (range, 6-33 months). Results: Four patients had locoregional recurrence, yielding an estimated 2-year locoregional control rate of 70.7%. Among them, 1 patient had persistent disease after treatment, and 3 had marginal recurrence. Distant metastasis occurred in 1 patient after extensive locoregional recurrence, yielding an estimated 2-year distant control rate of 85.7%. The estimated 2-year overall survival was 67.5%. The three cases of marginal recurrence were near the preauricular space and glenoid fossa of the temporomandibular joint, adjacent to the apex of the ear canal and glenoid fossa of the temporomandibular joint, and in the postauricular subcutaneous area and ipsilateral parotid nodes, respectively. Conclusions: Marginal misses should be recognized to improve target delineation. When treating SCC of the EAC and middle ear, care should be taken to cover the glenoid fossa of the temporomandibular joint and periauricular soft tissue. Elective ipsilateral parotid irradiation should be considered. The treatment planning procedure should also be refined to balance subcutaneous soft-tissue dosimetry and toxicity.

  1. Risk evaluation on leading companies in property and real estate subsector at IDX: A Value-at-Risk with ARMAX-GARCHX approach and duration test

    Science.gov (United States)

    Dwi Prastyo, Dedy; Handayani, Dwi; Fam, Soo-Fen; Puteri Rahayu, Santi; Suhartono; Luh Putu Satyaning Pradnya Paramita, Ni

    2018-03-01

    Risk assessment and evaluation becomes essential for financial institution to measure the potential risk of their counterparties. In middle of 2016 until first quarter of 2017, there is national program from Indonesian government so-called Tax Amnesty. One subsector that has potential to receive positive impact from the Tax Amnesty program is property and real estate. This work evaluates the risk of top five companies in term of capital share listed in Indonesia stock exchange (IDX). To do this, the Value-at-Risk (VaR) with ARMAX-GARCHX approach is employed. The ARMAX-GARCHX simultaneously models the adaptive mean and variance of stock return of each company considering exogenous variables, i.e. IDR/USD exchange rate and Jakarta Composite Index (JCI). The risk is evaluated in scheme of time moving window. The risk evaluation using 5% quantile with window size 500 transaction days perform better result compare to other scenarios. In addition, duration test is used to test the dependency between shortfalls. It informs that series of shortfall are independent.

  2. Remission and incidence of obstructive sleep apnea from middle childhood to late adolescence.

    Science.gov (United States)

    Spilsbury, James C; Storfer-Isser, Amy; Rosen, Carol L; Redline, Susan

    2015-01-01

    To study the incidence, remission, and prediction of obstructive sleep apnea (OSA) from middle childhood to late adolescence. Longitudinal analysis. The Cleveland Children's Sleep and Health Study, an ethnically mixed, urban, community-based cohort, followed 8 y. There were 490 participants with overnight polysomnography data available at ages 8-11 and 16-19 y. Baseline participant characteristics and health history were ascertained from parent report and US census data. OSA was defined as an obstructive apnea- hypopnea index ≥ 5 or an obstructive apnea index ≥ 1. OSA prevalence was approximately 4% at each examination, but OSA largely did not persist from middle childhood to late adolescence. Habitual snoring and obesity predicted OSA in cross-sectional analyses at each time point. Residence in a disadvantaged neighborhood, African-American race, and premature birth also predicted OSA in middle childhood, whereas male sex, high body mass index, and history of tonsillectomy or adenoidectomy were risk factors among adolescents. Obesity, but not habitual snoring, in middle childhood predicted adolescent OSA. Because OSA in middle childhood usually remitted by adolescence and most adolescent cases were incident cases, criteria other than concern alone over OSA persistence or incidence should be used when making treatment decisions for pediatric OSA. Moreover, OSA's distinct risk factors at each time point underscore the need for alternative risk-factor assessments across pediatric ages. The greater importance of middle childhood obesity compared to snoring in predicting adolescent OSA provides support for screening, preventing, and treating obesity in childhood. © 2014 Associated Professional Sleep Societies, LLC.

  3. Using intervention mapping for the development of a targeted secure web-based outreach strategy named SafeFriend, for Chlamydia trachomatis testing in young people at risk.

    Science.gov (United States)

    Theunissen, Kevin A T M; Hoebe, Christian J P A; Crutzen, Rik; Kara-Zaïtri, Chakib; de Vries, Nanne K; van Bergen, Jan E A M; van der Sande, Marianne A B; Dukers-Muijrers, Nicole H T M

    2013-10-22

    Many young people at high risk for Chlamydia trachomatis (Ct) are not reached by current sexual health care systems, such as general practitioners and public sexual health care centres (sexually transmitted infection clinics).Ct is the most frequently diagnosed bacterial sexually transmitted infection (STI) among sexually active people and in particular young heterosexuals. Innovative screening strategies are needed to interrupt the transmission of Ct among young people and connect the hidden cases to care. Intervention Mapping (IM), a systematic approach to develop theory- and evidence-based interventions, was used to develop a strategy to target Ct testing towards young people who are currently hidden to care in The Netherlands. Both clinical users (i.e. sexual health care nurses) and public users (i.e., young people at risk for Ct) were closely involved in the IM process. A needs assessment study was carried out using semi-structured interviews among users (N = 21), a literature search and by taking lessons learned from existing screening programmes. Theoretical methods and practical applications to reach high risk young people and influence testing were selected and translated into specific programme components. The IM approach resulted in the development of a secure and web-based outreach Ct screening strategy, named SafeFriend. It is developed to target groups of high-risk young people who are currently hidden to care. Key methods include web-based Respondent Driven Sampling, starting from young Ct positive sexual health care centre clients, to reach and motivate peers (i.e., sex partners and friends) to get tested for Ct. Testing and the motivation of peers were proposed as the desired behavioural outcomes and the Precaution Adoption Process Model was chosen as theoretical framework. End users, i.e., young people and sexual health care nurses were interviewed and included in the development process to increase the success of implementation. IM proved useful

  4. Development of Nuclear Energy and Radiation Textbooks for Middle School Students

    Energy Technology Data Exchange (ETDEWEB)

    Kim, JaeRok; Lee, SeungKoo; Choi, YoonSeok; Hahm, YoungKyu; Lee, JiEun; Han, EunOk [Korea Academy of Nuclear Safety, Seoul (Korea, Republic of)

    2015-05-15

    Although the need for raising the ability to judge the media critically is increasing, no one can escape the influence of media in our information-based society. It is very difficult for the average individual to make proper value judgments in a social environment where incorrect or difficult to understand information about nuclear power and radiation is disseminated through the media. For this reason, there are many issues surrounding the use of radiation and nuclear power in South Korea. Therefore, relevant education must be provided to ensure social acceptance and appropriate judgments of the values and risks of nuclear energy and radiation, which are important for future generations. Taking the circumstances of the present time and the situation of information receivers, this study aimed to develop textbooks about nuclear energy and radiation targeting middle school students - the leaders of the next generation. developed to help future generations make value judgments based on appropriate information about nuclear energy and radiation. The themes and educational contents of the 13 lessons, to be delivered in one semester at middle school, were selected by the educational requirements of students, science teachers, and experts. The middle school students desired information that could be viewed from various perspectives, such as atomic bombs. The general trend in recent educational curriculum development suppresses national education course organizations and authorities and expands the autonomy and authority of regions and schools.

  5. Development of Nuclear Energy and Radiation Textbooks for Middle School Students

    International Nuclear Information System (INIS)

    Kim, JaeRok; Lee, SeungKoo; Choi, YoonSeok; Hahm, YoungKyu; Lee, JiEun; Han, EunOk

    2015-01-01

    Although the need for raising the ability to judge the media critically is increasing, no one can escape the influence of media in our information-based society. It is very difficult for the average individual to make proper value judgments in a social environment where incorrect or difficult to understand information about nuclear power and radiation is disseminated through the media. For this reason, there are many issues surrounding the use of radiation and nuclear power in South Korea. Therefore, relevant education must be provided to ensure social acceptance and appropriate judgments of the values and risks of nuclear energy and radiation, which are important for future generations. Taking the circumstances of the present time and the situation of information receivers, this study aimed to develop textbooks about nuclear energy and radiation targeting middle school students - the leaders of the next generation. developed to help future generations make value judgments based on appropriate information about nuclear energy and radiation. The themes and educational contents of the 13 lessons, to be delivered in one semester at middle school, were selected by the educational requirements of students, science teachers, and experts. The middle school students desired information that could be viewed from various perspectives, such as atomic bombs. The general trend in recent educational curriculum development suppresses national education course organizations and authorities and expands the autonomy and authority of regions and schools

  6. Blood Brain Barrier and Neuroinflammation Are Critical Targets of IGF-1-Mediated Neuroprotection in Stroke for Middle-Aged Female Rats

    Science.gov (United States)

    Bake, Shameena; Selvamani, Amutha; Cherry, Jessica; Sohrabji, Farida

    2014-01-01

    Ischemia-induced cerebral infarction is more severe in older animals as compared to younger animals, and is associated with reduced availability of insulin-like growth factor (IGF)-1. This study determined the effect of post-stroke IGF-1 treatment, and used microRNA profiling to identify mechanisms underlying IGF-1’s neuroprotective actions. Post-stroke ICV administration of IGF-1 to middle-aged female rats reduced infarct volume by 39% when measured 24h later. MicroRNA analyses of ischemic tissue collected at the early post-stroke phase (4h) indicated that 8 out of 168 disease-related miRNA were significantly downregulated by IGF-1. KEGG pathway analysis implicated these miRNA in PI3K-Akt signaling, cell adhesion/ECM receptor pathways and T-and B-cell signaling. Specific components of these pathways were subsequently analyzed in vehicle and IGF-1 treated middle-aged females. Phospho-Akt was reduced by ischemia at 4h, but elevated by IGF-1 treatment at 24h. IGF-1 induced Akt activation was preceded by a reduction of blood brain barrier permeability at 4h post-stroke and global suppression of cytokines including IL-6, IL-10 and TNF-α. A subset of these cytokines including IL-6 was also suppressed by IGF-1 at 24h post-stroke. These data are the first to show that the temporal and mechanistic components of post-stroke IGF-1 treatment in older animals, and that cellular components of the blood brain barrier may serve as critical targets of IGF-1 in the aging brain. PMID:24618563

  7. Higher Intake of Fruit, but Not Vegetables or Fiber, at Baseline Is Associated with Lower Risk of Becoming Overweight or Obese in Middle-Aged and Older Women of Normal BMI at Baseline123

    Science.gov (United States)

    Rautiainen, Susanne; Wang, Lu; Lee, I-Min; Manson, JoAnn E; Buring, Julie E; Sesso, Howard D

    2015-01-01

    Background: Fruit, vegetable, and dietary fiber intake have been associated with lower risk of cardiovascular disease (CVD); however, little is known about their role in obesity prevention. Objective: Our goal was to investigate whether intake of fruits, vegetables, and dietary fiber is associated with weight change and the risk of becoming overweight and obese. Methods: We studied 18,146 women aged ≥45 y from the Women’s Health Study free of CVD and cancer with an initial body mass index (BMI) of 18.5 to Fruit, vegetable, and dietary fiber intakes were assessed at baseline through a 131-item food-frequency questionnaire, along with obesity-related risk factors. Women self-reported body weight on annual questionnaires. Results: During a mean follow-up of 15.9 y, 8125 women became overweight or obese (BMI ≥25 kg/m2). Intakes of total fruits and vegetables, fruits, and dietary fiber were not associated with the longitudinal changes in body weight, whereas higher vegetable intake was associated with greater weight gain (P-trend: 0.02). In multivariable analyses, controlling for total energy intake and physical activity along with other lifestyle, clinical, and dietary factors, women in the highest vs. lowest quintile of fruit intake had an HR of 0.87 (95% CI: 0.80, 0.94; P-trend: 0.01) of becoming overweight or obese. No association was observed for vegetable or dietary fiber intake. The association between fruit intake and risk of becoming overweight or obese was modified by baseline BMI (P-interaction: fruit, but not vegetables or fiber, by middle-aged and older women with a normal BMI at baseline is associated with lower risk of becoming overweight or obese. PMID:25934663

  8. Learning Communities for University Students At-Risk of School Failure: Can They Make a Difference?

    Science.gov (United States)

    Tharp, Terri J.

    2009-01-01

    This study investigated the impact of learning communities on the academic success of university students at-risk of academic failure. The effects of learning communities (LC) at Middle Tennessee State University (MTSU) on cumulative GPAs, retention rates, and earned cumulative hours of students with ACT sub-scores of 17 or 18 in math who were…

  9. Financail Disaster Risk Mangement Solutions for Life Systems Infrastructure in Low and Middle Income Countries

    Science.gov (United States)

    Skees, J. R.

    2016-12-01

    Growing populations and increased frequency of extreme climate events as a result of anthropogenic climate change will make poor populations more vulnerable in the future. Seismic events (earthquakes and tsunamis) also create extreme hazards for the poor and vulnerable living in cities in low and middle income countries. Vulnerability of life-systems infrastructure (e.g., water treatment facilities, hospitals, protective sea walls, etc.) to extreme climate and seismic events compound problems for the poor and vulnerable. By using risk hazard modelling with engineering design, it is possible to blend improved engineering in concert with financial disaster risk management (including insurance) solutions to improve the resiliency of life-systems infrastructure.

  10. Glutamic acid decarboxylase antibodies are indicators of the course, but not of the onset, of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities Study

    Directory of Open Access Journals (Sweden)

    A. Vigo

    2007-07-01

    Full Text Available To efficiently examine the association of glutamic acid decarboxylase antibody (GADA positivity with the onset and progression of diabetes in middle-aged adults, we performed a case-cohort study representing the ~9-year experience of 10,275 Atherosclerosis Risk in Communities Study participants, initially aged 45-64 years. Antibodies to glutamic acid decarboxylase (GAD65 were measured by radioimmunoassay in 580 incident diabetes cases and 544 non-cases. The overall weighted prevalence of GADA positivity (³1 U/mL was 7.3%. Baseline risk factors, with the exception of smoking and interleukin-6 (P £ 0.02, were generally similar between GADA-positive and -negative individuals. GADA positivity did not predict incident diabetes in multiply adjusted (HR = 1.04; 95%CI = 0.55, 1.96 proportional hazard analyses. However, a small non-significant adjusted risk (HR = 1.29; 95%CI = 0.58, 2.88 was seen for those in the highest tertile (³2.38 U/mL of positivity. GADA-positive and GADA-negative non-diabetic individuals had similar risk profiles for diabetes, with central obesity and elevated inflammation markers, aside from glucose, being the main predictors. Among diabetes cases at study's end, progression to insulin treatment increased monotonically as a function of baseline GADA level. Overall, being GADA positive increased risk of progression to insulin use almost 10 times (HR = 9.9; 95%CI = 3.4, 28.5. In conclusion, in initially non-diabetic middle-aged adults, GADA positivity did not increase diabetes risk, and the overall baseline profile of risk factors was similar for positive and negative individuals. Among middle-aged adults, with the possible exception of those with the highest GADA levels, autoimmune pathophysiology reflected by GADA may become clinically relevant only after diabetes onset.

  11. Ice targets for use at NTOF

    International Nuclear Information System (INIS)

    Mercer, D.J.

    1992-12-01

    This report describes ice targets which were used during an experiment at the Neutron Time of Flight facility (NTOF) at LAMPF. Reasons for using the ice targets are given, and the construction, refrigeration system, and target preparation are detailed. Results of the research using these ice targets will be published at a later date

  12. Sexting and sexual behavior in at-risk adolescents.

    Science.gov (United States)

    Houck, Christopher D; Barker, David; Rizzo, Christie; Hancock, Evan; Norton, Alicia; Brown, Larry K

    2014-02-01

    This study aimed to examine the prevalence of sexting behaviors (sexually explicit messages and/or pictures) among an at-risk sample of early adolescents as well as the associations between sexting behaviors and sexual behaviors, risk-related cognitions, and emotional regulation skills. It also aimed to determine whether differences in risk were associated with text-based versus photo-based sexts. Seventh-grade adolescents participating in a sexual risk prevention trial for at-risk early adolescents completed a computer-based survey at baseline regarding sexting behavior (having sent sexually explicit messages and/or pictures), sexual activities, intentions to have sex, perceived approval of sexual activity, and emotional regulation skills. Twenty-two percent of the sample reported having sexted in the past 6 months; sexual messages were endorsed by 17% (n = 71), sexual messages and photos by 5% (n = 21). Pictures were endorsed significantly more often by females (χ(2)[2] = 7.33, P = .03) and Latinos (χ(2)[2] = 7.27, P = .03). Sexting of any kind was associated with higher rates of engaging in a variety of sexual behaviors, and sending photos was associated with higher rates of sexual activity than sending text messages only. This was true for a range of behaviors from touching genitals over clothes (odds ratio [OR] = 1.98, P = .03) to oral sex (OR = 2.66, P Sexting behavior (both photo and text messages) was not uncommon among middle school youth and co-occurred with sexual behavior. These data suggest that phone behaviors, even flirtatious messages, may be an indicator of risk. Clinicians, parents, and health programs should discuss sexting with early adolescents.

  13. Sexting and Sexual Behavior in At-Risk Adolescents

    Science.gov (United States)

    Barker, David; Rizzo, Christie; Hancock, Evan; Norton, Alicia; Brown, Larry K.

    2014-01-01

    OBJECTIVES: This study aimed to examine the prevalence of sexting behaviors (sexually explicit messages and/or pictures) among an at-risk sample of early adolescents as well as the associations between sexting behaviors and sexual behaviors, risk-related cognitions, and emotional regulation skills. It also aimed to determine whether differences in risk were associated with text-based versus photo-based sexts. METHODS: Seventh-grade adolescents participating in a sexual risk prevention trial for at-risk early adolescents completed a computer-based survey at baseline regarding sexting behavior (having sent sexually explicit messages and/or pictures), sexual activities, intentions to have sex, perceived approval of sexual activity, and emotional regulation skills. RESULTS: Twenty-two percent of the sample reported having sexted in the past 6 months; sexual messages were endorsed by 17% (n = 71), sexual messages and photos by 5% (n = 21). Pictures were endorsed significantly more often by females (χ2[2] = 7.33, P = .03) and Latinos (χ2[2] = 7.27, P = .03). Sexting of any kind was associated with higher rates of engaging in a variety of sexual behaviors, and sending photos was associated with higher rates of sexual activity than sending text messages only. This was true for a range of behaviors from touching genitals over clothes (odds ratio [OR] = 1.98, P = .03) to oral sex (OR = 2.66, P Sexting behavior (both photo and text messages) was not uncommon among middle school youth and co-occurred with sexual behavior. These data suggest that phone behaviors, even flirtatious messages, may be an indicator of risk. Clinicians, parents, and health programs should discuss sexting with early adolescents. PMID:24394678

  14. There's a cream for that: A textual analysis of beauty and body-related advertisements aimed at middle-aged women.

    Science.gov (United States)

    Del Rosso, Teri

    2017-01-01

    This article explores the magazine advertising strategies and tactics used by health and beauty products to target middle-aged women. Advertisements found in the April 2013 issues of Shape, Fitness, and Women's Health were analyzed using intersectionality to determine how these advertisements are presenting messages pertaining to age, gender, and sexuality and how these messages can "other" and marginalize certain identities. The findings suggest that advertisement strategies implement pseudoscience, heteronormativity, hegemonic beauty, and body ideals to establish an idealized version of middle-aged womanhood.

  15. Exercise electrocardiogram in middle-aged and older leisure time sportsmen: 100 exercise tests would be enough to identify one silent myocardial ischemia at risk for cardiac event.

    Science.gov (United States)

    Hupin, David; Edouard, Pascal; Oriol, Mathieu; Laukkanen, Jari; Abraham, Pierre; Doutreleau, Stéphane; Guy, Jean-Michel; Carré, François; Barthélémy, Jean-Claude; Roche, Frédéric; Chatard, Jean-Claude

    2018-04-15

    The importance of exercise electrocardiogram (ECG) has been controversial in the prevention of cardiac events among sportsmen. The aim of this study was to determine the frequency of silent myocardial ischemia (SMI) from an exercise ECG and its relationship with induced coronary angiographic assessment and potentially preventable cardiac events. This prospective cohort study included leisure time asymptomatic sportsmen over 35years old, referred from 2011 to 2014 in the Sports Medicine Unit of the University Hospital of Saint-Etienne. Of the cohort of 1500 sportsmen (1205 men; mean age 50.7±9.4years; physical activity level 32.8±26.8MET-h/week), 951 (63%) had at least one cardiovascular disease (CVD) risk factor. Family history, medical examination and standard resting 12-lead were collected. A total of 163 exercise ECGs (10.9%) were defined as positive, most of them due to SMI (n=129, 8.6%). SMI was an indication for coronary angiography in 23 cases, leading to 17 documented SMIs (1.1%), including 11 significant stenoses requiring revascularization. In multivariate logistic regression analysis, a high risk of CVD (OR=2.65 [CI 95%: 1.33-5.27], p=0.005) and an age >50years (OR=2.71 [CI 95%: 1.65-4.44], p<0.0001) were independently associated with confirmed SMI. The association of positive exercise ECG with significant coronary stenosis was stronger among sportsmen with CVD risk factors and older than 50years. Screening by exercise ECG can lower the risk of cardiac events in middle-aged and older sportsmen. One hundred tests would be enough to detect one silent myocardial ischemia at risk for cardiac event. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Effectiveness of mHealth Interventions Targeting Health Care Workers to Improve Pregnancy Outcomes in Low- and Middle-Income Countries: A Systematic Review.

    Science.gov (United States)

    Amoakoh-Coleman, Mary; Borgstein, Alexander Berend-Jan; Sondaal, Stephanie Fv; Grobbee, Diederick E; Miltenburg, Andrea Solnes; Verwijs, Mirjam; Ansah, Evelyn K; Browne, Joyce L; Klipstein-Grobusch, Kerstin

    2016-08-19

    Low- and middle-income countries (LMICs) face the highest burden of maternal and neonatal deaths. Concurrently, they have the lowest number of physicians. Innovative methods such as the exchange of health-related information using mobile devices (mHealth) may support health care workers in the provision of antenatal, delivery, and postnatal care to improve maternal and neonatal outcomes in LMICs. We conducted a systematic review evaluating the effectiveness of mHealth interventions targeting health care workers to improve maternal and neonatal outcomes in LMIC. The Cochrane Library, PubMed, EMBASE, Global Health Library, and Popline were searched using predetermined search and indexing terms. Quality assessment was performed using an adapted Cochrane Risk of Bias Tool. A strength, weakness, opportunity, and threat analysis was performed for each included paper. A total of 19 studies were included for this systematic review, 10 intervention and 9 descriptive studies. mHealth interventions were used as communication, data collection, or educational tool by health care providers primarily at the community level in the provision of antenatal, delivery, and postnatal care. Interventions were used to track pregnant women to improve antenatal and delivery care, as well as facilitate referrals. None of the studies directly assessed the effect of mHealth on maternal and neonatal mortality. Challenges of mHealth interventions to assist health care workers consisted mainly of technical problems, such as mobile network coverage, internet access, electricity access, and maintenance of mobile phones. mHealth interventions targeting health care workers have the potential to improve maternal and neonatal health services in LMICs. However, there is a gap in the knowledge whether mHealth interventions directly affect maternal and neonatal outcomes and future research should employ experimental designs with relevant outcome measures to address this gap.

  17. Bacterial infection increases risk of carcinogenesis by targeting mitochondria

    DEFF Research Database (Denmark)

    Strickertsson, Jesper A.B.; Desler, Claus; Rasmussen, Lene Juel

    2017-01-01

    pathways, and compares the impact of the bacterial alteration of mitochondrial function to that of cancer. Bacterial virulence factors have been demonstrated to induce mutations of mitochondrial DNA (mtDNA) and to modulate DNA repair pathways of the mitochondria. Furthermore, virulence factors can induce...... or impair the intrinsic apoptotic pathway. The effect of bacterial targeting of mitochondria is analogous to behavior of mitochondria in a wide array of tumours, and this strongly suggests that mitochondrial targeting of bacteria is a risk factor for carcinogenesis....

  18. Predicting dyslexia at age 11 from a risk index questionnaire at age 5.

    Science.gov (United States)

    Helland, Turid; Plante, Elena; Hugdahl, Kenneth

    2011-08-01

    This study focused on predicting dyslexia in children ahead of formal literacy training. Because dyslexia is a constitutional impairment, risk factors should be seen in preschool. It was hypothesized that data gathered at age 5 using questions targeting the dyslexia endophenotype should be reliable and valid predictors of dyslexia at age 11. A questionnaire was given to caretakers of 120 5-year-old children, and a risk index score was calculated based on questions regarding health, laterality, motor skills, language, special needs education and heredity. An at-risk group (n = 25) and matched controls (n = 24) were followed until age 11, when a similar questionnaire and literacy tests were administered to the children who participated in the follow-up study (22 at risk and 20 control). Half of the at-risk children and two of the control children at age 5 were identified as having dyslexia at age 11 (8 girls and 5 boys). It is concluded that it is possible to identify children at the age of 5 who will have dyslexia at the age of 11 through a questionnaire approach. Copyright © 2011 John Wiley & Sons, Ltd.

  19. Addressing diabetes at the crossroads of global pandemic and regional culture: Comment on "The curse of wealth – Middle Eastern countries need to address the rapidly rising burden of diabetes"

    OpenAIRE

    Hsu, William C.; Gabbay, Robert A.

    2014-01-01

    As diabetes and obesity rates continue to climb at astronomical rates in the Middle East, future generations are at an even greater risk for diabetes and the associated complications. Many factors are at play and it is clear that creative solutions are needed to retool provider resources in the Middle East towards prevention of diabetes and its complications while leveraging technology to maximize outreach within the accepted cultural norms. Only by building the capacity to address the curren...

  20. Gender Differences in Internalizing Symptoms and Suicide Risk Among Men and Women Seeking Treatment for Cannabis Use Disorder from Late Adolescence to Middle Adulthood.

    Science.gov (United States)

    Foster, Katherine T; Li, Ningfei; McClure, Erin A; Sonne, Susan C; Gray, Kevin M

    2016-07-01

    Cannabis continues to rise in popularity as the perception of its harmfulness decreases and evidence of its deleterious developmental effect increases. While internalizing distress and suicide risk have been linked with cannabis use problems [DSM-5 cannabis use disorder (CUD); DSM-IV cannabis abuse and dependence] it remains unclear how this association varies over the course of development in treatment-seeking men and women. The current study utilized the National Drug Abuse Treatment Clinical Trials Network (NIDA CTN) to conduct a cross-sectional comparison of internalizing distress and suicide risk among men (n=437) and women (n=163) spanning ages 18-50 who met DSM-5 criteria for CUD. Interactions between gender and developmental stage (i.e., late adolescence, early adulthood, and middle adulthood) were observed for suicide risk and anxiety but not depression problems. Specifically, women seeking CUD treatment in late adolescence and middle adulthood exhibited significantly higher rates of anxiety and suicide risk compared to men seeking treatment during the same developmental stages. Internalizing distress and suicide risk did not differ between treatment-seeking men and women in the early adult stage. Overall, results suggest that the structure of risk for CUD may differ in men and women across the lifespan and that women presenting for CUD treatment during late adolescence and middle adulthood may uniquely benefit from intervention designed to address these elevations in anxiety and suicide risk. Published by Elsevier Inc.

  1. Perceived risks and use of psychotherapy via telemedicine for patients at risk for suicide.

    Science.gov (United States)

    Gilmore, Amanda K; Ward-Ciesielski, Erin F

    2017-01-01

    Introduction Suicide is a major public health problem and its human, emotional, and economic costs are significant. Individuals in rural areas are at highest risk for suicide. However, telemedicine services are typically not rendered to individuals who are actively suicidal. The goals of the current study were to identify the risks of using telemedicine for mental healthcare from the perspective of licensed mental health providers and to determine factors associated with the use of telemedicine with patients who are at high risk for suicide. Methods A total of 52 licensed mental health providers were recruited online through several professional organization listservs and targeted emails. Providers completed online questionnaires regarding demographics, caseload of suicidal patients, perceived risks for using telemedicine with patients at risk for suicide, attitudes towards telemedicine, and use of telemedicine with patients at risk for suicide. Results Three key perceived risks associated with using telemedicine were identified, including assessment, lack of control over patient, and difficulties triaging patients if needed. It was also found that individuals who had more positive attitudes towards telemedicine, younger providers, and more experienced providers were more likely to use telemedicine with patients who are at high risk for suicide. Discussion To our knowledge, this is the first study to examine the perceived risks and use of telemedicine with patients at high risk for suicide. It is essential to continue this line of research to develop protocols for the provision of evidence-based therapy via telemedicine for this high-risk group.

  2. Prevalence and risk factors of hypertension for the middle-aged population in China - results from the China Health and Retirement Longitudinal Study (CHARLS).

    Science.gov (United States)

    Li, Zhen; Fu, Chang; Yang, Fan; Mao, Zongfu

    2018-03-19

    The prevalence of hypertension in middle-aged people is increasing. However, few studies have examined the risk factors of hypertension among the middle-aged population. The aim of this study is to present the prevalence of hypertension and its risk factors for the middle-aged population in China. The data were from the third-wave national survey (2015) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7,178 respondents aged 45-59 years were included in this study. Hypertension was defined as SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg or currently taking antihypertensive medicines. Multivariate logistic regression analyses were used to identify the risk factors of hypertension. The prevalence of hypertension was 29.12% (95%CI = 28.07-30.17). Hypertension was more prevalent among men than women (31.63% vs. 27.03%). Older age, higher BMI, chronic diseases, and poor health status were independently associated with hypertension in both genders (p < 0.05). Among women, college education (OR = 0.302, 95%CI = 0.152-0.598), marriage or cohabitation (OR = 0.756, 95%CI = 0.584-0.98), and drinking more than once a month (OR = 0.645, 95% = 0.498-0.836) led to a decreased likelihood of hypertension. Individuals with larger waist circumference were more likely to have hypertension (OR = 1.57, 95%CI = 1.294-1.906). Our results indicate that hypertension is highly prevalent in the middle-aged population in China. Men are more likely to have hypertension than women. Older age, higher BMI, chronic diseases and poor self-rated health are risk factors for hypertension in both genders. Large waist circumference, singleness, low educational level, and non-drinking are risk factors of hypertension among women but not among men.

  3. Risk of revolutions in the Middle East. [Of importance for oil supplies

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, R.

    1983-01-01

    Western Europe and of course also Denmark will still for many years be dependent on the oil that is recovered in the Arabian Gulf. Denmark has the largest percentage oil conservation in Western Europe. It is not only due to the power plants using more coal, but also our energy consumption decreases more than in other Western European countries. In spite of these reulsts it is obvious, that Denmarks economy entirely depends on the economy of our neighbouring countries. Security of energy supply is therefore a western problem, which Denmark cannot solve alone. The development of societies in the Middle East countries, including the key country Saudi Arabia, is so labile, that a period of crisis with insecurity in the oil supplies cannot be excluded. In addition to this is the risk of international conflicts, that stop the oil export. The probability of these risks becoming actualized in the next 10 to 15 years is hard to tell, but it is important to call the attention to the risks. These risks seem to be much underrated in the discussions of security policy, where the east-west problems dominate. Therefore it would be wrong to take the westernization of the Arabic societies for granted. Periods with extreme ideologies are very probable. As to the international conflicts one only has to refer to the present war between Iraq and Iran.

  4. Common origin of positive ionospheric storms at middle latitudes and the geomagnetic activity effect at low latitudes

    International Nuclear Information System (INIS)

    Proelss, G.W.

    1993-01-01

    The author looks for a correlation between two different atmospheric effects. They are a positive atmospheric storm (an anomalous increase in the F2 region ionization density), observed at middle latitudes, and the geomagnetic activity effect (the anomalous changes of temperature and gas density seen in the thermosphere), observed at low latitudes. A temporal correlation is sought to test the argument that both of these effects are the result of travelling atmospheric disturbances (TAD). A TAD is a pulselike atmospheric wave thought to be generated by substorm activity, and to propagate with high velocity (600 m/s) from polar latitudes toward equatorial latitudes. The author looks at data from five separate events correlating magnetic, ionospheric, and neutral atmospheric measurements. The conclusion is that there is a positive correlation between magnetic substorm activity at high latitudes, and positive ionospheric storms at middle latitudes and geomagnetic activity at low latitudes. The time correlations are consistent with high propagation speeds between these events. The author also presents arguments which indicate that the middle latitude positive ionospheric storms are not the result of electric field effects

  5. Common Risk Target for severe accidents of nuclear power plants based on IAEA INES scale

    International Nuclear Information System (INIS)

    Vitázková, Jiřina; Cazzoli, Errico

    2013-01-01

    The IAEA has repeatedly recommended that the nuclear community should arrive at a common understanding and definition of safety goals for severe accidents in nuclear power plants. The recommendation has only found partial answers, despite the numerous working groups and forums devoted to this effort. The most widely accepted definition of goals is based on the concept of Large (Early) Release Frequencies (L(E)RF) and its derivatives, a surrogate concept derived from results of Probabilistic Safety Assessments (PSAs) which was first introduced in the USA almost twenty years ago and much later accepted by the USNRC for risk informed decision making, but not for safety demonstrations. Other types of Safety Goals have been adopted by some nuclear authorities, but the main drawback of all current definitions is that they may apply only to LWRs. The lack of unifying safety/risk parameter throughout of PSAs worldwide is the basis of the present work, and an attempt is made to arrive at the definition of a Risk Target for severe accidents in NPPs, consistent with the IAEA definitions having a technical basis, which can be adopted without modifications for Generation IV power plants. The proposal of Common Risk Target in this work represents an attempt to define a Common Risk Target based on technical reasoning, reflecting IAEA definitions as well as harmonization requirements raised by the whole European Community in various OECD, ASAMPSA2 and SARNET (Guentay et al., 2006) conclusions and Council Directive of The European Union (Community Framework, 2009) as well as lastly performed stress tests of nuclear power plants throughout the Europe (Peer Review Report, 2012). The basic concept of CRT was first introduced and developed within the European project ASAMPSA2 by the authors of this article and was accepted by majority of world PSA experts participating in final evaluation and survey of the project (Guentay, 2011). In the proposed Risk Target concept an innovative

  6. Common Risk Target for severe accidents of nuclear power plants based on IAEA INES scale

    Energy Technology Data Exchange (ETDEWEB)

    Vitázková, Jiřina, E-mail: jirina@snus.sk [Vitázková-Vitty, Sládkovičova 24, 900 28 Ivanka pri Dunaji (Slovakia); Cazzoli, Errico, E-mail: erik.cazzoli@gmx.net [Cazzoli Consulting, Wiesenweg 14, CH-5415 Nussbaumen (Switzerland)

    2013-09-15

    The IAEA has repeatedly recommended that the nuclear community should arrive at a common understanding and definition of safety goals for severe accidents in nuclear power plants. The recommendation has only found partial answers, despite the numerous working groups and forums devoted to this effort. The most widely accepted definition of goals is based on the concept of Large (Early) Release Frequencies (L(E)RF) and its derivatives, a surrogate concept derived from results of Probabilistic Safety Assessments (PSAs) which was first introduced in the USA almost twenty years ago and much later accepted by the USNRC for risk informed decision making, but not for safety demonstrations. Other types of Safety Goals have been adopted by some nuclear authorities, but the main drawback of all current definitions is that they may apply only to LWRs. The lack of unifying safety/risk parameter throughout of PSAs worldwide is the basis of the present work, and an attempt is made to arrive at the definition of a Risk Target for severe accidents in NPPs, consistent with the IAEA definitions having a technical basis, which can be adopted without modifications for Generation IV power plants. The proposal of Common Risk Target in this work represents an attempt to define a Common Risk Target based on technical reasoning, reflecting IAEA definitions as well as harmonization requirements raised by the whole European Community in various OECD, ASAMPSA2 and SARNET (Guentay et al., 2006) conclusions and Council Directive of The European Union (Community Framework, 2009) as well as lastly performed stress tests of nuclear power plants throughout the Europe (Peer Review Report, 2012). The basic concept of CRT was first introduced and developed within the European project ASAMPSA2 by the authors of this article and was accepted by majority of world PSA experts participating in final evaluation and survey of the project (Guentay, 2011). In the proposed Risk Target concept an innovative

  7. Targets and Witnesses: Middle School Students' Sexual Harassment Experiences

    Science.gov (United States)

    Lichty, Lauren F.; Campbell, Rebecca

    2012-01-01

    School-based peer-to-peer sexual harassment (SH) emerged as an issue of concern in the early 1990s. As a developing field, this literature has several notable gaps. The current study extends previous research by, (a) exploring the understudied experiences of middle school students, (b) assessing students' experiences witnessing SH, and (c)…

  8. MRI-assisted versus conventional treatment planning in brachytherapy of cervical and endometrial carcinoma: The impact of individual anatomy on dose distribution in target volume and organs at risk

    International Nuclear Information System (INIS)

    Wulf, Joern; Sauer, Otto A.; Herbolsheimer, Michael; Oppitz, Ulrich; Flentje, Michael

    1996-01-01

    Objective: Dose prescription and definition of target volume in brachytherapy of cervical and endometrial cancer are calculated to standard points as Manchester point A or point My(ometrium) in most centers. Calculation of doses to organs at risk mainly relies on ICRU-report 38. But standard dose prescription neglects individual patient anatomy. While MRI and CT had widespread impact on individual planning in external beam radiotherapy, there is still a minor influence on brachytherapy. The impact of individual anatomy on dose distribution in target volume and organs at risk demonstrates the objective of individual brachytherapy planning. Materials and Methods: 8 patients with cervical and 4 patients with endometrial carcinoma underwent MRI of the pelvis with in-situ applicators (ring-tandem applicators for cervical carcinoma and modified Heyman-capsules for endometrial carcinoma). T1w slices were angulated coronal and sagittal to get rectangular reproductions to applicator axis. Orthogonal or isocentric X-ray films for conventional treatment planning were done. MRI-information on target and organs at risk was transformed into coordinates relative to applicator axis and dose calculation on the database of conventional treatment planning was performed by Nucletron Planning System PLATO. Isodoses were projected into MRI slices. Prescribed dose to patients with cervical cancer was 8.5 Gy to point A resp. 10 Gy to point My (2cm below fundal myometrium and 2cm lateral applicator axis) in endometrial cancer. Results: Dose prescription to Manchester point A or point My represented in only 50% of cases uterine serosa. Instead of 2cm lateral of applicator axis, uterine surface ranged from 1.0 cm to 3.9 cm at the level of point A (mean 2.25 cm coronal and 1.77 cm sagittal) and from 1.5 cm to 4.4 cm at the level of point My (mean 2.7 cm coronal and 2.1 cm sagittal). Uterine volume ranged from 69 cc to 277 cc, mean volume was 150cc. Dose-volume histograms of patients with

  9. Risk-targeted safety distance of reinforced concrete buildings from natural-gas transmission pipelines

    International Nuclear Information System (INIS)

    Russo, Paola; Parisi, Fulvio

    2016-01-01

    Natural-gas pipeline accidents mostly result in major damage even to buildings located far away. Therefore, proper safety distances should be observed in land use planning to ensure target safety levels for both existing and new buildings. In this paper, a quantitative risk assessment procedure is presented for the estimation of the annual probability of direct structural damage to reinforced concrete buildings associated with high-pressure natural-gas pipeline explosions. The procedure is based on Monte Carlo simulation and takes into account physical features of blast generation and propagation, as well as damage to reinforced concrete columns. The natural-gas jet release process and the flammable cloud size are estimated through SLAB one-dimensional integral model incorporating a release rate model. The explosion effects are evaluated by a Multi-Energy Method. Damage to reinforced concrete columns is predicted by means of pressure–impulse diagrams. The conditional probability of damage was estimated at multiple pressure–impulse levels, allowing blast fragility surfaces to be derived at different performance limit states. Finally, blast risk was evaluated and allowed the estimation of minimum pipeline-to-building safety distances for risk-informed urban planning. The probabilistic procedure presented herein may be used for performance-based design/assessment of buildings and to define the path of new natural-gas pipeline networks. - Highlights: • The safety of buildings against blast loads due to pipeline accidents is assessed. • A probabilistic risk assessment procedure is presented for natural-gas pipelines. • The annual risk of collapse of reinforced concrete building columns is evaluated. • Monte Carlo simulation was carried out considering both pipeline and column features. • A risk-targeted safety distance is proposed for blast strength class 9.

  10. Depression and HIV risk behavior practices among at risk women.

    Science.gov (United States)

    Klein, Hugh; Elifson, Kirk W; Sterk, Claire E

    2008-01-01

    In this study, we examined the relationship between depression and HIV-related risk behavior practices in a sample of 250 at risk, predominantly African American women living in the Atlanta, Georgia metropolitan area. Interviews were conducted between August 1997 and August 2000. Street outreach efforts were used to identify potential study participants, with further expansion of the sample via targeted sampling and ethnographic mapping procedures. Our conceptual model hypothesized a relationship between depression and HIV risk in which depression and condom-related attitudes were construed as intervening (or mediating) variables. A multivariate analysis was used to determine the relationship between depression and women's risk behaviors. The results showed that depression was a key-mediating variable, having its primary influence on women's risky practices through its impact upon their attitudes toward using condoms. Factors associated with depression, included religiosity, closeness of family relationships, financial problems, childhood maltreatment experiences, and drug-related problems. The implications of these findings for prevention and intervention efforts are: (1) heightening faith community involvement and religious participation to decrease depression; (2) working with women whose familial bonds are in need of strengthening to combat depression; (3) providing mental health and counseling services to women who were emotionally and/or sexually abused during their formative years seems to help these women to recover from unresolved issues that may be fueling depression; (4) assisting at risk women who need training in money management issues to minimize their risk for depression; and (5) helping women drug abusers to receive treatment for their drug problems to combat their depression and lower their HIV risk.

  11. Does Head Start differentially benefit children with risks targeted by the program’s service model?☆

    Science.gov (United States)

    Miller, Elizabeth B.; Farkas, George; Duncan, Greg J.

