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Sample records for times greater risk

  1. Rumination time around calving: an early signal to detect cows at greater risk of disease.

    Science.gov (United States)

    Calamari, L; Soriani, N; Panella, G; Petrera, F; Minuti, A; Trevisi, E

    2014-01-01

    slower increase of RT after calving. Furthermore, more than 90% of the cows in the L group had clinical diseases in early lactation compared with 42% of the H cows. Overall, our results demonstrate the utility of monitoring RT around calving, and in particular during the first week of lactation, as a way to identify in a timely fashion those cows at a greater risk of developing a disease in early lactation. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  2. Credit risk transfer activities and systemic risk : How banks became less risky individually but posed greater risks to the financial system at the same time

    NARCIS (Netherlands)

    Wagner, W.B.; Nijskens, R.G.M.

    2011-01-01

    A main cause of the crisis of 2007–2009 is the various ways through which banks have transferred credit risk in the financial system. We study the systematic risk of banks before the crisis, using two samples of banks respectively trading Credit Default Swaps (CDS) and issuing Collateralized Loan

  3. Professional Rugby Union players have a 60% greater risk of time loss injury after concussion: a 2-season prospective study of clinical outcomes

    Science.gov (United States)

    Cross, Matthew; Kemp, Simon; Smith, Andrew; Trewartha, Grant; Stokes, Keith

    2016-01-01

    Aim To investigate incidence of concussion, clinical outcomes and subsequent injury risk following concussion. Methods In a two-season (2012/2013, 2013/2014) prospective cohort study, incidence of diagnosed match concussions (injuries/1000 h), median time interval to subsequent injury of any type (survival time) and time spent at each stage of the graduated return to play pathway were determined in 810 professional Rugby Union players (1176 player seasons). Results Match concussion incidence was 8.9/1000 h with over 50% occurring in the tackle. Subsequent incidence of any injury for players who returned to play in the same season following a diagnosed concussion (122/1000 h, 95% CI 106 to 141) was 60% higher (IRR 1.6, 95% CI 1.4 to 1.8) than for those who did not sustain a concussion (76/1000 h, 95% CI 72 to 80). Median time to next injury following return to play was shorter following concussion (53 days, 95% CI 41 to 64) than following non-concussive injuries (114 days, 95% CI 85 to 143). 38% of players reported recurrence of symptoms or failed to match their baseline neurocognitive test during the graduated return to play protocol. Summary and conclusions Players who returned to play in the same season after a diagnosed concussion had a 60% greater risk of time-loss injury than players without concussion. A substantial proportion of players reported recurrence of symptoms or failed to match baseline neurocognitive test scores during graduated return to play. These data pave the way for trials of more conservative and comprehensive graduated return to play protocols, with a greater focus on active rehabilitation. PMID:26626266

  4. Women at greater risk of HIV infection.

    Science.gov (United States)

    Mahathir, M

    1997-04-01

    Although many people believe that mainly men get infected with HIV/AIDS, women are actually getting infected at a faster rate than men, especially in developing countries, and suffer more from the adverse impact of AIDS. As of mid-1996, the Joint UN Program on AIDS estimated that more than 10 million of the 25 million adults infected with HIV since the beginning of the epidemic are women. The proportion of HIV-positive women is growing, with almost half of the 7500 new infections daily occurring among women. 90% of HIV-positive women live in a developing country. In Asia-Pacific, 1.4 million women have been infected with HIV out of an estimated total 3.08 million adults from the late 1970s until late 1994. Biologically, women are more vulnerable than men to infection because of the greater mucus area exposed to HIV during penile penetration. Women under age 17 years are at even greater risk because they have an underdeveloped cervix and low vaginal mucus production. Concurrent sexually transmitted diseases increase the risk of HIV transmission. Women's risk is also related to their exposure to gender inequalities in society. The social and economic pressures of poverty exacerbate women's risk. Prevention programs are discussed.

  5. Greater Caregiving Risk, Better Infant Memory Performance?

    Science.gov (United States)

    Rifkin-Graboi, Anne; Quan, Jeffry; Richmond, Jenny; Goh, Shaun Kok Yew; Sim, Lit Wee; Chong, Yap Seng; Francois-Bureau, Jean; Chen, Helen; Qiu, Anqi

    2018-04-16

    Poor early life care often relates to cognitive difficulties. However, newer work suggests that in early-life, adversity may associate with enhanced or accelerated neurodevelopment. We examine associations between postnatal caregiving risks (i.e., higher self-reported postnatal-anxiety and lower observed maternal sensitivity) and infant relational memory (i.e. via deferred imitation and relational binding). Using subsamples of 67-181 infants (aged 433-477 post-conceptual days, or roughly five to seven months since birth) taking part in the GUSTO study, we found such postnatal caregiving risk significantly predictive of "better" performance on a relational binding task following a brief delay, after Bonferroni adjustments. Subsequent analyses suggest that the association between memory and these risks may specifically be apparent amongst infants spending at least 50% of their waking hours in the presence of their mothers. Our findings echo neuroimaging research concerning similar risk exposure and larger infant hippocampal volume, and likewise underscore the importance of considering developmental context in understanding early life experience. With this in mind, these findings caution against the use of cognitive outcomes as indices of experienced risk. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

  6. Eveningness and Later Sleep Timing Are Associated with Greater Risk for Alcohol and Marijuana Use in Adolescence: Initial Findings from the National Consortium on Alcohol and Neurodevelopment in Adolescence Study.

    Science.gov (United States)

    Hasler, Brant P; Franzen, Peter L; de Zambotti, Massimiliano; Prouty, Devin; Brown, Sandra A; Tapert, Susan F; Pfefferbaum, Adolf; Pohl, Kilian M; Sullivan, Edith V; De Bellis, Michael D; Nagel, Bonnie J; Baker, Fiona C; Colrain, Ian M; Clark, Duncan B

    2017-06-01

    Abundant cross-sectional evidence links eveningness (a preference for later sleep-wake timing) and increased alcohol and drug use among adolescents and young adults. However, longitudinal studies are needed to examine whether eveningness is a risk factor for subsequent alcohol and drug use, particularly during adolescence, which is marked by parallel peaks in eveningness and risk for the onset of alcohol use disorders. This study examined whether eveningness and other sleep characteristics were associated with concurrent or subsequent substance involvement in a longitudinal study of adolescents. Participants were 729 adolescents (368 females; age 12 to 21 years) in the National Consortium on Alcohol and Neurodevelopment in Adolescence study. Associations between the sleep variables (circadian preference, sleep quality, daytime sleepiness, sleep timing, and sleep duration) and 3 categorical substance variables (at-risk alcohol use, alcohol bingeing, and past-year marijuana use [y/n]) were examined using ordinal and logistic regression with baseline age, sex, race, ethnicity, socioeconomic status, and psychiatric problems as covariates. At baseline, greater eveningness was associated with greater at-risk alcohol use, greater bingeing, and past-year use of marijuana. Later weekday and weekend bedtimes, but not weekday or weekend sleep duration, showed similar associations across the 3 substance outcomes at baseline. Greater baseline eveningness was also prospectively associated with greater bingeing and past-year use of marijuana at the 1-year follow-up, after covarying for baseline bingeing and marijuana use. Later baseline weekday and weekend bedtimes, and shorter baseline weekday sleep duration, were similarly associated with greater bingeing and past-year use of marijuana at the 1-year follow-up after covarying for baseline values. Findings suggest that eveningness and sleep timing may be under recognized risk factors and future areas of intervention for

  7. College Students with ADHD at Greater Risk for Sleep Disorders

    Science.gov (United States)

    Gaultney, Jane F.

    2014-01-01

    The pediatric literature indicates that children with ADHD are at greater risk for sleep problems, daytime sleepiness, and some sleep disorders than children with no diagnosed disability. It has not been determined whether this pattern holds true among emerging adults, and whether comorbid sleep disorders with ADHD predict GPA. The present study…

  8. Leveraging Enterprise Risk Management: Opportunity for Greater Relevance

    Science.gov (United States)

    Abraham, Janice M.; Baird, Robert; Neugebauer, Frank

    2013-01-01

    Enterprise Risk Management (ERM) gained a foothold in higher education during the first decade of the 21st century. College and university governing board members came to their board service with the perspective and experience of having served on corporate boards and in corporate leadership positions where ERM was in active use. Trustees asked…

  9. Scrotal neoplasia: would truck drivers be at greater risk?

    Directory of Open Access Journals (Sweden)

    Daniel Seabra

    2007-08-01

    Full Text Available OBJECTIVE: To analyze how scrotal neoplasias have been managed during the past decade and to question possible factors or professions associated to its presence. MATERIALS AND METHODS: We retrospectively evaluated every case reported from 1995 to 2005 at our hospital. We described the clinical scenario, complementary exams, treatments and outcomes. We also tried to verify if there was any risk, predisposing factors or professions that would explain the cancer origin. RESULTS: Six cases were reviewed. Out of these, three patients were truck drivers. Five of them showed restricted lesions without inguinal lymph nodes enlargement. Histologically, six patients presented squamous carcinoma, with two of them having the verrucous type. The median age of patients was 52 years old (31 to 89. The five patients who are still alive had their lesions completely removed with safety margin and primary closure. CONCLUSIONS: We have noticed that the scrotal carcinoma behavior is similar to that of the penis, where removal of the lesion and study of the regional lymph nodes help to increase the patient survival rate. The outstanding fact was that three out of six patients were truck drivers, raising the hypothesis that such profession, maybe due to the contact or attrition with the diesel exhaust expelled by the engine or to sexual promiscuity, would imply in a larger risk of developing this rare neoplasia.

  10. Suicide in married couples in Sweden: Is the risk greater in same-sex couples?

    Science.gov (United States)

    Björkenstam, Charlotte; Andersson, Gunnar; Dalman, Christina; Cochran, Susan; Kosidou, Kyriaki

    2016-07-01

    Minority sexual orientation is a predictor of suicide ideation and attempts, though its association with suicide mortality is less clear. We capitalize on Sweden's extensively linked databases, to investigate whether, among married individuals, same-sex marriage is associated with suicide. Using a population-based register design, we analyzed suicide risk among same-sex married women and men (n = 6456), as compared to different-sex married women and men (n = 1181723) in Sweden. We selected all newly partnered or married individuals in the intervening time between 1/1/1996 and 12/31/2009 and followed them with regard to suicide until 12/31/2011. Multivariate Poisson regression was used to calculate adjusted incidence risk ratios (IRR) with 95 % confidence intervals (CI). The risk of suicide was higher among same-sex married individuals as compared to different-sex married individuals (IRR 2.7, 95 % CI 1.5-4.8), after adjustment for time at risk and socioeconomic confounding. Sex-stratified analyses showed a tentatively elevated risk for same-sex married women (IRR 2.5, 95 % CI 0.8-7.7) as compared to different-sex married women. Among same-sex married men the suicide risk was nearly three-fold greater as compared to different-sex married (IRR 2.895 % CI 1.5-5.5). This holds true also after adjustment for HIV status. Even in a country with a comparatively tolerant climate regarding homosexuality such as Sweden, same-sex married individuals evidence a higher risk for suicide than other married individuals.

  11. Higher Pretransplantation Hemoglobin A1c Is Associated With Greater Risk of Posttransplant Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Jung-Im Shin

    2017-11-01

    Discussion: Higher pretransplantation HbA1c above 5.4% is independently associated with greater risk of PTDM among kidney transplant recipients. A continuous relationship between pretransplantation HbA1c and risk of PTDM suggests that increased risk starts at HbA1c levels well below current thresholds for prediabetes.

  12. Greater absolute risk for all subtypes of breast cancer in the US than Malaysia.

    Science.gov (United States)

    Horne, Hisani N; Beena Devi, C R; Sung, Hyuna; Tang, Tieng Swee; Rosenberg, Philip S; Hewitt, Stephen M; Sherman, Mark E; Anderson, William F; Yang, Xiaohong R

    2015-01-01

    Hormone receptor (HR) negative breast cancers are relatively more common in low-risk than high-risk countries and/or populations. However, the absolute variations between these different populations are not well established given the limited number of cancer registries with incidence rate data by breast cancer subtype. We, therefore, used two unique population-based resources with molecular data to compare incidence rates for the 'intrinsic' breast cancer subtypes between a low-risk Asian population in Malaysia and high-risk non-Hispanic white population in the National Cancer Institute's surveillance, epidemiology, and end results 18 registries database (SEER 18). The intrinsic breast cancer subtypes were recapitulated with the joint expression of the HRs (estrogen receptor and progesterone receptor) and human epidermal growth factor receptor-2 (HER2). Invasive breast cancer incidence rates overall were fivefold greater in SEER 18 than in Malaysia. The majority of breast cancers were HR-positive in SEER 18 and HR-negative in Malaysia. Notwithstanding the greater relative distribution for HR-negative cancers in Malaysia, there was a greater absolute risk for all subtypes in SEER 18; incidence rates were nearly 7-fold higher for HR-positive and 2-fold higher for HR-negative cancers in SEER 18. Despite the well-established relative breast cancer differences between low-risk and high-risk countries and/or populations, there was a greater absolute risk for HR-positive and HR-negative subtypes in the US than Malaysia. Additional analytical studies are sorely needed to determine the factors responsible for the elevated risk of all subtypes of breast cancer in high-risk countries like the United States.

  13. Are passive smoking, air pollution and obesity a greater mortality risk than major radiation incidents?

    Directory of Open Access Journals (Sweden)

    Smith Jim T

    2007-04-01

    Full Text Available Abstract Background Following a nuclear incident, the communication and perception of radiation risk becomes a (perhaps the major public health issue. In response to such incidents it is therefore crucial to communicate radiation health risks in the context of other more common environmental and lifestyle risk factors. This study compares the risk of mortality from past radiation exposures (to people who survived the Hiroshima and Nagasaki atomic bombs and those exposed after the Chernobyl accident with risks arising from air pollution, obesity and passive and active smoking. Methods A comparative assessment of mortality risks from ionising radiation was carried out by estimating radiation risks for realistic exposure scenarios and assessing those risks in comparison with risks from air pollution, obesity and passive and active smoking. Results The mortality risk to populations exposed to radiation from the Chernobyl accident may be no higher than that for other more common risk factors such as air pollution or passive smoking. Radiation exposures experienced by the most exposed group of survivors of Hiroshima and Nagasaki led to an average loss of life expectancy significantly lower than that caused by severe obesity or active smoking. Conclusion Population-averaged risks from exposures following major radiation incidents are clearly significant, but may be no greater than those from other much more common environmental and lifestyle factors. This comparative analysis, whilst highlighting inevitable uncertainties in risk quantification and comparison, helps place the potential consequences of radiation exposures in the context of other public health risks.

  14. Coping Skills Help Explain How Future-Oriented Adolescents Accrue Greater Well-Being Over Time.

    Science.gov (United States)

    Chua, Li Wen; Milfont, Taciano L; Jose, Paul E

    2015-11-01

    Adolescents who endorse greater levels of future orientation report greater well-being over time, but we do not know the mechanism by which this happens. The present longitudinal study examined whether both adaptive as well as maladaptive coping strategies might explain how future orientation leads to ill-being and well-being over time in young New Zealanders. A sample of 1,774 preadolescents and early adolescents (51.9 % female) aged 10-15 years at Time 1 completed a self-report survey three times with 1 year intervals in between. Longitudinal mediation path models were constructed to determine whether and how maladaptive and adaptive coping strategies at Time 2 functioned as mediators between future orientation at Time 1 and ill-being and well-being at Time 3. Results showed that future orientation predicted lower maladaptive coping, which in turn predicted lower substance use and self-harming behavior. All three well-being outcomes (i.e., happiness with weight, vitality, and sleep) were consistently predicted by future orientation, and all three pathways were mediated by both lower maladaptive and higher adaptive coping strategies (with the exception of happiness with weight, which was mediated only by lower maladaptive coping). The results suggest that several pathways by which future orientation leads to greater well-being occurs through an increased use of adaptive coping, a decreased use of maladaptive coping, or both.

  15. Is there time discounting for risk premium?

    Science.gov (United States)

    Shavit, Tal; Rosenboim, Mosi

    2015-03-01

    Individuals with a higher subjective discount rate concentrate more on the present and delay is more significant for them. However, when a risky asset is delayed, not only is the outcome delayed but also the risk. In this paper, we suggest a new, two-stage experimental method with real monetary incentives that allows us to distinguish between the effect of the risk and the effect of the time when pricing a risky asset. We show that when individuals have greater preference for the present, their risk aversion for a risky asset realized in the future decreases. We argue that the effect of the risk for future asset is lower for individuals with higher time preference because they discount not only the outcome but also the risks. © Society for the Experimental Analysis of Behavior.

  16. Why shorter half-times of repair lead to greater damage in pulsed brachytherapy

    International Nuclear Information System (INIS)

    Fowler, J.F.

    1993-01-01

    Pulsed brachytherapy consists of replacing continuous irradiation at low dose-rate with a series of medium dose-rate fractions in the same overall time and to the same total dose. For example, pulses of 1 Gy given every 2 hr or 2 Gy given every 4 hr would deliver the same 70 Gy in 140 hr as continuous irradiation at 0.5 Gy/hr. If higher dose-rates are used, even with gaps between the pulses, the biological effects are always greater. Provided that dose rates in the pulse do not exceed 3 Gy/hr, and provided that pulses are given as often as every 2 hr, the inevitable increases of biological effect are no larger than a few percent (of biologically effective dose or extrapolated response dose). However, these increases are more likely to exceed 10% (and thus become clinically significant) if the half-time of repair of sublethal damage is short (less than 1 hr) rather than long. This somewhat unexpected finding is explained in detail here. The rise and fall of Biologically Effective Dose (and hence of Relative Effectiveness, for a constant dose in each pulse) is calculated during and after single pulses, assuming a range of values of T 1/2 , the half-time of sublethal damage repair. The area under each curve is proportional to Biologically Effective Dose and therefore to log cell kill. Pulses at 3 Gy/hr do yield greater biological effect (dose x integrated Relative Effectiveness) than lower dose-rate pulses or continuous irradiation at 0.5 Gy/hr. The contrast is greater for the short T 1/2 of 0.5 hr than for the longer T 1/2 of 1.5 hr. More biological damage will be done (compared with traditional low dose rate brachytherapy) in tissues with short T 1/2 (0.1-1 hr) than in tissues with longer T 1/2 values. 8 refs., 3 figs

  17. Male Astronauts Have Greater Bone Loss and Risk of Hip Fracture Following Long Duration Spaceflights than Females

    Science.gov (United States)

    Ellman, Rachel; Sibonga, Jean; Bouxsein, Mary

    2010-01-01

    This slide presentation reviews bone loss in males and compares it to female bone loss during long duration spaceflight. The study indicates that males suffer greater bone loss than females and have a greater risk of hip fracture. Two possible reason for the greater male bone loss are that the pre-menopausal females have the estrogen protection and the greater strength of men max out the exercise equipment that provide a limited resistance to 135 kg.

  18. Time-varying Crash Risk

    DEFF Research Database (Denmark)

    Christoffersen, Peter; Feunoua, Bruno; Jeon, Yoontae

    We estimate a continuous-time model with stochastic volatility and dynamic crash probability for the S&P 500 index and find that market illiquidity dominates other factors in explaining the stock market crash risk. While the crash probability is time-varying, its dynamic depends only weakly on re...

  19. Greater involvement and diversity of Internet gambling as a risk factor for problem gambling

    Science.gov (United States)

    Russell, Alex; Blaszczynski, Alex; Hing, Nerilee

    2015-01-01

    Background: Concerns that Internet gambling has elevated the prevalence of problem gambling have not been substantiated; however, evidence suggests a subgroup of Internet gamblers do experience higher rates of gambling harms. Greater overall involvement in gambling appears to be predictive of harms. The purpose of this study was to examine differences between Internet gamblers with a single or multiple online gambling accounts, including their gambling behaviours, factors influencing their online gambling and risk of experiencing gambling problems. Methods: Internet gamblers (3178) responding to an online survey that assessed their gambling behaviour, and use of single or multiple online gambling accounts. Results: Results revealed that multiple account holders were more involved gamblers, gambling on more activities and more frequently, and had higher rates of gambling problems than single account holders. Multiple account holders selected gambling sites based on price, betting options, payout rates and game experience, whereas single account holders prioritized legality and consumer protection features. Conclusion: Results suggest two different types of Internet gamblers: one motivated to move between sites to optimize preferred experiences with a tendency to gamble in a more volatile manner; and a smaller, but more stable group less influenced by promotions and experiences, and seeking a reputable and safe gambling experience. As the majority of Internet gamblers use multiple accounts, more universal responsible gambling strategies are needed to assist gamblers to track and control their expenditure to reduce risks of harm. PMID:25745873

  20. Greater involvement and diversity of Internet gambling as a risk factor for problem gambling.

    Science.gov (United States)

    Gainsbury, Sally M; Russell, Alex; Blaszczynski, Alex; Hing, Nerilee

    2015-08-01

    Concerns that Internet gambling has elevated the prevalence of problem gambling have not been substantiated; however, evidence suggests a subgroup of Internet gamblers do experience higher rates of gambling harms. Greater overall involvement in gambling appears to be predictive of harms. The purpose of this study was to examine differences between Internet gamblers with a single or multiple online gambling accounts, including their gambling behaviours, factors influencing their online gambling and risk of experiencing gambling problems. Internet gamblers (3178) responding to an online survey that assessed their gambling behaviour, and use of single or multiple online gambling accounts. Results revealed that multiple account holders were more involved gamblers, gambling on more activities and more frequently, and had higher rates of gambling problems than single account holders. Multiple account holders selected gambling sites based on price, betting options, payout rates and game experience, whereas single account holders prioritized legality and consumer protection features. Results suggest two different types of Internet gamblers: one motivated to move between sites to optimize preferred experiences with a tendency to gamble in a more volatile manner; and a smaller, but more stable group less influenced by promotions and experiences, and seeking a reputable and safe gambling experience. As the majority of Internet gamblers use multiple accounts, more universal responsible gambling strategies are needed to assist gamblers to track and control their expenditure to reduce risks of harm. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  1. Cyclists Have Greater Chondromalacia Index Than Age-Matched Controls at the Time of Hip Arthroscopy.

    Science.gov (United States)

    Stone, Austin V; Howse, Elizabeth A; Mannava, Sandeep; Stubbs, Allston J

    2016-10-01

    To evaluate the clinical symptoms and intraoperative pathology associated with hip pain in the cyclist compared with a matched hip arthroscopy surgical group. In an institutional review board-approved study, we retrospectively reviewed a prospective database of 1,200 consecutive hip arthroscopy patients from 2008 to 2015. Adult patients were identified who reported cycling as a major component of their activity. Patients were age, gender, and body mass index matched to a control, noncycling group. Pain symptoms, preoperative examinations, radiographic and operative findings were compared. Primary outcome variables included the femoral and acetabular Outerbridge chondromalacia grade. Additional outcome measurements included the involved area and the chondromalacia index (CMI; the product of the Outerbridge chondromalacia grade and surface area [mm 2  × severity]). A total of 167 noncyclists were matched to the cycling group (n = 16). Cyclists had significantly greater femoral head chondromalacia grade (2.0 [95% confidence interval (CI), 1.5-2.5] v 1.4 [95% CI, 1.3-1.6], P = .043), femoral head chondromalacia area (242 mm 2 [95% CI, 191-293 mm 2 ] v 128 mm 2 [95% CI, 113-141 mm 2 ], P chondromalacia than a matched group of noncyclists. Cycling activity positively correlated with the presence of femoral chondromalacia with clinically significant gait alterations. These data support the hypothesis that cyclists with hip pain have more chondral pathology than a similar group of other patients with hip pain. Ultimately, cyclists with hip pain should be identified as higher risk for more advanced chondral damage. Level III, case-control study, therapeutic. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  2. Resistance patterns among multidrug-resistant tuberculosis patients in greater metropolitan Mumbai: trends over time.

    Science.gov (United States)

    Dalal, Alpa; Pawaskar, Akshay; Das, Mrinalini; Desai, Ranjan; Prabhudesai, Pralhad; Chhajed, Prashant; Rajan, Sujeet; Reddy, Deepesh; Babu, Sajit; Jayalakshmi, T K; Saranchuk, Peter; Rodrigues, Camilla; Isaakidis, Petros

    2015-01-01

    While the high burden of multidrug-resistant tuberculosis (MDR-TB) itself is a matter of great concern, the emergence and rise of advanced forms of drug-resistance such as extensively drug-resistant TB (XDR-TB) and extremely drug-resistant TB (XXDR-TB) is more troubling. The aim of this study was to investigate the trends over time of patterns of drug resistance in a sample of MDR-TB patients in greater metropolitan Mumbai, India. This was a retrospective, observational study of drug susceptibility testing (DST) results among MDR-TB patients from eight health care facilities in greater Mumbai between 2005 and 2013. We classified resistance patterns into four categories: MDR-TB, pre-XDR-TB, XDR-TB and XXDR-TB. A total of 340 MDR-TB patients were included in the study. Pre-XDR-TB was the most common form of drug-resistant TB observed overall in this Mumbai population at 56.8% compared to 29.4% for MDR-TB. The proportion of patients with MDR-TB was 39.4% in the period 2005-2007 and 27.8% in 2011-2013, while the proportion of those with XDR-TB and XXDR-TB was changed from 6.1% and 0% respectively to 10.6% and 5.6% during the same time period. During the same periods, the proportions of patients with ofloxacin, moxifloxacin and ethionamide resistance significantly increased from 57.6% to 75.3%, from 60.0% to 69.5% and from 24.2% to 52.5% respectively (pMumbai highlight the need for individualized drug regimens, designed on the basis of DST results involving first- and second-line anti-TB drugs and treatment history of the patient. A drug-resistant TB case-finding strategy based on molecular techniques that identify only rifampicin resistance will lead to initiation of suboptimal treatment regimens for a significant number of patients, which may in turn contribute to amplification of resistance and transmission of strains with increasingly advanced resistance within the community.

  3. Sewage-effluent phosphorus: A greater risk to river eutrophication than agricultural phosphorus?

    International Nuclear Information System (INIS)

    Jarvie, Helen P.; Neal, Colin; Withers, Paul J.A.

    2006-01-01

    Phosphorus (P) concentrations from water quality monitoring at 54 UK river sites across seven major lowland catchment systems are examined in relation to eutrophication risk and to the relative importance of point and diffuse sources. The over-riding evidence indicates that point (effluent) rather than diffuse (agricultural) sources of phosphorus provide the most significant risk for river eutrophication, even in rural areas with high agricultural phosphorus losses. Traditionally, the relative importance of point and diffuse sources has been assessed from annual P flux budgets, which are often dominated by diffuse inputs in storm runoff from intensively managed agricultural land. However, the ecological risk associated with nuisance algal growth in rivers is largely linked to soluble reactive phosphorus (SRP) concentrations during times of ecological sensitivity (spring/summer low-flow periods), when biological activity is at its highest. The relationships between SRP and total phosphorus (TP; total dissolved P + suspended particulate P) concentrations within UK rivers are evaluated in relation to flow and boron (B; a tracer of sewage effluent). SRP is the dominant P fraction (average 67% of TP) in all of the rivers monitored, with higher percentages at low flows. In most of the rivers the highest SRP concentrations occur under low-flow conditions and SRP concentrations are diluted as flows increase, which is indicative of point, rather than diffuse, sources. Strong positive correlations between SRP and B (also TP and B) across all the 54 river monitoring sites also confirm the primary importance of point source controls of phosphorus concentrations in these rivers, particularly during spring and summer low flows, which are times of greatest eutrophication risk. Particulate phosphorus (PP) may form a significant proportion of the phosphorus load to rivers, particularly during winter storm events, but this is of questionable relevance for river eutrophication

  4. Cardiovascular risk factors cause premature rarefaction of the collateral circulation and greater ischemic tissue injury.

    Science.gov (United States)

    Moore, Scott M; Zhang, Hua; Maeda, Nobuyo; Doerschuk, Claire M; Faber, James E

    2015-07-01

    Collaterals lessen tissue injury in occlusive disease. However, aging causes progressive decline in their number and smaller diameters in those that remain (collateral rarefaction), beginning at 16 months of age in mice (i.e., middle age), and worse ischemic injury-effects that are accelerated in even 3-month-old eNOS(-/-) mice. These findings have found indirect support in recent human studies. We sought to determine whether other cardiovascular risk factors (CVRFs) associated with endothelial dysfunction cause collateral rarefaction, investigate possible mechanisms, and test strategies for prevention. Mice with nine different models of CVRFs of 4-12 months of age were assessed for number and diameter of native collaterals in skeletal muscle and brain and for collateral-dependent perfusion and ischemic injury after arterial occlusion. Hypertension caused collateral rarefaction whose severity increased with duration and level of hypertension, accompanied by greater hindlimb ischemia and cerebral infarct volume. Chronic treatment of wild-type mice with L-N (G)-nitro-arginine methylester caused similar rarefaction and worse ischemic injury which were not prevented by lowering arterial pressure with hydralazine. Metabolic syndrome, hypercholesterolemia, diabetes mellitus, and obesity also caused collateral rarefaction. Neither chronic statin treatment nor exercise training lessened hypertension-induced rarefaction. Chronic CVRF presence caused collateral rarefaction and worse ischemic injury, even at relatively young ages. Rarefaction was associated with increased proliferation rate of collateral endothelial cells, effects that may promote accelerated endothelial cell senescence.

  5. Greater decision-making competence is associated with greater expected-value sensitivity, but not overall risk taking: an examination of concurrent validity.

    Science.gov (United States)

    Parker, Andrew M; Weller, Joshua A

    2015-01-01

    Decision-making competence reflects individual differences in the susceptibility to committing decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules). Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate processes that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC) and one such process, the degree to which individuals make choices consistent with maximizing expected value (EV). Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a) choosing risky options when EV favors those options and (b) avoiding risky options when EV favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.

  6. Greater decision-making competence is associated with greater expected-value sensitivity, but not overall risk taking: An examination of concurrent validity

    Directory of Open Access Journals (Sweden)

    Andrew M Parker

    2015-05-01

    Full Text Available Decision-making competence reflects individual differences in the susceptibility to decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules. Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate mechanisms that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC and one such mechanism, the degree to which individuals make choices consistent with maximizing expected value (EV. Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a choosing risky options when expected value favors those options and (b avoiding risky options when expected value favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.

  7. Decreased reaction time variability is associated with greater cardiovascular responses to acute stress.

    Science.gov (United States)

    Wawrzyniak, Andrew J; Hamer, Mark; Steptoe, Andrew; Endrighi, Romano

    2016-05-01

    Cardiovascular (CV) responses to mental stress are prospectively associated with poor CV outcomes. The association between CV responses to mental stress and reaction times (RTs) in aging individuals may be important but warrants further investigation. The present study assessed RTs to examine associations with CV responses to mental stress in healthy, older individuals using robust regression techniques. Participants were 262 men and women (mean age = 63.3 ± 5.5 years) from the Whitehall II cohort who completed a RT task (Stroop) and underwent acute mental stress (mirror tracing) to elicit CV responses. Blood pressure, heart rate, and heart rate variability were measured at baseline, during acute stress, and through a 75-min recovery. RT measures were generated from an ex-Gaussian distribution that yielded three predictors: mu-RT, sigma-RT, and tau-RT, the mean, standard deviation, and mean of the exponential component of the normal distribution, respectively. Decreased intraindividual RT variability was marginally associated with greater systolic (B = -.009, SE = .005, p = .09) and diastolic (B = -.004, SE = .002, p = .08) blood pressure reactivity. Decreased intraindividual RT variability was associated with impaired systolic blood pressure recovery (B = -.007, SE = .003, p = .03) and impaired vagal tone (B = -.0047, SE = .0024, p = .045). Study findings offer tentative support for an association between RTs and CV responses. Despite small effect sizes and associations not consistent across predictors, these data may point to a link between intrinsic neuronal plasticity and CV responses. © 2016 The Authors. Psychophysiology published by Wiley Periodicals, Inc. on behalf of Society for Psychophysiological Research.

  8. Prevalence and risk factors for hyperthyroidism in Irish cats from the greater Dublin area.

    Science.gov (United States)

    Bree, Laura; Gallagher, Barbara A; Shiel, Robert E; Mooney, Carmel T

    2018-01-01

    Hyperthyroidism is common in older cats. Prevalence varies geographically, but is anecdotally considered low in Ireland. The aim of this study was to document prevalence of hyperthyroidism in older cats in the greater Dublin area of Ireland and to assess environmental and clinical associations for development and identification of the disease. Primary-care veterinary practices were requested to select cats aged 10 years or older where blood sampling was being performed for health screening or clinical investigations. Surplus serum/plasma samples were submitted to University College Dublin Diagnostic Endocrine Laboratory for total thyroxine (T 4 ) measurement. Cats were classified as hyperthyroid, equivocal or euthyroid based on a total T 4 concentration (reference interval, 15-60 nmol/L), of >60 nmol/L, 30-60 nmol/L or hyperthyroidism were excluded. A questionnaire completed by the client and veterinarian detailing historical and physical information was also required. Associations between categorical variables were analysed by Chi-square or Fisher's exact test and odds ratio (OR) calculated. A P value of hyperthyroid, 54 (10.6%) equivocal and 346 (68.2%) euthyroid. The presence of goitre ( P  weight loss ( P  hyperthyroidism. Cats with goitre were more likely to be diagnosed as hyperthyroid [OR 2.85, (95% CI 1.75-4.62] compared to those without. However, goitre was only palpated in 40 of 102 (39.2%) hyperthyroid cats. Increasing age was the only significant ( P  hyperthyroidism. A relationship between hyperthyroidism and sex, breed, lifestyle, parasite control, vaccination status or feeding habits was not identified. Hyperthyroidism is not uncommon in Irish cats. Age was the only significant risk factor for its development. The high proportion of hyperthyroid cats without palpable goitre (> 60%) may reflect failure to detect goitre and account for the perceived low prevalence of this condition in Ireland.

  9. Greater Fall Risk in Elderly Women Than in Men Is Associated With Increased Gait Variability During Multitasking.

    Science.gov (United States)

    Johansson, Jonas; Nordström, Anna; Nordström, Peter

    2016-06-01

    As 90% of fractures are caused by falls, and as fractures are more common in elderly women than in elderly men, a better understanding of potential sex differences in fall rates and underlying mechanisms is needed. The purpose of this study was to determine whether women are more prone than men to falling, and to evaluate whether the risk of falling is associated with variations in gait patterns. The cohort for this prospective observational study consisted of 1390 community-dwelling men and women aged 70 years, examined in a health survey between July 2012 and November 2014. Gait patterns were measured using a computerized walkway system during normal-speed, fast-speed, and dual-task trials. Triaxial accelerometers were used to collect objective data on physical activity, and self-reported fall data were collected by telephone 6 and 12 months after examination. Incident low-energy falls were defined as unexpected events in which participants came to rest on the ground. During the follow-up period, 148 study participants (88 women, 60 men; P = .01) reported falls. After adjusting for multiple confounders, including objective measures of physical activity, socioeconomic factors, cardiovascular disease, and cognitive function, the odds ratio for falling in women was 1.49 (95% confidence interval [CI] 1.02-2.19). Variations in gait pattern were significantly (20%-40%) increased in fallers compared with nonfallers during the dual-task trial for step width, step length, stride length, step time, stance time, stride velocity, and single support time (all P women showed 15% to 35% increased variability in all of these gait parameters during the dual-task trial compared with men (all P women were at greater risk of falls compared with their male counterparts. This increased risk was associated with increased variation in gait pattern during dual-task activities, and may contribute to women's greater fracture risk compared with men. Copyright © 2016 AMDA – The

  10. 21 CFR 50.52 - Clinical investigations involving greater than minimal risk but presenting the prospect of direct...

    Science.gov (United States)

    2010-04-01

    ... minimal risk but presenting the prospect of direct benefit to individual subjects. 50.52 Section 50.52... investigations involving greater than minimal risk but presenting the prospect of direct benefit to individual... prospect of direct benefit for the individual subject, or by a monitoring procedure that is likely to...

  11. Do ewes born with a male co-twin have greater longevity with lambing over time?

    Science.gov (United States)

    Based on a recent analysis of historical records, ewes born co-twin to a ram had greater lifetime reproductive performance than ewes born co-twin to a ewe. We are interested in determining what component(s) of lifetime reproductive performance may be associated with a ewe’s co-twin sex. As an initi...

  12. Greater rupture risk for familial as compared to sporadic unruptured intracranial aneurysms.

    Science.gov (United States)

    Broderick, Joseph P; Brown, Robert D; Sauerbeck, Laura; Hornung, Richard; Huston, John; Woo, Daniel; Anderson, Craig; Rouleau, Guy; Kleindorfer, Dawn; Flaherty, Matthew L; Meissner, Irene; Foroud, Tatiana; Moomaw, E Charles J; Connolly, E Sander

    2009-06-01

    The risk of intracranial aneurysm (IA) rupture in asymptomatic members of families who have multiple affected individuals is not known. First-degree unaffected relatives of those with a familial history of IA who had a history of smoking or hypertension but no known IA were offered cerebral MR angiography (MRA) and followed yearly as part of a National Institute of Neurological Diseases and Stroke-funded study of familial IA (Familial Intracranial Aneurysm [FIA] Study). A total of 2874 subjects from 542 FIA Study families were enrolled. After study enrollment, MRAs were performed in 548 FIA Study family members with no known history of IA. Of these 548 subjects, 113 subjects (20.6%) had 148 IAs by MRA of whom 5 subjects had IA >or=7 mm. Two subjects with an unruptured IA by MRA/CT angiography (3-mm and 4-mm anterior communicating artery) subsequently had rupture of their IA. This represents an annual rate of 1.2 ruptures per 100 subjects (1.2% per year; 95% CI, 0.14% to 4.3% per year). None of the 435 subjects with a negative MRA have had a ruptured IA. Survival curves between the MRA-positive and -negative cohorts were significantly different (P=0.004). This rupture rate of unruptured IA in the FIA Study cohort of 1.2% per year is approximately 17 times higher than the rupture rate for subjects with an unruptured IA in the International Study of Unruptured Aneurysm Study with a matched distribution of IA size and location 0.069% per year. Small unruptured IAs in patients from FIA Study families may have a higher risk of rupture than sporadic unruptured IAs of similar size, which should be considered in the management of these patients.

  13. Fine particulate matter components and mortality in Greater Houston: Did the risk reduce from 2000 to 2011?

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Suyang; Zhang, Kai, E-mail: Kai.Zhang@uth.tmc.edu

    2015-12-15

    Fine particulate matter (less than 2.5 μm in aerodynamic diameter; PM{sub 2.5}) pollution poses a major environmental threat in Greater Houston due to rapid economic growth and the numerous PM{sub 2.5} sources including ports, vehicles, and the largest petrochemical industry in the United States (U.S.). Our objectives were to estimate the short-term associations between the PM{sub 2.5} components and mortality during 2000–2011, and evaluate whether these associations have changed over time. A total of 333,317 deaths were included in our assessment, with an average of 76 deaths per day. We selected 17 PM{sub 2.5} components from the U.S. Environmental Protection Agency's Chemical Speciation Network, and then applied Poisson regression models to assess the associations between the PM{sub 2.5} components and mortality. Additionally, we repeated our analysis for two consecutive periods: 2000–2005 and 2006–2011. Interquartile range increases in ammonium (0.881 μg/m{sup 3}), nitrate (0.487 μg/m{sup 3}), sulfate (2.245 μg/m{sup 3}), and vanadium (0.004 μg/m{sup 3}) were associated with an increased risk in mortality of 0.69% (95% confidence interval (CI): 0.26, 1.12%), 0.38% (95% CI: 0.11, 0.66%), 0.61% (95% CI: 0.15, 1.06%), and 0.58% (95% CI: 0.12, 1.04%), respectively. Seasonal analysis suggested that the associations were strongest during the winter months. The association between PM{sub 2.5} mass and mortality decreased during 2000–2011, however, the PM{sub 2.5} components showed no notable changes in mortality risk over time. Our study indicates that the short-term associations between PM{sub 2.5} and mortality differ across the PM{sub 2.5} components and suggests that future air pollution control measures should not only focus on mass but also pollutant sources. - Highlights: • PM{sub 2.5} concentrations were associated with increased mortality risk. • A few major PM{sub 2.5} components were associated with increased mortality risk.

  14. Fine particulate matter components and mortality in Greater Houston: Did the risk reduce from 2000 to 2011?

    International Nuclear Information System (INIS)

    Liu, Suyang; Zhang, Kai

    2015-01-01

    Fine particulate matter (less than 2.5 μm in aerodynamic diameter; PM_2_._5) pollution poses a major environmental threat in Greater Houston due to rapid economic growth and the numerous PM_2_._5 sources including ports, vehicles, and the largest petrochemical industry in the United States (U.S.). Our objectives were to estimate the short-term associations between the PM_2_._5 components and mortality during 2000–2011, and evaluate whether these associations have changed over time. A total of 333,317 deaths were included in our assessment, with an average of 76 deaths per day. We selected 17 PM_2_._5 components from the U.S. Environmental Protection Agency's Chemical Speciation Network, and then applied Poisson regression models to assess the associations between the PM_2_._5 components and mortality. Additionally, we repeated our analysis for two consecutive periods: 2000–2005 and 2006–2011. Interquartile range increases in ammonium (0.881 μg/m"3), nitrate (0.487 μg/m"3), sulfate (2.245 μg/m"3), and vanadium (0.004 μg/m"3) were associated with an increased risk in mortality of 0.69% (95% confidence interval (CI): 0.26, 1.12%), 0.38% (95% CI: 0.11, 0.66%), 0.61% (95% CI: 0.15, 1.06%), and 0.58% (95% CI: 0.12, 1.04%), respectively. Seasonal analysis suggested that the associations were strongest during the winter months. The association between PM_2_._5 mass and mortality decreased during 2000–2011, however, the PM_2_._5 components showed no notable changes in mortality risk over time. Our study indicates that the short-term associations between PM_2_._5 and mortality differ across the PM_2_._5 components and suggests that future air pollution control measures should not only focus on mass but also pollutant sources. - Highlights: • PM_2_._5 concentrations were associated with increased mortality risk. • A few major PM_2_._5 components were associated with increased mortality risk. • Associations were generally strongest in winter in Greater

  15. STUDY OF METABOLIC ACIDOSIS IN PATIENTS UNDERGOING SURGERIES OF OPERATIVE TIME GREATER THAN 2 HOURS DURATION

    Directory of Open Access Journals (Sweden)

    Sathu T. S

    2018-02-01

    Full Text Available BACKGROUND Metabolic acidosis is proven complication of major surgery, but very less significance is given to it. Metabolic acidosis has a significant effect in postoperative recovery and morbidity of patients undergoing major surgery. Metabolic acidosis has a say in proper functioning of cardiovascular, renal and pulmonary system, added to severe stress full condition related to postoperative period, it bring about major shift in the speedy recovery of patient. It becomes significantly important that metabolic acidosis in diagnosed as early as possible and corrective measures are taken immediately. MATERIALS AND METHODS Study design is a prospective observational study. 109 patients who underwent elective and emergency surgeries in the department of General Surgery, Govt. Medical College Kottayam was studied for a period of 3 months (2016. On arrival of the patient, a detailed history of the patient was taken, along with emphasis to the multiple factors in the history which could be contributory to postoperative metabolic acidosis such as diabetic status, drug history, history of respiratory, cardiac and renal status. Basic preoperative laboratory investigation was carried out and its values were recorded. A preoperative arterial blood gas analysis (ABG of the patient was done before patient was taken for surgery, values of which were recorded and analysed to rule out existing acidotic status of patient, if the patient is already having metabolic acidosis he was excluded from the study. A second ABG was sent at 2 hours after induction of anaesthesia, values of which was recorded, along with the values of intraoperative fluids, preoperative Hb, duration of surgery, type of surgery, blood transfusion and colloid administration given during the time of anaesthesia. A third ABG was sent within six hours of completion of surgery and the values analysed, with due notes on postoperative care done and the days of ICU stay, for analysis and comparison

  16. Rethinking International Counterterrorism Assistance to the Greater Horn of Africa: Toward a Regional Risk Reduction Strategy

    Directory of Open Access Journals (Sweden)

    Matthew Schwartz

    2013-12-01

    Full Text Available The Horn of Africa has long been a recipient of foreign security assistance, with significant funds increasingly devoted to supporting subregional civilian-oriented counterterrorism efforts over the past decade. Despite efforts to better coordinate delivery, counterterrorism programming in the subregion generally remains fragmented, short-term, and siloed in implementation. This article argues that it is time to rethink the international community’s approach to counterterrorism assistance to the Horn of Africa and calls for a cohesive regional approach that not only bridges the gap between security and development, but also the gap between counterterrorism and human security. It emphasizes that the international community must not only better coordinate existing streams of counterterrorism assistance to the region, but also rethink how this assistance is designed and the ways it can be delivered to complement broader subregional development and security agendas. After a brief introduction to international counterterrorism assistance to the Horn of Africa, the article examines linkages across three thematic streams of programming being delivered to the subregion: anti-money laundering and countering the financing of terrorism; criminal justice capacity building assistance to counter terrorism; and, countering violent extremism. This discussion will highlight the need for a regional risk reduction strategy for the Horn of Africa that not only builds on the interplay of different streams of counterterrorism assistance, but on synergies across broader subregional development and security agendas as well.

  17. Risk for affective disorders is associated with greater prefrontal gray matter volumes

    DEFF Research Database (Denmark)

    Macoveanu, Julian; Baaré, William Frans Christian; Madsen, Kristoffer H

    2018-01-01

    Background: Major depression and bipolar disorders aggregates in families and are linked with a wide range ofneurobiological abnormalities including cortical gray matter (GM) alterations. Prospective studies of individualsat familial risk may expose the neural mechanisms underlying risk...... inferior frontal cortex compared to high- and low-risk twins who remainedwell at follow-up.Conclusion: This pattern of apparently stable grater regional GM volume may constitute a neural marker of anincreased risk for developing an affective disorder in individuals at familial risk....... transmission.Methods: We used voxel based morphometry to investigate changes in regional GM brain volume, over a seven-year period, in 37 initially healthy individuals having a mono- or di-zygotic twin diagnosed with major de-pression or bipolar disorder (high-risk group; mean age 41.6 yrs.) as compared to 36...

  18. Increasing Time and Enriching Learning for Greater Equity in Schools: Perspective from Two Community Funders

    Science.gov (United States)

    Lopez, Janet; Rivera, Peter

    2015-01-01

    Foundations across the country engage in grantmaking to eliminate the opportunity and achievement gaps in K-12 public schools. Many of the strategies and investments that funders have supported in recent years focus not only on "more time" but also on "better use of time" in schools. This better use of time centers on outcomes…

  19. Optimal wildlife management in the greater Yellowstone ecosystem: A spatiotemporal model of disease risk

    Science.gov (United States)

    South of Yellowstone National Park there are twenty-three sites where elk herds are provided supplementary feeding during the winter and spring months. Supplementary feeding of elk in the Greater Yellowstone Ecosystem (GYE) has been practiced since the early twentieth century, but the practice has b...

  20. Distribution of arrival times of muons with energy greater than 10 GeV

    International Nuclear Information System (INIS)

    Badino, G.; Bianco, P.; Dardo, M.; Fulgione, W.; Galeotti, P.; Periale, L.; Saavedra, O.

    1982-01-01

    Recent data on the arrival time distribution of EAS of primary energy >=10 14 eV, and of high energy muons detected at great depth (5000 mwe), seem to indicate an excess of short time intervals. We are using an apparatus, installed at 40 mwe underground, and a surface shower array to investigate the distributions of a) the time intervals between muon groups and b) the arrival times of muons with respect to the front of air showers. Preliminary results of this search are presented

  1. Do beef risk perceptions or risk attitudes have a greater effect on the beef purchase decisions of Canadian consumers?

    Science.gov (United States)

    Yang, Jun; Goddard, Ellen

    2011-01-01

    Cluster analysis is applied in this study to group Canadian households by two characteristics, their risk perceptions and risk attitudes toward beef. There are some similarities in demographic profiles, meat purchases, and bovine spongiform encephalopathy (BSE) media recall between the cluster that perceives beef to be the most risky and the cluster that has little willingness to accept the risks of eating beef. There are similarities between the medium risk perception cluster and the medium risk attitude cluster, as well as between the cluster that perceives beef to have little risk and the cluster that is most willing to accept the risks of eating beef. Regression analysis shows that risk attitudes have a larger impact on household-level beef purchasing decisions than do risk perceptions for all consumer clusters. This implies that it may be more effective to undertake policies that reduce the risks associated with eating beef, instead of enhancing risk communication to improve risk perceptions. Only for certain clusters with higher willingness to accept the risks of eating beef might enhancing risk communication increase beef consumption significantly. The different role of risk perceptions and risk attitudes in beef consumption needs to be recognized during the design of risk management policies.

  2. Tuberculosis and poverty: why are the poor at greater risk in India?

    Science.gov (United States)

    Oxlade, Olivia; Murray, Megan

    2012-01-01

    Although poverty is widely recognized as an important risk factor for tuberculosis (TB) disease, the specific proximal risk factors that mediate this association are less clear. The objective of our study was to investigate the mechanisms by which poverty increases the risk of TB. Using individual level data from 198,754 people from the 2006 Demographic Health Survey (DHS) for India, we assessed self-reported TB status, TB determinants and household socioeconomic status. We used these data to calculate the population attributable fractions (PAF) for each key TB risk factor based on the prevalence of determinants and estimates of the effect of these risk factors derived from published sources. We conducted a mediation analysis using principal components analysis (PCA) and regression to demonstrate how the association between poverty and TB prevalence is mediated. The prevalence of self-reported TB in the 2006 DHS for India was 545 per 100,000 and ranged from 201 in the highest quintile to 1100 in the lowest quintile. Among those in the poorest population, the PAFs for low body mass index (BMI) and indoor air pollution were 34.2% and 28.5% respectively. The PCA analysis also showed that low BMI had the strongest mediating effect on the association between poverty and prevalent TB (12%, p = 0.019). TB control strategies should be targeted to the poorest populations that are most at risk, and should address the most important determinants of disease--specifically low BMI and indoor air pollution.

  3. Greater ability to express positive emotion is associated with lower projected cardiovascular disease risk.

    Science.gov (United States)

    Tuck, Natalie L; Adams, Kathryn S; Pressman, Sarah D; Consedine, Nathan S

    2017-12-01

    Positive emotion is associated with lower cardiovascular disease (CVD) risk, yet some mechanisms remain unclear. One potential pathway is via emotional competencies/skills. The present study tests whether the ability to facially express positive emotion is associated with CVD risk scores, while controlling for potential confounds and testing for sex moderation. Eighty-two men and women underwent blood draws before completing self-report assessments and a performance test of expressive skill. Positive expressions were scored for degree of 'happiness' using expression coding software. CVD risk scores were calculated using established algorithms based on biological, demographic, and behavioral risk factors. Linear regressions revealed a main effect for skill, with skill in expressing positive emotion associated with lower CVD risk scores. Analyses also revealed a sex-by-skill interaction whereby links between expressive skill and CVD risk scores were stronger among men. Objective tests of expressive skill have methodological advantages, appear to have links to physical health, and offer a novel avenue for research and intervention.

  4. An earlier time of scan is associated with greater threat-related amygdala reactivity.

    Science.gov (United States)

    Baranger, David A A; Margolis, Seth; Hariri, Ahmad R; Bogdan, Ryan

    2017-08-01

    Time-dependent variability in mood and anxiety suggest that related neural phenotypes, such as threat-related amygdala reactivity, may also follow a diurnal pattern. Here, using data from 1,043 young adult volunteers, we found that threat-related amygdala reactivity was negatively coupled with time of day, an effect which was stronger in the left hemisphere (β = -0.1083, p-fdr = 0.0012). This effect was moderated by subjective sleep quality (β = -0.0715, p-fdr = 0.0387); participants who reported average and poor sleep quality had relatively increased left amygdala reactivity in the morning. Bootstrapped simulations suggest that similar cross-sectional samples with at least 300 participants would be able to detect associations between amygdala reactivity and time of scan. In control analyses, we found no associations between time and V1 activation. Our results provide initial evidence that threat-related amygdala reactivity may vary diurnally, and that this effect is potentiated among individuals with average to low sleep quality. More broadly, our results suggest that considering time of scan in study design or modeling time of scan in analyses, as well as collecting additional measures of circadian variation, may be useful for understanding threat-related neural phenotypes and their associations with behavior, such as fear conditioning, mood and anxiety symptoms, and related phenotypes. © The Author (2017). Published by Oxford University Press.

  5. The impact of young drivers' lifestyle on their road traffic accident risk in greater Athens area.

    Science.gov (United States)

    Chliaoutakis, J E; Darviri, C; Demakakos, P T

    1999-11-01

    Young drivers (18-24) both in Greece and elsewhere appear to have high rates of road traffic accidents. Many factors contribute to the creation of these high road traffic accidents rates. It has been suggested that lifestyle is an important one. The main objective of this study is to find out and clarify the (potential) relationship between young drivers' lifestyle and the road traffic accident risk they face. Moreover, to examine if all the youngsters have the same elevated risk on the road or not. The sample consisted of 241 young Greek drivers of both sexes. The statistical analysis included factor analysis and logistic regression analysis. Through the principal component analysis a ten factor scale was created which included the basic lifestyle traits of young Greek drivers. The logistic regression analysis showed that the young drivers whose dominant lifestyle trait is alcohol consumption or drive without destination have high accident risk, while these whose dominant lifestyle trait is culture, face low accident risk. Furthermore, young drivers who are religious in one way or another seem to have low accident risk. Finally, some preliminary observations on how health promotion should be put into practice are discussed.

  6. Downside Risk Timing by Mutual Funds

    OpenAIRE

    Bodnaruk, Andriy; Chokaev, Bekhan; Simonov, Andrei

    2015-01-01

    We study whether mutual funds systematically manage downside risk of their portfolios in ways that improve their performance. We find that actively managed mutual funds on average possess positive downside risk timing ability. Funds investing in large-cap and value stocks have stronger downside risk timing skills. Managers adjust funds’ downside risk exposure in response to macroeconomic information. The economic value of downside risk timing is comparable to that of market timing.

  7. 40 CFR 26.405 - Observational research involving greater than minimal risk but presenting the prospect of direct...

    Science.gov (United States)

    2010-07-01

    ... greater than minimal risk but presenting the prospect of direct benefit to the individual subjects. 26.405... but presenting the prospect of direct benefit to the individual subjects. If the IRB finds that an...: (a) The intervention or procedure holds out the prospect of direct benefit to the individual subject...

  8. Tuberculosis and poverty: why are the poor at greater risk in India?

    Directory of Open Access Journals (Sweden)

    Olivia Oxlade

    Full Text Available Although poverty is widely recognized as an important risk factor for tuberculosis (TB disease, the specific proximal risk factors that mediate this association are less clear. The objective of our study was to investigate the mechanisms by which poverty increases the risk of TB.Using individual level data from 198,754 people from the 2006 Demographic Health Survey (DHS for India, we assessed self-reported TB status, TB determinants and household socioeconomic status. We used these data to calculate the population attributable fractions (PAF for each key TB risk factor based on the prevalence of determinants and estimates of the effect of these risk factors derived from published sources. We conducted a mediation analysis using principal components analysis (PCA and regression to demonstrate how the association between poverty and TB prevalence is mediated.The prevalence of self-reported TB in the 2006 DHS for India was 545 per 100,000 and ranged from 201 in the highest quintile to 1100 in the lowest quintile. Among those in the poorest population, the PAFs for low body mass index (BMI and indoor air pollution were 34.2% and 28.5% respectively. The PCA analysis also showed that low BMI had the strongest mediating effect on the association between poverty and prevalent TB (12%, p = 0.019.TB control strategies should be targeted to the poorest populations that are most at risk, and should address the most important determinants of disease--specifically low BMI and indoor air pollution.

  9. Risk for affective disorders is associated with greater prefrontal gray matter volumes: A prospective longitudinal study

    DEFF Research Database (Denmark)

    Macoveanu, Julian; Baaré, William; Madsen, Kristoffer Hougaard

    2017-01-01

    transmission. Methods: We used voxel based morphometry to investigate changes in regional GM brain volume, over a seven-year period, in 37 initially healthy individuals having a mono- or di-zygotic twin diagnosed with major depression or bipolar disorder (high-risk group; mean age 41.6 yrs.) as compared to 36...... anterior cingulate, inferior frontal gyrus and temporoparietal regions as compared to low-risk twins. Further, individuals who developed an affective disorder at follow-up (n=12), had relatively the largest GM volumes, both at baseline and follow-up, in the right dorsal anterior cingulate cortex and right...

  10. Beyond Hurt Feelings: Investigating Why Some Victims of Bullying Are at Greater Risk for Suicidal Ideation

    Science.gov (United States)

    Bonanno, Rina A.; Hymel, Shelley

    2010-01-01

    This study investigated why some adolescents who are victimized through peer bullying are more negatively impacted than others. Drawing from research on peer victimization and suicidology, two theoretically derived models were investigated, one examining social hopelessness as a risk factor, the other examining social support as a protective…

  11. Active unicameral bone cysts in the upper limb are at greater risk of fracture.

    Science.gov (United States)

    Tey, Inn Kuang; Mahadev, Arjandas; Lim, Kevin Boon Leong; Lee, Eng Hin; Nathan, Saminathan Suresh

    2009-08-01

    To elucidate the natural history of unicameral bone cyst (UBC) and risk factors for pathological fracture. 14 males and 8 females (mean age, 9 years) diagnosed with UBC were reviewed. Cyst location, symptoms, and whether there was any fracture or surgery were recorded. Cyst parameters were measured on radiographs, and included (1) the cyst index, (2) the ratio of the widest cyst diameter to the growth plate diameter, and (3) the adjusted distance of the cyst border from the growth plate. There were 11 upper- and 11 lower-limb cysts. 13 patients had pathological fractures and 9 did not. 20 patients were treated conservatively with limb immobilisation; 2 underwent curettage and bone grafting (one resolved and one did not). Seven cysts resolved (5 had fractures and 2 did not). The risk of fracture was higher in the upper than lower limbs (100% vs 18%, pFractured cysts were larger than unfractured cysts (mean cyst index, 4.5 vs. 2.2, p=0.07). Active cysts were more likely to fracture. Conservative management had a 30% resolution rate. Surgery should be considered for large active cysts in the upper limbs in order to minimise the fracture risk.

  12. Gratitude is associated with greater levels of protective factors and lower levels of risks in African American adolescents.

    Science.gov (United States)

    Ma, Mindy; Kibler, Jeffrey L; Sly, Kaye

    2013-10-01

    The literature suggests gratitude is associated with positive youth development. The current study examined the relationship between gratitude and protective/risk factors among African American youth. Adolescents (N = 389; 50.4% males) ages 12-14 completed measures of gratitude (moral affect and life-orientation), protective factors (e.g., academic and activity engagement, family relationship), and high-risk behaviors (e.g., sexual attitudes and behaviors, drug/alcohol use). Results indicated greater moral affect gratitude was the only variable significantly associated with greater academic interest, better academic performance, and more extra-curricular activity engagement. Greater moral affect and life-orientation gratitude both significantly correlated with positive family relationship. Greater life-orientation gratitude was the only variable significantly associated with abstinence from sexual intimacy, sexual intercourse, likelihood of engaging in sex during primary school, and abstinence from drug/alcohol use. The findings suggest that moral affect gratitude may enhance protective factors while life-orientation gratitude may buffer against high-risk behaviors among African American youth. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  13. Children in family foster care have greater health risks and less involvement in Child Health Services.

    Science.gov (United States)

    Köhler, M; Emmelin, M; Hjern, A; Rosvall, M

    2015-05-01

    This study investigated the impact of being in family foster care on selected health determinants and participation in Child Health Services (CHS). Two groups of 100 children, born between 1992 and 2008, were studied using data from Swedish Child Health Services for the preschool period up to the age of six. The first group had been in family foster care, and the controls, matched for age, sex and geographic location, had not. Descriptive statistics were used to describe differences in health determinants and participation in Child Health Services between the two groups. The foster care group had higher health risks, with lower rates of breastfeeding and higher levels of parental smoking. They were less likely to have received immunisations and attended key nurse or physician visits and speech and vision screening. Missing data for the phenylketonuria test were more common in children in family foster care. Children in family foster care were exposed to more health risks than the control children and had lower participation in the universal child health programme during the preschool period. These results call for secure access to high-quality preventive health care for this particularly vulnerable group of children. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. Benefit-cost-risk analysis of alternatives for greater-confinement disposal of radioactive waste

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Peterson, J.M.

    1983-01-01

    Seven alternatives are included in the analysis: near-surface disposal; improved waste form; below-ground engineered structure; augered shaft; shale fracturing; shallow geologic repository; and high-level waste repository. These alternatives are representative generic facilities that span the range from low-level waste disposal practice to high-level waste disposal practice, tentatively ordered according to an expected increasing cost and/or effectiveness of confinement. They have been chosen to enable an assessment of the degree of confinement that represents an appropriate balance between public health and safety requirements and costs rather than identification of a specific preferred facility design. The objective of the analysis is to provide a comparative ranking of the alternatives on the basis of benefit-cost-risk considerations

  15. Predation risk, elk, and aspen: tests of a behaviorally mediated trophic cascade in the Greater Yellowstone Ecosystem.

    Science.gov (United States)

    Winnie, John A

    2012-12-01

    Aspen in the Greater Yellowstone Ecosystem are hypothesized to be recovering from decades of heavy browsing by elk due to a behaviorally mediated trophic cascade (BMTC). Several authors have suggested that wolves interact with certain terrain features, creating places of high predation risk at fine spatial scales, and that elk avoid these places, which creates refugia for plants. This hypothesized BMTC could release aspen from elk browsing pressure, leading to a patchy recovery in places of high risk. I tested whether four specific, hypothesized fine-scale risk factors are correlated with changes in current elk browsing pressure on aspen, or with aspen recruitment since wolf reintroduction, in the Daly Creek drainage in Yellowstone National Park, and near two aspen enclosures outside of the park boundary. Aspen were not responding to hypothesized fine-scale risk factors in ways consistent with the current BMTC hypothesis.

  16. What to expect from a greater geographic dispersion of wind farms?-A risk portfolio approach

    International Nuclear Information System (INIS)

    Drake, Ben; Hubacek, Klaus

    2007-01-01

    The UK, like many other industrialised countries, is committed to reducing greenhouse gas emissions under the Kyoto Protocol. To achieve this goal the UK is increasingly turning towards wind power as a source of emissions free energy. However, the variable nature of wind power generation makes it an unreliable energy source, especially at higher rates of penetration. Likewise the aim of this paper is to measure the potential reduction in wind power variability that could be realised as a result of geographically dispersing the location of wind farm sites. To achieve this aim wind speed data will be used to simulate two scenarios. The first scenario involves locating a total of 2.7 gigawatts (GW) of wind power capacity in a single location within the UK while the second scenario consists of sharing the same amount of capacity amongst four different locations. A risk portfolio approach as used in financial appraisals is then applied in the second scenario to decide upon the allocation of wind power capacity, amongst the four wind farm sites, that succeeds in minimising overall variability for a given level of wind power generation. The findings of this paper indicate that reductions in the order of 36% in wind power variability are possible as a result of distributing wind power capacity

  17. Type 2 diabetes after gestational diabetes: greater than fourfold risk among Indigenous compared with non-Indigenous Australian women.

    Science.gov (United States)

    Chamberlain, Catherine R; Oldenburg, Brian; Wilson, Alyce N; Eades, Sandra J; O'Dea, Kerin; Oats, Jeremy J N; Wolfe, Rory

    2016-02-01

    Gestational diabetes is associated with a high risk of type 2 diabetes. However, progression rates among Indigenous women in Australia who experience high prevalence of gestational diabetes are unknown. This retrospective cohort study includes all births to women at a regional hospital in Far North Queensland, Australia, coded as having 'gestational diabetes' from 1 January 2004 to 31 December 2010 (1098 births) and receiving laboratory postpartum screening from 1 January 2004 to 31 December 2011 (n = 483 births). Women who did not receive postpartum screening were excluded from the denominator. Data were linked between hospital electronic records, routinely collected birth data and laboratories, with sample validation by reviews of medical records. Analysis was conducted using Cox-proportional regression models. Indigenous women had a greater than fourfold risk of developing type 2 diabetes within 8 years of having gestational diabetes, compared with non-Indigenous women (hazards ratio 4.55, 95% confidence interval 2.63-7.88, p Australian women have a greater than fourfold risk of developing type 2 diabetes after gestational diabetes. Strategies are urgently needed to reduce rates of type 2 diabetes by supporting a healthy weight and breastfeeding and to improve postpartum screening among Indigenous women with gestational diabetes. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  18. Limited risk assessment and some cost/benefit considerations for greater confinement disposal compared to shallow land burial

    International Nuclear Information System (INIS)

    Hunter, P.H.; Lester, D.H.; Robertson, L.D.; Spaeth, M.E.; Stoddard, J.A.; Dickman, P.T.

    1984-09-01

    A limited risk assessment and some cost/benefit considerations of greater confinement disposal (GCD) compared to shallow land burial (SLB) are presented. This study is limited to an analysis of the postclosure phase of hypothetical GCD and SLB facilities. Selected release scenarios are used which bound the range of risks to a maximally exposed individual and a hypothetical population. Based on the scenario assessments, GCD had a significant risk advantage over SLB for normal exposure pathways at both humid and arid sites, particularly for the human intrusion scenario. Since GCD costs are somewhat higher than SLB, it is necessary to weigh the higher costs of GCD against the higher risks of SLB. In this regard, GCD should be pursued as an alternative to SLB for certain types of low-level waste, and as an alternative to processing for wastes requiring improved stabilization or higher integrity packaging to be compatible with SLB. There are two reasons for this conclusion. First, GCD might diminish public apprehension regarding the disposal of wastes perceived to be too hazardous for SLB. Second, GCD may be a relatively cost-effective alternative to various stabilization and packaging schemes required to meet 10 CFR 61 near-surface requirements as well as being a cost-effective alternative to deep geologic disposal. Radionuclide transport through the biosphere and resultant dose consequences were determined using the RADTRAN radionuclide transport code. 19 references, 4 figures, 5 tables

  19. Angiogenesis in symptomatic intracranial atherosclerosis: predominance of the inhibitor endostatin is related to a greater extent and risk of recurrence.

    Science.gov (United States)

    Arenillas, Juan F; Alvarez-Sabín, José; Montaner, Joan; Rosell, Anna; Molina, Carlos A; Rovira, Alex; Ribó, Marc; Sánchez, Esther; Quintana, Manuel

    2005-01-01

    Angiogenesis may be beneficial in chronic myocardial and limb ischemia, but its role in intracranial atherosclerosis remains unknown. We aimed to investigate the relationship between the pro-angiogenic vascular endothelial growth factor (VEGF) and the anti-angiogenic endostatin, and the extent and risk of recurrence of symptomatic intracranial atherosclerosis. Of a total of 94 consecutive patients with symptomatic intracranial stenoses, 40 fulfilled all inclusion criteria. Intracranial stenoses were confirmed by magnetic resonance angiography. Magnetic resonance imaging (MRI) including diffusion-weighted sequences was conducted. Plasmatic VEGF and endostatin were determined from blood samples obtained 3 months after stroke onset, and patients were followed-up thereafter. A total of 144 intracranial stenoses were confirmed (median number per patient=3). Endostatin/VEGF ratio gradually augmented with the increasing number of intracranial stenoses (r=0.35, P=0.02). Diabetes mellitus (OR, 6.04; CI, 1.1 to 32.2; P=0.03) and a higher endostatin/VEGF ratio (OR, 15.7; CI, 2.2 to 112.3; P=0.006) were independently associated with a greater extent of intracranial atherosclerosis. During a median follow-up of 13 months, 8 patients (20%) experienced a new cerebral ischemic event. A higher baseline endostatin concentration was an independent predictor of new events (hazard ratio, 7.24; CI, 1.6 to 33.8; P=0.011) in a Cox regression model after adjustment for age, sex, number of stenotic vessels, and risk factors. Patients with a higher endostatin level had a lower survival free of new events (P=0.01, log-rank test). A predominance of the inhibitor endostatin within the endogenous angiogenic response is associated with a greater extent and risk of recurrence of symptomatic intracranial atherosclerosis, suggesting that angiogenesis may be beneficial in this condition.

  20. Effect of exposure to greater active videogame variety on time spent in moderate- to vigorous-intensity physical activity.

    Science.gov (United States)

    Raynor, Hollie A; Cardoso, Chelsi; Bond, Dale S

    2016-07-01

    This investigation examined whether exposure to greater active videogame variety increases moderate- to vigorous-intensity physical activity (MVPA). Twenty-three participants (age=22.7±4.2yrs; body mass index=23.5±3.0kg/m(2); self-reported MVPA=298.7±116.7min/wk; 62.2% female; 73.9% Caucasian) participated in VARIETY (4 different active videogames during 4, 15-min bouts) and NON-VARIETY (only 1 active videogame during 4, 15-min bouts) counterbalanced sessions. VARIETY provided a different active videogame in each bout. NON-VARIETY provided participants their most highly liked active videogame in each bout. The Sensewear Mini Armband objectively assessed MVPA. For MVPA minutes, a session×bout (p<0.05) interaction occurred. In NON-VARIETY, bouts 2, 3, and 4 had significantly (p<0.05) fewer minutes than bout 1, with no decrease occurring in VARIETY. In bout 4, VARIETY had significantly (p<0.05) more minutes than NON-VARIETY. A main effect of session (p<0.05) occurred for MVPA minutes and energy expenditure, with VARIETY achieving greater amounts (31.8±14.3min vs. 27.6±16.9min; 186.1±96.8kcal vs. 171.2±102.8kcal). Exposure to greater activity variety within a session increased MVPA. Future research should examine exposure to a variety of activities over a longer time frame with participants of differing lifestyles in free-living environments. Copyright © 2016. Published by Elsevier Inc.

  1. Competing risks and time-dependent covariates

    DEFF Research Database (Denmark)

    Cortese, Giuliana; Andersen, Per K

    2010-01-01

    Time-dependent covariates are frequently encountered in regression analysis for event history data and competing risks. They are often essential predictors, which cannot be substituted by time-fixed covariates. This study briefly recalls the different types of time-dependent covariates......, as classified by Kalbfleisch and Prentice [The Statistical Analysis of Failure Time Data, Wiley, New York, 2002] with the intent of clarifying their role and emphasizing the limitations in standard survival models and in the competing risks setting. If random (internal) time-dependent covariates...

  2. Investigating Gender Differences under Time Pressure in Financial Risk Taking.

    Science.gov (United States)

    Xie, Zhixin; Page, Lionel; Hardy, Ben

    2017-01-01

    There is a significant gender imbalance on financial trading floors. This motivated us to investigate gender differences in financial risk taking under pressure. We used a well-established approach from behavior economics to analyze a series of risky monetary choices by male and female participants with and without time pressure. We also used second to fourth digit ratio (2D:4D) and face width-to-height ratio (fWHR) as correlates of pre-natal exposure to testosterone. We constructed a structural model and estimated the participants' risk attitudes and probability perceptions via maximum likelihood estimation under both expected utility (EU) and rank-dependent utility (RDU) models. In line with existing research, we found that male participants are less risk averse and that the gender gap in risk attitudes increases under moderate time pressure. We found that female participants with lower 2D:4D ratios and higher fWHR are less risk averse in RDU estimates. Males with lower 2D:4D ratios were less risk averse in EU estimations, but more risk averse using RDU estimates. We also observe that men whose ratios indicate a greater prenatal exposure to testosterone exhibit a greater optimism and overestimation of small probabilities of success.

  3. Relapse insomnia increases greater risk of anxiety and depression: evidence from a population-based 4-year cohort study.

    Science.gov (United States)

    Chen, Ping-Jen; Huang, Charles Lung-Cheng; Weng, Shih-Feng; Wu, Ming-Ping; Ho, Chung-Han; Wang, Jhi-Joung; Tsai, Wan-Chi; Hsu, Ya-Wen

    2017-10-01

    We investigated the longitudinal impacts of insomnia on the subsequent developments of anxiety and depression during a four-year follow-up. We further categorized individuals with insomnia into different insomnia subgroups to examine whether the risk of anxiety and depression varies by subtype. Participants were identified from National Health Insurance enrollees in Taiwan during 2002-2009. The study included 19,273 subjects with insomnia and 38,546 matched subjects without insomnia. All subjects did not have previous diagnosis of insomnia, sleep apnea, anxiety, or depression. Compared with non-insomniacs, insomniacs had a higher risk of developing anxiety only [adjusted hazard ratio (HR) = 8.83, 95% CI = 7.59-10.27], depression only (adjusted HR = 8.48, 95% CI = 6.92-10.39), and both anxiety and depression (adjusted HR = 17.98, 95% CI = 12.65-25.56). When breaking down the insomnia subgroups, individuals with a relapse of insomnia (adjusted HR = 10.42-26.80) had the highest risk of anxiety only, depression only, and both anxiety and depression, followed by persistent insomnia (adjusted HR = 9.82-18.98), then remitted insomnia (adjusted HR = 4.50-8.27). All three insomnia subgroups had a greater four-year cumulative incidence rate than the non-insomnia group for anxiety only, depression only, and both anxiety and depression (p anxiety or/and depression. Awareness of insomnia and treatment of insomnia should be recommended at clinics, and patterns of insomnia should be monitored to help treatment and control of subsequent psychiatric disorders. Future research with comprehensive data collection is needed to identify factors that contribute to different insomnia subtypes. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Changes in risk perception over time

    International Nuclear Information System (INIS)

    Gomez, L.S.; Jenkins-Smith, H.C.; Miller, K.W.

    1992-01-01

    The focus of this paper is on changes in perceptions of the risks associated with nuclear waste management over time. In particular, we are interested in the kinds of change that take place when the management programs, and those who are charged with implementing them, are subject to intensive public debate over an extended period of time. We are undertaken an over-time study of perceived risks in Colorado and New Mexico by implementing sequential random household surveys in each state, timed at six month intervals. This study employs three of these surveys, spanning the period from summer, 1990 to summer, 1991. Using these data, we examine the dynamics that may underlie variations in perceived risks over time. In particular, our analysis is focused on changes in the roles played by (1) basic political orientations (i.e. political ideology) and (2) trust in those who advocate conflicting policy positions

  5. Puerarin exhibits greater distribution and longer retention time in neurons than astrocytes in a co-cultured system

    Directory of Open Access Journals (Sweden)

    Shu-Yong Wei

    2015-01-01

    Full Text Available The phytoestrogen puerarin has been shown to protect neurons and astrocytes in the brain, and is therefore an attractive drug in the treatment of Alzheimer′s disease, Parkinson′s disease and cerebral ischemia. Whether puerarin exhibits the same biological processes in neurons and astrocytes in vitro has rarely been reported. In this study, cortical neurons and astrocytes of newborn Sprague-Dawley rats were separated, identified and co-cultured in a system based on Transwell membranes. The retention time and distribution of puerarin in each cell type was detected by fluorescence spectrophotometry and fluorescence microscope. The concentration of puerarin in both co-cultured and separately cultured neurons was greater than that of astrocytes. Puerarin concentration reached a maximum 20 minutes after it was added. At 60 minutes after its addition, a scant amount of drug was detected in astrocytes; however in both separately cultured and co-cultured neurons, the concentration of puerarin achieved a stable level of about 12.8 ng/mL. The results indicate that puerarin had a higher concentration and longer retention time in neurons than that observed in astrocytes.

  6. Is compromised oral health associated with a greater risk of mortality among nursing home residents? A controlled clinical study.

    Science.gov (United States)

    Klotz, Anna-Luisa; Hassel, Alexander Jochen; Schröder, Johannes; Rammelsberg, Peter; Zenthöfer, Andreas

    2017-08-30

    The objective of this controlled clinical study was to evaluate the association between oral health and 1-year mortality among nursing home residents with or without oral health intervention. This research was part of a multidisciplinary intervention study (EVI-P) performed in 14 nursing homes in Germany. Two-hundred and nineteen nursing home residents were included in the study and assigned to an intervention group, for which dental health education was offered and ultrasonic baths were used for denture cleaning (n = 144), or to a control group (n = 75). Before the intervention, each participant was examined, and dental status, plaque control record (PCR), Denture Hygiene Index, and results from the Revised Oral Assessment Guide were recorded. Amount of care needed and dementia were also assessed, by use of the Barthel Index and the Mini Mental State Examination, respectively. Participant mortality was determined after 12 months, and bivariate analysis and logistic regression models were used to evaluate possible factors affecting mortality. Bivariate analysis detected a direct association between greater mortality and being in the control group (p = .038). Participants with higher PCR were also more likely to die during the study period (p = .049). For dentate participants, the protective effect of being in the intervention group was confirmed by multivariate analysis in which covariates such as age and gender were considered. Oral hygiene and oral health seem to affect the risk of mortality of nursing home residents. Dental intervention programs seem to reduce the risk of 1-year mortality among nursing home residents having remaining natural teeth. Further studies, with larger sample sizes and evaluation of the causes of death, are necessary to investigate the reasons for these associations.

  7. Plate fixation for proximal chevron osteotomy has greater risk for hallux valgus recurrence than Kirschner wire fixation.

    Science.gov (United States)

    Park, Chul-Hyun; Ahn, Ji-Yong; Kim, Yu-Mi; Lee, Woo-Chun

    2013-06-01

    The purpose of this study was to compare the results of hallux valgus surgery between feet fixed with Kirschner wires and those fixed with a plate and screws. Between December 2008 and November 2009, 53 patients (62 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic moderate to severe hallux valgus deformity. Thirty-four patients (41 feet) were stabilised with Kirschner wires (K-wire group) and 19 patients (21 feet) were stabilised with a locking plate (plate group). Clinical results were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiographic parameters were compared between these groups. Recurrence rate at the last follow-up was compared between the K-wire and plate groups. Mean AOFAS score was lower in the plate group, however, the difference between the groups was not statistically significant in AOFAS score at the last follow-up. Hallux valgus angle and intermetatarsal angle were significantly larger in the plate group at the last follow-up. Mean 1-2 metatarsal (MT) distance on immediately postoperative radiographs was significant larger in the plate group. Four (9.8 %) of the 41 feet in the K-wire group and 7 (33.3 %) of the 21 feet in the plate group showed hallux valgus recurrence at the last follow-up. The plate group had a significantly higher risk of recurrence than the K-wire group. Fixation of proximal chevron osteotomy using a plate and screws has a greater risk of hallux valgus recurrence than fixation using Kirschner wires.

  8. The risk of cirrhosis in non-alcohol drinkers is greater in female than male betel nut chewers.

    Science.gov (United States)

    Chu, Yu-Hua; Wang, Lee; Ko, Pei-Chieh; Lan, Shou-Jen; Liaw, Yung-Po

    2018-02-02

    The association of betel nut with liver cirrhosis among alcohol drinkers has been clearly shown. However, very few studies have shown such an association among non-alcohol drinkers. The aim of this study was to assess the relationship between betel nut chewing and cirrhosis among non-alcohol drinkers. This study retrospectively analyzed data retrieved from the 2012 Adult Preventive Medical Services and the National Health Insurance Research Datasets in Taiwan. Participants' information included physical examination and lifestyle, alongside laboratory tests. Betel nut chewers were grouped into three categories: never, occasional and frequent. Diseases were diagnosed using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Initially, 1573024 adults aged 40 years and above who engaged in the free adult preventive medical services in 2012 were recruited. However, only 1065246 of them were included in the analysis. Chi-square test and logistic regression were used for the analyses. After multivariable adjustments, there were significant relationships between cirrhosis and betel nut chewing in both sexes (P-trend betel nut chewing and cirrhosis in both male and female non-alcohol drinkers. The risk of cirrhosis was greater in female than male chewers.

  9. Greater Pupil Size in Response to Emotional Faces as an Early Marker of Social-Communicative Difficulties in Infants at High Risk for Autism.

    Science.gov (United States)

    Wagner, Jennifer B; Luyster, Rhiannon J; Tager-Flusberg, Helen; Nelson, Charles A

    2016-01-01

    When scanning faces, individuals with autism spectrum disorder (ASD) have shown reduced visual attention (e.g., less time on eyes) and atypical autonomic responses (e.g., heightened arousal). To understand how these differences might explain sub-clinical variability in social functioning, 9-month-olds, with or without a family history of ASD, viewed emotionally-expressive faces, and gaze and pupil diameter (a measure of autonomic activation) were recorded using eye-tracking. Infants at high-risk for ASD with no subsequent clinical diagnosis (HRA-) and low-risk controls (LRC) showed similar face scanning and attention to eyes and mouth. Attention was overall greater to eyes than mouth, but this varied as a function of the emotion presented. HRA- showed significantly larger pupil size than LRC. Correlations between scanning at 9 months, pupil size at 9 months, and 18-month social-communicative behavior, revealed positive associations between pupil size and attention to both face and eyes at 9 months in LRC, and a negative association between 9-month pupil size and 18-month social-communicative behavior in HRA-. The present findings point to heightened autonomic arousal in HRA-. Further, with greater arousal relating to worse social-communicative functioning at 18 months, this work points to a mechanism by which unaffected siblings might develop atypical social behavior.

  10. Are female daycare workers at greater risk of cytomegalovirus infection? A secondary data analysis of CMV seroprevalence between 2010 and 2013 in Hamburg, Germany

    Directory of Open Access Journals (Sweden)

    Stranzinger, Johanna

    2016-04-01

    Full Text Available Background: Close contact with asymptomatic children younger than three years is a risk factor for a primary cytomegalovirus (CMV infection. In pregnant women, such primary infection increases the risk of CMV-induced feto- or embryopathy. Daycare providers have therefore implemented working restrictions for pregnant daycare workers (DCWs in accordance with legislation and guidelines for maternity protection. However, little is known about the infection risk for DCWs. We therefore compared the prevalence of CMV antibodies of pregnant DCWs to that of female blood donors (BDs.Method: In a secondary data analysis, the prevalence of anti-CMV IgG among pregnant DCWs (N=509 in daycare centers (DCCs was compared to the prevalence of female first-time BDs (N=14,358 from the greater region of Hamburg, Germany. Data collection took place between 2010 and 2013. The influence of other risk factors such as age, pregnancies and place of residence was evaluated using logistic regression models. Results: The prevalence of CMV antibodies in pregnant DCWs was higher than in female BDs (54.6 vs 41.5%; OR 1.6; 95%CI 1.3–1.9. The subgroup of BDs who had given birth to at least one child and who lived in the city of Hamburg (N=2,591 had a prevalence of CMV antibodies similar to the prevalence in pregnant DCWs (53.9 vs 54.6%; OR 0.9; 95%CI 0.8–1.2. Age, pregnancy history and living in the center of Hamburg were risk factors for CMV infections.Conclusion: The comparison of pregnant DCWs to the best-matching subgroup of female first-time BDs with past pregnancies and living in the city of Hamburg does not indicate an elevated risk of CMV infection among DCWs. However, as two secondary data sets from convenience samples were used, a more detailed investigation of the risk factors other than place of residence, age and maternity was not possible. Therefore, the CMV infection risk in DCWs should be further studied by taking into consideration the potential preventive

  11. Lycopene supplementation elevates circulating insulin-like growth factor binding protein-1 and -2 concentrations in persons at greater risk of colorectal cancer.

    NARCIS (Netherlands)

    Vrieling, A.; Voskuil, D.W.; Bonfrer, J.M.; Korse, C.M.; Doorn, J. van; Cats, A.; Depla, A.C.; Timmer, R.; Witteman, B.J.M.; Leeuwen, F.E. van; Veer, L.J. van 't; Rookus, M.A.; Kampman, E.

    2007-01-01

    BACKGROUND: Higher circulating insulin-like growth factor I (IGF-I) concentrations have been related to a greater risk of cancer. Lycopene intake is inversely associated with cancer risk, and experimental studies have shown that it may affect the IGF system, possibly through an effect on IGF-binding

  12. Lycopene supplementation elevates circulating insulin-like growth factor-binding protein-1 and-2 concentrations in persons at greater risk of colorectal cancer

    NARCIS (Netherlands)

    Vrieling, A.; Voskuil, D.W.; Bonfrer, J.M.; Korse, C.M.; Doorn, J.; Cats, A.; Depla, A.C.; Timmer, R.; Witteman, B.J.M.; Leeuwen, van F.E.; van't Veer, L.J.; Rookus, M.A.; Kampman, E.

    2007-01-01

    Background: Higher circulating insulin-like growth factor I (IGF-I) concentrations have been related to a greater risk of cancer. Lycopene intake is inversely associated with cancer risk, and experimental studies have shown that it may affect the IGF system, possibly through an effect on IGF-binding

  13. Coevolution between Hispaniolan crossbills and pine: does more time allow for greater phenotypic escalation at lower latitude?

    Science.gov (United States)

    Parchman, Thomas L; Benkman, Craig W; Mezquida, Eduardo T

    2007-09-01

    Crossbills (Aves: Loxia) and several conifers have coevolved in predator-prey arms races over the last 10,000 years. However, the extent to which coevolutionary arms races have contributed to the adaptive radiation of crossbills or to any other adaptive radiation is largely unknown. Here we extend our previous studies of geographically structured coevolution by considering a crossbill-conifer interaction that has persisted for a much longer time period and involves a conifer with more variable annual seed production. We examined geographic variation in the cone and seed traits of two sister species of pines, Pinus occidentalis and P. cubensis, on the islands of Hispaniola and Cuba, respectively. We also compared the Hispaniolan crossbill (Loxia megaplaga) to its sister taxa the North American white-winged crossbill (Loxia leucoptera leucoptera). The Hispaniolan crossbill is endemic to Hispaniola whereas Cuba lacks crossbills. In addition and in contrast to previous studies, the variation in selection experienced by these pines due to crossbills is not confounded by the occurrence of selection by tree squirrels (Tamiasciurus and Sciurus). As predicted if P. occidentalis has evolved defenses in response to selection exerted by crossbills, cones of P. occidentalis have scales that are 53% thicker than those of P. cubensis. Cones of P. occidentalis, but not P. cubensis, also have well-developed spines, a known defense against vertebrate seed predators. Consistent with patterns of divergence seen in crossbills coevolving locally with other conifers, the Hispaniolan crossbill has evolved a bill that is 25% deeper than the white-winged crossbill. Together with phylogenetic analyses, our results suggest that predator-prey coevolution between Hispaniolan crossbills and P. occidentalis over approximately 600,000 years has caused substantial morphological evolution in both the crossbill and pine. This also indicates that cone crop fluctuations do not prevent crossbills and

  14. Exploitation, Violence, and Suicide Risk Among Child and Adolescent Survivors of Human Trafficking in the Greater Mekong Subregion.