    2015-01-01

    Data from the Head Start Impact Study (N = 3540) were used to test for differential benefits of Head Start after one program year and after kindergarten on pre-academic and behavior outcomes for children at risk in the domains targeted by the program’s comprehensive services. Although random assignment to Head Start produced positive treatment main effects on children’s pre-academic skills and behavior problems, residualized growth models showed that random assignment to Head Start did not differentially benefit the pre-academic skills of children with risk factors targeted by the Head Start service model. The models showed detrimental impacts of Head Start for maternal-reported behavior problems of high-risk children, but slightly more positive impacts for teacher-reported behavior. Policy implications for Head Start are discussed. PMID:26379369

  12. Predicting transitions in low and high levels of risk behavior from early to middle adolescence: the TRAILS study

    NARCIS (Netherlands)

    Monshouwer, K.; Harakeh, Z.; Lugtig, P.; Huizink, A.; Creemers, H.E.; Reijneveld, S.A.; de Winter, A.F.; van Oort, F.; Ormel, J.; Vollebergh, W.A.M.

    2012-01-01

    The present study examined the joint development of substance use and externalizing problems in early and middle adolescence. First, it was tested whether the relevant groups found in previous studies i.e., those with an early onset, a late onset, and no onset or low levels of risk behavior could be

  13. Radioactivity measurements and risk assessments in soil samples at south and middle of Qatar

    International Nuclear Information System (INIS)

    Al-Kinani, A.; Al Dosari, M.; Amr, M.A.; Al-Saad, K.A.; Helal, A.I.

    2012-01-01

    Health risks associated with the exposure to the natural radioactivity present in soil materials has great concern all over the world. Thus soil samples collected from an urban area at south and middle of Qatar in order to measure natural radioactivity, 40 K, 226 Ra and 232 Th and the artificial 137 Cs using gamma-ray spectrometry method.The soil activity concentrations ranges from 25.01- 40.31 for 226 Ra, 12.37- 4.99 for 232 Th and 133.8 - 250.1 for 40 K with mean values of 57, 87 and 207 Bq/ kg, respectively. The concentrations of these radionuclides are compared with the available data from other countries. The average and ranges of activity concentration of 226 Ra in Qatar soil areas are very much comparable to the world Figures. However, the concentration for 232 Th is comparable to other Gulf area and lower than that for Egypt and the world figures.The concentration for 40 K is lower as compared with Egypt, world, and Kuwait figures but comparable to Oman figures.The radium equivalent activity (Ra eq) in these soil samples ranges from 74.45 Bq/ kg to 41.21 Bq/ kg) with mean value of 57.4 Bq/ kg which is far below the safe limit (permissible) limit (370 Bq/ kg). The calculated values for external hazard index Hex for the soil samples range from 0.102 - 0.21 and average concentration of 0.164 which is lower than other values reported .However these values are lower than unity; therefore, the soil from these regions is safe and can be used as a construction material without posing any significant radiological threat to population.The absorbed dose rate calculated from activity concentration of 226 Ra, 232 Th and 40 K ranges between 11.529 - 21.446, 2.383 - 11.744, and 5.304 -10.357 n Gy/ h, respectively and the total average absorbed dose rate 28.915 n Gy/ h which are lower than the world wide average absorbed dose rate 51 n Gy/ h. The total absorbed dose in the study area ranges from 20.146 - 40.389 n Gy/ h with an average value of 28.915 n Gy/ h .The

  14. Middle East respiratory syndrome in children. Dental considerations

    Directory of Open Access Journals (Sweden)

    Fares S. Al-Sehaibany

    2017-04-01

    Full Text Available As of January 2016, 1,633 laboratory-confirmed cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV infection and 587 MERS-related deaths have been reported by the World Health Organization globally. Middle East Respiratory Syndrome Coronavirus may occur sporadically in communities or may be transmitted within families or hospitals. The number of confirmed MERS-CoV cases among healthcare workers has been increasing. Middle East Respiratory Syndrome Coronavirus may also spread through aerosols generated during various dental treatments, resulting in transmission between patients and dentists. As MERS-CoV cases have also been reported among children, pediatric dentists are at risk of MERS-CoV infection. This review discusses MERS-CoV infection in children and healthcare workers, especially pediatric dentists, and considerations pertaining to pediatric dentistry. Although no cases of MERS-CoV transmission between a patient and a dentist have yet been reported, the risk of MERS-CoV transmission from an infected patient may be high due to the unique work environment of dentists (aerosol generation.

  15. Visit-to-Visit Blood Pressure Variability in Young Adulthood and Hippocampal Volume and Integrity at Middle Age: The CARDIA Study (Coronary Artery Risk Development in Young Adults).

    Science.gov (United States)

    Yano, Yuichiro; Reis, Jared P; Levine, Deborah A; Bryan, R Nick; Viera, Anthony J; Shimbo, Daichi; Tedla, Yacob G; Allen, Norrina B; Schreiner, Pamela J; Bancks, Michael P; Sidney, Stephen; Pletcher, Mark J; Liu, Kiang; Greenland, Philip; Lloyd-Jones, Donald M; Launer, Lenore J

    2017-12-01

    The aims of this study are to assess the relationships of visit-to-visit blood pressure (BP) variability in young adulthood to hippocampal volume and integrity at middle age. We used data over 8 examinations spanning 25 years collected in the CARDIA study (Coronary Artery Risk Development in Young Adults) of black and white adults (age, 18-30 years) started in 1985 to 1986. Visit-to-visit BP variability was defined as by SD BP and average real variability (ARV BP , defined as the absolute differences of BP between successive BP measurements). Hippocampal tissue volume standardized by intracranial volume (%) and integrity assessed by fractional anisotropy were measured by 3-Tesla magnetic resonance imaging at the year-25 examination (n=545; mean age, 51 years; 54% women and 34% African Americans). Mean systolic BP (SBP)/diastolic BP levels were 110/69 mm Hg at year 0 (baseline), 117/73 mm Hg at year 25, and ARV SBP and SD SBP were 7.7 and 7.9 mm Hg, respectively. In multivariable-adjusted linear models, higher ARV SBP was associated with lower hippocampal volume (unstandardized regression coefficient [standard error] with 1-SD higher ARV SBP : -0.006 [0.003]), and higher SD SBP with lower hippocampal fractional anisotropy (-0.02 [0.01]; all P young adulthood may be useful in assessing the potential risk for reductions in hippocampal volume and integrity in midlife. © 2017 American Heart Association, Inc.

  16. Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study

    Directory of Open Access Journals (Sweden)

    Bloch Katia V

    2008-08-01

    Full Text Available Abstract Background Fracture after falling has been identified as an important problem in public health. Most studies of risk factors for fractures due to falls have been carried out in developed countries, although the size of the elderly population is increasing fast in middle income countries. The objective of this paper is to identify risk factors for fall related to severe fractures in those aged 60 or more in a middle-income country. Methods A case-control study was carried out in Rio de Janeiro-Brazil based general hospitals between 2002–2003. Two hundred-fifty hospitalised cases of fracture were matched with 250 community controls by sex, age group and living area. Data were collected for socio-demographic variables, health status and drugs used before the fall. A conditional logistic regression model was fitted to identify variables associated with the risk of fall related severe fracture. Results Low body mass index, cognitive impairment, stroke and lack of urine control were associated with increased risk of severe fall related fractures. Benzodiazepines and muscle relaxants were also related to an increased risk of severe fractures while moderate use of alcohol was associated with reduced risk. Conclusion Although the association between benzodiazepines and fractures due to fall has been consistently demonstrated for old people, this has not been the case for muscle relaxant drugs. The decision to prescribe muscle relaxants for elderly people should take into account the risk of severe fracture associated with these drugs.

  17. Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study.

    Science.gov (United States)

    Coutinho, Evandro S F; Fletcher, Astrid; Bloch, Katia V; Rodrigues, Laura C

    2008-08-26

    Fracture after falling has been identified as an important problem in public health. Most studies of risk factors for fractures due to falls have been carried out in developed countries, although the size of the elderly population is increasing fast in middle income countries. The objective of this paper is to identify risk factors for fall related to severe fractures in those aged 60 or more in a middle-income country. A case-control study was carried out in Rio de Janeiro-Brazil based general hospitals between 2002-2003. Two hundred-fifty hospitalised cases of fracture were matched with 250 community controls by sex, age group and living area. Data were collected for socio-demographic variables, health status and drugs used before the fall. A conditional logistic regression model was fitted to identify variables associated with the risk of fall related severe fracture. Low body mass index, cognitive impairment, stroke and lack of urine control were associated with increased risk of severe fall related fractures. Benzodiazepines and muscle relaxants were also related to an increased risk of severe fractures while moderate use of alcohol was associated with reduced risk. Although the association between benzodiazepines and fractures due to fall has been consistently demonstrated for old people, this has not been the case for muscle relaxant drugs. The decision to prescribe muscle relaxants for elderly people should take into account the risk of severe fracture associated with these drugs.

  18. Targeted proteins for diabetes drug design

    Science.gov (United States)

    Doan Trang Nguyen, Ngoc; Thi Le, Ly

    2012-03-01

    Type 2 diabetes mellitus is a common metabolism disorder characterized by high glucose in the bloodstream, especially in the case of insulin resistance and relative insulin deficiency. Nowadays, it is very common in middle-aged people and involves such dangerous symptoms as increasing risk of stroke, obesity and heart failure. In Vietnam, besides the common treatment of insulin injection, some herbal medication is used but no unified optimum remedy for the disease yet exists and there is no production of antidiabetic drugs in the domestic market yet. In the development of nanomedicine at the present time, drug design is considered as an innovative tool for researchers to study the mechanisms of diseases at the molecular level. The aim of this article is to review some common protein targets involved in type 2 diabetes, offering a new idea for designing new drug candidates to produce antidiabetic drugs against type 2 diabetes for Vietnamese people.

  19. Targeted proteins for diabetes drug design

    International Nuclear Information System (INIS)

    Trang Nguyen, Ngoc Doan; Le, Ly Thi

    2012-01-01

    Type 2 diabetes mellitus is a common metabolism disorder characterized by high glucose in the bloodstream, especially in the case of insulin resistance and relative insulin deficiency. Nowadays, it is very common in middle-aged people and involves such dangerous symptoms as increasing risk of stroke, obesity and heart failure. In Vietnam, besides the common treatment of insulin injection, some herbal medication is used but no unified optimum remedy for the disease yet exists and there is no production of antidiabetic drugs in the domestic market yet. In the development of nanomedicine at the present time, drug design is considered as an innovative tool for researchers to study the mechanisms of diseases at the molecular level. The aim of this article is to review some common protein targets involved in type 2 diabetes, offering a new idea for designing new drug candidates to produce antidiabetic drugs against type 2 diabetes for Vietnamese people. (review)

  20. Social and individual risk factors for suicide ideation among Chinese children and adolescents: A multilevel analysis.

    Science.gov (United States)

    Tan, Ling; Xia, Tiansheng; Reece, Christy

    2018-04-01

    The objective of this study was to investigate the prevalence and predictors of suicide ideation among primary, middle and high school students. We used multilevel modelling to investigate suicide ideation among 12,733 Chinese children and adolescents aged 9-18 years from wide range of areas across China. Approximately, 32.09% of children and adolescents reported suicide ideation, with females were more likely to report suicide ideation than males (38.09% vs. 29.95%). Our results showed that the risk factors in primary school students were different from middle and high school student groups, whereas significant risk factors for middle and high school students were similar. The city's standard of living as indicated by the Engel coefficient and the city's divorce rate were positively associated with the prevalence of suicide ideation; in contrast, the school's pupil-to-teacher ratio was negatively correlated with elevated suicide ideation. Significant risk factors for suicide ideation included study anxiety, self-accusation tendency, impulsive tendency, terror tendency and physical symptoms. These results have important implications for the prevention of suicide, suggesting that both contextual (city-level) and compositional (individual-level) factors could be important targets for prevention and intervention for children and adolescents at risk of suicide ideation. © 2016 International Union of Psychological Science.

  1. Migration to middle-income countries and tuberculosis-global policies for global economies.

    Science.gov (United States)

    Pescarini, Julia Moreira; Rodrigues, Laura Cunha; Gomes, M Gabriela M; Waldman, Eliseu Alves

    2017-03-15

    International migration to middle-income countries is increasing and its health consequences, in particular increasing transmission rates of tuberculosis (TB), deserve consideration. Migration and TB are a matter of concern in high-income countries and targeted screening of migrants for active and latent TB infection is a main strategy to manage risk and minimize transmission. In this paper, we discuss some aspects of TB control and migration in the context of middle-income countries, together with the prospect of responding with equitable and comprehensive policies. TB rates in middle-income countries remain disproportionally high among the poorest and most vulnerable groups in large cities where most migrant populations are concentrated. Policies that tackle migrant TB in high-income countries may be inadequate for middle-income countries because of their different socio-economic and cultural scenarios. Strategies to control TB in these settings must take into account the characteristics of middle-income countries and the complexity of TB as a disease of poverty. Intersectoral policies of social protection such as cash-transfer programs help reducing poverty and improving health in vulnerable populations. We address the development of new approaches to improve well-established strategies including contact tracing and active and latent TB screening as an 'add on' to the existing health care guidelines of conditional cash transfer programs. In addition, we discuss how it might improve health and welfare among both poor migrants and locally-born populations. Authorities from middle-income countries should recognise that migrants are a vulnerable social group and promote cooperation efforts between sending and receiving countries for mitigation of poverty and prevention of disease in this group. Middle-income countries have long sent migrants overseas. However, the influx of large migrant populations into their societies is relatively new and a growing phenomenon and

  2. Elemental conservation units: communicating extinction risk without dictating targets for protection.

    Science.gov (United States)

    Wood, Chris C; Gross, Mart R

    2008-02-01

    Conservation biologists mostly agree on the need to identify and protect biodiversity below the species level but have not yet resolved the best approach. We addressed 2 issues relevant to this debate. First, we distinguished between the abstract goal of preserving the maximum amount of unique biodiversity and the pragmatic goal of minimizing the loss of ecological goods and services given that further loss of biodiversity seems inevitable. Second, we distinguished between the scientific task of assessing extinction risk and the normative task of choosing targets for protection. We propose that scientific advice on extinction risk be given at the smallest meaningful scale: the elemental conservation unit (ECU). An ECU is a demographically isolated population whose probability of extinction over the time scale of interest (say 100 years) is not substantially affected by natural immigration from other populations. Within this time frame, the loss of an ECU would be irreversible without human intervention. Society's decision to protect an ECU ought to reflect human values that have social, economic, and political dimensions. Scientists can best inform this decision by providing advice about the probability that an ECU will be lost and the ecological and evolutionary consequences of that loss in a form that can be integrated into landscape planning. The ECU approach provides maximum flexibility to decision makers and ensures that the scientific task of assessing extinction risk informs, but remains distinct from, the normative social challenge of setting conservation targets.

  3. The costs of a sexually transmitted infection outreach and treatment programme targeting most at risk youth in Tajikistan

    Directory of Open Access Journals (Sweden)

    Johns Benjamin

    2009-11-01

    Full Text Available Abstract Background Targeted outreach, counselling, and treatment of sexually transmitted infections (STIs are among the most cost-effective interventions aimed at ameliorating the burden of HIV/STIs. Since many new HIV infections occur in people under the age of 25, youth, and especially most at risk adolescents (MARA, need to be able to access HIV/STI services. Starting in 2006, a programme targeting MARA including outreach, confidential and voluntary counselling and testing, and STI diagnosis and treatment was piloted in three cities in Tajikistan. This study uses data from these pilot sites to estimate the costs of a national programme. Methods Cost data were collected from the three pilot sites. Then, the target population and the number of patients receiving specific types of services are calculated for other areas. The unit costs from the pilot sites are multiplied by usage rates to determine the total costs of a national programme. Scenarios were developed to reflect data uncertainty. The government's ability to finance the programme was estimated using Ministry of Health budget data. Further analyses were done for one of the pilot cities where more detailed data were available. Results In total, costs were projected for eight programme sites, covering an estimated 8,020 MARA. Operational and variable cost for the programme are projected to be US$ 119,159 (range US$ 104,953 to 151,524 per year. Including annual equivalent cost for capital and start-up items raises this to US$ 137,082 (range: US$ 123,022 to 169,597 per year. The analyses of potential sources of financing for the programme remain inconclusive, but it may take multiple sources of financing to fund the programme. Conclusion While the cost-effectiveness of similar programmes have been previously assessed using modelled data, more work needs to be done to assess the costs of new programmes in relation to financial resources available. Full costing should consider cost

  4. Evaluation of a Family-based Substance Abuse Prevention Program Targeted for the Middle School Years.

    Science.gov (United States)

    Abbey, Antonia; Pilgrim, Colleen; Hendrickson, Peggy; Buresl, Sue

    2000-01-01

    Evaluates family-based substance abuse prevention program implemented in a rural community for families with middle school students. In comparison with nonparticipants, students had higher family cohesion, less family fighting, greater school attachment, higher self-esteem, and believed alcohol should be consumed at an older age, at one-year…

  5. Risk-Based Treatment Targets for Onsite Non-Potable Water Reuse

    Science.gov (United States)

    This presentation presents risk-based enteric pathogen log reduction targets for non-potable and potable uses of a variety of alternative source waters (i.e., municipal wastewater, locally-collected greywater, rainwater, and stormwater). A probabilistic, forward Quantitative Micr...

  6. A prospective examination of the path from child abuse and neglect to illicit drug use in middle adulthood: the potential mediating role of four risk factors.

    Science.gov (United States)

    Wilson, Helen W; Widom, Cathy Spatz

    2009-03-01

    This study examines prostitution, homelessness, delinquency and crime, and school problems as potential mediators of the relationship between childhood abuse and neglect (CAN) and illicit drug use in middle adulthood. Children with documented cases of physical and sexual abuse and neglect (ages 0-11) during 1967-1971 were matched with non-maltreated children and followed into middle adulthood (approximate age 39). Mediators were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995 and official arrest records through 1994 (N = 1,196). Drug use was assessed via self-reports of past year use of marijuana, psychedelics, cocaine, and/or heroin during 2000-2002 (N = 896). Latent variable structural equation modeling (SEM) was used to test: (1) a four-factor model with separate pathways from CAN to illicit drug use through each of the mediating risk factors and (2) a second-order model with a single mediating risk factor comprised of prostitution, homelessness, delinquency and crime, and poor school performance. Analyses were performed separately for women and men, controlling for race/ethnicity and early drug use. In the four-factor model for both men and women, CAN was significantly related to each of the mediators, but no paths from the mediators to drug use were significant. For women, the second-order risk factor mediated the relationship between CAN and illicit drug use in middle adulthood. For men, neither child abuse and neglect nor the second-order risk factor predicted drug use in middle adulthood. These results suggest that for women, the path from CAN to middle adulthood drug use is part of a general "problem behavior syndrome" evident earlier in life.

  7. A Nascent Look at Theoretical Frameworks in Middle Level Education Research

    Science.gov (United States)

    Reyes, Cynthia; Netcoh, Steven

    2015-01-01

    This paper describes a qualitative content analysis of research articles published on middle level education in the last decade. This analysis was conducted on manuscripts appearing in two premier middle level education journals: "Middle Grades Research Journal" (MGRJ) and "Research in Middle Level Education Online" (RMLE) to…

  8. Estimating risk at a Superfund site contaminated with radiological and chemical wastes

    International Nuclear Information System (INIS)

    Temeshy, A.; Liedle, J.M.; Sims, L.M.; Efird, C.R.

    1992-01-01

    This paper describes the method and results for estimating carcinogenic and noncarcinogenic effects at a Superfund site that is radiologically and chemically contaminated. Risk to receptors from disposal of waste in soil and resulting contamination of groundwater, air, surface water, and sediment is quantified. Specific risk assessment components which are addressed are the exposure assessment, toxicity assessment, and the resulting risk characterization. In the exposure assessment, potential exposure pathways are identified using waste disposal inventory information for soil and modeled information for other media. Models are used to calculate future radionuclide concentrations in groundwater, soil, surface water and air. Chemical exposure concentrations are quantified using site characterization data. Models are used to determine concentrations of chemicals in surface water and in air. Toxicity parameters used to quantify the dose-response relationship associated with the carcinogenic contaminants are slope factors and with noncarcinogenic contaminants are reference doses. In the risk characterization step, results from the exposure assessment and toxicity assessment are summarized and integrated into quantitative risk estimates for carcinogens and hazard induces for noncarcinogens. Calculated risks for carcinogenic contaminants are compared with EPA's target risk range. At WAG 6, the risk from radionuclides and chemicals for an on-WAG homesteader exceeds EPA's target risk range. Hazard indices are compared to unity for noncarcinogenic contaminants. At WAG 6, the total pathway hazard index for the on-WAG homesteader exceeds unity

  9. Differences in grip force control between young and late middle-aged adults.

    Science.gov (United States)

    Zheng, Lianrong; Li, Kunyang; Wang, Qian; Chen, Wenhui; Song, Rong; Liu, Guanzheng

    2017-09-01

    Grip force control is a crucial function for human to guarantee the quality of life. To examine the effects of age on grip force control, 10 young adults and 11 late middle-aged adults participated in visually guided tracking tasks using different target force levels (25, 50, and 75% of the subject's maximal grip force). Multiple measures were used to evaluate the tracking performance during force rising phase and force maintenance phase. The measurements include the rise time, fuzzy entropy, mean force percentage, coefficient of variation, and target deviation ratio. The results show that the maximal grip force was significantly lower in the late middle-aged adults than in the young adults. The time of rising phase was systematically longer among late middle-aged adults. The fuzzy entropy is a useful indicator for quantitating the force variability of the grip force signal at higher force levels. These results suggest that the late middle-aged adults applied a compensatory strategy that allow allows for sufficient time to reach the required grip force and reduce the impact of the early and subtle degenerative changes in hand motor function.

  10. Do interventions targeted at micro-entrepreneurs and small and medium-sized firms create jobs? A systematic review of the evidence for low and middle income countries

    NARCIS (Netherlands)

    M. Grimm (Michael); A.L. Paffhausen

    2015-01-01

    markdownabstract__Abstract__ Worldwide, 600 million jobs are needed over the next 15 years to keep employment rates at their current level. Because most employment in low and middle income countries is in micro-, small and medium-sized enterprises, governments, non-governmental organizations and

  11. Learning to Appreciate At-Risk Students: Challenging the Beliefs and Attitudes of Teachers and Administrators

    Science.gov (United States)

    Calabrese, Raymond L.; Hummel, Crystal; San Martin, Teresa

    2007-01-01

    Purpose: The purpose of this paper is to examine the issue of at-risk students in a rural district in Midwestern USA. Design/methodology/approach: This field-based research study used a qualitative embedded case study of a middle and high school informed by an appreciative inquiry theoretical research perspective to identify a positive core of…

  12. Dissociation between the activity of the right middle frontal gyrus and the middle temporal gyrus in processing semantic priming.

    Science.gov (United States)

    Laufer, Ilan; Negishi, Michiro; Lacadie, Cheryl M; Papademetris, Xenophon; Constable, R Todd

    2011-01-01

    The aim of this event-related functional magnetic resonance imaging (fMRI) study was to test whether the right middle frontal gyrus (MFG) and middle temporal gyrus (MTG) would show differential sensitivity to the effect of prime-target association strength on repetition priming. In the experimental condition (RP), the target occurred after repetitive presentation of the prime within an oddball design. In the control condition (CTR), the target followed a single presentation of the prime with equal probability of the target as in RP. To manipulate semantic overlap between the prime and the target both conditions (RP and CTR) employed either the onomatopoeia "oink" as the prime and the referent "pig" as the target (OP) or vice-versa (PO) since semantic overlap was previously shown to be greater in OP. The results showed that the left MTG was sensitive to release of adaptation while both the right MTG and MFG were sensitive to sequence regularity extraction and its verification. However, dissociated activity between OP and PO was revealed in RP only in the right MFG. Specifically, target "pig" (OP) and the physically equivalent target in CTR elicited comparable deactivations whereas target "oink" (PO) elicited less inhibited response in RP than in CTR. This interaction in the right MFG was explained by integrating these effects into a competition model between perceptual and conceptual effects in priming processing.

  13. Dissociation between the activity of the right middle frontal gyrus and the middle temporal gyrus in processing semantic priming.

    Directory of Open Access Journals (Sweden)

    Ilan Laufer

    Full Text Available The aim of this event-related functional magnetic resonance imaging (fMRI study was to test whether the right middle frontal gyrus (MFG and middle temporal gyrus (MTG would show differential sensitivity to the effect of prime-target association strength on repetition priming. In the experimental condition (RP, the target occurred after repetitive presentation of the prime within an oddball design. In the control condition (CTR, the target followed a single presentation of the prime with equal probability of the target as in RP. To manipulate semantic overlap between the prime and the target both conditions (RP and CTR employed either the onomatopoeia "oink" as the prime and the referent "pig" as the target (OP or vice-versa (PO since semantic overlap was previously shown to be greater in OP. The results showed that the left MTG was sensitive to release of adaptation while both the right MTG and MFG were sensitive to sequence regularity extraction and its verification. However, dissociated activity between OP and PO was revealed in RP only in the right MFG. Specifically, target "pig" (OP and the physically equivalent target in CTR elicited comparable deactivations whereas target "oink" (PO elicited less inhibited response in RP than in CTR. This interaction in the right MFG was explained by integrating these effects into a competition model between perceptual and conceptual effects in priming processing.

  14. Comparison of therapeutic lipid target achievements among high-risk patients in Oman.

    Science.gov (United States)

    Al-Waili, Khalid; Al-Zakwani, Ibrahim; Al-Dughaishi, Tamima; Baneerje, Yajnavalka; Al-Sabti, Hilal; Al-Hashmi, Khamis; Farhan, Hatem; Habsi, Khadija Al; Al-Hinai, Ali T; Al-Rasadi, Khalid

    2014-05-01

    We compared therapeutic lipid target achievements among patients with diabetes or coronary heart disease (CHD) in Oman. A retrospective chart review of 94 patients was conducted at an outpatient clinic in Sultan Qaboos University Hospital, Muscat, Oman. The variables included low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein B (apo B). The overall mean age of the cohort was 59 ± 12 years, 54% were male, 66% were diabetic, 48% hypertensive, 45% had CHD, 94% were on simvastatin, 4% were on fenofibrate, and 2% were on both simvastatin and fenofibrate. Lipid goal attainments of calculated LDL-C (<2.6 mmol/L), apo B (<0.9 g/L), and non-HDL-C (<3.36 mmol/L) were reached in 52%, 39%, and 53% of the patients, respectively. A significant proportion of high-risk patients treated with lipid-lowering agents reach LDL-C but not the apo B treatment targets, suggesting that the use of apo B target values should also be considered.

  15. Non-targeted effects of ionising radiation—Implications for low dose risk

    DEFF Research Database (Denmark)

    Kadhim, Munira; Salomaa, Sisko; Wright, Eric

    2013-01-01

    and adaptive responses are powered by fundamental, but not clearly understood systems that maintain tissue homeostasis. Despite excellent research in this field by various groups, there are still gaps in our understanding of the likely mechanisms associated with non-DNA targeted effects, particularly......Non-DNA targeted effects of ionising radiation, which include genomic instability, and a variety of bystander effects including abscopal effects and bystander mediated adaptive response, have raised concerns about the magnitude of low-dose radiation risk. Genomic instability, bystander effects....... Furthermore, it is still not known what the initial target and early interactions in cells are that give rise to non-targeted responses in neighbouring or descendant cells. This paper provides a commentary on the current state of the field as a result of the non-targeted effects of ionising radiation (NOTE...

  16. Collaborative care intervention targeting violence risk behaviors, substance use, and posttraumatic stress and depressive symptoms in injured adolescents: a randomized clinical trial.

    Science.gov (United States)

    Zatzick, Douglas; Russo, Joan; Lord, Sarah Peregrine; Varley, Christopher; Wang, Jin; Berliner, Lucy; Jurkovich, Gregory; Whiteside, Lauren K; O'Connor, Stephen; Rivara, Frederick P

    2014-06-01

    Violence and injury risk behaviors, alcohol and drug use problems, and posttraumatic stress disorder (PTSD) and depressive symptoms occur frequently among adolescents presenting to acute care medical settings after traumatic physical injury. To test the effectiveness of a stepped collaborative care intervention targeting this constellation of risk behaviors and symptoms in randomly sampled hospitalized adolescents with and without traumatic brain injury. A pragmatic randomized clinical trial was conducted at a single US level I trauma center. Participants included 120 adolescents aged 12 to 18 years randomized to intervention (n = 59) and control (n = 61) conditions. Stepped collaborative care intervention included motivational interviewing elements targeting risk behaviors and substance use as well as medication and cognitive behavioral therapy elements targeting PTSD and depressive symptoms. Adolescents were assessed at baseline before randomization and 2, 5, and 12 months after injury hospitalization. Standardized instruments were used to assess violence risk behaviors, alcohol and drug use, and PTSD and depressive symptoms. The investigation attained more than 95% adolescent follow-up at each assessment point. At baseline, approximately one-third of the participants endorsed the violence risk behavior of carrying a weapon. Regression analyses demonstrated that intervention patients experienced significant reductions in weapon carrying compared with controls during the year after injury (group × time effect, F3,344 = 3.0; P = .03). At 12 months after the injury, 4 (7.3%) intervention patients vs 13 (21.3%) control patients reported currently carrying a weapon (relative risk, 0.31; 95% CI, 0.11-0.90). The intervention was equally effective in reducing the risk of weapon carrying among injured adolescents with and without traumatic brain injury. Other treatment targets, including alcohol and drug use problems and high levels of PTSD and

  17. Targeted Temperature Management at 33°C or 36°C Produces Equivalent Neuroprotective Effects in the Middle Cerebral Artery Occlusion Rat Model of Ischemic Stroke.

    Science.gov (United States)

    Lee, Jung Ho; Lim, Jisoo; Chung, Yong Eun; Chung, Sung Phil; Park, Incheol; Kim, Chul Hoon; You, Je Sung

    2018-01-15

    Targeted temperature management (TTM, 32°C to 36°C) is one of the most successful achievements in modern resuscitation medicine. It has become standard treatment for survivors of sudden cardiac arrest to minimize secondary brain damage. TTM at 36°C is just as effective as TTM at 33°C and is actually preferred because it reduces adverse TTM-associated effects. TTM also likely has direct neuroprotective effects in ischemic brains in danger of stroke. It remains unclear, however, whether higher temperature TTM is equally effective in protecting the brain from the effects of stroke. Here, we asked whether TTM at 36°C is as effective as TTM at 33°C in improving outcomes in a middle cerebral artery occlusion (MCAO) model of ischemic stroke. After dividing rats randomly into MCAO, MCAO+33°C TTM, MCAO+36°C TTM and sham groups, we subjected all of them except for the sham group to MCAO for 3 h (for the behavioral tests) or 4 h (for all other biochemical analyses). We found TTM protocols at both 33°C and 36°C produce comparable reductions of infarct volumes in the MCAO territory and equally attenuate the extracellular release of high mobility group box 1 (HMGB1) in post-ischemic brains. Both TTM conditions prevent the mRNA induction of a major pro-inflammatory cytokine, TNF-α, in the ischemic penumbra region. Finally, both TTM protocols produce similar improvements in neurological outcomes in rats, as measured by a battery of behavior tests 21 h after the start of reperfusion. These data acquired in a rat MCAO model suggest TTM at 36°C has excellent therapeutic potential for improving clinical outcomes for patients with acute ischemic stroke.

  18. The influence of sensation-seeking and parental and peer influences in early adolescence on risk involvement through middle adolescence: A structural equation modeling analysis.

    Science.gov (United States)

    Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Dinaj-Koci, Veronica; Li, Xiaoming; Stanton, Bonita

    2016-03-01

    This study examined the relationships between youth and parental sensation-seeking, peer influence, parental monitoring and youth risk involvement in adolescence using structural equation modeling. Beginning in grade-six, longitudinal data were collected from 543 students over three years. Youth sensation-seeking in grade six contributed to risk involvement in early adolescence (grades six and seven) indirectly through increased peer risk influence and decreased parental monitoring but did not have a direct contribution. It contributed directly and indirectly to risk involvement in middle adolescence (grades eight and nine). Parent sensation-seeking at baseline was positively associated with peer risk influence and negatively associated with parental monitoring; it had no direct effect on adolescent risk involvement. Parental monitoring buffers negative peer influence on adolescent risk involvement. Results highlight the need for intervention efforts to provide normative feedback about adolescent risky behaviors and to vary among families in which parents and/or youth have high sensation-seeking propensities.

  19. The influence of sensation-seeking and parental and peer influences in early adolescence on risk involvement through middle adolescence: A structural equation modeling analysis

    Science.gov (United States)

    Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Dinaj-Koci, Veronica; Li, Xiaoming; Stanton, Bonita

    2014-01-01

    This study examined the relationships between youth and parental sensation-seeking, peer influence, parental monitoring and youth risk involvement in adolescence using structural equation modeling. Beginning in grade-six, longitudinal data were collected from 543 students over three years. Youth sensation-seeking in grade six contributed to risk involvement in early adolescence (grades six and seven) indirectly through increased peer risk influence and decreased parental monitoring but did not have a direct contribution. It contributed directly and indirectly to risk involvement in middle adolescence (grades eight and nine). Parent sensation-seeking at baseline was positively associated with peer risk influence and negatively associated with parental monitoring; it had no direct effect on adolescent risk involvement. Parental monitoring buffers negative peer influence on adolescent risk involvement. Results highlight the need for intervention efforts to provide normative feedback about adolescent risky behaviors and to vary among families in which parents and/or youth have high sensation-seeking propensities. PMID:27030784

  20. Safety targets and public risk perceptions in the nuclear field - technical treadmill or institutional responses?

    International Nuclear Information System (INIS)

    Wynne, B.

    1989-01-01

    The context of our treatment of risk perceptions and safety targets is the apparently wide gap between expert judgements of 'objective risks' and public perceptions of those risks. In the nuclear field the latter appear to so multiply the objective risks as seen by the experts, as to make safety targets vastly too strict (whether for routine discharges or for large accidents), thus design extravagantly expensive on any 'rational' criteria. In recent years the nuclear industry has come to terms more with the public perceptions problem, and has accepted that it is legitimate to exercise different, more severe and costly safety standards in the nuclear field if that is what society wants, as it appears to do. Whilst retaining the conviction that this is scientifically unwarranted, the industry has therefore reconciled itself somewhat to more stringent technical safety targets. (author)

  1. Does elementary school alcohol, tobacco, and marijuana use increase middle school risk?

    Science.gov (United States)

    Wilson, Nance; Battistich, Victor; Syme, S Leonard; Boyce, W Thomas

    2002-06-01

    To assess whether alcohol, tobacco, and other drug (ATOD) use in elementary school may have serious implications for continued ATOD use in middle school and beyond. Longitudinal analyses were conducted on questionnaire data from 331 middle school students who had previously provided ATOD-use data during elementary school. Non-school personnel administered questionnaires in three participating school districts in three different states. The sample of students was ethnically and geographically diverse, including students from a range of low socioeconomic status backgrounds living in rural, urban or inner-city environments. Middle school alcohol use was almost three times as likely to occur if alcohol use had occurred in elementary school (OR = 2.94, p Elementary school use of tobacco and marijuana also greatly increased the likelihood of middle school use (OR = 5.35, p elementary school, during the middle childhood years.

  2. Prevalence and associated risk factors of dyslexic children in a middle-sized city of China: a cross-sectional study.

    Science.gov (United States)

    Sun, Zhao; Zou, Li; Zhang, Jiajia; Mo, Shengnan; Shao, Shanshan; Zhong, Rong; Ke, Juntao; Lu, Xuzai; Miao, Xiaoping; Song, Ranran

    2013-01-01

    There are many discussions about dyslexia based on studies conducted in western countries, and some risk factors to dyslexia, such as gender and home literacy environment, have been widely accepted based on these studies. However, to our knowledge, there are few studies focusing on the risk factors of dyslexia in China. Therefore, the aim of our study was to investigate the prevalence of dyslexia and its potential risk factors. A cross-sectional study was conducted in Qianjiang, a city in Hubei province, China. Two stages sampling strategy was applied to randomly selected 5 districts and 9 primary schools in Qianjiang. In total, 6,350 students participated in this study and there were 5,063 valid student questionnaires obtained for the final analyses. Additional questionnaires (such as Dyslexia Checklist for Chinese Children and Pupil Rating Scale) were used to identify dyslexic children. The chi-square test and multivariate logistic regression were employed to reveal the potential risk factors to dyslexia. Our study revealed that the prevalence of dyslexia was 3.9% in Qianjiang city, which is a middle-sized city in China. Among dyslexic children, the gender ratio (boys to girls) was nearly 3∶1. According to the P-value in the multivariate logistic regression, the gender (Pdyslexia. The prevalence rate of dyslexic children in middle-sized cities is 3.9%. The potential risk factors of dyslexic children revealed in this study will have a great impact on detecting and treating dyslexic children in China as early as possible, although more studies are still needed to further investigate the risk factors of dyslexic children in China.

  3. [Morphometrical analyze of the middle cerebral artery system at the 13-15 weeks fetuses].

    Science.gov (United States)

    Macovei, Georgeta Nataşa; Varlam, H; St Antohe, D

    2002-01-01

    Tele-encephalization process is accompanied by the appearance and progressive complication of the middle cerebral artery system. The aim of our study is to analyze the morphometrical parameters of the middle cerebral artery branches in the beginning of the edification of its system. We used 162 cerebral hemispheres from 88 fetuses aged of 13-15 weeks. Middle cerebral artery system was injected with a gelatin-China ink mixture and images recorded by means of a Zeiss surgical microscope. Parameters evaluation (length, proximal and distal diameters, external surface, volume, angles of bifurcation) was realized with KS-300 program. At this early age middle cerebral artery system has only 4-5 generations of branches usually resulting from acute angle bifurcations.

  4. Development of a risk-prediction model for Middle East respiratory syndrome coronavirus infection in dialysis patients.

    Science.gov (United States)

    Ahmed, Anwar E; Alshukairi, Abeer N; Al-Jahdali, Hamdan; Alaqeel, Mody; Siddiq, Salma S; Alsaab, Hanan A; Sakr, Ezzeldin A; Alyahya, Hamed A; Alandonisi, Munzir M; Subedar, Alaa T; Aloudah, Nouf M; Baharoon, Salim; Alsalamah, Majid A; Al Johani, Sameera; Alghamdi, Mohammed G

    2018-04-14

    Introduction The Middle East respiratory syndrome coronavirus (MERS-CoV) infection can cause transmission clusters and high mortality in hemodialysis facilities. We attempted to develop a risk-prediction model to assess the early risk of MERS-CoV infection in dialysis patients. Methods This two-center retrospective cohort study included 104 dialysis patients who were suspected of MERS-CoV infection and diagnosed with rRT-PCR between September 2012 and June 2016 at King Fahd General Hospital in Jeddah and King Abdulaziz Medical City in Riyadh. We retrieved data on demographic, clinical, and radiological findings, and laboratory indices of each patient. Findings A risk-prediction model to assess early risk for MERS-CoV in dialysis patients has been developed. Independent predictors of MERS-CoV infection were identified, including chest pain (OR = 24.194; P = 0.011), leukopenia (OR = 6.080; P = 0.049), and elevated aspartate aminotransferase (AST) (OR = 11.179; P = 0.013). The adequacy of this prediction model was good (P = 0.728), with a high predictive utility (area under curve [AUC] = 76.99%; 95% CI: 67.05% to 86.38%). The prediction of the model had optimism-corrected bootstrap resampling AUC of 71.79%. The Youden index yielded a value of 0.439 or greater as the best cut-off for high risk of MERS infection. Discussion This risk-prediction model in dialysis patients appears to depend markedly on chest pain, leukopenia, and elevated AST. The model accurately predicts the high risk of MERS-CoV infection in dialysis patients. This could be clinically useful in applying timely intervention and control measures to prevent clusters of infections in dialysis facilities or other health care settings. The predictive utility of the model warrants further validation in external samples and prospective studies. © 2018 International Society for Hemodialysis.

  5. "Boy Crisis" or "Girl Risk"? The Gender Difference in Nonsuicidal Self-Injurious Behavior Among Middle-School Students in China and its Relationship to Gender Role Conflict and Violent Experiences.

    Science.gov (United States)

    Yang, Xueyan; Xin, Moye

    2018-03-01

    We attempted to test if there were gender differences in nonsuicidal self-injurious (NSSI) behaviors among Chinese middle-school students, and analyze the impact of gender role conflict and violent experiences on these behaviors among middle-school students of different genders. Based on the survey data from seven middle schools in Xi'an region of China, the gender difference in NSSI behaviors and its associated factors were analyzed in this study. There was no significant gender difference in NSSI behaviors among middle-school students; however, female middle-school students were more likely to experience gender role conflicts while male students were more likely to experience all kinds of violence earlier. Gender role conflicts and violent experiences can explain the prevalence of NSSI behaviors by gender, to some extent. The hypothesis on gender patterns of "boy crisis" or "girl risk" on NSSI prevalence was not verified; however, a "girl risk" for gender role conflicts and a "boy crisis" in violent experiences were found. The gender role conflicts were significantly associated with NSSI prevalence among middle-school students to some extent; however, this relationship was adjusted by variables of violent experiences. The different variables of violent experiences were the important predictors of NSSI prevalence among male and female middle-school students with specific contents varying across genders.

  6. The role of classic risk factors and prothrombotic factor gene mutations in ischemic stroke risk development in young and middle-aged individuals.

    Science.gov (United States)

    Supanc, Visnja; Sonicki, Zdenko; Vukasovic, Ines; Solter, Vesna V; Zavoreo, Iris; Kes, Vanja B

    2014-03-01

    In young individuals, a genetically predisposing hypercoagulability and classic modifying risk factors can act synergistically on the ischemic stroke risk development. The aim of the study was to compare the prevalence of classic vascular risk factors and polymorphisms of the G20210A coagulation factor II (prothrombin), Arg506Glu coagulation factor V Leiden, C677T methylenetetrahydrofolate reductase (MTHFR), and 4G/5G plasminogen activator inhibitor-1 (PAI-1) and the impact of these gene mutations and classic vascular risk factors on the overall stroke risk in individuals aged 55 years or younger. The study included 155 stroke patients aged 55 years or younger and 150 control subjects. Stroke prevalence and odds ratio (OR) were assessed for the following parameters: G20210A prothrombin, Arg506Glu factor V Leiden, C677T MTHFR, and 4G/5G PAI-1 polymorphisms; total number of study polymorphisms in a particular subject (genetic sum); and classic vascular risk factors of hypertension, obesity, diabetes mellitus, cigarette smoking, hypercholesterolemia, hypertriglyceridemia, and elevated levels of low-density lipoprotein (LDL) cholesterol and very low-density lipoprotein cholesterol. The prevalence of hypertension (P stroke patients. The following parameters were found to act as independent risk factors for ischemic stroke: decreased HDL cholesterol level (P ischemic stroke in young and middle-aged individuals. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  7. Dietary patterns during high school and risk of colorectal adenoma in a cohort of middle-aged women.

    Science.gov (United States)

    Nimptsch, Katharina; Malik, Vasanti S; Fung, Teresa T; Pischon, Tobias; Hu, Frank B; Willett, Walter C; Fuchs, Charles S; Ogino, Shuji; Chan, Andrew T; Giovannucci, Edward; Wu, Kana

    2014-05-15

    Adolescent diet may be etiologically relevant for later risk of colorectal adenoma, a precursor of colorectal cancer. We aimed to examine associations between adolescent dietary patterns (derived using factor analysis) and risk of colorectal adenoma in middle adulthood. We analyzed data from 17,221 women participating in the Nurses' Health Study II, who had completed a validated high school (HS) food frequency questionnaire in 1998 when they were 34-51 years old, and had subsequently undergone at least one lower bowel endoscopy. Between 1998 and 2007, 1,299 women were diagnosed with at least one colorectal adenoma. In multivariable models adjusted for adult dietary patterns, a higher "prudent" pattern during HS, characterized by high consumption of vegetables, fruit and fish was associated with a statistically significantly lower risk of rectal (odds ratio [OR] highest vs. lowest quintile, 0.45, 95% CI 0.27-0.75, p-trend = 0.005), but not colon adenomas. A higher "Western" pattern during HS, characterized by high consumption of desserts and sweets, snack foods and red and processed meat, was significantly associated with rectal (OR 1.78, 95% CI 1.12-2.85, p-trend = 0.005) and advanced (OR 1.58, 95% CI 1.07-2.33, p-trend = 0.08), but not associated with colon or non-advanced adenomas. This study suggests that overall eating patterns during high school may influence later risk of rectal and advanced adenoma, independent of adult diet. Our results support the hypothesis that diet during early life may influence colorectal carcinogenesis. © 2013 UICC.

  8. Encouraging the Disuse of Illicit Drugs Among At-Risk Youth.

    Science.gov (United States)

    Cheung, Chau-kiu; Ngai, Steven Sek-yum

    2016-05-01

    Youth at risk of illicit drug abuse and other delinquent acts are the target of social work services. Preventing or discouraging the use of illicit drugs among at-risk youth is a long-standing practical and research concern. For this reason, the preventive function of courage is a research gap the present study seeks to fill. The study collected data from 169 at-risk youths and their social workers with two-wave panel surveys. Results show that courage in Wave 1 presented a strong negative effect on illicit drug use in Wave 2 in the youth, controlling for illicit drug use in Wave 1 and background characteristics. Moreover, the negative effect was stronger when Wave 1 drug use was more likely. These results imply the helpfulness of encouraging at-risk youth to gather courage to resist the temptation to use illicit drugs. © The Author(s) 2014.

  9. Targets for the APEX experiment at ATLAS

    International Nuclear Information System (INIS)

    Greene, J.P.; Thomas, G.E.; Leonard, R.H.

    1994-01-01

    Targets of lead, tantalum, thorium and uranium have been produced for experiments with the APEX (Argonne Positron Experiment) apparatus at ATLAS (Argonne Tandem Linac Accelerator System). APEX is a device built at Argonne National Laboratory to investigate the anomalous positrons observed in collisions of very heavy ion beams on heavy targets. Both fixed and rotating targets have been used. The rotating target system involves a 4-quadrant wheel rotating at speeds up to 700 rpm with the position encoded into the data stream. In addition to the hundreds of targets produced for the heavy-ion reactions studied, a wide variety of targets were employed for beam diagnostics, detector calibration and target wheel development. The experiment used very heavy ion beams ( 238 U, 206 Pb and 208 Pb) from ATLAS and targets of 206 Pb, 208 Pb, 232 Th and 238 U produced in the laboratory

  10. Measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis: a systematic review.

    Science.gov (United States)

    Kroman, S L; Roos, E M; Bennell, K L; Hinman, R S; Dobson, F

    2014-01-01

    To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA). Electronic searches were performed in MEDLINE, CINAHL, Scopus and SPORTDiscus in May 2013. Two reviewers independently rated the measurement properties using the 4-point COSMIN checklist. Best evidence synthesis was made using COSMIN quality, consistency and direction of findings and sample size. Twenty of 2736 papers were eligible for inclusion and 24 different performance-based outcome measures knee or obese populations were evaluated. No tests related to hip populations were included. Twenty-five measurement properties including reliability (nine studies), construct validity (hypothesis testing) (nine studies), measurement error (three studies), structural validity (two studies), interpretability (one study) and responsiveness (one study) were evaluated. A positive rating was given to 12.5% (30/240) of all possible measurement ratings. Tests were grouped into two categories based on the population characteristics. The one-legged hop for distance, followed by the 6-m timed hop and cross over hop for distance were the best-rated tests for the knee-injured population. Whereas the 6-min walk test was the only included test for the obese population. This review highlights the many gaps in knowledge about the measurement properties of performance-based outcome measures for young and middle-aged people known to be at high risk of hip and/or knee OA. There is a need for consensus on which outcome measures should be used and/or combined when assessing physical function in this population. Further good quality research is required. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  11. Socio-psychological stressors as risk factors for low back pain in Chinese middle-aged women.

    Science.gov (United States)

    Yip, Y B; Ho, S C; Chan, S G

    2001-11-01

    This study aims to explore the relationship between socio-psychological stress and low back pain (LBP) prevalence among Chinese middle-aged women. Women in mid-life experience increasing socio-psychological stress because of midlife transitions, stressful life events and housework or work factors. Encountering socio-psychological stress itself may result in the manifestation of LBP. A case-control study of Hong Kong community-based middle-aged women was conducted. The study subjects were either from the University Family Medicine Clinic or from a previous population-based cross-sectional study of middle-aged women conducted by Department of Community and Family Medicine. Among the 928 potential eligible subjects from both sources, a total of 182 cases and 235 controls participated in this study. Data were collected from face-to-face interviews and included demographic factors, menopausal status, socio-psychological stress and occurrence of LBP. Socio-psychological stress covered social factors, self-reported nature of housework/work, housework/work stress and stressful life events. Among the 182 cases who entered this study, 83 women (45.6%) had experienced 1-work stress had an increased risk of suffering both types of LBP of nearly two- and half-fold (95% CI 1.61-3.85). The results indicate that an association exists between high socio-psychological stress and LBP prevalence. Alleviating the impact of housework or work related factors would, however, involve improving both the work and home environment.

  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. Cardiovascular risk factors burden in Saudi Arabia: The Africa Middle East Cardiovascular Epidemiological (ACE) study.

    Science.gov (United States)

    Ahmed, Amjad M; Hersi, Ahmad; Mashhoud, Walid; Arafah, Mohammed R; Abreu, Paula C; Al Rowaily, Mohammed Abdullah; Al-Mallah, Mouaz H

    2017-10-01

    Limited data exist on the epidemiology of cardiovascular risk factors in Saudi Arabia, particularly in relation to the differences between Saudi nationals and expatriates in Saudi Arabia. The aim of this analysis was to describe the current prevalence of cardiovascular risk factors among patients attending general practice clinics across Saudi Arabia. In this cross-sectional epidemiological analysis of the Africa Middle East Cardiovascular Epidemiological (ACE) study, the prevalence of cardiovascular risk factors (hypertension, diabetes, dyslipidemia, obesity, smoking, abdominal obesity) was evaluated in adults attending primary care clinics in Saudi Arabia. Group comparisons were made between patients of Saudi ethnicity (SA nationals) and patients who were not of Saudi ethnicity (expatriates). A total of 550 participants were enrolled from different clinics across Saudi Arabia [aged (mean ± standard deviation) 43 ± 11 years; 71% male]. Nearly half of the study cohort (49.8%) had more than three cardiovascular risk factors. Dyslipidemia was the most prevalent risk factor (68.6%). The prevalence of hypertension (47.5%) and dyslipidemia (75.5%) was higher among expatriates when compared with SA nationals (31.4% vs. 55.1%, p  = 0.0003 vs. p  Saudi Arabia. Improving primary care services to focus on risk factor control may ultimately decrease the incidence of coronary artery disease and improve overall quality of life. The ACE trial is registered under NCT01243138.

  14. A cross-sectional study on trans-fatty acids and risk markers of CHD among middle-aged men representing a broad range of BMI

    DEFF Research Database (Denmark)

    Nielsen, Birgit M.; Nielsen, Marie M.; Jakobsen, Marianne U.

    2011-01-01

    Intake of trans-fatty acids (TFA), especially industrially produced TFA (I-TFA), has been associated with the risk of CHD through influence on serum lipid levels. Other causal pathways remain less investigated. In the present cross-sectional study of middle-aged men representing a broad range...... of BMI, the association between intake of TFA, I-TFA and ruminant TFA (R-TFA) and obesity-associated risk markers of CHD was assessed. The study comprised 393 Danish men (median age 49 years) with a median BMI of 28·4 kg/m2. Intake of TFA was estimated based on 7 d dietary records, whereas outcomes...... pressure and insulin homeostasis. Among middle-aged men with a generally low intake of TFA, neither I-TFA nor R-TFA was significantly related to obesity-associated risk markers of CHD. The decreased average intake of I-TFA in Denmark since 1995 is suggested to effectively prevent occurrence of the adverse...

  15. Hazard identification and risk assessment for biologics targeting the immune system.

    Science.gov (United States)

    Weir, Andrea B

    2008-01-01

    Biologic pharmaceuticals include a variety of products, such as monoclonal antibodies, fusion proteins and cytokines. Products in those classes include immunomodulatory biologics, which are intended to enhance or diminish the activity of the immune system. Immunomodulatory biologics have been approved by the U.S. FDA for a variety of indications, including cancer and inflammatory conditions. Prior to gaining approval for marketing, sponsoring companies for all types of products must demonstrate a product's safety in toxicology studies conducted in animals and show safety and efficacy in clinical trials conducted in patients. The overall goal of toxicology studies, which applies to immunomodulatory and other product types, is to identify the hazards that products pose to humans. Because biologics are generally highly selective for specific targets (receptors/epitopes), conducting toxicology studies in animal models with the target is essential. Such animals are referred to as pharmacologically relevant. Endpoints routinely included in toxicology studies, such as hematology, organ weight and histopathology, can be used to assess the effect of a product on the structure of the immune system. Additionally, specialized endpoints, such as immunophenotyping and immune function tests, can be used to define effects of immunomodulatory products on the immune system. Following hazard identification, risks posed to patients are assessed and managed. Risks can be managed through clinical trial design and risk communication, a practice that applies to immunomodulatory and other product types. Examples of risk management in clinical trial design include establishing a safe starting dose, defining the appropriate patient population and establishing appropriate patient monitoring. Risk communication starts during clinical trials and continues after product approval. A combination of hazard identification, risk assessment and risk management allows for drug development to proceed

  16. Preventing Family and Educational Disconnection through Wilderness-Based Therapy Targeting Youth at Risk

    Science.gov (United States)

    Ronalds, Lisa; Allen-Craig, Sandy

    2008-01-01

    In an effort to address the issue of youth homelessness in Australia, Regional Extended Family Services (REFS) have developed a wilderness-based therapeutic intervention. REFS aim to provide early intervention services for young people at risk of homelessness, and their families. This study examined the outcomes of the REFS wilderness program by…

  17. New "Risk-Targeted" Seismic Maps Introduced into Building Codes

    Science.gov (United States)

    Luco, Nicholas; Garrett, B.; Hayes, J.

    2012-01-01

    Throughout most municipalities of the United States, structural engineers design new buildings using the U.S.-focused International Building Code (IBC). Updated editions of the IBC are published every 3 years. The latest edition (2012) contains new "risk-targeted maximum considered earthquake" (MCER) ground motion maps, which are enabling engineers to incorporate a more consistent and better defined level of seismic safety into their building designs.

  18. Empirical Analysis of the Impact of Inflation Targeting on the Risk Premium

    Directory of Open Access Journals (Sweden)

    Krušković Borivoje D.

    2014-09-01

    Full Text Available The basis for the conduct of monetary policy is monetary policy strategy. Monetary strategy is necessary for monetary policy makers to analyse all relevant information in order to undertake effective policy actions. Inflation targeting has enabled countries to achieve low inflation in the very short term. Due to this, the financial markets have adjusted their long-term inflation expectations and incorporated them into the interest rate. Risk premiums that compensate for the uncertainty of inflation have fallen. The aim of this paper is to examine how the adoption of inflation targeting affects the movement of the risk premium. The hypothesis we want to test is that the adoption of inflation targeting affects the reduction of the country risk premium by affecting the formation of a more stable macroeconomic environment through a more stable and predictable inflation rate in the medium and long term. The method used for evaluating the regression coefficients is the dynamic panel generalized method of moments (GMM. This method involves the use of conditional moments in endogenous and exogenous variables with a lag as instruments for the assessment of differential equations, while the difference lagged endogenous variables are used as instruments in the levels equation.

  19. Value-at-Risk Performances during the 2007-2008 Global Financial Crisis: a comparison of three Value-at-Risk models in the emerging markets of China, India and Philippines.

    OpenAIRE

    Li, Mi

    2012-01-01

    Ever since the world economic outlook was fundamentally changed by the 2007-2008 financial crisis, risk management and reliable risk measurements have been drew much attentions. This thesis selects three Asian emerging markets, that is, China, India, Philippine, as the research targets and evaluates the performances of three different Value-at-Risk (VaR) models (the Historical Simulation, the Monte Carlo Simulation, and the Extreme Value Theory) in these three emerging markets’ stock markets ...

  20. Targeted outreach hepatitis B vaccination program in high-risk adults: The fundamental challenge of the last mile.

    Science.gov (United States)

    Mangen, M-J J; Stibbe, H; Urbanus, A; Siedenburg, E C; Waldhober, Q; de Wit, G A; van Steenbergen, J E

    2017-05-31

    The aim of this study was to evaluate the cost-effectiveness of the on-going decentralised targeted hepatitis B vaccination program for behavioural high-risk groups operated by regional public health services in the Netherlands since 1-November-2002. Target groups for free vaccination are men having sex with men (MSM), commercial sex workers (CSW) and hard drug users (HDU). Heterosexuals with a high partner change rate (HRP) were included until 1-November-2007. Based on participant, vaccination and serology data collected up to 31-December-2012, the number of participants and program costs were estimated. Observed anti-HBc prevalence was used to estimate the probability of susceptible individuals per risk-group to become infected with hepatitis B virus (HBV) in their remaining life. We distinguished two time-periods: 2002-2006 and 2007-2012, representing different recruitment strategies and target groups. Correcting for observed vaccination compliance, the number of future HBV-infections avoided was estimated per risk-group. By combining these numbers with estimates of life-years lost, quality-of-life losses and healthcare costs of HBV-infections - as obtained from a Markov model-, the benefit of the program was estimated for each risk-group separately. The overall incremental cost-effectiveness ratio of the program was €30,400/QALY gained, with effects and costs discounted at 1.5% and 4%, respectively. The program was more cost-effective in the first period (€24,200/QALY) than in the second period (€42,400/QALY). In particular, the cost-effectiveness for MSM decreased from €20,700/QALY to €47,700/QALY. This decentralised targeted HBV-vaccination program is a cost-effective intervention in certain unvaccinated high-risk adults. Saturation within the risk-groups, participation of individuals with less risky behaviour, and increased recruitment investments in the second period made the program less cost-effective over time. The project should therefore

  1. Physician assessment of stroke risk in hypertensive patients in the Middle East and Africa: results of the action survey.

    Science.gov (United States)

    Badr, Kamal F; Boudia, Khereddine M Merad; Alami, Mohamed; Khoja, Waleed A; Belhani, Ali B; Nawar, Moustafa; Ragy, Hany; Ishaq, Mohammad; Baron, J M Muscat; Hammoudeh, Ayman J; De Mar Youssef, Suzan S; Nakhle, Reine M; Chalfoun, Amale G

    2007-01-01

    In the absence of reliable, contemporary national data, the ACTION survey was designed to: a) provide preliminary data on stroke risk in the MEA (Middle East and Africa); b) describe the contribution of specific cardiovascular risk factors; 3) assess blood pressure (BP) control. This was a multi-center observational study in nine countries in the MEA region. From 2003 to 2005, 562 physicians from a variety of specialties recorded observations of cardiovascular risk factors in 4,747 hypertensive patients, aged 54-80 years. The 10-year absolute stroke risk was calculated using a scoring system based on the Framingham Heart Study observations, and comparisons made with an age-matched cohort. The mean 10-year stroke risk was estimated at 22.7% and was significantly higher for men (25.4%) than for women (19.5%) (P age-matched Framingham cohort, the estimated stroke risk in our population was almost double, and was significantly higher for females (212%) than for males (192%) (P < .001). Hypertension, diabetes, left ventricular hypertrophy, and smoking were major contributing risk factors, as were physical inactivity and elevated cholesterol. Blood pressure was controlled in only 18% of the population and in 12% of diabetics. Physicians of all specialties were willing to participate in stroke risk assessment. The risk of stroke in hypertensive patients in the MEA region is high, and is higher than would be predicted using Framingham data, particularly for females. Hypertension appears to be poorly controlled in more than 80% of hypertensive patients in the MEA region.

  2. Risk-Based School Inspections: Impact of Targeted Inspection Approaches on Dutch Secondary Schools

    Science.gov (United States)

    Ehren, Melanie C.; Shackleton, Nichola

    2016-01-01

    In most countries, publicly funded schools are held accountable to one inspectorate and are judged against agreed national standards. Many inspectorates of education have recently moved towards more proportional risk-based inspection models, targeting high-risk schools for visits, while schools with satisfactory student attainment levels are…

  3. HEALTHY study rationale, design and methods: moderating risk of type 2 diabetes in multi-ethnic middle school students.

    Science.gov (United States)

    Hirst, Kathryn; Baranowski, Tom; DeBar, Lynn; Foster, Gary D; Kaufman, Francine; Kennel, Phyllis; Linder, Barbara; Schneider, Margaret; Venditti, Elizabeth M; Yin, Zenong

    2009-08-01

    The HEALTHY primary prevention trial was designed and implemented in response to the growing numbers of children and adolescents being diagnosed with type 2 diabetes. The objective was to moderate risk factors for type 2 diabetes. Modifiable risk factors measured were indicators of adiposity and glycemic dysregulation: body mass index > or =85th percentile, fasting glucose > or =5.55 mmol l(-1) (100 mg per 100 ml) and fasting insulin > or =180 pmol l(-1) (30 microU ml(-1)). A series of pilot studies established the feasibility of performing data collection procedures and tested the development of an intervention consisting of four integrated components: (1) changes in the quantity and nutritional quality of food and beverage offerings throughout the total school food environment; (2) physical education class lesson plans and accompanying equipment to increase both participation and number of minutes spent in moderate-to-vigorous physical activity; (3) brief classroom activities and family outreach vehicles to increase knowledge, enhance decision-making skills and support and reinforce youth in accomplishing goals; and (4) communications and social marketing strategies to enhance and promote changes through messages, images, events and activities. Expert study staff provided training, assistance, materials and guidance for school faculty and staff to implement the intervention components. A cohort of students were enrolled in sixth grade and followed to end of eighth grade. They attended a health screening data collection at baseline and end of study that involved measurement of height, weight, blood pressure, waist circumference and a fasting blood draw. Height and weight were also collected at the end of the seventh grade. The study was conducted in 42 middle schools, six at each of seven locations across the country, with 21 schools randomized to receive the intervention and 21 to act as controls (data collection activities only). Middle school was the unit of

  4. Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes

    DEFF Research Database (Denmark)

    Gunge, V B; Andersen, I; Kyrø, C

    2017-01-01

    BACKGROUND/OBJECTIVES: For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether...... adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes. SUBJECTS/METHODS: Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50 − 64 years recruited between 1993 and 1997. The healthy.......55, 95% CI = 0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR = 0.95, 95% CI = 0.92, 0.99) and women (HR = 0.93, 95% CI = 0.88, 0.98). CONCLUSIONS: A healthy Nordic diet is associated...

  5. What Is Middle Class about the Middle Classes around the World?

    OpenAIRE

    Abhijit V. Banerjee; Esther Duflo

    2008-01-01

    We expect a lot from the middle classes. At least three distinct arguments about the special economic role of the middle class are traditionally made. In one, new entrepreneurs armed with a capacity and a tolerance for delayed gratification emerge from the middle class and create employment and productivity growth for the rest of society. In a second, perhaps more conventional view, the middle class is primarily a source of vital inputs for the entrepreneurial class: it is their "middle class...

  6. Employment situation and risk of death among middle-aged Japanese women.

    Science.gov (United States)

    Honjo, Kaori; Iso, Hiroyasu; Ikeda, Ai; Fujino, Yoshihisa; Tamakoshi, Akiko

    2015-10-01

    Few studies have examined the health effects of employment situation among women, taking social and economic conditions into consideration. The objective of this research was to investigate the association of employment situation (full-time or part-time employee and self-employed) with mortality risk in women over a 20-year follow-up period. Additionally, we examined whether the association between employment situation and mortality in women differed by education level and marital status. We investigated the association of employment situation with mortality among 16,692 women aged 40-59 years enrolled in the Japan Collaborative Cohort Study. Multivariate HRs and 95% CIs for total deaths by employment situation were calculated after adjustment for age, disease history, residential area, education level, marital status and number of children. We also conducted subgroup analysis by education level and marital status. Multivariate HRs for mortality of part-time employees and self-employed workers were 1.48 (95% CI, 1.25 to 1.75) and 1.44 (95% CI, 1.21 to 1.72), respectively, with reference to women working full-time. Subgroup analysis by education level indicated that health effects in women according to employment situation were likely to be more evident in the low education-level group. Subgroup analysis by marital status indicated that this factor also affected the association between employment situation and risk of death. Among middle-aged Japanese women, employment situation was associated with mortality risk. Health effects were likely to differ by household structure and socioeconomic conditions. 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.

  7. Heated hatha yoga to target cortisol reactivity to stress and affective eating in women at risk for obesity-related illnesses: A randomized controlled trial.

    Science.gov (United States)

    Hopkins, Lindsey B; Medina, Johnna L; Baird, Scarlett O; Rosenfield, David; Powers, Mark B; Smits, Jasper A J

    2016-06-01

    Cortisol reactivity to stress is associated with affective eating, an important behavioral risk factor for obesity and related metabolic diseases. Yoga practice is related to decreases in stress and cortisol levels, thus emerging as a potential targeted complementary intervention for affective eating. This randomized controlled trial examined the efficacy of a heated, hatha yoga intervention for reducing cortisol reactivity to stress and affective eating. Females (N = 52; ages 25-46 years; 75% White) at risk for obesity and related illnesses were randomly assigned to 8 weeks of Bikram Yoga practice or to waitlist control. Cortisol reactivity to a laboratory stress induction were measured at Weeks 0 (pretreatment) and 9 (posttreatment). Self-reported binge eating frequency and coping motives for eating were assessed at Weeks 0, 3, 6, and 9. Among participants with elevated cortisol reactivity at pretreatment ("high reactors"), those randomized to the yoga condition evidenced greater pre- to posttreatment reductions in cortisol reactivity (p = .042, d = .85), but there were not significant condition differences for the "low reactors" (p = .178, d = .53). Yoga participants reported greater decreases in binge eating frequency (p = .040, d = .62) and eating to cope with negative affect (p = .038, d = .54). This study provides preliminary support for the efficacy of heated hatha yoga for treating physiological stress reactivity and affective eating among women at risk for obesity-related illnesses. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Use of non-steroidal anti-inflammatory drugs that elevate cardiovascular risk: an examination of sales and essential medicines lists in low-, middle-, and high-income countries.

    Directory of Open Access Journals (Sweden)

    Patricia McGettigan

    Full Text Available BACKGROUND: Certain non-steroidal anti-inflammatory drugs (NSAIDs (e.g., rofecoxib [Vioxx] increase the risk of heart attack and stroke and should be avoided in patients at high risk of cardiovascular events. Rates of cardiovascular disease are high and rising in many low- and middle-income countries. We studied the extent to which evidence on cardiovascular risk with NSAIDs has translated into guidance and sales in 15 countries. METHODS AND FINDINGS: Data on the relative risk (RR of cardiovascular events with individual NSAIDs were derived from meta-analyses of randomised trials and controlled observational studies. Listing of individual NSAIDs on Essential Medicines Lists (EMLs was obtained from the World Health Organization. NSAID sales or prescription data for 15 low-, middle-, and high-income countries were obtained from Intercontinental Medical Statistics Health (IMS Health or national prescription pricing audit (in the case of England and Canada. Three drugs (rofecoxib, diclofenac, etoricoxib ranked consistently highest in terms of cardiovascular risk compared with nonuse. Naproxen was associated with a low risk. Diclofenac was listed on 74 national EMLs, naproxen on just 27. Rofecoxib use was not documented in any country. Diclofenac and etoricoxib accounted for one-third of total NSAID usage across the 15 countries (median 33.2%, range 14.7-58.7%. This proportion did not vary between low- and high-income countries. Diclofenac was by far the most commonly used NSAID, with a market share close to that of the next three most popular drugs combined. Naproxen had an average market share of less than 10%. CONCLUSIONS: Listing of NSAIDs on national EMLs should take account of cardiovascular risk, with preference given to low risk drugs. Diclofenac has a risk very similar to rofecoxib, which was withdrawn from worldwide markets owing to cardiovascular toxicity. Diclofenac should be removed from EMLs.

  9. Sexting and sexual behavior among middle school students.

    Science.gov (United States)

    Rice, Eric; Gibbs, Jeremy; Winetrobe, Hailey; Rhoades, Harmony; Plant, Aaron; Montoya, Jorge; Kordic, Timothy

    2014-07-01

    It is unknown if "sexting" (i.e., sending/receiving sexually explicit cell phone text or picture messages) is associated with sexual activity and sexual risk behavior among early adolescents, as has been found for high school students. To date, no published data have examined these relationships exclusively among a probability sample of middle school students. A probability sample of 1285 students was collected alongside the 2012 Youth Risk Behavior Survey in Los Angeles middle schools. Logistic regressions assessed the correlates of sexting behavior and associations between sexting and sexual activity and risk behavior (ie, unprotected sex). Twenty percent of students with text-capable cell phone access reported receiving a sext and 5% reported sending a sext. Students who text at least 100 times per day were more likely to report both receiving (odds ratio [OR]: 2.4) and sending (OR: 4.5) sexts and to be sexually active (OR: 4.1). Students who sent sexts (OR: 3.2) and students who received sexts (OR: 7.0) were more likely to report sexual activity. Compared with not being sexually active, excessive texting and receiving sexts were associated with both unprotected sex (ORs: 4.7 and 12.1, respectively) and with condom use (ORs: 3.7 and 5.5, respectively). Because early sexual debut is correlated with higher rates of sexually transmitted infections and teen pregnancies, pediatricians should discuss sexting with young adolescents because this may facilitate conversations about sexually transmitted infection and pregnancy prevention. Sexting and associated risks should be considered for inclusion in middle school sex education curricula. Copyright © 2014 by the American Academy of Pediatrics.

  10. SIOP PODC adapted treatment recommendations for standard-risk medulloblastoma in low and middle income settings.

    Science.gov (United States)

    Parkes, Jeannette; Hendricks, Marc; Ssenyonga, Peter; Mugamba, John; Molyneux, Elizabeth; Schouten-van Meeteren, Antoinette; Qaddoumi, Ibrahim; Fieggen, Graham; Luna-Fineman, Sandra; Howard, Scott; Mitra, Dipayan; Bouffet, Eric; Davidson, Alan; Bailey, Simon

    2015-04-01

    Effective treatment of children with medulloblastoma requires a functioning multi-disciplinary team with adequate neurosurgical, neuroradiological, pathological, radiotherapy and chemotherapy facilities and personnel. In addition the treating centre should have the capacity to effectively screen and manage any tumour and treatment-associated complications. These requirements have made it difficult for many low and middle-income countries (LMIC) centres to offer curative treatment. This article provides management recommendations for children with standard-risk medulloblastoma (localised tumours in children over the age of 3-5 years) according to the level of facilities available. © 2014 Wiley Periodicals, Inc.

  11. Reduced glomerular filtration rate and its association with clinical outcome in older patients at risk of vascular events: secondary analysis.

    LENUS (Irish Health Repository)

    Ford, Ian

    2009-01-20

    Reduced glomerular filtration rate (GFR) is associated with increased cardiovascular risk in young and middle aged individuals. Associations with cardiovascular disease and mortality in older people are less clearly established. We aimed to determine the predictive value of the GFR for mortality and morbidity using data from the 5,804 participants randomized in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).

  12. Robust Tracking with Discriminative Ranking Middle-Level Patches

    Directory of Open Access Journals (Sweden)

    Hong Liu

    2014-04-01

    Full Text Available The appearance model has been shown to be essential for robust visual tracking since it is the basic criterion to locating targets in video sequences. Though existing tracking-by-detection algorithms have shown to be greatly promising, they still suffer from the drift problem, which is caused by updating appearance models. In this paper, we propose a new appearance model composed of ranking middle-level patches to capture more object distinctiveness than traditional tracking-by-detection models. Targets and backgrounds are represented by both low-level bottom-up features and high-level top-down patches, which can compensate each other. Bottom-up features are defined at the pixel level, and each feature gets its discrimination score through selective feature attention mechanism. In top-down feature extraction, rectangular patches are ranked according to their bottom-up discrimination scores, by which all of them are clustered into irregular patches, named ranking middle-level patches. In addition, at the stage of classifier training, the online random forests algorithm is specially refined to reduce drifting problems. Experiments on challenging public datasets and our test videos demonstrate that our approach can effectively prevent the tracker drifting problem and obtain competitive performance in visual tracking.

  13. Prevalence of atherogenic dyslipidemia in primary care patients at moderate-very high risk of cardiovascular disease. Cardiovascular risk perception.

    Science.gov (United States)

    Plana, Nuria; Ibarretxe, Daiana; Cabré, Anna; Ruiz, Emilio; Masana, Lluis

    2014-01-01

    Atherogenic dyslipidemia is an important risk factor for cardiovascular disease. We aim to determine atherogenic dyslipidemia prevalence in primary care patients at moderate-very high cardiovascular risk and its associated cardiovascular risk perception in Spain. This cross-sectional study included 1137 primary care patients. Patients had previous cardiovascular disease, diabetes mellitus, SCORE risk ≥ 3, severe hypertension or dyslipidemia. Atherogenic dyslipidemia was defined as low HDL-C (<40 mg/dL [males], <50 mg/dL [females]) and elevated triglycerides (≥ 150 mg/dL). A visual analog scale was used to define a perceived cardiovascular disease risk score. Mean age was 63.9 ± 9.7 years (64.6% males). The mean BMI was 29.1 ± 4.3 kg/m(2), and mean waist circumference 104.2 ± 12.7 cm (males), and 97.2 ± 14.0 cm (females). 29.4% were smokers, 76.4% had hypertension, 48.0% were diabetics, 24.7% had previous myocardial infarction, and 17.8% peripheral arterial disease. European guidelines classified 83.6% at very high cardiovascular risk. Recommended HDL-C levels were achieved by 50.1% of patients and 37.3% had triglycerides in the reference range. Target LDL-C was achieved by 8.8%. The overall atherogenic dyslipidemia prevalence was 27.1% (34.1% in diabetics). This prevalence in patients achieving target LDL-C was 21.4%. Cardiovascular risk perceived by patients was 4.3/10, while primary care physicians scored 5.7/10. When LDL-C levels are controlled, atherogenic dyslipidemia is more prevalent in those patients at highest cardiovascular risk and with diabetes. This highlights the importance of intervention strategies to prevent the residual vascular risk in this population. Both patients and physicians underestimated cardiovascular risk. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  14. Racial sexual mixing and factors associated with condom use among Middle Eastern-Canadians.

    Science.gov (United States)

    Schoueri, Nour; Bullock, Sandra L; Dubin, Joel A

    2010-02-01

    Interracial relationships in Canada have increased over the years. However, little research has focused on comparing STI/HIV risk and condom use between those in intra- and interracial relationships, specifically among Middle Eastern-Canadians. A web-based survey was administered to Middle Eastern-Canadians. Logistic regression analysis was used to assess factors associated with consistent condom use. Analyses were stratified by partner's race (Middle Eastern or non-Middle Eastern). The analysis sub-sample consisted of 92 participants. Factors associated with consistent condom use varied between the stratified groups. Among those with Middle Eastern partners, attitude towards marriage and the family and control in the relationship were associated with condom use. Among participants with non-Middle Eastern partners, acculturation and HIV knowledge were found to be associated with condom use. Factors associated with condom use varied between Middle Eastern-Canadians in intra- and interracial relationships. These differences illustrate the need for tailored interventions aimed at increasing condom use among this racial group.

  15. Behavioral and psychosocial effects of two middle school sexual health education programs at tenth-grade follow-up.

    Science.gov (United States)

    Markham, Christine M; Peskin, Melissa F; Shegog, Ross; Baumler, Elizabeth R; Addy, Robert C; Thiel, Melanie; Escobar-Chaves, Soledad Liliana; Robin, Leah; Tortolero, Susan R

    2014-02-01

    An earlier randomized controlled trial found that two middle school sexual education programs-a risk avoidance (RA) program and a risk reduction (RR) program-delayed initiation of sexual intercourse (oral, vaginal, or anal sex) and reduced other sexual risk behaviors in ninth grade. We examined whether these effects extended into 10th grade. Fifteen middle schools were randomly assigned to RA, RR, or control conditions. Follow-up surveys were conducted with participating students in 10th grade (n = 1,187; 29.2% attrition). Participants were 60% female, 50% Hispanic, and 39% black; seventh grade mean age was 12.6 years. In 10th grade, compared with the control condition, both programs significantly delayed anal sex initiation in the total sample (RA: adjusted odds ratio [AOR], .64, 95% confidence interval [CI], .42-.99; RR: AOR, .65, 95% CI, .50-.84) and among Hispanics (RA: AOR, .53, 95% CI, .31-.91; RR: AOR, .82, 95% CI, .74-.93). Risk avoidance students were less likely to report unprotected vaginal sex, either by using a condom or by abstaining from sex (AOR: .61, 95% CI, .45-.85); RR students were less likely to report recent unprotected anal sex (AOR: .34, 95% CI, .20-.56). Both programs sustained positive impact on some psychosocial outcomes. Although both programs delayed anal sex initiation into 10th grade, effects on the delayed initiation of oral and vaginal sex were not sustained. Additional high school sexual education may help to further delay sexual initiation and reduce other sexual risk behaviors in later high school years. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  16. Different physical activity subtypes and risk of metabolic syndrome in middle-aged and older Chinese people.

    Directory of Open Access Journals (Sweden)

    Mu Chen

    Full Text Available BACKGROUND: The prevalence of metabolic syndrome (MetS is growing rapidly in China. Tai chi and dancing are common types of exercise among middle-aged and elderly Chinese. It remains unclear whether these activities are associated with a lower risk of MetS. METHODOLOGY/PRINCIPAL FINDINGS: A total of 15,514 individuals (6,952 men, 8,562 women aged 50 to 70 years from the Dongfeng-Tongji Cohort in Shiyan, China participated in a cross-sectional study. Physical activity and other lifestyle factors were assessed with semi-structured questionnaires during face-to-face interviews. MetS was defined by the current National Cholesterol Education Program/Adult treatment Panel III criteria for Asian Americans. The prevalence of MetS was 33.2% in the study population. In the multivariable-adjusted logistic regression analyses, total physical activity levels were monotonically associated with a lower odds of MetS [OR 0.75 comparing extreme quintiles, 95% confidence interval (CI 0.66-0.86, P<0.001]. Compared with non-exercisers in a specific exercise type, jogging (OR 0.82, 95% CI 0.68-1.00, P = 0.046, tai chi (OR 0.72, 95% CI 0.60-0.88, P<0.001, and dancing (OR 0.56, 95% CI 0.47-0.67, P<0.001 were associated with significantly lower odds of MetS. Furthermore, each 1-h/week increment in tai chi and dancing was associated with a 5% (95% CI 2%-9% and a 9% (95% CI 6%, 12% lower risk of MetS. CONCLUSIONS/SIGNIFICANCE: Jogging, tai chi and dancing are associated with a significantly lower risk of having MetS in middle-aged and older Chinese. Future intervention studies should consider the role of jogging, tai chi and dancing in preventing MetS.

  17. Neonicotinoids target distinct nicotinic acetylcholine receptors and neurons, leading to differential risks to bumblebees

    Science.gov (United States)

    Moffat, Christopher; Buckland, Stephen T.; Samson, Andrew J.; McArthur, Robin; Chamosa Pino, Victor; Bollan, Karen A.; Huang, Jeffrey T.-J.; Connolly, Christopher N.

    2016-04-01

    There is growing concern over the risk to bee populations from neonicotinoid insecticides and the long-term consequences of reduced numbers of insect pollinators to essential ecosystem services and food security. Our knowledge of the risk of neonicotinoids to bees is based on studies of imidacloprid and thiamethoxam and these findings are extrapolated to clothianidin based on its higher potency at nicotinic acetylcholine receptors. This study addresses the specificity and consequences of all three neonicotinoids to determine their relative risk to bumblebees at field-relevant levels (2.5 ppb). We find compound-specific effects at all levels (individual cells, bees and whole colonies in semi-field conditions). Imidacloprid and clothianidin display distinct, overlapping, abilities to stimulate Kenyon cells, indicating the potential to differentially influence bumblebee behavior. Bee immobility was induced only by imidacloprid, and an increased vulnerability to clothianidin toxicity only occurred following chronic exposure to clothianidin or thiamethoxam. At the whole colony level, only thiamethoxam altered the sex ratio (more males present) and only clothianidin increased queen production. Finally, both imidacloprid and thiamethoxam caused deficits in colony strength, while no detrimental effects of clothianidin were observed. Given these findings, neonicotinoid risk needs to be considered independently for each compound and target species.

  18. Identifying eustachian tube dysfunction prior to hyperbaric oxygen therapy: Who is at risk for intolerance?

    Science.gov (United States)

    Cohn, Jason E; Pfeiffer, Michael; Patel, Niki; Sataloff, Robert T; McKinnon, Brian J

    Determine whether specific risk factors, symptoms and clinical examination findings are associated with hyperbaric oxygen therapy (HBOT) intolerance and subsequent tympanotomy tube placement. A retrospective case series with chart review was conducted from 2007 to 2016 of patients undergoing HBOT clearance at a tertiary care university hospital in an urban city. Eighty-one (n=81) patient charts were reviewed for risk factors, symptoms and clinical examination findings related to HBOT eustachian tube dysfunction and middle ear barotrauma. Relative risk was calculated for each variable to determine risk for HBOT intolerance and need for tympanotomy tube placement. Risk factor, symptom, physical examination and HBOT complication-susceptibility scores were calculated for each patient. Mean risk factor, clinical and HBOT complication-susceptibility scores were significantly higher in patients who did not tolerate HBOT compared to patients who tolerated HBOT. Patients reporting a history of otitis media, tinnitus, and prior ear surgery were at a higher risk for HBOT intolerance. Patients reporting a history of pressure intolerance and prior ear surgery were more likely to undergo tympanotomy tube placement. Patients noted to have otologic findings prior to HBOT were at a higher risk for both HBOT intolerance and tympanotomy tube placement. A thorough otolaryngological evaluation can potentially predict and identify patients at risk for HBOT intolerance and tympanotomy tube placement. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Intensity-Modulated Radiotherapy for Craniospinal Irradiation: Target Volume Considerations, Dose Constraints, and Competing Risks

    International Nuclear Information System (INIS)

    Parker, William; Filion, Edith; Roberge, David; Freeman, Carolyn R.

    2007-01-01

    Purpose: To report the results of an analysis of dose received to tissues and organs outside the target volume, in the setting of spinal axis irradiation for the treatment of medulloblastoma, using three treatment techniques. Methods and Materials: Treatment plans (total dose, 23.4 Gy) for a standard two-dimensional (2D) technique, a three-dimensional (3D) technique using a 3D imaging-based target volume, and an intensity-modulated radiotherapy (IMRT) technique, were compared for 3 patients in terms of dose-volume statistics for target coverage, as well as organ at risk (OAR) and overall tissue sparing. Results: Planning target volume coverage and dose homogeneity was superior for the IMRT plans for V 95% (IMRT, 100%; 3D, 96%; 2D, 98%) and V 107% (IMRT, 3%; 3D, 38%; 2D, 37%). In terms of OAR sparing, the IMRT plan was better for all organs and whole-body contour when comparing V 10Gy , V 15Gy , and V 20Gy . The 3D plan was superior for V 5Gy and below. For the heart and liver in particular, the IMRT plans provided considerable sparing in terms of V 10Gy and above. In terms of the integral dose, the IMRT plans were superior for liver (IMRT, 21.9 J; 3D, 28.6 J; 2D, 38.6 J) and heart (IMRT, 9 J; 3D, 14.1J; 2D, 19.4 J), the 3D plan for the body contour (IMRT, 349 J; 3D, 337 J; 2D, 555 J). Conclusions: Intensity-modulated radiotherapy is a valid treatment option for spinal axis irradiation. We have shown that IMRT results in sparing of organs at risk without a significant increase in integral dose

  20. Polarized targets at triangle universities nuclear laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Seely, M.L. [North Carolina State Univ., Raleigh, NC (United States); Gould, C.R. [North Carolina State Univ., Raleigh, NC (United States); Haase, D.G. [North Carolina State Univ., Raleigh, NC (United States); Huffman, P.R. [Triangle Universities Nuclear Laboratory, Durham, NC 27708 (United States); Keith, C.D. [North Carolina State Univ., Raleigh, NC (United States); Roberson, N.R. [Triangle Universities Nuclear Laboratory, Durham, NC 27708 (United States); Tornow, W. [Triangle Universities Nuclear Laboratory, Durham, NC 27708 (United States); Wilburn, W.S. [Triangle Universities Nuclear Laboratory, Durham, NC 27708 (United States)

    1995-03-01

    A summary of the polarized and aligned nuclear targets which have been constructed and used at the Triangle Universities Nuclear Laboratory is given. Statically polarized targets, typically operating at a temperature of 12 mK and a magnetic field of 7 T, have provided significant nuclear polarization in {sup 1}H, {sup 3}He, {sup 27}Al, {sup 93}Nb and {sup 165}Ho. A rotating, aligned {sup 165}Ho target is also in use. A {sup 3}He melting curve thermometer has been developed for use in statically polarized targets. A dynamically polarized proton target is under construction. ((orig.))