    Science.gov (United States)

    Kiss, Ligia; Yun, Katherine; Pocock, Nicola; Zimmerman, Cathy

    2015-09-01

    Human trafficking and exploitation of children have profound health consequences. To our knowledge, this study represents the largest survey on the health of child and adolescent survivors of human trafficking. To describe experiences of abuse and exploitation, mental health outcomes, and suicidal behavior among children and adolescents in posttrafficking services. We also examine how exposures to violence, exploitation, and abuse affect the mental health and suicidal behavior of trafficked children. A survey was conducted with 387 children and adolescents aged 10 to 17 years in posttrafficking services in Cambodia, Thailand, or Vietnam, which along with Laos, Myanmar, and Yunnan Province, China, compose the Greater Mekong Subregion. Participants were interviewed within 2 weeks of entering services from October 2011 through May 2013. Depression, posttraumatic stress disorder, anxiety, suicidal ideation, self-injury, and suicide attempts. Among the 387 children and adolescent study participants, most (82%) were female. Twelve percent had tried to harm or kill themselves in the month before the interview. Fifty-six percent screened positive for depression, 33% for an anxiety disorder, and 26% for posttraumatic stress disorder. Abuse at home was reported by 20%. Physical violence while trafficked was reported by 41% of boys and 19% of girls. Twenty-three percent of girls and 1 boy reported sexual violence. Mental health symptoms were strongly associated with recent self-harm and suicide attempts. Severe physical violence was associated with depression (adjusted odds ratio [AOR], 3.55; 95% CI, 1.64-7.71), anxiety (AOR, 2.13; 95% CI, 1.12-4.05), and suicidal ideation (AOR, 3.68; 95% CI, 1.77-7.67). Sexual violence while trafficked was associated with depression (AOR, 2.27; 95% CI, 1.22-4.23) and suicidal ideation (AOR, 3.43; 95% CI, 1.80-6.54). Children and adolescents in posttrafficking care showed high symptom levels of depression, anxiety, and posttraumatic stress

  15. Risk assessment and management of brucellosis in the southern greater Yellowstone area (I): A citizen-science based risk model for bovine brucellosis transmission from elk to cattle.

    Science.gov (United States)

    Kauffman, Mandy; Peck, Dannele; Scurlock, Brandon; Logan, Jim; Robinson, Timothy; Cook, Walt; Boroff, Kari; Schumaker, Brant

    2016-09-15

    Livestock producers and state wildlife agencies have used multiple management strategies to control bovine brucellosis in the Greater Yellowstone Area (GYA). However, spillover from elk to domestic bison and cattle herds continues to occur. Although knowledge is increasing about the location and behavior of elk in the SGYA, predicting spatiotemporal overlap between elk and cattle requires locations of livestock operations and observations of elk contact by producers. We queried all producers in a three-county area using a questionnaire designed to determine location of cattle and whether producers saw elk comingle with their animals. This information was used to parameterize a spatially-explicit risk model to estimate the number of elk expected to overlap with cattle during the brucellosis transmission risk period. Elk-cattle overlap was predicted in areas further from roads and forest boundaries in areas with wolf activity, with higher slopes, lower hunter densities, and where the cost-distance to feedgrounds was very low or very high. The model was used to estimate the expected number of years until a cattle reactor will be detected, under alternative management strategies. The model predicted cattle cases every 4.28 years in the highest risk herd unit, a higher prediction than the one case in 26 years we have observed. This difference likely indicates that ongoing management strategies are at least somewhat effective in preventing potential elk-cattle brucellosis transmission in these areas. Using this model, we can infer the expected effectiveness of various management strategies for reducing the risk of brucellosis spillover from elk to cattle. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Health risk assessment of pesticides and polychlorinated biphenyls contaminations in dairy products from selected farms in Greater Accra Region - Ghana

    International Nuclear Information System (INIS)

    Amoako, D.

    2013-07-01

    The residual concentrations of synthetic chemicals such as organochlorines pesticides (OCPs), pyrethroids and polychlorinated biphenyls (PCBs) in dairy products (milk, yoghurt, cheese) from selected farms in Greater Accra were analyzed using Gas Chromatography (GC). A total of 50 samples of dairy products (9 cheese, 25 cow milk and 16 yogourt) were analyzed for OCPs, prethroids and PCBs. Of the numerious pesticides evaluated, detectable levels of OCPs (β-HCH, endrin, heptachlor, endosulfan, p ' p-DDT and methoxchlor); synthetic prethroids (permathrin, allethrin, cypermethrin and deltamethrin) and PCBs (18, 28, 52, 101, 153, 138, and 180) were found in all the dairy product samples analysed. Milk samples were found to be the most contaminated with respect to the OCPs and the levels ranged between 0.0001µg/ml and 0.0407µg/ml. ß-HCH was the highest OCP with concentration of 0.0407µg/ml while cyfluthrin was the highest synthetic prethroids recorded in yoghurt sample (0.0318µg/ml). The highest PCB 18 (2,2,5-Trichlorobiphenyl) recorded (0.2668µg/ml) in yoghurt samples. (Data obtained from the field survey regarding safe use of pesticides, toxicity awareness and symptoms among farmers indicated that a very high proportion of animal farmers were at a high risk of pesticide poisoning from occupational exposure. More than 70% of farm workers did not practise safety precaution during pesticide mixing and application leading to considerable prevalence of pesticide related illness including nausea, vomiting, blurred vision, abdominal cramps, dizziness, diarrhoea and headaches in this agricultural community. The presence of pesticide residues in dairy products was of further concern because milk is the main protein diet for infants. The estimated dose for γ-chlordane(8.5x10 5 µ/ml), endrin(0.0114 µg/ml) p ' p ' -DDT(8.5x10 5 µg/ml), DDE(8.5x10 5 µg/ml),heptachlor(2.5x10 5 µg/ml), dieldrin(6.8x10 5 µg/ml) do not pose a direct hazard to human health, although present

  17. Risk and Time Preferences of Entrepreneurs

    DEFF Research Database (Denmark)

    Andersen, Steffen; Di Girolamo, Amalia; Harrison, Glenn W.

    2014-01-01

    To understand how small business entrepreneurs respond to government policy one has to know their risk and time preferences. Are they risk averse, or have high discount rates, such that they are hard to motivate? We have conducted a set of field experiments in Denmark that will allow a direct...... characterization of small business entrepreneurs in terms of these traits. We build on experimental tasks that are well established in the literature. The results do not suggest that small business entrepreneurs are more or less risk averse than the general population under the assumption of Expected Utility...... Theory. However, we generally find an S-shaped probability weighting function for both small business entrepreneurs and non-entrepreneurs, with entrepreneurs being more optimistic about the chance of occurrence for the best outcome in lotteries with real monetary outcomes. The results also point...

  18. Polygenic Risk Score Identifies Subgroup With Higher Burden of Atherosclerosis and Greater Relative Benefit From Statin Therapy in the Primary Prevention Setting.

    Science.gov (United States)

    Natarajan, Pradeep; Young, Robin; Stitziel, Nathan O; Padmanabhan, Sandosh; Baber, Usman; Mehran, Roxana; Sartori, Samantha; Fuster, Valentin; Reilly, Dermot F; Butterworth, Adam; Rader, Daniel J; Ford, Ian; Sattar, Naveed; Kathiresan, Sekar

    2017-05-30

    Relative risk reduction with statin therapy has been consistent across nearly all subgroups studied to date. However, in analyses of 2 randomized controlled primary prevention trials (ASCOT [Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm] and JUPITER [Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin]), statin therapy led to a greater relative risk reduction among a subgroup at high genetic risk. Here, we aimed to confirm this observation in a third primary prevention randomized controlled trial. In addition, we assessed whether those at high genetic risk had a greater burden of subclinical coronary atherosclerosis. We studied participants from a randomized controlled trial of primary prevention with statin therapy (WOSCOPS [West of Scotland Coronary Prevention Study]; n=4910) and 2 observational cohort studies (CARDIA [Coronary Artery Risk Development in Young Adults] and BioImage; n=1154 and 4392, respectively). For each participant, we calculated a polygenic risk score derived from up to 57 common DNA sequence variants previously associated with coronary heart disease. We compared the relative efficacy of statin therapy in those at high genetic risk (top quintile of polygenic risk score) versus all others (WOSCOPS), as well as the association between the polygenic risk score and coronary artery calcification (CARDIA) and carotid artery plaque burden (BioImage). Among WOSCOPS trial participants at high genetic risk, statin therapy was associated with a relative risk reduction of 44% (95% confidence interval [CI], 22-60; P statin therapy was 3.6% (95% CI, 2.0-5.1) among those in the high genetic risk group and 1.3% (95% CI, 0.6-1.9) in all others. Each 1-SD increase in the polygenic risk score was associated with 1.32-fold (95% CI, 1.04-1.68) greater likelihood of having coronary artery calcification and 9.7% higher (95% CI, 2.2-17.8) burden of carotid plaque. Those at high genetic risk have a greater

  19. Greater-than-Class C low-level radioactive waste characterization. Appendix A-2: Timing of greater-than-Class C low-level radioactive waste from nuclear power plants

    International Nuclear Information System (INIS)

    Steinke, W.F.

    1994-09-01

    Planning for the storage or disposal of greater-than-Class C low-level radioactive waste (GTCC LLW) requires characterization of that waste. Timing, or the date the waste will require storage or disposal, is an integral aspect of that planning. The majority of GTCC LLW is generated by nuclear power plants, and the length of time a reactor remains operational directly affects the amount of GTCC waste expected from that reactor. This report uses data from existing literature to develop high, base, and low case estimates for the number of plants expected to experience (a) early shutdown, (b) 40-year operation, or (c) life extension to 60-year operation. The discussion includes possible effects of advanced light water reactor technology on future GTCC LLW generation. However, the main focus of this study is timing for shutdown of current technology reactors that are under construction or operating

  20. 21 CFR 50.53 - Clinical investigations involving greater than minimal risk and no prospect of direct benefit to...

    Science.gov (United States)

    2010-04-01

    ... minimal risk and no prospect of direct benefit to individual subjects, but likely to yield generalizable... minimal risk and no prospect of direct benefit to individual subjects, but likely to yield generalizable... intervention or procedure that does not hold out the prospect of direct benefit for the individual subject, or...

  1. 34 CFR 97.406 - Research involving greater than minimal risk and no prospect of direct benefit to individual...

    Science.gov (United States)

    2010-07-01

    ... subject, or by a monitoring procedure which is not likely to contribute to the well-being of the subject, only if the IRB finds that— (a) The risk represents a minor increase over minimal risk; (b) The... Education PROTECTION OF HUMAN SUBJECTS Additional ED Protections for Children Who Are Subjects in Research...

  2. 45 CFR 46.406 - Research involving greater than minimal risk and no prospect of direct benefit to individual...

    Science.gov (United States)

    2010-10-01

    ... to the well-being of the subject, only if the IRB finds that: (a) The risk represents a minor... HUMAN SERVICES GENERAL ADMINISTRATION PROTECTION OF HUMAN SUBJECTS Additional Protections for Children...

  3. Time and time again: risk perceptions by experts, legislators and the public over time

    International Nuclear Information System (INIS)

    Paris, I.; Mays, C.; Sugier, N.

    1998-01-01

    This paper explores the hypothesis that a very different curve in perceptions of managed technological risks may be observed over time in experts, political decision makers, and the general public. Experts may have high risk perceptions during the phase of technology development, with the outcome of risk-reducing design. Members of the public, in their role as consumers, may perceive new technologies as very risky until such time as they have become integrated into everyday practice. At that time, with feedback from experience, risk perceptions may rise again in experts. The perceptions of legislators may respond to those expressed by either or both groups. Economic and social theories of risk perception are cited to construct the curve of risk perception for each group. (authors)

  4. 45 CFR 46.405 - Research involving greater than minimal risk but presenting the prospect of direct benefit to the...

    Science.gov (United States)

    2010-10-01

    ... presenting the prospect of direct benefit to the individual subjects. 46.405 Section 46.405 Public Welfare... risk but presenting the prospect of direct benefit to the individual subjects. HHS will conduct or fund... procedure that holds out the prospect of direct benefit for the individual subject, or by a monitoring...

  5. Loop diuretics are associated with greater risk of sarcopenia in patients with non-dialysis-dependent chronic kidney disease.

    Science.gov (United States)

    Ishikawa, Seiko; Naito, Shotaro; Iimori, Soichiro; Takahashi, Daiei; Zeniya, Moko; Sato, Hidehiko; Nomura, Naohiro; Sohara, Eisei; Okado, Tomokazu; Uchida, Shinichi; Rai, Tatemitsu

    2018-01-01

    Sarcopenia, the age-related loss of muscle mass and function, frequently accompanies chronic kidney disease. The aim of this study was to clarify the prevalence and the risk factors for sarcopenia among patients with non-dialysis-dependent chronic kidney disease (NDD-CKD), focusing on the use of drugs. We conducted a cross-sectional analysis on a cohort of 260 patients with NDD-CKD in a university hospital, recruited between June 2016 and March 2017. We extracted data on patient gender, age, cause of chronic kidney disease, use of drugs, and comorbidities that could potentially affect the prevalence of sarcopenia. Sarcopenia was diagnosed using the criteria of the Asian Working Group for Sarcopenia. Logistic regression analysis was performed to analyze the association of each factor on the prevalence of sarcopenia. 25.0% of our study subjects had sarcopenia. Multivariable analysis revealed that an increased risk of sarcopenia was significantly associated with age, male gender, body mass index, diabetes mellitus, and loop diuretic use (odds ratio, 4.59: 95% confidence interval, 1.81-11.61: P-value 0.001). In our cohort, the prevalence of sarcopenia in patients with NDD-CKD was high, and diuretics use, particularly loop diuretic use, was suggested to be a risk factor of sarcopenia. Although loop diuretics are commonly used in patients with CKD, careful consideration of the risk of sarcopenia may be necessary.

  6. Role of prostate dose escalation in patients with greater than 15% risk of pelvic lymph node involvement

    International Nuclear Information System (INIS)

    Jacob, Rojymon; Hanlon, Alexandra L.; Horwitz, Eric M.; Movsas, Benjamin; Uzzo, Robert G.; Pollack, Alan

    2005-01-01

    Purpose: To determine whether the radiation dose is a determinant of clinical outcome in patients with a lymph node risk of >15% treated using whole pelvic (WP), partial pelvic (PP), or prostate only (PO) fields. Methods and materials: A total of 420 patients with prostate cancer treated with three-dimensional conformal radiotherapy with or without short-term androgen deprivation (STAD) between June 1989 and July 2000 were included in this study. Patients had an initial pretreatment prostate-specific antigen level of 15% in the patient population studied. These data suggest that the primary tumor takes precedence over lymph node coverage or the use of STAD. Doses >70 Gy are of paramount importance in such intermediate- and high-risk patients

  7. Pathological Outcome following Radical Prostatectomy in Men with Prostate Specific Antigen Greater than 10 ng/ml and Histologically Favorable Risk Prostate Cancer.

    Science.gov (United States)

    Yu, Jiwoong; Kwon, Young Suk; Kim, Sinae; Han, Christopher Sejong; Farber, Nicholas; Kim, Jongmyung; Byun, Seok Soo; Kim, Wun-Jae; Jeon, Seong Soo; Kim, Isaac Yi

    2016-05-01

    Active surveillance is now the treatment of choice in men with low risk prostate cancer. Although there is no consensus on which patients are eligible for active surveillance, prostate specific antigen above 10 ng/ml is generally excluded. In an attempt to determine the validity of using a prostate specific antigen cutoff of 10 ng/ml to counsel men considering active surveillance we analyzed a multi-institution database to determine the pathological outcome in men with prostate specific antigen greater than 10 ng/ml but histologically favorable risk prostate cancer. We queried a prospectively maintained database of men with histologically favorable risk prostate cancer who underwent radical prostatectomy between 2003 and 2015. The cohort was categorized into 3 groups based on prostate specific antigen level, including low-less than 10 ng/ml, intermediate-10 or greater to less than 20 and high-20 or greater. Associations of prostate specific antigen group with adverse pathological and oncologic outcomes were analyzed. Of 2,125 patients 1,327 were categorized with histologically favorable risk disease. However on multivariate analyses the rates of up staging and upgrading were similar between the intermediate and low prostate specific antigen groups. In contrast compared to the intermediate prostate specific antigen group the high group had higher incidences of up staging (p = 0.02) and upgrading to 4 + 3 or greater disease (p = 0.046). Biochemical recurrence-free survival rates revealed no pairwise intergroup differences except between the low and high groups. Patients with preoperatively elevated prostate specific antigen between 10 and less than 20 ng/ml who otherwise had histologically favorable risk prostate cancer were not at higher risk for adverse pathological outcomes than men with prostate specific antigen less than 10 ng/ml. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Paired Synchronous Rhythmic Finger Tapping without an External Timing Cue Shows Greater Speed Increases Relative to Those for Solo Tapping.

    Science.gov (United States)

    Okano, Masahiro; Shinya, Masahiro; Kudo, Kazutoshi

    2017-03-09

    In solo synchronization-continuation (SC) tasks, intertap intervals (ITI) are known to drift from the initial tempo. It has been demonstrated that people in paired and group contexts modulate their action timing unconsciously in various situations such as choice reaction tasks, rhythmic body sway, and hand clapping in concerts, which suggests the possibility that ITI drift is also affected by paired context. We conducted solo and paired SC tapping experiments with three tempos (75, 120, and 200 bpm) and examined whether tempo-keeping performance changed according to tempo and/or the number of players. Results indicated that those tapping in the paired conditions were faster, relative to those observed in the solo conditions, for all tempos. For the faster participants, the degree of ITI drift in the solo conditions was strongly correlated with that in the paired conditions. Regression analyses suggested that both faster and slower participants adapted their tap timing to that of their partners. A possible explanation for these results is that the participants reset the phase of their internal clocks according to the faster beat between their own tap and the partners' tap. Our results indicated that paired context could bias the direction of ITI drift toward decreasing.

  9. Role-Playing and Real-Time Strategy Games Associated with Greater Probability of Internet Gaming Disorder.

    Science.gov (United States)

    Eichenbaum, Adam; Kattner, Florian; Bradford, Daniel; Gentile, Douglas A; Green, C Shawn

    2015-08-01

    Research indicates that a small subset of those who routinely play video games show signs of pathological habits, with side effects ranging from mild (e.g., being late) to quite severe (e.g., losing a job). However, it is still not clear whether individual types, or genres, of games are most strongly associated with Internet gaming disorder (IGD). A sample of 4,744 University of Wisconsin-Madison undergraduates (Mage=18.9 years; SD=1.9 years; 60.5% female) completed questionnaires on general video game playing habits and on symptoms of IGD. Consistent with previous reports: 5.9-10.8% (depending on classification criteria) of individuals who played video games show signs of pathological play. Furthermore, real-time strategy and role-playing video games were more strongly associated with pathological play, compared with action and other games (e.g., phone games). The current investigation adds support to the idea that not all video games are equal. Instead, certain genres of video games, specifically real-time strategy and role-playing/fantasy games, are disproportionately associated with IGD symptoms.

  10. F227. PSYCHOLOGICAL TRAUMA OCCURRING DURING ADOLESCENCE IS ASSOCIATED WITH AN INCREASED RISK OF GREATER WAIST CIRCUMFERENCE IN EARLY PSYCHOSIS PATIENTS INDEPENDENTLY OF MEDICATION

    Science.gov (United States)

    Alameda, Luis; Levier, Axel; Golay, Philippe; Gholam-Rezaee, Mehdi; Vandenberghe, Frederik; Delacretaz, Aurélie; Glatard, Anaïs; Dubath, Céline; Do, Kim Q; Eap, Chin B; Conus, Philippe

    2018-01-01

    present in 32% of the sample. No differences between groups were found at baseline in terms of BMI or WC. Late-Trauma patients, when compared to Non-Trauma patients showed greater WCs during the follow-up (p=0.012). No differences between Early or Late-Trauma patients and Non-Trauma patients were found in any of the other outcome measures during the follow up. Baseline BMI and treatment duration were significantly associated with the level of BMI and WC during the follow up. None of the other potential confounding factors were significantly associated with the outcome measures during the follow up. Discussion Exposition to trauma during adolescence in EP patients is associated with a higher risk of greater WC during the early phase of the disease, independently of the medication intake, depression and other confounding factors. Specific preventive measures should be addressed in these patients in order to reduce the risk of obesity. Depending on the timing of traumatic exposure, different developmental mechanisms may underlie this differential possible impact on WC. Further studies on interactions between central consequences of traumatism and metabolic syndrome are warranted.

  11. National evaluation of the benefits and risks of greater structuring and coding of the electronic health record: exploratory qualitative investigation.

    Science.gov (United States)

    Morrison, Zoe; Fernando, Bernard; Kalra, Dipak; Cresswell, Kathrin; Sheikh, Aziz

    2014-01-01

    We aimed to explore stakeholder views, attitudes, needs, and expectations regarding likely benefits and risks resulting from increased structuring and coding of clinical information within electronic health records (EHRs). Qualitative investigation in primary and secondary care and research settings throughout the UK. Data were derived from interviews, expert discussion groups, observations, and relevant documents. Participants (n=70) included patients, healthcare professionals, health service commissioners, policy makers, managers, administrators, systems developers, researchers, and academics. Four main themes arose from our data: variations in documentation practice; patient care benefits; secondary uses of information; and informing and involving patients. We observed a lack of guidelines, co-ordination, and dissemination of best practice relating to the design and use of information structures. While we identified immediate benefits for direct care and secondary analysis, many healthcare professionals did not see the relevance of structured and/or coded data to clinical practice. The potential for structured information to increase patient understanding of their diagnosis and treatment contrasted with concerns regarding the appropriateness of coded information for patients. The design and development of EHRs requires the capture of narrative information to reflect patient/clinician communication and computable data for administration and research purposes. Increased structuring and/or coding of EHRs therefore offers both benefits and risks. Documentation standards within clinical guidelines are likely to encourage comprehensive, accurate processing of data. As data structures may impact upon clinician/patient interactions, new models of documentation may be necessary if EHRs are to be read and authored by patients.

  12. No time to lose. The IAEA seeks greater resources to fight cancer in the world's poorest regions

    International Nuclear Information System (INIS)

    Samiei, M.; Rosenthal, M.D.; Kinley, D. III

    2005-01-01

    The IAEA is stepping up efforts to help more patients survive cancer through earlier diagnosis and better treatment. As the cancer burden mounts in developing countries, many more doctors, nurses, and skilled personnel will be needed, as well as necessary equipment. Through IAEA supported projects, some institutes in developing Member States are better prepared to help patients breast cancer. But equipment alone will not solve the problem, and establishing new treatment facilities is a long process that requires strong governmental support. It involves staff training (up to four years for a radiation oncologist and two years for a medical physicist), facility planning and construction, equipment specification and procurement, installation, acceptance testing and commissioning, registration and licensing, designing protocol and procedure manuals, and development of quality control programmes prior to initiating treatment. Typically, up to five years may be needed to complete all phases. However, in many cases improvements in existing facilities can lead to significant increases in patient treatment in much less time. The IAEA continues to address this enormous task and is currently involved in helping to upgrade radiotherapy facilities, train staff and establish quality assurance programmes in approximately 100 countries worldwide through national and regional projects

  13. Health-damaging policing practices among persons who inject drugs in Mexico: Are deported migrants at greater risk?

    Science.gov (United States)

    Pinedo, Miguel; Beletsky, Leo; Alamillo, Nathan; Ojeda, Victoria D

    2017-08-01

    Evidence-based public health and criminal justice policies aimed at addressing the structurally vulnerable population of persons who inject drugs (PWID) and who are involved in the immigrant enforcement and deportation system are lacking. Policing practices are critical structural determinants of HIV among PWID. PWID in Mexico who have been deported from the US are at elevated risk of HIV. From 2011 to 2013, 733 PWID were recruited to complete structured questionnaires, including past 6-month experiences with police. Eligible PWID were 18 years or older, had injected in the past month, and resided in Tijuana, Mexico with no intentions of moving. To determine if deportation status was associated with experiences of arrests and problematic policing practices, we conducted separate multivariate logistic regression models for independent policing variables. In multivariate analyses, deportation status was independently associated with higher odds of being arrested (Adjusted Odds Ratio (AOR): 1.45; 95% Confidence Interval (CI): 1.02-2.05), being asked for a bribe (AOR: 1.39; 95% CI: 1.05-2.04), and being forced to leave a place of residence (AOR: 2.00; 95% CI: 1.08-3.70) in the past 6 months. Results highlight a previously poorly understood elements of the US-deportation experience: migrants' experiences with law enforcement post-deportation and the role of deportation policies and practices as structural drivers of public health risk in destination countries. We provide policy recommendations for Mexico and the US based on our findings, which have potential application in other countries seeking to improve enforcement and related policing practices from a public health perspective. Copyright © 2017. Published by Elsevier B.V.

  14. Elevated resting heart rate is associated with greater risk of cardiovascular and all-cause mortality in current and former smokers

    DEFF Research Database (Denmark)

    Jensen, Magnus T; Marott, Jacob L; Jensen, Gorm B

    2010-01-01

    . Current and former smokers had, irrespective of tobacco consumption, greater relative risk of elevated RHR compared to never smokers. The relative risk of all-cause mortality per 10bpm increase in RHR was (95% CI): 1.06 (1.01-1.10) in never smokers, 1.11 (1.07-1.15) in former smokers, 1.13 (1......BACKGROUND: Elevated resting heart rate is associated with mortality in general populations. Smokers may be at particular risk. The association between resting heart rate (RHR), smoking status and cardiovascular and total mortality was investigated in a general population. METHODS: Prospective.......09-1.16) in moderate smokers, and 1.13 (1.10-1.16) in heavy smokers. There was no gender difference. The risk estimates for cardiovascular and all-cause mortality were essentially similar. In univariate analyses, the difference in survival between a RHR in the highest (>80bpm) vs lowest quartile (...

  15. Elevated resting heart rate is associated with greater risk of cardiovascular and all-cause mortality in current and former smokers

    DEFF Research Database (Denmark)

    Jensen, Magnus T; Marott, Jacob L; Jensen, Gorm B

    2010-01-01

    BACKGROUND: Elevated resting heart rate is associated with mortality in general populations. Smokers may be at particular risk. The association between resting heart rate (RHR), smoking status and cardiovascular and total mortality was investigated in a general population. METHODS: Prospective....... Current and former smokers had, irrespective of tobacco consumption, greater relative risk of elevated RHR compared to never smokers. The relative risk of all-cause mortality per 10bpm increase in RHR was (95% CI): 1.06 (1.01-1.10) in never smokers, 1.11 (1.07-1.15) in former smokers, 1.13 (1.......09-1.16) in moderate smokers, and 1.13 (1.10-1.16) in heavy smokers. There was no gender difference. The risk estimates for cardiovascular and all-cause mortality were essentially similar. In univariate analyses, the difference in survival between a RHR in the highest (>80bpm) vs lowest quartile (...

  16. Labour Trafficking among Men and Boys in the Greater Mekong Subregion: Exploitation, Violence, Occupational Health Risks and Injuries

    Science.gov (United States)

    Pocock, Nicola S.; Kiss, Ligia; Oram, Sian; Zimmerman, Cathy

    2016-01-01

    Background Men comprise nearly two-thirds of trafficked and forced labourers in common low-skilled labour sectors including fishing, agriculture and factory work. Yet, most evidence on human trafficking has focused on women and girls trafficked for sex work, with scant research on trafficked men and boys. Methods We analyse survey data from the largest systematic consecutive sample of trafficked people collected to date to describe the prevalence of violence, occupational health risks and injuries and associated factors. Participants were labour-trafficked men and boys using post-trafficking support services in Thailand, Cambodia and Vietnam. Findings Data are presented on 446 males aged 10–58. Men and boys were mainly trafficked for fishing (61.7%), manufacturing (19.1%) and begging (5.2%). Fishermen worked extensive hours (mean 18.8 hours/day, SD 5.9) and factory workers worked on average 11.9 hours/day (SD 2.9). 35.5% of male survivors had been injured while trafficked; 29.4% received no personal protective equipment (e.g. gloves). The most commonly reported injuries among all males were deep cuts (61.8%) and skin injuries (36.7%), injuries for which fewer than one-quarter reported receiving medical care. Six fishermen lost body parts, none of whom received medical care. Most males (80.5%) had no or very few rest breaks. One-third (37.8%) experienced severe violence. Work-related injuries were associated with severe violence (AOR 3.44, CI:1.63–7.26), being in the fishing sector, (AOR 4.12, CI:2.39–7.09) and threats (AOR 2.77, CI:1.62–4.75). Experiencing any violence was associated with threats (AOR 26.86, CI:14.0–51.23), being in the fishing sector (AOR 18.53, CI:8.74–39.28) and fluency in language of destination country (AOR 0.39, CI:0.20–0.75). Conclusion This study highlights the abuse and extreme occupational hazards suffered by trafficked men and boys. Occupational health and safety interventions are urgently needed to protect male migrant

  17. Labour Trafficking among Men and Boys in the Greater Mekong Subregion: Exploitation, Violence, Occupational Health Risks and Injuries.

    Science.gov (United States)

    Pocock, Nicola S; Kiss, Ligia; Oram, Sian; Zimmerman, Cathy

    2016-01-01

    Men comprise nearly two-thirds of trafficked and forced labourers in common low-skilled labour sectors including fishing, agriculture and factory work. Yet, most evidence on human trafficking has focused on women and girls trafficked for sex work, with scant research on trafficked men and boys. We analyse survey data from the largest systematic consecutive sample of trafficked people collected to date to describe the prevalence of violence, occupational health risks and injuries and associated factors. Participants were labour-trafficked men and boys using post-trafficking support services in Thailand, Cambodia and Vietnam. Data are presented on 446 males aged 10-58. Men and boys were mainly trafficked for fishing (61.7%), manufacturing (19.1%) and begging (5.2%). Fishermen worked extensive hours (mean 18.8 hours/day, SD 5.9) and factory workers worked on average 11.9 hours/day (SD 2.9). 35.5% of male survivors had been injured while trafficked; 29.4% received no personal protective equipment (e.g. gloves). The most commonly reported injuries among all males were deep cuts (61.8%) and skin injuries (36.7%), injuries for which fewer than one-quarter reported receiving medical care. Six fishermen lost body parts, none of whom received medical care. Most males (80.5%) had no or very few rest breaks. One-third (37.8%) experienced severe violence. Work-related injuries were associated with severe violence (AOR 3.44, CI:1.63-7.26), being in the fishing sector, (AOR 4.12, CI:2.39-7.09) and threats (AOR 2.77, CI:1.62-4.75). Experiencing any violence was associated with threats (AOR 26.86, CI:14.0-51.23), being in the fishing sector (AOR 18.53, CI:8.74-39.28) and fluency in language of destination country (AOR 0.39, CI:0.20-0.75). This study highlights the abuse and extreme occupational hazards suffered by trafficked men and boys. Occupational health and safety interventions are urgently needed to protect male migrant labourers working in high-risk sectors, particularly

  18. Is greater acculturation associated with an increased prevalence of cardiovascular risk factors among Latinos in South Florida?

    Science.gov (United States)

    Chang, Aileen; Kenya, Sonjia; Ilangovan, Kumar; Li, Hua; Koru-Sengul, Tulay; Alonzo, Yisel; Carrasquillo, Olveen

    2015-05-01

    To examine the association of acculturation with various cardiovascular risk factors (CRFs) among Latinos with diabetes in South Florida. In a cross-sectional analysis of data collected from 300 Latinos with poorly controlled diabetes we measured acculturation using the Marin Short Acculturation Scale. We examined correlations between acculturation and the following 7 CRFs: hemoglobin A1C, low-density lipoprotein, systolic blood pressure, body mass index, smoking status, physical activity, and fruit and vegetable intake. Cubans made up 38% of our population; no other Latino subgroup represented over 17% of the sample. Of the 8 outcomes examined, only smoking was associated with increased acculturation; 12% of Latinos in the 2 lowest acculturation groups were current smokers versus 25% in the highest acculturation group (P=0.02). Furthermore, Cuban Americans from our sample had over double the prevalence of smoking compared with non-Cubans in both the lowest and highest acculturation groups. With the exception of smoking, our data does not support a link between increased acculturation and higher prevalence of CRFs in Latinos with diabetes. Smoking prevention and cessation programs targeting Latinos and particularly among Cubans are needed.

  19. Environmental fate and ecotoxicological risk of the antibiotic sulfamethoxazole across the Katari catchment (Bolivian Altiplano) : application of the GREAT-ER model

    OpenAIRE

    Archundia, D.; Boithias, Laurie; Duwig, Céline; Morel, M. C.; Aviles, G. F.; Martins, J. M. F.

    2018-01-01

    Antibiotics are emergent contaminants that can induce adverse effects in terrestrial and aquatic organisms. The surface water compartment is of particular concern as it receives direct waste water discharge. Modeling is highlighted as an essential tool to understand the fate and behavior of these compounds and to assess their eco-toxicological risk. This study aims at testing the ability of the GREAT-ER model in simulating sulfamethoxazole (SMX) concentrations in the surface waters of the ari...

  20. Variable use of amiodarone is associated with a greater risk of recurrence of atrial fibrillation in the critically ill.

    Science.gov (United States)

    Mitrić, Goran; Udy, Andrew; Bandeshe, Hiran; Clement, Pierre; Boots, Rob

    2016-04-02

    Atrial fibrillation is a common rhythm disturbance in the general medical-surgical intensive care unit. Amiodarone is a popular drug in this setting but evidence to inform clinical practice remains scarce. We aimed to identify whether variation in the clinical use of amiodarone was associated with recurrent atrial fibrillation. This was a retrospective audit of 177 critically ill patients who developed new-onset atrial fibrillation after admission to a tertiary level medical-surgical trauma intensive care unit. Patterns of amiodarone prescription (including dosage schedule and duration) were assessed in relation to recurrence of atrial fibrillation during the intensive care unit stay. Known recurrence risk factors, such as inotrope administration, cardiac disease indices, Charlson Comorbidity Index, magnesium concentrations, fluid balance, and potassium concentrations, were also included in adjusted analysis using forward stepwise logistic regression modelling. The cohort had a median (interquartile range) age of 69 years (60-75), Acute Physiology and Chronic Health Evalution II score of 22 (17-28) and Charlson Comorbidity Index of 2 (1-4). A bolus dose of amiodarone followed by infusion (P = 0.02), in addition to continuing amiodarone infusion through to discharge from the intensive care unit (P < 0.001), were associated with less recurrent dysrhythmia. Recurrence after successful treatment was associated with ceasing amiodarone while an inotrope infusion continued (P < 0.001), and was more common in patients with a prior history of congestive cardiac failure (P = 0.04), and a diagnosis of systemic inflammatory response syndrome (P = 0.02). Amiodarone should be administered as a bolus dose followed immediately with an infusion when treating atrial fibrillation in the medical-surgical intensive care unit. Consideration should be given to continuing amiodarone infusions in patients on inotropes until they are ceased.

  1. Double jeopardy in astronomy and planetary science: Women of color face greater risks of gendered and racial harassment

    Science.gov (United States)

    Clancy, Kathryn B. H.; Lee, Katharine M. N.; Rodgers, Erica M.; Richey, Christina

    2017-07-01

    Women generally, and women of color specifically, have reported hostile workplace experiences in astronomy and related fields for some time. However, little is known of the extent to which individuals in these disciplines experience inappropriate remarks, harassment, and assault. We hypothesized that the multiple marginality of women of color would mean that they would experience a higher frequency of inappropriate remarks, harassment, and assault in the astronomical and planetary science workplace. We conducted an internet-based survey of the workplace experiences of 474 astronomers and planetary scientists between 2011 and 2015 and found support for this hypothesis. In this sample, in nearly every significant finding, women of color experienced the highest rates of negative workplace experiences, including harassment and assault. Further, 40% of women of color reported feeling unsafe in the workplace as a result of their gender or sex, and 28% of women of color reported feeling unsafe as a result of their race. Finally, 18% of women of color, and 12% of white women, skipped professional events because they did not feel safe attending, identifying a significant loss of career opportunities due to a hostile climate. Our results suggest that the astronomy and planetary science community needs to address the experiences of women of color and white women as they move forward in their efforts to create an inclusive workplace for all scientists.

  2. The early warning application role in facing the environmental crisis and disasters: "Preliminarily risk management strategy for the greater city of Cairo"

    Directory of Open Access Journals (Sweden)

    Ghoneem Yousef M.

    2013-01-01

    Full Text Available Natural disasters are inevitable and it is almost impossible to fully recoup the damage caused by the disasters. But it is possible to minimize the potential risk by developing disaster early warning strategies, methods using the new technology applications which play a crucial role in efficient mitigation and management of disasters. This paper describes the importance of the remote sensing and Geographical Information System (GIS in evolving a suitable strategy for disaster, crises and risk management using these technologies. The main objective of this paper is to make a Preliminary risk management plan (it is a logical and systematic method of identifying, analyzing, treating and monitoring the risks involved in any activity or process. This process helps Administrations to focus on priorities and in decisions on deploying limited resources to deal with the highest risks using the Environmental risk map of the greater city of Cairo demonstrating the most high-risk administrative areas in the city, supported by field evidence and different sources of information. to reduce the loss of life and property and protect the Nation from all hazards, including natural disasters and other man-made disasters, by leading and supporting the Nation in a risk-based, comprehensive emergency management system of preparedness, protection, response, recovery, and mitigation. This study has shown that how can the early warning Applications can be useful in analyzing, Integrating and managing different datasets for predicting the environmental crises and disasters that may affect the urbanism inside the city and help in the preparation of the Risk management plan.

  3. Contaminant risks from biosolids land application Contemporary organic contaminant levels in digested sewage sludge from five treatment plants in Greater Vancouver, British Columbia

    International Nuclear Information System (INIS)

    Bright, D.A.; Healey, N.

    2003-01-01

    The risks of organic contaminants in sewage sludges are evaluated. - This study examines the potential for environmental risks due to organic contaminants at sewage sludge application sites, and documents metals and various potential organic contaminants (volatile organics, chlorinated pesticides, PCBs, dioxins/furans, extractable petroleum hydrocarbons, PAHs, phenols, and others) in current production biosolids from five wastewater treatment plants (WWTPs) within the Greater Vancouver Regional District (GVRD). There has been greater focus in Europe, North America and elsewhere on metals accumulation in biosolids-amended soil than on organic substances, with the exception of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans. Another objective, therefore, was to evaluate the extent to which management of biosolids re-use based on metal/metalloid levels coincidentally minimizes environmental risks from organic contaminants. Historical-use contaminants such as chlorophenols, PCBs, and chlorinated pesticides were not detected at environmentally relevant concentrations in any of the 36 fresh biosolids samples, and appear to have virtually eliminated from sanitary collection system inputs. The few organic contaminants found in freshly produced biosolids samples that exhibited high concentrations relative to British Columbia and Canadian soil quality benchmarks included p-cresol, phenol, phenanthrene, pyrene, naphthalene, and heavy extractable petroleum hydrocarbons (HEPHs-nCl9-C34 effective carbon chain length). It was concluded that, with the exception of these petroleum hydrocarbon constituents or their microbial metabolites, the mixing of biosolids with uncontaminated soils during land application and based on the known metal concentrations in biosolids from the Greater Vancouver WWTPs investigated provides adequate protection against the environmental risks associated with organic substances such as dioxins and furans, phthalate esters, or volatile

  4. Greater sexual risk-taking in female and male recreational MDMA/ecstasy users compared with alcohol drinkers: a questionnaire study.

    Science.gov (United States)

    May, Aimee L; Parrott, Andrew C

    2015-07-01

    Previous studies have shown increased sexual risk-taking in experienced MDMA/ecstasy users. The main objectives of this study were to compare levels of sexual risk-taking between a young student sample of predominantly heterosexual MDMA users and alcohol-drinker controls and investigate potential gender differences. Recreational drug use and sexual risk questionnaires were completed by 20 MDMA users (10 females, 10 males) and 20 non-user controls (10 females, 10 males). They were predominantly university students, aged between 20-22 years, mainly heterosexual (n = 37), with three bisexual participants. MDMA users displayed significantly greater levels of sexual risk-taking than the alcohol-drinker controls. It involved significantly higher rates of casual sex, non-condom use during sex, and penetrative sexual risks. This increase in sexual riskiness occurred to a similar extent in males and females. These findings indicate that both female and male ecstasy/MDMA users reported more risky sexual behaviours, than the non-user controls. Further research into the sexual behaviour and sexual risk-taking of heterosexual MDMA users should be conducted because much of the past literature has focused on homosexual participants. Copyright © 2015 John Wiley & Sons, Ltd.

  5. A Greater Extent of Insomnia Symptoms and Physician-Recommended Sleep Medication Use Predict Fall Risk in Community-Dwelling Older Adults.

    Science.gov (United States)

    Chen, Tuo-Yu; Lee, Soomi; Buxton, Orfeu M

    2017-11-01

    Cross-sectional studies suggest that insomnia symptoms are associated with falls in later life. This longitudinal study examines the independent and interactive effects of the extent of insomnia symptoms (i.e., multiple co-existing insomnia symptoms) and sleep medications on fall risk over a 2-year follow-up among community-dwelling older adults. Using data from the Health and Retirement Study (2006-2014, N = 6882, Mage = 74.5 years ± 6.6 years), we calculated the extent of insomnia symptoms (range = 0-4) participants reported (i.e., trouble falling asleep, waking up during the night, waking up too early, and not feeling rested). At each wave, participants reported recent sleep medications use and falls since the last wave, and were evaluated for balance and walking speed. A greater burden of insomnia symptoms and using physician-recommended sleep medications at baseline independently predicted falling after adjusting for known risk factors of falling. The effects of insomnia symptoms on fall risk differed by sleep medications use. The extent of insomnia symptoms exhibited a positive, dose-response relation with risk of falling among those not using sleep medications. Older adults using physician-recommended sleep medications exhibited a consistently higher fall risk irrespective of the extent of insomnia symptoms. The number of insomnia symptoms predicts 2-year fall risk in older adults. Taking physician-recommended sleep medications increases the risks for falling in older adults, irrespective of the presence of insomnia symptoms. Future efforts should be directed toward treating insomnia symptoms, and managing and selecting sleep medications effectively to decrease the risk of falling in older adults. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  6. Ecological Risk Assessment of Metal Pollution along Greater Cairo Sector of the River Nile, Egypt, Using Nile Tilapia, Oreochromis niloticus, as Bioindicator

    Directory of Open Access Journals (Sweden)

    Wael A. Omar

    2015-01-01

    Full Text Available The present work aims to evaluate seasonal metal pollution along Greater Cairo sector of the River Nile, Egypt, using wild Nile tilapia, Oreochromis niloticus, as bioindicator and to conduct a risk assessment for human consumers. Greater Cairo is the largest populated area along the whole course of River Nile with a wide range of anthropogenic activities. Effects of metal pollution on fish body indices were studied using condition factor (CF and scaled mass index (SMI. Metal pollution index (MPI showed that the total metal load in fish organs followed the follwoing order: kidney > liver > gill > muscle which gives a better idea about the target organs for metal accumulation. Metal concentrations in fish muscle (edible tissue showed the following arrangement: Fe > Zn > Cu > Mn > Pb > Cd. Metal’s bioaccumulation factor (BAF in fish muscle showed the following arrangement: Zn > Cu > Fe > Mn > Cd and Pb. The hazard index (HI as an indicator of human health risks associated with fish consumption showed that adverse health effects are not expected to occur in most cases. However, the metals’ cumulative risk effects gave an alarming sign specifically at high fish consumption rates.

  7. Quantum process tomography with informational incomplete data of two J-coupled heterogeneous spins relaxation in a time window much greater than T1

    Science.gov (United States)

    Maciel, Thiago O.; Vianna, Reinaldo O.; Sarthour, Roberto S.; Oliveira, Ivan S.

    2015-11-01

    We reconstruct the time dependent quantum map corresponding to the relaxation process of a two-spin system in liquid-state NMR at room temperature. By means of quantum tomography techniques that handle informational incomplete data, we show how to properly post-process and normalize the measurements data for the simulation of quantum information processing, overcoming the unknown number of molecules prepared in a non-equilibrium magnetization state (Nj) by an initial sequence of radiofrequency pulses. From the reconstructed quantum map, we infer both longitudinal (T1) and transversal (T2) relaxation times, and introduce the J-coupling relaxation times ({T}1J,{T}2J), which are relevant for quantum information processing simulations. We show that the map associated to the relaxation process cannot be assumed approximated unital and trace-preserving for times greater than {T}2J.