  1. Gout in Older Adults: The Atherosclerosis Risk in Communities Study

    Science.gov (United States)

    Burke, Bridget Teevan; Köttgen, Anna; Law, Andrew; Grams, Morgan; Baer, Alan N.; Coresh, Josef

    2016-01-01

    Background: It is unclear whether traditional and genetic risk factors in middle age predict the onset of gout in older age. Methods: We studied the incidence of gout in older adults using the Atherosclerosis Risk in Communities study, a prospective U.S. population–based cohort of middle-aged adults enrolled between 1987 and 1989 with ongoing follow-up. A genetic urate score was formed from common urate-associated single nucleotide polymorphisms for eight genes. The adjusted hazard ratio and 95% confidence interval of incident gout by traditional and genetic risk factors in middle age were estimated using a Cox proportional hazards model. Results: The cumulative incidence from middle age to age 65 was 8.6% in men and 2.5% in women; by age 75 the cumulative incidence was 11.8% and 5.0%. In middle age, increased adiposity, beer intake, protein intake, smoking status, hypertension, diuretic use, and kidney function (but not sex) were associated with an increased gout risk in older age. In addition, a 100 µmol/L increase in genetic urate score was associated with a 3.29-fold (95% confidence interval: 1.63–6.63) increased gout risk in older age. Conclusions: These findings suggest that traditional and genetic risk factors in middle age may be useful for identifying those at risk of gout in older age. PMID:26714568

  2. Prevalence of Risk Factors for the Metabolic Syndrome in the Middle Income Caribbean Nation of St. Lucia

    Science.gov (United States)

    Cherry, Colleen O'Brien; Serieux, Elizabeth; Didier, Martin; Nuttal, Mary Elizabeth; Schuster, Richard J.

    2014-01-01

    The objective of this research was to measure the presence of metabolic syndrome risk factors in a sample population in the middle income Caribbean nation of St. Lucia and to identify the demographic and behavioral factors of metabolic syndrome among the study participants. Interviews and anthropometric measures were conducted with 499 St. Lucians of ages 18–99. Descriptive statistics were used for the analysis. Fifty-six percent of females and 18 percent of males had a waist size equal to or above the indicator for the metabolic syndrome. Behavioral risk factors such as sedentary lifestyle, smoking, and alcohol consumption varied by gender. Thirty-six percent of women and 22% of men reported a sedentary lifestyle and 43% of women and 65% of men reported any alcohol consumption. More research should be done to determine the cultural norms and gender differences associated with modifiable risk behaviors in St. Lucia. PMID:25309758

  3. Asymptotically Constant-Risk Predictive Densities When the Distributions of Data and Target Variables Are Different

    Directory of Open Access Journals (Sweden)

    Keisuke Yano

    2014-05-01

    Full Text Available We investigate the asymptotic construction of constant-risk Bayesian predictive densities under the Kullback–Leibler risk when the distributions of data and target variables are different and have a common unknown parameter. It is known that the Kullback–Leibler risk is asymptotically equal to a trace of the product of two matrices: the inverse of the Fisher information matrix for the data and the Fisher information matrix for the target variables. We assume that the trace has a unique maximum point with respect to the parameter. We construct asymptotically constant-risk Bayesian predictive densities using a prior depending on the sample size. Further, we apply the theory to the subminimax estimator problem and the prediction based on the binary regression model.

  4. Girls in Foster Care: Risk and Promotive Factors for School Adjustment Across the Transition to Middle School.

    Science.gov (United States)

    Pears, Katherine C; Kim, Hyoun K; Leve, Leslie D

    2012-01-01

    Girls in foster care may face difficulties across the transition to middle school. Latent growth curve modeling was employed to examine trajectories and predictors of academic competence and aggression from and against peers for 75 girls in foster care from the end of elementary school to the 2(nd) year of middle school. Across the transition to middle school, academic competence increased. Poor self-regulation was associated with decreased academic competence, and higher caregiver support was associated with increased academic competence. Frequency of aggression from peers decreased across the transition, with perceived school competence predicting smaller decreases. Aggression against peers dropped initially and then increased to pretransition levels by the end of the 2(nd) year of middle school. Lower caregiver support was associated with higher rates of aggression against peers at the end of the 1(st) year of middle school. The results are discussed in terms of implications for interventions for girls in foster care.

  5. Diet and cognitive decline at middle age : The role of antioxidants

    NARCIS (Netherlands)

    Nooyens, Astrid C J; Milder, Ivon E J; Van Gelder, Boukje M.; Bueno-De-Mesquita, H. Bas; Van Boxtel, Martin P J; Verschuren, W. M Monique

    2015-01-01

    To assess the relationship between dietary intake of antioxidants (vitamin C, vitamin E, β-carotene, lutein, flavonoids and lignans) and cognitive decline at middle age, analyses were performed on data from the population based Doetinchem Cohort Study. Habitual diet and cognitive function were

  6. Caught in the Middle: Some in Canada’s Middle Class are Doing Well; Others Have Good Reason to Worry

    Directory of Open Access Journals (Sweden)

    Philip Cross

    2015-03-01

    -sector professionals in particular have come to share the human-capital and income characteristics of Canada’s highest-paid managers and professionals, often enjoying greater job security as well. In reality, anxiety over the state of the middle class and its future is actually about the working class. Lumping middle-class factory workers and clerical assistants in with middle-class teachers and nurses — as current political discussion tends to do — obscures the truth about which members of that group are genuinely struggling to keep up. As long as politicians continue to promote policies aimed at helping everyone within such a vague and broad target group, they can only end up misdirecting resources by enriching those who are already doing reasonably well, rather than focusing on those working-class Canadians who truly are not. Already net transfers through the tax system to middle-income groups have grown markedly. These transfers have managed to offset about half the erosion of middle-class incomes in the marketplace. Those transfers have been financed through increased tax payments from high-income groups, but also through shrinking transfers to low-income groups. These developments raise serious policy issues for which there are no simple answers. The breadth of Canada’s middle class obviously means that it encompasses the largest proportion of families, by far. Any further policies aimed at transferring wealth from other income groups to appease middle-class voters will be costly. Given that the main cause for concern is the worsening situation of lowerskilled workers, politicians who truly want to help those struggling in the “middle class,” should focus their efforts on helping Canadians acquire more education and more skills.

  7. Serum 25(OHD is inversely associated with metabolic syndrome risk profile among urban middle-aged Chinese population

    Directory of Open Access Journals (Sweden)

    Yin Xiao

    2012-09-01

    Full Text Available Abstract Background Vitamin D deficiency is associated with a variety of chronic metabolic diseases. Limited evidence regarding vitamin D deficiency exists within the Chinese population. The present study aims to examine the association between serum vitamin D concentrations and cardiometabolic risk factors in the young and middle-aged, urban Chinese population Methods The cross-sectional relationships between serum 25-hydroxyvitamin D [25(OHD] concentrations and indices of adiposity and cardiometabolic risk factors (e.g., body mass index, waist circumference, fasting plasma glucose, etc. were evaluated in 601 non-diabetic adults. Result Vitamin D deficiency or insufficiency was present in 66% of the tested population, and serum 25(OHD levels were lower in patients who were overweight/obese or suffered metabolic syndrome when compared to individuals of healthy weight without metabolic syndrome (24.08 ± 8.08 vs 31.70 ± 11.77 ng/ml, 21.52 ± 6.9 vs 31.74 ± 10.21 ng/ml respectively. 25(OHD was inversely associated with waist circumference, fasting glucose, fasting insulin, triglycerides and LDL-cholesterol, and it was positively associated with HDL-cholesterol in a multivariable-adjusted regression model. Conclusion Vitamin D deficiency is common in the young and middle-aged, urban Chinese population, with high prevalence in overweight/obese individuals and patients with metabolic syndrome. Low vitamin D concentration was associated with indices of adiposity and cardiometabolic risk factors. Further studies are warranted to elucidate the cause-effect relation between vitamin D status, obesity and related metabolic disorders. Trial registration Current Controlled Trials (ISRCTN21527585

  8. A review of the report ''IAEA safety targets and probabilistic risk assessment'' prepared for Greenpeace International

    International Nuclear Information System (INIS)

    1991-01-01

    At the request of the Director General, INSAG reviewed the report ''IAEA Safety Targets and Probabilistic Risk Assessment'' prepared for Greenpeace International by the Gesellschaft fuer Oekologische Forschung und Beratung mbH, Hannover, Germany. The conclusions of the report as well as the review results of INSAG experts are reproduced in this document

  9. Identification and management of patients at increased risk of osteoporotic fracture

    DEFF Research Database (Denmark)

    Kanis, J A; Cooper, C; Rizzoli, R

    2017-01-01

    where the risk of a subsequent fracture following a first fracture is high. Consequently, there is a significant treatment gap between those who would benefit from treatment and those who receive it, which urgently needs to be addressed so that the burden of disease can be reduced. Conclusions......Summary: Osteoporosis represents a significant and increasing healthcare burden in Europe, but most patients at increased risk of fracture do not receive medication, resulting in a large treatment gap. Identification of patients who are at particularly high risk will help clinicians target...... appropriate treatment more precisely and cost-effectively, and should be the focus of future research. Introduction: The purpose of the study was to review data on the identification and treatment of patients with osteoporosis at increased risk of fracture. Methods: A working group convened by the European...

  10. A Case Study of Policies and Procedures to Address Cyberbullying at a Technology-Based Middle School

    Science.gov (United States)

    Tate, Bettina Polite

    2017-01-01

    This qualitative case study explored the policies and procedures used to effectively address cyberbullying at a technology-based middle school. The purpose of the study was to gain an in-depth understanding of policies and procedures used to address cyberbullying at a technology-based middle school in the southern United States. The study sought…

  11. Life Satisfaction and Violent Behaviors among Middle School Students

    Science.gov (United States)

    Valois, Robert F.; Paxton, Raheem J.; Zullig, Keith J.; Huebner, E. Scott

    2006-01-01

    We explored relationships between violent behaviors and perceived life satisfaction among 2,138 middle school students in a southern state using the CDC Middle School Youth Risk Behavior Survey (MSYRBS) and the Brief Multidimensional Student Life Satisfaction Scale (BMSLSS). Logistic regression analyses and multivariate models constructed…

  12. Credit securitization and credit derivatives: Financial instruments and the credit risk management of middle market commercial loan portfolios

    OpenAIRE

    Henke, Sabine; Burghof, Hans-Peter; Rudolph, Bernd

    1998-01-01

    Banks increasingly recognize the need to measure and manage the credit risk of their loans on a portfolio basis. We address the subportfolio "middle market". Due to their specific lending policy for this market segment it is an important task for banks to systematically identify regional and industrial credit concentrations and reduce the detected concentrations through diversification. In recent years, the development of markets for credit securitization and credit derivatives has provided n...

  13. Toward a Middle-Range Theory of Weight Management.

    Science.gov (United States)

    Pickett, Stephanie; Peters, Rosalind M; Jarosz, Patricia A

    2014-07-01

    The authors of this paper present the middle-range theory of weight management that focuses on cultural, environmental, and psychosocial factors that influence behaviors needed for weight control. The theory of weight management was developed deductively from Orem's theory of self-care, a constituent theory within the broader self-care deficit nursing theory and from research literature. Linkages between the conceptual and middle-range theory concepts are illustrated using a substruction model. The development of the theory of weight management serves to build nursing science by integrating extant nursing theory and empirical knowledge. This theory may help predict weight management in populations at risk for obesity-related disorders. © The Author(s) 2014.

  14. Tritium-target performance at RTNS-II

    International Nuclear Information System (INIS)

    Heikkinen, D.W.; Logan, C.M.

    1982-01-01

    The Rotating Target Neutron Source (RTNS-II) uses a 360-keV deuteron beam and the 3 He(d,n) 4 He reaction to generate 14-MeV neutrons. The neutrons are used for fusion materials damage studies. The tritium target consists of a band of titanium tritide on copper alloy substrates of 23- or 50-cm diameter. During operation, the substrates are internally cooled and rotated at approx. 4000 rpm to withstand beam intensities in excess of 100 mA. Neutron production data have been accumulated for fifty-eight 23-cm and five 50-cm targets. From these data, using a non-linear least-squares fitting procedure, target performance parameters have been obtained which permit a quantitative comparison of individual targets. Average parameters are obtained for the 23- and 50-cm targets

  15. Heated hatha yoga to target cortisol reactivity to stress and affective eating in women at risk for obesity-related illnesses: A randomized controlled trial

    NARCIS (Netherlands)

    Hopkins, L.B.; Medina, J.L.; Baird, S.O.; Rosenfield, D.; Powers, M.B.; Smits, J.A.J.

    2016-01-01

    Objective: Cortisol reactivity to stress is associated with affective eating, an important behavioral risk factor for obesity and related metabolic diseases. Yoga practice is related to decreases in stress and cortisol levels, thus emerging as a potential targeted complementary intervention for

  16. Fixed-target physics at LHCb

    CERN Document Server

    Maurice, Emilie Amandine

    2017-01-01

    The LHCb experiment has the unique possibility, among the LHC experiments, to be operated in fixed target mode, using its internal gas target SMOG. The energy scale achievable at the LHC and the excellent detector capabilities for vertexing, tracking and particle identification allow a wealth of measurements of great interest for cosmic ray and heavy ions physics. We report the first measurements made in this configuration: the measurement of antiproton production in proton-helium collisions and the measurements of open and hidden charm production in proton-argon collisions at $\\sqrt{s_\\textrm{NN}} =$ 110 GeV.

  17. Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest

    DEFF Research Database (Denmark)

    Nielsen, Niklas; Wetterslev, Jørn; Cronberg, Tobias

    2013-01-01

    Background Unconscious survivors of out-of-hospital cardiac arrest have a high risk of death or poor neurologic function. Therapeutic hypothermia is recommended by international guidelines, but the supporting evidence is limited, and the target temperature associated with the best outcome...... is unknown. Our objective was to compare two target temperatures, both intended to prevent fever. Methods In an international trial, we randomly assigned 950 unconscious adults after out-of-hospital cardiac arrest of presumed cardiac cause to targeted temperature management at either 33°C or 36°C....... The primary outcome was all-cause mortality through the end of the trial. Secondary outcomes included a composite of poor neurologic function or death at 180 days, as evaluated with the Cerebral Performance Category (CPC) scale and the modified Rankin scale. Results In total, 939 patients were included...

  18. Effect of androgen replacement therapy on atherosclerotic risk markers in young-to-middle-aged men with idiopathic hypogonadotropic hypogonadism.

    Science.gov (United States)

    Doğan, Berçem Ayçiçek; Karakılıç, Ersen; Tuna, Mazhar Müslüm; Arduç, Ayşe; Berker, Dilek; Güler, Serdar

    2015-03-01

    Idiopathic hypogonadotropic hypogonadism is a rare disorder. This study evaluated the effect of androgen replacement therapy on atherosclerotic risk markers in young-to-middle-aged men with this disorder. Forty-three male patients aged 30 (range: 24-39 years) who were newly diagnosed with idiopathic hypogonadotropic hypogonadism and 20 age-, sex- and weight-matched controls (range: 26-39 years) were included in the study. Androgen replacement therapy was given according to the Algorithm of Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes (2010; Journal of Clinical Endocrinology and Metabolism, 95, 2536). The patients were assessed at a pretreatment visit and 3 and 6 months after the treatment. Inflammatory markers and lipid parameters were evaluated. Endothelial function was assessed with brachial flow-mediated dilation of a brachial artery and high-resolution ultrasonography of the carotid intima-media thickness. The carotid intima-media thickness (P hypogonadism compared to the control subjects at the pretreatment visit. There was a negative correlation between the total testosterone level and carotid intima-media thickness (r = -0·556, P = hypogonadism and that androgen replacement therapy significantly reduces atherosclerotic risk markers in these patients after 6 months. © 2014 John Wiley & Sons Ltd.

  19. VALUE AT RISK - CORPORATE RISK MEASUREMENT

    Directory of Open Access Journals (Sweden)

    Anis Cecilia-Nicoleta

    2011-12-01

    Full Text Available The notion of 'risk' is used in a number of sciences. The Faculty of Law studies the risk depending on its legality. The Accident Theory applies this term to describe the damage and the disasters. One can find studies on the risks in the works of psychology, philosophy, medicine and within each of these areas the study of the risk is based on the given science subject and, of course, on their methods and approaches. Such a variety of risk study is explained by the diversity of this phenomenon. Under the market economy conditions, the risk is an essential component of any economic agent management policy, of the approach developed by this one, a strategy that depends almost entirely on individual ability and capacity to anticipate his evolution and to exploit his opportunities, assuming a so-called 'risk of business failure.' There are several ways to measure the risks in projects, one of the most used methods to measure this being the Value at Risk(VaR. Value at Risk (VaR was made famous by JP Morgan in the mid 1990s, by introducing the RiskMetrics approach, and hence, by far, has been sanctioned by several Governing Bodies throughout the world bank. In short, it measures the value of risk capital stocks in a given period at a certain probability of loss. This measurement can be modified for risk applications through, for example, the potential loss values affirmation in a certain amount of time during the economic life of the project- clearly, a project with a lower VaR is better. It should be noted that it is not always possible or advisable for a company to limit itself to the remote analysis of each risk because the risks and their effects are interdependent and constitute a system .In addition, there are risks which, in combination with other risks, tend to produce effects which they would not have caused by themselves and risks that tend to offset and even cancel each other out.

  20. Escalating heat-stress mortality risk due to global warming in the Middle East and North Africa (MENA).

    Science.gov (United States)

    Ahmadalipour, Ali; Moradkhani, Hamid

    2018-08-01

    Climate change will substantially exacerbate extreme temperature and heatwaves. The impacts will be more intense across the Middle East and North Africa (MENA), a region mostly characterized by hot and arid climate, already intolerable for human beings in many parts. In this study, daily climate data from 17 fine-resolution Regional Climate Models (RCMs) are acquired to calculate wet-bulb temperature and investigate the mortality risk for people aged over 65 years caused by excessive heat stress across the MENA region. Spatially adaptive temperature thresholds are implemented for quantifying the mortality risk, and the analysis is conducted for the historical period of 1951-2005 and two future scenarios of RCP4.5 and RCP8.5 during the 2006-2100 period. Results show that the mortality risk will increase in distant future to 8-20 times higher than that of the historical period if no climate change mitigation is implemented. The coastal regions of the Red sea, Persian Gulf, and Mediterranean Sea indicate substantial increase in mortality risk. Nonetheless, the risk ratio will be limited to 3-7 times if global warming is limited to 2 °C. Climate change planning and adaptation is imperative for mitigating heat-related mortality risk across the region. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Prevalence of Risk Factors for the Metabolic Syndrome in the Middle Income Caribbean Nation of St. Lucia

    Directory of Open Access Journals (Sweden)

    Colleen O’Brien Cherry

    2014-01-01

    Full Text Available The objective of this research was to measure the presence of metabolic syndrome risk factors in a sample population in the middle income Caribbean nation of St. Lucia and to identify the demographic and behavioral factors of metabolic syndrome among the study participants. Interviews and anthropometric measures were conducted with 499 St. Lucians of ages 18–99. Descriptive statistics were used for the analysis. Fifty-six percent of females and 18 percent of males had a waist size equal to or above the indicator for the metabolic syndrome. Behavioral risk factors such as sedentary lifestyle, smoking, and alcohol consumption varied by gender. Thirty-six percent of women and 22% of men reported a sedentary lifestyle and 43% of women and 65% of men reported any alcohol consumption. More research should be done to determine the cultural norms and gender differences associated with modifiable risk behaviors in St. Lucia.

  2. Modeling Retention at a Large Public University: Can At-Risk Students Be Identified Early Enough to Treat?

    Science.gov (United States)

    Singell, Larry D.; Waddell, Glen R.

    2010-01-01

    We examine the extent to which readily available data at a large public university can be used to a priori identify at-risk students who may benefit from targeted retention efforts. Although it is possible to identify such students, there remains an inevitable tradeoff in any resource allocation between not treating the students who are likely to…

  3. A systematic review of training interventions addressing sexual violence against marginalized at-risk groups of women.

    Science.gov (United States)

    Kouta, Christiana; Pithara, Christalla; Zobnina, Anna; Apostolidou, Zoe; Christodoulou, Josie; Papadakaki, Maria; Chliaoutakis, Joannes

    2015-12-01

    Women from marginalized groups working in occupations such as domestic work are at increased risk for sexual violence. Scarce evidence exists about training interventions targeting such groups. The article aims to identify community and workplace-based training interventions aiming to increase capacity among marginalized at-risk women to deal with sexual violence. A systematic review was applied. Inclusion criteria were English language published between 2003 and 2013; reporting on delivery and/or evaluation; focusing on any form of sexual violence; delivered to professionals, affected or at-risk women; targeting migrant, at-risk women or domestic workers. Data were extracted on the setting, content, evaluation process and target population. Four studies which focused on prevention or responding to sexual violence were included. One study provided sexual violence training to vulnerable female and one provided a HIV prevention intervention to marginalized women. Learning objectives included increasing knowledge around issues of sexual violence and/or gender and human rights, prevention and response strategies. Two studies aimed to train trainers. All studies conducted an outcome evaluation and two a process evaluation. It seems there is a gap on participatory empowerment training for marginalized women. Community train-the-trainer interventions are imperative to protect themselves and deal with the risk of sexual violence. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  4. Gout in Older Adults: The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Burke, Bridget Teevan; Köttgen, Anna; Law, Andrew; Grams, Morgan; Baer, Alan N; Coresh, Josef; McAdams-DeMarco, Mara A

    2016-04-01

    It is unclear whether traditional and genetic risk factors in middle age predict the onset of gout in older age. We studied the incidence of gout in older adults using the Atherosclerosis Risk in Communities study, a prospective U.S. population-based cohort of middle-aged adults enrolled between 1987 and 1989 with ongoing follow-up. A genetic urate score was formed from common urate-associated single nucleotide polymorphisms for eight genes. The adjusted hazard ratio and 95% confidence interval of incident gout by traditional and genetic risk factors in middle age were estimated using a Cox proportional hazards model. The cumulative incidence from middle age to age 65 was 8.6% in men and 2.5% in women; by age 75 the cumulative incidence was 11.8% and 5.0%. In middle age, increased adiposity, beer intake, protein intake, smoking status, hypertension, diuretic use, and kidney function (but not sex) were associated with an increased gout risk in older age. In addition, a 100 µmol/L increase in genetic urate score was associated with a 3.29-fold (95% confidence interval: 1.63-6.63) increased gout risk in older age. These findings suggest that traditional and genetic risk factors in middle age may be useful for identifying those at risk of gout in older age. © The Author 2015. 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.

  5. Oral health as a risk factor for mortality in middle-aged men: the role of socioeconomic position and health behaviours.

    Science.gov (United States)

    Sabbah, Wael; Mortensen, Laust Hvas; Sheiham, Aubrey; Batty, G David; Batty, David

    2013-05-01

    There is evidence of an association between poor oral health and mortality. This association is usually attributed to inflammatory and nutrition pathways. However, the role of health behaviours and socioeconomic position has not been adequately examined. The aims of this study were to examine the association between oral health and premature death among middle-aged men and to test whether it was explained by socioeconomic position and behaviours. Data were from the Vietnam Experience Study, a prospective cohort study of Vietnam War-era (1965-1971), American male army personnel. The authors examined risk of cause-specific and all-cause mortality in relation to poor oral health in middle age, adjusting for age, ethnicity, socioeconomic position, IQ, behavioural factors and systemic conditions. Men with poor oral health experienced a higher risk of cause-specific and all-cause mortality. HRs for all-cause mortality were 2.94 (95% CI 2.11 to 4.08) among individuals with poor oral health and 3.98 (95% CI 2.43 to 6.49) among edentates compared with those with good oral health after adjusting for ethnicity and age. The association attenuated but remained significant after further adjustment for systemic conditions, socioeconomic position and behaviours. Socioeconomic and behavioural factors explained 52% and 44% of mortality risks attributed to poor oral health and being edentate, respectively. The findings suggest that oral health-mortality relation is partly due to measured covariates in the present study. Oral health appears to be a marker of socioeconomic and behavioural risk factors related to all-cause mortality.

  6. What types of social interactions reduce the risk of psychological distress? Fixed effects longitudinal analysis of a cohort of 30,271 middle-to-older aged Australians.

    Science.gov (United States)

    Feng, Xiaoqi; Astell-Burt, Thomas

    2016-11-01

    Research on the impact of social interactions on psychological distress tends to be limited to particular forms of support, cross-sectional designs and by the spectre of omitted variables bias. A baseline sample with 3.4±0.95 years follow-up time was extracted from the 45 and Up Study. Change in the risk of psychological distress (Kessler Psychological Distress Scale) was assessed using fixed effects logistic regressions in relation to the number of times in the past week a participant: i) spent time with friends or family they did not live with; ii) talked to friends, relatives or others on the telephone; iii) attended meetings at social clubs or religious groups; and the count of people outside their home, but within one hour travel-time, participants felt close to. Separate models were fitted for men and women, adjusting for age, income, economic and couple status. An increase in the number of social interactions was associated with a reduction in the risk of psychological distress, with some gender differences. Interactions with friends or family were important for women (adjusted OR 0.85, 95%CI 0.74, 0.98, p=0.024), whereas telephone calls were effective among men (adjusted OR 0.83, 95%CI 0.72, 0.96, p=0.011). Strong effects for the number of people that can be relied on were observed for men and women, but attendance at clubs and groups was not. No age-specific effects were observed. No indicator of positive mental health. Policies targeting greater social interactions in middle-to-older age may help protect mental health. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer

    DEFF Research Database (Denmark)

    Vaidya, Jayant S; Wenz, Frederik; Bulsara, Max

    2014-01-01

    The TARGIT-A trial compared risk-adapted radiotherapy using single-dose targeted intraoperative radiotherapy (TARGIT) versus fractionated external beam radiotherapy (EBRT) for breast cancer. We report 5-year results for local recurrence and the first analysis of overall survival....

  8. Intensive Treat-to-Target Statin Therapy in High-Risk Japanese Patients With Hypercholesterolemia and Diabetic Retinopathy: Report of a Randomized Study.

    Science.gov (United States)

    Itoh, Hiroshi; Komuro, Issei; Takeuchi, Masahiro; Akasaka, Takashi; Daida, Hiroyuki; Egashira, Yoshiki; Fujita, Hideo; Higaki, Jitsuo; Hirata, Ken-Ichi; Ishibashi, Shun; Isshiki, Takaaki; Ito, Sadayoshi; Kashiwagi, Atsunori; Kato, Satoshi; Kitagawa, Kazuo; Kitakaze, Masafumi; Kitazono, Takanari; Kurabayashi, Masahiko; Miyauchi, Katsumi; Murakami, Tomoaki; Murohara, Toyoaki; Node, Koichi; Ogawa, Susumu; Saito, Yoshihiko; Seino, Yoshihiko; Shigeeda, Takashi; Shindo, Shunya; Sugawara, Masahiro; Sugiyama, Seigo; Terauchi, Yasuo; Tsutsui, Hiroyuki; Ueshima, Kenji; Utsunomiya, Kazunori; Yamagishi, Masakazu; Yamazaki, Tsutomu; Yo, Shoei; Yokote, Koutaro; Yoshida, Kiyoshi; Yoshimura, Michihiro; Yoshimura, Nagahisa; Nakao, Kazuwa; Nagai, Ryozo

    2018-06-01

    Diabetes is associated with high risk of cardiovascular (CV) events, particularly in patients with dyslipidemia and diabetic complications. We investigated the incidence of CV events with intensive or standard lipid-lowering therapy in patients with hypercholesterolemia, diabetic retinopathy, and no history of coronary artery disease (treat-to-target approach). In this multicenter, prospective, randomized, open-label, blinded end point study, eligible patients were randomly assigned (1:1) to intensive statin therapy targeting LDL cholesterol (LDL-C) targeting LDL-C 100-120 mg/dL ( n = 2,524). Mean follow-up was 37 ± 13 months. LDL-C at 36 months was 76.5 ± 21.6 mg/dL in the intensive group and 104.1 ± 22.1 mg/dL in the standard group ( P target strategy in high-risk patients deserves further investigation. © 2018 by the American Diabetes Association.

  9. Retention of ferrofluid aggregates at the target site during magnetic drug targeting

    Energy Technology Data Exchange (ETDEWEB)

    Asfer, Mohammed, E-mail: asfer786@gmail.com [School of Engineering and Technology, BML Munjal University, Haryana (India); Saroj, Sunil Kumar [Department of Mechanical Engineering, IIT Kanpur, Kanpur (India); Panigrahi, Pradipta Kumar, E-mail: panig@iitk.ac.in [Department of Mechanical Engineering, IIT Kanpur, Kanpur (India)

    2017-08-15

    Highlights: • The present in vitro work reports the retention dynamics of ferrofluid aggregates at the target site against a bulk flow of DI water inside a micro capillary during magnetic drug targeting. • The recirculation zone at the downstream of the aggregate is found to be a function of aggregate height, Reynolds number and the degree of surface roughness of the outer boundary of the aggregate. • The reported results of the present work can be used as a guideline for the better design of MDT technique for in vivo applications. - Abstract: The present study reports the retention dynamics of a ferrofluid aggregate localized at the target site inside a glass capillary (500 × 500 µm{sup 2} square cross section) against a bulk flow of DI water (Re = 0.16 and 0.016) during the process of magnetic drug targeting (MDT). The dispersion dynamics of iron oxide nanoparticles (IONPs) into bulk flow for different initial size of aggregate at the target site is reported using the brightfield visualization technique. The flow field around the aggregate during the retention is evaluated using the µPIV technique. IONPs at the outer boundary experience a higher shear force as compared to the magnetic force, resulting in dispersion of IONPs into the bulk flow downstream to the aggregate. The blockage effect and the roughness of the outer boundary of the aggregate resulting from chain like clustering of IONPs contribute to the flow recirculation at the downstream region of the aggregate. The entrapment of seeding particles inside the chain like clusters of IONPs at the outer boundary of the aggregate reduces the degree of roughness resulting in a streamlined aggregate at the target site at later time. The effect of blockage, structure of the aggregate, and disturbed flow such as recirculation around the aggregate are the primary factors, which must be investigated for the effectiveness of the MDT process for in vivo applications.

  10. New discoveries in Upper and Middle Magdalena

    International Nuclear Information System (INIS)

    Carta Petrolera

    1998-01-01

    In six association contracts and one risk participation contract may give Colombia the possibility of finding new oil reserves. These prospects, located in the Upper and Middle Magdalena Valleys and the Eastern Plains. the completion process, evaluation, confirmation and commercialization should be in the next two years, these new discoveries also reveal interesting geological aspects; some in fractured limestone, similar to the found at Maracaibo lake in Venezuela, where vast oil fields were discovered

  11. Modifiable risk factors for Alzheimer disease and subjective memory impairment across age groups.

    Science.gov (United States)

    Chen, Stephen T; Siddarth, Prabha; Ercoli, Linda M; Merrill, David A; Torres-Gil, Fernando; Small, Gary W

    2014-01-01

    Previous research has identified modifiable risk factors for Alzheimer's disease (AD) in older adults. Research is limited on the potential link between these risk factors and subjective memory impairment (SMI), which may precede AD and other dementias. Examination of these potential relationships may help identify those at risk for AD at a stage when interventions may delay or prevent further memory problems. The objective of this study was to determine whether risk factors for AD are associated with SMI among different age groups. Trained interviewers conducted daily telephone surveys (Gallup-Healthways) of a representative community sample of 18,614 U.S. respondents, including 4,425 younger (age 18 to 39 years), 6,365 middle-aged (40 to 59 years), and 7,824 older (60 to 99 years) adults. The surveyors collected data on demographics, lifestyles, and medical information. Less education, smoking, hypertension, diabetes, less exercise, obesity and depression, and interactions among them, were examined for associations with SMI. Weighted logistic regressions and chi-square tests were used to calculate odds ratios and confidence intervals for SMI with each risk factor and pairwise interactions across age groups. Depression, less education, less exercise, and hypertension were significantly associated with SMI in all three age groups. Several interactions between risk factors were significant in younger and middle-aged adults and influenced their associations with SMI. Frequency of SMI increased with age and number of risk factors. Odds of having SMI increased significantly with just having one risk factor. These results indicate that modifiable risk factors for AD are also associated with SMI, suggesting that these relationships occur in a broad range of ages and may be targeted to mitigate further memory problems. Whether modifying these risk factors reduces SMI and the eventual incidence of AD and other dementias later in life remains to be determined.

  12. Modifiable risk factors for Alzheimer disease and subjective memory impairment across age groups.

    Directory of Open Access Journals (Sweden)

    Stephen T Chen

    Full Text Available INTRODUCTION: Previous research has identified modifiable risk factors for Alzheimer's disease (AD in older adults. Research is limited on the potential link between these risk factors and subjective memory impairment (SMI, which may precede AD and other dementias. Examination of these potential relationships may help identify those at risk for AD at a stage when interventions may delay or prevent further memory problems. The objective of this study was to determine whether risk factors for AD are associated with SMI among different age groups. METHOD: Trained interviewers conducted daily telephone surveys (Gallup-Healthways of a representative community sample of 18,614 U.S. respondents, including 4,425 younger (age 18 to 39 years, 6,365 middle-aged (40 to 59 years, and 7,824 older (60 to 99 years adults. The surveyors collected data on demographics, lifestyles, and medical information. Less education, smoking, hypertension, diabetes, less exercise, obesity and depression, and interactions among them, were examined for associations with SMI. Weighted logistic regressions and chi-square tests were used to calculate odds ratios and confidence intervals for SMI with each risk factor and pairwise interactions across age groups. RESULTS: Depression, less education, less exercise, and hypertension were significantly associated with SMI in all three age groups. Several interactions between risk factors were significant in younger and middle-aged adults and influenced their associations with SMI. Frequency of SMI increased with age and number of risk factors. Odds of having SMI increased significantly with just having one risk factor. CONCLUSIONS: These results indicate that modifiable risk factors for AD are also associated with SMI, suggesting that these relationships occur in a broad range of ages and may be targeted to mitigate further memory problems. Whether modifying these risk factors reduces SMI and the eventual incidence of AD and other

  13. Do non-targeted effects increase or decrease low dose risk in relation to the linear-non-threshold (LNT) model?

    International Nuclear Information System (INIS)

    Little, M.P.

    2010-01-01

    In this paper we review the evidence for departure from linearity for malignant and non-malignant disease and in the light of this assess likely mechanisms, and in particular the potential role for non-targeted effects. Excess cancer risks observed in the Japanese atomic bomb survivors and in many medically and occupationally exposed groups exposed at low or moderate doses are generally statistically compatible. For most cancer sites the dose-response in these groups is compatible with linearity over the range observed. The available data on biological mechanisms do not provide general support for the idea of a low dose threshold or hormesis. This large body of evidence does not suggest, indeed is not statistically compatible with, any very large threshold in dose for cancer, or with possible hormetic effects, and there is little evidence of the sorts of non-linearity in response implied by non-DNA-targeted effects. There are also excess risks of various types of non-malignant disease in the Japanese atomic bomb survivors and in other groups. In particular, elevated risks of cardiovascular disease, respiratory disease and digestive disease are observed in the A-bomb data. In contrast with cancer, there is much less consistency in the patterns of risk between the various exposed groups; for example, radiation-associated respiratory and digestive diseases have not been seen in these other (non-A-bomb) groups. Cardiovascular risks have been seen in many exposed populations, particularly in medically exposed groups, but in contrast with cancer there is much less consistency in risk between studies: risks per unit dose in epidemiological studies vary over at least two orders of magnitude, possibly a result of confounding and effect modification by well known (but unobserved) risk factors. In the absence of a convincing mechanistic explanation of epidemiological evidence that is, at present, less than persuasive, a cause-and-effect interpretation of the reported

  14. Brain structure in people at ultra-high risk of psychosis, patients with first-episode schizophrenia, and healthy controls: a VBM study.

    Science.gov (United States)

    Nenadic, Igor; Dietzek, Maren; Schönfeld, Nils; Lorenz, Carsten; Gussew, Alexander; Reichenbach, Jürgen R; Sauer, Heinrich; Gaser, Christian; Smesny, Stefan

    2015-02-01

    Early intervention research in schizophrenia has suggested that brain structural alterations might be present in subjects at high risk of developing psychosis. The heterogeneity of regional effects of these changes, which is established in schizophrenia, however, has not been explored in prodromal or high-risk populations. We used high-resolution MRI and voxel-based morphometry (VBM8) to analyze grey matter differences in 43 ultra high-risk subjects for psychosis (meeting ARMS criteria, identified through CAARMS interviews), 24 antipsychotic-naïve first-episode schizophrenia patients and 49 healthy controls (groups matched for age and gender). Compared to healthy controls, resp., first-episode schizophrenia patients had reduced regional grey matter in left prefrontal, insula, right parietal and left temporal cortices, while the high-risk group showed reductions in right middle temporal and left anterior frontal cortices. When dividing the ultra-high-risk group in those with a genetic risk vs. those with attenuated psychotic symptoms, the former showed left anterior frontal, right caudate, as well as a smaller right hippocampus, and amygdala reduction, while the latter subgroup showed right middle temporal cortical reductions (each compared to healthy controls). Our findings in a clinical psychosis high-risk cohort demonstrate variability of brain structural changes according to subgroup and background of elevated risk, suggesting frontal and possibly also hippocampal/amygdala changes in individuals with genetic susceptibility. Heterogeneity of structural brain changes (as seen in schizophrenia) appears evident even at high-risk stage, prior to potential onset of psychosis. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Lifestyle, glucose regulation and the cognitive effects of glucose load in middle-aged adults.

    Science.gov (United States)

    Riby, Leigh M; McLaughlin, Jennifer; Riby, Deborah M; Graham, Cheryl

    2008-11-01

    Interventions aimed at improving glucose regulatory mechanisms have been suggested as a possible source of cognitive enhancement in the elderly. In particular, previous research has identified episodic memory as a target for facilitation after either moderate increases in glycaemia (after a glucose drink) or after improvements in glucose regulation. The present study aimed to extend this research by examining the joint effects of glucose ingestion and glucose regulation on cognition. In addition, risk factors associated with the development of poor glucose regulation in middle-aged adults were considered. In a repeated measures design, thirty-three middle-aged adults (aged 35-55 years) performed a battery of memory and non-memory tasks after either 25 g or 50 g glucose or a sweetness matched placebo drink. To assess the impact of individual differences in glucose regulation, blood glucose measurements were taken on four occasions during testing. A lifestyle and diet questionnaire was also administered. Consistent with previous research, episodic memory ability benefited from glucose ingestion when task demands were high. Blood glucose concentration was also found to predict performance across a number of cognitive domains. Interestingly, the risk factors associated with poor glucose regulation were linked to dietary impacts traditionally associated with poor health, e.g. the consumption of high-sugar sweets and drinks. The research replicates earlier work suggesting that task demands are critical to the glucose facilitation effect. Importantly, the data demonstrate clear associations between elevated glycaemia and relatively poor cognitive performance, which may be partly due to the effect of dietary and lifestyle factors.

  16. Prevalence of high, medium and low-risk medical conditions for pneumococcal vaccination in Catalonian middle-aged and older adults: a population-based study

    Directory of Open Access Journals (Sweden)

    O. Ochoa-Gondar

    2017-06-01

    Full Text Available Abstract Background Updated population-based data on the frequency and distribution of risk factors for pneumococcal disease is scarce. This study investigated the prevalence of distinct comorbidities and underlying risk conditions related to an increasing risk of pneumococcal disease among Catalonian middle-aged and older adults. Methods Cross-sectional population-based study including 2,033,465 individuals aged 50 years or older registered at 01/01/2015 in the Catalonian Health Institute (Catalonia, Spain. The clinical research database of the Information System for the Development of Research in Primary Care (SIDIAP database was used to identify high-risk (asplenia and/or immunocompromising conditions and other increased-risk conditions (chronic pulmonary, cardiac or liver disease, diabetes mellitus, alcoholism and/or smoking among study subjects. Results Globally, 980,310 (48.2% of the 2,033,465 study population had at least one risk condition of suffering pneumococcal disease (55.4% in men vs 42.0% in women, p < 0.001; 41.7% in people 50–64 years vs 54.7% in persons 65 years or older, p < 0.001. An amount of 176,600 individuals (8.7% had high-risk conditions (basically immunocompromising conditions. On the other hand, 803,710 persons (39.5% had one or more other risk conditions. In fact, 212,255 (10.4% had chronic pulmonary diseases, 248,377 (12.2% cardiac disease, 41,734 (2.1% liver disease, 341,535 (16.8% diabetes mellitus, 58,781 (2.9% alcoholism and 317,558 (15.6% were smokers. Conclusion In our setting, approximately 50 % of overall persons 50 years or older may be considered at-risk population for pneumococcal disease (almost 10 % have high-risk conditions and 40 % have other risk conditions.

  17. Burden of typhoid fever in low-income and middle-income countries: a systematic, literature-based update with risk-factor adjustment.

    Science.gov (United States)

    Mogasale, Vittal; Maskery, Brian; Ochiai, R Leon; Lee, Jung Seok; Mogasale, Vijayalaxmi V; Ramani, Enusa; Kim, Young Eun; Park, Jin Kyung; Wierzba, Thomas F

    2014-10-01

    No access to safe water is an important risk factor for typhoid fever, yet risk-level heterogeneity is unaccounted for in previous global burden estimates. Since WHO has recommended risk-based use of typhoid polysaccharide vaccine, we revisited the burden of typhoid fever in low-income and middle-income countries (LMICs) after adjusting for water-related risk. We estimated the typhoid disease burden from studies done in LMICs based on blood-culture-confirmed incidence rates applied to the 2010 population, after correcting for operational issues related to surveillance, limitations of diagnostic tests, and water-related risk. We derived incidence estimates, correction factors, and mortality estimates from systematic literature reviews. We did scenario analyses for risk factors, diagnostic sensitivity, and case fatality rates, accounting for the uncertainty in these estimates and we compared them with previous disease burden estimates. The estimated number of typhoid fever cases in LMICs in 2010 after adjusting for water-related risk was 11·9 million (95% CI 9·9-14·7) cases with 129 000 (75 000-208 000) deaths. By comparison, the estimated risk-unadjusted burden was 20·6 million (17·5-24·2) cases and 223 000 (131 000-344 000) deaths. Scenario analyses indicated that the risk-factor adjustment and updated diagnostic test correction factor derived from systematic literature reviews were the drivers of differences between the current estimate and past estimates. The risk-adjusted typhoid fever burden estimate was more conservative than previous estimates. However, by distinguishing the risk differences, it will allow assessment of the effect at the population level and will facilitate cost-effectiveness calculations for risk-based vaccination strategies for future typhoid conjugate vaccine. Copyright © 2014 Mogasale et al. Open Access article distributed under the terms of CC BY-NC-SA. Published by .. All rights reserved.