  8. Greater early and mid-pregnancy gestational weight gain are associated with increased risk of gestational diabetes mellitus: A prospective cohort study.

    Science.gov (United States)

    Zhong, Chunrong; Li, Xiating; Chen, Renjuan; Zhou, Xuezhen; Liu, Chaoqun; Wu, Jiangyue; Xu, Shangzhi; Wang, Weiye; Xiao, Mei; Xiong, Guoping; Wang, Jing; Yang, Xuefeng; Hao, Liping; Yang, Nianhong

    2017-12-01

    Gestational diabetes mellitus is associated with adverse short- and long-term consequences for both the mother and the offspring. To examine the relationship between the rates of gestational weight gain (RGWG) during early and mid-pregnancy and the risk of gestational diabetes mellitus (GDM). 2090 singleton pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC) without overt diabetes before pregnancy were analyzed in our study. Gestational weight were measured regularly in every antenatal visit. Gestational diabetes mellitus was assessed with the 75-g, 2-h oral glucose tolerance test at 24-28 weeks of gestation. Multivariable logistic regression was performed to estimate effect of RGWG on GDM. A total of 8.3% (n = 173) of pregnant women were diagnosed with GDM. Women with elevated rate of gestational weight gain prior to glucose screening test (RGWG-PG) increased the risk of GDM (adjusted p-trend = 0.004; odds ratios (OR) 1.64, 95% confidence intervals (CI) 1.01-2.68 and OR 2.30,95% CI 1.44-3.66 for 0.297-0.384 kg/wk and 0.385 kg/wk or more vs. 0.213 kg/wk or less, respectively). Women with greater rate of gestational weight gain in the first trimester (RGWG-F) increased the risk of GDM (adjusted p-trend = 0.048; OR 1.83, 95% CI 1.14-2.94 and OR 1.76, 95% CI 1.10-2.83 for 0.086-0.200 kg/wk and 0.201 kg/wk or more vs. -0.025 kg/wk or less, respectively). The rate of gestational weight gain in the second trimester (RGWG-S) was significantly associated with GDM only among women with RGWG-F more than 0.086 kg/wk (adjusted p-trend = 0.035; OR 2.04, 95% CI 1.16-3.59 for 0.658 kg/wk or more vs. 0.418 kg/wk or less). Greater early pregnancy weight gain are associated with increased risk of GDM. Elevated weight gain in mid-pregnancy increased the risk of GDM only among pregnant women with greater weight gain in the first trimester. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All

  9. Greater intake of fruit and vegetables is associated with a lower risk of osteoporotic hip fractures in elderly Chinese: a 1:1 matched case-control study.

    Science.gov (United States)

    Xie, H-L; Wu, B-H; Xue, W-Q; He, M-G; Fan, F; Ouyang, W-F; Tu, S-L; Zhu, H-L; Chen, Y-M

    2013-11-01

    In this case-control study, we examined the relationship between the consumption of fruit and vegetables and risk of hip fractures in 646 pairs of incident cases and controls in elderly Chinese. We found that greater consumption of both fruit and vegetables in men and vegetables in women was associated with a lower risk of osteoporotic hip fractures in elderly Chinese. The association between fruit and vegetable consumption and the risk of osteoporotic fractures remains controversial due to limited published evidence. The purpose of this study was to determine whether consuming fruits and vegetables has a protective effect against hip fractures. Between January 2008 and December 2012, 646 (162 males, 484 females) incident cases (70.9 ± 6.8 years) of hip fractures were enrolled from five hospitals, with 646 sex- and age-matched (±3 years) controls (70.7 ± 6.8 years) from hospitals or the community. Face-to-face interviews were conducted to assess habitual dietary intakes using a 79-item food frequency questionnaire and various covariates by structured questionnaires. Multivariate conditional logistic regression analyses showed dose-dependent inverse correlations between the intake of total fruit (p-trend = 0.014), total vegetables (p-trend fruits and vegetables combined (p-trend fruits, vegetables and the combination of fruits and vegetables were 0.53 (0.32-0.87), 0.37 (0.23-0.60) and 0.25 (0.15-0.41), respectively. Stratified analyses showed that the benefits remained significant in males (p = 0.001) but not in females (p = 0.210) (p-interaction 0.045). Among the subcategories of fruits and vegetables, similar associations were observed for all subgroups except light-coloured fruits. Our findings suggest that greater consumption of both fruits and vegetables in men and vegetables in women may decrease the risk of osteoporotic hip fractures in elderly Chinese.

  10. Project finance risks - getting it right first time

    International Nuclear Information System (INIS)

    Bain, F.

    1996-01-01

    Bankers seeking to invest in the construction of new power stations by independent power producers, face greater risks than those lending to companies. Independent risk and insurance advisers are used to assess project risk. ''Project finance'' has become increasingly popular as it allows projects to go ahead that could not be supported from sponsors' own resources. In addition, project finance means that various equity partners can join together in a joint venture company and limit their individual risk. Project finance can be delayed by differences between the needs of sponsors, financiers and insurers. The process can be speeded up by foreknowledge of bankers' requirements. (UK)

  11. Time trends in osteoporosis risk factor profiles

    DEFF Research Database (Denmark)

    Holm, Jakob Præst; Hyldstrup, Lars; Jensen, Jens-Erik Beck

    2016-01-01

    The aim of this article was to identify prevalent osteoporosis risk factors, medications and comorbidities associated with bone mineral density (BMD). Furthermore to evaluate changes in risk factor profiles over 12 years. 6285 women consecutively referred to an osteoporosis specialist clinic were...... was established in a real-life setting. The prevalence of osteoporosis and proportion of patient's having comorbidity's associated with osteoporosis were increasing during the inclusion period (start 23.8 %, end 29.7 %). Increasing age (OR = 1.05), current smoking (OR = 1.18), estrogen deficiency (OR = 1.......7), hyperthyroidism (OR = 1.5), previous major osteoporotic fracture (OR = 1.7), former osteoporosis treatment (OR = 3.5), higher BMI (OR = 0.87), use of calcium supplementation (OR = 1.2), high exercise level (OR = 0.7), and use of thiazide diuretics (OR = 0.7) were identified as predictors of osteoporosis by DXA...

  12. First passage time probability in risk analysis

    International Nuclear Information System (INIS)

    Karmeshu; Ariaratnam, S.T.

    1982-01-01

    Many natural phenomena are subject to uncertain fluctuations due to a variety of internal or external factors. These phenomena can be described using stochastic models. An important quantity of interest involves the time lapse before some variables reach unacceptable values: the first passage time. A related question pertains to the statistical distributions of the extreme values of these variables in a given period of time. The authors discuss some problems drawn from population ecology and environmental engineering to illustrate the usefulness of the first passage time concept

  13. From which level of competition in clubs are adolescents at greater risk of injury compared with outside-of-clubs athletes? A school-based study.

    Science.gov (United States)

    Luiggi, Maxime; Rindler, Victoria; Griffet, Jean

    2018-02-01

    Sport practice is a key factor in a person's physical and mental health but, for adolescent athletes, some injuries lead to health problems in the long term. The literature provides multiple factors for understanding injury but does not give information about injury risk related to each level of play in a large sample of multisport athletes. This study investigates this relationship in 14- to 19-year-old adolescents. The survey on adolescents and health was conducted in classrooms of France, from February to March 2015. Only sports players were included in the analyses (n = 986). The levels of play were divided into five categories: outside of a club/no competition, club player/no competition, club player/local level, club player/state level and club player/national and higher level. A three-step binary logistic regression analysis with age, sex, type of sport, weekly hours of exposure, and level of play was used. During the past year, 48.1% of the adolescents were injured. Age and sex were not risk factors. The injury risk associated with the increases in level of play is higher than those related to the hours of exposure per week or the type of sport. In clubs, adolescents who do not compete or play at a local level showed no evidence of greater injury risk whereas state-level and national- and higher-level athletes were at greater risk than outside-of-club players (OR = 2.18, 95%CI = 1.13-3.94 and OR = 3.89, 95%CI = 2.07-7.31, respectively). Adolescents who play sports in clubs are clearly more exposed to injury than those who play outside of a club, mainly from state level. Age and sex are not related to injury. Future epidemiological studies should control adolescents' level of play. Special attention should be accorded to the injury risk of athletes playing at these levels of competition.

  14. Occupational dust exposure and head and neck squamous cell carcinoma risk in a population-based case–control study conducted in the greater Boston area

    International Nuclear Information System (INIS)

    Langevin, Scott M; McClean, Michael D; Michaud, Dominique S; Eliot, Melissa; Nelson, Heather H; Kelsey, Karl T

    2013-01-01

    Head and neck cancers account for an estimated 549,000 global cancer diagnoses each year. While tobacco use, alcohol consumption, and HPV16 infection are considered to be the major risk factors for this disease, occupational risk factors, including exposure to asbestos, have also been described, although dust exposures other than asbestos have been historically understudied. We have investigated the relationship between occupational exposures to five types of dusts, including sawdust, concrete dust, leather dust, metal dust, and chimney soot, and head and neck squamous cell carcinomas (HNSCC) in the greater Boston area. We report findings from a population-based case–control study involving 951 incident HNSCC cases and 1193 controls, frequency matched on age (±3 years), sex, and town/neighborhood of residence. Multivariable logistic regression was used to assess the association between occupational exposure to each type of dust and HNSCC, overall and by primary tumor site. After adjusting for age, sex, race, smoking, alcohol consumption, education, and HPV16 serology, laryngeal carcinoma risk increased for each decade of occupational exposure to sawdust (OR = 1.2, 95% CI: 1.0, 1.3) and metal dust (OR = 1.2, 95% CI: 1.0, 1.4); and HNSCC risk increased for each decade of occupational leather dust exposure (OR = 1.5, 95% CI: 1.2, 1.9). We have provided evidence for an association between occupational sawdust and metal dust and laryngeal squamous cell carcinoma, and leather dust and HNSCC, with increasing risk with longer duration at the exposed occupation

  15. Occupational dust exposure and head and neck squamous cell carcinoma risk in a population-based case-control study conducted in the greater Boston area.

    Science.gov (United States)

    Langevin, Scott M; McClean, Michael D; Michaud, Dominique S; Eliot, Melissa; Nelson, Heather H; Kelsey, Karl T

    2013-12-01

    Head and neck cancers account for an estimated 549,000 global cancer diagnoses each year. While tobacco use, alcohol consumption, and HPV16 infection are considered to be the major risk factors for this disease, occupational risk factors, including exposure to asbestos, have also been described, although dust exposures other than asbestos have been historically understudied. We have investigated the relationship between occupational exposures to five types of dusts, including sawdust, concrete dust, leather dust, metal dust, and chimney soot, and head and neck squamous cell carcinomas (HNSCC) in the greater Boston area. We report findings from a population-based case-control study involving 951 incident HNSCC cases and 1193 controls, frequency matched on age (±3 years), sex, and town/neighborhood of residence. Multivariable logistic regression was used to assess the association between occupational exposure to each type of dust and HNSCC, overall and by primary tumor site. After adjusting for age, sex, race, smoking, alcohol consumption, education, and HPV16 serology, laryngeal carcinoma risk increased for each decade of occupational exposure to sawdust (OR = 1.2, 95% CI: 1.0, 1.3) and metal dust (OR = 1.2, 95% CI: 1.0, 1.4); and HNSCC risk increased for each decade of occupational leather dust exposure (OR = 1.5, 95% CI: 1.2, 1.9). We have provided evidence for an association between occupational sawdust and metal dust and laryngeal squamous cell carcinoma, and leather dust and HNSCC, with increasing risk with longer duration at the exposed occupation. © 2013 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  16. Risk assessment and management of brucellosis in the southern greater Yellowstone area (II): Cost-benefit analysis of reducing elk brucellosis prevalence.

    Science.gov (United States)

    Boroff, Kari; Kauffman, Mandy; Peck, Dannele; Maichak, Eric; Scurlock, Brandon; Schumaker, Brant

    2016-11-01

    Recent cases of bovine brucellosis (Brucella abortus) in cattle (Bos taurus) and domestic bison (Bison bison) of the southern Greater Yellowstone Area (SGYA) have been traced back to free-ranging elk (Cervus elaphus). Several management activities have been implemented to reduce brucellosis seroprevalence in elk, including test-and-slaughter, low-density feeding at elk winter feedgrounds, and elk vaccination. It is unclear which of these activities are most cost-effective at reducing the risk of elk transmitting brucellosis to cattle. In a companion paper, a stochastic risk model was used to translate a reduction in elk seroprevalence to a reduction in the risk of transmission to cattle. Here, we use those results to estimate the expected economic benefits and costs of reducing seroprevalence in elk using three different management activities: vaccination of elk with Brucella strain 19 (S19), low-density feeding of elk, and elk test-and-slaughter. Results indicate that the three elk management activities yield negative expected net benefits, ranging from -$2983 per year for low-density feeding to -$595,471 per year for test-and-slaughter. Society's risk preferences will determine whether strategies that generate small negative net benefit, such as low-density feeding, are worth implementing. However, activities with large negative net benefits, such as test-and-slaughter and S19 vaccination, are unlikely to be economically worthwhile. Given uncertainty about various model parameters, we identify some circumstances in which individual management activities might generate positive expected net benefit. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. 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

  18. Risk management for buildings -- Has the time come?

    Energy Technology Data Exchange (ETDEWEB)

    Berry, D.L.; Hunter, R.L.

    1997-08-01

    There are both incentives and challenges for applying formal risk management processes to buildings and other structures, including bridges, highways, dams, stadiums, shopping centers, and private dwellings. Based on an assessment of several issues, the authors conclude that for certain types of buildings and structures the time has come for the use of a formal risk-management approach, including probabilistic risk assessment methods, to help identify dominant risks to public health, safety, and security and to help manage these risks in a cost-effective manner.

  19. Patient-specific radiation dose and cancer risk in computed tomography examinations in some selected CT facilities in the Greater Accra Region of Ghana

    International Nuclear Information System (INIS)

    Osei, R. K.

    2012-01-01

    The effective dose and cancer risk were determined for patients undergoing seven different types of CT examinations in two CT facilities in the Greater Accra region of Ghana. The two facilities, namely; the Diagnostic Centre Ltd and Cocoa Clinic were chosen because of their significant patient throughput. The effective dose was from patient data namely age, sex, height, weight and technique factors; namely scan length, KVp (Kilovolts peak), mAs (milliamperes per second) and CTDIv from the control console of the CT machines. The effective dose was also estimated using the dose length product (DLP) and k Coefficients which is the anatomic region specific conversion factors. The cancer risk for each patient for a particular examination was determined from the effective dose, age and sex of each patient with the help of BEIR VII. In all, a total number of 800 adult patients with 400 from each of the two CT facilities were compiled. From Diagnostic Centre Ltd, the average effective dose was 5.61mSv in the range of 1.41mSv to 13.34mSv with average BMI of 26.19kg/m 2 in the range of 16.90kg/m 2 to 48.28kg/m 2 for all types of examinations. The average cancer risk was 0.0458 Sv - 1 for 400 patients in the range of 0.0001 Sv - 1 to 0.3036 Sv -1 compared with a population of 900 patients undergoing CT examination per year. From Cocoa Clinic, the average effective dose was 3.91MSv in the range of 0.54mSv to 27.32mSv with an average BMI of 25.59 kg/m 2 in the range of 17.18kg/m 2 to 35.34kg/m 2 and the average cancer risk was 0.0371 Sv - 1 in the range of 0.0001 Sv - 1 and 0.7125 Sv -1 . Some of the values were within the range of values of typical for typical effective dose for CT examinations reported by the ICRP. It was evident from this study that the variations in scanning parameters had significant impact on the effective doses to patient for similar CT examinations among the two facilities.(au)

  20. Transphyseal ACL Reconstruction in Skeletally Immature Patients: Does Independent Femoral Tunnel Drilling Place the Physis at Greater Risk Compared With Transtibial Drilling?

    Science.gov (United States)

    Cruz, Aristides I; Lakomkin, Nikita; Fabricant, Peter D; Lawrence, J Todd R

    2016-06-01

    Most studies examining the safety and efficacy of transphyseal anterior cruciate ligament (ACL) reconstruction for skeletally immature patients utilize transtibial drilling. Independent femoral tunnel drilling may impart a different pattern of distal femoral physeal involvement. To radiographically assess differences in distal femoral physeal disruption between transtibial and independent femoral tunnel drilling. We hypothesized that more oblique tunnels associated with independent drilling involve a significantly larger area of physeal disruption compared with vertically oriented tunnels. Cross-sectional study; Level of evidence, 3. We analyzed skeletally immature patients aged between 10 and 15 years who underwent transphyseal ACL reconstruction utilizing an independent femoral tunnel drilling technique between January 1, 2008, and March 31, 2011. These patients were matched with a transtibial technique cohort based on age and sex. Radiographic measurements were recorded from preoperative magnetic resonance imaging and postoperative radiographs. Ten patients in each group were analyzed. There were significant differences between independent drilling and transtibial drilling cohorts in the estimated area of physeal disruption (1.64 vs 0.74 cm(2); P drilling technique disrupt a larger area of the distal femoral physis and create more eccentric tunnels compared with a transtibial technique. As most studies noting the safety of transphyseal ACL reconstruction have utilized a central, vertical femoral tunnel, surgeons should be aware that if an independent femoral tunnel technique is utilized during transphyseal ACL reconstruction, more physeal tissue is at risk and tunnels are more eccentrically placed across the physis when drilling at more horizontal angles. Prior studies have shown that greater physeal involvement and eccentric tunnels may increase the risk of growth disturbance.

  1. Tomato Sauce Enriched with Olive Oil Exerts Greater Effects on Cardiovascular Disease Risk Factors than Raw Tomato and Tomato Sauce: A Randomized Trial

    Directory of Open Access Journals (Sweden)

    Palmira Valderas-Martinez

    2016-03-01

    Full Text Available Epidemiological studies have observed a negative association between tomato intake and the incidence of cardiovascular disease. As tomato sauces are usually cooked with the addition of oil, some studies have pointed out that both processes may increase the bioavailability of the bioactive compounds. However, the effect of consumption of raw tomatoes and tomato sauces on inflammation biomarkers and adhesion molecules related to atherosclerosis remains unknown. The aim of this study was to test the postprandial effects of a single dose of raw tomatoes (RT, tomato sauce (TS and tomato sauce with refined olive oil (TSOO on cardiovascular disease risk factors. We performed an open, prospective, randomized, cross-over, controlled feeding trial in 40 healthy subjects who randomly received: 7.0 g of RT/kg of body weight (BW, 3.5 g of TS/kg BW, 3.5 g of TSOO/Kg BW and 0.25 g of sugar solved in water/kg BW on a single occasion on four different days. Biochemical parameters and cellular and circulating inflammatory biomarkers were assessed at baseline and 6 h after each intervention. The results indicate that, compared to control intervention, a single tomato intake in any form decreased plasma total cholesterol, triglycerides and several cellular and plasma inflammatory biomarkers, and increased plasma high density lipoproteins (HDL cholesterol and interleukine (IL 10 concentrations. However, the changes of plasma IL-6 and vascular cell adhesion molecule-1 (VCAM-1, and lymphocyte function-associated antigen-1 (LFA-1 from T-lymphocytes and CD36 from monocytes were significantly greater after TSOO than after RT and TS interventions. We concluded that tomato intake has beneficial effects on cardiovascular risk factors, especially cooked and enriched with oil.

  2. Time-varying risk aversion. An application to energy hedging

    Energy Technology Data Exchange (ETDEWEB)

    Cotter, John [Centre for Financial Markets, School of Business, University College Dublin, Blackrock, Co. Dublin (Ireland); Hanly, Jim [School of Accounting and Finance, Dublin Institute of Technology, Dublin 2 (Ireland)

    2010-03-15

    Risk aversion is a key element of utility maximizing hedge strategies; however, it has typically been assigned an arbitrary value in the literature. This paper instead applies a GARCH-in-Mean (GARCH-M) model to estimate a time-varying measure of risk aversion that is based on the observed risk preferences of energy hedging market participants. The resulting estimates are applied to derive explicit risk aversion based optimal hedge strategies for both short and long hedgers. Out-of-sample results are also presented based on a unique approach that allows us to forecast risk aversion, thereby estimating hedge strategies that address the potential future needs of energy hedgers. We find that the risk aversion based hedges differ significantly from simpler OLS hedges. When implemented in-sample, risk aversion hedges for short hedgers outperform the OLS hedge ratio in a utility based comparison. (author)

  3. Time-varying risk aversion. An application to energy hedging

    International Nuclear Information System (INIS)

    Cotter, John; Hanly, Jim

    2010-01-01

    Risk aversion is a key element of utility maximizing hedge strategies; however, it has typically been assigned an arbitrary value in the literature. This paper instead applies a GARCH-in-Mean (GARCH-M) model to estimate a time-varying measure of risk aversion that is based on the observed risk preferences of energy hedging market participants. The resulting estimates are applied to derive explicit risk aversion based optimal hedge strategies for both short and long hedgers. Out-of-sample results are also presented based on a unique approach that allows us to forecast risk aversion, thereby estimating hedge strategies that address the potential future needs of energy hedgers. We find that the risk aversion based hedges differ significantly from simpler OLS hedges. When implemented in-sample, risk aversion hedges for short hedgers outperform the OLS hedge ratio in a utility based comparison. (author)

  4. 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

  5. The GREAT-ER model in China: Evaluating the risk of both treated and untreated wastewater discharges and a consideration to the future.

    Science.gov (United States)

    Jackson, Benjamin; Jones, Kevin; Sweetman, Andrew

    2016-04-01

    As a result of rapid economic development, the production and usage of chemicals in China has risen significantly. This has resulted in China's environment becoming degraded. The Chinese government has attempted to ease these problems with significant investment towards upgrading the wastewater network. These efforts have initially focused upon large cities; progressing towards smaller populations within the most recent 5 year plan. However rural populations were largely overlooked, ~90% of rural settlements do not have treatment facilities for their wastewater. The next (13th) five year plan is a great opportunity to improve upon wastewater infrastructure. This transition is particularly important and it is essential for the government to prioritise settlements to provide treatment facilities and to improve water quality in receiving waters. This study focuses upon the use of a catchment model in order make progress towards this goal. A reliable model which can capture the complexity of the catchment is needed, but one without complexity in itself, in order for it to be developed and validated without an excessive requirement for data. The Geo-referenced Regional Exposure Assessment Tool for European Rivers (GREAT-ER) model is a catchment-scale stochastic-deterministic GIS model. It is primarily used for higher-tier chemical risk assessment. Emissions are from point source only and are calculated based upon population and calculated emission rates per capita. Dilution and transportation are determined using low-flow statistics within each stretch; calculated based upon catchment soil and topographic properties. Removal of the contaminant can occur prior to emission and in-stream. The lowest tier methodology applies a simple 1st-order removal rate and a flat percentage removal for in-stream and sewage treatment work removal respectively. The data requirements are relatively low, although still challenging for many situations. Many authors have reported reasonable

  6. Greater-confinement disposal

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Schubert, J.P.

    1989-01-01

    Greater-confinement disposal (GCD) is a general term for low-level waste (LLW) disposal technologies that employ natural and/or engineered barriers and provide a degree of confinement greater than that of shallow-land burial (SLB) but possibly less than that of a geologic repository. Thus GCD is associated with lower risk/hazard ratios than SLB. Although any number of disposal technologies might satisfy the definition of GCD, eight have been selected for consideration in this discussion. These technologies include: (1) earth-covered tumuli, (2) concrete structures, both above and below grade, (3) deep trenches, (4) augered shafts, (5) rock cavities, (6) abandoned mines, (7) high-integrity containers, and (8) hydrofracture. Each of these technologies employ several operations that are mature,however, some are at more advanced stages of development and demonstration than others. Each is defined and further described by information on design, advantages and disadvantages, special equipment requirements, and characteristic operations such as construction, waste emplacement, and closure

  7. Continuous Time Portfolio Selection under Conditional Capital at Risk

    Directory of Open Access Journals (Sweden)

    Gordana Dmitrasinovic-Vidovic

    2010-01-01

    Full Text Available Portfolio optimization with respect to different risk measures is of interest to both practitioners and academics. For there to be a well-defined optimal portfolio, it is important that the risk measure be coherent and quasiconvex with respect to the proportion invested in risky assets. In this paper we investigate one such measure—conditional capital at risk—and find the optimal strategies under this measure, in the Black-Scholes continuous time setting, with time dependent coefficients.

  8. Management and Risk Characteristics of Part-Time and Full-Time Farmers in Norway

    OpenAIRE

    Gudbrand Lien; Ola Flaten; Anne Moxnes Jervell; Martha Ebbesvik; Matthias Koesling; Paul Steinar Valle

    2006-01-01

    The objective of this exploratory study was to provide empirical insight into how different categories of farmers perceive and manage risk. The data originate from a questionnaire of dairy and crop farmers in Norway. The associations between part-time and full-time farming and farm and farmer characteristics, farmers' goals and future plans, risk perceptions, and risk management responses were examined with simple t- and chi-square tests, as well as with logistic regression. The results indic...

  9. New paleomagnetic results from the Paleocene redbeds in the Tethyan Himalaya: Insights into the precollisional extension of Greater India and the time of the India-Asia collision

    Science.gov (United States)

    Yang, T.; Jin, J.; Ma, Y.; Bian, W.; Zhang, S.; Gao, F.; Wu, H.; Li, H.; Yang, Z.; Cao, L.

    2017-12-01

    The collision and ongoing convergence between the India and Asia continents have produced the Himalayan-Tibetan Orogen. The precollisional extension of Greater India and the time of the India-Asia collision are very important to understand the tectonic evolution of the Tibetan Plateau, but disputes still remain concerning these two problems. A paleomagnetic and rock-magnetic study has been carried out on the Sangdanlin and Zheya Formation redbeds, which were dated at 60-58.5 Ma, in the Saga area of the Tethyan Himalaya. Thirty-six Paleocene redbed sites provide a tilt-corrected site-mean direction of D=178.3°, I=9.8° with ɑ95=5.5°, corresponding to a paleopole at 55.6°N, 268.5°E with A95 = 4.9°. This Paleocene paleomagnetic dataset passes positive fold tests and shows that the Saga area (29.3°N, 85.3°E) was located at 5.1°S during 60-58.5 Ma. Comparing the Paleocene (60-58.5 Ma) paleomagnetic results observed from the Tethyan Himalaya with those expected from the Indian APWP indicates a paleolatitude difference of 2.1°, which, combined with that the Early Cretaceous paleomagnetic results obtained from the Tethyan Himalaya and the Indian craton also showed a similar paleolatitude difference, suggests that neither a great north-south crustal shortening occurred between the Indian craton and the Tethyan Himalaya after the India-Asia collision, nor that a wide ocean extended between them after the Early Cretaceous. Therefore, high-quality paleomagnetic results show no a big Greater India. Based on our new Paleocene results obtained from the Tethyan Himalaya and the reliable Cretaceous-Early Eocene paleomagnetic results observed from the Lhasa terrane, as well as on extrapolating a constant Indian northward velocity of 18.8 cm/yr, the India-Asia collision occurred at 49.2 Ma for the reference point at 29.3°N, 85.3°E. This work was supported by the National Natural Science Foundation of China (41572205) and the Fundamental Research Fund for the Central

  10. Measuring time and risk preferences: Reliability, stability, domain specificity

    NARCIS (Netherlands)

    Wölbert, E.M.; Riedl, A.M.

    2013-01-01

    To accurately predict behavior economists need reliable measures of individual time preferences and attitudes toward risk and typically need to assume stability of these characteristics over time and across decision domains. We test the reliability of two choice tasks for eliciting discount rates,

  11. Endogenous time-varying risk aversion and asset returns.

    Science.gov (United States)

    Berardi, Michele

    2016-01-01

    Stylized facts about statistical properties for short horizon returns in financial markets have been identified in the literature, but a satisfactory understanding for their manifestation is yet to be achieved. In this work, we show that a simple asset pricing model with representative agent is able to generate time series of returns that replicate such stylized facts if the risk aversion coefficient is allowed to change endogenously over time in response to unexpected excess returns under evolutionary forces. The same model, under constant risk aversion, would instead generate returns that are essentially Gaussian. We conclude that an endogenous time-varying risk aversion represents a very parsimonious way to make the model match real data on key statistical properties, and therefore deserves careful consideration from economists and practitioners alike.

  12. Lack of time management as a psychosocial work risk

    Directory of Open Access Journals (Sweden)

    Ramon Cladellas

    2008-10-01

    Full Text Available This paper is aimed to explore the possible relationship between workers' lack of time management and several psychosocial risks. The psychosocial risks were assessed by means of the ISTAS21 Questionnaire, the Spanish version of the CoPsoQ (Copenhagen Psychological Questionnaire. More specifically, nine dimensions, which are directly related with time management, satisfaction, health and stress, were selected for evaluation. Time management was measured through the following variables: quantitative demands, influences and control of the time. Drawing on a sample of 142 workers from four departments (development, implantation, support and administration, the research results show that the employees who belong to a department that offers few opportunities for individual time management are less satisfied, have worse general and mental health, and experience more behavioral, symptomatic and cognitive stress than those who can manage their work schedule.

  13. Latest Rate, Extent, and Temporal Evolution of Growth Faulting over Greater Houston Region Revealed by Multi- Band InSAR Time-Series Analysis

    Science.gov (United States)

    Qu, F.; Lu, Z.; Kim, J. W.

    2017-12-01

    Growth faults are common and continue to evolve throughout the unconsolidated sediments of Greater Houston (GH) region in Texas. Presence of faults can induce localized surface displacements, aggravate localized subsidence, and discontinue the integrity of ground water flow. Property damages due to fault creep have become more evident during the past few years over the GH area, portraying the necessity of further study of these faults. Interferometric synthetic aperture radar (InSAR) has been proven to be effective in mapping creep along and/or across faults. However, extracting a short wavelength, as well as small amplitude of the creep signal (about 10-20 mm/year) from long time span interferograms is extremely difficult, especially in agricultural or vegetated areas. This paper aims to map and monitor the latest rate, extent, and temporal evolution of faulting at a highest spatial density over GH region using an improved Multi-temporal InSAR (MTI) technique. The method, with maximized usable signal and correlation, has the ability to identify and monitor the active faults to provide an accurate and elaborate image of the faults. In this study, two neighboring ALOS tracks and Sentinel-1A datasets are used. Many zones of steep phase gradients and/or discontinuities have been recognized from the long term velocity maps by both ALOS (2007-2011) and Sentinei-1A (2015-2017) imagery. Not only those previously known faults position but also the new fault traces that have not been mapped by other techniques are imaged by our MTI technique. Fault damage and visible cracking of ground were evident at most locations through our field survey. The discovery of new fault activation, or faults moved from earlier locations is a part of the Big Barn Fault and Conroe fault system, trending from southwest to northeast between Hockley and Conroe. The location of area of subsidence over GH is also shrinking and migrating toward the northeast (Montgomery County) after 2000. The

  14. Perceived inadequate care and excessive overprotection during childhood are associated with greater risk of sleep disturbance in adulthood: the Hisayama Study.

    Science.gov (United States)

    Shibata, Mao; Ninomiya, Toshiharu; Anno, Kozo; Kawata, Hiroshi; Iwaki, Rie; Sawamoto, Ryoko; Kubo, Chiharu; Kiyohara, Yutaka; Sudo, Nobuyuki; Hosoi, Masako

    2016-07-07

    Sleep disturbance and poor sleep quality are major health problems worldwide. One potential risk factor for the development and maintenance of sleep disturbance is the parenting style experienced during childhood. However, its role in sleep disturbance in adulthood has not yet been estimated. This Japanese population study was done to clarify the relation between the parenting styles "care" and "overprotection" during childhood and sleep disturbance in adulthood. A total of 702 community-dwelling Japanese residents aged ≥ 40 years were assessed in 2011 for their perceptions of the parenting style of their parents by use of the Parental Bonding Instrument (PBI) and for sleep disturbance by use of the Pittsburgh Sleep Quality Index (PSQI). The odds ratio (OR) for sleep disturbance (a global PSQI score > 5) was calculated using a logistic regression model. The prevalence of sleep disturbance was 29 %. After adjusting for sociodemographic, lifestyle, and physical factors in a comparison with the optimal parenting styles (high care and low overprotection), the ORs for sleep disturbance by men were significantly higher for low paternal care, by 2.49 times (95 % confidence interval [CI]: 1.21-5.09), and for high overprotection, by 2.40 times (95 % CI: 1.19-4.85), while the ORs were not significant for low maternal care and high overprotection. For women the only significant factor was high maternal overprotection, by 1.62 times (95 % CI: 1.05-2.52), while the ORs were not significant for low maternal care, low paternal care and high paternal overprotection. The association remained significant for high paternal overprotection for men after additionally controlling for depression. This study suggests that parenting style, especially inadequate care and excessive overprotection during childhood, is related to sleep disturbance in adulthood and that the association is much more significant for parents of the same sex as the child.

  15. Time-based collision risk modeling for air traffic management

    Science.gov (United States)

    Bell, Alan E.

    Since the emergence of commercial aviation in the early part of last century, economic forces have driven a steadily increasing demand for air transportation. Increasing density of aircraft operating in a finite volume of airspace is accompanied by a corresponding increase in the risk of collision, and in response to a growing number of incidents and accidents involving collisions between aircraft, governments worldwide have developed air traffic control systems and procedures to mitigate this risk. The objective of any collision risk management system is to project conflicts and provide operators with sufficient opportunity to recognize potential collisions and take necessary actions to avoid them. It is therefore the assertion of this research that the currency of collision risk management is time. Future Air Traffic Management Systems are being designed around the foundational principle of four dimensional trajectory based operations, a method that replaces legacy first-come, first-served sequencing priorities with time-based reservations throughout the airspace system. This research will demonstrate that if aircraft are to be sequenced in four dimensions, they must also be separated in four dimensions. In order to separate aircraft in four dimensions, time must emerge as the primary tool by which air traffic is managed. A functional relationship exists between the time-based performance of aircraft, the interval between aircraft scheduled to cross some three dimensional point in space, and the risk of collision. This research models that relationship and presents two key findings. First, a method is developed by which the ability of an aircraft to meet a required time of arrival may be expressed as a robust standard for both industry and operations. Second, a method by which airspace system capacity may be increased while maintaining an acceptable level of collision risk is presented and demonstrated for the purpose of formulating recommendations for procedures

  16. Generalization of risk concept in case risk components depend on time

    International Nuclear Information System (INIS)

    Volkov, Yu.V.

    2006-01-01

    Ratios of risk assessments vs. nuclear technologies objects have been obtained for cases when that kind of risk components as accident probability and the consequent damage depend on time. Such generalization of risk concept ensures new possibilities for performing the probabilistic safety analysis which have been demonstrated with simple models in the present paper. As an example safety of radioactive storage with one-component activity has been analyzed with a very simple model [ru

  17. Risk factors for first time incidence sciatica: a systematic review.

    Science.gov (United States)

    Cook, Chad E; Taylor, Jeffrey; Wright, Alexis; Milosavljevic, Steven; Goode, Adam; Whitford, Maureen

    2014-06-01

    Characteristically, sciatica involves radiating leg pain that follows a dermatomal pattern along the distribution of the sciatic nerve. To our knowledge, there are no studies that have investigated risk factors associated with first time incidence sciatica. The purpose of the systematic review was to identify the longitudinal risk factors associated with first time incidence sciatica and to report incidence rates for the condition. For the purposes of this review, first time incidence sciatica was defined as either of the following: 1) no prior history of sciatica or 2) transition from a pain-free state to sciatica. Studies included subjects of any age from longitudinal, observational, cohort designs. The study was a systematic review. Eight of the 239 articles identified by electronic search strategies met the inclusion criteria. Risk factors and their respective effect estimates were reported using descriptive analysis and the preferred reporting items for systematic reviews and meta-analyses guidelines. Modifiable risk factors included smoking, obesity, occupational factors and health status. Non-modifiable factors included age, gender and social class. Incidence rates varied among the included studies, in part reflecting the variability in the operationalized definition of sciatica but ranged from sciatica are modifiable, suggesting the potential benefits of primary prevention. In addition, those risk factors are also associated with unhealthy lifestyles, which may function concomitantly toward the development of sciatica. Sciatica as a diagnosis is inconsistently defined among studies. © 2013 John Wiley & Sons, Ltd.

  18. Total sitting time, leisure time physical activity and risk of hospitalization due to low back pain

    DEFF Research Database (Denmark)

    Balling, Mie; Holmberg, Teresa; Petersen, Christina B

    2018-01-01

    AIMS: This study aimed to test the hypotheses that a high total sitting time and vigorous physical activity in leisure time increase the risk of low back pain and herniated lumbar disc disease. METHODS: A total of 76,438 adults answered questions regarding their total sitting time and physical...... activity during leisure time in the Danish Health Examination Survey 2007-2008. Information on low back pain diagnoses up to 10 September 2015 was obtained from The National Patient Register. The mean follow-up time was 7.4 years. Data were analysed using Cox regression analysis with adjustment...... disc disease. However, moderate or vigorous physical activity, as compared to light physical activity, was associated with increased risk of low back pain (HR = 1.16, 95% CI: 1.03-1.30 and HR = 1.45, 95% CI: 1.15-1.83). Moderate, but not vigorous physical activity was associated with increased risk...

  19. A quantile-based Time at Risk: A new approach for assessing risk in financial markets

    Science.gov (United States)

    Bolgorian, Meysam; Raei, Reza

    2013-11-01

    In this paper, we provide a new measure for evaluation of risk in financial markets. This measure is based on the return interval of critical events in financial markets or other investment situations. Our main goal was to devise a model like Value at Risk (VaR). As VaR, for a given financial asset, probability level and time horizon, gives a critical value such that the likelihood of loss on the asset over the time horizon exceeds this value is equal to the given probability level, our concept of Time at Risk (TaR), using a probability distribution function of return intervals, provides a critical time such that the probability that the return interval of a critical event exceeds this time equals the given probability level. As an empirical application, we applied our model to data from the Tehran Stock Exchange Price Index (TEPIX) as a financial asset (market portfolio) and reported the results.

  20. TV time but not computer time is associated with cardiometabolic risk in Dutch young adults.

    Science.gov (United States)

    Altenburg, Teatske M; de Kroon, Marlou L A; Renders, Carry M; Hirasing, Remy; Chinapaw, Mai J M

    2013-01-01

    TV time and total sedentary time have been positively related to biomarkers of cardiometabolic risk in adults. We aim to examine the association of TV time and computer time separately with cardiometabolic biomarkers in young adults. Additionally, the mediating role of waist circumference (WC) is studied. Data of 634 Dutch young adults (18-28 years; 39% male) were used. Cardiometabolic biomarkers included indicators of overweight, blood pressure, blood levels of fasting plasma insulin, cholesterol, glucose, triglycerides and a clustered cardiometabolic risk score. Linear regression analyses were used to assess the cross-sectional association of self-reported TV and computer time with cardiometabolic biomarkers, adjusting for demographic and lifestyle factors. Mediation by WC was checked using the product-of-coefficient method. TV time was significantly associated with triglycerides (B = 0.004; CI = [0.001;0.05]) and insulin (B = 0.10; CI = [0.01;0.20]). Computer time was not significantly associated with any of the cardiometabolic biomarkers. We found no evidence for WC to mediate the association of TV time or computer time with cardiometabolic biomarkers. We found a significantly positive association of TV time with cardiometabolic biomarkers. In addition, we found no evidence for WC as a mediator of this association. Our findings suggest a need to distinguish between TV time and computer time within future guidelines for screen time.

  1. Radioactive waste. Risk, reward, space and time dynamics

    International Nuclear Information System (INIS)

    Duncan, I.J.

    2001-01-01

    This study considers, in a geographical context, issues arising from the disposal of radioactive waste with particular emphasis on societal perceptions of Risk, Trust, NIMBYand Time. It establishes that the wider community now accepts the concepts of 'user pays' and offsetting compensation to any community that accepts a risk, such risk to be minimised and interruptible as necessary. The underlying causes of NIMBYism have been misjudged by industry and this work establishes that they are as much due to exclusion from the decision making process as they are to direct concerns about the social impact, health and environment. The principal cause of NIMBYism is discussed and a procedure to assist siting approval is suggested. This study establishes that industry, government authorities or specialists working alone in this field engender less trust by society than composite bodies including government departments, industry, environmentalists, health, science and society. The dimension of an individual's perception of forward time has been quantified and found to be much shorter than the time required for the isolation of radioactive waste. This research highlights the dynamic nature of all waste isolation processes and proposes a procedure that could render the concept of long term geological disposal more acceptable to the public. It evolved that the disposal of all waste is a dynamic process, the management of which must provide the time necessary for physical and chemical change and to ensure isolation from the biosphere while it remains hazardous. The outcome of this research is applicable to the disposal of all solid hazardous waste. (author)

  2. Risk factors and timing of default from treatment for non-multidrug-resistant tuberculosis in Moldova.

    Science.gov (United States)

    Jenkins, H E; Ciobanu, A; Plesca, V; Crudu, V; Galusca, I; Soltan, V; Cohen, T

    2013-03-01

    The Republic of Moldova, in Eastern Europe, has among the highest reported nationwide proportions of tuberculosis (TB) patients with multidrug-resistant tuberculosis (MDR-TB) worldwide. Default has been associated with increased mortality and amplification of drug resistance, and may contribute to the high MDR-TB rates in Moldova. To assess risk factors and timing of default from treatment for non-MDR-TB from 2007 to 2010. A retrospective analysis of routine surveillance data on all non-MDR-TB patients reported. A total of 14.7% of non-MDR-TB patients defaulted from treatment during the study period. Independent risk factors for default included sociodemographic factors, such as homelessness, living alone, less formal education and spending substantial time outside Moldova in the year prior to diagnosis; and health-related factors such as human immunodeficiency virus co-infection, greater lung pathology and increasing TB drug resistance. Anti-tuberculosis treatment is usually initiated within an institutional setting in Moldova, and the default risk was highest in the month following the phase of hospitalized treatment (among civilians) and after leaving prison (among those diagnosed while incarcerated). Targeted interventions to increase treatment adherence for patients at highest risk of default, and improving the continuity of care for patients transitioning from institutional to community care may substantially reduce risk of default.

  3. Foraging site selection of two subspecies of Bar-tailed Godwit Limosa lapponica: time minimizers accept greater predation danger than energy minimizers

    NARCIS (Netherlands)

    Duijns, S.; Dijk, van J.G.B.; Spaans, B.; Jukema, J.; Boer, de W.F.; Piersma, Th.

    2009-01-01

    Different spatial distributions of food abundance and predators may urge birds to make a trade-off between food intake and danger. Such a trade-off might be solved in different ways in migrant birds that either follow a time-minimizing or energy-minimizing strategy; these strategies have been

  4. Foraging site selection of two subspecies of Bar-tailed Godwit Limosa lapponica : time minimizers accept greater predation danger than energy minimizers

    NARCIS (Netherlands)

    Duijns, Sjoerd; van Dijk, Jacintha G. B.; Spaans, Bernard; Jukema, Joop; de Boer, Willem F.; Piersma, Theunis

    2009-01-01

    Different spatial distributions Of food abundance and predators may urge birds to make a trade-off between food intake and danger. Such a trade-off might be solved in different ways in migrant birds that either follow a time-minimizing or energy-minimizing strategy; these strategies have been

  5. Perceived inadequate care and excessive overprotection during childhood are associated with greater risk of sleep disturbance in adulthood: the Hisayama Study

    OpenAIRE

    Shibata, Mao; Ninomiya, Toshiharu; Anno, Kozo; Kawata, Hiroshi; Iwaki, Rie; Sawamoto, Ryoko; Kubo, Chiharu; Kiyohara, Yutaka; Sudo, Nobuyuki; Hosoi, Masako

    2016-01-01

    Background Sleep disturbance and poor sleep quality are major health problems worldwide. One potential risk factor for the development and maintenance of sleep disturbance is the parenting style experienced during childhood. However, its role in sleep disturbance in adulthood has not yet been estimated. This Japanese population study was done to clarify the relation between the parenting styles ?care? and ?overprotection? during childhood and sleep disturbance in adulthood. Methods A total of...

  6. Risk-based evaluation of Allowed Outage Times (AOTs) considering risk of shutdown

    International Nuclear Information System (INIS)

    Mankamo, T.; Kim, I.S.; Samanta, P.K.

    1992-01-01

    When safety systems fail during power operation, Technical Specifications (TS) usually limit the repair within Allowed Outage Time (AOT). If the repair cannot be completed within the AOT, or no AOT is allowed, the plant is required to be shut down for the repair. However, if the capability to remove decay heat is degraded, shutting down the plant with the need to operate the affected decay-heat removal systems may impose a substantial risk compared to continued power operation over a usual repair time. Thus, defining a proper AOT in such situations can be considered as a risk-comparison between the repair in frill power state with a temporarily increased level of risk, and the altemative of shutting down the plant for the repair in zero power state with a specific associated risk. The methodology of the risk-comparison approach, with a due consideration of the shutdown risk, has been further developed and applied to the AOT considerations of residual heat removal and standby service water systems of a boiling water reactor (BWR) plant. Based on the completed work, several improvements to the TS requirements for the systems studied can be suggested

  7. A Real-Time Offshore Weather Risk Advisory System

    Science.gov (United States)

    Jolivet, Samuel; Zemskyy, Pavlo; Mynampati, Kalyan; Babovic, Vladan

    2015-04-01

    Offshore oil and gas operations in South East Asia periodically face extended downtime due to unpredictable weather conditions, including squalls that are accompanied by strong winds, thunder, and heavy rains. This downtime results in financial losses. Hence, a real time weather risk advisory system is developed to provide the offshore Oil and Gas (O&G) industry specific weather warnings in support of safety and environment security. This system provides safe operating windows based on sensitivity of offshore operations to sea state. Information products for safety and security include area of squall occurrence for the next 24 hours, time before squall strike, and heavy sea state warning for the next 3, 6, 12 & 24 hours. These are predicted using radar now-cast, high resolution Numerical Weather Prediction (NWP) and Data Assimilation (DA). Radar based now-casting leverages the radar data to produce short term (up to 3 hours) predictions of severe weather events including squalls/thunderstorms. A sea state approximation is provided through developing a translational model based on these predictions to risk rank the sensitivity of operations. A high resolution Weather Research and Forecasting (WRF, an open source NWP model) is developed for offshore Brunei, Malaysia and the Philippines. This high resolution model is optimized and validated against the adaptation of temperate to tropical met-ocean parameterization. This locally specific parameters are calibrated against federated data to achieve a 24 hour forecast of high resolution Convective Available Potential Energy (CAPE). CAPE is being used as a proxy for the risk of squall occurrence. Spectral decomposition is used to blend the outputs of the now-cast and the forecast in order to assimilate near real time weather observations as an implementation of the integration of data sources. This system uses the now-cast for the first 3 hours and then the forecast prediction horizons of 3, 6, 12 & 24 hours. The output is

  8. Time-perspective in cardiovascular risk of NSAID use after first-time myocardial infarction

    DEFF Research Database (Denmark)

    Olsen, Anne-Marie Schjerning; Gislason, Gunnar H; Fosbøl, Emil L

    2013-01-01

    PURPOSE OF REVIEW: Despite the fact that NSAIDs are not recommended among patients with established cardiovascular disease, many patients receive NSAID treatment for a short period of time. However, up until recently, data on the relationship between treatment duration and associated cardiovascular...... furthermore demonstrated that NSAID use among patients with first-time MI was associated with persistently increased risk of all-cause mortality and of a composite of coronary death or nonfatal recurrent MI for at least 5 years thereafter. SUMMARY: The present review indicates that there is no apparent well......-tolerated therapeutic window for associated cardiovascular risk and NSAID use in patients with prior MI. Further randomized studies are warranted to evaluate the cardiovascular safety of NSAIDs, but, at this point, the overall evidence suggests advising caution in using NSAIDs at all times after MI. Legislation bodies...

  9. Work time control, sleep & accident risk: A prospective cohort study.

    Science.gov (United States)

    Tucker, Philip; Albrecht, Sophie; Kecklund, Göran; Beckers, Debby G J; Leineweber, Constanze

    We examined whether the beneficial impact of work time control (WTC) on sleep leads to lower accident risk, using data from a nationally representative survey conducted in Sweden. Logistic regressions examined WTC in 2010 and 2012 as predictors of accidents occurring in the subsequent 2 years (N = 4840 and 4337, respectively). Sleep disturbance and frequency of short sleeps in 2012 were examined as potential mediators of the associations between WTC in 2010 and subsequent accidents as reported in 2014 (N = 3636). All analyses adjusted for age, sex, education, occupational category, weekly work hours, shift work status, job control and perceived accident risk at work. In both waves, overall WTC was inversely associated with accidents (p = 0.048 and p = 0.038, respectively). Analyses of the sub-dimensions of WTC indicated that Control over Daily Hours (influence over start and finish times, and over length of shift) did not predict accidents in either wave, while Control over Time-off (CoT; influence over taking breaks, running private errands during work and taking paid leave) predicted fewer accidents in both waves (p = 0.013 and p = 0.010). Sleep disturbance in 2012 mediated associations between WTC/CoT in 2010 and accidents in 2014, although effects' sizes were small (effectWTC = -0.006, 95% confidence interval [CI] = -0.018 to -0.001; effectCoT = -0.009, 95%CI = -0.022 to -0.001; unstandardized coefficients), with the indirect effects of sleep disturbance accounting for less than 5% of the total direct and indirect effects. Frequency of short sleeps was not a significant mediator. WTC reduces the risk of subsequently being involved in an accident, although sleep may not be a strong component of the mechanism underlying this association.

  10. Greater autonomy at work

    NARCIS (Netherlands)

    Houtman, I.L.D.

    2004-01-01

    In the past 10 years, workers in the Netherlands increasingly report more decision-making power in their work. This is important for an economy in recession and where workers face greater work demands. It makes work more interesting, creates a healthier work environment, and provides opportunities

  11. Risk aversion, time preference, and the social cost of carbon

    International Nuclear Information System (INIS)

    Anthoff, David; Tol, Richard S J; Yohe, Gary W

    2009-01-01

    The Stern Review reported a social cost of carbon of over $300/tC, calling for ambitious climate policy. We here conduct a systematic sensitivity analysis of this result on two crucial parameters: the rate of pure time preference, and the rate of risk aversion. We show that the social cost of carbon lies anywhere in between 0 and $120 000/tC. However, if we restrict these two parameters to matching observed behaviour, an expected social cost of carbon of $60/tC results. If we correct this estimate for income differences across the world, the social cost of carbon rises to over $200/tC.

  12. Child undernutrition in one of the cities with greater nutritional risk in Brazil: population-based study in the Western Brazilian Amazon.

    Science.gov (United States)

    Araújo, Thiago Santos de; Oliveira, Cristieli Sérgio de Menezes; Muniz, Pascoal Torres; Silva-Nunes, Mônica da; Cardoso, Marly Augusto

    2016-01-01

    To estimate the prevalence of child undernutrition and associated factors in a municipality with high nutritional risk in Brazil. This cross-sectional, population-based study was conducted with a sample of 478 children aged under 5 years in the city of Jordão, Acre, Brazil. The following indicators were calculated: weight for age (W/A), height for age (H/A), and weight for height (W/H), using the growth curves of the WHO as reference, which adopts a cutoff of -2 z scores for identification of malnourished children. Adjusted prevalence ratios (PRs) were obtained using multiple Poisson regression models with robust error estimate (p history of introduction of cow's milk before 30 days of age (PR = 1.4; 95%CI 1.0 - 1.8). Children with updated vaccination cards were inversely associated with stunting risk (PR = 0.7; 95%CI 0.5 - 0.9). Child undernutrition remains a serious public health problem in the Amazon, indicating additional difficulties in facing the problem in this region of the country.

  13. The risk of shorter fasting time for pediatric deep sedation.

    Science.gov (United States)

    Clark, Mathew; Birisci, Esma; Anderson, Jordan E; Anliker, Christina M; Bryant, Micheal A; Downs, Craig; Dalabih, Abdallah

    2016-01-01

    Current guidelines adopted by the American Academy of Pediatrics calls for prolonged fasting times before performing pediatric procedural sedation and analgesia (PSA). PSA is increasingly provided to children outside of the operating theater by sedation trained pediatric providers and does not require airway manipulation. We investigated the safety of a shorter fasting time compared to a longer and guideline compliant fasting time. We tried to identify the association between fasting time and sedation-related complications. This is a prospective observational study that included children 2 months to 18 years of age and had an American Society of Anesthesiologists physical status classification of I or II, who underwent deep sedation for elective procedures, performed by pediatric critical care providers. Procedures included radiologic imaging studies, electroencephalograms, auditory brainstem response, echocardiograms, Botox injections, and other minor surgical procedures. Subjects were divided into two groups depending on the length of their fasting time (4-6 h and >6 h). Complication rates were calculated and compared between the three groups. In the studied group of 2487 subjects, 1007 (40.5%) had fasting time of 4-6 h and the remaining 1480 (59.5%) subjects had fasted for >6 h. There were no statistically significant differences in any of the studied complications between the two groups. This study found no difference in complication rate in regard to the fasting time among our subjects cohort, which included only healthy children receiving elective procedures performed by sedation trained pediatric critical care providers. This suggests that using shorter fasting time may be safe for procedures performed outside of the operating theater that does not involve high-risk patients or airway manipulation.

  14. Combining numerical simulations with time-domain random walk for pathogen risk assessment in groundwater

    Science.gov (United States)

    Cvetkovic, V.; Molin, S.

    2012-02-01

    We present a methodology that combines numerical simulations of groundwater flow and advective transport in heterogeneous porous media with analytical retention models for computing the infection risk probability from pathogens in aquifers. The methodology is based on the analytical results presented in [1,2] for utilising the colloid filtration theory in a time-domain random walk framework. It is shown that in uniform flow, the results from the numerical simulations of advection yield comparable results as the analytical TDRW model for generating advection segments. It is shown that spatial variability of the attachment rate may be significant, however, it appears to affect risk in a different manner depending on if the flow is uniform or radially converging. In spite of the fact that numerous issues remain open regarding pathogen transport in aquifers on the field scale, the methodology presented here may be useful for screening purposes, and may also serve as a basis for future studies that would include greater complexity.

  15. On the Anonymity Risk of Time-Varying User Profiles

    Directory of Open Access Journals (Sweden)

    Silvia Puglisi

    2017-04-01

    Full Text Available Websites and applications use personalisation services to profile their users, collect their patterns and activities and eventually use this data to provide tailored suggestions. User preferences and social interactions are therefore aggregated and analysed. Every time a user publishes a new post or creates a link with another entity, either another user, or some online resource, new information is added to the user profile. Exposing private data does not only reveal information about single users’ preferences, increasing their privacy risk, but can expose more about their network that single actors intended. This mechanism is self-evident in social networks where users receive suggestions based on their friends’ activities. We propose an information-theoretic approach to measure the differential update of the anonymity risk of time-varying user profiles. This expresses how privacy is affected when new content is posted and how much third-party services get to know about the users when a new activity is shared. We use actual Facebook data to show how our model can be applied to a real-world scenario.

  16. An ecological momentary intervention for smoking cessation: The associations of just-in-time, tailored messages with lapse risk factors.

    Science.gov (United States)

    Hébert, Emily T; Stevens, Elise M; Frank, Summer G; Kendzor, Darla E; Wetter, David W; Zvolensky, Michael J; Buckner, Julia D; Businelle, Michael S

    2018-03-01

    Smartphone apps can provide real-time, tailored interventions for smoking cessation. The current study examines the effectiveness of a smartphone-based smoking cessation application that assessed risk for imminent smoking lapse multiple times per day and provided messages tailored to current smoking lapse risk and specific lapse triggers. Participants (N=59) recruited from a safety-net hospital smoking cessation clinic completed phone-based ecological momentary assessments (EMAs) 5 times/day for 3 consecutive weeks (1week pre-quit, 2weeks post-quit). Risk for smoking lapse was estimated in real-time using a novel weighted lapse risk estimator. With each EMA, participants received messages tailored to current level of risk for imminent smoking lapse and self-reported presence of smoking urge, stress, cigarette availability, and motivation to quit. Generalized linear mixed model analyses determined whether messages tailored to specific lapse risk factors were associated with greater reductions in these triggers than messages not tailored to specific triggers. Overall, messages tailored to smoking urge, cigarette availability, or stress corresponded with greater reductions in those triggers than messages that were not tailored to specific triggers (p's=0.02 to <0.001). Although messages tailored to stress were associated with greater reductions in stress than messages not tailored to stress, the association was non-significant (p=0.892) when only moments of high stress were included in the analysis. Mobile technology can be used to conduct real-time smoking lapse risk assessment and provide tailored treatment content. Findings provide initial evidence that tailored content may impact users' urge to smoke, stress, and cigarette availability. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Longitude Position in a Time Zone and Cancer Risk in the United States.

    Science.gov (United States)

    Gu, Fangyi; Xu, Shangda; Devesa, Susan S; Zhang, Fanni; Klerman, Elizabeth B; Graubard, Barry I; Caporaso, Neil E

    2017-08-01

    Background: Circadian disruption is a probable human carcinogen. From the eastern to western border of a time zone, social time is equal, whereas solar time is progressively delayed, producing increased discrepancies between individuals' social and biological circadian time. Accordingly, western time zone residents experience greater circadian disruption and may be at an increased risk of cancer. Methods: We examined associations between the position in a time zone and age-standardized county-level incidence rates for total cancers combined and 23 specific cancers by gender using the data of the Surveillance, Epidemiology, and End Results Program (2000-2012), including four million cancer diagnoses in white residents of 607 counties in 11 U.S. states. Log-linear regression was conducted, adjusting for latitude, poverty, cigarette smoking, and state. Bonferroni-corrected P values were used as the significance criteria. Results: Risk increased from east to west within a time zone for total and for many specific cancers, including chronic lymphocytic leukemia (both genders) and cancers of the stomach, liver, prostate, and non-Hodgkin lymphoma in men and cancers of the esophagus, colorectum, lung, breast, and corpus uteri in women. Conclusions: Risk increased from the east to the west in a time zone for total and many specific cancers, in accord with the circadian disruption hypothesis. Replications in analytic epidemiologic studies are warranted. Impact: Our findings suggest that circadian disruption may not be a rare phenomenon affecting only shift workers, but is widespread in the general population with broader implications for public health than generally appreciated. Cancer Epidemiol Biomarkers Prev; 26(8); 1306-11. ©2017 AACR . ©2017 American Association for Cancer Research.

  18. Fascioliasis risk factors and space-time clusters in domestic ruminants in Bangladesh.

    Science.gov (United States)

    Rahman, A K M Anisur; Islam, S K Shaheenur; Talukder, Md Hasanuzzaman; Hassan, Md Kumrul; Dhand, Navneet K; Ward, Michael P

    2017-05-08

    A retrospective observational study was conducted to identify fascioliasis hotspots, clusters, potential risk factors and to map fascioliasis risk in domestic ruminants in Bangladesh. Cases of fascioliasis in cattle, buffalo, sheep and goats from all districts in Bangladesh between 2011 and 2013 were identified via secondary surveillance data from the Department of Livestock Services' Epidemiology Unit. From each case report, date of report, species affected and district data were extracted. The total number of domestic ruminants in each district was used to calculate fascioliasis cases per ten thousand animals at risk per district, and this was used for cluster and hotspot analysis. Clustering was assessed with Moran's spatial autocorrelation statistic, hotspots with the local indicator of spatial association (LISA) statistic and space-time clusters with the scan statistic (Poisson model). The association between district fascioliasis prevalence and climate (temperature, precipitation), elevation, land cover and water bodies was investigated using a spatial regression model. A total of 1,723,971 cases of fascioliasis were reported in the three-year study period in cattle (1,164,560), goats (424,314), buffalo (88,924) and sheep (46,173). A total of nine hotspots were identified; one of these persisted in each of the three years. Only two local clusters were found. Five space-time clusters located within 22 districts were also identified. Annual risk maps of fascioliasis cases correlated with the hotspots and clusters detected. Cultivated and managed (P fascioliasis in Bangladesh, respectively. Results indicate that due to land use characteristics some areas of Bangladesh are at greater risk of fascioliasis. The potential risk factors, hot spots and clusters identified in this study can be used to guide science-based treatment and control decisions for fascioliasis in Bangladesh and in other similar geo-climatic zones throughout the world.

  19. Omnibus risk assessment via accelerated failure time kernel machine modeling.

    Science.gov (United States)

    Sinnott, Jennifer A; Cai, Tianxi

    2013-12-01

    Integrating genomic information with traditional clinical risk factors to improve the prediction of disease outcomes could profoundly change the practice of medicine. However, the large number of potential markers and possible complexity of the relationship between markers and disease make it difficult to construct accurate risk prediction models. Standard approaches for identifying important markers often rely on marginal associations or linearity assumptions and may not capture non-linear or interactive effects. In recent years, much work has been done to group genes into pathways and networks. Integrating such biological knowledge into statistical learning could potentially improve model interpretability and reliability. One effective approach is to employ a kernel machine (KM) framework, which can capture nonlinear effects if nonlinear kernels are used (Scholkopf and Smola, 2002; Liu et al., 2007, 2008). For survival outcomes, KM regression modeling and testing procedures have been derived under a proportional hazards (PH) assumption (Li and Luan, 2003; Cai, Tonini, and Lin, 2011). In this article, we derive testing and prediction methods for KM regression under the accelerated failure time (AFT) model, a useful alternative to the PH model. We approximate the null distribution of our test statistic using resampling procedures. When multiple kernels are of potential interest, it may be unclear in advance which kernel to use for testing and estimation. We propose a robust Omnibus Test that combines information across kernels, and an approach for selecting the best kernel for estimation. The methods are illustrated with an application in breast cancer. © 2013, The International Biometric Society.

  20. 20 Gy Versus 44 Gy of Supplemental External Beam Radiotherapy With Palladium-103 for Patients With Greater Risk Disease: Results of a Prospective Randomized Trial

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Wallner, Kent E.; Butler, Wayne M.; Galbreath, Robert W.; Taira, Al V.; Orio, Peter; Adamovich, Edward

    2012-01-01

    Purpose: The necessity of external beam radiotherapy (EBRT) as a supplement to prostate brachytherapy remains unknown. We report brachytherapy outcomes for patients with higher risk features randomized to substantially different supplemental EBRT regimens. Methods and Materials: Between December 1999 and June 2004, 247 patients were randomized to 20 Gy vs. 44 Gy EBRT followed by a palladium-103 boost (115 Gy vs. 90 Gy). The eligibility criteria included clinically organ-confined disease with Gleason score 7–10 and/or pretreatment prostate-specific antigen (PSA) level 10–20 ng/mL. The median follow-up period was 9.0 years. Biochemical progression-free survival (bPFS) was defined as a PSA level of ≤0.40 ng/mL after nadir. The median day 0 prescribed dose covering 90% of the target volume was 125.7%; 80 men received androgen deprivation therapy (median, 4 months). Multiple parameters were evaluated for their effect on bPFS. Results: For the entire cohort, the cause-specific survival, bPFS, and overall survival rates were 97.7%, 93.2%, and 80.8% at 8 years and 96.9%, 93.2%, and 75.4% at 10 years, respectively. The bPFS rate was 93.1% and 93.4% for the 20-Gy and 44-Gy arms, respectively (p = .994). However, no statistically significant differences were found in cause-specific survival or overall survival were identified. When stratified by PSA level of ≤10 ng/mL vs. >10 ng/mL, Gleason score, or androgen deprivation therapy, no statistically significant differences in bPFS were discerned between the two EBRT regimens. On multivariate analysis, bPFS was most closely related to the preimplant PSA and clinical stage. For patients with biochemically controlled disease, the median PSA level was <0.02 ng/mL. Conclusion: The results of the present trial strongly suggest that two markedly different supplemental EBRT regimens result in equivalent cause-specific survival, bPFS, and overall survival. It is probable that the lack of benefit for a higher supplemental EBRT

  1. Real-time risk assessment of operational events

    International Nuclear Information System (INIS)

    Perryman, L.J.; Foster, N.A.S.; Nicholls, D.R.; Grobbelaar, J.F.

    1996-01-01

    Probabilistic risk assessment (PRA) has always been fundamental to the licensing process of Koeberg nuclear power station. Furthermore, over the past 8 years PRA has assisted in many areas of operation. One of these areas is the real-time assessment of abnormal operating events. Over the years, considerable experience has been gained in using PRA to improve plant safety and performance. This paper presents some of the insights obtained in using PRA in such a dynamic role and demonstrates that, by developing and using the plant-specific 'living' PRA, considerable safety and financial gains can be obtained. These insights specifically concern the prerequisites before optimal use of a plant-specific 'living' PRA can be made. Finally, examples are presented of occurrences when PRA was used to improve plant safety and performance. These examples serve to demonstrate the advantages that can be obtained if sufficient resources are placed at the disposal of the PRA team. (orig.)

  2. [Obesity and complementary feeding time: a period at risk].

    Science.gov (United States)

    Vidailhet, M

    2010-12-01

    Relation between rapid growth during the first months of life and secondary risk of excessive adiposity is well demonstrated. Many works have indicated a birth feeding effect on weight gain during the first year of life and a protective effect towards later childhood and adult obesity. However all these studies are observational and several works denied this protective effect. Concerning complementary feeding, 3 interventional, randomized, studies achieved between 4 and 6 months of age, showed a good regulation of caloric intake and no weight gain modification due to complementary foods. Most of others studies are observational and don't show any relation between time of introduction of complementary foods and later fat mass. However 3 recent studies indicate, respectively at 7, 10 and 42 years of age, an increased adiposity, suggesting the possibility of a programmed excessive fat gain induced by an early complementary foods introduction. Very few studies have evaluated, besides the time of weaning, the kind, quantity and caloric density of foods used as complements, whereas other recent studies show the importance of appetite differences since the first months of life and the importance of genetic influence on these variations. Others works have emphasized the possible role of an excessive protein intake during the first 2 years of life. So, it appears that it may be necessary to pay attention not only on the date, but also on the kind and quantity of complementary foods, particularly in infants at risk for obesity, because of parental obesity, rapid weight growth or an excessive appetite. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  3. More features, greater connectivity.

    Science.gov (United States)

    Hunt, Sarah

    2015-09-01

    Changes in our political infrastructure, the continuing frailties of our economy, and a stark growth in population, have greatly impacted upon the perceived stability of the NHS. Healthcare teams have had to adapt to these changes, and so too have the technologies upon which they rely to deliver first-class patient care. Here Sarah Hunt, marketing co-ordinator at Aid Call, assesses how the changing healthcare environment has affected one of its fundamental technologies - the nurse call system, argues the case for wireless such systems in terms of what the company claims is greater adaptability to changing needs, and considers the ever-wider range of features and functions available from today's nurse call equipment, particularly via connectivity with both mobile devices, and ancillaries ranging from enuresis sensors to staff attack alert 'badges'.

  4. Greater oil investment opportunities

    International Nuclear Information System (INIS)

    Arenas, Ismael Enrique

    1997-01-01

    Geologically speaking, Colombia is a very attractive country for the world oil community. According to this philosophy new and important steps are being taken to reinforce the oil sector: Expansion of the exploratory frontier by including a larger number of sedimentary areas, and the adoption of innovative contracting instruments. Colombia has to offer, Greater economic incentives for the exploration of new areas to expand the exploratory frontier, stimulation of exploration in areas with prospectivity for small fields. Companies may offer Ecopetrol a participation in production over and above royalties, without it's participating in the investments and costs of these fields, more favorable conditions for natural gas seeking projects, in comparison with those governing the terms for oil

  5. Planning for greater confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1985-01-01

    A report that provides guidance for planning for greater-confinement disposal (GCD) of low-level radioactive waste is being prepared. The report addresses procedures for selecting a GCD technology and provides information for implementing these procedures. The focus is on GCD; planning aspects common to GCD and shallow-land burial are covered by reference. Planning procedure topics covered include regulatory requirements, waste characterization, benefit-cost-risk assessment and pathway analysis methodologies, determination of need, waste-acceptance criteria, performance objectives, and comparative assessment of attributes that support these objectives. The major technologies covered include augered shafts, deep trenches, engineered structures, hydrofracture, improved waste forms, and high-integrity containers. Descriptive information is provided, and attributes that are relevant for risk assessment and operational requirements are given. 10 refs., 3 figs., 2 tabs

  6. Timing incorporation of different green manure crops to minimize the risk of nitrogen leaching

    Directory of Open Access Journals (Sweden)

    H. KÄNKÄNEN

    2008-12-01

    Full Text Available Seven field trials at four research sites were carried out to study the effect of incorporation time of different plant materials on soil mineral N content during two successive seasons. Annual hairy vetch (Vicia villosa Roth, red clover (Trifolium pratense L., westerwold ryegrass (Lolium multiflorum Lam. var. westerwoldicum and straw residues of N-fertilized spring barley (Hordeum vulgare were incorporated into the soil by ploughing in early September, late October and the following May, and by reduced tillage in May. Delaying incorporation of the green manure crop in autumn lessened the risk of N leaching. The higher the crop N and soil NO3-N content, the greater the risk of leaching. Incorporation in the following spring, which lessened the risk of N leaching as compared with early autumn ploughing, often had an adverse effect on the growth of the succeeding crop. After spring barley, the NO3-N content of the soil tended to be high, but the timing of incorporation did not have a marked effect on soil N. With exceptionally high soil mineral N content, N leaching was best inhibited by growing westerwold ryegrass in the first experimental year. ;

  7. Meal frequency and timing: impact on metabolic disease risk.

    Science.gov (United States)

    Varady, Krista A

    2016-10-01

    The purpose of this article is to provide an overview of the most recent human intervention trials that have examined the impact of meal frequency or meal timing on metabolic disease risk factors. Findings from intervention studies published over the past 12 months indicate that weight loss may be more pronounced with decreased meal frequency (two meals per day) versus increased meal frequency (six meals per day) under hypocaloric conditions. However, under isocaloric conditions, no effect on body weight was noted. Plasma lipid concentrations and glucoregulatory factors (fasting glucose, insulin, and insulin sensitivity) were not affected by alterations in meal frequency. As for meal timing, delaying the lunchtime meal by 3.5 h (from 1.30 p.m. to 4.30 p.m.) has no impact on body weight, but may impair glucose tolerance in young healthy adults. In sum, altering meal frequency has little impact on body weight, plasma lipids, or glucoregulatory factors, whereas eating the majority of calories later in the day may be detrimental for glycemic control. These preliminary findings, however, still require confirmation by longer term, larger scale controlled trials.

  8. Household Portfolios and Risk Bearing over Age and Time

    OpenAIRE

    Alessandro Bucciol; Raffaele Miniaci

    2011-01-01

    We exploit the US Survey of Consumer Finances from 1998 to 2007 to study households’ portfolio risk bearing. We compare four alternative measures of risk, two based on a financial portfolio and two based on a broader portfolio also including – as illiquid assets – human capital, real estate, business wealth and related debt. The measures provide a different ranking of household risk bearing, but they consistently show that risk bearing fell after 2001, and it positively correlates with wealth...

  9. Is seeing believing? Perceptions of wildfire risk over time

    Science.gov (United States)

    Patricia A. Champ; Hannah Brenkert-Smith

    2016-01-01

    Ongoing challenges to understanding how hazard exposure and disaster experiences influence perceived risk lead us to ask: Is seeing believing? We approach risk perception by attending to two components of overall risk perception: perceived probability of an event occurring and perceived consequences if an event occurs. Using a two-period longitudinal data set...

  10. individual vs. collective behavior: an experimental. investigation of risk and time preferences in couples

    OpenAIRE

    Abdellaoui, Mohammed; l'Haridon, Olivier; Paraschiv, Corina

    2010-01-01

    Author's abstract. This paper study decision-making under risk and decision-making over time made by couples. We performed a joint experimental elicitation of risk and time preferences both for couples and for their individual members. We used general behavioral models of decision under risk and over time and measured utility, probability weighting, and discounting. Under risk, our main result is that probabilistic risk attitude for couples lay within the boundaries of individual attitudes: c...

  11. Detection of cavity migration risks using radar interferometric time series

    Science.gov (United States)

    Chang, L.; Hanssen, R. F.

    2012-12-01

    The upward migration of near-surface underground cavities can pose a major hazard for people and infrastructure. Being the major cause of sudden collapse-sinkholes, or causing a sudden lack of support of building foundations, a migrating cavity can cause the collapse of buildings, water defense systems, drainage of water bodies, or transport infrastructure. Cavity migration can occur naturally, e.g. in karst-massifs, but could also be caused by anthropogenic activities such as mining. The chief difficulty in the assessment of sinkhole risk is the lack of prior knowledge on the location of the cavity. Although in situ measurements such as gravimetry, seismic or EM-surveying or GPR are in principle able to detect an underground void, it is generally not economically possible to use these techniques over vast areas. Moreover, the risk of casualties is highest for urbanized areas, in which it is difficult to get close enough to perform these measurements. The second problem is that there is usually no data available prior to the collapse, to understand whether there is for example precursory motion, and how far ahead in time critical levels can be detected. Here we report on the catastrophic collapse of the foundation of an underground parking garage in Heerlen, the Netherlands. In December 2011, some pillars supporting the roof of the garage and the shopping mall above it suddenly subsided more than one meter. This caused the near collapse of a part of the shopping mall, the immediate evacuation of the building, and the decision of the authorities to eliminate the building. In the analysis of the event, several hypotheses were formulated on the driving mechanisms, such as subsurface water flows and karst. However, as the region was subject to coal mining in the last century, alternative hypotheses were cavity migration due to the mining, or rebound of the surface due to mine water. Our study jointly exploits the data archives of four imaging radar satellites, ERS-1

  12. Evaluation of allowed outage times (AOTS) from a risk and reliability standpoint

    International Nuclear Information System (INIS)

    Vesely, W.E.

    1989-08-01

    This report describes the basic risks associated with allowed outage times (AOTS), defines strategies for selecting the risks to be quantified, and describes how the risks can be quantified. This report provides a basis for risk-based approaches for regulatory and plant implementation. The AOT risk evaluations can be applied to proposed one-time AOT changes, or to permanent changes. The evaluations can also be used to quantify risks associated with present AOTs, and in establishing AOTs from a risk perspective. The report shows that the standard way of calculating AOT risks in probabilistic risk analyses (PRAs) generally is not sufficient when evaluating all the risks associated with an AOT in order to assess its acceptability. The PRA calculates an average AOT risk which includes the frequency at which the AOT is expected to occur. Other risks associated with an AOT include the single downtime risk, which is the risk incurred when (given) the AOT has occurred. The single downtime risk is generally the most applicable risk in determining the acceptability of the AOT. The single downtime risks are generally much larger than the PRA-averaged risk. For more comprehensive evaluations, both risks should be calculated. The report also describes other risks which can be considered, including personnel and economic risks. Finally, the report discusses the detailed evaluations which are involved in calculating AOT risks, including considerations of uncertainty. (author)

  13. Timing of delivery after external cephalic version and the risk for cesarean delivery.

    Science.gov (United States)

    Kabiri, Doron; Elram, Tamar; Aboo-Dia, Mushira; Elami-Suzin, Matan; Elchalal, Uriel; Ezra, Yossef

    2011-08-01

    To estimate the association between time of delivery after external cephalic version at term and the risk for cesarean delivery. This retrospective cohort study included all successful external cephalic versions performed in a tertiary center between January 1997 and January 2010. Stepwise logistic regression was used to calculate the odds ratio (OR) for cesarean delivery. We included 483 external cephalic versions in this study, representing 53.1% of all external cephalic version attempts. The incidence of cesarean delivery for 139 women (29%) who gave birth less than 96 hours from external cephalic version was 16.5%; for 344 women (71%) who gave birth greater than 96 hours from external cephalic version, the incidence of cesarean delivery was 7.8% (P = .004). The adjusted OR for cesarean delivery was 2.541 (95% confidence interval 1.36-4.72). When stratified by parity, the risk for cesarean delivery when delivery occurred less than 96 hours after external cephalic version was 2.97 and 2.28 for nulliparous and multiparous women, respectively. Delivery at less than 96 hours after successful external cephalic version was associated with an increased risk for cesarean delivery. III.

  14. Changes in time-use and drug use by young adults in poor neighbourhoods of Greater Buenos Aires, Argentina, after the political transitions of 2001-2002: Results of a survey.

    Science.gov (United States)

    Rossi, Diana; Zunino Singh, Dhan; Pawlowicz, María Pía; Touzé, Graciela; Bolyard, Melissa; Mateu-Gelabert, Pedro; Sandoval, Milagros; Friedman, Samuel R

    2011-01-20

    In some countries, "Big Events" like crises and transitions have been followed by large increases in drug use, drug injection and HIV/AIDS. Argentina experienced an economic crisis and political transition in 2001/2002 that affected how people use their time. This paper studies how time use changes between years 2001 and 2004, subsequent to these events, were associated with drug consumption in poor neighbourhoods of Greater Buenos Aires. In 2003-2004, 68 current injecting drug users (IDUs) and 235 young non-IDUs, aged 21-35, who lived in impoverished drug-impacted neighbourhoods in Greater Buenos Aires, were asked about time use then and in 2001. Data on weekly hours spent working or looking for work, doing housework/childcare, consuming drugs, being with friends, and hanging out in the neighbourhood, were studied in relation to time spent using drugs. Field observations and focus groups were also conducted. After 2001, among both IDUs and non-IDUs, mean weekly time spent working declined significantly (especially among IDUs); time spent looking for work increased, and time spent with friends and hanging out in the neighbourhood decreased.We found no increase in injecting or non-injecting drug consumption after 2001. Subjects most affected by the way the crises led to decreased work time and/or to increased time looking for work--and by the associated increase in time spent in one's neighbourhood--were most likely to increase their time using drugs. Time use methods are useful to study changes in drug use and their relationships to every day life activities. In these previously-drug-impacted neighbourhoods, the Argentinean crisis did not lead to an increase in drug use, which somewhat contradicts our initial expectations. Nevertheless, those for whom the crises led to decreased work time, increased time looking for work, and increased time spent in indoor or outdoor neighbourhood environments, were likely to spend more time using drugs. These data suggest that

  15. Changes in time-use and drug use by young adults in poor neighbourhoods of Greater Buenos Aires, Argentina, after the political transitions of 2001-2002: Results of a survey

    Directory of Open Access Journals (Sweden)

    Mateu-Gelabert Pedro

    2011-01-01

    Full Text Available Abstract Background In some countries, "Big Events" like crises and transitions have been followed by large increases in drug use, drug injection and HIV/AIDS. Argentina experienced an economic crisis and political transition in 2001/2002 that affected how people use their time. This paper studies how time use changes between years 2001 and 2004, subsequent to these events, were associated with drug consumption in poor neighbourhoods of Greater Buenos Aires. Methods In 2003-2004, 68 current injecting drug users (IDUs and 235 young non-IDUs, aged 21-35, who lived in impoverished drug-impacted neighbourhoods in Greater Buenos Aires, were asked about time use then and in 2001. Data on weekly hours spent working or looking for work, doing housework/childcare, consuming drugs, being with friends, and hanging out in the neighbourhood, were studied in relation to time spent using drugs. Field observations and focus groups were also conducted. Results After 2001, among both IDUs and non-IDUs, mean weekly time spent working declined significantly (especially among IDUs; time spent looking for work increased, and time spent with friends and hanging out in the neighbourhood decreased. We found no increase in injecting or non-injecting drug consumption after 2001. Subjects most affected by the way the crises led to decreased work time and/or to increased time looking for work--and by the associated increase in time spent in one's neighbourhood--were most likely to increase their time using drugs. Conclusions Time use methods are useful to study changes in drug use and their relationships to every day life activities. In these previously-drug-impacted neighbourhoods, the Argentinean crisis did not lead to an increase in drug use, which somewhat contradicts our initial expectations. Nevertheless, those for whom the crises led to decreased work time, increased time looking for work, and increased time spent in indoor or outdoor neighbourhood environments, were

  16. Household portfolios and risk taking over age and time

    NARCIS (Netherlands)

    Bucciol, A.; Miniaci, R.

    2011-01-01

    We exploit the US Survey of Consumer Finances (SCF) from 1998 to 2007 to provide new insights on the evolution of US households’ willingness to undertake portfolio risk. Specifically, we consider four alternative measures of portfolio risk, based on two definitions of portfolio - a narrow one,

  17. Changes in erectile dysfunction over time in relation to Framingham cardiovascular risk in the Boston Area Community Health (BACH) Survey.

    Science.gov (United States)

    Fang, Shona C; Rosen, Raymond C; Vita, Joseph A; Ganz, Peter; Kupelian, Varant

    2015-01-01

    Erectile dysfunction (ED) is associated with cardiovascular disease (CVD); however, the association between change in ED status over time and future underlying CVD risk is unclear. The aim of this study was to investigate the association between change in ED status and Framingham CVD risk, as well change in Framingham risk. We studied 965 men free of CVD in the Boston Area Community Health (BACH) Survey, a longitudinal cohort study with three assessments. ED was assessed with the five-item International Index of Erectile Function at BACH I (2002-2005) and BACH II (2007-2010) and classified as no ED/transient ED/persistent ED. CVD risk was assessed with 10-year Framingham CVD risk algorithm at BACH I and BACH III (2010-2012). Linear regression models controlled for baseline age, socio-demographic and lifestyle factors, as well as baseline Framingham risk. Models were also stratified by age (≥/< 50 years). Framingham CVD risk and change in Framingham CVD risk were the main outcome measures. Transient and persistent ED was significantly associated with increased Framingham risk and change in risk over time in univariate and age-adjusted models. In younger men, persistent ED was associated with a Framingham risk that was 1.58 percentage points higher (95% confidence interval [CI]: 0.11, 3.06) and in older men, a Framingham risk that was 2.54 percentage points higher (95% CI: -1.5, 6.59), compared with those without ED. Change in Framingham risk over time was also associated with transient and persistent ED in men <50 years, but not in older men. Data suggest that even after taking into account other CVD risk factors, transient and persistent ED is associated with Framingham CVD risk and a greater increase in Framingham risk over time, particularly in younger men. Findings further support clinical assessment of CVD risk in men presenting with ED, especially those under 50 years. © 2014 International Society for Sexual Medicine.

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

    Science.gov (United States)

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

    2013-01-01

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

  19. Monitoring risk-adjusted outcomes in congenital heart surgery: does the appropriateness of a risk model change with time?

    Science.gov (United States)

    Tsang, Victor T; Brown, Katherine L; Synnergren, Mats Johanssen; Kang, Nicholas; de Leval, Marc R; Gallivan, Steve; Utley, Martin

    2009-02-01

    Risk adjustment of outcomes in pediatric congenital heart surgery is challenging due to the great diversity in diagnoses and procedures. We have previously shown that variable life-adjusted display (VLAD) charts provide an effective graphic display of risk-adjusted outcomes in this specialty. A question arises as to whether the risk model used remains appropriate over time. We used a recently developed graphic technique to evaluate the performance of an existing risk model among those patients at a single center during 2000 to 2003 originally used in model development. We then compared the distribution of predicted risk among these patients with that among patients in 2004 to 2006. Finally, we constructed a VLAD chart of risk-adjusted outcomes for the latter period. Among 1083 patients between April 2000 and March 2003, the risk model performed well at predicted risks above 3%, underestimated mortality at 2% to 3% predicted risk, and overestimated mortality below 2% predicted risk. There was little difference in the distribution of predicted risk among these patients and among 903 patients between June 2004 and October 2006. Outcomes for the more recent period were appreciably better than those expected according to the risk model. This finding cannot be explained by any apparent bias in the risk model combined with changes in case-mix. Risk models can, and hopefully do, become out of date. There is scope for complacency in the risk-adjusted audit if the risk model used is not regularly recalibrated to reflect changing standards and expectations.

  20. Metric properties of the "timed get up and go- modified version" test, in risk assessment of falls in active women.

    Science.gov (United States)

    Alfonso Mora, Margareth Lorena

    2017-03-30

    To analyse the metric properties of the Timed Get up and Go-Modified Version Test (TGUGM), in risk assessment of falls in a group of physically active women. A sample was constituted by 202 women over 55 years of age, were assessed through a crosssectional study. The TGUGM was applied to assess their fall risk. The test was analysed by comparison of the qualitative and quantitative information and by factor analysis. The development of a logistic regression model explained the risk of falls according to the test components. The TGUGM was useful for assessing the risk of falls in the studied group. The test revealed two factors: the Get Up and the Gait with dual task . Less than twelve points in the evaluation or runtimes higher than 35 seconds was associated with high risk of falling. More than 35 seconds in the test indicated a risk fall probability greater than 0.50. Also, scores less than 12 points were associated with a delay of 7 seconds more in the execution of the test ( p = 0.0016). Factor analysis of TGUGM revealed two dimensions that can be independent predictors of risk of falling: The Get up that explains between 64% and 87% of the risk of falling, and the Gait with dual task, that explains between 77% and 95% of risk of falling.

  1. Real time risk analysis of kick detection: Testing and validation

    International Nuclear Information System (INIS)

    Islam, Rakibul; Khan, Faisal; Venkatesan, Ramchandran

    2017-01-01

    Oil and gas development is moving into harsh and remote locations where the highest level of safety is required. A blowout is one of the most feared accidents in oil and gas developments projects. The main objective of this paper is to test and validate the kick detection of blowout risk assessment model using uniquely developed experimental results. Kick detection is a major part of the blowout risk assessment model. The accuracy and timeliness of kick detection are dependent on the monitoring of multiple downhole parameters such as downhole pressure, fluid density, fluid conductivity and mass flow rate. In the present study these four parameters are considered in different logical combinations to assess the occurrence of kick and associated blowout risk. The assessed results are compared against the experimental observations. It is observed that simultaneous monitoring of mass flow rate combined with any one the three parameters provides most reliable detection of kick and potential blowout likelihood. The current work presents the framework for a dynamic risk assessment and management model. Upon success testing of this approach at the pilot and field levels, this approach could provide a paradigm shift in drilling safety. - Highlights: • A novel dynamic risk model of kick detection and blowout prediction. • Testing and Validation of the risk model. • Application of the dynamic risk model.

  2. Risk, time and social preferences : Evidence from large scale experiments

    NARCIS (Netherlands)

    Perez Padilla, Mitzi

    2017-01-01

    This dissertation contains four chapters studying individual preferences and economic decision-making. The first three chapters study preferences for risk taking and intertemporal choice. First, it asks the question whether economic preferences are related to psychological measures of personality

  3. Optimal International Asset Allocation with Time-varying Risk

    OpenAIRE

    Flavin, Thomas; Wickens, M.R.

    2006-01-01

    This paper examines the optimal allocation each period of an internationally diversified portfolio from the different points of view of a UK and a US investor. We find that investor location affects optimal asset allocation. The presence of exchange rate risk causes the markets to appear not fully integrated and creates a preference for home assets. Domestic equity is the dominant asset in the optimal portfolio for both investors, but the US investor bears less risk than the UK...