  18. Dyslipidemia and its risk factors among urban middle-aged Iranians: A population-based study.

    Science.gov (United States)

    Ebrahimi, Hossein; Emamian, Mohammad Hassan; Hashemi, Hassan; Fotouhi, Akbar

    2016-01-01

    Dyslipidemia is a known risk factor for cardiovascular disease and is a leading cause of mortality in developed and developing countries. This study was aimed to determine the prevalence of dyslipidemia and its risk factors in an urban group of Iranian adult population. In this study, based on the criteria set by the National Cholesterol Education Program, the prevalence of dyslipidemia was evaluated in a population of 4737 people aged 45-69 years who participated in the second phase of an ophthalmology cohort study in Shahroud. Dyslipidemia prevalence was determined by age, sex, and risk factors of the disease; the findings were tested by using simple and multiple logistic regression. The prevalence of dyslipidemia was 66.5% (CI 95%: 64.4-68.6) in males, 61.3% (CI 95%: 59.5-63.2) in females, and 63.4% (CI 95%: 62.0-64.9%) in both sexes. The prevalence of hypertriglyceridemia, hypercholesterolemia, low HDL-C, and high LDL-C, respectively, was 28.8%, 13.4%, 42.3%, and 13.4%, respectively. In multivariate logistic regression model, increase of age (for females), abdominal obesity, overweight and obesity, hypertension, and diabetes were associated with an increased odd of dyslipidemia. The prevalence of dyslipidemia in middle-aged urban population in Iran is high, and with increasing age there is an increased risk of dyslipidemia. Hence, considering the growing trend of aging in Iran, there is need for taking special measures to deal with dyslipidemia as a health priority. Furthermore, the need for planning in order to reduce the risk of dyslipidemia and prevent its complications is greater than ever. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  19. Body mass index in early and middle adult life: prospective associations with myocardial infarction, stroke and diabetes over a 30-year period: the British Regional Heart Study.

    Science.gov (United States)

    Owen, Christopher G; Kapetanakis, Venediktos V; Rudnicka, Alicja R; Wathern, Andrea K; Lennon, Lucy; Papacosta, Olia; Cook, Derek G; Wannamethee, S Goya; Whincup, Peter H

    2015-09-15

    Adiposity in middle age is an established risk factor for cardiovascular disease and type 2 diabetes; less is known about the impact of adiposity from early adult life. We examined the effects of high body mass index (BMI) in early and middle adulthood on myocardial infarction (MI), stroke and diabetes risks. A prospective cohort study. 7735 men with BMI measured in middle age (40-59 years) and BMI ascertained at 21 years from military records or participant recall. 30-year follow-up data for type 2 diabetes, MI and stroke incidence; Cox proportional hazards models were used to examine the effect of BMI at both ages on these outcomes, adjusted for age and smoking status. Among 4846 (63%) men (with complete data), a 1 kg/m(2) higher BMI at 21 years was associated with a 6% (95% CI 4% to 9%) higher type 2 diabetes risk, compared with a 21% (95% CI 18% to 24%) higher diabetes risk for a 1 kg/m(2) higher BMI in middle age (hazard ratio (HR) 1.21, 95% CI 1.18 to 1.24). Higher BMI in middle age was associated with a 6% (95% CI 4% to 8%) increase in MI and a 4% (95% CI 1% to 7%) increase in stroke; BMI at 21 years showed no associations with MI or stroke risk. Higher BMI at 21 years of age is associated with later diabetes incidence but not MI or stroke, while higher BMI in middle age is strongly associated with all outcomes. Early obesity prevention may reduce later type 2 diabetes risk, more than MI and stroke. 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.

  20. CACAO facility. Radioactive targets at Orsay

    International Nuclear Information System (INIS)

    Bacri, C.O.; Petitbon-Thevenet, V.; Mottier, J.; Lefort, H.; Durnez, A.; Fortuna, F.

    2014-01-01

    CACAO, Chimie des Actinides et Cibles radioActives a Orsay (actinide chemistry and radioactive targets at Orsay), is a new laboratory dedicated to the fabrication and characterization of radioactive targets. It is supported by the radiochemistry group and the stable target service of the IPNO. The recurring needs of physicists working in the nuclear fuel cycle physics and the growing difficulties to obtain radioactive targets elsewhere were the main motivating factors behind the construction of this new laboratory. The first targets of 235,238 U and 232 Th have already been prepared although the full operating licenses still need to be obtained. In this paper, the installation and the equipment of CACAO will be described. An extensive study of a U test target fabricated by the CACAO laboratory has been performed and results are reported here. The different techniques used to characterize the deposit are presented and the outcome is discussed. (author)

  1. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students, Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study

    Directory of Open Access Journals (Sweden)

    Stanislaw Gorski

    2017-01-01

    Full Text Available Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students, targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards. Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization, received standard care. Outcome Measures. Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward.

  2. [Preschool familial environment and academic difficulties: A 10-year follow-up from kindergarten to middle school].

    Science.gov (United States)

    Câmara-Costa, H; Pulgar, S; Cusin, F; Dellatolas, G

    2016-02-01

    The persistence of academic difficulties from childhood through adulthood has led researchers to focus on the identification of the early factors influencing children's subsequent achievement in order to improve the efficient screening of children who might be at risk of school failure. The foundations of academic achievement can be accurately traced back to the preschool years prior to children's entry in formal schooling and are largely influenced by environmental determinants. Importantly, some environmental conditions act as early risk factors undermining children's later academic achievement due to the well-established relation between underachievement and exposure to moderate to high levels of environmental risk. In the present study, we aimed to investigate the longitudinal effects of environment-level factors (sociodemographic and family characteristics) and early risk exposure at kindergarten on children's subsequent academic achievement at the end of middle school (grade 9). The sample of analysis comprised 654 kindergarteners aged 5-6 years (2001-2002 school year) followed through the end of middle school when they were aged 14-15 years (2010-2011 school year). At kindergarten, assessment included questionnaire-based measures of sociodemographic and family background characteristics. These included an original set of information pertaining to family background including parental nationality, education level, history of reading difficulties, type of early childcare, family situation, family size, and language-based bedtime routines, as well as individual-level factors such as children's first language, medical history, language delay, birth weight, age of walking onset, and gestation period. At grade 9, outcome measures were composed of children's results in the national evaluations performed at the end of middle school ("Diplôme National du Brevet"), or history of repetition for a second year of the same class. The results indicated that all family

  3. A Systematic Review of Training Interventions Addressing Sexual Violence against Marginalized At-Risk Groups of Women

    Science.gov (United States)

    Kouta, Christiana; Pithara, Christalla; Zobnina, Anna; Apostolidou, Zoe; Christodoulou, Josie; Papadakaki, Maria; Chliaoutakis, Joannes

    2015-01-01

    Women from marginalized groups working in occupations such as domestic work are at increased risk for sexual violence. Scarce evidence exists about training interventions targeting such groups. The article aims to identify community and workplace-based training interventions aiming to increase capacity among marginalized at-risk women to deal with…

  4. The effect of pharmacist-provided non-dispensing services on patient outcomes, health service utilisation and costs in low- and middle-income countries.

    Science.gov (United States)

    Pande, Sami; Hiller, Janet E; Nkansah, Nancy; Bero, Lisa

    2013-02-28

    The role of pharmacists has expanded beyond dispensing and packaging over the past two decades, and now includes ensuring rational use of drugs, improving clinical outcomes and promoting health status by working with the public and other healthcare professionals. To examine the effect of pharmacist-provided non-dispensing services on patient outcomes, health service utilisation and costs in low- and middle-income countries. Studies were identified by electronically searching the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (February 2010), MEDLINE (1949 to February 2010), Scopus (1960 to March 2010) and International Pharmaceutical Abstracts (1970 to January 2010) databases. An update of this review is currently ongoing. The search was re-run September 2012 and the potentially relevant studies are awaiting classification. Randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted time series analyses comparing 1. pharmacist-provided non-dispensing services targeted at patients versus (a) the same services provided by other healthcare professionals, (b) the same services provided by untrained health workers, and (c) usual care; and 2. pharmacist-provided non-dispensing services targeted at healthcare professionals versus (a) the same services provided by other healthcare professionals, (b) the same services provided by untrained health workers, and (c) usual care in low- and middle-income countries. The research sites must have been located in low or middle income countries according to World Bank Group 2009 at the time of the study, regardless of the location or the origin of the researchers. Two authors independently reviewed studies for inclusion in the review. Two review authors independently extracted data for each study. Risk of bias of the included studies was also assessed independently by two authors. Twelve studies comparing pharmacist-provided services versus usual

  5. Targeted resequencing of regulatory regions at schizophrenia risk loci: Role of rare functional variants at chromatin repressive states.

    Science.gov (United States)

    González-Peñas, Javier; Amigo, Jorge; Santomé, Luis; Sobrino, Beatriz; Brenlla, Julio; Agra, Santiago; Paz, Eduardo; Páramo, Mario; Carracedo, Ángel; Arrojo, Manuel; Costas, Javier

    2016-07-01

    There is mounting evidence that regulatory variation plays an important role in genetic risk for schizophrenia. Here, we specifically search for regulatory variants at risk by sequencing promoter regions of twenty-three genes implied in schizophrenia by copy number variant or genome-wide association studies. After strict quality control, a total of 55,206bp per sample were analyzed in 526 schizophrenia cases and 516 controls from Galicia, NW Spain, using the Applied Biosystems SOLiD System. Variants were filtered based on frequency from public databases, chromatin states from the RoadMap Epigenomics Consortium at tissues relevant for schizophrenia, such as fetal brain, mid-frontal lobe, and angular gyrus, and prediction of functionality from RegulomeDB. The proportion of rare variants at polycomb repressive chromatin state at relevant tissues was higher in cases than in controls. The proportion of rare variants with predicted regulatory role was significantly higher in cases than in controls (P=0.0028, OR=1.93, 95% C.I.=1.23-3.04). Combination of information from both sources led to the identification of an excess of carriers of rare variants with predicted regulatory role located at polycomb repressive chromatin state at relevant tissues in cases versus controls (P=0.0016, OR=19.34, 95% C.I.=2.45-2495.26). The variants are located at two genes affected by the 17q12 copy number variant, LHX1 and HNF1B. These data strongly suggest that a specific epigenetic mechanism, chromatin remodeling by histone modification during early development, may be impaired in a subset of schizophrenia patients, in agreement with previous data. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Targets and self-management for the control of blood pressure in stroke and at risk groups (TASMIN-SR): protocol for a randomised controlled trial.

    Science.gov (United States)

    O'Brien, Claire; Bray, Emma P; Bryan, Stirling; Greenfield, Sheila M; Haque, M Sayeed; Hobbs, F D Richard; Jones, Miren I; Jowett, Sue; Kaambwa, Billingsley; Little, Paul; Mant, Jonathan; Penaloza, Cristina; Schwartz, Claire; Shackleford, Helen; Varghese, Jinu; Williams, Bryan; McManus, Richard J

    2013-03-23

    Self-monitoring of hypertension with self-titration of antihypertensives (self-management) results in lower systolic blood pressure for at least one year. However, few people in high risk groups have been evaluated to date and previous work suggests a smaller effect size in these groups. This trial therefore aims to assess the added value of self-management in high risk groups over and above usual care. The targets and self-management for the control of blood pressure in stroke and at risk groups (TASMIN-SR) trial will be a pragmatic primary care based, unblinded, randomised controlled trial of self-management of blood pressure (BP) compared to usual care. Eligible patients will have a history of stroke, coronary heart disease, diabetes or chronic kidney disease and will be recruited from primary care. Participants will be individually randomised to either usual care or self-management. The primary outcome of the trial will be difference in office SBP between intervention and control groups at 12 months adjusted for baseline SBP and covariates. 540 patients will be sufficient to detect a difference in SBP between self-management and usual care of 5 mmHg with 90% power. Secondary outcomes will include self-efficacy, lifestyle behaviours, health-related quality of life and adverse events. An economic analysis will consider both within trial costs and a model extrapolating the results thereafter. A qualitative analysis will gain insights into patients' views, experiences and decision making processes. The results of the trial will be directly applicable to primary care in the UK. If successful, self-management of blood pressure in people with stroke and other high risk conditions would be applicable to many hundreds of thousands of individuals in the UK and beyond. ISRCTN87171227.

  7. MRI screening-detected breast lesions in high-risk young women: the value of targeted second-look ultrasound and imaging-guided biopsy.

    Science.gov (United States)

    Peter, P; Dhillon, R; Bose, S; Bourke, A

    2016-10-01

    To analyse the value of targeted second-look ultrasound and imaging-guided biopsy in high-risk young women eligible for screening magnetic resonance imaging (MRI) in a tertiary referral centre in Perth, Western Australia. A retrospective analysis of eligible high-risk young women who underwent screening breast MRI and targeted second-look ultrasound between June 2012 and June 2014 was performed with review of data. Over a 2-year period, 139 women underwent high-risk screening MRI. Of these, 30 women (with a total of 45 lesions) were recalled for targeted second-look ultrasound. Thirty-four MRI-detected lesions were identified on targeted ultrasound with 19 of them proceeding to ultrasound-guided biopsy, while the remaining 15 lesions were considered benign on ultrasound, were not biopsied, and were stable on follow-up imaging 12 months later. One lesion proceeded to an MRI-guided biopsy to confirm a benign result. Of the 11 lesions not seen on ultrasound, nine underwent MRI biopsy, one proceeded directly to hook wire localisation and excision, and one did not return for biopsy and was lost to follow-up. The overall biopsy rate was 14.4%. The cancer detection rate was 1.4%. The results of this study indicate that targeted second-look ultrasound and ultrasound-guided biopsy is a cost-effective and time-efficient approach for MRI-detected lesions in young women at high risk of developing breast cancer. MRI-guided biopsy should be considered for ultrasonographically occult suspicious lesions as there is a low, but definite, risk of cancer. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  8. Long-term prediction of prostate cancer diagnosis and death using PSA and obesity related anthropometrics at early middle age: data from the malmö preventive project.

    Science.gov (United States)

    Assel, Melissa J; Gerdtsson, Axel; Thorek, Daniel L J; Carlsson, Sigrid V; Malm, Johan; Scardino, Peter T; Vickers, Andrew; Lilja, Hans; Ulmert, David

    2018-01-19

    To evaluate whether anthropometric parameters add to PSA measurements in middle-aged men for risk assessment of prostate cancer (PCa) diagnosis and death. After adjusting for PSA, both BMI and weight were significantly associated with an increased risk of PCa death with the odds of a death corresponding to a 10 kg/m2 or 10 kg increase being 1.58 (95% CI 1.10, 2.28; p = 0.013) and 1.14 (95% CI 1.02, 1.26; p = 0.016) times greater, respectively. AUCs did not meaningfully increase with the addition of weight or BMI to prediction models including PSA. In 1974 to 1986, 22,444 Swedish men aged 44 to 50 enrolled in Malmö Preventive Project, Sweden, and provided blood samples and anthropometric data. Rates of PSA screening in the cohort were very low. Documentation of PCa diagnosis and disease-specific death up to 2014 was retrieved through national registries. Among men with anthropometric measurements available at baseline, a total of 1692 men diagnosed with PCa were matched to 4190 controls, and 464 men who died of disease were matched to 1390 controls. Multivariable conditional logistic regression was used to determine whether diagnosis or death from PCa were associated with weight and body mass index (BMI) at adulthood after adjusting for PSA. Men with higher BMI and weight at early middle age have an increased risk of PCa diagnosis and death after adjusting for PSA. However, in a multi-variable numerical statistical model, BMI and weight do not importantly improve the predictive accuracy of PSA. Risk-stratification of screening should be based on PSA without reference to anthropometrics.

  9. Between individual agency and structure in HIV prevention: understanding the middle ground of social practice.

    Science.gov (United States)

    Kippax, Susan; Stephenson, Niamh; Parker, Richard G; Aggleton, Peter

    2013-08-01

    When HIV prevention targets risk and vulnerability, it focuses on individual agency and social structures, ignoring the centrality of community in effective HIV prevention. The neoliberal concept of risk assumes individuals are rational agents who act on information provided to them regarding HIV transmission. This individualistic framework does not recognize the communities in which people act and connect. The concept of vulnerability on the other hand acknowledges the social world, but mainly as social barriers that make it difficult for individuals to act. Neither approach to HIV prevention offers understanding of community practices or collective agency, both central to success in HIV prevention to date. Drawing on examples of the social transformation achieved by community action in Australia and Brazil, this article focuses on this middle ground and its role in effective HIV prevention.

  10. Relative cerebral blood volume as a marker of durable tissue-at-risk viability in hyperacute ischemic stroke.

    Science.gov (United States)

    Cortijo, Elisa; Calleja, Ana Isabel; García-Bermejo, Pablo; Mulero, Patricia; Pérez-Fernández, Santiago; Reyes, Javier; Muñoz, Ma Fe; Martínez-Galdámez, Mario; Arenillas, Juan Francisco

    2014-01-01

    Selection of best responders to reperfusion therapies could be aided by predicting the duration of tissue-at-risk viability, which may be dependant on collateral circulation status. We aimed to identify the best predictor of good collateral circulation among perfusion computed tomography (PCT) parameters in middle cerebral artery (MCA) ischemic stroke and to analyze how early MCA response to intravenous thrombolysis and PCT-derived markers of good collaterals interact to determine stroke outcome. We prospectively studied patients with acute MCA ischemic stroke treated with intravenous thrombolysis who underwent PCT before treatment showing a target mismatch profile. Collateral status was assessed using a PCT source image-based score. PCT maps were quantitatively analyzed. Cerebral blood volume (CBV), cerebral blood flow, and Tmax were calculated within the hypoperfused volume and in the equivalent region of unaffected hemisphere. Occluded MCAs were monitored by transcranial Duplex to assess early recanalization. Main outcome variables were brain hypodensity volume and modified Rankin scale score at day 90. One hundred patients with MCA ischemic stroke imaged by PCT received intravenous thrombolysis, and 68 met all inclusion criteria. A relative CBV (rCBV) >0.93 emerged as the only predictor of good collaterals (odds ratio, 12.6; 95% confidence interval, 2.9-55.9; P=0.001). Early MCA recanalization was associated with better long-term outcome and lower infarct volume in patients with rCBV<0.93, but not in patients with high rCBV. None of the patients with rCBV<0.93 achieved good outcome in absence of early recanalization. High rCBV was the strongest marker of good collaterals and may characterize durable tissue-at-risk viability in hyperacute MCA ischemic stroke.

  11. Biosafety research for non-target organism risk assessment of RNAi-based GE plants

    Science.gov (United States)

    Roberts, Andrew F.; Devos, Yann; Lemgo, Godwin N. Y.; Zhou, Xuguo

    2015-01-01

    RNA interference, or RNAi, refers to a set of biological processes that make use of conserved cellular machinery to silence genes. Although there are several variations in the source and mechanism, they are all triggered by double stranded RNA (dsRNA) which is processed by a protein complex into small, single stranded RNA, referred to as small interfering RNAs (siRNA) with complementarity to sequences in genes targeted for silencing. The use of the RNAi mechanism to develop new traits in plants has fueled a discussion about the environmental safety of the technology for these applications, and this was the subject of a symposium session at the 13th ISBGMO in Cape Town, South Africa. This paper continues that discussion by proposing research areas that may be beneficial for future environmental risk assessments of RNAi-based genetically modified plants, with a particular focus on non-target organism assessment. PMID:26594220

  12. Perceptions of a HIV testing message targeted for at-risk adults with low functional health literacy

    Science.gov (United States)

    Hunter, Susan L.

    This study analyses warehoused data collected by Georgia State University and Centers for Disease Control and Prevention (GSU/CDC) researchers after developing an HIV testing message for urban adults with low functional health literacy. It expands previous work by examining data collected when 202 primarily African-American homeless clients of an urban community based organization (CBO) reviewed both the low literacy brochure (Wallace et al., 2006) and a standard HIV brochure (Georgia Department of Human Resources, 1997). Participants' health literacy was assessed using 2 measures; the Rapid Estimate of Adult Literacy in Medicine or REALM (Davis, Crouch, Long & Green) and the Test of Functional Health Literacy Assessment or TOFHLA (Nurss, Parker & Baker, 2001). HIV risk was determined using an interview questionnaire developed by the research group (Belcher, Deming, Hunter & Wallace, 2005) which allowed participants to self-report recent alcohol and drug use, sexual behavior, sexually transmitted disease (STD) history and exposure to abuse and sexual coercion. Open-ended response questions regarding readability, understanding, main message, and importance for each brochure provided the qualitative data. This analysis confirms previous work showing accessibility, readability, cultural sensitivity and user-friendly formatting are important when attempting to engage at-risk adults with varying levels of functional health literacy in an HIV testing message. The visual aspects of the brochure can be essential in capturing the reader's attention and should be relevant to the target audience (Wallace, Deming, Hunter, Belcher & Choi, 2006). Mono-colored graphics may be perceived as dated and irrelevant or worse yet, threatening to some readers. Whenever possible culturally appropriate color photos of people depicting relevant content should replace excess text and difficult medical terms should be eliminated. Wording on the cover and within the brochure should be used to

  13. The Influence of Grade-Span Configuration on Student Performance in K-8 Schools and Middle Schools in New Jersey

    Science.gov (United States)

    Keegan, Edward W.

    2010-01-01

    Recent literature casts unfavorable light upon the middle school as the most appropriate grade configuration in which to effectively educate young adolescents. The current criticism of middle schools may be fueled, in part, by "A Nation at Risk," the "No Child Left Behind Act," and a growing subsequent emphasis on…

  14. Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults

    Directory of Open Access Journals (Sweden)

    Diane Santa Maria

    2018-01-01

    Full Text Available While HIV disproportionately impacts homeless individuals, little is known about the prevalence of HIV risk behaviors in the southwest and how age factors and HIV risk perceptions influence sexual risk behaviors. We conducted a secondary data analysis (n = 460 on sexually active homeless adults from a cross-sectional study of participants (n = 610 recruited from homeless service locations, such as shelters and drop-in centers, in an understudied region of the southwest. Covariate-adjusted logistic regressions were used to assess the impact of age at homelessness onset, current age, age at first sex, and HIV risk perceptions on having condomless sex, new sexual partner(s, and multiple sexual partners (≥4 sexual partners in the past 12 months. Individuals who first experienced homelessness by age 24 were significantly more likely to report condomless sex and multiple sexual partners in the past year than those who had a later onset of their first episode of homelessness. Individuals who were currently 24 years or younger were more likely to have had condomless sex, new sexual partners, and multiple sexual partners in the past 12 months than those who were 25 years or older. Those who had low perceived HIV risk had lower odds of all three sexual risk behaviors. Social service and healthcare providers should consider a younger age at homelessness onset when targeting HIV prevention services to youth experiencing homelessness.

  15. A Web-Based Respondent Driven Sampling Pilot Targeting Young People at Risk for Chlamydia Trachomatis in Social and Sexual Networks with Testing : A Use Evaluation

    NARCIS (Netherlands)

    Theunissen, Kevin; Hoebe, Christian; Kok, Gerjo; Crutzen, Rik; Kara-Zaïtri, Chakib; de Vries, Nanne; van Bergen, Jan; Hamilton, Robert; van der Sande, Marianne; Dukers-Muijrers, Nicole

    BACKGROUND: With the aim of targeting high-risk hidden heterosexual young people for Chlamydia trachomatis (CT) testing, an innovative web-based screening strategy using Respondent Driven Sampling (RDS) and home-based CT testing, was developed, piloted and evaluated. METHODS: Two STI clinic nurses

  16. The Effects of Age at Cleft Palate Repair on Middle Ear Function and Hearing Level.

    Science.gov (United States)

    Lou, Qun; Zhu, Hongping; Luo, Yi; Zhou, Zhibo; Ma, Lian; Ma, Xiaoran; Fu, Yuan

    2018-05-01

    To investigate the age effects of cleft palate repair on middle ear function and hearing level in patients who underwent cleft palate repair at different ages by audiologic examination. Medical histories were gathered in detail, and audiologic tests (ie, tympanometry and pure tone hearing threshold) were conducted in 126 patients after palatoplasty. The patients were divided into the following 4 groups according to their ages when they underwent cleft palate repair: group I (0-3 years, 73 patients), group II (4-7 years, 29 patients), group III (8-11 years, 16 patients), and group IV (12 years and older, 8 patients). The data regarding tympanograms, hearing levels, and the average hearing thresholds of each group were analyzed using chi-square tests. The prevalence of middle ear dysfunction and hearing loss in the patients who underwent palatoplasty before 3 years old (27.4% and 2.0% respectively) was significantly lower than that in patients who underwent palatopalsty at 12 years or older (75.0% and 43.7%, respectively). Linear-by-linear association revealed that the prevalences of middle ear dysfunction and hearing loss among the 4 groups were significantly different ( P cleft palate repair. From an audiologist's perspective, palatoplasty at an early age is very beneficial in helping children with cleft palates acquire better middle ear function and hearing level.

  17. Protocol of a cluster randomised stepped-wedge trial of behavioural interventions targeting amphetamine-type stimulant use and sexual risk among female entertainment and sex workers in Cambodia.

    Science.gov (United States)

    Page, Kimberly; Stein, Ellen S; Carrico, Adam W; Evans, Jennifer L; Sokunny, Muth; Nil, Ean; Ngak, Song; Sophal, Chhit; McCulloch, Charles; Maher, Lisa

    2016-05-09

    HIV risk among female entertainment and sex workers (FESW) remains high and use of amphetamine-type stimulants (ATS) significantly increases this risk. We designed a cluster randomised stepped wedge trial (The Cambodia Integrated HIV and Drug Prevention Implementation (CIPI) study) to test sequentially delivered behavioural interventions targeting ATS use. The trial combines a 12-week Conditional Cash Transfer (CCT) intervention with 4 weeks of cognitive-behavioural group aftercare (AC) among FESW who use ATS. The primary goal is to reduce ATS use and unprotected sex among FESW. The CCT+AC intervention is being implemented in 10 provinces where order of delivery was randomised. Outcome assessments (OEs) including biomarkers and self-reported measures of recent sexual and drug use behaviours are conducted prior to implementation, and at three 6-month intervals after completion. Consultation with multiple groups and stakeholders on implementation factors facilitated acceptance and operationalisation of the trial. Statistical power and sample size calculations were based on expected changes in ATS use and unprotected sex at the population level as well as within subjects. Ethical approvals were granted by the Cambodia National Ethics Committee; University of New Mexico; University of California, San Francisco; and FHI360. The trial is registered with ClinicalTrials.gov. Dissemination of process indicators during the multiyear trial is carried out through annual in-country Stakeholder Meetings. Provincial 'Close-Out' forums are held at the conclusion of data collection in each province. When analysis is completed, dissemination meetings will be held in Cambodia with stakeholders, including community-based discussion sessions, policy briefs and results published and presented in the HIV prevention scientific journals and conferences. CIPI is the first trial of an intervention to reduce ATS use and HIV risk among FESW in Cambodia. Will inform both CCT+AC implementation

  18. Aerosol optical depth trend over the Middle East

    KAUST Repository

    Klingmü ller, Klaus; Pozzer, Andrea; Metzger, Swen; Stenchikov, Georgiy L.; Lelieveld, Jos

    2016-01-01

    We use the combined Dark Target/Deep Blue aerosol optical depth (AOD) satellite product of the moderate-resolution imaging spectroradiometer (MODIS) collection 6 to study trends over the Middle East between 2000 and 2015. Our analysis corroborates a

  19. Gender-Based Education: Why It Works at the Middle School Level.

    Science.gov (United States)

    Perry, William C.

    1996-01-01

    To counter gender bias effects and improve student learning, staff at a Virginia middle school decided to group eighth-grade students by gender for math and science instruction. Girls felt freer to speak out. Grade point averages in gender-based science and math classes for both girls and boys were higher than in coeducational classes. (MLH)

  20. Teaching Case: Security Breach at Target

    Science.gov (United States)

    Plachkinova, Miloslava; Maurer, Chris

    2018-01-01

    This case study follows the security breach that affected Target at the end of 2013 and resulted in the loss of financial data for over 70 million customers. The case provides an overview of the company and describes the reasons that led to one of the biggest security breaches in history. It offers a discussion on Target's vendor management…

  1. Women Who Have Sex with Women Living in Low- and Middle-Income Countries: A Systematic Review of Sexual Health and Risk Behaviors.

    Science.gov (United States)

    Tat, Susana A; Marrazzo, Jeanne M; Graham, Susan M

    2015-06-01

    Women who have sex with women (WSW) have long been considered at low risk of acquiring and transmitting HIV and other sexually transmitted infections (STIs). However, limited research has been conducted on WSW, especially those living in low-and middle-income countries (LMICs). We reviewed available research on sexual health and risk behaviors of WSW in LMICs. We searched CINAHL, Embase, and PubMed for studies of WSW in LMICs published between January 1, 1980, and December 31, 2013. Studies of any design and subject area that had at least two WSW participants were included. Data extraction was performed to report quantifiable WSW-specific results related to sexual health and risk behaviors, and key findings of all other studies on WSW in LMICs. Of 652 identified studies, 56 studies from 22 countries met inclusion criteria. Reported HIV prevalence among WSW ranged from 0% in East Asia and Pacific and 0%-2.9% in Latin America and the Caribbean to 7.7%-9.6% in Sub-Saharan Africa. Other regions did not report WSW HIV prevalence. Overall, many WSW reported risky sexual behaviors, including sex with men, men who have sex with men (MSM), and HIV-infected partners; transactional sex; and substance abuse. WSW are at risk for contracting HIV and STIs. While the number of research studies on WSW in LMICs continues to increase, data to address WSW sexual health needs remain limited.

  2. [Food and health risks: views on healthy food and food consumption practices among middle-class women and men in the Metropolitan Area of Buenos Aires].

    Science.gov (United States)

    Freidin, Betina

    2016-01-01

    In this article we analyze notions about healthy food and the perceptions of risks related to industrialized foodstuffs within a group of young and middle-aged females and males who belong to the middle class and live in the Metropolitan Area of Buenos Aires. Data come from eight focus groups that were carried out in 2013. The study shows that the participants of the focus group have incorporated scientific-nutritional knowledge into their conceptions of healthy food. However, few discuss the risks of industrialized food beyond the growing public attention regarding trans fats and salt content. Although organic foods are positively valued, participants object to their high cost and the location of their commercialization. We show how in their food practices, the participants of the focus groups weigh their concern about health against other priorities such as costs, convenience, aesthetics, pleasure and sociability.

  3. Fixed Target Collisions at STAR

    Energy Technology Data Exchange (ETDEWEB)

    Meehan, Kathryn C.

    2016-12-15

    The RHIC Beam Energy Scan (BES) program was proposed to look for the turn-off of signatures of the quark gluon plasma (QGP), search for a possible QCD critical point, and study the nature of the phase transition between hadronic and partonic matter. Previous results have been used to claim that the onset of deconfinement occurs at a center-of-mass energy of 7 GeV. Data from lower energies are needed to test if this onset occurs. The goal of the STAR Fixed-Target Program is to extend the collision energy range in BES II to energies that are likely below the onset of deconfinement. Currently, STAR has inserted a gold target into the beam pipe and conducted test runs at center-of-mass energies of 3.9 and 4.5 GeV. Tests have been done with both Au and Al beams. First physics results from a Coulomb potential analysis of Au + Au fixed-target collisions are presented and are found to be consistent with results from previous experiments. Furthermore, the Coulomb potential, which is sensitive to the Z of the projectile and degree of baryonic stopping, will be compared to published results from the AGS.

  4. Cambodian Remarried Women Are at Risk for Domestic Violence.

    Science.gov (United States)

    Eng, Sothy; Szmodis, Whitney; Grace, Kelly

    2017-01-01

    Divorce rates continue to rise, especially in urban centers, which in turn contributes to increasing numbers of women who remarry. While remarriage is one of the only options for survival for divorced women, especially those from low socioeconomic status, remarriage also brings with it increased stressors of financial strain and the strain of blended families. This study tested the hypothesis that remarried women compared with first-time married and divorced women are at increased risk for domestic violence. The sample was drawn from the Cambodia Demographic and Health Survey, consisting of 1,560 women with the average age of 31.64. Results showed that 20% of women reported emotional violence and 14%, physical violence. Based on hierarchical multiple regressions, this study found that remarried women were more likely to experience physical and emotional abuse than women in their first marriage or women who remain divorced/not in union. Further interaction analyses showed that domestic violence varies depending on place of residence, number of children younger than 5 years, partners' education, and wealth index. Rural residents who were in poorest and poorer groups and urban residents in their poorer and middle groups of their wealth index showed high risk of domestic violence. Remarried women with two or three children younger than 5 years showed highest risk of domestic violence. Additional three-way interaction analysis revealed that remarried women residing in rural/urban areas with a spouse having no education and/or primary level of education were at highest risk of domestic violence. The study lends support to the structural role of the power of male dominance on women's social and emotional well-being. This study suggested that to reduce men's perceived domination, structural intervention that includes implementing gender-responsive curriculum in formal education, as well as strengthening domestic violence law enforcement would help reduce domestic violence

  5. Management of severe acute malnutrition in low-income and middle-income countries

    Science.gov (United States)

    Kwashiorkor and marasmus, collectively termed severe acute malnutrition (SAM), account for at least 10% of all deaths among children under 5 years of age worldwide, virtually all of them in low-income and middle-income countries. A number of risk factors, including seasonal food insecurity, environm...

  6. Polarized target physics at the Bonn electron accelerators

    International Nuclear Information System (INIS)

    Meyer, W.

    1988-12-01

    At the BONN 2.5 GeV electron synchrotron experiments with polarized nucleon targets have a long tradition. Starting with measurements of the target asymmetry in single pion photoproduction off polarized protons, resp. neutrons, the experiments have been concentrated on photodisintegration measurements of polarized deuterons. Parallel to these activities a considerable progress in the field of the target technology, e.g. cryogenics and target materials, has been made, by which all the measurements have profitted enormously. Especially the development of the new target material ammonia has allowed the first use of a polarized deuteron (ND 3 ) target in an intense electron beam. The construction of a frozen spin target, which will be used in combination with a tagged polarized photon beam, makes a new generation of polarized target experiments in photon induced reactions possible. Together with electron scattering off polarized deuterons and neutrons they will be a main activity in the physics program at the new stretcher accelerator ELSA in BONN. (orig.)

  7. A Web-Based Respondent Driven Sampling Pilot Targeting Young People at Risk for Chlamydia Trachomatis in Social and Sexual Networks with Testing: A Use Evaluation

    NARCIS (Netherlands)

    Theunissen, Kevin; Hoebe, Christian; Kok, Gerjo; Crutzen, Rik; Kara-Zaïtri, Chakib; de Vries, Nanne; van Bergen, Jan; Hamilton, Robert; van der Sande, Marianne; Dukers-Muijrers, Nicole

    2015-01-01

    With the aim of targeting high-risk hidden heterosexual young people for Chlamydia trachomatis (CT) testing, an innovative web-based screening strategy using Respondent Driven Sampling (RDS) and home-based CT testing, was developed, piloted and evaluated. Two STI clinic nurses encouraged 37 CT

  8. Syphilis among middle-aged female sex workers in China: a three-site cross-sectional study

    OpenAIRE

    Liu, Hongjie; Dumenci, Levent; Morisky, Donald E; Xu, Yongfang; Li, Xiaojing; Jiang, Baofa

    2016-01-01

    Objectives This study addresses the lack of empirical studies about the epidemic of syphilis among middle-aged female sex workers (FSWs). The objectives of this study were to investigate prevalence of syphilis, and its potential risk factors among middle-aged FSWs in China. Design A cross-sectional study with respondent-driven sampling (RDS). Setting A multisite study conducted at three Chinese cites (Nanning, Hefei, and Qingdao) with different levels of sexually transmitted diseases in 2014....

  9. On the configuration of an active target for a fixed-target B experiment at SSC energies

    International Nuclear Information System (INIS)

    Dukes, E.C.

    1993-01-01

    The optimal configuration of target and silicon microvertex detector for fixed-target B experiments has yet to be determined. For fixed-target charm experiments the usual setup consists of a series of inert target foils - typically a few millimeters thick and separated by a few centimeters - immediately followed by a silicon microvertex detector. Because of the larger boost at the SSC, the efficacy of using active target foils - tightly packed silicon microstrip detectors - has been considered by at least one group: the SFT collaboration. It is hoped that with an active target the tracks of charged B's themselves can be measured, improving charged B reconstruction efficiencies. The author examines two issues concerning silicon active targets for fixed-target experiments at the SSC: (1) the effect on the acceptance of the requirement that the B decay vertices occur outside of the target foils, and (2) the ability of an active target to directly track charged B's

  10. Rescuing Middle School Astronomy

    Science.gov (United States)

    Mayo, L. A.; Janney, D.

    2010-12-01

    There is a crisis in education at the middle school level (Spellings, 2006). Recent studies point to large disparities in middle school performance in schools with high minority populations. The largest disparities exist in areas of math and science. Astronomy has a universal appeal for K-12 students but is rarely taught at the middle school level. When it is taught at all it is usually taught in isolation with few references in other classes such as other sciences (e.g. physics, biology, and chemistry), math, history, geography, music, art, or English. The problem is greatest in our most challenged school districts. With scores in reading and math below national averages in these schools and with most state achievement tests ignoring subjects like astronomy, there is little room in the school day to teach about the world outside our atmosphere. Add to this the exceedingly minimal training and education in astronomy that most middle school teachers have and it is a rare school that includes any astronomy teaching at all. In this presentation, we show how to develop and offer an astronomy education training program for middle school teachers encompassing a wide range of educational disciplines that are frequently taught at the middle school level. The prototype for this program was developed and launched in two of the most challenged and diverse school systems in the country; D.C. Public Schools, and Montgomery County (MD) Public Schools.

  11. Effect of simple, targeted diet in pregnant women with metabolic risk factors on maternal and fetal outcomes (ESTEEM): study protocol for a pragmatic multicentre randomised trial

    NARCIS (Netherlands)

    Al Wattar, Bassel H.; Dodds, Julie; Placzek, Anna; Spyreli, Eleni; Moore, Amanda; Hooper, Richard; Beresford, Lee; Roseboom, Tessa J.; Bes-Rastrollo, Maira; Hitman, Graham; Khan, Khalid S.; Thangaratinam, Shakila

    2016-01-01

    Women with metabolic risk factors are at higher risk of adverse pregnancy outcomes. Mediterranean-based dietary interventions have the potential to minimise these risks. We aim to evaluate the effectiveness of a simple, targeted intervention modelled on Mediterranean diet in preventing maternal and

  12. Dietary Patterns in Relation to Cardiovascular Disease Incidence and Risk Markers in a Middle-Aged British Male Population: Data from the Caerphilly Prospective Study

    NARCIS (Netherlands)

    Mertens, Elly; Markey, Oonagh; Geleijnse, Johanna; Givens, David; Lovegrove, Julie

    2017-01-01

    Dietary behaviour is an important modifiable factor in cardiovascular disease (CVD) prevention. The study aimed to identify dietary patterns (DPs) and explore their association with CVD incidence and risk markers. A follow-up of 1838 middle-aged men, aged 47–67 years recruited into the Caerphilly

  13. Physical Activity-Related Injury and Its Associated Factors among Middle School Students in Southern China

    Directory of Open Access Journals (Sweden)

    Weicong Cai

    2018-06-01

    Full Text Available Physical activity (PA promotion is beneficial to gain and maintain optimal health, but might increase risks for physical activity-related injury (PARI. This cross-sectional study aimed to investigate the incidence rate and identify risk factors of PARI among Chinese middle school students. Selected via the method of cluster random sampling, students graded 7–8 (junior and 10–11 (senior from five middle schools (aged from 10 to 18 years old in Shantou were invited to participate in the survey. Information on socio-demography, PA involvement, sleep duration, individual safety awareness and exercise behavior, and PARI experiences in the past 12 month was collected. Multivariate logistic regression model was performed to estimate the risk factors of PARI. A total of 3082 participants completed the valid questionnaires, with an overall incidence rate of 25.1%. Boys, junior school students, sports team members, and those with lower safety awareness, living with single parent, and without any chronic conditions were at higher risks for PARI. Moreover, exercising on wet floor or with illness frequently would also be more likely to experience injury, especially those with at least 120 min per day. In conclusion, PARI was prevalent among middle school students in southern China. The above data provide insights that were focused and effective actions should be taken to prevent school-aged adolescents from PARI and maximize the benefits of PA.

  14. A qualitative descriptive study of risk reduction for coronary disease among the Hong Kong Chinese.

    Science.gov (United States)

    Chan, Choi Wan; Lopez, Violeta

    2014-01-01

    Achieving optimal control and reduction in coronary heart disease (CHD) risks in Hong Kong (HK) remains significant and requires exploring. This article addresses the ability to reduce CHD risks among the HK Chinese. Through secondary analysis, a qualitative descriptive design using focus group interviews and content analysis were adopted. Older and younger adults were invited for the study. An interview schedule was used to guide discussions during focus group interviews. Four categories emerged from the data: planning of health actions, control of risk-reducing behavior, perceived opportunities for understanding CHD, and chest pain appraisal. Local culture and population needs play a central role in disease perception and prevention. The findings are essential to target strategies for initiating health acts for younger adults and establish public education resources that underscore understanding of CHD risk, symptom recognition, and disease management, particularly among those middle-aged and older people at high risk and with the diseased populations. © 2013 Wiley Periodicals, Inc.