  4. Operative Start Time Does Not Affect Post-Operative Infection Risk.

    Science.gov (United States)

    Guidry, Christopher A; Davies, Stephen W; Willis, Rhett N; Dietch, Zachary C; Shah, Puja M; Sawyer, Robert G

    2016-10-01

    Surgical care is delivered 24 h a day at most institutions. Alarmingly, some authors have found that certain operative start times are associated with greater morbidity and mortality rates. This effect has been noted in both the public and private sector. Although some of these differences may be related to process, they may also be caused by the human circadian rhythm and corresponding changes in host defenses. We hypothesized that the time of day of an operation would impact the frequency of certain post-operative outcomes significantly. Cases at a single tertiary-care center reported to the American College of Surgeons National Surgical Quality Improvement Program over a 10-year period were identified. Operative start times were divided into six-hour blocks, with 6 am to noon serving as the reference. Standard univariable techniques were applied. Multivariable logistic regression with mixed effects modeling then was used to determine the relation between operative start times and infectious outcomes, controlling for surgeon clustering. Statistical significance was set at p operative infectious complication. Seventy percent of these infections (n = 1,506) were surgical site infections. On univariable analysis considering all cases, nighttime and evening operations had higher rates of post-operative infections than those in performed during the day (9.1% from 6 am to noon; 9.7% from noon to 6 pm; 14.8% from 6 pm to midnight; and 14.4% from midnight to 6 am; p operative start time was not associated with the risk of post-operative infection, even when emergency cases were considered independently. Our data suggest that operative start times have no correlation with post-operative infectious complications. Further work is required to identify the source of the time-dependent outcome variability observed in previous studies.

  5. Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes?

    Directory of Open Access Journals (Sweden)

    Sylvie Provost

    2017-04-01

    Full Text Available Introduction: Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montréal for patients with diabetes or hypertension. One of this study's objectives was to assess the impact of care coordination between the interdisciplinary teams and physicians on patient participation in the program, lifestyle improvements and disease control. Methods: We obtained data on health outcomes from a register of clinical data, questionnaires completed by patients upon entry into the program and at the 12-month mark, and we drew information on the program's characteristics from the implementation analysis. We conducted multiple regression analyses, controlling for patient sociodemographic and health characteristics to measure the association between interdisciplinary team coordination with primary care physicians and various health outcomes. Results: A total of 1689 patients took part in the study (60.1% participation rate. Approximately 40% of patients withdrew from the program during the first year. At the 12-month follow-up (n = 992, we observed a significant increase in the proportion of patients achieving the various clinical targets. The perception by the interdisciplinary team of greater care coordination with primary care physicians was associated with increased participation in the program and the achievement of better clinical results. Conclusion: Greater coordination of patient services between interdisciplinary teams and primary care physicians translates into benefits for patients.

  6. Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes?

    Science.gov (United States)

    Provost, Sylvie; Pineault, Raynald; Grimard, Dominique; Pérez, José; Fournier, Michel; Lévesque, Yves; Desforges, Johanne; Tousignant, Pierre; Borgès Da Silva, Roxane

    2017-04-01

    Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montréal for patients with diabetes or hypertension. One of this study's objectives was to assess the impact of care coordination between the interdisciplinary teams and physicians on patient participation in the program, lifestyle improvements and disease control. We obtained data on health outcomes from a register of clinical data, questionnaires completed by patients upon entry into the program and at the 12-month mark, and we drew information on the program's characteristics from the implementation analysis. We conducted multiple regression analyses, controlling for patient sociodemographic and health characteristics, to measure the association between interdisciplinary team coordination with primary care physicians and various health outcomes. A total of 1689 patients took part in the study (60.1% participation rate). Approximately 40% of patients withdrew from the program during the first year. At the 12-month follow-up (n = 992), we observed a significant increase in the proportion of patients achieving the various clinical targets. The perception by the interdisciplinary team of greater care coordination with primary care physicians was associated with increased participation in the program and the achievement of better clinical results. Greater coordination of patient services between interdisciplinary teams and primary care physicians translates into benefits for patients.

  7. Innovative real time simulation training and nuclear probabilistic risk assessment

    International Nuclear Information System (INIS)

    Reisinger, M.F.

    1991-01-01

    Operator errors have been an area of public concern for the safe operation of nuclear power plants since the TMI2 incident. Simply stated, nuclear plants are very complex systems and the public is skeptical of the operators' ability to comprehend and deal with the vast indications and complexities of potential nuclear power plant events. Prior to the TMI2 incident, operator errors and human factors were not included as contributing factors in the Probabilistic Risk Assessment (PRA) studies of nuclear power plant accidents. More recent efforts in nuclear risk assessment have addressed some of the human factors affecting safe nuclear plant operations. One study found four major factors having significant impact on operator effectiveness. This paper discusses human factor PRAs, new applications in simulation training and the specific potential benefits from simulation in promoting safer operation of future power plants as well as current operating power plants

  8. Ruin Probabilities in a Dependent Discrete-Time Risk Model With Gamma-Like Tailed Insurance Risks

    Directory of Open Access Journals (Sweden)

    Xing-Fang Huang

    2017-03-01

    Full Text Available This paper considered a dependent discrete-time risk model, in which the insurance risks are represented by a sequence of independent and identically distributed real-valued random variables with a common Gamma-like tailed distribution; the financial risks are denoted by another sequence of independent and identically distributed positive random variables with a finite upper endpoint, but a general dependence structure exists between each pair of the insurance risks and the financial risks. Following the works of Yang and Yuen in 2016, we derive some asymptotic relations for the finite-time and infinite-time ruin probabilities. As a complement, we demonstrate our obtained result through a Crude Monte Carlo (CMC simulation with asymptotics.

  9. Effects of context on risk taking and decision times in obsessive-compulsive disorder.

    Science.gov (United States)

    Sip, Kamila E; Muratore, Alexandra F; Stern, Emily R

    2016-04-01

    Despite the fact that OCD patients show altered decision making in everyday life, few studies have investigated how patients make risky decisions and what contextual factors impact choices. We investigated cognitive context with the use of the "framing effect" task, which investigates decision making based on whether monetarily equivalent choice options are framed in terms of a potential to either lose (lose $20 out of $50) or gain (gain $30 out of $50) money. In addition, we manipulated social context by providing positive or neutral feedback on subjects' choices. Overall, participants were risk taking for options framed in terms of potential loss and risk averse for options framed in terms of potential gain (the classic framing effect). Although OCD patients were generally more risk averse, the effect of the frame on choices did not differ significantly from healthy participants and choices were not impacted by social context. Within OCD patients, greater self-reported indecisiveness was associated with a larger effect of the frame on choices. OCD patients were also significantly slower to make choices in the loss compared to gain frame, an effect that was not observed among healthy participants. Overall, our results suggest that the framing of choice options has a differential effect on decision times but not the actual choices made by OCD patients, and that patients are not sensitive to social feedback when making choices. The correlation between indecisiveness and the framing effect in OCD suggests that further work interrogating the relationship between specific symptoms and decision making among patients may yield new insights into the disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Time will tell: changes in risk perception and the processing of risk information about the Y2K-risk.

    NARCIS (Netherlands)

    Kuttschreuter, M.; Gutteling, Jan M.

    2004-01-01

    A field study was performed on the perceived risks related to the Y2K-problem. Two cross-sectional surveys were executed to study whether risk perception regarding the Y2K-problem, the perceived societal and personal capabilities to mitigate the risks, the attitude toward computers and the attitude

  11. Fall risk as a function of time after admission to sub-acute geriatric hospital units.

    Science.gov (United States)

    Rapp, Kilian; Ravindren, Johannes; Becker, Clemens; Lindemann, Ulrich; Jaensch, Andrea; Klenk, Jochen

    2016-10-07

    There is evidence about time-dependent fracture rates in different settings and situations. Lacking are data about underlying time-dependent fall risk patterns. The objective of the study was to analyse fall rates as a function of time after admission to sub-acute hospital units and to evaluate the time-dependent impact of clinical factors at baseline on fall risk. This retrospective cohort study used data of 5,255 patients admitted to sub-acute units in a geriatric rehabilitation clinic in Germany between 2010 and 2014. Falls, personal characteristics and functional status at admission were extracted from the hospital information system. The rehabilitation stay was divided in 3-day time-intervals. The fall rate was calculated for each time-interval in all patients combined and in subgroups of patients. To analyse the influence of covariates on fall risk over time multivariate negative binomial regression models were applied for each of 5 time-intervals. The overall fall rate was 10.2 falls/1,000 person-days with highest fall risks during the first week and decreasing risks within the following weeks. A particularly pronounced risk pattern with high fall risks during the first days and decreasing risks thereafter was observed in men, disoriented people, and people with a low functional status or impaired cognition. In disoriented patients, for example, the fall rate decreased from 24.6 falls/1,000 person-days in day 2-4 to about 13 falls/1,000 person-days 2 weeks later. The incidence rate ratio of baseline characteristics changed also over time. Fall risk differs considerably over time during sub-acute hospitalisation. The strongest association between time and fall risk was observed in functionally limited patients with high risks during the first days after admission and declining risks thereafter. This should be considered in the planning and application of fall prevention measures.

  12. Time-dependent changes in mortality and transformation risk in MDS.

    Science.gov (United States)

    Pfeilstöcker, Michael; Tuechler, Heinz; Sanz, Guillermo; Schanz, Julie; Garcia-Manero, Guillermo; Solé, Francesc; Bennett, John M; Bowen, David; Fenaux, Pierre; Dreyfus, Francois; Kantarjian, Hagop; Kuendgen, Andrea; Malcovati, Luca; Cazzola, Mario; Cermak, Jaroslav; Fonatsch, Christa; Le Beau, Michelle M; Slovak, Marilyn L; Levis, Alessandro; Luebbert, Michael; Maciejewski, Jaroslaw; Machherndl-Spandl, Sigrid; Magalhaes, Silvia M M; Miyazaki, Yasushi; Sekeres, Mikkael A; Sperr, Wolfgang R; Stauder, Reinhard; Tauro, Sudhir; Valent, Peter; Vallespi, Teresa; van de Loosdrecht, Arjan A; Germing, Ulrich; Haase, Detlef; Greenberg, Peter L

    2016-08-18

    In myelodysplastic syndromes (MDSs), the evolution of risk for disease progression or death has not been systematically investigated despite being crucial for correct interpretation of prognostic risk scores. In a multicenter retrospective study, we described changes in risk over time, the consequences for basal prognostic scores, and their potential clinical implications. Major MDS prognostic risk scoring systems and their constituent individual predictors were analyzed in 7212 primary untreated MDS patients from the International Working Group for Prognosis in MDS database. Changes in risk of mortality and of leukemic transformation over time from diagnosis were described. Hazards regarding mortality and acute myeloid leukemia transformation diminished over time from diagnosis in higher-risk MDS patients, whereas they remained stable in lower-risk patients. After approximately 3.5 years, hazards in the separate risk groups became similar and were essentially equivalent after 5 years. This fact led to loss of prognostic power of different scoring systems considered, which was more pronounced for survival. Inclusion of age resulted in increased initial prognostic power for survival and less attenuation in hazards. If needed for practicability in clinical management, the differing development of risks suggested a reasonable division into lower- and higher-risk MDS based on the IPSS-R at a cutoff of 3.5 points. Our data regarding time-dependent performance of prognostic scores reflect the disparate change of risks in MDS subpopulations. Lower-risk patients at diagnosis remain lower risk whereas initially high-risk patients demonstrate decreasing risk over time. This change of risk should be considered in clinical decision making. © 2016 by The American Society of Hematology.

  13. Real-time risk monitoring in business processes : a sensor-based approach

    NARCIS (Netherlands)

    Conforti, R.; La Rosa, M.; Fortino, G.; Hofstede, ter A.H.M.; Recker, J.; Adams, M.

    2013-01-01

    This article proposes an approach for real-time monitoring of risks in executable business process models. The approach considers risks in all phases of the business process management lifecycle, from process design, where risks are defined on top of process models, through to process diagnosis,

  14. Parametric Roll - Risk Reduction through Real-time Detection

    DEFF Research Database (Denmark)

    Galeazzi, Roberto

    2014-01-01

    PAROLL is an innovative condition-monitoring system for the timely detection of parametric roll on merchant vessels. It has been invented and developed by the Technical University of Denmark. DNV GL and Wallenius Marine have supported the development and full-scale validation of this monitoring...

  15. Waiting Time Increases Risk of Attrition in Gambling Disorder Treatment

    DEFF Research Database (Denmark)

    Linnet, Jakob; Pedersen, Anders Sune

    2014-01-01

    Attrition is a well known problem in psychotherapeutic treatment. Patients with addiction have high attrition rates, and it is therefore important to identify factors that can improve completion rates in addiction. Here, we investigated the influence of waiting time as a predictor of treatment...

  16. Real time avalanche detection for high risk areas.

    Science.gov (United States)

    2014-12-01

    Avalanches routinely occur on State Highway 21 (SH21) between Lowman and Stanley, Idaho each winter. The avalanches pose : a threat to the safety of maintenance workers and the traveling public. A real-time avalanche detection system will allow the :...

  17. Timing of the introduction of complementary feeding and risk of childhood obesity: a systematic review.

    Science.gov (United States)

    Pearce, J; Taylor, M A; Langley-Evans, S C

    2013-10-01

    The World Health Organisation recommends exclusive breastfeeding until 6 months of age and continued breastfeeding until 2 years of age or beyond. Appropriate complementary foods should be introduced in a timely fashion, beginning when the infant is 6 months old. In developing countries, early or inappropriate complementary feeding may lead to malnutrition and poor growth, but in countries such as the United Kingdom and United States of America, where obesity is a greater public health concern than malnutrition, the relationship to growth is unclear. We conducted a systematic review of the literature that investigated the relationship between the timing of the introduction of complementary feeding and overweight or obesity during childhood. Electronic databases were searched from inception until 30 September 2012 using specified keywords. Following the application of strict inclusion/exclusion criteria, 23 studies were identified and reviewed by two independent reviewers. Data were extracted and aspects of quality were assessed using an adapted Newcastle-Ottawa scale. Twenty-one of the studies considered the relationship between the time at which complementary foods were introduced and childhood body mass index (BMI), of which five found that introducing complementary foods at childhood. Seven of the studies considered the association between complementary feeding and body composition but only one study reported an increase in the percentage of body fat among children given complementary foods before 15 weeks of age. We conclude that there is no clear association between the timing of the introduction of complementary foods and childhood overweight or obesity, but some evidence suggests that very early introduction (at or before 4 months), rather than at 4-6 months or >6 months, may increase the risk of childhood overweight.

  18. Unmanned air vehicles - real time intelligence without the risk

    OpenAIRE

    Miller, James Bryan.

    1988-01-01

    Unmanned Air Vehicles (UAVs) are capable of supporting the officer in tactical command (OTC) by gathering intelligence in real- or near real-time. UAVs now under development will be able to collect high-resolution imagery, and thus provide the OTC with the option of gathering tactical intelligence without using manned reconnaissance platforms. This thesis asserts that UAVs should be used to supplement existing intelligence sensors, particularly in those cases where current sources are too amb...

  19. A time series modeling approach in risk appraisal of violent and sexual recidivism.

    Science.gov (United States)

    Bani-Yaghoub, Majid; Fedoroff, J Paul; Curry, Susan; Amundsen, David E

    2010-10-01

    For over half a century, various clinical and actuarial methods have been employed to assess the likelihood of violent recidivism. Yet there is a need for new methods that can improve the accuracy of recidivism predictions. This study proposes a new time series modeling approach that generates high levels of predictive accuracy over short and long periods of time. The proposed approach outperformed two widely used actuarial instruments (i.e., the Violence Risk Appraisal Guide and the Sex Offender Risk Appraisal Guide). Furthermore, analysis of temporal risk variations based on specific time series models can add valuable information into risk assessment and management of violent offenders.

  20. Parisian ruin for the dual risk process in discrete-time

    OpenAIRE

    Palmowski, Zbigniew; Ramsden, Lewis; Papaioannou, Apostolos D.

    2017-01-01

    In this paper we consider the Parisian ruin probabilities for the dual risk model in a discrete-time setting. By exploiting the strong Markov property of the risk process we derive a recursive expression for the fnite-time Parisian ruin probability, in terms of classic discrete-time dual ruin probabilities. Moreover, we obtain an explicit expression for the corresponding infnite-time Parisian ruin probability as a limiting case. In order to obtain more analytic results, we employ a conditioni...

  1. Leisure time physical activity is associated with a reduced risk of preterm delivery

    DEFF Research Database (Denmark)

    Hegaard, Hanne Kristine; Hedegaard, Morten; Damm, Peter

    2008-01-01

    This study was undertaken to study the association between the times spent on sports activities and leisure time physical activity in the first and early second trimester of pregnancy and the risk of preterm delivery.......This study was undertaken to study the association between the times spent on sports activities and leisure time physical activity in the first and early second trimester of pregnancy and the risk of preterm delivery....

  2. Uniform Estimate of the Finite-Time Ruin Probability for All Times in a Generalized Compound Renewal Risk Model

    Directory of Open Access Journals (Sweden)

    Qingwu Gao

    2012-01-01

    Full Text Available We discuss the uniformly asymptotic estimate of the finite-time ruin probability for all times in a generalized compound renewal risk model, where the interarrival times of successive accidents and all the claim sizes caused by an accident are two sequences of random variables following a wide dependence structure. This wide dependence structure allows random variables to be either negatively dependent or positively dependent.

  3. Competing approaches to analysis of failure times with competing risks.

    Science.gov (United States)

    Farley, T M; Ali, M M; Slaymaker, E

    2001-12-15

    For the analysis of time to event data in contraceptive studies when individuals are subject to competing causes for discontinuation, some authors have recently advocated the use of the cumulative incidence rate as a more appropriate measure to summarize data than the complement of the Kaplan-Meier estimate of discontinuation. The former method estimates the rate of discontinuation in the presence of competing causes, while the latter is a hypothetical rate that would be observed if discontinuations for the other reasons could not occur. The difference between the two methods of analysis is the continuous time equivalent of a debate that took place in the contraceptive literature in the 1960s, when several authors advocated the use of net (adjusted or single decrement life table rates) rates in preference to crude rates (multiple decrement life table rates). A small simulation study illustrates the interpretation of the two types of estimate - the complement of the Kaplan-Meier estimate corresponds to a hypothetical rate where discontinuations for other reasons did not occur, while the cumulative incidence gives systematically lower estimates. The Kaplan-Meier estimates are more appropriate when estimating the effectiveness of a contraceptive method, but the cumulative incidence estimates are more appropriate when making programmatic decisions regarding contraceptive methods. Other areas of application, such as cancer studies, may prefer to use the cumulative incidence estimates, but their use should be determined according to the application. Copyright 2001 John Wiley & Sons, Ltd.

  4. Divorce risk factors and their variation over time in Spain

    Directory of Open Access Journals (Sweden)

    Fabrizio Bernardi

    2011-05-01

    Full Text Available The aim of this article is to analyse the determinants of marriage dissolution in Spain and their variation over time for women married between 1949 and 2006. Data are drawn from the Survey of Fertility, Family and Values of 2006. The article analyses the transition from first marriage to marital dissolution for couples who married in two eras: one prior to the Divorce Law of 1981, during which social and legal barriers to dissolution were many, and one in the period after the law was introduced, during which barriers to marriage dissolution were far fewer. Analyses are conducted using a continuous time event history model. The results indicate some similarities between Spain and other countries, such as the positive relationship between the typical features of unconventional families and marital dissolution, but also some specific differences, such as an increase in the importance of premarital pregnancy and/or not having children. It is also important to stress the declining importance of socio-economic variables, such as education and the labour market situation of women.

  5. Timing and risk factors associated with relapse among smokers attempting to quit in Malaysia.

    Science.gov (United States)

    Yasin, S M; Moy, F M; Retneswari, M; Isahak, M; Koh, D

    2012-07-01

    Many smokers attempt to quit smoking, but very few succeed. To identify the timing and risk factors involved in smoking relapse. We conducted a prospective cohort study among staff in two public universities in Malaysia. Behavioural therapy with free nicotine replacement therapy was given as treatment. Participants were followed up for 6 months. Relapse was defined as returning to smoking after having quit for at least 24 h. Of 185 smokers who volunteered to participate, 120 achieved at least 24-h abstinence, and 80% of these relapsed within 2 months. Compared to participants who attended a single smoking cessation session, participants who attended three sessions had a lower likelihood of relapse within 6 months of quitting. In contrast, smokers with a much longer exposure to cigarette smoking in the workplace (>3 h per week) had a greater chance of relapse compared to those with no exposure. Frequent attendance at clinic sessions and less exposure to other people smoking in the workplace can potentially reduce the likelihood of relapse among smokers who have recently quit.

  6. Changes in physical activity, sedentary time, and risk of falling: The Women's Health Initiative Observational Study.

    Science.gov (United States)

    Bea, Jennifer W; Thomson, Cynthia A; Wallace, Robert B; Wu, Chunyuan; Seguin, Rebecca A; Going, Scott B; LaCroix, Andrea; Eaton, Charles; Ockene, Judith K; LaMonte, Michael J; Jackson, Rebecca; Jerry Mysiw, W; Wactawski-Wende, Jean

    2017-02-01

    Falling significantly affects quality of life, morbidity, and mortality among older adults. We sought to evaluate the prospective association between sedentary time, physical activity, and falling among post-menopausal women aged 50-79years recruited to the Women's Health Initiative Observational Study between 1993 and 1998 from 40 clinical centers across the United States. Baseline (B) and change in each of the following were evaluated at year 3 (Y3) and year 6 (Y6; baseline n=93,676; Y3 n=76,598; Y6 n=75,428): recreational physical activity (MET-h/wk), sitting, sleeping (min/day), and lean body mass by dual energy X-ray absorptiometry (subset N=6475). Falls per year (0, 1, 2, ≥3) were assessed annually by self-report questionnaire and then dichotomized as ≤1 and ≥2falls/year. Logistic regression models were adjusted for demographics, body mass index, fall history, tobacco and alcohol use, medical conditions, and medications. Higher baseline activity was associated with greater risk of falling at Y6 (18%; p for trend falling (1% Y3; 2% Y6; pfalling at Y3 and Y6 (p for trend falling among post-menopausal women. Additional fall prevention strategies, such as balance and resistance training, should be evaluated to assist post-menopausal women in reaching or maintaining levels of aerobic activity known to prevent and manage several chronic diseases. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. FORMENTOR real-time decision support for risk management

    International Nuclear Information System (INIS)

    Pennings, R.; Gerlinger, G.; Ponamale, M.

    1995-01-01

    The supervision of complex industrial processes, such as in the chemical, nuclear or aerospace industries, is a difficult task. The FORMENTOR methodology allows the development of supervision support systems to aid operations in their tasks, especially when dealing with perturbations and hazardous situations. A FORMENTOR system presents a synthetic plant-wide view of the current situation, diagnoses the underlying causes of perturbations, predicts possible future evolutions and proposes remedial actions. For this the methodology integrates models, techniques and tools from four domains namely artificial intelligence, safety analysis, real-time computing and ergonomics. The methodological approach provides firm control over the development process while meeting the quality and technical requirements of the client; furthermore it ensures the reliability and maintainability of the obtained system

  8. The psychophysiology of real-time financial risk processing.

    Science.gov (United States)

    Lo, Andrew W; Repin, Dmitry V

    2002-04-01

    A longstanding controversy in economics and finance is whether financial markets are governed by rational forces or by emotional responses. We study the importance of emotion in the decision-making process of professional securities traders by measuring their physiological characteristics (e.g., skin conductance, blood volume pulse, etc.) during live trading sessions while simultaneously capturing real-time prices from which market events can be detected. In a sample of 10 traders, we find statistically significant differences in mean electrodermal responses during transient market events relative to no-event control periods, and statistically significant mean changes in cardiovascular variables during periods of heightened market volatility relative to normal-volatility control periods. We also observe significant differences in these physiological responses across the 10 traders that may be systematically related to the traders' levels of experience.

  9. [Unipedal stance time and fall risk in the elderly].

    Science.gov (United States)

    Domínguez-Carrillo, Luis Gerardo; Arellano-Aguilar, Gregorio; Leos-Zierold, Héctor

    2007-01-01

    We undertook this study to relate unipodal stance time (UST) as a falls indicator in the elderly and to corroborate with UST exercise increments. One hundred sixty eight elderly subjects (age >70 years) with two or more falls during the previous 12 months were compared with 150 similar subjects without falls. UST chronometry and quadriceps and triceps brachialis strength dynamometry were used. Equilibrium and antigravity muscle-strengthening exercise program with 20 work sessions were carried out. Results were analyzed with chi(2), Student's t-test, and Fisher tests. UST of the control group showed 28.84 +/- 4.73 sec (mean +/- SD). The UST sample showed 19.18 +/- 4.24 sec. The test was initially impossible to carry out in 42 cases (p = 0.05). The final evaluation showed 142 cases with 30 sec of UST (p = 0.00001), isometric force increased in 70% and 30%, respectively (p = 0.05). At 6-month follow-up, 53 falls were reported, 29 were in patients who could not accomplish UST measurement on initial evaluation. UST falls in elderly people, and exercise programs increase UST.

  10. Overrated credit risk: three essays on credit risk in turbulent times

    NARCIS (Netherlands)

    Bongaerts, D.G.J.

    2010-01-01

    Credit markets have shown a dramatic development at the start of the 21st century. Increased regulatory pressure on financial institutions has spurred the development of innovative products that allow for transfer of credit risk. These developments lay at the base of the largest financial crisis

  11. Optimal Consumption and Investment under Time-Varying Relative Risk Aversion

    DEFF Research Database (Denmark)

    Steffensen, Mogens

    2011-01-01

    We consider the continuous time consumption-investment problem originally formalized and solved by Merton in case of constant relative risk aversion. We present a complete solution for the case where relative risk aversion with respect to consumption varies with time, having in mind an investor...... with age-dependent risk aversion. This provides a new motivation for life-cycle investment rules. We study the optimal consumption and investment rules, in particular in the case where the relative risk aversion with respect to consumption is increasing with age....

  12. Time-explicit methods for joint economical and geological risk mitigation in production optimization

    DEFF Research Database (Denmark)

    Christiansen, Lasse Hjuler; Capolei, Andrea; Jørgensen, John Bagterp

    2016-01-01

    Real-life applications of production optimization face challenges of risks related to unpredictable fluctuations in oil prices and sparse geological data. Consequently, operating companies are reluctant to adopt model-based production optimization into their operations. Conventional production...... of mitigating economical and geological risks. As opposed to conventional strategies that focus on a single long-term objective, TE methods seek to reduce risks and promote returns over the entire reservoir life by optimization of a given ensemble-based geological risk measure over time. By explicit involvement...... of time, economical risks are implicitly addressed by balancing short-term and long-term objectives throughout the reservoir life. Open-loop simulations of a two-phase synthetic reservoir demonstrate that TE methods may significantly improve short-term risk measures such as expected return, standard...

  13. TIME VARIATION AND ASYMMETRY IN THE WORLD PRICE OF COVARIANCE RISK: THE IMPLICATIONS FOR INTERNATIONAL DIVERSIFICATION

    OpenAIRE

    Olan T. Henry; Nilss Olekalns; Kalvinder Shields

    2004-01-01

    The International Capital Asset Pricing Model measures country risk in terms of the conditional covariance of national returns with the world return. Using impulse responses from a multivariate nonlinear model we provide evidence of time variation and asymmetry in the measure of country risk. and the implied benefit to international diversification. The evidence implies that the price of risk and the benefits from diversification may differ in a statistically and economically meaningful fashi...

  14. The roles of the trading time risks on stock investment return and risks in stock price crashes

    Science.gov (United States)

    Li, Jiang-Cheng; Dong, Zhi-Wei; Yang, Guo-Hui; Long, Chao

    2017-03-01

    The roles of the trading time risks (TTRs) on stock investment return and risks are investigated in the condition of stock price crashes with Hushen300 data (CSI300) and Dow Jones Industrial Average (ˆDJI), respectively. In order to describe the TTR, we employ the escape time that the stock price drops from the maximum to minimum value in a data window length (DWL). After theoretical and empirical research on probability density function of return, the results in both ˆDJI and CSI300 indicate that: (i) As increasing DWL, the expectation of returns and its stability are weakened. (ii) An optimal TTR is related to a maximum return and minimum risk of stock investment in stock price crashes.

  15. The determination of allowed outage time using the evaluation of transition risk

    International Nuclear Information System (INIS)

    Kang, D. I.; Kim, K. Y.; Jang, S. C.

    2001-03-01

    he objectives of this study are to propose a new evaluation method for transition risk and to determine the AOT using the new method. We review and compare the evaluation methods of transition risk which was previously studied. We also identify important assumptions used in previous studies for the evaluation of transition risk. We select general items required for the development of evaluation method for the transition risk. Based on the items selected, we propose a new evaluation method for transition risk. The new evaluation method for the transition risk is based on following assumptions; 1)For the same time span, the risk occurred from the failure to the completion of component repair during power operation is the same as the total risk including the risk occurred from power operation to specific shutdown/low power operation and the risk from specific shutdown/low power operation to power operation. 2)Shutdown operation and the repair of components are initiated just after the identification of the failure of components. The evaluation of the transition risk is performed to incorporate the characteristics of shutdown operation into Ulchin Units 3 and 4 Level 1 internal PSA for power operation. The application results of the new method to the HPSIS and the LPSIS for Ulchin Units 3 and 4 show that the AOT of HPSIS is properly determined and the AOT of LPSIS can be greatly increased. In this study, the main factors affecting the determination of AOT using the evaluation for transition risk are identified as the time of shutdown operation, the consideration of the change on common cause failure probability, and the risk of shutdown operation. It is expected that the evaluation method for the transition risk proposed in this study will be used for the determination of AOT and for the decision, in the case of the components unavailable, whether power operation is continuously performed or shutdown operation is initiated

  16. Real-time safety risk assessment based on a real-time location system for hydropower construction sites.

    Science.gov (United States)

    Jiang, Hanchen; Lin, Peng; Fan, Qixiang; Qiang, Maoshan

    2014-01-01

    The concern for workers' safety in construction industry is reflected in many studies focusing on static safety risk identification and assessment. However, studies on real-time safety risk assessment aimed at reducing uncertainty and supporting quick response are rare. A method for real-time safety risk assessment (RTSRA) to implement a dynamic evaluation of worker safety states on construction site has been proposed in this paper. The method provides construction managers who are in charge of safety with more abundant information to reduce the uncertainty of the site. A quantitative calculation formula, integrating the influence of static and dynamic hazards and that of safety supervisors, is established to link the safety risk of workers with the locations of on-site assets. By employing the hidden Markov model (HMM), the RTSRA provides a mechanism for processing location data provided by the real-time location system (RTLS) and analyzing the probability distributions of different states in terms of false positives and negatives. Simulation analysis demonstrated the logic of the proposed method and how it works. Application case shows that the proposed RTSRA is both feasible and effective in managing construction project safety concerns.

  17. Risk assessment framework on time impact: Infrastructure projects in soft soil during construction stage

    Science.gov (United States)

    Low, W. W.; Wong, K. S.; Lee, J. L.

    2018-04-01

    With the growth of economy and population, there is an increase in infrastructure construction projects. As such, it is unavoidable to have construction projects on soft soil. Without proper risk management plan, construction projects are vulnerable to different types of risks which will have negative impact on project’s time, cost and quality. Literature review showed that little or none of the research is focused on the risk assessment on the infrastructure project in soft soil. Hence, the aim of this research is to propose a risk assessment framework in infrastructure projects in soft soil during the construction stage. This research was focused on the impact of risks on project time and internal risk factors. The research method was Analytical Hierarchy Process and the sample population was experienced industry experts who have experience in infrastructure projects. Analysis was completed and result showed that for internal factors, the five most significant risks on time element are lack of special equipment, potential contractual disputes and claims, shortage of skilled workers, delay/lack of materials supply, and insolvency of contractor/sub-contractor. Results indicated that resources risk factor play a critical role on project time frame in infrastructure projects in soft soil during the construction stage.

  18. Greater Leisure Time Physical Activity Is Associated with Lower Allostatic Load in White, Black, and Mexican American Midlife Women: Findings from the National Health and Nutrition Examination Survey, 1999 through 2004.

    Science.gov (United States)

    Upchurch, Dawn M; Rainisch, Bethany Wexler; Chyu, Laura

    2015-01-01

    Allostatic load is a useful construct to understand how social and environmental conditions get under the skin to affect health. To date, few studies have examined health-enhancing lifestyle behaviors and their potential benefits in reducing allostatic load. The purpose of this study was to investigate the contributions of leisure time physical activity on level of allostatic load among White, Black, and Mexican American midlife women. Data were from the National Health and Nutrition Examination Survey, 1999 through 2004 (n = 1,680, women ages 40-59). All analyses were weighted. Negative binomial regression was used to model a summative count measure of allostatic load (M = 2.30). Models were also computed to estimate adjusted predicted allostatic load for given levels of physical activity, and by race/ethnicity for each age category (40-44, 45-49, 50-54, 55-59), controlling for other demographics and medication use. Higher levels of physical activity were associated significantly with lower levels of allostatic load, independent of demographics. Compared with White women ages 40 to 44, all other racial/ethnic-by-age groups had significantly higher allostatic load. Higher socioeconomic status was associated with a lower allostatic load. Adjusted prediction models demonstrated associations between greater levels of physical activity and lower allostatic load for all ages and racial/ethnic groups. Our findings suggest physical activity may ameliorate some of the effects of cumulative physiological dysregulation and subsequent disease burden in midlife women. Programs and policies that encourage and promote healthy aging and provide opportunities for a diversity of women to engage in health-enhancing lifestyle practices such as physical activity are recommended. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  19. A New Time-varying Concept of Risk in a Changing Climate.

    Science.gov (United States)

    Sarhadi, Ali; Ausín, María Concepción; Wiper, Michael P

    2016-10-20

    In a changing climate arising from anthropogenic global warming, the nature of extreme climatic events is changing over time. Existing analytical stationary-based risk methods, however, assume multi-dimensional extreme climate phenomena will not significantly vary over time. To strengthen the reliability of infrastructure designs and the management of water systems in the changing environment, multidimensional stationary risk studies should be replaced with a new adaptive perspective. The results of a comparison indicate that current multi-dimensional stationary risk frameworks are no longer applicable to projecting the changing behaviour of multi-dimensional extreme climate processes. Using static stationary-based multivariate risk methods may lead to undesirable consequences in designing water system infrastructures. The static stationary concept should be replaced with a flexible multi-dimensional time-varying risk framework. The present study introduces a new multi-dimensional time-varying risk concept to be incorporated in updating infrastructure design strategies under changing environments arising from human-induced climate change. The proposed generalized time-varying risk concept can be applied for all stochastic multi-dimensional systems that are under the influence of changing environments.

  20. A New Time-varying Concept of Risk in a Changing Climate

    Science.gov (United States)

    Sarhadi, Ali; Ausín, María Concepción; Wiper, Michael P.

    2016-10-01

    In a changing climate arising from anthropogenic global warming, the nature of extreme climatic events is changing over time. Existing analytical stationary-based risk methods, however, assume multi-dimensional extreme climate phenomena will not significantly vary over time. To strengthen the reliability of infrastructure designs and the management of water systems in the changing environment, multidimensional stationary risk studies should be replaced with a new adaptive perspective. The results of a comparison indicate that current multi-dimensional stationary risk frameworks are no longer applicable to projecting the changing behaviour of multi-dimensional extreme climate processes. Using static stationary-based multivariate risk methods may lead to undesirable consequences in designing water system infrastructures. The static stationary concept should be replaced with a flexible multi-dimensional time-varying risk framework. The present study introduces a new multi-dimensional time-varying risk concept to be incorporated in updating infrastructure design strategies under changing environments arising from human-induced climate change. The proposed generalized time-varying risk concept can be applied for all stochastic multi-dimensional systems that are under the influence of changing environments.

  1. Overlapping Boundaries of the Project Time Management and Project Risk Management

    Directory of Open Access Journals (Sweden)

    Marius PODEAN

    2010-01-01

    Full Text Available Based on utility function, milestones during project and/or the end of projects or programme may be categorized in what are called soft-deadline and hard-deadline. In contrast with the soft-end projects, the hard-end projects posses a decrease of utility function with a vertical asymptote character around the deadline for project completion. In extreme situations, the utility function itself may fall under zero (projects may generate losses to both constructor and customer. Existing risk analysis methodologies observe risks from monetary terms. The typical risks are correlated with an increase in final project costs. In order to estimate harddeadline milestones and/or end of projects or programme is critical to employ the time dimension rather than the typical cost-based risk analysis. Here, we comprehensively describe a structured methodology that focuses on minimizing and mitigating project specific delay risks. The method may supplement existing cost-based risk analysis in projects. We aim to elegantly combine moderation techniques to reveal the intrinsic risk of the projects. In addition to the technical risks, the moderation techniques are able to bring evidence of risks as the team efficacy, diverse un-correlations or miss-understanding about the roles of the team members in the team – most of the project soft risk. Described methodology encourages the common understanding of risks for participants, crystallizing the essence of what can go wrong in complex situations and where the opportunities can be unlocked.

  2. Risk-reducing mastectomy and salpingo-oophorectomy in unaffected BRCA mutation carriers: uptake and timing

    DEFF Research Database (Denmark)

    Skytte, A-B; Gerdes, Anne-Marie Axø; Andersen, M K

    2010-01-01

    from 306 healthy BRCA carriers with no personal history of ovarian or breast cancer. We found a 10-year uptake of 75% for risk-reducing salpingo-oophorectomy and 50% for risk-reducing mastectomy by time to event analysis. Age and childbirth influenced this decision. The uptake rate has not changed......Once female carriers of a BRCA mutation are identified they have to make decisions on risk management. The aim of this study is to outline the uptake of risk-reducing surgery in the Danish population of BRCA mutation positive women and to search for factors affecting this decision. We analysed data...

  3. Greater happiness for a greater number: Is that possible in Austria?

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2011-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the happiness of the great number could not be measured

  4. Greater happiness for a greater number: Is that possible? If so how? (Arabic)

    NARCIS (Netherlands)

    R. Veenhoven (Ruut); E. Samuel (Emad)

    2012-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time, the happiness of the great number could not be

  5. Greater happiness for a greater number: Is that possible in Germany?

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2009-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the Happiness of the great number could not be measured

  6. Self-reported screen time and cardiometabolic risk in obese Dutch adolescents.

    Directory of Open Access Journals (Sweden)

    Teatske M Altenburg

    Full Text Available BACKGROUND: It is not clear whether the association between sedentary time and cardiometabolic risk exists among obese adolescents. We examined the association between screen time (TV and computer time and cardiometabolic risk in obese Dutch adolescents. METHODS AND FINDINGS: For the current cross-sectional study, baseline data of 125 Dutch overweight and obese adolescents (12-18 years participating in the Go4it study were included. Self-reported screen time (Activity Questionnaire for Adolescents and Adults and clustered and individual cardiometabolic risk (i.e. body composition, systolic and diastolic blood pressure, low-density (LDL-C, high-density (HDL-C and total cholesterol (TC, triglycerides, glucose and insulin were assessed in all participants. Multiple linear regression analyses were used to assess the association between screen time and cardiometabolic risk, adjusting for age, gender, pubertal stage, ethnicity and moderate-to-vigorous physical activity. We found no significant relationship between self-reported total screen time and clustered cardiometabolic risk or individual risk factors in overweight and obese adolescents. Unexpectedly, self-reported computer time, but not TV time, was slightly but significantly inversely associated with TC (B = -0.002; CI = [-0.003;-0.000] and LDL-C (B = -0.002; CI = [-0.001;0.000]. CONCLUSIONS: In obese adolescents we could not confirm the hypothesised positive association between screen time and cardiometabolic risk. Future studies should consider computer use as a separate class of screen behaviour, thereby also discriminating between active video gaming and other computer activities.

  7. Determinants and stability over time of perception of health risks related to mobile phone base stations

    DEFF Research Database (Denmark)

    Kowall, Bernd; Breckenkamp, Jürgen; Blettner, Maria

    2012-01-01

    about other environmental and health risks, is associated with psychological strain, and is stable on the individual level over time. METHODS: Self-administered questionnaires filled in by 3,253 persons aged 15-69 years in 2004 and 2006 in Germany. RESULTS: Risk perception of MPBS was strongly......OBJECTIVE: Perception of possible health risks related to mobile phone base stations (MPBS) is an important factor in citizens' opposition against MPBS and is associated with health complaints. The aim of the present study is to assess whether risk perception of MPBS is associated with concerns...... in 2004 expressed these concerns again 2 years later, the corresponding figure for attribution of health complaints to MPBS was 31.3%. CONCLUSION: Risk perception of MPBS is strongly associated with general concern, anxiety, depression, and stress, and rather instable over time....

  8. Space-Time Analysis to Identify Areas at Risk of Mortality from Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Poliany C. O. Rodrigues

    2015-01-01

    Full Text Available This study aimed at identifying areas that were at risk of mortality due to cardiovascular disease in residents aged 45 years or older of the cities of Cuiabá and Várzea Grande between 2009 and 2011. We conducted an ecological study of mortality rates related to cardiovascular disease. Mortality rates were calculated for each census tract by the Local Empirical Bayes estimator. High- and low-risk clusters were identified by retrospective space-time scans for each year using the Poisson probability model. We defined the year and month as the temporal analysis unit and the census tracts as the spatial analysis units adjusted by age and sex. The Mann-Whitney U test was used to compare the socioeconomic and environmental variables by risk classification. High-risk clusters showed higher income ratios than low-risk clusters, as did temperature range and atmospheric particulate matter. Low-risk clusters showed higher humidity than high-risk clusters. The Eastern region of Várzea Grande and the central region of Cuiabá were identified as areas at risk of mortality due to cardiovascular disease in individuals aged 45 years or older. High mortality risk was associated with socioeconomic and environmental factors. More high-risk clusters were observed at the end of the dry season.

  9. The relationship between weight loss and time and risk preference parameters: a randomized controlled trial.

    Science.gov (United States)

    Takada, Akemi; Nakamura, Ryota; Furukawa, Masakazu; Takahashi, Yoshimitsu; Nishimura, Shuzo; Kosugi, Shinji

    2011-07-01

    This study aimed to assess the effectiveness of intervention (specifically, intervention by telephone and mails, known as 'tele-care') relative to self-help as a weight-loss method. The question of whether there is a correlation between changes in two preference parameters--time discounting (i.e. impatience) and risk aversion--and the level of commitment was examined. The study, spanning a period of 24 weeks in 2006-2007, comprised 118 participants, each of whom was randomly assigned to either the tele-care or the self-help group. A public-health nurse provided support through telephone and mail communications to the tele-care group, aiming to reduce their calorie intake and increase exercise via this intervention. There was a significant decrease in the body weight of the participants of the tele-care group from the baseline; however, there were no significant differences in the weight loss, median time discounting or risk aversion between the two groups. The subsequent analysis for weight loss with changes in time and risk parameters revealed a significant difference in the weight loss in the time-discounting-loss and risk-aversion-gain groups. From the results of the multiple regression analysis, the time discounting was noted to be associated with age, initial BMI and marital status among men, and risk aversion was associated with age and job status among women. There is a possibility that a decrease in time discounting and increase in risk aversion might correlate with the weight loss or effectiveness of commitment in this trial. This study suggests that time discounting and risk aversion may be useful in anti-obesity efforts, since they are accurate criteria of behavioural patterns associated with weight problems. © Cambridge University Press, 2011

  10. Implementation of lean construction techniques for minimizing the risks effect on project construction time

    Directory of Open Access Journals (Sweden)

    Usama Hamed Issa

    2013-12-01

    Full Text Available The construction projects involve various risk factors which have various impacts on time objective that may lead to time-overrun. This study suggests and applies a new technique for minimizing risk factors effect on time using lean construction principles. The lean construction is implemented in this study using the last planner system through execution of an industrial project in Egypt. Evaluating the effect of using the new tool is described in terms of two measurements: Percent Expected Time-overrun (PET and Percent Plan Completed (PPC. The most important risk factors are identified and assessed, while PET is quantified at the project start and during the project execution using a model for time-overrun quantification. The results showed that total project time is reduced by 15.57% due to decreasing PET values, while PPC values improved. This is due to minimizing and mitigating the effect of most of the risk factors in this project due to implementing lean construction techniques. The results proved that the quantification model is suitable for evaluating the effect of using lean construction techniques. In addition, the results showed that average value of PET due to factors affected by lean techniques represents 67% from PET values due to all minimized risk factors.

  11. Television viewing time and risk of incident diabetes mellitus: the English Longitudinal Study of Ageing.

    Science.gov (United States)

    Smith, L; Hamer, M

    2014-12-01

    To investigate the longitudinal association between television viewing time and risk of incident diabetes mellitus in an elderly sample of adults in England. Analyses of data from the English Longitudinal Study of Ageing. At baseline (2008), participants reported their television viewing time and physical activity level. Diabetes mellitus was recorded from self-reported physician diagnosis at 2-year follow-up. Associations between television viewing time and combined television viewing time and physical activity level with risk of incident diabetes mellitus at follow-up were examined using adjusted logistic regression models. A total of 5964 participants (mean ± sd age 65 ± 9 years at baseline, 44% male) were included in the analyses. There was an association between baseline television viewing time and risk of incident diabetes mellitus at 2-year follow-up (≥ 6 h/day compared with television viewing time at baseline were almost twice as likely to have diabetes mellitus at 2-year follow-up than those who were active/had low television viewing time (fully adjusted odds ratio 1.94, 95% CI 1.02, 3.68), although active participants reporting high television viewing were not at risk. Interventions to reduce the incidence of diabetes in the elderly that focus on both increasing physical activity and reducing television viewing time might prove useful. © 2014 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  12. Variations with time and age in the relative risks of solid cancer incidence after radiation exposure

    International Nuclear Information System (INIS)

    Little, M.P.; Muirhead, C.R.; de Vathaire, F.; Charles, M.W.

    1997-01-01

    The Japanese atomic bomb survivor cancer incidence dataset and data on five groups exposed to radiation for medical reasons in childhood are analysed and evidence found for a reduction in the radiation-induced relative risk of cancers other than leukaemia with increasing time since exposure and age at exposure. The rate of the reductions in relative risk with time since exposure are not significantly different for those exposed in childhood and for those exposed in adulthood, if adjustment is made for the effects on the relative risk of age at exposure. For those irradiated in childhood, there is a statistically significant annual reduction of 5.8% (95% Cl 2.8, 8.9) in excess relative risk, and there are no strong indications of inter-cohort heterogeniety in the speed of reduction of relative risk. After adjustment for the effects of age at exposure, there is a significant annual reduction of 3.6% (95% Cl 1.6, 5.6) in excess relative risk in all age-at-exposure groups. There are significant reductions of 5.2% (95% Cl 3.7, 6.8) in excess relative risk per year of age at exposure. There are statistically significant (P = 0.04) interactions between the exponential adjustments to the excess relative risk for age at exposure and time since exposure in the Japanese data, but no indications (P = 0.38) of such interactions when powers of time since exposure and attained age are used to adjust the excess relative risk, so that the fit of the model with power adjustments is to be preferred to that of the model with exponential adjustments. (author)

  13. Variations with time and age of the excess cancer risk among A-bomb survivors

    International Nuclear Information System (INIS)

    Pierce, D.A.; Vaeth, M.; Preston, D.L.

    1990-08-01

    This report has two aims: 1) to describe and analyze the age/time patterns of excess cancer risk in the atomic bomb survivor cohort followed up by RERF, and 2) to describe statistical methods which are used in RERF's analyses of data on mortality and morbidity in the cohort. In contrast to previous analyses of the cohort cancer mortality data, substantial use is made of Japanese national cancer rates for the purpose of investigation of the age/time variations in excess risk. This analysis considers mortality from all cancers except leukemia as a group. Primary attention is given to description in terms of the age-specific excess relative risk, but the importance of appropriate descriptions of the absolute excess risk is also emphasized. When models for the excess risk allow variation with age and time, both constant relative and absolute excess risk models provide very similar fits to the data. Previous reports have indicated that for a given age-at-exposure and sex, the excess age-specific relative risk is remarkably constant throughout the current follow-up period. Statistical analysis here indicates that for those less than about 35 years of age at exposure there is no departure from this pattern, beyond ordinary sampling variation. For those over about 35 years of age-at-exposure, there is modest evidence of an increasing trend in the excess relative risk, which could be plausibly attributed to effects related to minimal latent period. Some brief consideration is given to modeling the absolute excess risk as the product of an age-at-exposure and time-since-exposure effect. Interpretation of these results, particularly in regard to projections beyond the current follow-up, is discussed. (author)

  14. Randomness in preference orderings, outcomes and attribute tastes: An application to journey time risk

    DEFF Research Database (Denmark)

    Batley, Richard; Ibáñez Rivas, Juan Nicolás

    2012-01-01

    estimate a mean ‘reliability ratio’ (ratio of the value of standard deviation of journey time to the value of scheduled journey time) of 2.07, against a median of 0.85. The properties of the distribution of the reliability ratio suggest a predominant behaviour of aversion to journey time risk.......Within the broad area of probabilistic modelling of individual discrete choice, we develop three strands of discussion. First, we outline a theoretical framework for the modelling of individual discrete choice under risk, distinguishing between three specific sources of randomness; in preference...... orderings, in outcomes, and in attribute tastes. Second, we apply this theoretical modelling framework to the domain of journey time risk (or ‘reliability’), a subject which has acquired prominence in the transportation policies of many countries. Third, we apply the modelling framework empirically, based...

  15. Estimating the Counterparty Risk Exposure by Using the Brownian Motion Local Time

    Directory of Open Access Journals (Sweden)

    Bonollo Michele

    2017-06-01

    Full Text Available In recent years, the counterparty credit risk measure, namely the default risk in over-the-counter (OTC derivatives contracts, has received great attention by banking regulators, specifically within the frameworks of Basel II and Basel III. More explicitly, to obtain the related risk figures, one is first obliged to compute intermediate output functionals related to the mark-to-market position at a given time no exceeding a positive and finite time horizon. The latter implies an enormous amount of computational effort is needed, with related highly time consuming procedures to be carried out, turning out into significant costs. To overcome the latter issue, we propose a smart exploitation of the properties of the (local time spent by the Brownian motion close to a given value.

  16. Precommitted Investment Strategy versus Time-Consistent Investment Strategy for a Dual Risk Model

    Directory of Open Access Journals (Sweden)

    Lidong Zhang

    2014-01-01

    Full Text Available We are concerned with optimal investment strategy for a dual risk model. We assume that the company can invest into a risk-free asset and a risky asset. Short-selling and borrowing money are allowed. Due to lack of iterated-expectation property, the Bellman Optimization Principle does not hold. Thus we investigate the precommitted strategy and time-consistent strategy, respectively. We take three steps to derive the precommitted investment strategy. Furthermore, the time-consistent investment strategy is also obtained by solving the extended Hamilton-Jacobi-Bellman equations. We compare the precommitted strategy with time-consistent strategy and find that these different strategies have different advantages: the former can make value function maximized at the original time t=0 and the latter strategy is time-consistent for the whole time horizon. Finally, numerical analysis is presented for our results.

  17. Time-related factors in the study of risks in animals and humans

    International Nuclear Information System (INIS)

    Gilbert, E.S.; Park, J.F.; Buschbom, R.L.

    1989-01-01

    Data from epidemiological studies of humans exposed to potentially harmful substances are usually analyzed using methods that account for the dependence of risks on time-related factors such as age and follow-up period. Recently developed statistical procedures allow modeling of the age-specific risks as a function of dose as well as factors such as age at exposure, time since exposure, exposure duration, and dose rate. These procedures potentially allow more rigorous inferences and clearer understanding of the patterns of risk observed in epidemiological studies than has been available in the past. Statistical procedures that consider time-related factors can also be applied to laboratory animal data, providing information that is useful for the problems involved in extrapolating from animal studies to humans. By applying such procedures to data on exposure to the same substance in different species (including humans) or to different substances in the same species, better understanding of the relationship of risks across species and across substances can be achieved. In addition, such statistical procedures allow appropriate treatment of exposure that is accumulated over time and lead to improved understanding of patterns of risk over time. The approach is illustrated using data from a lifespan study of beagle dogs exposed to inhaled Pu

  18. Time-related factors in the study of risks in animals and man

    International Nuclear Information System (INIS)

    Gilbert, E.S.; Park, J.F.; Buschbom, R.L.

    1988-01-01

    Data from epidemiological studies of humans exposed to potentially harmful substances are usually analyzed using methods that account for the dependence of risks on time-related factors such as age and follow-up period. Recently developed statistical procedures allow modeling of the age-specific risks as a function of dose as well as factors such as age at exposure, time from exposure, exposure duration, and dose rate. These procedures potentially allow more rigorous inferences and clearer understanding of the patterns of risks observed in epidemiological studies than has been available in the past. Statistical procedures that consider time-related factors can also be applied to laboratory animal data, and provide information that is useful for the problem of extrapolating from animal studies to humans. By applying such procedures to data on exposure to the same substance in different species (including humans) or to different substances in the same species, a better understanding of the relationship of risks across species and across substances can be achieved. In addition, such statistical procedures allow appropriate treatment of exposure that is accumulated over time and lead to improved understanding of patterns of risk over time. The approach is illustrated using data from a lifespan study of beagle dogs exposed to inhaled plutonium. 12 refs., 1 fig., 3 tabs

  19. A Twin Study of Objective and Subjective Pubertal Timing and Peer Influence on Risk-Taking.

    Science.gov (United States)

    Kretsch, Natalie; Mendle, Jane; Harden, K Paige

    2016-03-01

    The current study used a behavioral genetic design to test whether three measures of pubertal timing moderated peer influence on risk-taking in a sample of 248 female adolescent twin pairs ( M age =16.0, SD =1.5) from the National Longitudinal Study of Adolescent Health. Peer influence was operationalized as the quasi-causal association between girls' self-reported risk-taking and the risk-taking reported by their friends. Girls with earlier ages at menarche and who perceived themselves as more developed than peers were more susceptible to peer influence on risk-taking. However, age-standardized ratings of body changes did not moderate peer influence. This study highlights distinctions between multiple measures of pubertal timing, using an innovative synthesis of genetically informative data and peer nomination data.

  20. A generalised Dynamic Overflow Risk Assessment (DORA) for Real Time Control of urban drainage systems

    DEFF Research Database (Denmark)

    Vezzaro, Luca; Grum, Morten

    2014-01-01

    An innovative and generalised approach to the integrated Real Time Control of urban drainage systems is presented. The Dynamic Overflow Risk Assessment (DORA) strategy aims to minimise the expected Combined Sewer Overflow (CSO) risk by considering (i) the water volume presently stored in the drai......An innovative and generalised approach to the integrated Real Time Control of urban drainage systems is presented. The Dynamic Overflow Risk Assessment (DORA) strategy aims to minimise the expected Combined Sewer Overflow (CSO) risk by considering (i) the water volume presently stored...... and their uncertainty contributed to further improving the performance of drainage systems. The results of this paper will contribute to the wider usage of global RTC methods in the management of urban drainage networks....

  1. Risk-sensitive control of stochastic hybrid systems on infinite time horizon

    Directory of Open Access Journals (Sweden)

    Runolfsson Thordur

    1999-01-01

    Full Text Available A risk-sensitive optimal control problem is considered for a hybrid system that consists of continuous time diffusion process that depends on a discrete valued mode variable that is modeled as a Markov chain. Optimality conditions are presented and conditions for the existence of optimal controls are derived. It is shown that the optimal risk-sensitive control problem is equivalent to the upper value of an associated stochastic differential game, and insight into the contributions of the noise input and mode variable to the risk sensitivity of the cost functional is given. Furthermore, it is shown that due to the mode variable risk sensitivity, the equivalence relationship that has been observed between risk-sensitive and H ∞ control in the nonhybrid case does not hold for stochastic hybrid systems.

  2. Modelling the joint distribution of competing risks survival times using copula functions

    OpenAIRE

    Kaishev, V. K.; Haberman, S.; Dimitrova, D. S.

    2005-01-01

    The problem of modelling the joint distribution of survival times in a competing risks model, using copula functions is considered. In order to evaluate this joint distribution and the related overall survival function, a system of non-linear differential equations is solved, which relates the crude and net survival functions of the modelled competing risks, through the copula. A similar approach to modelling dependent multiple decrements was applied by Carriere (1994) who used a Gaussian cop...

  3. Effect of smoking on the radon risk in dependence on the time elapsed from exposure

    International Nuclear Information System (INIS)

    Boehm, Radoslav; Holy, Karol; Sedlak, A.

    2013-01-01

    The synergistic effect of cigarette smoking and radon exposure on the lung cancer risk was assessed by using the threshold energy model, which allows the biological effects of radon daughter products on the lung tissue to be analyzed. The shape of the curves describing the relation between the risk and the time after exposure was estimated. The change in the lung function caused by chronic smoking was considered in the calculations. (orig.)

  4. The estimation of time-varying risks in asset pricing modelling using B-Spline method

    Science.gov (United States)

    Nurjannah; Solimun; Rinaldo, Adji

    2017-12-01

    Asset pricing modelling has been extensively studied in the past few decades to explore the risk-return relationship. The asset pricing literature typically assumed a static risk-return relationship. However, several studies found few anomalies in the asset pricing modelling which captured the presence of the risk instability. The dynamic model is proposed to offer a better model. The main problem highlighted in the dynamic model literature is that the set of conditioning information is unobservable and therefore some assumptions have to be made. Hence, the estimation requires additional assumptions about the dynamics of risk. To overcome this problem, the nonparametric estimators can also be used as an alternative for estimating risk. The flexibility of the nonparametric setting avoids the problem of misspecification derived from selecting a functional form. This paper investigates the estimation of time-varying asset pricing model using B-Spline, as one of nonparametric approach. The advantages of spline method is its computational speed and simplicity, as well as the clarity of controlling curvature directly. The three popular asset pricing models will be investigated namely CAPM (Capital Asset Pricing Model), Fama-French 3-factors model and Carhart 4-factors model. The results suggest that the estimated risks are time-varying and not stable overtime which confirms the risk instability anomaly. The results is more pronounced in Carhart’s 4-factors model.

  5. Methods and tools to support real time risk-based flood forecasting - a UK pilot application

    Directory of Open Access Journals (Sweden)

    Brown Emma

    2016-01-01

    Full Text Available Flood managers have traditionally used probabilistic models to assess potential flood risk for strategic planning and non-operational applications. Computational restrictions on data volumes and simulation times have meant that information on the risk of flooding has not been available for operational flood forecasting purposes. In practice, however, the operational flood manager has probabilistic questions to answer, which are not completely supported by the outputs of traditional, deterministic flood forecasting systems. In a collaborative approach, HR Wallingford and Deltares have developed methods, tools and techniques to extend existing flood forecasting systems with elements of strategic flood risk analysis, including probabilistic failure analysis, two dimensional flood spreading simulation and the analysis of flood impacts and consequences. This paper presents the results of the application of these new operational flood risk management tools to a pilot catchment in the UK. It discusses the problems of performing probabilistic flood risk assessment in real time and how these have been addressed in this study. It also describes the challenges of the communication of risk to operational flood managers and to the general public, and how these new methods and tools can provide risk-based supporting evidence to assist with this process.

  6. When's dinner? Does timing of dinner affect the cardiometabolic risk profiles of South-Asian Canadians at risk for diabetes.

    Science.gov (United States)

    Sandhu, S K; Tang, T S

    2017-04-01

    To explore the relationship between the time dinner is consumed (dinnertime or timing of dinner) and cardiometabolic risk factors among South-Asian Canadians at risk for diabetes. We recruited 432 South-Asian adults affiliated with Sikh and Hindu Temples in Metro Vancouver. Participants deemed to be at risk of diabetes underwent a clinical and behavioural assessment. Dinnertime was measured via self-report. Clinical endpoints included HbA 1c , apolipoprotein, blood pressure, weight, BMI and waist circumference. The mean age of participants was 65 years and 59% were male. Dinnertime was categorized into three groups: early (before 18:00 h); average (18:00 to 20:00 h); and late (later than 20:00 h). Among the participants, 19% (n = 79), 44% (n = 187) and 37% (n = 157) reported early, average and late dinnertimes, respectively. Significant differences were found for dinnertime groups and years of residence in Canada, gender and employment. Compared with the early dinnertime group, the late dinnertime group lived in Canada for a shorter duration, comprised a higher proportion of males (66 vs 48%; P = 0.01) and were currently employed (37 vs 22%; P = 0.02). With regard to clinical endpoints, compared with the early dinnertime group, the late dinnertime group had lower systolic blood pressure (135.9 vs 131.7 mmHg; P = 0.03). After controlling for demographic characteristics, this difference was diminished. No significant differences were found between dinnertime and HbA 1c , apolipoprotein, diastolic blood pressure, weight, BMI and waist circumference. Findings suggest that, among this sample of South-Asian Canadians at risk of Type 2 diabetes, there was no association between timing of the evening meal and cardiometabolic profiles. © 2016 Diabetes UK.

  7. Transferability and robustness of real-time freeway crash risk assessment.

    Science.gov (United States)

    Shew, Cameron; Pande, Anurag; Nuworsoo, Cornelius

    2013-09-01

    This study examines the data from single loop detectors on northbound (NB) US-101 in San Jose, California to estimate real-time crash risk assessment models. The classification tree and neural network based crash risk assessment models developed with data from NB US-101 are applied to data from the same freeway, as well as to the data from nearby segments of the SB US-101, NB I-880, and SB I-880 corridors. The performance of crash risk assessment models on these nearby segments is the focus of this research. The model applications show that it is in fact possible to use the same model for multiple freeways, as the underlying relationships between traffic data and crash risk remain similar. The framework provided here may be helpful to authorities for freeway segments with newly installed traffic surveillance apparatuses, since the real-time crash risk assessment models from nearby freeways with existing infrastructure would be able to provide a reasonable estimate of crash risk. The robustness of the model output is also assessed by location, time of day, and day of week. The analysis shows that on some locations the models may require further learning due to higher than expected false positive (e.g., the I-680/I-280 interchange on US-101 NB) or false negative rates. The approach for post-processing the results from the model provides ideas to refine the model prior to or during the implementation. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

  8. Evaluation of risk impact of changes to Completion Times addressing model and parameter uncertainties

    International Nuclear Information System (INIS)

    Martorell, S.; Martón, I.; Villamizar, M.; Sánchez, A.I.; Carlos, S.

    2014-01-01

    This paper presents an approach and an example of application for the evaluation of risk impact of changes to Completion Times within the License Basis of a Nuclear Power Plant based on the use of the Probabilistic Risk Assessment addressing identification, treatment and analysis of uncertainties in an integrated manner. It allows full development of a three tired approach (Tier 1–3) following the principles of the risk-informed decision-making accounting for uncertainties as proposed by many regulators. Completion Time is the maximum outage time a safety related equipment is allowed to be down, e.g. for corrective maintenance, which is established within the Limiting Conditions for Operation included into Technical Specifications for operation of a Nuclear Power Plant. The case study focuses on a Completion Time change of the Accumulators System of a Nuclear Power Plant using a level 1 PRA. It focuses on several sources of model and parameter uncertainties. The results obtained show the risk impact of the proposed CT change including both types of epistemic uncertainties is small as compared with current safety goals of concern to Tier 1. However, what concerns to Tier 2 and 3, the results obtained show how the use of some traditional and uncertainty importance measures helps in identifying high risky configurations that should be avoided in NPP technical specifications no matter the duration of CT (Tier 2), and other configurations that could take part of a configuration risk management program (Tier 3). - Highlights: • New approach for evaluation of risk impact of changes to Completion Times. • Integrated treatment and analysis of model and parameter uncertainties. • PSA based application to support risk-informed decision-making. • Measures of importance for identification of risky configurations. • Management of important safety issues to accomplish safety goals

  9. A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes.

    Directory of Open Access Journals (Sweden)

    Stuart J H Biddle

    Full Text Available Type 2 diabetes mellitus (T2DM, a serious and prevalent chronic disease, is traditionally associated with older age. However, due to the rising rates of obesity and sedentary lifestyles, it is increasingly being diagnosed in the younger population. Sedentary (sitting behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes, including T2DM. Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM. We aimed to investigate, through a randomised controlled trial (RCT design, whether a group-based structured education workshop focused on sitting reduction, with self-monitoring, reduced sitting time.Adults aged 18-40 years who were either overweight (with an additional risk factor for T2DM or obese were recruited for the Sedentary Time ANd Diabetes (STAND RCT. The intervention programme comprised of a 3-hour group-based structured education workshop, use of a self-monitoring tool, and follow-up motivational phone call. Data were collected at three time points: baseline, 3 and 12 months after baseline. The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months. Secondary outcomes included other objective (activPAL and self-reported measures of sedentary behaviour and physical activity, and biochemical, anthropometric, and psycho-social variables.187 individuals (69% female; mean age 33 years; mean BMI 35 kg/m2 were randomised to intervention and control groups. 12 month data, when analysed using intention-to-treat analysis (ITT and per-protocol analyses, showed no significant difference in the primary outcome variable, nor in the majority of the secondary outcome measures.A structured education intervention designed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months. Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change

  10. Stepping reaction time and gait adaptability are significantly impaired in people with Parkinson's disease: Implications for fall risk.

    Science.gov (United States)

    Caetano, Maria Joana D; Lord, Stephen R; Allen, Natalie E; Brodie, Matthew A; Song, Jooeun; Paul, Serene S; Canning, Colleen G; Menant, Jasmine C

    2018-02-01

    Decline in the ability to take effective steps and to adapt gait, particularly under challenging conditions, may be important reasons why people with Parkinson's disease (PD) have an increased risk of falling. This study aimed to determine the extent of stepping and gait adaptability impairments in PD individuals as well as their associations with PD symptoms, cognitive function and previous falls. Thirty-three older people with PD and 33 controls were assessed in choice stepping reaction time, Stroop stepping and gait adaptability tests; measurements identified as fall risk factors in older adults. People with PD had similar mean choice stepping reaction times to healthy controls, but had significantly greater intra-individual variability. In the Stroop stepping test, the PD participants were more likely to make an error (48 vs 18%), took 715 ms longer to react (2312 vs 1517 ms) and had significantly greater response variability (536 vs 329 ms) than the healthy controls. People with PD also had more difficulties adapting their gait in response to targets (poorer stepping accuracy) and obstacles (increased number of steps) appearing at short notice on a walkway. Within the PD group, higher disease severity, reduced cognition and previous falls were associated with poorer stepping and gait adaptability performances. People with PD have reduced ability to adapt gait to unexpected targets and obstacles and exhibit poorer stepping responses, particularly in a test condition involving conflict resolution. Such impaired stepping responses in Parkinson's disease are associated with disease severity, cognitive impairment and falls. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Time Factor in the Theory of Anthropogenic Risk Prediction in Complex Dynamic Systems

    Science.gov (United States)

    Ostreikovsky, V. A.; Shevchenko, Ye N.; Yurkov, N. K.; Kochegarov, I. I.; Grishko, A. K.

    2018-01-01

    The article overviews the anthropogenic risk models that take into consideration the development of different factors in time that influence the complex system. Three classes of mathematical models have been analyzed for the use in assessing the anthropogenic risk of complex dynamic systems. These models take into consideration time factor in determining the prospect of safety change of critical systems. The originality of the study is in the analysis of five time postulates in the theory of anthropogenic risk and the safety of highly important objects. It has to be stressed that the given postulates are still rarely used in practical assessment of equipment service life of critically important systems. That is why, the results of study presented in the article can be used in safety engineering and analysis of critically important complex technical systems.

  12. Crash risk analysis during fog conditions using real-time traffic data.

    Science.gov (United States)

    Wu, Yina; Abdel-Aty, Mohamed; Lee, Jaeyoung

    2018-05-01

    This research investigates the changes of traffic characteristics and crash risks during fog conditions. Using real-time traffic flow and weather data at two regions in Florida, the traffic patterns at the fog duration were compared to the traffic patterns at the clear duration. It was found that the average 5-min speed and the average 5-min volume were prone to decreasing during fog. Based on previous studies, a "Crash Risk Increase Indicator (CRII)" was proposed to explore the differences of crash risk between fog and clear conditions. A binary logistic regression model was applied to link the increase of crash risks with traffic flow characteristics. The results suggested that the proposed indicator worked well in evaluating the increase of crash risk under fog condition. It was indicated that the crash risk was prone to increase at ramp vicinities in fog conditions. Also, the average 5-min volume during fog and the lane position are important factors for crash risk increase. The differences between the regions were also explored in this study. The results indicated that the locations with heavier traffic or locations at the lanes that were closest to the median in Region 2 were more likely to observe an increase in crash risks in fog conditions. It is expected that the proposed indicator can help identify the dangerous traffic status under fog conditions and then proper ITS technologies can be implemented to enhance traffic safety when the visibility declines. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Timed Up And Go Risk Predictor Of Falls In Elderly People Residing In The Community?

    Directory of Open Access Journals (Sweden)

    Mayara Muniz Peixoto Rodrigues

    2017-04-01

    Full Text Available Objective: evaluate the risk of falls of elderly people residing in a community in northeastern Brazil using the “Timed up and go”. Method: descriptive study, with a quantitative approach, performed with elderly people residing in a community. The collected data related to the sociodemographic and economic characteristics of episodes of falls in the last two years, regular practice of physical exercise and complaint of pain at the time of the interview; and, at last, the application of the “Timed Up and Go” test. Result: Most of the elderly were classified as free and independent and independent. There is a direct relationship between advanced age and increased time to perform the test. Conclusion: the "Timed Up and Go" test was not effective in predicting risk of falls alone and should associate with other indicators. Descriptors: Elderly people; Accidents by fall; Walking; Postural balance.

  14. Insights from the analyses of risk-informed extension of diesel generator allowed outage time

    International Nuclear Information System (INIS)

    Lin, J.C.; He Wei

    2005-01-01

    In recent years, many U.S. nuclear plants have applied and received approval for the risk-informed extension of the Allowed Outage Time (AOT) for Emergency Diesel Generators (EDGs). These risk-informed applications need to meet the regulatory guidance on the risk criteria. This paper discusses in detail insights derived from the risk-informed analyses performed to support these applications. The risk criteria on ΔCDF/ΔLERF evaluate the increase in average risk by extending the AOT for EDGs, induced primarily by an increase in EDG maintenance unavailability due to the introduction of additional EDG preventive maintenance. By performing this preventive maintenance work on-line, the outage duration can be shortened. With proper refinement of the risk model, most plants can meet the ΔCDF/ΔLERF criteria for extending the EDGAOT from, for example, 3 days to 14 days. The key areas for model enhancements to meet these criteria include offsite/onsite power recovery, LERF modeling, etc. The most important LERF model enhancements consist of refinement of the penetrations included in the containment isolation model for the consideration of a large release, and taking credit for operator vessel depressurization during the time period between core damage and vessel failure. A recent study showed that although the frequency of loss of offsite power (LOSP) has decreased, the duration of offsite power recovery has actually increased. However, many of the events used to derive this conclusion may not be applicable to PRAs. One approach develops the offsite power non-recovery factor by first screening the LOSP events for applicability to the plant being analyzed, power operation, and LOSP initiating event, then using the remaining events data for the derivation based on the fraction of events with recovery duration longer than the time window allowed. The risk criteria on ICCDP/ICLERP examine the increase in risk from the average CDF/LERF, based on the increased maintenance

  15. The Association between Leisure-Time Physical Activity and Risk of Undetected Prediabetes

    Science.gov (United States)

    Wang, Jia; Wu, Yili; Ning, Feng; Zhang, Chaoying

    2017-01-01

    Aims. The purpose of the study was to assess the effects of leisure-time physical activity on undetected prediabetes. Methods. Data from the National Health and Nutrition Examination Survey 2007–2012 were used in our analyses. Logistic regression was conducted to estimate the odds ratios (ORs) with 95% confidence intervals (CIs) of prediabetes associated with leisure-time physical activity. Results. A total of 8204 subjects were eligible for our analyses. For all subjects, high level of total leisure-time physical activity (OR = 0.78, 95% CI: 0.66, 0.94) and low level of vigorous leisure-time physical activity (OR = 0.72, 95% CI: 0.58, 0.90) were inversely associated with the risk of prediabetes in multivariate-adjusted model. For subjects under 45 years of age, high level of total leisure-time physical activity (OR = 0.78, 95% CI: 0.61, 0.99) and low (OR = 0.61, 95% CI: 0.45, 0.83) and high (OR = 0.72, 95% CI: 0.53, 1.00) level of vigorous leisure-time physical activity were associated with a decreased risk of prediabetes. In the 45 to 65 age group, only high level of total leisure-time physical activity (OR = 0.73, 95% CI: 0.57, 0.95) had protective effect on prediabetes. Conclusions. Leisure-time physical activity may be associated with a decreased risk of prediabetes. PMID:28367452

  16. Time since first sexual intercourse and the risk of cervical cancer

    DEFF Research Database (Denmark)

    Plummer, Martyn; Peto, Julian; Franceschi, Silvia

    2012-01-01

    Young age at first sexual intercourse (AFI) is an important risk factor for cervical cancer, but no simple statistical model of its influence has been established. We investigated the relationship between risk of cervical carcinoma and time since first intercourse using data on monogamous women (5...... proportional to the square of time since first intercourse (exponent 1.95, 95% CI: 1.76-2.15) up to age 45. First cervical infection with human papillomavirus (HPV) often occurs soon after first sexual intercourse, so early AFI is a reasonable proxy for early age at first exposure to HPV. In addition, age...

  17. Time dependence of intestinal proliferative cell risk vs. stem cell risk to radiation or colcemid cytotoxicity following hydroxyurea

    International Nuclear Information System (INIS)

    Hanson, W.R.; Henninger, D.L.; Fry, R.J.M.

    1979-01-01

    A comparison of the time dependence between intestinal crypt damage by hydroxyurea (HU) and crypt cell or clonogenic cell risk to colcemid (COL) cytotoxicity was made to determine if rapidly cycling cells are clonogenic or if crypt damage by HU induces clonogenic cells into rapid cycle. B6CF 1 /An1 mice were given 15 mg HU 15 min before or after increments of 137 Csγ-irradiation for the crypt colony assay. HU reduced the crypt cells from 254 + - 11 to 170 + - 8; however, the clonogenic cell survival curve was unaltered. At 2 hours after administration of HU, the dose for clonogenic cell survival giving rise to 10 microcolonies/circumference was reduced from 1625 rad in controls to 1375 rad; but at 6 hours after HU, the dose was 2200 rad. Hydroxyurea appears to stimulate stem cells from G 1 into rapid cycle. To test this, groups of mice were given HU and at 6, 12, 18, 24, and 30 hr, a 12 hr treatment of COL was given to kill cells in M phase of the cell cycle. At 3 hr after the last COL injection, mice were killed for crypt cell counts or given 1100 rad 137 Csγ for the microcolony assay. The greatest clonogenic cell risk (38/40) occurred when COL was begun 12 hr after HU, but the greatest total crypt cell risk (183/254) occurred when COL was begun 24 hr after HU at a time when clonogenic cell risk was 10/40. The data suggest that the cell cycle kinetics of clonogenic and rapidly proliferating cells are different. Further, damage to crypts by HU stimulates G 1 clonogenic cells into rapid cycle

  18. Workers' compensation loss prevention representative contact and risk of lost-time injury in construction policyholders.

    Science.gov (United States)

    Schofield, Katherine E; Alexander, Bruce H; Gerberich, Susan G; MacLehose, Richard F

    2017-09-01

    Insurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders. Workers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI). Compared no LP contact, one contact was associated with a 27% reduction of risk (HR=0.73, CI=0.65-0.82), two with a 41% (HR=0.59, CI=0.51-0.68), and three or more contacts with a 28% reduction of risk (HR=0.72, CI=0.65-0.81). LP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries. Reduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. [Autoerotic fatalities in Greater Dusseldorf].

    Science.gov (United States)

    Hartung, Benno; Hellen, Florence; Borchard, Nora; Huckenbeck, Wolfgang

    2011-01-01

    Autoerotic fatalities in the Greater Dusseldorf area correspond to the relevant medicolegal literature. Our results included exclusively young to middle-aged, usually single men who were found dead in their city apartments. Clothing and devices used showed a great variety. Women's or fetish clothing and complex shackling or hanging devices were disproportionately frequent. In most cases, death occurred due to hanging or ligature strangulation. There was no increased incidence of underlying psychiatric disorders. In most of the deceased no or at least no remarkable alcohol intoxication was found. Occasionally, it may be difficult to reliably differentiate autoerotic accidents, accidents occurring in connection with practices of bondage & discipline, dominance & submission (BDSM) from natural death, suicide or homicide.

  20. Advanced age, cardiovascular risk burden, and timed up and go test performance in Parkinson disease.

    Science.gov (United States)

    Kotagal, Vikas; Albin, Roger L; Müller, Martijn L T M; Koeppe, Robert A; Studenski, Stephanie; Frey, Kirk A; Bohnen, Nicolaas I

    2014-12-01

    Cardiovascular comorbidities are a known risk factor for impaired mobility in elderly individuals. Motor impairments in Parkinson disease are conventionally ascribed to nigrostriatal dopaminergic denervation although progressive gait and balance impairments become more common with aging and often show limited response to dopaminergic replacement therapies. We explored the association between elevated cardiovascular risk factors and performance on the Timed Up and Go test in cross-sectional of Parkinson disease subjects (n = 83). Cardiovascular risk factor status was estimated using the Framingham General Cardiovascular Disease risk-scoring algorithm in order to dichotomize the cohort into those with and without elevated modifiable cardiovascular risk compared with normative scores for age and gender. All subjects underwent clinical and neuroimaging evaluations including a 3-m Timed Up and Go test, [(11)C]dihydrotetrabenazine positron emission tomography imaging to estimate nigrostriatal dopamine terminal loss, and an magnetic resonance imaging assessment of leukoaraiosis. A similar analysis was performed in 49 healthy controls. After adjusting for disease duration, leukoaraiosis, and nigrostriatal dopaminergic denervation, Parkinson disease subjects with elevated Framingham risk scores (n = 61) displayed slower Timed Up and Go test performance (β = 1.86, t = 2.41, p = .018) compared with subjects with normal range Framingham risk scores (n = 22). When age ≥65 was added to the model in a post hoc analysis, the strength of effect seen with older age (β = 1.51, t = 2.44, p = .017) was similar to that of elevated Framingham risk scoring (β = 1.87, t = 2.51, p = .014). In a multivariable regression model studying the healthy control population, advanced age (t = 2.15, p = .037) was a significant predictor of Timed Up and Go speed though striatal [(11)C]dihydrotetrabenazine (t = -1.30, p = .19) and elevated Framingham risk scores (t = 1.32, p = .19) were not

  1. Risk Reduction Effects Due to the Start Time Extension of EDGs in OPR-1000

    International Nuclear Information System (INIS)

    Lim, Ho-Gon; Yang, Joon-Eon; Hwang, Mee-Jeong

    2006-01-01

    Under the condition that the ECCS rule in Korea will be revised based on the new U.S. 10 CFR 50.46, the risk impact due to the EDG start time extension is analyzed in the present study. This paper is composed of 6 sections. In the section 2, the LOCA break size that cannot be mitigable under the condition of extended EDG start time is obtained from the thermal hydraulic analysis. The section 3 discusses the frequency of the immitigable LOCA and the probability of the LOOP given a LOCA. In the section 4, the effect of the EDG start time extension on its failure probability is discussed with a qualitative manner. Finally, the whole risk change due to the EDG start time extension is calculated in the section 5 with the conclusions given in the section 6

  2. Time-varying Concurrent Risk of Extreme Droughts and Heatwaves in California

    Science.gov (United States)

    Sarhadi, A.; Diffenbaugh, N. S.; Ausin, M. C.

    2016-12-01

    Anthropogenic global warming has changed the nature and the risk of extreme climate phenomena such as droughts and heatwaves. The concurrent of these nature-changing climatic extremes may result in intensifying undesirable consequences in terms of human health and destructive effects in water resources. The present study assesses the risk of concurrent extreme droughts and heatwaves under dynamic nonstationary conditions arising from climate change in California. For doing so, a generalized fully Bayesian time-varying multivariate risk framework is proposed evolving through time under dynamic human-induced environment. In this methodology, an extreme, Bayesian, dynamic copula (Gumbel) is developed to model the time-varying dependence structure between the two different climate extremes. The time-varying extreme marginals are previously modeled using a Generalized Extreme Value (GEV) distribution. Bayesian Markov Chain Monte Carlo (MCMC) inference is integrated to estimate parameters of the nonstationary marginals and copula using a Gibbs sampling method. Modelled marginals and copula are then used to develop a fully Bayesian, time-varying joint return period concept for the estimation of concurrent risk. Here we argue that climate change has increased the chance of concurrent droughts and heatwaves over decades in California. It is also demonstrated that a time-varying multivariate perspective should be incorporated to assess realistic concurrent risk of the extremes for water resources planning and management in a changing climate in this area. The proposed generalized methodology can be applied for other stochastic nature-changing compound climate extremes that are under the influence of climate change.

  3. A mathematical model for crashing projects by considering time, cost, quality and risk

    Directory of Open Access Journals (Sweden)

    Amin Mahmoudi

    2017-01-01

    Full Text Available Employers are looking for reducing execution time and maintaining the quality of the projects that are the main objective of the projects. In this article, we focus on crashing projects by con-sidering different factors such as cost, time, quality and risk. For the proposed integer linear model, cost of conformance and cost of non-conformance are considered as parts of the costs of quality of deliverables in projects. The cost of conformance consists of the costs of training the project team, inspection and test of deliverables. The cost of non-conformance also includes costs of rework and scrap. Project risk management is one of the important aspects of the pro-jects. The present study also considers the impact of risks, which is highly applicable in projects with a high level of uncertainty. Results are presented using integer programming approach with the aim of minimizing the costs of the project.

  4. Risk analysis of radioactive waste repository based on the time dependent hazard rate

    International Nuclear Information System (INIS)

    Chang, S.H.; Cho, W.J.

    1984-01-01

    For the probabilistic risk analysis of the radioactive high level waste repository, the simplified method based on the time dependent hazard rate is proposed. The obtained results are compared with those from the time independent hazard rate. The estimation of the failure probability of the waste repository through this method gives more conservative results, especially when the half-life of nuclide is larger and retardation factors of nuclide is smaller. (Auth.)

  5. Determination operation Time Risk of Box Spinning Components-oe Spinning Machine

    OpenAIRE

    Slobodan Stefanovic

    2013-01-01

    Based on the constructed dependency diagram reliability of the exploitation operation time of each constituent components of the analyzed frame in the case of selected statistical distributions, areas of the operation exploitation and repair intervals are determined. This is done by determining the first inflection points. Based on these points analysis to determine the time of safety operation of frame components with allowable risk to the segmental linear function of the intensity of failur...

  6. Plasma Clot Lysis Time and Its Association with Cardiovascular Risk Factors in Black Africans

    NARCIS (Netherlands)

    Z. de Lange (Zelda); M. Pieters (Marlien); J.C. Jerling (Johann); A. Kruger (Annamarie); D.C. Rijken (Dingeman)

    2012-01-01

    textabstractStudies in populations of European descent show longer plasma clot lysis times (CLT) in patients with cardiovascular disease (CVD) than in controls. No data are available on the association between CVD risk factors and fibrinolytic potential in black Africans, a group undergoing rapid

  7. Adverse radiation effect after stereotactic radiosurgery for brain metastases : incidence, time course, and risk factors

    NARCIS (Netherlands)

    Sneed, Penny K.; Mendez, Joe; Vemer-van den Hoek, Johanna; Seymour, Zachary A.; Ma, Lijun; Molinaro, Annette M.; Fogh, Shannon E.; Nakamura, Jean L.; McDermott, Michael W.

    OBJECT The authors sought to determine the incidence, time course, and risk factors for overall adverse radiation effect (ARE) and symptomatic ARE after stereotactic radiosurgery (SRS) for brain metastases. METHODS All cases of brain metastases treated from 1998 through 2009 with Gamma Knife SRS at

  8. The ruin probability of a discrete time risk model under constant interest rate with heavy tails

    NARCIS (Netherlands)

    Tang, Q.

    2004-01-01

    This paper investigates the ultimate ruin probability of a discrete time risk model with a positive constant interest rate. Under the assumption that the gross loss of the company within one year is subexponentially distributed, a simple asymptotic relation for the ruin probability is derived and

  9. The Timing of Entry into Fatherhood in Young, At-Risk Men

    Science.gov (United States)

    Pears, Katherine C.; Pierce, Susan L.; Kim, Hyoun K.; Capaldi, Deborah M.; Owen, Lee D.

    2005-01-01

    Timing of first fatherhood was examined in a sample of 206 at-risk, predominantly White men, followed prospectively for 17 years. An event history analysis was used to test a model wherein antisocial behavior, the contextual and familial factors that may contribute to the development of antisocial behavior, and common correlates of such behavior,…

  10. A simultaneous approach to the estimation of risk aversion and the subjective time discount rate

    NARCIS (Netherlands)

    Booij, A.S.; van Praag, B.M.S.

    2009-01-01

    In this paper we analyze a sample of 1832 individuals who responded to six randomly generated lottery questions that differ with respect to chance, prize and the timing of the draw. Using a model that explicitly allows for consumption smoothing, we obtain an estimate of relative risk aversion of 82.

  11. Predicting the Risk of Attrition for Undergraduate Students with Time Based Modelling

    Science.gov (United States)

    Chai, Kevin E. K.; Gibson, David

    2015-01-01

    Improving student retention is an important and challenging problem for universities. This paper reports on the development of a student attrition model for predicting which first year students are most at-risk of leaving at various points in time during their first semester of study. The objective of developing such a model is to assist…

  12. Leisure time physical exercise during pregnancy and the risk of miscarriage

    DEFF Research Database (Denmark)

    Madsen, M; Jørgensen, T; Jensen, M L

    2007-01-01

    OBJECTIVE: To examine the association between leisure time physical exercise during pregnancy and the risk of miscarriage. DESIGN: Prospective study with elements of retrospective data collection. SETTING: Denmark 1996-2002. POPULATION: A total of 92,671 pregnant women enrolled in the Danish...

  13. Clinical relevance of and risk factors associated with medication administration time errors

    NARCIS (Netherlands)

    Teunissen, R.; Bos, J.; Pot, H.; Pluim, M.; Kramers, C.

    2013-01-01

    PURPOSE: The clinical relevance of and risk factors associated with errors related to medication administration time were studied. METHODS: In this explorative study, 66 medication administration rounds were studied on two wards (surgery and neurology) of a hospital. Data on medication errors were

  14. Optimal timing of vitamin K antagonist resumption after upper gastrointestinal bleeding. A risk modelling analysis.

    Science.gov (United States)

    Majeed, Ammar; Wallvik, Niklas; Eriksson, Joakim; Höijer, Jonas; Bottai, Matteo; Holmström, Margareta; Schulman, Sam

    2017-02-28

    The optimal timing of vitamin K antagonists (VKAs) resumption after an upper gastrointestinal (GI) bleeding, in patients with continued indication for oral anticoagulation, is uncertain. We included consecutive cases of VKA-associated upper GI bleeding from three hospitals retrospectively. Data on the bleeding location, timing of VKA resumption, recurrent GI bleeding and thromboembolic events were collected. A model was constructed to evaluate the 'total risk', based on the sum of the cumulative rates of recurrent GI bleeding and thromboembolic events, depending on the timing of VKA resumption. A total of 121 (58 %) of 207 patients with VKA-associated upper GI bleeding were restarted on anticoagulation after a median (interquartile range) of one (0.2-3.4) week after the index bleeding. Restarting VKAs was associated with a reduced risk of thromboembolism (HR 0.19; 95 % CI, 0.07-0.55) and death (HR 0.61; 95 % CI, 0.39-0.94), but with an increased risk of recurrent GI bleeding (HR 2.5; 95 % CI, 1.4-4.5). The composite risk obtained from the combined statistical model of recurrent GI bleeding, and thromboembolism decreased if VKAs were resumed after three weeks and reached a nadir at six weeks after the index GI bleeding. On this background we will discuss how the disutility of the outcomes may influence the decision regarding timing of resumption. In conclusion, the optimal timing of VKA resumption after VKA-associated upper GI bleeding appears to be between 3-6 weeks after the index bleeding event but has to take into account the degree of thromboembolic risk, patient values and preferences.