  15. Are Australian immigrants at a risk of being physically inactive?

    Directory of Open Access Journals (Sweden)

    Gurrin Lyle

    2011-06-01

    Full Text Available Abstract Background We examined whether physical activity risk differed between migrant sub-groups and the Australian-born population. Methods Data were drawn from the Australian National Health Survey (2001 and each resident's country of birth was classified into one of 13 regions. Data were gathered on each resident's physical activity level in the fortnight preceding the survey. Multivariable logistic regression, adjusted for potential confounders examined the risk of physical inactivity of participants from each of the 13 regions compared to the Australian-born population. Results There was a greater prevalence of physical inactivity for female immigrants from most regions compared to male immigrants from a like region. Immigrants from South East Asia (OR 2.04% 95% CI 1.63, 2.56, Other Asia (OR 1.53 95% CI 1.10, 2.13, Other Oceania (1.81 95% CI 1.11, 2.95, the Middle East (OR 1.42 95% CI 0.97, 2.06 [note: border line significance] and Southern & Eastern Europe are at a significantly higher risk of being physically inactive compared to those born in Australian. In contrast, immigrants from New Zealand (OR 0.77 95% CI 0.62, 0.94, the UK & Ireland (OR 0.82 95% CI 0.73, 0.92, and other Africa (OR 0.69 95% CI 0.51, 0.94 are at a significantly lower risk of being physically inactive compared to the Australian born population. Conclusion Future research identifying potential barriers and facilitators to participation in physical activity will inform culturally sensitive physical activity programs that aim to encourage members of specific regional ethnic sub-groups to undertake physical activity.

  16. Temporal associations of popularity and alcohol use among middle school students.

    Science.gov (United States)

    Tucker, Joan S; Miles, Jeremy N V; D'Amico, Elizabeth J; Zhou, Annie J; Green, Harold D; Shih, Regina A

    2013-01-01

    The goal of this study is to better understand the longitudinal cross-lagged associations between popularity, assessed through self-rating and peer nominations, and alcohol use among middle school students. The analytical sample comprises 1,835 sixth- to eighth-grade students who were initially recruited from three California middle schools and surveyed in the fall and spring semesters of 2 academic years. Students reported on their background characteristics, past-month alcohol use, and perceived popularity. Additionally, students provided school-based friendship nominations, which were used to calculate peer-nominated popularity. A cross-lagged regression approach within a structural equation modeling framework was used to examine the longitudinal relationship between popularity (self-rated and peer-nominated) and alcohol use. There was a statistically significant (p = .024) association between peer-nominated popularity and the probability of alcohol consumption at the subsequent survey, but not vice versa. Our results suggest that in a scenario where 8% of students are past-month drinkers, each increase of five friendship nominations is associated with a 30% greater risk of being a current drinker at the next wave. We found no evidence of longitudinal associations between past-month alcohol consumption and self-rated popularity. Popularity is a risk factor for drinking during the middle school years, with peer-nominated popularity being more predictive of use than self-perceptions of popularity. To inform alcohol prevention efforts for middle school students, additional research is needed to better understand why adolescents with a larger number of school-based friendship ties are more inclined to drink. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. [Health risks in different living circumstances of mothers. Analyses based on a population study].

    Science.gov (United States)

    Sperlich, Stefanie

    2014-12-01

    The objective of this study was to determine the living circumstances ('Lebenslagen') in mothers which are associated with elevated health risks. Data were derived from a cross-sectional population based sample of German women (n = 3129) with underage children. By means of a two-step cluster analysis ten different maternal living circumstances were assessed which proved to be distinct with respect to indicators of socioeconomic position, employment status and family-related factors. Out of the ten living circumstances, one could be attributed to higher socioeconomic status (SES), while five were assigned to a middle SES and four to a lower SES. In line with previous findings, mothers with a high SES predominantly showed the best health while mothers with a low SES tended to be at higher health risk with respect to subjective health, mental health (anxiety and depression), obesity and smoking. However, there were important health differences between the different living circumstances within the middle and lower SES. In addition, varying health risks were found among different living circumstances of single mothers, pointing to the significance of family and job-related living conditions in establishing health risks. With this exploratory analysis strategy small-scale living conditions could be detected which were associated with specific health risks. This approach seemed particularly suitable to provide a more precise definition of target groups for health promotion. The findings encourage a more exrensive application of the concept of living conditions in medical sociology research as well as health monitoring.

  18. Assessment of vitamin D and its association with cardiovascular disease risk factors in an adult migrant population: an audit of patient records at a Community Health Centre in Kensington, Melbourne, Australia.

    Science.gov (United States)

    Ruwanpathirana, Thilanga; Reid, Christopher M; Owen, Alice J; Fong, David P S; Gowda, Usha; Renzaho, Andre M N

    2014-11-11

    Vitamin D deficiency is a global public health problem associated with increased risk of cardio-metabolic diseases and osteoarthritis. Migrants with dark skin settled in temperate climates are at greater risk of both vitamin D deficiency and cardiovascular diseases. This study aims to identify the risk of vitamin D deficiency and associations with cardiovascular disease in a migrant population in Australia. An audit was carried out at a Community Health Service in Kensington, Melbourne which, services a large migrant population. Data from the clinical records of all adults who visited the medical centre at least once during the period from 1st January 2010 to 31st December 2012 was extracted. The future (10 year) coronary heart disease risk was estimated using Framingham Risk Score. The centre has given higher priority to vitamin D testing in migrants, those middle-aged, females and those with diabetes and osteoarthritis. Migrants from countries located in lower latitude regions (Latitude N230 to S230) were 1.48 (95% C.I. 1.32-1.65) times more likely to develop vitamin D deficiency post migration and 0.44 (95% C.I. 0.31-0.62) times less likely to have a >15% 10-year risk of coronary heart disease when compared to their Australian-born counterparts. Adherence to a high risk strategy for vitamin D testing was observed in the centre. Pre-migration latitude is an important factor for vitamin D deficiency (lower the latitude higher the risk) and in predicting future risk of cardiovascular disease in migrants. These findings suggest that a targeted approach for vitamin D testing, including zone of origin might better identify individuals at higher risk of both vitamin D deficiency and cardiovascular disease.

  19. Socioeconomic Inequalities in Secondhand Smoke Exposure at Home and at Work in 15 Low- and Middle-Income Countries.

    Science.gov (United States)

    Nazar, Gaurang P; Lee, John Tayu; Arora, Monika; Millett, Christopher

    2016-05-01

    In high-income countries, secondhand smoke (SHS) exposure is higher among disadvantaged groups. We examine socioeconomic inequalities in SHS exposure at home and at workplace in 15 low- and middle-income countries (LMICs). Secondary analyses of cross-sectional data from 15 LMICs participating in Global Adult Tobacco Survey (participants ≥ 15 years; 2008-2011) were used. Country-specific analyses using regression-based methods were used to estimate the magnitude of socioeconomic inequalities in SHS exposure: (1) Relative Index of Inequality and (2) Slope Index of Inequality. SHS exposure at home ranged from 17.4% in Mexico to 73.1% in Vietnam; exposure at workplace ranged from 16.9% in Uruguay to 65.8% in Bangladesh. In India, Bangladesh, Thailand, Malaysia, Philippines, Vietnam, Uruguay, Poland, Turkey, Ukraine, and Egypt, SHS exposure at home reduced with increasing wealth (Relative Index of Inequality range: 1.13 [95% confidence interval [CI] 1.04-1.22] in Turkey to 3.31 [95% CI 2.91-3.77] in Thailand; Slope Index of Inequality range: 0.06 [95% CI 0.02-0.11] in Turkey to 0.43 [95% CI 0.38-0.48] in Philippines). In these 11 countries, and in China, SHS exposure at home reduced with increasing education. In India, Bangladesh, Thailand, and Philippines, SHS exposure at workplace reduced with increasing wealth. In India, Bangladesh, Thailand, Philippines, Vietnam, Poland, Russian Federation, Turkey, Ukraine, and Egypt, SHS exposure at workplace reduced with increasing education. SHS exposure at homes is higher among the socioeconomically disadvantaged in the majority of LMICs studied; at workplaces, exposure is higher among the less educated. Pro-equity tobacco control interventions alongside targeted efforts in these groups are recommended to reduce inequalities in SHS exposure. SHS exposure is higher among the socioeconomically disadvantaged groups in high-income countries. Comprehensive smoke-free policies are pro-equity for certain health outcomes that are

  20. Socioeconomic Inequalities in Secondhand Smoke Exposure at Home and at Work in 15 Low- and Middle-Income Countries

    Science.gov (United States)

    Lee, John Tayu; Arora, Monika; Millett, Christopher

    2016-01-01

    Introduction: In high-income countries, secondhand smoke (SHS) exposure is higher among disadvantaged groups. We examine socioeconomic inequalities in SHS exposure at home and at workplace in 15 low- and middle-income countries (LMICs). Methods: Secondary analyses of cross-sectional data from 15 LMICs participating in Global Adult Tobacco Survey (participants ≥ 15 years; 2008–2011) were used. Country-specific analyses using regression-based methods were used to estimate the magnitude of socioeconomic inequalities in SHS exposure: (1) Relative Index of Inequality and (2) Slope Index of Inequality. Results: SHS exposure at home ranged from 17.4% in Mexico to 73.1% in Vietnam; exposure at workplace ranged from 16.9% in Uruguay to 65.8% in Bangladesh. In India, Bangladesh, Thailand, Malaysia, Philippines, Vietnam, Uruguay, Poland, Turkey, Ukraine, and Egypt, SHS exposure at home reduced with increasing wealth (Relative Index of Inequality range: 1.13 [95% confidence interval [CI] 1.04–1.22] in Turkey to 3.31 [95% CI 2.91–3.77] in Thailand; Slope Index of Inequality range: 0.06 [95% CI 0.02–0.11] in Turkey to 0.43 [95% CI 0.38–0.48] in Philippines). In these 11 countries, and in China, SHS exposure at home reduced with increasing education. In India, Bangladesh, Thailand, and Philippines, SHS exposure at workplace reduced with increasing wealth. In India, Bangladesh, Thailand, Philippines, Vietnam, Poland, Russian Federation, Turkey, Ukraine, and Egypt, SHS exposure at workplace reduced with increasing education. Conclusion: SHS exposure at homes is higher among the socioeconomically disadvantaged in the majority of LMICs studied; at workplaces, exposure is higher among the less educated. Pro-equity tobacco control interventions alongside targeted efforts in these groups are recommended to reduce inequalities in SHS exposure. Implications: SHS exposure is higher among the socioeconomically disadvantaged groups in high-income countries. Comprehensive smoke

  1. Identifying groups at risk for 1-year membership termination from a fitness center at enrollment

    Directory of Open Access Journals (Sweden)

    Stephanie A. Hooker

    2016-12-01

    Full Text Available The vast majority of Americans do not engage in adequate regular physical activity despite its well-known health benefits. Even when individuals attempt to become more active by joining a fitness center, estimates suggest that nearly half terminate their membership within the first 6 months. A better understanding of who is at risk for early membership termination upon joining may help researchers develop targeted interventions to improve the likelihood that individuals will successfully maintain memberships and physical activity. This study's purpose was to identify, based on a wellness assessment (WA used in fitness centers, individuals at risk for fitness membership termination prior to 1-year. Center members (N = 441; Mage = 41.9, SD = 13.1; 74.4% female completed a comprehensive WA of stress, life satisfaction, physical fitness, metabolic health, and sleep quality at the beginning of their memberships and were followed for one year. Latent class analyses utilized the WA to identify four groups: (a healthy, (b unhealthy, (c poor psychological wellness, and (d poor physical wellness. Participants in the poor psychological wellness group (OR = 2.24, p = 0.007 and the unhealthy group (OR = 2.40, p = 0.037 were significantly more likely to terminate their memberships at 1-year as compared to the healthy group. Participants with poor physical wellness visited the fitness center less frequently than healthy participants (p < 0.01. Results suggest that poor psychological wellness is a risk factor for terminating memberships, whereas poor physical wellness is not. Future studies should replicate these latent classes and develop targeted interventions to address psychological wellness as a method to improve fitness membership retention.

  2. Quantile uncertainty and value-at-risk model risk.

    Science.gov (United States)

    Alexander, Carol; Sarabia, José María

    2012-08-01

    This article develops a methodology for quantifying model risk in quantile risk estimates. The application of quantile estimates to risk assessment has become common practice in many disciplines, including hydrology, climate change, statistical process control, insurance and actuarial science, and the uncertainty surrounding these estimates has long been recognized. Our work is particularly important in finance, where quantile estimates (called Value-at-Risk) have been the cornerstone of banking risk management since the mid 1980s. A recent amendment to the Basel II Accord recommends additional market risk capital to cover all sources of "model risk" in the estimation of these quantiles. We provide a novel and elegant framework whereby quantile estimates are adjusted for model risk, relative to a benchmark which represents the state of knowledge of the authority that is responsible for model risk. A simulation experiment in which the degree of model risk is controlled illustrates how to quantify Value-at-Risk model risk and compute the required regulatory capital add-on for banks. An empirical example based on real data shows how the methodology can be put into practice, using only two time series (daily Value-at-Risk and daily profit and loss) from a large bank. We conclude with a discussion of potential applications to nonfinancial risks. © 2012 Society for Risk Analysis.

  3. Job Loss at Mid-Life: Managers and Executives Face the "New Risk Economy"

    Science.gov (United States)

    Mendenhall, Ruby; Kalil, Ariel; Spindel, Laurel J.; Hart, Cassandra M. D.

    2008-01-01

    We use a life course framework to examine how the "new risk economy" has left middle-age professionals, managers and executives more vulnerable to job loss and unemployment despite high levels of human capital. Using in-depth qualitative data from 77 recently-unemployed white-collar workers, we examine perceptions of macro-economic…

  4. Graphite targets at LAMPF

    International Nuclear Information System (INIS)

    Brown, R.D.; Grisham, D.L.

    1983-01-01

    Rotating polycrystalline and stationary pyrolytic graphite target designs for the LAMPF experimental area are described. Examples of finite element calculations of temperatures and stresses are presented. Some results of a metallographic investigation of irradiated pyrolytic graphite target plates are included, together with a brief description of high temperature bearings for the rotating targets

  5. Toxic aluminium and heavy metals in groundwater of middle Russia: health risk assessment.

    Science.gov (United States)

    Momot, Olga; Synzynys, Boris

    2005-08-01

    Two approaches are distinguished in modern ecological monitoring. The first one is physicochemical analysis of environmental objects with respect to maximum allowable concentrations (MACs) of chemical substances, which is performed by standards methods in accordance with state regulations. The second approach (biological monitoring) is based on the methodology of biotesting and bio indication. The task of this work is to create biotests for estimation of Al and other metals toxicity in ground water and to compare these results with physicochemical analysis dates. Risk assessment for heavy metals contaminated groundwater was also performed. Risk assessment was performed accordingly EPA US recommendation and gave results about 90 per 100000 citizens for Al and 402 per 100000 for mixture of different heavy metals. For comparison: risk for earth background radiation for Middle Russia is (Individual dose 1 millisivert per year) consist 5 per 100000 people. It was shown that groundwater consist HCO3- ions (360 mg/l), sometimes Al compounds 0.21-0.65 mg/l (MAC for Al is 0.5 mg/l for Russia). Other groundwater contain Hg - 0.004 mg/l (MAC - 0.0005 mg/l); Cr - 0.072 mg/l (MAC - 0.05 mg/l); As - less than 0.03 mg/l (MAC - 0.05 mg/l). We developed plant biotest for estimation of groundwater quality with barley roots, tradescatia and others. Some biotests parameters correlate with HCO3-, Cl-, SO(4)2- and metal ions content positively, for another biotest this correlation is strongly negative. The quality of groundwater near Obninsk and in Kaluga Region is very different but hasnit been changed since the year 1998.

  6. A perspective of Middle-Atmosphere Dynamics (MAD) studies at the New International Equatorial Observatory (NIEO)

    Science.gov (United States)

    Yamanaka, M. D.; Fukao, S.

    1989-01-01

    The equatorial region has attracted many MAD studies mainly based on data of limited locations and resolutions. Established at NIEO are: (1) Climatology of the equatorial middle atmosphere (all of the mean zonal flow, the meridional and/or east-west circulations and the planetary/gravity waves are described based on massive, reliable data statistics); (2) Troposphere-stratosphere coupling at the equator (the candidate location of NIEO is just at the stratospheric fountain area where the tracers and waves are pumped up into the middle atmosphere); and (3) Mesosphere-thermosphere coupling at the equator; thermospheric superrotation, which may be caused either by ion drag or by tidal breaking, is examined in detail by observations covering a wide altitude range from the mesosphere through the thermosphere.

  7. An Integrated Approach to Change the Outcome Part II: Targeted Neuromuscular Training Techniques to Reduce Identified ACL Injury Risk Factors

    Science.gov (United States)

    Myer, Gregory D.; Ford, Kevin R.; Brent, Jensen L.; Hewett, Timothy E.

    2014-01-01

    Prior reports indicate that female athletes who demonstrate high knee abduction moments (KAMs) during landing are more responsive to neuromuscular training designed to reduce KAM. Identification of female athletes who demonstrate high KAM, which accurately identifies those at risk for noncontact anterior cruciate ligament (ACL) injury, may be ideal for targeted neuromuscular training. Specific neuromuscular training targeted to the underlying biomechanical components that increase KAM may provide the most efficient and effective training strategy to reduce noncontact ACL injury risk. The purpose of the current commentary is to provide an integrative approach to identify and target mechanistic underpinnings to increased ACL injury in female athletes. Specific neuromuscular training techniques will be presented that address individual algorithm components related to high knee load landing patterns. If these integrated techniques are employed on a widespread basis, prevention strategies for noncontact ACL injury among young female athletes may prove both more effective and efficient. PMID:22580980

  8. Retrospective Audit: Does Prior Assessment by Oral and Maxillofacial Surgeons Reduce the Risk of Osteonecrosis of The Jaw in Patients Receiving Bone-Targeted Therapies for Metastatic Cancers to the Skeleton?--Part II.

    Science.gov (United States)

    Turner, Bruce; Ali, Sacha; Pati, Jhumur; Nargund, Vinod; Ali, Enamul; Cheng, Leo; Wells, Paula

    2016-01-01

    Men who receive bone-targeted therapy for metastatic prostate cancer are at increased risk of osteonecrosis of the jaw (ONJ). Development of ONJ has been associated with the administration of bone-targeted therapies in association with other risk factors. ONJ can be distressing for a patient because it can cause pain, risk of jaw fracture, body image disturbance, difficultly eating, and difficulty maintaining good oral hygiene. The aim of this article is to report results of an audit of prior assessment by oral and maxillofacial surgeons (OMFS) before initiation of bone-targeted therapies and whether it may reduce the risk of ONJ in patients receiving bone-targeted therapies for advanced cancers.

  9. Target Visualization at the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Potter, Daniel Abraham [Univ. of California, Davis, CA (United States)

    2011-01-01

    As the National Ignition Facility continues its campaign to achieve ignition, new methods and tools will be required to measure the quality of the targets used to achieve this goal. Techniques have been developed to measure target surface features using a phase-shifting diffraction interferometer and Leica Microsystems confocal microscope. Using these techniques we are able to produce a detailed view of the shell surface, which in turn allows us to refine target manufacturing and cleaning processes. However, the volume of data produced limits the methods by which this data can be effectively viewed by a user. This paper introduces an image-based visualization system for data exploration of target shells at the National Ignition Facility (NIF) at Lawrence Livermore National Laboratory. It aims to combine multiple image sets into a single visualization to provide a method of navigating the data in ways that are not possible with existing tools.

  10. Changes in Waist Circumference and the Incidence of Acute Myocardial Infarction in Middle-Aged Men and Women

    DEFF Research Database (Denmark)

    Berentzen, Tina Landsvig; Jakobsen, Marianne Uhre; Stegger, Jakob Gerhard

    2011-01-01

    Waist circumference (WC) measured at one point in time is positively associated with the risk of acute myocardial infarction (MI), but the association with changes in WC (DWC) is not clear. We investigated the association between DWC and the risk of MI in middle-aged men and women, and evaluated...

  11. Targeting membrane-bound viral RNA synthesis reveals potent inhibition of diverse coronaviruses including the middle East respiratory syndrome virus.

    Directory of Open Access Journals (Sweden)

    Anna Lundin

    2014-05-01

    Full Text Available Coronaviruses raise serious concerns as emerging zoonotic viruses without specific antiviral drugs available. Here we screened a collection of 16671 diverse compounds for anti-human coronavirus 229E activity and identified an inhibitor, designated K22, that specifically targets membrane-bound coronaviral RNA synthesis. K22 exerts most potent antiviral activity after virus entry during an early step of the viral life cycle. Specifically, the formation of double membrane vesicles (DMVs, a hallmark of coronavirus replication, was greatly impaired upon K22 treatment accompanied by near-complete inhibition of viral RNA synthesis. K22-resistant viruses contained substitutions in non-structural protein 6 (nsp6, a membrane-spanning integral component of the viral replication complex implicated in DMV formation, corroborating that K22 targets membrane bound viral RNA synthesis. Besides K22 resistance, the nsp6 mutants induced a reduced number of DMVs, displayed decreased specific infectivity, while RNA synthesis was not affected. Importantly, K22 inhibits a broad range of coronaviruses, including Middle East respiratory syndrome coronavirus (MERS-CoV, and efficient inhibition was achieved in primary human epithelia cultures representing the entry port of human coronavirus infection. Collectively, this study proposes an evolutionary conserved step in the life cycle of positive-stranded RNA viruses, the recruitment of cellular membranes for viral replication, as vulnerable and, most importantly, druggable target for antiviral intervention. We expect this mode of action to serve as a paradigm for the development of potent antiviral drugs to combat many animal and human virus infections.

  12. Pathway to Graduation: A Pilot Reading Project for Middle School Students during the Summer Months

    Science.gov (United States)

    Hilsmier, Amanda Strong; Wood, Patricia F.; Wirt, Susan; McTamney, Diane; Malone, Mary Beth; Milstead, Becky

    2014-01-01

    The purpose of this article is to outline the implementation of a summer reading project targeted at middle school students with identified reading deficits and behavioral concerns called Pathway to Graduation (PTG). The project was a collaborative process between a school district, local university, and department of mental health. The students…

  13. Risk of Leptomeningeal Disease in Patients Treated With Stereotactic Radiosurgery Targeting the Postoperative Resection Cavity for Brain Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Atalar, Banu [Department of Radiation Oncology, Acibadem University School of Medicine, Istanbul (Turkey); Modlin, Leslie A. [Department of Radiation Oncology, Stanford University Medical Center, Stanford, California (United States); Choi, Clara Y.H.; Adler, John R. [Department of Neurosurgery, Stanford University Medical Center, Stanford, California (United States); Gibbs, Iris C. [Department of Radiation Oncology, Stanford University Medical Center, Stanford, California (United States); Chang, Steven D.; Harsh, Griffith R.; Li, Gordon [Department of Neurosurgery, Stanford University Medical Center, Stanford, California (United States); Nagpal, Seema [Department of Neurology, Stanford University Medical Center, Stanford, California (United States); Hanlon, Alexandra [Department of Radiation Oncology, Stanford University Medical Center, Stanford, California (United States); Soltys, Scott G., E-mail: sgsoltys@stanford.edu [Department of Radiation Oncology, Stanford University Medical Center, Stanford, California (United States)

    2013-11-15

    Purpose: We sought to determine the risk of leptomeningeal disease (LMD) in patients treated with stereotactic radiosurgery (SRS) targeting the postsurgical resection cavity of a brain metastasis, deferring whole-brain radiation therapy (WBRT) in all patients. Methods and Materials: We retrospectively reviewed 175 brain metastasis resection cavities in 165 patients treated from 1998 to 2011 with postoperative SRS. The cumulative incidence rates, with death as a competing risk, of LMD, local failure (LF), and distant brain parenchymal failure (DF) were estimated. Variables associated with LMD were evaluated, including LF, DF, posterior fossa location, resection type (en-bloc vs piecemeal or unknown), and histology (lung, colon, breast, melanoma, gynecologic, other). Results: With a median follow-up of 12 months (range, 1-157 months), median overall survival was 17 months. Twenty-one of 165 patients (13%) developed LMD at a median of 5 months (range, 2-33 months) following SRS. The 1-year cumulative incidence rates, with death as a competing risk, were 10% (95% confidence interval [CI], 6%-15%) for developing LF, 54% (95% CI, 46%-61%) for DF, and 11% (95% CI, 7%-17%) for LMD. On univariate analysis, only breast cancer histology (hazard ratio, 2.96) was associated with an increased risk of LMD. The 1-year cumulative incidence of LMD was 24% (95% CI, 9%-41%) for breast cancer compared to 9% (95% CI, 5%-14%) for non-breast histology (P=.004). Conclusions: In patients treated with SRS targeting the postoperative cavity following resection, those with breast cancer histology were at higher risk of LMD. It is unknown whether the inclusion of whole-brain irradiation or novel strategies such as preresection SRS would improve this risk or if the rate of LMD is inherently higher with breast histology.

  14. Predictors of Cigarette Smoking Initiation in Early, Middle, and Late Adolescence.

    Science.gov (United States)

    O'Loughlin, Jennifer; O'Loughlin, Erin K; Wellman, Robert J; Sylvestre, Marie-Pierre; Dugas, Erika N; Chagnon, Miguel; Dutczak, Hartley; Laguë, Johanne; McGrath, Jennifer J

    2017-09-01

    Little is known about age-related differences in risk factors for cigarette smoking initiation. We identified predictors of initiation in early, middle, and late adolescence from among sociodemographic factors, indicators of smoking in the social environment, psychological characteristics, lifestyle indicators, and perceived need for cigarettes. Data were drawn from a longitudinal study of 1,801 children recruited at age 10-11 years from 29 elementary schools in Montreal, Canada. Multivariable logistic regression within a generalized estimating equations framework was used to identify predictors among never smokers across three 2-year windows: age 11-13 years (n = 1,221); age 13-15 years (n = 737); and age 15-17 years (n = 690). Among the 18 risk factors investigated, two differed across age. Friends' smoking, a strong risk factor in early adolescence (odds ratio [95% confidence interval] = 5.78 [3.90-8.58]), lost potency in late adolescence (1.83 [1.31-2.57]). Depressive symptoms, a risk factor in early and middle adolescence (1.60 [1.26-2.02] and 1.92 [1.45-2.54], respectively), were inversely associated in late adolescence (.76 [.58-1.00]). Sex, TV viewing, and weight-related goals were not associated with initiation at any age. All other factors were significant in two or three age groups. Most risk factors for smoking initiation were stable across age. Tobacco control interventions may be robust for risk factors across age groups and may not need adjustment. At all ages, interventions should focus on eliminating smoking in the social environment and on reducing the availability of tobacco products. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  15. A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Prevalence and risk factors meta-analysis.

    Science.gov (United States)

    Farrag, Nesrine S; Cheskin, Lawrence J; Farag, Mohamed K

    2017-01-01

    Obesity rates are rising globally, but there is evidence that young people in the Middle East and North Africa (MENA) region are at particularly high risk. We systematically searched the literature to map the MENA region for prevalence of childhood overweight and obesity, and examine the underlying risk factors and adverse effects associated with obesity in this region. Inclusion criteria were: English-language, non-basic-science focused articles that used any of the standard obesity definitions and were conducted in the MENA countries within the last five years. We searched PubMed using combinations of key terms ((childhood) OR adolescence) AND obesity) AND (MENA or each country) AND ("last five years" [PDat]). Studies demonstrated an increasing prevalence of obesity among many countries in the MENA region, especially in the Gulf area. Notably, in Kuwait, prevalence rates of overweight and obesity were 25.6% and 34.8% among young males and 20.8% and 20.5% among females. A meta-analysis revealed that physical inactivity, increased screen time, and higher social status were risk factors for childhood obesity. Childhood and adolescent obesity is a major challenge facing countries of the MENA region. Further research is needed to fully investigate the role of nutrition and other specific risk factors and evaluate various interventions to manage this pervasive and growing health problem.

  16. Atlas-based automatic segmentation of head and neck organs at risk and nodal target volumes: a clinical validation

    International Nuclear Information System (INIS)

    Daisne, Jean-François; Blumhofer, Andreas

    2013-01-01

    Intensity modulated radiotherapy for head and neck cancer necessitates accurate definition of organs at risk (OAR) and clinical target volumes (CTV). This crucial step is time consuming and prone to inter- and intra-observer variations. Automatic segmentation by atlas deformable registration may help to reduce time and variations. We aim to test a new commercial atlas algorithm for automatic segmentation of OAR and CTV in both ideal and clinical conditions. The updated Brainlab automatic head and neck atlas segmentation was tested on 20 patients: 10 cN0-stages (ideal population) and 10 unselected N-stages (clinical population). Following manual delineation of OAR and CTV, automatic segmentation of the same set of structures was performed and afterwards manually corrected. Dice Similarity Coefficient (DSC), Average Surface Distance (ASD) and Maximal Surface Distance (MSD) were calculated for “manual to automatic” and “manual to corrected” volumes comparisons. In both groups, automatic segmentation saved about 40% of the corresponding manual segmentation time. This effect was more pronounced for OAR than for CTV. The edition of the automatically obtained contours significantly improved DSC, ASD and MSD. Large distortions of normal anatomy or lack of iodine contrast were the limiting factors. The updated Brainlab atlas-based automatic segmentation tool for head and neck Cancer patients is timesaving but still necessitates review and corrections by an expert

  17. Atlas-based automatic segmentation of head and neck organs at risk and nodal target volumes: a clinical validation.

    Science.gov (United States)

    Daisne, Jean-François; Blumhofer, Andreas

    2013-06-26

    Intensity modulated radiotherapy for head and neck cancer necessitates accurate definition of organs at risk (OAR) and clinical target volumes (CTV). This crucial step is time consuming and prone to inter- and intra-observer variations. Automatic segmentation by atlas deformable registration may help to reduce time and variations. We aim to test a new commercial atlas algorithm for automatic segmentation of OAR and CTV in both ideal and clinical conditions. The updated Brainlab automatic head and neck atlas segmentation was tested on 20 patients: 10 cN0-stages (ideal population) and 10 unselected N-stages (clinical population). Following manual delineation of OAR and CTV, automatic segmentation of the same set of structures was performed and afterwards manually corrected. Dice Similarity Coefficient (DSC), Average Surface Distance (ASD) and Maximal Surface Distance (MSD) were calculated for "manual to automatic" and "manual to corrected" volumes comparisons. In both groups, automatic segmentation saved about 40% of the corresponding manual segmentation time. This effect was more pronounced for OAR than for CTV. The edition of the automatically obtained contours significantly improved DSC, ASD and MSD. Large distortions of normal anatomy or lack of iodine contrast were the limiting factors. The updated Brainlab atlas-based automatic segmentation tool for head and neck Cancer patients is timesaving but still necessitates review and corrections by an expert.

  18. Risk of Concussion During Sports Versus Physical Education Among New Mexico Middle and High School Students.

    Science.gov (United States)

    Campbell, Richard A; Gorman, Stephanie A; Thoma, Robert J; Annett, Robert D; McGrew, Christopher A; Yeo, Ronald A; Mayer, Andrew R; King, John H; Rowland, Andrew S

    2018-01-01

    To measure the risk of concussion among New Mexico middle and high school students during both sports and physical education. Athletic directors or athletic trainers in 147 schools were asked to report the number of concussions occurring during sports and physical education in the 2013 to 2014 school year. We calculated 1-year cumulative incidence rates. Of the 147 schools, 99 responded (67%). During the school year, 598 students were removed from athletics because of a concussion, a 1-year cumulative incidence of 3.5 per 100. The concussion rate during sports was 3.0: 3.5 for boys and 2.4 for girls (relative risk [RR] = 1.5; 95% confidence interval [CI] = 1.2, 1.7). An additional 335 students experienced concussions during physical education. Concussion rates during physical education were 60% higher than during sports (RR = 1.6; 95% CI = 1.4, 1.8). In our data, the risk of concussion was higher in physical education than in sports. This suggests that concussions should be tracked for a wide range of youth athletic activities, not just for sports. Monitoring cumulative incidence, in addition to other measures, may allow comparisons across schools and regions. More prevention efforts are needed.

  19. The target vacuum storage facility at iThemba LABS

    Science.gov (United States)

    Neveling, R.; Kheswa, N. Y.; Papka, P.

    2018-05-01

    A number of nuclear physics experiments at iThemba LABS require target foils that consist of specific isotopes of elements which are reactive in air. Not only is it important to prepare these targets in a suitable environment to prevent oxidation, but consideration should also be given to the long term storage and handling facilities of such targets. The target vacuum storage facility at iThemba LABS, as well as additional hardware necessary to transport and install the target foils in the experimental chamber, will be discussed.

  20. Evidence to modify guidelines for routine retinopathy of prematurity screening to avoid childhood blindness in middle-income countries

    Directory of Open Access Journals (Sweden)

    Miroslava Paolah Meraz-Gutiérrez

    2016-07-01

    Conclusions: These findings show that the valid guidelines at the time of the screening were based on a different population and were not sufficient to detect all ROP cases in a middle-income country. With the update of the Mexican guidelines established in July 2015, the patients from this study would have been screened. Therefore, review and modification of the current screening guidelines in other middle-income countries should be considered to include all babies at risk for ROP.

  1. Stringent Nucleotide Recognition by the Ribosome at the Middle Codon Position.

    Science.gov (United States)

    Liu, Wei; Shin, Dongwon; Ng, Martin; Sanbonmatsu, Karissa Y; Tor, Yitzhak; Cooperman, Barry S

    2017-08-29

    Accurate translation of the genetic code depends on mRNA:tRNA codon:anticodon base pairing. Here we exploit an emissive, isosteric adenosine surrogate that allows direct measurement of the kinetics of codon:anticodon University of California base formation during protein synthesis. Our results suggest that codon:anticodon base pairing is subject to tighter constraints at the middle position than at the 5'- and 3'-positions, and further suggest a sequential mechanism of formation of the three base pairs in the codon:anticodon helix.

  2. Depressive symptoms and other risk factors predicting suicide in middle-aged men: a prospective cohort study among Korean Vietnam War veterans

    Directory of Open Access Journals (Sweden)

    Sang-Wook Yi

    2015-07-01

    Full Text Available Background. Few studies have prospectively examined whether depressive symptoms and other risk factors are associated with a higher risk of suicide death in individuals other than high-risk populations such as psychiatric patients and individuals with self-harm histories. The purpose of the study is to prospectively examine whether depressive symptoms assessed by the Beck Depression Inventory (BDI are associated with greater risk of suicide death and whether depressive symptoms and other risk factors are independent predictors of suicide in general-risk populations. Another aim is to evaluate the sensitivity of the BDI for predicting suicide death.Methods. 10,238 Korean Vietnam War veterans (mean age: 56.3 years who participated in two surveys in 2001 were followed up for suicide mortality over 7.5 years.Results. 41 men died by suicide. Severely depressed participants had a higher adjusted hazard ratio (aHR = 3.4; 95% CI [1.5–7.7] of suicide than non-to-moderately depressed ones. Higher suicide risk was associated with more severe depressive symptoms (p for trend = 0.009. After adjustment for depressive symptoms and other factors, very poor health, low education, and past drinking were associated with higher suicide risk, while good health, body mass index, and marital status were not associated with suicide. The sensitivity at the cut-off score of 31 for detecting suicide was higher during the earlier 3.5 years of the follow-up (75%; 95% CI [50–90] than during the latter 4 years (60%; 95% CI [41–76].Conclusions. Depressive symptoms are a strong independent predictor and very poor health, low education, and drinking status may be independent predictors of future suicide. The BDI may have acceptable diagnostic properties as a risk assessment tool for identifying people with depression and suicidal potential among middle-aged men.

  3. Depressive symptoms and other risk factors predicting suicide in middle-aged men: a prospective cohort study among Korean Vietnam War veterans.

    Science.gov (United States)

    Yi, Sang-Wook; Hong, Jae-Seok

    2015-01-01

    Background. Few studies have prospectively examined whether depressive symptoms and other risk factors are associated with a higher risk of suicide death in individuals other than high-risk populations such as psychiatric patients and individuals with self-harm histories. The purpose of the study is to prospectively examine whether depressive symptoms assessed by the Beck Depression Inventory (BDI) are associated with greater risk of suicide death and whether depressive symptoms and other risk factors are independent predictors of suicide in general-risk populations. Another aim is to evaluate the sensitivity of the BDI for predicting suicide death. Methods. 10,238 Korean Vietnam War veterans (mean age: 56.3 years) who participated in two surveys in 2001 were followed up for suicide mortality over 7.5 years. Results. 41 men died by suicide. Severely depressed participants had a higher adjusted hazard ratio (aHR = 3.4; 95% CI [1.5-7.7]) of suicide than non-to-moderately depressed ones. Higher suicide risk was associated with more severe depressive symptoms (p for trend = 0.009). After adjustment for depressive symptoms and other factors, very poor health, low education, and past drinking were associated with higher suicide risk, while good health, body mass index, and marital status were not associated with suicide. The sensitivity at the cut-off score of 31 for detecting suicide was higher during the earlier 3.5 years of the follow-up (75%; 95% CI [50-90]) than during the latter 4 years (60%; 95% CI [41-76]). Conclusions. Depressive symptoms are a strong independent predictor and very poor health, low education, and drinking status may be independent predictors of future suicide. The BDI may have acceptable diagnostic properties as a risk assessment tool for identifying people with depression and suicidal potential among middle-aged men.

  4. The prevalence of extreme Middle Eastern ideologies around the world.

    Science.gov (United States)

    Loza, Wagdy; Abd-el-Fatah, Youssef; Prinsloo, Johan; Hesselink-Louw, Anni; Seidler, Katie

    2011-02-01

    The Belief Diversity Scale (BDS) was administered to Australian, Canadian, Egyptian, and South African participants of different religious backgrounds. The BDS is a 33-item, six subscale instrument that is designed to quantitatively measure Middle Eastern extremist ideologies on risk areas that are reported in the literature. Results demonstrated the reliability and validity of the BDS, thus suggesting that the BDS could be used as an objective tool to measure Middle Eastern extremist ideologies. Results also supported the hypothesis of prevalence of Middle Eastern extremist ideologies around different parts of the world.

  5. Formulation and Presentation of Risk Assessments to Address Risk Targets for Radioactive Waste Disposal

    International Nuclear Information System (INIS)

    Wilmot, R.D.

    2002-10-01

    The Swedish regulators have been active in the field of performance assessment of radioactive waste disposal facilities for many years and have developed sophisticated approaches to the development of scenarios and other aspects of assessments. These assessments have generally used dose as the assessment end-point. Regulations recently established in Sweden (SSI FS 1998:1) have introduced a risk criterion for radioactive waste disposal: the annual risk of harmful effects after closure of a disposal facility should not exceed 10 -6 for a representative individual in the group exposed to the greatest risk. This report evaluates different approaches to the definition and use of probabilities in the context of risk assessments, and examines the presentation of the results of risk assessments in safety cases to meet risk targets. The report illustrates the strengths and weaknesses of different possible approaches to risk assessment by reference to assessments in other countries, and provides suggestions for future activity and development in this area by the Swedish regulators. The review of experience in other countries has led to a number of key observations relevant to the conduct of regulatory work on risk assessments and preparations for review. These highlight the importance of developing a protocol for conducting calculations, and linking such a protocol to the requirements of risk assessment calculations and to existing code and model capabilities. There are a number of decisions and assumptions required in developing a risk assessment methodology that could potentially affect the calculated results. These assumptions are independent of the analysis of performance, and relate to issues such as the expectation value of risk, risk dilution, the definition of probability density functions and achieving convergence. A review of a proponent's risk assessment should address these issues in determining the appropriateness and validity of the results presented

  6. Formulation and Presentation of Risk Assessments to Address Risk Targets for Radioactive Waste Disposal

    Energy Technology Data Exchange (ETDEWEB)

    Wilmot, R.D. [Galson Sciences Ltd, Oakham (United Kingdom)

    2002-10-01

    The Swedish regulators have been active in the field of performance assessment of radioactive waste disposal facilities for many years and have developed sophisticated approaches to the development of scenarios and other aspects of assessments. These assessments have generally used dose as the assessment end-point. Regulations recently established in Sweden (SSI FS 1998:1) have introduced a risk criterion for radioactive waste disposal: the annual risk of harmful effects after closure of a disposal facility should not exceed 10{sup -6} for a representative individual in the group exposed to the greatest risk. This report evaluates different approaches to the definition and use of probabilities in the context of risk assessments, and examines the presentation of the results of risk assessments in safety cases to meet risk targets. The report illustrates the strengths and weaknesses of different possible approaches to risk assessment by reference to assessments in other countries, and provides suggestions for future activity and development in this area by the Swedish regulators. The review of experience in other countries has led to a number of key observations relevant to the conduct of regulatory work on risk assessments and preparations for review. These highlight the importance of developing a protocol for conducting calculations, and linking such a protocol to the requirements of risk assessment calculations and to existing code and model capabilities. There are a number of decisions and assumptions required in developing a risk assessment methodology that could potentially affect the calculated results. These assumptions are independent of the analysis of performance, and relate to issues such as the expectation value of risk, risk dilution, the definition of probability density functions and achieving convergence. A review of a proponent's risk assessment should address these issues in determining the appropriateness and validity of the results presented

  7. Intravascular optical imaging of high-risk plaques in vivo by targeting macrophage mannose receptors

    Science.gov (United States)

    Kim, Ji Bak; Park, Kyeongsoon; Ryu, Jiheun; Lee, Jae Joong; Lee, Min Woo; Cho, Han Saem; Nam, Hyeong Soo; Park, Ok Kyu; Song, Joon Woo; Kim, Tae Shik; Oh, Dong Joo; Gweon, Daegab; Oh, Wang-Yuhl; Yoo, Hongki; Kim, Jin Won

    2016-03-01

    Macrophages mediate atheroma expansion and disruption, and denote high-risk arterial plaques. Therefore, they are substantially gaining importance as a diagnostic imaging target for the detection of rupture-prone plaques. Here, we developed an injectable near-infrared fluorescence (NIRF) probe by chemically conjugating thiolated glycol chitosan with cholesteryl chloroformate, NIRF dye (cyanine 5.5 or 7), and maleimide-polyethylene glycol-mannose as mannose receptor binding ligands to specifically target a subset of macrophages abundant in high-risk plaques. This probe showed high affinity to mannose receptors, low toxicity, and allowed the direct visualization of plaque macrophages in murine carotid atheroma. After the scale-up of the MMR-NIRF probe, the administration of the probe facilitated in vivo intravascular imaging of plaque inflammation in coronary-sized vessels of atheromatous rabbits using a custom-built dual-modal optical coherence tomography (OCT)-NIRF catheter-based imaging system. This novel imaging approach represents a potential imaging strategy enabling the identification of high-risk plaques in vivo and holds promise for future clinical implications.

  8. Methods for conducting systematic reviews of risk factors in low- and middle-income countries

    Directory of Open Access Journals (Sweden)

    Yulia Shenderovich

    2016-03-01

    Full Text Available Abstract Background Rates of youth violence are disproportionately high in many low- and middle-income countries [LMICs] but existing reviews of risk factors focus almost exclusively on high-income countries. Different search strategies, including non-English language searches, might be required to identify relevant evidence in LMICs. This paper discusses methodological issues in systematic reviews aiming to include evidence from LMICs, using the example of a recent review of risk factors for child conduct problems and youth violence in LMICs. Methods We searched the main international databases, such as PsycINFO, Medline and EMBASE in English, as well as 12 regional databases in Arabic, Chinese, English, French, Spanish, Portuguese and Russian. In addition, we used internet search engines and Google Scholar, and contacted over 200 researchers and organizations to identify potentially eligible studies in LMICs. Results The majority of relevant studies were identified in the mainstream databases, but additional studies were also found through regional databases, such as CNKI, Wangfang, LILACS and SciELO. Overall, 85 % of eligible studies were in English, and 15 % were reported in Chinese, Spanish, Portuguese, Russian or French. Among eligible studies in languages other than English, two-thirds were identified only by regional databases and one-third was also indexed in the main international databases. Conclusions There are many studies on child conduct problems and youth violence in LMICs which have not been included in prior reviews. Most research on these subjects in LMICs has been produced in the last two-three decades and mostly in middle-income countries, such as China, Brazil, Turkey, South Africa and Russia. Based on our findings, it appears that many studies of child conduct problems and youth violence in LMICs are reported in English, Chinese, Spanish and Portuguese, but few such studies are published in French, Arabic or Russian. If

  9. Non-targeted effects of ionising radiation

    International Nuclear Information System (INIS)

    Belyakov, O.V.

    2008-01-01

    The universality of the target theory of radiation-induced effects is challenged by observations on non-targeted effects such as bystander effects and genomic instability. Essential features of non-targeted effects are that they do not require direct nuclear exposure by radiation and they are particularly significant at low doses. This new evidence suggests a need for a new paradigm in radiation biology. The new paradigm would cover both the classical (targeted) and the non-targeted effects. New aspects include the role of cellular communication and tissue-level responses. A better understanding of non-targeted effects may have important consequences for health risk assessment and, consequently, on radiation protection. Non-targeted effects may contribute to the estimation of cancer risk from occupational, medical and environmental exposures. In particular, they may have implications for the applicability of the Linear-No-Threshold (LNT) model in extrapolating radiation risk data into the low-dose region. This also means that the adequacy of the concept of dose to estimate risk is challenged by these findings. Moreover, these effects may provide new mechanistic explanations for the development of non-cancer diseases. Further research is required to determine if these effects, typically measured in cell cultures, are applicable in tissue level, whole animals, and ultimately in humans. (orig.)

  10. Evaluating risk communication: examining target audience perceptions about four presentation formats for fish consumption health advisory information.

    Science.gov (United States)

    Connelly, N A; Knuth, B A

    1998-10-01

    Information format can influence the extent to which target audiences understand and respond to risk-related information. This study examined four elements of risk information presentation format. Using printed materials, we examined target audience perceptions about: (a) reading level; (b) use of diagrams vs. text; (c) commanding versus cajoling tone; and (d) use of qualitative vs. quantitative information presented in a risk ladder. We used the risk communication topic of human health concerns related to eating noncommercial Great Lakes fish affected by chemical contaminants. Results from the comparisons of specific communication formats indicated that multiple formats are required to meet the needs of a significant percent of anglers for three of the four format types examined. Advisory text should be reviewed to ensure the reading level is geared to abilities of the target audience. For many audiences, a combination of qualitative and quantitative information, and a combination of diagrams and text may be most effective. For most audiences, a cajoling rather than commanding tone better provides them with the information they need to make a decision about fish consumption. Segmenting audiences regarding information needs and communication formats may help clarify which approaches to take with each audience.

  11. Research on energy strategy and Chinese energy investment in the middle east

    Science.gov (United States)

    Huang, Yiling

    2017-08-01

    The Middle East is a key node of “One Belt and One Road strategy”. Energy investment is an important part of Chinese investment in the Middle East. The political turmoil in the Middle East has brought the political risks to Chinese investors. In the future, with the globalization of Chinese resource distribution and the expansion of Chinese outward investment, it is significant for China to ensure its energy security. Based on the analysis of the situation of Chinese energy strategy in the Middle East, this paper tries to put forward some suggestion about Chinese energy investment in the Middle East in order to protect Chinese energy security effectively.

  12. General strategy for the protection of organs at risk in IMRT therapy of a moving body

    International Nuclear Information System (INIS)

    Abolfath, Ramin M.; Papiez, Lech

    2009-01-01

    We investigated protection strategies of organs at risk (OARs) in intensity modulated radiation therapy (IMRT). These strategies apply to delivery of IMRT to moving body anatomies that show relative displacement of OAR in close proximity to a tumor target. We formulated an efficient genetic algorithm which makes it possible to search for global minima in a complex landscape of multiple irradiation strategies delivering a given, predetermined intensity map to a target. The optimal strategy was investigated with respect to minimizing the dose delivered to the OAR. The optimization procedure developed relies on variability of all parameters available for control of radiation delivery in modern linear accelerators, including adaptation of leaf trajectories and simultaneous modification of beam dose rate during irradiation. We showed that the optimization algorithms lead to a significant reduction in the dose delivered to OAR in cases where organs at risk move relative to a treatment target.

  13. General strategy for the protection of organs at risk in IMRT therapy of a moving body

    Energy Technology Data Exchange (ETDEWEB)

    Abolfath, Ramin M.; Papiez, Lech [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas 75390 (United States)

    2009-07-15

    We investigated protection strategies of organs at risk (OARs) in intensity modulated radiation therapy (IMRT). These strategies apply to delivery of IMRT to moving body anatomies that show relative displacement of OAR in close proximity to a tumor target. We formulated an efficient genetic algorithm which makes it possible to search for global minima in a complex landscape of multiple irradiation strategies delivering a given, predetermined intensity map to a target. The optimal strategy was investigated with respect to minimizing the dose delivered to the OAR. The optimization procedure developed relies on variability of all parameters available for control of radiation delivery in modern linear accelerators, including adaptation of leaf trajectories and simultaneous modification of beam dose rate during irradiation. We showed that the optimization algorithms lead to a significant reduction in the dose delivered to OAR in cases where organs at risk move relative to a treatment target.

  14. ‘Why have STI rates increased in the middle age population?’ -A critical review

    OpenAIRE

    Monsell, Ellen

    2013-01-01

    Background- Recent reports have shown that individuals aged 45-64 are at an increased risk of contracting a sexually transmitted infection, with rates rising steadily over the last several years. Sexual health research has historically focused on the needs and behaviours of the young, with more recent interest into the needs of the older population. This has led to an interest into the literature available regarding the population in the middle of these two groups; the ‘middle age’ population...

  15. Sarcopenia and sarcopenic obesity in Spanish community-dwelling middle-aged and older women: Association with balance confidence, fear of falling and fall risk.

    Science.gov (United States)

    Aibar-Almazán, Agustín; Martínez-Amat, Antonio; Cruz-Díaz, David; Jiménez-García, José D; Achalandabaso, Alexander; Sánchez-Montesinos, Indalecio; de la Torre-Cruz, Manuel; Hita-Contreras, Fidel

    2018-01-01

    To analyze the association of sarcopenia, obesity, and sarcopenic obesity (SO) with fear of falling (FoF) and balance confidence in a Spanish sample of middle-aged and older community-dwelling women. A total of 235 women (69.21±7.56 years) participated in this study. Body composition (bioelectrical impedance analysis), hand-grip strength, and physical performance (gait speed) were evaluated for the diagnosis of sarcopenia, obesity, and SO. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. The Activities-Specific Balance Confidence Scale (ABC) and the Falls Efficacy Scale-International (FES-I) were employed to assess FoF and balance confidence, respectively. Scores of >26 on the FES-I and risk of falling. The independent associations of sarcopenia, obesity and SO with FoF, balance confidence, and fall risk were evaluated by multivariate linear and logistic regressions, adjusting for potential confounding variables. 27.23% and 18.72% of women presented with sarcopenia and SO, respectively. Gait speed, body mass index (BMI), and fall history were independently associated with ABC score (adjusted-R 2 =0.152) and fall risk (ABC) (adjusted-R 2 =0.115). FES-I score was independently associated (adjusted-R 2 =0.193) with fall history, gait speed, BMI, and depression, which, together with obesity (BMI) and SO, remained independent factors for fall risk measured as FES-I score (adjusted-R 2 =0.243). In community-dwelling middle-aged and older Spanish women, BMI, gait speed, and fall history were independently associated with FoF, balance confidence, and fall risk. Depression was related only to FoF, and, together with obesity (BMI) and SO, was an independent predictor of fall risk as assessed by the FES-I. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Cardiovascular risk factors in Middle Eastern patients undergoing percutaneous coronary intervention: Results from the first Jordanian percutaneous coronary intervention study.

    Science.gov (United States)

    Hammoudeh, Ayman J; Alhaddad, Imad A; Khader, Yousef; Tabbalat, Ramzi; Al-Mousa, Eyas; Saleh, Akram; Jarrah, Mohamad; Nammas, Assem; Izraiq, Mahmoud

    2017-07-01

    Background and aims: Cardiovascular disease (CVD) is the leading cause of death in the Middle East. We sought to study the prevalence and coexistence of 6 cardiovascular risk factors (RFs) among patients who underwent percutaneous coronary intervention (PCI), and to evaluate the impact of age and gender on the presence of multiple RFs. In this prospective, multicenter study, 2426 consecutive patients were enrolled. Mean age was 59.0 ± 10.1 years and 500 (20.6%) were women. Acute coronary syndrome and stable coronary disease were the indications for PCI in 77.1% and 22.9%, respectively. Hypertension was present in 62.3%, diabetes in 53.8%, hypercholesterolemia in 48.8%, smoking in 43.5%, family history of premature CVD 39.4% and obesity in 28.8%. Only 3.8% did not have any of these RFs. Presence of ⩾3 and ⩾4 RFS was observed in 57.4% and 29.5% of patients, respectively. Presence of ⩾3 RFs was more common in women than men (69.0% vs. 54.5%, p  Eastern population undergoing PCI. More than half and more than one-fourth of the patients had at least 3 or 4 RFs; respectively. More women than men and more middle aged patients than older or younger patients had significantly higher rates of presence of multiple RFs.

  17. The effects of Risk Factor-Targeted Lifestyle Counselling Intervention on working-age stroke patients' adherence to lifestyle change.

    Science.gov (United States)

    Oikarinen, Anne; Engblom, Janne; Kääriäinen, Maria; Kyngäs, Helvi

    2017-09-01

    Since a history of stroke or transient ischaemic attack is a major risk factor for a recurrent event, lifestyle counselling during the hospital phase is an essential component of treatment and may increase the probability of lifestyle change. To study the effect of risk factor-targeted lifestyle counselling intervention on working-age stroke patients' adherence to lifestyle changes. A quasi-experimental, nonequivalent control group pretest-post-test design. Stroke patients in an acute neurological unit were divided into a control group (n = 75) receiving standard counselling and an experimental group (n = 75) receiving risk factor-targeted counselling. Lifestyle data and clinical outcomes were collected at hospital between January 2010 and October 2011, while data on adherence to lifestyle changes 3, 6, and 12 months after discharge. The baseline lifestyle habits did not differ significantly other than in alcohol behaviour. Both groups increased their intake, but the intervention group to a lesser degree. However, the experimental group significantly lost their weight for the first 3 and 6 months; at 3 months reduction in cigarette consumption and at 6 months significant increases in smoking cessation were also achieved. All improved some of their lifestyle habits. Intervention was associated with support from nurses as well as from family and friends. Adherence scores were higher in the experimental group. Some short-term advantages in lifestyle habits due to the intervention were noted. Participants in both groups improved some of their lifestyle habits. © 2016 Nordic College of Caring Science.

  18. Fixed target physics at high energies

    International Nuclear Information System (INIS)

    Kirk, T.B.

    1984-01-01

    The number and type of fixed target experiments that can be pursued at a proton synchrotron are very large. The advent of the Fermilab superconducting accelerator, the Tevatron, will extend and improve the results which are given here from recent CERN and Fermilab experiments. The sample of experiments given in this paper is neither meant to be inclusive nor intensive. Hopefully, it will give the flavor of contemporary fixed target physics to a predominantly cosmic ray oriented audience. (author)

  19. Experimental results from a flowing-lithium target

    International Nuclear Information System (INIS)

    Annese, C.E.; Schwartz, K.E.

    1982-01-01

    Hydraulic stability of a free surface lithium jet was demonstrated at 260 0 C and from the middle-vacuum region of 0.01 Pa (10 - 4 Torr) up to 124 kPa (18 psia). The jet is formed by flowing lithium at rates to 0.04 m 3 /s (600 GPM) through a precisely defined nozzle which directs the flow along a curved wall where velocities of up to 17 m/s are attained. This nozzle and curved wall configuration form the basis of the Fusion Materials Irradiation Test (FMIT) Facility lithium target. A full-size experimental model of this target is presently under test with flowing lithium in the Experimental Lithium System (ELS). The FMIT is being developed for the Department of Energy by the Westinghouse Hanford Company at the Hanford Engineering Development Laboratory

  20. Who are the fathers in Healthy Families Arizona? An examination of father data in at-risk families.

    Science.gov (United States)

    Shapiro, Alyson F; Krysik, Judy; Pennar, Amy L

    2011-07-01

    Despite substantial research documenting the importance of father-child relations, little is known about fathers in families considered at risk for child abuse, and this lack of information makes adequate targeting of fathers in interventions challenging. This research aims to provide information that will aid interventions in targeting fathers and addressing father-related family issues through: (a) providing descriptive information regarding fathers in families at risk for child abuse, and (b) examining aspects of family well-being relative to father involvement. Analyses were conducted on mother-report data in families eligible for the Healthy Families Arizona prevention program (N = 197). Results indicated that although only 15% of parents in the sample were married, 47% of families had resident fathers, and 77% of fathers had some contact with their new babies. Families with greater father involvement had better prenatal care, higher incomes, less maternal involvement in Child Protective Services, less physical domestic violence (DV), and greater maternal mental health reflected through less loneliness. These findings have implications for targeting nonresident as well as resident fathers in families at risk for child abuse and for exploring DV issues in families with noninvolved fathers. © 2011 American Orthopsychiatric Association.

  1. Chronic lymphocytic leukemia and infection risk in the era of targeted therapies: Linking mechanisms with infections.

    Science.gov (United States)

    Hilal, Talal; Gea Banacloche, Juan C; Leis, Jose F

    2018-03-16

    Chronic lymphocytic leukemia (CLL) is the most common adult leukemia in the world. Patient with CLL are at particular risk for infections due to inherent disease-related immune dysfunction in addition to the effect of certain systemic therapies on the immune system. The advent of B-cell receptor (BCR) inhibitors such as ibrutinib and idelalisib has led to a practice change that utilizes these targeted agents in the treatment of CLL, either in place of chemoimmunotherapy (CIT) or in later line settings. In this paper, we review the pathophysiology of immune dysfunction in CLL, the spectrum of immunodeficiency with the various therapeutic agents along with prevention strategies with a focus on targeted therapies. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Predictive Risk Factors for Impaired Quality of Life in Middle-Aged Women with Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    Youn-Jung Son

    2010-12-01

    Full Text Available Purpose Urinary incontinence (UI has substantial and important impacts on quality of life (QoL. The purpose of this study was to identify the associated risk factors of QoL in middle-aged women with UI. Methods The participants were 127 women aged 40-64 years who experienced UI. Data were collected from October to November, 2008 using a self-reported questionnaires. The data were analyzed through t-test, one-way ANOVA, Scheffe test, and multiple linear regression with SPSS ver. 16.0 program. Results The distribution of UI severity was mild 18.1%, moderate 40.2% and severe 41.7%. In univariate analysis, differences in the score for QoL according to participants' characteristics were statistically significant on the type of delivery, number of births and severity of UI. In multiple linear regression analysis after adjustment of other variables, the most powerful predictor of QoL is severity of UI. Number of births was also significant predictor. These two variables explained 25% of variance in QoL of women with UI. Conclusions UI is highly prevalent and causes suffering and impaired QoL among middle-aged women, but it stands beyond our attention. The results of this study suggest that women with moderate to severe UI should be screened for QoL by health care providers regularly. Further research is needed to determine comprehensive factors including psychosocial factors predicting the QoL for incontinent women.

  3. Diabetes and depression comorbidity and socio-economic status in low and middle income countries (LMICs: a mapping of the evidence

    Directory of Open Access Journals (Sweden)

    Leone Tiziana

    2012-11-01

    Full Text Available Abstract Non-communicable diseases account for more than 50% of deaths in adults aged 15–59 years in most low income countries. Depression and diabetes carry an enormous public health burden, making the identification of risk factors for these disorders an important strategy. While socio-economic inequalities in chronic diseases and their risk factors have been studied extensively in high-income countries, very few studies have investigated social inequalities in chronic disease risk factors in low or middle-income countries. Documenting chronic disease risk factors is important for understanding disease burdens in poorer countries and for targeting specific populations for the most effective interventions. The aim of this review is to systematically map the evidence for the association of socio-economic status with diabetes and depression comorbidity in low and middle income countries. The objective is to identify whether there is any evidence on the direction of the relationship: do co-morbidities have an impact on socio-economic status or vice versa and whether the prevalence of diabetes combined with depression is associated with socio-economic status factors within the general population. To date no other study has reviewed the evidence for the extent and nature of this relationship. By systematically mapping the evidence in the broader sense we can identify the policy and interventions implications of existing research, highlight the gaps in knowledge and suggest future research. Only 14 studies were found to analyse the associations between depression and diabetes comorbidity and socio-economic status. Studies show some evidence that the occurrence of depression among people with diabetes is associated with lower socio-economic status. The small evidence base that considers diabetes and depression in low and middle income countries is out of step with the scale of the burden of disease.

  4. Management of severe asthma: targeting the airways, comorbidities and risk factors.

    Science.gov (United States)

    Gibson, Peter G; McDonald, Vanessa M

    2017-06-01

    Severe asthma is a complex heterogeneous disease that is refractory to standard treatment and is complicated by multiple comorbidities and risk factors. In mild to moderate asthma, the burden of disease can be minimised by inhaled corticosteroids, bronchodilators and self-management education. In severe asthma, however, management is more complex. When patients with asthma continue to experience symptoms and exacerbations despite optimal management, severe refractory asthma (SRA) should be suspected and confirmed, and other aetiologies ruled out. Once a diagnosis of SRA is established, patients should undergo a systematic and multidimensional assessment to identify inflammatory endotypes, risk factors and comorbidities, with targeted and individualised management initiated. We describe a practical approach to assessment and management of patients with SRA. © 2017 Royal Australasian College of Physicians.

  5. Stringent Nucleotide Recognition by the Ribosome at the Middle Codon Position

    Directory of Open Access Journals (Sweden)

    Wei Liu

    2017-08-01

    Full Text Available Accurate translation of the genetic code depends on mRNA:tRNA codon:anticodon base pairing. Here we exploit an emissive, isosteric adenosine surrogate that allows direct measurement of the kinetics of codon:anticodon University of California base formation during protein synthesis. Our results suggest that codon:anticodon base pairing is subject to tighter constraints at the middle position than at the 5′- and 3′-positions, and further suggest a sequential mechanism of formation of the three base pairs in the codon:anticodon helix.

  6. Culture and Language Learning: Middle Eastern Students.

    Science.gov (United States)

    Magrath, Douglas

    Middle Eastern students face cultural conflicts in adapting to the western value system. While feeling obligated to maintain their native culture they also need to feel comfortable with the culture of their target language. In attempting to identify with a new group, ESL students may sense a loss of membership in their native group. Culture stress…

  7. Impaired insulin signaling and spatial learning in middle-aged rats: The role of PTP1B.

    Science.gov (United States)

    Kuga, Gabriel Keine; Muñoz, Vitor Rosetto; Gaspar, Rafael Calais; Nakandakari, Susana Castelo Branco Ramos; da Silva, Adelino Sanchez Ramos; Botezelli, José Diego; Leme, José Alexandre Curiacos de Almeida; Gomes, Ricardo José; de Moura, Leandro Pereira; Cintra, Dennys Esper; Ropelle, Eduardo Rochete; Pauli, José Rodrigo

    2018-04-01

    The insulin and Brain-Derived Neurotrophic Factor (BDNF) signaling in the hippocampus promotes synaptic plasticity and memory formation. On the other hand, aging is related to the cognitive decline and is the main risk factor for Alzheimer's Disease (AD). The Protein-Tyrosine Phosphatase 1B (PTP1B) is related to several deleterious processes in neurons and emerges as a promising target for new therapies. In this context, our study aims to investigate the age-related changes in PTP1B content, insulin signaling, β-amyloid content, and Tau phosphorylation in the hippocampus of middle-aged rats. Young (3 months) and middle-aged (17 months) Wistar rats were submitted to Morris-water maze (MWM) test, insulin tolerance test, and molecular analysis in the hippocampus. Aging resulted in increased body weight, and insulin resistance and decreases learning process in MWM. Interestingly, the middle-aged rats have higher levels of PTP-1B, lower phosphorylation of IRS-1, Akt, GSK3β, mTOR, and TrkB. Also, the aging process increased Tau phosphorylation and β-amyloid content in the hippocampus region. In summary, this study provides new evidence that aging-related PTP1B increasing, contributing to insulin resistance and the onset of the AD. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Outcomes of Middle Eastern Patients Undergoing Percutaneous Coronary Intervention: The Primary Analysis of the First Jordanian PCI Registry.

    Science.gov (United States)

    Alhaddad, Imad A; Tabbalat, Ramzi; Khader, Yousef; Al-Mousa, Eyas; Izraiq, Mahmoud; Nammas, Assem; Jarrah, Mohammad; Saleh, Akram; Hammoudeh, Ayman

    2017-01-01

    This is a prospective multicenter registry designed to evaluate the incidence of adverse cardiovascular events in Middle Eastern patients undergoing percutaneous coronary interventions (PCI). The registry was also designed to determine the predictors of poor outcomes in such patients. We enrolled 2426 consecutive patients who underwent PCI at 12 tertiary care centers in Jordan between January 2013 and February 2014. A case report form was used to record data prospectively at hospital admission, discharge, and 12 months of follow-up. Mean age was 56 ± 11 years, females comprised 21% of the study patients, 62% had hypertension, 53% were diabetics, and 57% were cigarette smokers. Most patients (77%) underwent PCI for acute coronary syndrome. In-hospital and 1-year mortality rates were 0.78% and 1.94%, respectively. Definite or probable stent thrombosis occurred in 9 patients (0.37%) during hospitalization and in 47 (1.94%) at 1 year. Rates of target vessel repeat PCI and coronary artery bypass graft surgery at 1 year were 3.4% and 0.6%, respectively. The multivariate analysis revealed that cardiogenic shock, congestive heart failure, ST-segment deviation, diabetes, and major bleeding were significantly associated with higher risk of 1-year mortality. In this first large Jordanian registry of Middle Eastern patients undergoing PCI, patients treated were relatively young age population with low in-hospital and 1-year adverse cardiovascular events. Certain clinical features were associated with worse outcomes and may warrant aggressive therapeutic strategies.

  9. Moving target feature phenomenology data collection at China Lake

    Science.gov (United States)

    Gross, David C.; Hill, Jeff; Schmitz, James L.

    2002-08-01

    This paper describes the DARPA Moving Target Feature Phenomenology (MTFP) data collection conducted at the China Lake Naval Weapons Center's Junction Ranch in July 2001. The collection featured both X-band and Ku-band radars positioned on top of Junction Ranch's Parrot Peak. The test included seven targets used in eleven configurations with vehicle motion consisting of circular, straight-line, and 90-degree turning motion. Data was collected at 10-degree and 17-degree depression angles. Key parameters in the collection were polarization, vehicle speed, and road roughness. The collection also included a canonical target positioned at Junction Ranch's tilt-deck turntable. The canonical target included rotating wheels (military truck tire and civilian pick-up truck tire) and a flat plate with variable positioned corner reflectors. The canonical target was also used to simulate a rotating antenna and a vibrating plate. The target vehicles were instrumented with ARDS pods for differential GPS and roll, pitch and yaw measurements. Target motion was also documented using a video camera slaved to the X-band radar antenna and by a video camera operated near the target site.

  10. Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

    Science.gov (United States)

    Mendes, Romeu; Sousa, Nelson; Reis, Victor Machado; Themudo-Barata, Jose Luis

    2017-09-13

    The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. Participants ( n = 124; 63.25 ± 7.20 years old) engaged in either a 9-month supervised exercise program ( n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session) or a control group ( n = 85) who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. A significant time * group interaction effect ( p exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628.

  11. Effect of cyclic pre-strain on low cycle fatigue life at middle high temperature

    International Nuclear Information System (INIS)

    Nakane, Motoki; Kanno, Satoshi; Takagi, Yoshio

    2011-01-01

    This study examined the effect of cyclic plastic pre-strain on low cycle fatigue life at middle high temperature to evaluate the structural integrity of the nuclear components introduced plastic strain to the local portion by the large seismic load. The materials selected in this study were austenitic steel (SUS316NG) and ferritic steel (SFVQ1A, STS410: JIS (Japanese Industrial Standards). The low cycle fatigue tests at RT and middle high temperature (300 degrees C) were carried out using cyclic plastic pre-strained materials. The results obtained here show that the damage by the cyclic plastic pre-strain, which is equivalent to usage factor UF=0.2, does not affect the fatigue lives of the materials. In addition, it is confirmed that the estimation based on the usage factor UF can also be useful for the life prediction at 300 degrees C as well as RT. (author)

  12. Charm and beauty measurements at Fermilab fixed target

    International Nuclear Information System (INIS)

    Mishra, C.S.

    1993-10-01

    Eighteen months after a successful run of the Fermilab fixed target program, interesting results from several experiments are available. This is the first time that more than one Fermilab fixed target experiment has reported the observation of beauty mesons. In this paper we review recent results from charm and beauty fixed target experiments at Fermilab

  13. Charm and beauty measurements at Fermilab fixed target

    International Nuclear Information System (INIS)

    Mishra, C.S.

    1993-01-01

    Eighteen months after a successful run of the Fermilab fixed target program, interesting results from several experiments are available. This is the first time that more than one Fermilab fixed target experiment has reported the observation of beauty mesons. In this paper the author reviews recent results from charm and beauty fixed target experiments at Fermilab

  14. Development of an intervention delivered by mobile phone aimed at decreasing unintended pregnancy among young people in three lower middle income countries.

    Science.gov (United States)

    McCarthy, Ona L; Wazwaz, Ola; Osorio Calderon, Veronica; Jado, Iman; Saibov, Salokhiddin; Stavridis, Amina; López Gallardo, Jhonny; Tokhirov, Ravshan; Adada, Samia; Huaynoca, Silvia; Makleff, Shelly; Vandewiele, Marieka; Standaert, Sarah; Free, Caroline

    2018-05-02

    Unintended pregnancies can result in poorer health outcomes for women, children and families. Young people in low and middle income countries are at particular risk of unintended pregnancies and could benefit from innovative contraceptive interventions. There is growing evidence that interventions delivered by mobile phone can be effective in improving a range of health behaviours. This paper describes the development of a contraceptive behavioural intervention delivered by mobile phone for young people in Tajikistan, Bolivia and Palestine, where unmet need for contraception is high among this group. Guided by Intervention Mapping, the following steps contributed to the development of the interventions: (1) needs assessment; (2) specifying behavioural change to result from the intervention; (3) selecting behaviour change methods to include in the intervention; (4) producing and refining the intervention content. The results of the needs assessment produced similar interventions across the countries. The interventions consist of short daily messages delivered over 4 months (delivered by text messaging in Palestine and mobile phone application instant messages in Bolivia and Tajikistan). The messages provide information about contraception, target attitudes that are barriers to contraceptive uptake and support young people in feeling that they can influence their reproductive health. The interventions each contain the same ten behaviour change methods, adapted for delivery by mobile phone. The development resulted in a well-specified, theory-based intervention, tailored to each country. It is feasible to develop an intervention delivered by mobile phone for young people in resource-limited settings.

  15. The Effect of Bullying and Victimization on Cognitive Empathy Development during the Transition to Middle School

    Science.gov (United States)

    Williford, Anne; Boulton, Aaron J.; Forrest-Bank, Shandra S.; Bender, Kimberly A.; Dieterich, William A.; Jenson, Jeffrey M.

    2016-01-01

    Background: Interventions aimed at reducing bullying behavior commonly target the development of empathy. Yet, few longitudinal studies have investigated how empathy levels vary with bullying and victimization over time, especially during the transition to middle school. Objective: To that end, the purpose of the present study was to: (1) examine…

  16. Identifying children at risk for being bullies in the United States.

    Science.gov (United States)

    Shetgiri, Rashmi; Lin, Hua; Flores, Glenn

    2012-01-01

    To identify risk factors associated with the greatest and lowest prevalence of bullying perpetration among U.S. children. Using the 2001-2002 Health Behavior in School-Aged Children, a nationally representative survey of U.S. children in 6th-10th grades, bivariate analyses were conducted to identify factors associated with any (once or twice or more), moderate (two to three times/month or more), and frequent (weekly or more) bullying. Stepwise multivariable analyses identified risk factors associated with bullying. Recursive partitioning analysis (RPA) identified risk factors which, in combination, identify students with the highest and lowest bullying prevalence. The prevalence of any bullying in the 13,710 students was 37.3%, moderate bullying was 12.6%, and frequent bullying was 6.6%. Characteristics associated with bullying were similar in the multivariable analyses and RPA clusters. In RPA, the highest prevalence of any bullying (67%) accrued in children with a combination of fighting and weapon-carrying. Students who carry weapons, smoke, and drink alcohol more than 5 to 6 days/week were at greatest risk for moderate bullying (61%). Those who carry weapons, smoke, have more than one alcoholic drink per day, have above-average academic performance, moderate/high family affluence, and feel irritable or bad-tempered daily were at greatest risk for frequent bullying (68%). Risk clusters for any, moderate, and frequent bullying differ. Children who fight and carry weapons are at greatest risk of any bullying. Weapon-carrying, smoking, and alcohol use are included in the greatest risk clusters for moderate and frequent bullying. Risk-group categories may be useful to providers in identifying children at the greatest risk for bullying and in targeting interventions. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  17. Longitudinal Youth-At-Risk Study (LYRIKS): outreach strategies based on a community-engaged framework.

    Science.gov (United States)

    Mitter, Natasha; Nah, Guo Quan Ryan; Bong, Yioe Ling; Lee, Jimmy; Chong, Siow-Ann

    2014-08-01

    Schizophrenia and psychoses are debilitating disorders often leading to serious functional impairments. Early detection efforts have shifted focus to the prodromal phase and the emphasis is now on individuals at risk of developing psychosis. The Longitudinal Youth-At-Risk Study (LYRIKS) seeks to elucidate the biological markers of psychosis. This paper describes the application of a community-engaged framework to the outreach strategies of LYRIKS. It describes the outreach goals, strategies used and their impact, as well as the various challenges faced by the research team and community partners. The target population was defined. Community organizations having close ties with the target population were identified and approached for collaboration. These included educational and healthcare institutions, and government and welfare organizations. Strategies were categorized as active or passive. Active strategies included clinical screening and recruitment, workshops, roadshows and student internships. Passive strategies included utilizing print and social media. Three thousand three hundred twenty-one youth were approached and 401 called the hotline to find out more about the study. Three thousand five hundred one were pre-screened; 864 were further screened using the Comprehensive Assessment of At Risk Mental State. One hundred seventy-eight and 346 were eventually recruited as subjects and controls, respectively. Challenges encountered included differing priorities, maintaining collaborative relationships, stigmatization and inadequate understanding of the profile of at risk youth. Future community-engaged research should be conducted more comprehensively to generate maximum benefits. © 2013 Wiley Publishing Asia Pty Ltd.

  18. Managing risk at Hanford

    International Nuclear Information System (INIS)

    Hesser, W.A.; Stillwell, W.G.; Rutherford, W.A.

    1994-01-01

    Clearly, there is sufficient motivation from Washington for the Hanford community to pay particular attention to the risks associated with the substantial volumes of radiological, hazardous, and mixed waste at Hanford. But there is also another reason for emphasizing risk: Hanford leaders have come to realize that their decisions must consider risk and risk reduction if those decisions are to be technically sound, financially affordable, and publicly acceptable. The 560-square miles of desert land is worth only a few thousand dollars an acre (if that) -- hardly enough to justify the almost two billion dollars that will be spent at Hanford this year. The benefit of cleaning up the Hanford Site is not the land but the reduction of potential risk to the public and the environment for future generations. If risk reduction is our ultimate goal, decisions about priority of effort and resource allocation must consider those risks, now and in the future. The purpose of this paper is to describe how Hanford is addressing the issues of risk assessment, risk management, and risk-based decision making and to share some of our experiences in these areas

  19. Fixed target facility at the SSC

    Energy Technology Data Exchange (ETDEWEB)

    Loken, S.C.; Morfin, J.G.

    1985-01-01

    The question of whether a facility for fixed target physics should be provided at the SSC must be answered before the final technical design of the SSC can be completed, particularly if the eventual form of extraction would influence the magnet design. To this end, an enthusiastic group of experimentalists, theoreticians and accelerator specialists have studied this point. The accelerator physics issues were addressed by a group led by E. Colton whose report is contained in these proceedings. The physics addressable by fixed target was considered by many of the Physics area working groups and in particular by the Structure Function Group. This report is the summary of the working group which considered various SSC fixed target experiments and determined which types of beams and detectors would be required. 13 references, 5 figures.

  20. Fixed target facility at the SSC

    International Nuclear Information System (INIS)

    Loken, S.C.; Morfin, J.G.

    1985-01-01

    The question of whether a facility for fixed target physics should be provided at the SSC must be answered before the final technical design of the SSC can be completed, particularly if the eventual form of extraction would influence the magnet design. To this end, an enthusiastic group of experimentalists, theoreticians and accelerator specialists have studied this point. The accelerator physics issues were addressed by a group led by E. Colton whose report is contained in these proceedings. The physics addressable by fixed target was considered by many of the Physics area working groups and in particular by the Structure Function Group. This report is the summary of the working group which considered various SSC fixed target experiments and determined which types of beams and detectors would be required. 13 references, 5 figures

  1. Mesoscale circulation at the upper cloud level at middle latitudes from the imaging by Venus Monitoring Camera onboard Venus Express

    Science.gov (United States)

    Patsaeva, Marina; Ignatiev, Nikolay; Markiewicz, Wojciech; Khatuntsev, Igor; Titov, Dmitrij; Patsaev, Dmitry

    The Venus Monitoring Camera onboard ESA Venus Express spacecraft acquired a great number of UV images (365 nm) allowing us to track the motion of cloud features at the upper cloud layer of Venus. A digital method developed to analyze correlation functions between two UV images provided wind vector fields on the Venus day side (9-16 hours local time) from the equator to high latitudes. Sizes and regions for the correlation were chosen empirically, as a trade-off of sensitivity against noise immunity and vary from 10(°) x7.5(°) to 20(°) x10(°) depending on the grid step, making this method suitable to investigate the mesoscale circulation. Previously, the digital method was used for investigation of the circulation at low latitudes and provided good agreement with manual tracking of the motion of cloud patterns. Here we present first results obtained by this method for middle latitudes (25(°) S-75(°) S) on the basis of 270 orbits. Comparing obtained vector fields with images for certain orbits, we found a relationship between morphological patterns of the cloud cover at middle latitudes and parameters of the circulation. Elongated cloud features, so-called streaks, are typical for middle latitudes, and their orientation varies over wide range. The behavior of the vector field of velocities depends on the angle between the streak and latitude circles. In the middle latitudes the average angle of the flow deviation from the zonal direction is equal to -5.6(°) ± 1(°) (the sign “-“ means the poleward flow, the standard error is given). For certain orbits, this angle varies from -15.6(°) ± 1(°) to 1.4(°) ± 1(°) . In some regions at latitudes above 60(°) S the meridional wind is equatorward in the morning. The relationship between the cloud cover morphology and circulation peculiarity can be attributed to the motion of the Y-feature in the upper cloud layer due to the super-rotation of the atmosphere.

  2. Communication Between Middle SES Black Women and Healthcare Providers About HIV Testing.

    Science.gov (United States)

    Fray, Niasha A; Caldwell, Kia Lilly

    2017-01-01

    This article explores the impact of patient and healthcare provider communication (PPC) on the HIV testing behaviors of middle socioeconomic status (SES) Black women in North Carolina. We explore how PPC about STIs and HIV (or the lack thereof) affects the provision of STI/HIV testing by either confirming the need for middle SES Black women to test routinely or potentially deterring women from feeling they need to be tested. After conducting 15 qualitative interviews with middle SES Black women between 25 and 45 years of age, we uncovered the role of patient self-advocacy in promoting HIV testing among middle SES Black women when they communicate with their healthcare providers. We discuss the importance of healthcare providers engaging their middle SES Black female patients in routine discussions about sexual health and sexual risk reduction, regardless of providers' perceptions of their potential STI/HIV risk. We recommend including SES as a variable in data collection and research in order to better understand how social class, race, and gender affect sexual health behavior and the provision of STI and HIV/AIDS prevention to diverse populations. Copyright © 2016 National Medical Association. Published by Elsevier Inc. All rights reserved.

  3. Targeted outreach hepatitis B vaccination program in high-risk adults : The fundamental challenge of the last mile

    NARCIS (Netherlands)

    Mangen, M. J.J.; Stibbe, H; Urbanus, A.; Siedenburg, E C; Waldhober, Q; de Wit, G. A.; Steenbergen, Eric J

    2017-01-01

    Background The aim of this study was to evaluate the cost-effectiveness of the on-going decentralised targeted hepatitis B vaccination program for behavioural high-risk groups operated by regional public health services in the Netherlands since 1-November-2002. Target groups for free vaccination are

  4. Common variants at the CHEK2 gene locus and risk of epithelial ovarian cancer

    DEFF Research Database (Denmark)

    Lawrenson, Kate; Iversen, Edwin S; Tyrer, Jonathan

    2015-01-01

    genes and EOC risk. We genotyped 2896 common variants at 143 gene loci in DNA samples from 15 397 patients with invasive EOC and controls. We found evidence of associations with EOC risk for variants at FANCA, EXO1, E2F4, E2F2, CREB5 and CHEK2 genes (P ≤ 0.001). The strongest risk association......, CHEK2 gene expression was significantly higher in primary EOCs compared to normal fallopian tube tissues (P = 3.72×10(-8)). We also identified an association between genotypes of the candidate causal SNP rs12166475 (r (2) = 0.99 with rs6005807) and CHEK2 expression (P = 2.70×10(-8)). These data suggest...... that common variants at 22q12.1 are associated with risk of serous EOC and CHEK2 as a plausible target susceptibility gene....

  5. Biodiversity at risk under future cropland expansion and intensification.

    Science.gov (United States)

    Kehoe, Laura; Romero-Muñoz, Alfredo; Polaina, Ester; Estes, Lyndon; Kreft, Holger; Kuemmerle, Tobias

    2017-08-01

    Agriculture is the leading driver of biodiversity loss. However, its future impact on biodiversity remains unclear, especially because agricultural intensification is often neglected, and high path-dependency is assumed when forecasting agricultural development-although the past suggests that shock events leading to considerable agricultural change occur frequently. Here, we investigate the possible impacts on biodiversity of pathways of expansion and intensification. Our pathways are not built to reach equivalent production targets, and therefore they should not be directly compared; they instead highlight areas at risk of high biodiversity loss across the entire option space of possible agricultural change. Based on an extensive database of biodiversity responses to agriculture, we find 30% of species richness and 31% of species abundances potentially lost because of agricultural expansion across the Amazon and Afrotropics. Only 21% of high-risk expansion areas in the Afrotropics overlap with protected areas (compared with 43% of the Neotropics). Areas at risk of biodiversity loss from intensification are found in India, Eastern Europe and the Afromontane region (7% species richness, 13% abundance loss). Many high-risk regions are not adequately covered by conservation prioritization schemes, and have low national conservation spending and high agricultural growth. Considering rising agricultural demand, we highlight areas where timely land-use planning may proactively mitigate biodiversity loss.

  6. Randomized Controlled Evaluation of the "Too Good for Drugs" Prevention Program: Impact on Adolescents at Different Risk Levels for Drug Use

    Science.gov (United States)

    Hall, Bruce W.; Bacon, Tina P.; Ferron, John M.

    2013-01-01

    Sixth graders participating in the "Too Good for Drugs" (TGFD) prevention program in comparison to 6th graders not participating show different results by student risk level. Sixth graders from 20 middle schools were randomly assigned to receive the intervention and those from 20 paired middle schools assigned to serve as controls (N =…

  7. Association of obesity in early adulthood and middle age with incipient left ventricular dysfunction and structural remodeling: the CARDIA study (Coronary Artery Risk Development in Young Adults).

    Science.gov (United States)

    Kishi, Satoru; Armstrong, Anderson C; Gidding, Samuel S; Colangelo, Laura A; Venkatesh, Bharath A; Jacobs, David R; Carr, J Jeffery; Terry, James G; Liu, Kiang; Goff, David C; Lima, João A C

    2014-10-01

    The goal of this study was to investigate the relationship of body mass index (BMI) and its 25-year change to left ventricular (LV) structure and function. Longstanding obesity may be associated with clinical cardiac dysfunction and heart failure. Whether obesity relates to cardiac dysfunction during young adulthood and middle age has not been investigated. The CARDIA (Coronary Artery Risk Development in Young Adult) study enrolled white and black adults ages 18 to 30 years in 1985 to 1986 (Year-0). At Year-25, cardiac function was assessed by conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE). Twenty-five-year change in BMI (classified as low: obesity from young adulthood to middle age is associated with impaired LV systolic and diastolic function assessed by conventional echocardiography, TDI, and STE in a large biracial cohort of adults age 43 to 55 years. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  8. Disability Among Middle-Aged and Older Persons With Human Immunodeficiency Virus Infection.

    Science.gov (United States)

    Johs, Nikolas A; Wu, Kunling; Tassiopoulos, Katherine; Koletar, Susan L; Kalayjian, Robert C; Ellis, Ronald J; Taiwo, Babafemi; Palella, Frank J; Erlandson, Kristine M

    2017-07-01

    Older human immunodeficiency virus (HIV)-infected adults may experience higher rates of frailty and disability than the general population. Improved understanding of the prevalence, risk factors, and types of impairment can better inform providers and the healthcare system. HIV-infected participants within the AIDS Clinical Trials Group A5322 HAILO study self-reported disability by the Lawton-Brody Instrumental Activities of Daily Living (IADL) Questionnaire. Frailty was measured by 4-m walk time, grip strength, self-reported weight loss, exhaustion, and low activity. Logistic regression models identified characteristics associated with any IADL impairment. Agreement between IADL impairment and frailty was assessed using the weighted kappa statistic. Of 1015 participants, the median age was 51 years, 15% were aged ≥60 years, 19% were female, 29% black, and 20% Hispanic. At least 1 IADL impairment was reported in 18% of participants, most commonly with housekeeping (48%) and transportation (36%) and least commonly with medication management (5%). In multivariable models, greater disability was significantly associated with neurocognitive impairment, lower education, Medicare/Medicaid insurance (vs private/other coverage), smoking, and low physical activity. Although a greater proportion of frail participants had IADL impairment (52%) compared to non-frail (11%) persons, agreement was poor (weighted kappa disability occurs frequently among middle-aged and older HIV-infected adults on effective antiretroviral therapy. Potentially modifiable risk factors (smoking, physical activity) provide targets for interventions to maintain independent living. Systematic recognition of persons at greater risk for disability can facilitate connection to resources that may help preserve independence. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  9. Estimation of value at risk and conditional value at risk using normal mixture distributions model

    Science.gov (United States)

    Kamaruzzaman, Zetty Ain; Isa, Zaidi

    2013-04-01

    Normal mixture distributions model has been successfully applied in financial time series analysis. In this paper, we estimate the return distribution, value at risk (VaR) and conditional value at risk (CVaR) for monthly and weekly rates of returns for FTSE Bursa Malaysia Kuala Lumpur Composite Index (FBMKLCI) from July 1990 until July 2010 using the two component univariate normal mixture distributions model. First, we present the application of normal mixture distributions model in empirical finance where we fit our real data. Second, we present the application of normal mixture distributions model in risk analysis where we apply the normal mixture distributions model to evaluate the value at risk (VaR) and conditional value at risk (CVaR) with model validation for both risk measures. The empirical results provide evidence that using the two components normal mixture distributions model can fit the data well and can perform better in estimating value at risk (VaR) and conditional value at risk (CVaR) where it can capture the stylized facts of non-normality and leptokurtosis in returns distribution.

  10. Psychosocial Factors Associated with Smoking Intention in Korean Male Middle School Students

    Science.gov (United States)

    Ra, Jin Suk; Cho, Yoon Hee

    2017-01-01

    This study examined psychosocial factors influencing smoking intention in Korean male middle school students. We used a descriptive cross-sectional design, based on the biopsychosocial model, to analyze data from 309 male adolescents aged 14-16 years in middle school. Of the psychological factors examined, stress and risk-taking tendency were…

  11. Case mix-adjusted cost of colectomy at low-, middle-, and high-volume academic centers.

    Science.gov (United States)

    Chang, Alex L; Kim, Young; Ertel, Audrey E; Hoehn, Richard S; Wima, Koffi; Abbott, Daniel E; Shah, Shimul A

    2017-05-01

    Efforts to regionalize surgery based on thresholds in procedure volume may have consequences on the cost of health care delivery. This study aims to delineate the relationship between hospital volume, case mix, and variability in the cost of operative intervention using colectomy as the model. All patients undergoing colectomy (n = 90,583) at 183 academic hospitals from 2009-2012 in The University HealthSystems Consortium Database were studied. Patient and procedure details were used to generate a case mix-adjusted predictive model of total direct costs. Observed to expected costs for each center were evaluated between centers based on overall procedure volume. Patient and procedure characteristics were significantly different between volume tertiles. Observed costs at high-volume centers were less than at middle- and low-volume centers. According to our predictive model, high-volume centers cared for a less expensive case mix than middle- and low-volume centers ($12,786 vs $13,236 and $14,497, P case mix at low-volume centers, which may lead to perceived poor performance at these centers. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. A One-to-One Programme for At-Risk Readers Delivered by Older Adult Volunteers

    Science.gov (United States)

    Fives, Allyn; Kearns, Noreen; Devaney, Carmel; Canavan, John; Russell, Dan; Lyons, Rena; Eaton, Patricia; O'Brien, Aoife

    2013-01-01

    This paper is based on a randomized controlled trial (RCT) evaluation of a reading programme delivered by older adult volunteers for at-risk early readers. Wizards of Words (WoW) was targeted at socially disadvantaged children in first and second grade experiencing delays in reading but who were not eligible for formal literacy supports. The…

  13. Easing the Transition to Middle Adolescence: Educational Implications

    Science.gov (United States)

    Beland, Kathy

    2014-01-01

    Mitigating the perils of transition to early adolescence, while also supporting the promise of this stage of human development, has been a major focus of middle school reform (Carnegie Council on Adolescent Development, 1989; Jackson & Davis, 2000). As a result, there are many classroom-based educational programs that target the social and…

  14. First experience with the MATLAB Middle Layer at ANKA

    International Nuclear Information System (INIS)

    Marsching, S.; Huttel, E.; Klein, M.; Mueller, A.S.; Smale, N.J.

    2012-01-01

    ANKA is a synchrotron radiation facility at the Karlsruhe Institute of Technology. The MATLAB Middle Layer (MML) is a collection of scripts for the MATLAB programming environment, designed to control and measure parameters of an accelerator. MML has been adapted for use at ANKA and the commissioning process was quite simple and would have been even simpler if we had used one of the control systems directly supported by MML. At ANKA MML is used for accelerator physics studies and regular tasks like beam-based alignment and response matrix analysis using LOCO. Furthermore, we intend to study the MML as default orbit correction tool for user operation. We report on the experience made during the commissioning process and present the latest results obtained while using the MML for machine studies. MML simplifies the task of performing a beam-based alignment dramatically compared to our old solution which required the user to copy the measured data into specific files for further evaluation

  15. Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies.

    Science.gov (United States)

    Bohora, Som; Chaffin, Mark; Shaboltas, Alla; Bonner, Barbara; Isurina, Galina; Batluk, Julia; Bard, David; Tsvetkova, Larissa; Skitnevskaya, Larissa; Volkova, Elena; Balachova, Tatiana

    2017-11-01

    of being in class I compared with class III were 3.3 (95% CI [1.06, 10.38]) times higher for those women who had Alcohol Use Disorders Identification Test scores ≥ 8 than those who had lower scores, and were 3.9 (95% CI [1.69, 8.97]) times higher for those who used alcohol before sex than those who did not. In addition, women who drank more days per week were 1.36 times more likely to be in class II than in class III. The study informs prevention by identifying specific population groups and targets for interventions. Alcohol use is a significant predictor and an overarching factor of HIV risk in women. Since at-risk drinking is common among young Russian women, alcohol risk reduction should be an essential component of HIV prevention efforts.

  16. Cyberbullying perpetration and victimization among middle-school students.

    Science.gov (United States)

    Rice, Eric; Petering, Robin; Rhoades, Harmony; Winetrobe, Hailey; Goldbach, Jeremy; Plant, Aaron; Montoya, Jorge; Kordic, Timothy

    2015-03-01

    We examined correlations between gender, race, sexual identity, and technology use, and patterns of cyberbullying experiences and behaviors among middle-school students. We collected a probability sample of 1285 students alongside the 2012 Youth Risk Behavior Survey in Los Angeles Unified School District middle schools. We used logistic regressions to assess the correlates of being a cyberbully perpetrator, victim, and perpetrator-victim (i.e., bidirectional cyberbullying behavior). In this sample, 6.6% reported being a cyberbully victim, 5.0% reported being a perpetrator, and 4.3% reported being a perpetrator-victim. Cyberbullying behavior frequently occurred on Facebook or via text messaging. Cyberbully perpetrators, victims, and perpetrators-victims all were more likely to report using the Internet for at least 3 hours per day. Sexual-minority students and students who texted at least 50 times per day were more likely to report cyberbullying victimization. Girls were more likely to report being perpetrators-victims. Cyberbullying interventions should account for gender and sexual identity, as well as the possible benefits of educational interventions for intensive Internet users and frequent texters.

  17. Cyberbullying Perpetration and Victimization Among Middle-School Students

    Science.gov (United States)

    Rice, Eric; Rhoades, Harmony; Winetrobe, Hailey; Goldbach, Jeremy; Plant, Aaron; Montoya, Jorge; Kordic, Timothy

    2015-01-01

    Objectives. We examined correlations between gender, race, sexual identity, and technology use, and patterns of cyberbullying experiences and behaviors among middle-school students. Methods. We collected a probability sample of 1285 students alongside the 2012 Youth Risk Behavior Survey in Los Angeles Unified School District middle schools. We used logistic regressions to assess the correlates of being a cyberbully perpetrator, victim, and perpetrator–victim (i.e., bidirectional cyberbullying behavior). Results. In this sample, 6.6% reported being a cyberbully victim, 5.0% reported being a perpetrator, and 4.3% reported being a perpetrator–victim. Cyberbullying behavior frequently occurred on Facebook or via text messaging. Cyberbully perpetrators, victims, and perpetrators–victims all were more likely to report using the Internet for at least 3 hours per day. Sexual-minority students and students who texted at least 50 times per day were more likely to report cyberbullying victimization. Girls were more likely to report being perpetrators–victims. Conclusions. Cyberbullying interventions should account for gender and sexual identity, as well as the possible benefits of educational interventions for intensive Internet users and frequent texters. PMID:25602905

  18. Risks for the global freshwater system at 1.5 °C and 2 °C global warming

    Science.gov (United States)

    Döll, Petra; Trautmann, Tim; Gerten, Dieter; Müller Schmied, Hannes; Ostberg, Sebastian; Saaed, Fahad; Schleussner, Carl-Friedrich

    2018-04-01

    To support implementation of the Paris Agreement, the new HAPPI ensemble of 20 bias-corrected simulations of four climate models was used to drive two global hydrological models, WaterGAP and LPJmL, for assessing freshwater-related hazards and risks in worlds approximately 1.5 °C and 2 °C warmer than pre-industrial. Quasi-stationary HAPPI simulations are better suited than transient CMIP-like simulations for assessing hazards at the two targeted long-term global warming (GW) levels. We analyzed seven hydrological hazard indicators that characterize freshwater-related hazards for humans, freshwater biota and vegetation. Using a strict definition for significant differences, we identified for all but one indicator that areas with either significantly wetter or drier conditions (calculated as percent changes from 2006–2015) are smaller in the 1.5 °C world. For example, 7 day high flow is projected to increase significantly on 11% and 21% of the global land area at 1.5 °C and 2 °C, respectively. However, differences between hydrological hazards at the two GW levels are significant on less than 12% of the area. GW affects a larger area and more people by increases—rather than by decreases—of mean annual and 1-in-10 dry year streamflow, 7 day high flow, and groundwater recharge. The opposite is true for 7 day low flow, maximum snow storage, and soil moisture in the driest month of the growing period. Mean annual streamflow shows the lowest projected percent changes of all indicators. Among country groups, low income countries and lower middle income countries are most affected by decreased low flows and increased high flows, respectively, while high income countries are least affected by such changes. The incremental impact between 1.5 °C and 2 °C on high flows would be felt most by low income and lower middle income countries, the effect on soil moisture and low flows most by high income countries.

  19. Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes: the diet, cancer and health cohort study.

    Science.gov (United States)

    Gunge, V B; Andersen, I; Kyrø, C; Hansen, C P; Dahm, C C; Christensen, J; Tjønneland, A; Olsen, A

    2017-05-01

    For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes. Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50-64 years recruited between 1993 and 1997. The healthy Nordic food index comprised healthy Nordic food items selected a priori (fish, cabbage, rye bread, oatmeal, apple and pears and root vegetables). Information on incident MI was ascertained through linkage with national registries. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated from sex-specific Cox proportional hazard models. In total, 1669 men and 653 women developed MI during follow-up (13.6 median years). In adjusted models, those with an index score of 5-6 points (highest scores) had significantly lower MI risk (men: HR=0.77, 95% CI=0.62, 0.97; women: HR=0.55, 95% CI=0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR=0.95, 95% CI=0.92, 0.99) and women (HR=0.93, 95% CI=0.88, 0.98). A healthy Nordic diet is associated with lower MI risk among middle-aged Danes, suggesting that Nordic diets should be considered in recommendations for dietary changes in the promotion of coronary health.

  20. Genetic risk load according to the site of intracranial aneurysms

    NARCIS (Netherlands)

    van 't Hof, Femke N. G.; Kurki, Mitja I.; Kleinloog, Rachel; de Bakker, Paul I. W.; von Und Zu Fraunberg, Mikael; Jääskeläinen, Juha E.; Gaál, Emília I.; Lehto, Hanna; Kivisaari, Riku; Laakso, Aki; Niemelä, Mika; Hernesniemi, Juha; Brouwer, Matthijs C.; van de Beek, Diederik; Rinkel, Gabriël J. E.; Ruigrok, Ynte M.

    2014-01-01

    We investigated whether risk alleles of single nucleotide polymorphisms associated with intracranial aneurysm (IA) are enriched in patients with familial IA, IA located at the middle cerebral artery (MCA), or IA rupture at a younger age. In this case-only study, we calculated genetic risk scores

  1. Value at Risk models for Energy Risk Management

    OpenAIRE

    Novák, Martin

    2010-01-01

    The main focus of this thesis lies on description of Risk Management in context of Energy Trading. The paper will predominantly discuss Value at Risk and its modifications as a main overall indicator of Energy Risk.

  2. Cardiovascular risk factors and cognitive function in middle aged and elderly Lithuanian urban population: results from the HAPIEE study

    Directory of Open Access Journals (Sweden)

    Tamosiunas Abdonas

    2012-11-01

    Full Text Available Abstract Background The purpose of this study was to examine associations between cardiovascular risk factors and cognitive ability in middle aged and elderly Lithuanian urban population. Methods Data from the survey performed in the framework of the HAPIEE (Health, Alcohol, Psychosocial Factors in Eastern Europe study were presented. A random sample of 7,087 individuals aged 45–72 years was screened in 2006–2008. Results The scores of immediate recall and delayed verbal recall, cognitive speed and attention were significantly lower in men than in women; yet numerical ability scores were higher in men. Significant associations between lowered cognitive functions and previous stroke (in male OR = 2.52; 95% CI = 1.75-3.64; in female OR = 2.45; 95% CI = 1.75, 3.64 as well as ischemic heart disease history (among male OR = 1.28; 95% CI = 1.03-1.60 have been determined. Higher level of physical activity in leisure time (among female OR = 1.32; 95% CI = 1.03-1.69, poor self-rated health (among male OR = 1.57; 95% CI = 1.15-2.14 and poor quality of life (in male OR = 1.67; 95% CI = 1.07-2.61; in female OR = 2.81; 95% CI = 1.92-4.11 were related to lowered cognitive function. Conclusions The findings of the study suggest that associations between cardiovascular risk factors and lowered cognitive function among healthy middle-aged and elderly adults strongly depend on gender.

  3. 76 FR 39885 - Risk-Based Targeting of Foreign Flagged Mobile Offshore Drilling Units (MODUs)

    Science.gov (United States)

    2011-07-07

    ... Foreign Flagged Mobile Offshore Drilling Units (MODUs) AGENCY: Coast Guard, DHS. ACTION: Notice of... 11-06, Risk-Based Targeting of Foreign Flagged Mobile Offshore Drilling Units (MODUs). This policy... applicable regulations, every foreign-flagged mobile offshore drilling unit (MODU) must undergo a Coast Guard...

  4. Middle Palaeolithic toolstone procurement behaviors at Lusakert Cave 1, Hrazdan valley, Armenia.

    Science.gov (United States)

    Frahm, Ellery; Feinberg, Joshua M; Schmidt-Magee, Beverly A; Wilkinson, Keith N; Gasparyan, Boris; Yeritsyan, Benik; Adler, Daniel S

    2016-02-01

    Strategies employed by Middle Palaeolithic hominins to acquire lithic raw materials often play key roles in assessing their movements through the landscape, relationships with neighboring groups, and cognitive abilities. It has been argued that a dependence on local resources is a widespread characteristic of the Middle Palaeolithic, but how such behaviors were manifested on the landscape remains unclear. Does an abundance of local toolstone reflect frequent encounters with different outcrops while foraging, or was a particular outcrop favored and preferentially quarried? This study examines such behaviors at a finer geospatial scale than is usually possible, allowing us to investigate hominin movements through the landscape surrounding Lusakert Cave 1 in Armenia. Using our newly developed approach to obsidian magnetic characterization, we test a series of hypotheses regarding the locations where hominins procured toolstone from a volcanic complex adjacent to the site. Our goal is to establish whether the cave's occupants procured local obsidian from preferred outcrops or quarries, secondary deposits of obsidian nodules along a river, or a variety of exposures as encountered while moving through the river valley or across the wider volcanic landscape during the course of foraging activities. As we demonstrate here, it is not the case that one particular outcrop or deposit attracted the cave occupants during the studied time intervals. Nor did they acquire obsidian at random across the landscape. Instead, our analyses support the hypothesis that these hominins collected obsidian from outcrops and exposures throughout the adjacent river valley, reflecting the spatial scale of their day-to-day foraging activities. The coincidence of such behaviors within the resource-rich river valley suggests efficient exploitation of a diverse biome during a time interval immediately preceding the Middle to Upper Palaeolithic "transition," the nature and timing of which has yet to

  5. Risk profiles for heavy drinking in adolescence: differential effects of gender.

    Science.gov (United States)

    Seo, Sambu; Beck, Anne; Matthis, Caroline; Genauck, Alexander; Banaschewski, Tobias; Bokde, Arun L W; Bromberg, Uli; Büchel, Christian; Quinlan, Erin Burke; Flor, Herta; Frouin, Vincent; Garavan, Hugh; Gowland, Penny; Ittermann, Bernd; Martinot, Jean-Luc; Paillère Martinot, Marie-Laure; Nees, Frauke; Papadopoulos Orfanos, Dimitri; Poustka, Luise; Hohmann, Sarah; Fröhner, Juliane H; Smolka, Michael N; Walter, Henrik; Whelan, Robert; Desrivières, Sylvane; Heinz, Andreas; Schumann, Gunter; Obermayer, Klaus

    2018-05-30

    Abnormalities across different domains of neuropsychological functioning may constitute a risk factor for heavy drinking during adolescence and for developing alcohol use disorders later in life. However, the exact nature of such multi-domain risk profiles is unclear, and it is further unclear whether these risk profiles differ between genders. We combined longitudinal and cross-sectional analyses on the large IMAGEN sample (N ≈ 1000) to predict heavy drinking at age 19 from gray matter volume as well as from psychosocial data at age 14 and 19-for males and females separately. Heavy drinking was associated with reduced gray matter volume in 19-year-olds' bilateral ACC, MPFC, thalamus, middle, medial and superior OFC as well as left amygdala and anterior insula and right inferior OFC. Notably, this lower gray matter volume associated with heavy drinking was stronger in females than in males. In both genders, we observed that impulsivity and facets of novelty seeking at the age of 14 and 19, as well as hopelessness at the age of 14, are risk factors for heavy drinking at the age of 19. Stressful life events with internal (but not external) locus of control were associated with heavy drinking only at age 19. Personality and stress assessment in adolescents may help to better target counseling and prevention programs. This might reduce heavy drinking in adolescents and hence reduce the risk of early brain atrophy, especially in females. In turn, this could additionally reduce the risk of developing alcohol use disorders later in adulthood. © 2018 Society for the Study of Addiction.

  6. The Utility of Conflict Resolution and Study Skills Interventions with Middle School Students at Risk for Antisocial Behavior: A Methodological Illustration

    Science.gov (United States)

    Kalberg, Jemma Robertson; Lane, Kathleen; Lambert, Warren

    2012-01-01

    This article provides a methodological illustration of how to conduct randomized controls trials (RCT) for secondary levels of prevention within the context of three-tiered models of support. First, the authors demonstrate one method of using school-wide data to identify middle school students (N = 45) who were struggling in academic and…

  7. Psychosocial predictors of sexual initiation and high-risk sexual behaviors in early adolescence

    Directory of Open Access Journals (Sweden)

    Schwab-Stone Mary

    2007-11-01

    Full Text Available Abstract Background This longitudinal study examined psychosocial factors associated with risky sexual behavior in early adolescence. Methods Data were collected through a self-report survey, the Social and Health Assessment (SAHA, which was administered in three waves between 2001 and 2003 to a cohort of incoming sixth grade students in the public school system (149 classes at 17 middle and high schools, N = 1,175 of a small northeastern city in the United States. We first examined whether internalizing and externalizing problems in sixth grade, and the rate of change in these factors during middle school, were predictive of sexual initiation two years later, when most of the sample was in eighth grade. We then assessed whether internalizing and externalizing problems in sixth grade, and the rate of change in these factors during middle school, were predictive of engaging in high risk sexual behavior over the subsequent two years. Results Externalizing factors are more predictive of sexual risk in early adolescence than are internalizing factors. Specifically, substance use and violent delinquency over the course of middle school were associated with higher, while anxiety with lower, sexual initiation rates during middle school. Additionally, increased substance use over the course of middle school was associated with greater likelihood of engaging in high risk sexual behavior. Conclusion By identifying particular psychosocial risk factors among young adolescents, the findings of this study have implications for designing multi-dimensional programs aimed at preventing health-compromising sexual behavior among young teens.

  8. Continuous Risk Management at NASA

    Science.gov (United States)

    Hammer, Theodore F.; Rosenberg, Linda

    1999-01-01

    NPG 7120.5A, "NASA Program and Project Management Processes and Requirements" enacted in April, 1998, requires that "The program or project manager shall apply risk management principles..." The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to comply with this edict. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This presentation will briefly discuss the six functions for risk management: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions. This risk management structure of functions has been taught to projects at all NASA Centers and is being successfully implemented on many projects. This presentation will give project managers the information they need to understand if risk management is to be effectively implemented on their projects at a cost they can afford.

  9. Kids, Cops, Counselors, and Character: Teaching Respect and Responsibility at the Middle Level.

    Science.gov (United States)

    Richards, Mary Ann; Deuel, Vikki

    2001-01-01

    Describes efforts such as diversity tolerance, gang resistance, and summer youth programs at Walnut Middle School (Nebraska) to help reduce incidents of bullying and violence. States that the number of assaults dropped from 146 in 1998-99 to 51 in 2000-2001, after the anti-violence campaign was implemented. (Contains 12 references.) (NB)

  10. Faculty Response to Ethical Issues at an American University in the Middle-East

    Science.gov (United States)

    Tabsh, Sami W.; El Kadi, Hany A.; Abdelfatah, Akmal S.

    2012-01-01

    Purpose: The objective of this study is to get feedback on faculty perception of ethical issues related to teaching, scholarship and service at a relatively new American-style university in the Middle-East. Design/methodology/approach: A questionnaire involving 21 scenarios with multiple choice answers was developed and distributed to all faculty…

  11. Chronic disease self-management education courses: utilization by low-income, middle-aged participants.

    Science.gov (United States)

    Horrell, Lindsey N; Kneipp, Shawn M; Ahn, SangNam; Towne, Samuel D; Mingo, Chivon A; Ory, Marcia G; Smith, Matthew Lee

    2017-06-27

    Individuals living in lower-income areas face an increased prevalence of chronic disease and, oftentimes, greater barriers to optimal self-management. Disparities in disease management are seen across the lifespan, but are particularly notable among middle-aged adults. Although evidence-based Chronic Disease Self-management Education courses are available to enhance self-management among members of this at-risk population, little information is available to determine the extent to which these courses are reaching those at greatest risk. The purpose of this study is to compare the extent to which middle-aged adults from lower- and higher-income areas have engaged in CDSME courses, and to identify the sociodemographic characteristics of lower-income, middle aged participants. The results of this study were produced through analysis of secondary data collected during the Communities Putting Prevention to Work: Chronic Disease Self-Management Program initiative. During this initiative, data was collected from 100,000 CDSME participants across 45 states within the United States, the District of Columbia, and Puerto Rico. Of the entire sample included in this analysis (19,365 participants), 55 people lived in the most impoverished counties. While these 55 participants represented just 0.3% of the total study sample, researchers found this group completed courses more frequently than participants from less impoverished counties once enrolled. These results signal a need to enhance participation of middle-aged adults from lower-income areas in CDSME courses. The results also provide evidence that can be used to inform future program delivery choices, including decisions regarding recruitment materials, program leaders, and program delivery sites, to better engage this population.

  12. The readmission risk flag: using the electronic health record to automatically identify patients at risk for 30-day readmission.

    Science.gov (United States)

    Baillie, Charles A; VanZandbergen, Christine; Tait, Gordon; Hanish, Asaf; Leas, Brian; French, Benjamin; Hanson, C William; Behta, Maryam; Umscheid, Craig A

    2013-12-01

    Identification of patients at high risk for readmission is a crucial step toward improving care and reducing readmissions. The adoption of electronic health records (EHR) may prove important to strategies designed to risk stratify patients and introduce targeted interventions. To develop and implement an automated prediction model integrated into our health system's EHR that identifies on admission patients at high risk for readmission within 30 days of discharge. Retrospective and prospective cohort. Healthcare system consisting of 3 hospitals. All adult patients admitted from August 2009 to September 2012. An automated readmission risk flag integrated into the EHR. Thirty-day all-cause and 7-day unplanned healthcare system readmissions. Using retrospective data, a single risk factor, ≥ 2 inpatient admissions in the past 12 months, was found to have the best balance of sensitivity (40%), positive predictive value (31%), and proportion of patients flagged (18%), with a C statistic of 0.62. Sensitivity (39%), positive predictive value (30%), proportion of patients flagged (18%), and C statistic (0.61) during the 12-month period after implementation of the risk flag were similar. There was no evidence for an effect of the intervention on 30-day all-cause and 7-day unplanned readmission rates in the 12-month period after implementation. An automated prediction model was effectively integrated into an existing EHR and identified patients on admission who were at risk for readmission within 30 days of discharge. © 2013 Society of Hospital Medicine.

  13. National cohort study of absolute risk and age-specific incidence of multiple adverse outcomes between adolescence and early middle age.

    Science.gov (United States)

    Mok, Pearl L H; Antonsen, Sussie; Pedersen, Carsten Bøcker; Appleby, Louis; Shaw, Jenny; Webb, Roger T

    2015-09-19

    Psychiatric illness, substance misuse, suicidality, criminality and premature death represent major public health challenges that afflict a sizeable proportion of young people. However, studies of multiple adverse outcomes in the same cohort at risk are rare. In a national Danish cohort we estimated sex- and age-specific incidence rates and absolute risks of these outcomes between adolescence and early middle age. Using interlinked registers, persons born in Denmark 1966-1996 were followed from their 15(th) until 40(th) birthday or December 2011 (N = 2,070,904). We estimated sex- and age-specific incidence rates of nine adverse outcomes, in three main categories: Premature mortality (all-causes, suicide, accident); Psychiatric morbidity (any mental illness diagnosis, suicide attempt, alcohol or drug misuse disorder); Criminality (violent offending, receiving custodial sentence, driving under influence of alcohol or drugs). Cumulative incidences were also calculated using competing risk survival analyses. For cohort members alive on their 15(th) birthday, the absolute risks of dying by age 40 were 1.99 % for males [95 % confidence interval (CI) 1.95-2.03 %] and 0.85 % for females (95 % CI 0.83-0.88 %). The risks of substance misuse and criminality were also much higher for males, especially younger males, than for females. Specifically, the risk of a first conviction for a violent offence was highest amongst males aged below 20. Females, however, were more likely than males to have a hospital-treated psychiatric disorder. By age 40, 13.25 % of females (95 % CI 13.16-13.33 %) and 9.98 % of males (95 % CI 9.91-10.06 %) had been treated. Women aged below 25 were also more likely than men to first attempt suicide, but this pattern was reversed beyond this age. The greatest gender differentials in incidence rates were in criminality outcomes. This is the first comprehensive assessment of the incidence rates and absolute risks of these multiple adverse outcomes

  14. Delivering Food Safety Education to Middle School Students Using a Web-Based, Interactive, Multimedia, Computer Program

    Science.gov (United States)

    Lynch, Rebecca A.; Steen, M. Dale; Pritchard, Todd J.; Buzzell, Paul R.; Pintauro, Stephen J.

    2008-01-01

    More than 76 million persons become ill from foodborne pathogens in the United States each year. To reduce these numbers, food safety education efforts need to be targeted at not only adults, but school children as well. The middle school grades are ideal for integrating food safety education into the curriculum while simultaneously contributing…

  15. Functional Stroke Mimics: Incidence and Characteristics at a Primary Stroke Center in the Middle East

    Science.gov (United States)

    Wilkins, Stacy Schantz; Bourke, Paula; Salam, Abdul; Akhtar, Naveed; D'Souza, Atlantic; Kamran, Saadat; Bhutta, Zain; Shuaib, Ashfaq

    2018-01-01

    ABSTRACT Objective Approximately 30% of individuals who initially present with stroke are found to be stroke mimics (SM), with functional/psychological SM (FSM) accounting for up to 6.4% of all stroke presentations. Middle Eastern countries may have higher rates of somatization of emotional distress. The aim of this study was to evaluate the incidence and characteristics of FSM at a large general hospital in the Middle East. Methods All patients presenting with an initial diagnosis of stroke from June 2015 to September 2016 were eligible for this study. Clinical and sociodemographic data were obtained from the hospital's stroke database. All SM and strokes were diagnosed by Joint Commission International–certified stroke program neurologists. SM was defined as any discharge diagnosis (other than acute stroke) for symptoms that prompted initial admission for suspected stroke. FSM were compared with medical stroke mimics (MSM) and strokes (ischemic, hemorrhagic, and transient ischemic attacks). Results A total of 1961 patients were identified; 161 FSM (8.2%), 390 MSM (19.9%), and 1410 strokes (71.9%) (985 ischemic strokes, 196 transient ischemic attacks, 229 intracerebral hemorrhages). Admission with FSM was related to patients' nationality, with the highest frequency in Arabic (15.6%) and African (16.8%) patients. FSM patients were younger, more often female, and had fewer cardiovascular risk factors except for smoking compared with the strokes. FSM patients presented with more left-sided weakness and had more magnetic resonance imagings than the stroke and MSM groups. A total of 9.9% of FSM patients received thrombolysis versus only 0.5% of the MSM and 16.4% of ischemic strokes. Conclusions FSM frequencies varied by nationality, with Arab and African nationals being twice as prevalent. Stress, vulnerable status as expats, sociopolitical instability, and exposure to trauma are proposed as potential factors contributing to FSM. PMID:29394187

  16. Association between Dietary Patterns and Cardiovascular Risk Factors among Middle-Aged and Elderly Adults in Taiwan: A Population-Based Study from 2003 to 2012

    Science.gov (United States)

    Muga, Miriam Adoyo; Owili, Patrick Opiyo; Hsu, Chien-Yeh; Rau, Hsiao-Hsien; Chao, Jane C-J

    2016-01-01

    Background Cardiovascular disease (CVD) is one of the leading causes of mortality and loss of disability-adjusted life years in developed countries. This study derived a dietary pattern using an a priori method and additionally derived dietary patterns using a posteriori methods, and assessed the relationship with CVD risk factors in Taiwanese middle-aged and elderly adults. Methods Cross-sectional analyses of 62,965 subjects aged 40 years and above from the Mei Jau (MJ) database collected between 2003 and 2012 in Taiwan. Diet was assessed using a 22 item semi-quantitative food frequency questionnaire. Using this information, three dietary patterns were generated. The a priori diet was labeled the Taiwanese dietary pattern and was derived using hypothesized effect of 22 food groups, while two a posteriori dietary patterns, “vegi-fruits” and “meat-processed”, were derived using principal component analysis. The association between dietary patterns and a range of CVD risk factors (i.e. blood lipids, blood glucose and C-reactive protein) was evaluated using linear regression. Results The results showed that high intake (Q5, quintile 5) of Taiwanese diet was negatively associated with CVD risk factors at (p dietary pattern (Q5) was negatively associated with CVD risk factors (p dietary pattern (Q5) was positively associated with CVD risk factors (p dietary patterns and CVD risk factors, while a positive association was found between meat-processed dietary pattern and CVD risk factors. The findings suggested that a diet rich in vegetables and fruits has a beneficial effect in the management of CVD risk factors. PMID:27366909

  17. Association Between Lifetime Marijuana Use and Cognitive Function in Middle Age: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

    Science.gov (United States)

    Auer, Reto; Vittinghoff, Eric; Yaffe, Kristine; Künzi, Arnaud; Kertesz, Stefan G; Levine, Deborah A; Albanese, Emiliano; Whitmer, Rachel A; Jacobs, David R; Sidney, Stephen; Glymour, M Maria; Pletcher, Mark J

    2016-03-01

    Marijuana use is increasingly common in the United States. It is unclear whether it has long-term effects on memory and other domains of cognitive function. To study the association between cumulative lifetime exposure to marijuana use and cognitive performance in middle age. We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of 5115 black and white men and women aged 18 to 30 years at baseline from March 25, 1985, to June 7, 1986 (year 0), and followed up over 25 years from June 7, 1986, to August 31, 2011, to estimate cumulative years of exposure to marijuana (1 year = 365 days of marijuana use) using repeated measures and to assess associations with cognitive function at year 25. Linear regression was used to adjust for demographic factors, cardiovascular risk factors, tobacco smoking, use of alcohol and illicit drugs, physical activity, depression, and results of the mirror star tracing test (a measure of cognitive function) at year 2. Data analysis was conducted from June 7, 1986, to August 31, 2011. Three domains of cognitive function were assessed at year 25 using the Rey Auditory Verbal Learning Test (verbal memory), the Digit Symbol Substitution Test (processing speed), and the Stroop Interference Test (executive function). Among 3385 participants with cognitive function measurements at the year 25 visit, 2852 (84.3%) reported past marijuana use, but only 392 (11.6%) continued to use marijuana into middle age. Current use of marijuana was associated with worse verbal memory and processing speed; cumulative lifetime exposure was associated with worse performance in all 3 domains of cognitive function. After excluding current users and adjusting for potential confounders, cumulative lifetime exposure to marijuana remained significantly associated with worse verbal memory. For each 5 years of past exposure, verbal memory was 0.13 standardized units lower (95% CI, -0.24 to -0.02; P = .02), corresponding to a mean of

  18. Differences in reproductive risk factors for breast cancer in middle-aged women in Marin County, California and a sociodemographically similar area of Northern California

    Directory of Open Access Journals (Sweden)

    Uratsu Connie S

    2009-03-01

    Full Text Available Abstract Background The Northern California county of Marin (MC has historically had high breast cancer incidence rates. Because of MC's high socioeconomic status (SES and racial homogeneity (non-Hispanic White, it has been difficult to assess whether these elevated rates result from a combination of established risk factors or other behavioral or environmental factors. This survey was designed to compare potential breast cancer risks and incidence rates for a sample of middle-aged MC women with those of a demographically similar population. Methods A random sample of 1500 middle-aged female members of a large Northern California health plan, half from Marin County (MC and half from a comparison area in East/Central Contra Costa County (ECCC, were mailed a survey covering family history, reproductive history, use of oral contraceptives (OC and hormone replacement therapy (HRT, behavioral health risks, recency of breast screening, and demographic characteristics. Weighted data were used to compare prevalence of individual breast cancer risk factors and Gail scores. Age-adjusted cumulative breast cancer incidence rates (2000–2004 were also calculated for female health plan members aged 40–64 residing in the two geographic areas. Results Survey response was 57.1% (n = 427 and 47.9% (n = 359 for MC and ECCC samples, respectively. Women in the two areas were similar in SES, race, obesity, exercise frequency, current smoking, ever use of OCs and HRT, age at onset of menarche, high mammography rates, family history of breast cancer, and Gail scores. However, MC women were significantly more likely than ECCC women to be former smokers (43.6% vs. 31.2%, have Ashkenazi Jewish heritage (12.8% vs. 7.1%, have no live births before age 30 (52.7% vs. 40.8%, and be nulliparous (29.2% vs. 15.4%, and less likely to never or rarely consume alcohol (34.4% vs. 41.9%. MC and ECCC women had comparable 2000–2004 invasive breast cancer incidence rates. Conclusion

  19. Sleep-time blood pressure: prognostic value and relevance as a therapeutic target for cardiovascular risk reduction.

    Science.gov (United States)

    Hermida, Ramón C; Ayala, Diana E; Fernández, José R; Mojón, Artemio

    2013-03-01

    Correlation between blood pressure (BP) level and target organ damage, cardiovascular disease (CVD) risk, and long-term prognosis is greater for ambulatory BP monitoring (ABPM) than clinical BP measurements. Nevertheless, the latter continue to be the "gold standard" to diagnose hypertension, assess CVD risk, and evaluate hypertension treatment. Independent ABPM studies have found that elevated sleep-time BP is a better predictor of CVD risk than either the awake or 24-h BP mean. A major limitation of all previous ABPM-based prognostic studies is the reliance only upon a single baseline profile from each participant at the time of inclusion, without accounting for potential changes in the level and pattern of ambulatory BP thereafter during follow-up. Accordingly, impact of the alteration over time, i.e., during long-term follow-up, of specific features of the 24-h BP variation on CVD risk has never been properly investigated. We evaluated the comparative prognostic value of (i) clinic and ambulatory BP; (ii) different ABPM-derived characteristics, e.g., asleep or awake BP mean; and (iii) specific changes in ABPM characteristic during follow-up, mainly whether reduced CVD risk is more related to the progressive decrease of asleep or awake BP. We prospectively studied 3344 subjects (1718 men/1626 women), 52.6 ± 14.5 (mean ± SD) yrs of age, during a median follow-up of 5.6 yrs. Those with hypertension at baseline were randomized to ingest all their prescribed hypertension medications upon awakening or ≥1 of them at bedtime. At baseline, BP was measured at 20-min intervals from 07:00 to 23:00 h and at 30-min intervals at night for 48-h, and physical activity was simultaneously monitored every min by wrist actigraphy to accurately derive awake and asleep BP means. Identical assessment was scheduled annually and more frequently (quarterly) if treatment adjustment was required. Data collected either at baseline or the last ABPM evaluation per participant

  20. Race Differences: Use of Walking Speed to Identify Community-Dwelling Women at Risk for Poor Health Outcomes--Osteoarthritis Initiative Study.

    Science.gov (United States)

    Kirkness, Carmen S; Ren, Jinma

    2015-07-01

    of less than 1.0 m/s in community-dwelling women who had or were at risk for osteoarthritis, with African American women having 3 times the risk for slow walking as white American women. This finding suggests that middle-aged African American women have an increased risk for poor health outcomes. Further longitudinal evaluations are needed to confirm the long-term health outcomes in a middle-aged population and to establish walking speed as a useful tool for identifying middle-aged women at high risk for poor health outcomes. © 2015 American Physical Therapy Association.

  1. Underreporting of high-risk water and sanitation practices undermines progress on global targets.

    Science.gov (United States)

    Vedachalam, Sridhar; MacDonald, Luke H; Shiferaw, Solomon; Seme, Assefa; Schwab, Kellogg J

    2017-01-01

    Water and sanitation indicators under the Millennium Development Goals failed to capture high-risk practices undertaken on a regular basis. In conjunction with local partners, fourteen rounds of household surveys using mobile phones with a customized open-source application were conducted across nine study geographies in Asia and Africa. In addition to the main water and sanitation facilities, interviewees (n = 245,054) identified all water and sanitation options regularly used for at least one season of the year. Unimproved water consumption and open defecation were targeted as high-risk practices. We defined underreporting as the difference between the regular and main use of high-risk practices. Our estimates of high-risk practices as the main option matched the widely accepted Demographic and Health Surveys (DHS) estimates within the 95% confidence interval. However, estimates of these practices as a regular option was far higher than the DHS estimates. Across the nine geographies, median underreporting of unimproved water use was 5.5%, with a range of 0.5% to 13.9%. Median underreporting of open defecation was much higher at 9.9%, with a range of 2.7% to 11.5%. This resulted in an underreported population of 25 million regularly consuming unimproved water and 50 million regularly practicing open defecation. Further examination of data from Ethiopia suggested that location and socio-economic factors were significant drivers of underreporting. Current global monitoring relies on a framework that considers the availability and use of a single option to meet drinking water and sanitation needs. Our analysis demonstrates the use of multiple options and widespread underreporting of high-risk practices. Policies based on current monitoring data, therefore, fail to consider the range of challenges and solutions to meeting water and sanitation needs, and result in an inflated sense of progress. Mobile surveys offer a cost-effective and innovative platform to rapidly

  2. Family Income, Cumulative Risk Exposure, and White Matter Structure in Middle Childhood

    Directory of Open Access Journals (Sweden)

    Alexander J. Dufford

    2017-11-01

    Full Text Available Family income is associated with gray matter morphometry in children, but little is known about the relationship between family income and white matter structure. In this paper, using Tract-Based Spatial Statistics, a whole brain, voxel-wise approach, we examined the relationship between family income (assessed by income-to-needs ratio and white matter organization in middle childhood (N = 27, M = 8.66 years. Results from a non-parametric, voxel-wise, multiple regression (threshold-free cluster enhancement, p < 0.05 FWE corrected indicated that lower family income was associated with lower white matter organization [assessed by fractional anisotropy (FA] for several clusters in white matter tracts involved in cognitive and emotional functions including fronto-limbic circuitry (uncinate fasciculus and cingulum bundle, association fibers (inferior longitudinal fasciculus, superior longitudinal fasciculus, and corticospinal tracts. Further, we examined the possibility that cumulative risk (CR exposure might function as one of the potential pathways by which family income influences neural outcomes. Using multiple regressions, we found lower FA in portions of these tracts, including those found in the left cingulum bundle and left superior longitudinal fasciculus, was significantly related to greater exposure to CR (β = -0.47, p < 0.05 and β = -0.45, p < 0.05.

  3. Adiposity in early, middle and later adult life and cardiometabolic risk markers in later life; findings from the British regional heart study.

    Science.gov (United States)

    Kapetanakis, Venediktos V; Rudnicka, Alicja R; Wathern, Andrea K; Lennon, Lucy; Papacosta, Olia; Cook, Derek G; Wannamethee, S Goya; Whincup, Peter H; Owen, Christopher G

    2014-01-01

    This research investigates the associations between body mass index (BMI) at 21, 40-59, 60-79 years of age on cardiometabolic