  15. Time-Dependent Risk Estimation and Cost-Benefit Analysis for Mitigation Actions

    Science.gov (United States)

    van Stiphout, T.; Wiemer, S.; Marzocchi, W.

    2009-04-01

    Earthquakes strongly cluster in space and time. Consequently, the most dangerous time is right after a moderate earthquake has happened, because their is a ‘high' (i.e., 2-5 percent) probability that this event will be followed by a subsequent aftershock which happens to be as large or larger than the initiating event. The seismic hazard during this time-period exceeds the background probability significantly and by several orders of magnitude. Scientists have developed increasingly accurate forecast models that model this time-dependent hazard, and such models are currently being validated in prospective testing. However, this probabilistic information in the hazard space is difficult to digest for decision makers, the media and general public. Here, we introduce a possible bridge between seismology and decision makers (authorities, civil defense) by proposing a more objective way to estimate time-dependent risk assessment. Short Term Earthquake Risk assessment (STEER) combines aftershock hazard and loss assessments. We use site-specific information on site effects and building class distribution and combine this with existing loss models to compute site specific time-dependent risk curves (probability of exceedance for fatalities, injuries, damages etc). We show the effect of uncertainties in the different components using Monte Carlo Simulations of the input parameters. This time-dependent risk curves can act as a decision support. We extend the STEER approach by introducing a Cost-Benefit approach for certain mitigation actions after a medium-sized earthquake. Such Cost-Benefit approaches have been recently developed for volcanic risk assessment to rationalize precautionary evacuations in densely inhabitated areas threatened by volcanoes. Here we extend the concept to time-dependent probabilistic seismic risk assessment. For the Cost-Benefit analysis of mitigation actions we calculate the ratio between the cost for the mitigation actions and the cost of the

  16. Time processing impairments in preschoolers at risk of developing difficulties in mathematics.

    Science.gov (United States)

    Tobia, Valentina; Rinaldi, Luca; Marzocchi, Gian Marco

    2018-03-01

    The occurrence of time processing problems in individuals with Development Dyscalculia (DD) has favored the view of a general magnitude system devoted to both numerical and temporal information. Yet, this scenario has been partially challenged by studies indicating that time difficulties can be attributed to poor calculation or counting skills, which can support reasoning on time in school-aged children and adults. Here, we tackle this debate by exploring the performance of young children before they fully develop the symbolic number system. Preschoolers at risk of developing DD were compared with typically developing children in a series of tasks investigating time processing and in their 'sense of time', evaluated by parents and teachers. Results yielded a poorer performance in time reproduction of 5-second intervals and in time discrimination, as well as a weaker 'sense of time', in children at risk of DD. These findings provide evidence of a common magnitude system that would be responsible for deficits in both numerical and temporal domains, already at early stages of life. © 2016 John Wiley & Sons Ltd.

  17. Relationship of Near-Crash/Crash Risk to Time Spent on a Cell Phone While Driving.

    Science.gov (United States)

    Farmer, Charles M; Klauer, Sheila G; McClafferty, Julie A; Guo, Feng

    2015-01-01

    The objective of this study was to examine in a naturalistic driving setting the dose-response relationship between cell phone usage while driving and risk of a crash or near crash. How is the increasing use of cell phones by drivers associated with overall near-crash/crash risk (i.e., during driving times both on and off the phone)? Day-to-day driving behavior of 105 volunteer subjects was monitored over a period of 1 year. A random sample was selected comprised of 4 trips from each month that each driver was in the study, and in-vehicle video was used to classify driver behavior. The proportion of driving time spent using a cell phone was estimated for each 3-month period and correlated with overall crash and near-crash rates for each period. Thus, it was possible to test whether changes in an individual driver's cell phone use over time were associated with changes in overall near-crash/crash risk. Drivers in the study spent 11.7% of their driving time interacting with a cell phone, primarily talking on the phone (6.5%) or simply holding the phone in their hand or lap (3.7%). The risk of a near-crash/crash event was approximately 17% higher when the driver was interacting with a cell phone, due primarily to actions of reaching for/answering/dialing, which nearly triples risk (relative risk = 2.84). However, the amount of driving time spent interacting with a cell phone did not affect a driver's overall near-crash/crash risk. Vehicle speeds within 6 s of the beginning of each call on average were 5-6 mph lower than speeds at other times. Results of this naturalistic driving study are consistent with the observation that increasing cell phone use in the general driving population has not led to increased crash rates. Although cell phone use can be distracting and crashes have occurred during this distraction, overall crash rates appear unaffected by changes in the rate of cell phone use, even for individual drivers. Drivers compensate somewhat for the distraction

  18. Duration of Second Stage of Labour at Term and Pushing Time: Risk Factors for Postpartum Haemorrhage.

    Science.gov (United States)

    Looft, Emelie; Simic, Marija; Ahlberg, Mia; Snowden, Jonathan M; Cheng, Yvonne W; Stephansson, Olof

    2017-03-01

    Prolonged labour is associated with increased risk of postpartum haemorrhage (PPH), but the role of active pushing time and the relation with management during labour remains poorly understood. A population-based cohort study from electronic medical record data in the Stockholm-Gotland Region, Sweden. We included 57 267 primiparous women with singleton, term gestation, livebirths delivered vaginally in cephalic presentation in 2008-14. We performed multivariable Poisson regression to estimate the association between length of second stage, pushing time, and PPH (estimated blood loss >500 mL during delivery), adjusting for maternal, delivery, and fetal characteristics as potential confounders. The incidence of PPH was 28.9%. The risk of PPH increased with each passing hour of second stage: compared with a second stage pushing time exceeding 30 min. Compared to pushing time between 15 and 29 min, the RR for PPH were for pushing time during labour are both associated with increased risk of PPH. © 2017 John Wiley & Sons Ltd.

  19. Leisure-time physical activity and cardiometabolic risk among children and adolescents

    Directory of Open Access Journals (Sweden)

    Luz M. Cárdenas-Cárdenas

    2015-04-01

    Full Text Available OBJECTIVE: To assess the effect of Leisure-time physical activity (LTPA on cardiometabolic risk by nutritional status in Mexican children and adolescents. METHODS: This was a cross-sectional study conducted with 1,309 participants aged between 5 and 17 years. Nutritional status was classified according to the BMI Z-score by age and gender. A previously validated questionnaire was used to evaluate LTPA; a cardiometabolic risk score was calculated. Multiple linear regression analysis was performed to assess the effect of LTPA on cardiometabolic risk. RESULTS: After adjusting for risk factors, mild LTPA were positively associated with cardiometabolic risk score (ßMildvsIntenseLTPA: 0.68; 95% CI: 0.18 to 1.18; pfortrend = 0.007. This association became stronger when estimated for overweight (ß MildvsIntenseLTPA: 1.24; 95% CI: 0.24 to 2.24; pfortrend = 0.015 and obese participants (ß MildvsIntenseLTPA: 1.02; 95% CI: 0.07 to 1.97; pfortrend= 0.045 CONCLUSION: Mild LTPA was positively associated with cardiometabolic risk in overweight and obese children and adolescents. Given the emerging childhood obesity epidemic in Mexico, these results may be useful in the design of strategies and programs to increase physical activity levels in order to achieve better health.

  20. The German Labor Market Miracle Revisited: Risk Elimination in Working Time Accounts

    Directory of Open Access Journals (Sweden)

    Vivian Carstensen

    2013-08-01

    Full Text Available This paper contributes to analyses of sustainable enterprise with focus on quality of present and future employment, maintenance of human capital and constituting characteristics of institutional arrangements between the social partners. We add by proving that a specific option from the toolkit of flexible work schedules reduces unemployment risk over the business cycle, while providing mutual insurance of employers and employees. In labor market practice this option is known as working time accounts. Working time accounts are exceptionally widespread and wellinstitutionalized in Germany. We also introduce a risk elimination model of working time accounts and thus contribute to closing the jobs miracle research gap that has become evident since the global financial and economic crisis.

  1. Common risks affecting time overrun in road construction projects in Palestine: Contractors’ perspective

    Directory of Open Access Journals (Sweden)

    Ibrahim Mahamid

    2013-06-01

    Full Text Available The construction sector is one of the key economic sectors and is the main force motivating the Palestinian national economy. However, it suffers from number of problems that affect time, cost and quality performances. This study aims at identifying the common risks affecting time overrun in road construction projects in the West Bank in Palestine from contractors’ viewpoint. 45 factors that might cause delays of road construction projects were defined through a detailed literature review. A questionnaire survey was performed to rank the considered factors in terms of severity and frequency. The analysis of the survey indicated that the top risks affecting time overrun in road construction projects in Palestine are: financial status of the contractors, payments delay by the owner, political situation, segmentation of the West Bank, poor communication between construction parties, lack of equipment efficiency, and high competition in bids.

  2. Long-term cardiovascular risk of nonsteroidal anti-inflammatory drug use according to time passed after first-time myocardial infarction

    DEFF Research Database (Denmark)

    Olsen, Anne-Marie Schjerning; Fosbøl, Emil L; Lindhardsen, Jesper

    2012-01-01

    The cardiovascular risk after the first myocardial infarction (MI) declines rapidly during the first year. We analyzed whether the cardiovascular risk associated with using nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with the time elapsed following first-time MI....

  3. Waste management in Greater Vancouver

    Energy Technology Data Exchange (ETDEWEB)

    Carrusca, K. [Greater Vancouver Regional District, Burnaby, BC (Canada); Richter, R. [Montenay Inc., Vancouver, BC (Canada)]|[Veolia Environmental Services, Vancouver, BC (Canada)

    2006-07-01

    An outline of the Greater Vancouver Regional District (GVRD) waste-to-energy program was presented. The GVRD has an annual budget for solid waste management of $90 million. Energy recovery revenues from solid waste currently exceed $10 million. Over 1,660,00 tonnes of GVRD waste is recycled, and another 280,000 tonnes is converted from waste to energy. The GVRD waste-to-energy facility combines state-of-the-art combustion and air pollution control, and has processed over 5 million tonnes of municipal solid waste since it opened in 1988. Its central location minimizes haul distance, and it was originally sited to utilize steam through sales to a recycle paper mill. The facility has won several awards, including the Solid Waste Association of North America award for best facility in 1990. The facility focuses on continual improvement, and has installed a carbon injection system; an ammonia injection system; a flyash stabilization system; and heat capacity upgrades in addition to conducting continuous waste composition studies. Continuous air emissions monitoring is also conducted at the plant, which produces a very small percentage of the total air emissions in metropolitan Vancouver. The GVRD is now seeking options for the management of a further 500,000 tonnes per year of solid waste, and has received 23 submissions from a range of waste energy technologies which are now being evaluated. It was concluded that waste-to-energy plants can be located in densely populated metropolitan areas and provide a local disposal solution as well as a source of renewable energy. Other GVRD waste reduction policies were also reviewed. refs., tabs., figs.

  4. Time-varying disaster risk models: An empirical assessment of the Rietz-Barro hypothesis

    DEFF Research Database (Denmark)

    Irarrazabal, Alfonso; Parra-Alvarez, Juan Carlos

    This paper revisits the fit of disaster risk models where a representative agent has recursive preferences and the probability of a macroeconomic disaster changes over time. We calibrate the model as in Wachter (2013) and perform two sets of tests to assess the empirical performance of the model ...... and hence to reduce the Sharpe Ratio, a lower elasticity of substitution generates a more reasonable level for the equity risk premium and for the volatility of the government bond returns without compromising the ability of the price-dividend ratio to predict excess returns....

  5. Time variability of C-reactive protein: implications for clinical risk stratification.

    Directory of Open Access Journals (Sweden)

    Peter Bogaty

    Full Text Available C-reactive protein (CRP is proposed as a screening test for predicting risk and guiding preventive approaches in coronary artery disease (CAD. However, the stability of repeated CRP measurements over time in subjects with and without CAD is not well defined. We sought to determine the stability of serial CRP measurements in stable subjects with distinct CAD manifestations and a group without CAD while carefully controlling for known confounders.We prospectively studied 4 groups of 25 stable subjects each 1 a history of recurrent acute coronary events; 2 a single myocardial infarction ≥7 years ago; 3 longstanding CAD (≥7 years that had never been unstable; 4 no CAD. Fifteen measurements of CRP were obtained to cover 21 time-points: 3 times during one day; 5 consecutive days; 4 consecutive weeks; 4 consecutive months; and every 3 months over the year. CRP risk threshold was set at 2.0 mg/L. We estimated variance across time-points using standard descriptive statistics and Bayesian hierarchical models.Median CRP values of the 4 groups and their pattern of variability did not differ substantially so all subjects were analyzed together. The median individual standard deviation (SD CRP values within-day, within-week, between-weeks and between-months were 0.07, 0.19, 0.36 and 0.63 mg/L, respectively. Forty-six percent of subjects changed CRP risk category at least once and 21% had ≥4 weekly and monthly CRP values in both low and high-risk categories.Considering its large intra-individual variability, it may be problematic to rely on CRP values for CAD risk prediction and therapeutic decision-making in individual subjects.

  6. Leisure-time running reduces all-cause and cardiovascular mortality risk.

    Science.gov (United States)

    Lee, Duck-Chul; Pate, Russell R; Lavie, Carl J; Sui, Xuemei; Church, Timothy S; Blair, Steven N

    2014-08-05

    Although running is a popular leisure-time physical activity, little is known about the long-term effects of running on mortality. The dose-response relations between running, as well as the change in running behaviors over time, and mortality remain uncertain. We examined the associations of running with all-cause and cardiovascular mortality risks in 55,137 adults, 18 to 100 years of age (mean age 44 years). Running was assessed on a medical history questionnaire by leisure-time activity. During a mean follow-up of 15 years, 3,413 all-cause and 1,217 cardiovascular deaths occurred. Approximately 24% of adults participated in running in this population. Compared with nonrunners, runners had 30% and 45% lower adjusted risks of all-cause and cardiovascular mortality, respectively, with a 3-year life expectancy benefit. In dose-response analyses, the mortality benefits in runners were similar across quintiles of running time, distance, frequency, amount, and speed, compared with nonrunners. Weekly running even benefits, with 29% and 50% lower risks of all-cause and cardiovascular mortality, respectively, compared with never-runners. Running, even 5 to 10 min/day and at slow speeds benefits. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. Leisure time physical activity and the risk of pre-eclampsia

    DEFF Research Database (Denmark)

    Wolf, H T; Owe, K M; Juhl, M

    2014-01-01

    Today, pre-eclampsia (PE) is one of the leading causes of maternal and perinatal morbidity and mortality. It has been proposed that leisure time physical activity (LTPA) is associated with a decreased risk of PE. The objective of this study was to perform a systematic literature review examining...... the association between LTPA before and/or during pregnancy and the risk of PE. A systematic search of the EMBASE and PUBMED databases from inception to November 17, 2011 was conducted by two independent reviewers. Only studies describing the association between the intensity or amount of LTPA before and....../or during pregnancy and the risk of PE were included. A narrative synthesis of the results was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A quality assessment was performed using the Newcastle Ottawa Scale. Eleven studies were included. None...

  8. Real time forest fire warning and forest fire risk zoning: a Vietnamese case study

    Science.gov (United States)

    Chu, T.; Pham, D.; Phung, T.; Ha, A.; Paschke, M.

    2016-12-01

    Forest fire occurs seriously in Vietnam and has been considered as one of the major causes of forest lost and degradation. Several studies of forest fire risk warning were conducted using Modified Nesterov Index (MNI) but remaining shortcomings and inaccurate predictions that needs to be urgently improved. In our study, several important topographic and social factors such as aspect, slope, elevation, distance to residential areas and road system were considered as "permanent" factors while meteorological data were updated hourly using near-real-time (NRT) remotely sensed data (i.e. MODIS Terra/Aqua and TRMM) for the prediction and warning of fire. Due to the limited number of weather stations in Vietnam, data from all active stations (i.e. 178) were used with the satellite data to calibrate and upscale meteorological variables. These data with finer resolution were then used to generate MNI. The only significant "permanent" factors were selected as input variables based on the correlation coefficients that computed from multi-variable regression among true fire-burning (collected from 1/2007) and its spatial characteristics. These coefficients also used to suggest appropriate weight for computing forest fire risk (FR) model. Forest fire risk model was calculated from the MNI and the selected factors using fuzzy regression models (FRMs) and GIS based multi-criteria analysis. By this approach, the FR was slightly modified from MNI by the integrated use of various factors in our fire warning and prediction model. Multifactor-based maps of forest fire risk zone were generated from classifying FR into three potential danger levels. Fire risk maps were displayed using webgis technology that is easy for managing data and extracting reports. Reported fire-burnings thereafter have been used as true values for validating the forest fire risk. Fire probability has strong relationship with potential danger levels (varied from 5.3% to 53.8%) indicating that the higher

  9. Risk factors, mortality, and timing of ischemic and hemorrhagic stroke with left ventricular assist devices.

    Science.gov (United States)

    Frontera, Jennifer A; Starling, Randall; Cho, Sung-Min; Nowacki, Amy S; Uchino, Ken; Hussain, M Shazam; Mountis, Maria; Moazami, Nader

    2017-06-01

    Stroke is a major cause of mortality after left ventricular assist device (LVAD) placement. Prospectively collected data of patients with HeartMate II (n = 332) and HeartWare (n = 70) LVADs from October 21, 2004, to May 19, 2015, were reviewed. Predictors of early (during index hospitalization) and late (post-discharge) ischemic and hemorrhagic stroke and association of stroke subtypes with mortality were assessed. Of 402 patients, 83 strokes occurred in 69 patients (17%; 0.14 events per patient-year [EPPY]): early ischemic stroke in 18/402 (4%; 0.03 EPPY), early hemorrhagic stroke in 11/402 (3%; 0.02 EPPY), late ischemic stroke in 25/402 (6%; 0.04 EPPY) and late hemorrhagic stroke in 29/402 (7%; 0.05 EPPY). Risk of stroke and death among patients with stroke was bimodal with highest risks immediately post-implant and increasing again 9-12 months later. Risk of death declined over time in patients without stroke. Modifiable stroke risk factors varied according to timing and stroke type, including tobacco use, bacteremia, pump thrombosis, pump infection, and hypertension (all p hemorrhagic stroke (adjusted odds ratio [aOR] 4.3, 95% confidence interval [CI] 1.0-17.8, p = 0.04), late ischemic stroke (aOR 3.2, 95% CI 1.1-9.0, p = 0.03), and late hemorrhagic stroke (aOR 3.7, 95% CI 1.5-9.2, p = 0.005) predicted death, whereas early ischemic stroke did not. Stroke is a leading cause and predictor of death in patients with LVADs. Risk of stroke and death among patients with stroke is bimodal, with highest risk at time of implant and increasing risk again after 9-12 months. Management of modifiable risk factors may reduce stroke and mortality rates. Copyright © 2017 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  10. Precommitted Investment Strategy versus Time-Consistent Investment Strategy for a General Risk Model with Diffusion

    Directory of Open Access Journals (Sweden)

    Lidong Zhang

    2014-01-01

    Full Text Available We mainly study a general risk model and investigate the precommitted strategy and the time-consistent strategy under mean-variance criterion, respectively. A lagrange method is proposed to derive the precommitted investment strategy. Meanwhile from the game theoretical perspective, we find the time-consistent investment strategy by solving the extended Hamilton-Jacobi-Bellman equations. By comparing the precommitted strategy with the time-consistent strategy, we find that the company under the time-consistent strategy has to give up the better current utility in order to keep a consistent satisfaction over the whole time horizon. Furthermore, we theoretically and numerically provide the effect of the parameters on these two optimal strategies and the corresponding value functions.

  11. Timing of Incident Stroke Risk After Cervical Artery Dissection Presenting Without Ischemia.

    Science.gov (United States)

    Morris, Nicholas A; Merkler, Alexander E; Gialdini, Gino; Kamel, Hooman

    2017-03-01

    Cervical artery dissection is a common cause of stroke in young people. The temporal profile of stroke risk after cervical artery dissection presenting without ischemia remains uncertain. We performed a crossover cohort study using administrative claims data on all emergency department visits and acute care hospitalizations from 2005 to 2011 in CA, 2006 to 2013 in NY, and 2005 to 2013 in FL. Using previously validated International Classification of Diseases, Ninth Revision, Clinical Modification codes, we identified patients with a cervical artery dissection and no previous or concurrent stroke or transient ischemic attack diagnosis. We compared the risk of stroke in successive 2-week periods during the 12 weeks after dissection versus the corresponding 2-week period 1 year later. Absolute risk increases were calculated using McNemar test for matched data. In a sensitivity analysis, we limited our population to patients presenting with typical symptoms of cervical artery dissection. We identified 2791 patients with dissection without ischemia. The absolute increase in stroke risk was 1.25% (95% confidence interval, 0.84-1.67%) in the first 2 weeks after dissection compared with the same time period 1 year later. The absolute risk increase was 0.18% (95% confidence interval, 0.02-0.34%) during weeks 3 to 4 and was no longer significant during the remainder of the 12-week postdissection period. Our findings were similar in a sensitivity analysis identifying patients who presented with typical symptoms of acute dissection. The risk of stroke after cervical artery dissection unaccompanied by ischemia at time of diagnosis seems to be limited to the first 2 weeks. © 2017 American Heart Association, Inc.

  12. Greater milk intake is associated with lower bone turnover, higher bone density, and higher bone microarchitecture index in a population of elderly Japanese men with relatively low dietary calcium intake: Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Study.

    Science.gov (United States)

    Sato, Y; Iki, M; Fujita, Y; Tamaki, J; Kouda, K; Yura, A; Moon, J-S; Winzenrieth, R; Iwaki, H; Ishizuka, R; Amano, N; Tomioka, K; Okamoto, N; Kurumatani, N

    2015-05-01

    The effects of milk intake on bone health are not clear in elderly Asian men with low dietary calcium intake. This study showed that greater milk intake is associated with lower bone turnover, higher bone density, and higher bone microarchitecture index in community-dwelling elderly Japanese men. The consumption of milk or dairy products is widely recommended for maintaining bone health regardless of gender or age. However, little evidence exists on the beneficial effects of milk intake on bone health in elderly Japanese men characterized with relatively low dietary calcium intake. Here we examined whether or not greater milk intake was associated with lower bone turnover, higher bone density, and stronger bone microarchitecture in community-dwelling elderly Japanese men. Interviews were conducted to obtain information on medical history and lifestyle, including the amount of habitual milk intake, nutrient intake calculations based on a 1-week food diary, and measurements of areal bone mineral density (aBMD) at the lumbar spine (LS), total hip (TH), and femoral neck (FN) by dual-energy x-ray absorptiometry (DXA), trabecular bone score (TBS) using DXA images at LS, and biochemical markers of bone turnover in sera. Participants with a history of diseases or medications that affect bone metabolism, or with missing data, were excluded from the analysis. The median intake of milk in the 1479 participants (mean age, 73.0 ± 5.1 years) was one glass of milk per day. Bone turnover markers showed a decreasing trend (p turnover, higher aBMD, and higher TBS in community-dwelling elderly Japanese men.

  13. Leisure-time physical activity, sedentary behaviors, sleep, and cardiometabolic risk factors at baseline in the PREDIMED-PLUS intervention trial: A cross-sectional analysis.

    Directory of Open Access Journals (Sweden)

    Nuria Rosique-Esteban

    Full Text Available Limited data exists on the interrelationships between physical activity (PA, sedentary behaviors and sleep concerning cardiometabolic risk factors in aged adults at high cardiovascular disease risk. Our aim was to examine independent and joint associations between time spent in leisure-time PA, sedentary behaviors and sleep on the prevalence of obesity, type 2 diabetes (T2D and components of the metabolic syndrome (MetS in Mediterranean individuals at high cardiovascular risk. Cross-sectional analyses were performed on baseline data from 5776 Spanish adults (aged 55-75y in men; 60-75y in women with overweight/obesity and MetS, from October 2013 to October 2016, in the PREDIMED-PLUS trial. Employing multivariable-adjusted Cox regression with robust variance and constant time (given the cross-sectional design, higher prevalence of obesity, T2D and abdominal obesity as component of the MetS were associated with greater time in TV-viewing (Relative Risk, RR: 1.02, 95%CI: 1.01, 1.03; RR:1.04, 95%CI: 1.02, 1.06 and RR: 1.01 95%CI: 1.00, 1.02; respectively, all P < .01. Conversely, greater time in moderate-vigorous PA (MVPA was associated with lower prevalence of obesity, T2D, abdominal obesity and low HDL-cholesterol (RR: 0.95, 95%CI: 0.93, 0.97; RR: 0.94, 95%CI: 0.89, 0.99; RR: 0.97, 95%CI: 0.96, 0.98; and RR: 0.95, 95%CI: 0.91, 0.99, respectively, all P < .05. For these outcomes, theoretically substituting 1-h/day of MVPA for 1-h/day TV-viewing was also significantly associated with lower prevalence (RR 0.91 to 0.97, all P < .05. Similar lower RR in these outcomes was observed when substituting 1-h/day of MVPA for 1-h/day of sleeping. Longer time watching TV and not meeting MVPA recommendations were jointly associated with higher RR of the prevalence of obesity and T2D. We concluded that, in senior individuals at high cardiovascular risk, greater time spent on MVPA and fewer on sedentary behaviors was inversely associated with prevalence of obesity

  14. Impact of daylight saving time on road traffic collision risk: a systematic review.

    Science.gov (United States)

    Carey, Rachel N; Sarma, Kiran M

    2017-07-02

    Bills have been put forward in the UK and Republic of Ireland proposing a move to Central European Time (CET). Proponents argue that such a change will have benefits for road safety, with daylight being shifted from the morning, when collision risk is lower, to the evening, when risk is higher. Studies examining the impact of daylight saving time (DST) on road traffic collision risk can help inform the debate on the potential road safety benefits of a move to CET. The objective of this systematic review was to examine the impact of DST on collision risk. Major electronic databases were searched, with no restrictions as to date of publication (the last search was performed in January 2017). Access to unpublished reports was requested through an international expert group. Studies that provided a quantitative analysis of the effect of DST on road safety-related outcomes were included. The primary outcomes of interest were road traffic collisions, injuries and fatalities. Twenty-four studies met the inclusion criteria. Seventeen examined the short-term impact of transitions around DST and 12 examined long-term effects. Findings from the short-term studies were inconsistent. The long-term findings suggested a positive effect of DST. However, this cannot be attributed solely to DST, as a range of road collision risk factors vary over time. The evidence from this review cannot support or refute the assertion that a permanent shift in light from morning to evening will have a road safety benefit. © 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.

  15. Neighborhood street scale elements, sedentary time and cardiometabolic risk factors in inactive ethnic minority women.

    Science.gov (United States)

    Lee, Rebecca E; Mama, Scherezade K; Adamus-Leach, Heather J

    2012-01-01

    Cardiometabolic risk factors such as obesity, excess percent body fat, high blood pressure, elevated resting heart rate and sedentary behavior have increased in recent decades due to changes in the environment and lifestyle. Neighborhood micro-environmental, street scale elements may contribute to health above and beyond individual characteristics of residents. To investigate the relationship between neighborhood street scale elements and cardiometabolic risk factors among inactive ethnic minority women. Women (N = 410) completed measures of BMI, percent body fat, blood pressure, resting heart rate, sedentary behavior and demographics. Trained field assessors completed the Pedestrian Environment Data Scan in participants' neighborhoods. Data were collected from 2006-2008. Multiple regression models were conducted in 2011 to estimate the effect of environmental factors on cardiometabolic risk factors. Adjusted regression models found an inverse association between sidewalk buffers and blood pressure, between traffic control devices and resting heart rate, and a positive association between presence of pedestrian crossing aids and BMI (psattractiveness and safety for walking and cycling were related to more time spent in a motor vehicle (psrelationships among micro-environmental, street scale elements that may confer important cardiometabolic benefits and risks for residents. Living in the most attractive and safe neighborhoods for physical activity may be associated with longer times spent sitting in the car.

  16. Neighborhood street scale elements, sedentary time and cardiometabolic risk factors in inactive ethnic minority women.

    Directory of Open Access Journals (Sweden)

    Rebecca E Lee

    Full Text Available Cardiometabolic risk factors such as obesity, excess percent body fat, high blood pressure, elevated resting heart rate and sedentary behavior have increased in recent decades due to changes in the environment and lifestyle. Neighborhood micro-environmental, street scale elements may contribute to health above and beyond individual characteristics of residents.To investigate the relationship between neighborhood street scale elements and cardiometabolic risk factors among inactive ethnic minority women.Women (N = 410 completed measures of BMI, percent body fat, blood pressure, resting heart rate, sedentary behavior and demographics. Trained field assessors completed the Pedestrian Environment Data Scan in participants' neighborhoods. Data were collected from 2006-2008. Multiple regression models were conducted in 2011 to estimate the effect of environmental factors on cardiometabolic risk factors.Adjusted regression models found an inverse association between sidewalk buffers and blood pressure, between traffic control devices and resting heart rate, and a positive association between presence of pedestrian crossing aids and BMI (ps<.05. Neighborhood attractiveness and safety for walking and cycling were related to more time spent in a motor vehicle (ps<.05.Findings suggest complex relationships among micro-environmental, street scale elements that may confer important cardiometabolic benefits and risks for residents. Living in the most attractive and safe neighborhoods for physical activity may be associated with longer times spent sitting in the car.

  17. Solid malignant neoplasms after childhood irradiation: decrease of the relative risk with time after irradiation

    International Nuclear Information System (INIS)

    Vathaire, F. de; Shamsaldin, A.; Grimaud, E.; Campbell, S.; Guerra, M.; Raquin, M.; Hardiman, C.; Jan, P.; Rumeau, N.; Diallo, I.; Nicolazic, G.; Lamon, A.; Oberlin, O.; Cervens, C. de; Suarez, A.; Meresse, V.; Eschwege, F.; Sancho-Garnier, H.; Chavaudra, J.; Lermerle, J.; Bessa, E.; Bell, J.; Hawkins, M.; Schlienger, J.Y.; Panis, X.; Lagrande, J.L.; Gaboriaud, G.; Zucker, J.M.; Daly-Schveitzer, N.

    1995-01-01

    The pattern of the temporal distribution of solid cancer incidence after irradiation in childhood is not well known, although, its importance in radioprotection is well known. We studied a cohort of 1 055 children from 8 European cancer centres, who received radiotherapy between 1942 and 1985 for a first cancer in childhood. After a mean follow-up of 19 years, 26 children developed a solid second malignant neoplasm (SMN), as compared to 5.6 expected from general population rates. Both the excess relative risk and the excess of absolute risk of solid SMN were higher among children who were younger at time of the irradiation. After reaching a maximum 15 to 20 years after irradiation, the excess relative risk of SMN decreased with time after irradiation, when controlling for age at irradiation and sex. The analysis of the risk of thyroid, brain and breast cancer together, as a function of the dose averaged on these 3 organs lead to similar results. (authors). 16 refs., 8 tabs., 2 figs

  18. Plasma clot lysis time and its association with cardiovascular risk factors in black Africans.

    Directory of Open Access Journals (Sweden)

    Zelda de Lange

    Full Text Available Studies in populations of European descent show longer plasma clot lysis times (CLT in patients with cardiovascular disease (CVD than in controls. No data are available on the association between CVD risk factors and fibrinolytic potential in black Africans, a group undergoing rapid urbanisation with increased CVD prevalence. We investigated associations between known CVD risk factors and CLT in black Africans and whether CLTs differ between rural and urban participants in light of differences in CVD risk.Data from 1000 rural and 1000 urban apparently healthy black South Africans (35-60 years were cross-sectionally analysed.Increased PAI-1(act, BMI, HbA1c, triglycerides, the metabolic syndrome, fibrinogen concentration, CRP, female sex and positive HIV status were associated with increased CLTs, while habitual alcohol consumption associated with decreased CLT. No differences in CLT were found between age and smoking categories, contraceptive use or hyper- and normotensive participants. Urban women had longer CLT than rural women while no differences were observed for men.CLT was associated with many known CVD risk factors in black Africans. Differences were however observed, compared to data from populations of European descent available in the literature, suggesting possible ethnic differences. The effect of urbanisation on CLT is influenced by traditional CVD risk factors and their prevalence in urban and rural communities.

  19. Risk aversion, time preference and health production: theory and empirical evidence from Cambodia.

    Science.gov (United States)

    Rieger, Matthias

    2015-04-01

    This paper quantifies the relationship between risk aversion and discount rates on the one hand and height and weight on the other. It studies this link in the context of poor households in Cambodia. Evidence is based on an original dataset that contains both experimental measures of risk taking and impatience along with anthropometric measurements of children and adults. The aim of the paper is to (i) explore the importance of risk and time preferences in explaining undernutrition and (ii) compare the evidence stemming from poor households to strikingly similar findings from industrialized countries. It uses an inter-generational approach to explain observed correlations in adults and children that is inspired by the height premium on labor markets. Parents can invest in the health capital of their child to increase future earnings and their consumption when old: better nutrition during infancy translates into better human capital and better wages, and ultimately better financial means to take care of elderly parents. However this investment is subject to considerable uncertainty, since parents neither perfectly foresee economic conditions when the child starts earning nor fully observe the ability to transform nutritional investments into long-term health capital. As a result, risk taking households have taller and heavier children. Conversely, impatience does not affect child health. In the case of adults, only weight and the body mass index (BMI), but not height, are positively and moderately correlated with risk taking and impatience. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Which population groups are most unaware of CVD risks associated with sitting time?

    Science.gov (United States)

    Duncan, Mitch J; Gilson, Nicholas; Vandelanotte, Corneel

    2014-08-01

    Prolonged sitting is an emerging risk factor for poor health yet few studies have examined awareness of the risks associated with sitting behaviours. This study identifies the population subgroups with the highest levels of unawareness regarding the cardiovascular disease (CVD) risks associated with sitting behaviours. Adults (n=1256) living in Queensland, Australia completed a telephone-based survey in 2011, analysis conducted in 2013. The survey assessed participant's socio-demographic characteristics, physical activity, sitting behaviours and awareness of CVD risks associated with three sitting behaviours: 1) sitting for prolonged periods, 2), sitting for prolonged periods whilst also engaging in regular physical activity, and 3) breaking up periods of prolonged sitting with short activity breaks. Population sub-groups with the highest levels of unawareness were identified based on socio-demographic and behavioural characteristics using signal detection analysis. Unawareness ranged from 23.3% to 67.0%. Age was the most important variable in differentiating awareness levels; younger adults had higher levels of unawareness. Body mass index, physical activity, TV viewing, employment status and time spent at work also identified population sub-groups. Unawareness of CVD risk for prolonged sitting was moderately high overall. Younger adults had high levels of unawareness on all of the outcomes examined. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Plasma clot lysis time and its association with cardiovascular risk factors in black Africans.

    Science.gov (United States)

    de Lange, Zelda; Pieters, Marlien; Jerling, Johann C; Kruger, Annamarie; Rijken, Dingeman C

    2012-01-01

    Studies in populations of European descent show longer plasma clot lysis times (CLT) in patients with cardiovascular disease (CVD) than in controls. No data are available on the association between CVD risk factors and fibrinolytic potential in black Africans, a group undergoing rapid urbanisation with increased CVD prevalence. We investigated associations between known CVD risk factors and CLT in black Africans and whether CLTs differ between rural and urban participants in light of differences in CVD risk.Data from 1000 rural and 1000 urban apparently healthy black South Africans (35-60 years) were cross-sectionally analysed.Increased PAI-1(act), BMI, HbA1c, triglycerides, the metabolic syndrome, fibrinogen concentration, CRP, female sex and positive HIV status were associated with increased CLTs, while habitual alcohol consumption associated with decreased CLT. No differences in CLT were found between age and smoking categories, contraceptive use or hyper- and normotensive participants. Urban women had longer CLT than rural women while no differences were observed for men.CLT was associated with many known CVD risk factors in black Africans. Differences were however observed, compared to data from populations of European descent available in the literature, suggesting possible ethnic differences. The effect of urbanisation on CLT is influenced by traditional CVD risk factors and their prevalence in urban and rural communities.

  2. The development and application of an integrated radiological risk assessment procedure using time-dependent probabilistic risk analysis

    International Nuclear Information System (INIS)

    Laurens, J.M.; Thompson, B.G.J.; Sumerling, T.J.

    1990-01-01

    During the past decade, the UKDoE has funded the development of an integrated assessment procedure centred around probabilistic risk analysis (p.r.a.) using Monte Carlo simulation techniques to account for the effects of parameter value uncertainty, including those associated with temporal changes in the environment over a postclosure period of about one million years. The influence of these changes can now be incorporated explicitly into the p.r.a. simulator VANDAL (Variability ANalysis of Disposal ALternatives) briefly described here. Although a full statistically converged time-dependent p.r.a. will not be demonstrated until the current Dry Run 3 trial is complete, illustrative examples are given showing the ability of VANDAL to represent spatially complex groundwater and repository systems evolving under the influence of climatic change. 18 refs., 10 figs., 1 tab

  3. Duration and Timing of Exposure to Neighborhood Poverty and the Risk of Adolescent Parenthood

    Science.gov (United States)

    Wodtke, Geoffrey T.

    2013-01-01

    Theory suggests that the impact of neighborhood poverty depends on both the duration and timing of exposure. Previous research, however, does not properly analyze the sequence of neighborhoods to which children are exposed throughout the early life course. This study investigates the effects of different longitudinal patterns of exposure to disadvantaged neighborhoods on the risk of adolescent parenthood. It follows a cohort of children in the PSID from age 4 to 19 and uses novel methods for time-varying exposures that overcome critical limitations of conventional regression when selection processes are dynamic. Results indicate that sustained exposure to poor neighborhoods substantially increases the risk of becoming a teen parent and that exposure to neighborhood poverty during adolescence may be more consequential than exposure earlier during childhood. PMID:23720166

  4. Nexsys{trademark} real time risk management system and demonstration at Kushiro coal mine

    Energy Technology Data Exchange (ETDEWEB)

    Addinell, S.J.; Rowan, G.; Matsuyama, S. [CSIRO (Australia). Division of Exploration and Mining

    2005-03-01

    In March 2005, the CSIRO Nexsys{trademark} development team travelled to Kushiro Coal Mine (KCM) to install and evaluate the Nexsys{trademark} real time risk management system developed under joint collaboration with JCOAL and other industry partners. After successful installation and configuration the system was able to interface directly to the existing mine site MELSEC monitoring hardware and system database. Once fully commissioned, Nexsys{trademark} will provide mine operators with a real-time risk management system with the capability to initiate preemptive Trigger Action Response Plans (TARPS) should mine operating parameters change for the worse. A range of autonomous altering and alarming options are available, including the capability to email the nature and severity of the alarm to key personnel, on or off site. The system is also fully compatible with wireless network systems and can be accessed through WLAN devices such as Ethernet enabled PDAs. 2 refs., 3 figs.

  5. Unbiasedness and time varying risk premia in the crude oil futures market

    International Nuclear Information System (INIS)

    Moosa, I.A.; Al-Loughani, N.E.

    1994-01-01

    This paper presents some empirical evidence on market efficiency and unbiasedness in the crude oil futures market and some related issues. On the basis of monthly observations on spot and futures prices of the West Texas Intermediate (WTI) crude oil, several tests are carried out on the relevant hypotheses. The evidence suggests that futures prices are neither unbiased nor efficient forecasters of spot prices. Furthermore, a GARCH-M(1,1) model reveals the existence of a time varying risk premium. (author)

  6. Deprivation and health risk indicators in full-time permanent workers.

    Science.gov (United States)

    Gusto, Gaëlle; Vol, Sylviane; Lasfargues, Gérard; Guillaud, Christian; Lantieri, Olivier; Tichet, Jean

    2014-08-01

    Association between deprivation and health is well established, particularly among unemployed or fixed-term contract or temporary contract subjects. This study aimed to assess if this relationship existed as well in full-time permanent workers. Biometrical, biological, behavioural and psychosocial health risk indicators and an individual deprivation score, the Evaluation of Precarity and Inequalities in Health Examination Centres score, were recorded from January 2007 to June 2008, in 34 905 full-time permanent workers aged 18-70 years, all volunteers for a free health examination. Comparisons of the behavioural, metabolic, cardiovascular and health risk indicators between quintiles of the deprivation score with adjustments on age and socioeconomic categories were made by covariance analysis or logistic regression. For both genders, degradation of nutritional behaviours, metabolic and cardiovascular indicators and health appeared gradually with deprivation, even for deprivation score usually considered as an insignificant value. The absence of only one social support or one social network was associated with a degradation of health. Full-time permanent workers with the poorest health risk indicators had more frequent social exclusion signs. These results were independent of socioeconomic categories and age. Understanding how deprivation influences health status may lead to more effective interventions to reduce social inequalities in health. The deprivation Evaluation of Precarity and Inequalities in Health Examination Centres score is a relevant tool to detect subjects who could benefit from preventive interventions. Our findings suggest that this deprivation score should be used as a health risk indicator even in full-time permanent workers. Assessing deprivation is useful to design and evaluate specific intervention programmes. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  7. Risk factors for caries-free time: longitudinal study in early childhood

    Directory of Open Access Journals (Sweden)

    Maria Beatriz Barreto de Sousa Cabral

    2017-12-01

    Full Text Available ABSTRACT OBJECTIVE To estimate time in days from the beginning of follow-up up to the development of dental caries in children under 30 months and to assess risk factors potentially affecting the development of the disease. METHODS The study population of the cohort study were children attending public, private, and charitable day care centers in Salvador, Northeastern Brazil, followed up for fourteen months. We used the multivariate Cox regression to estimate risk and Kaplan-Meier method to estimate the caries-free time. RESULTS Of the 495 children studied, 112 developed caries (22.6%. Mean caries-free time was 248.6 (SD = 96.2 days. The comparasion of curves by age group (> 24 months and children attending public day care showed more caries in a shorter period (p < 0.00. The following variables were important risk factors for increased rate of caries: district of origin (HR = 1.88, 95%CI 1.27–2.77, category of day care (HR = 3.88, 95%CI 2.04–7.38, age (HR = 1.77, 95%CI 1.15–2.74, bottle-feeding before sleep time after the age of 12 months (HR = 1.62, 95%CI 1.04–2.51, presence of active white spots (HR = 2.70, 95%CI 1.07–6.80, and living in non-masonry house (HR = 1.68, 95%CI 1.02–2.76. The highest hazard ratio (HR = 4.60, 95%CI 2.80–7.42 was found for previous caries experience. CONCLUSIONS Social variables were considered as of high risk for the development of dental caries.

  8. Effects of physical activity and sedentary time on the risk of heart failure.

    Science.gov (United States)

    Young, Deborah Rohm; Reynolds, Kristi; Sidell, Margo; Brar, Somjot; Ghai, Nirupa R; Sternfeld, Barbara; Jacobsen, Steven J; Slezak, Jeffrey M; Caan, Bette; Quinn, Virginia P

    2014-01-01

    Although the benefits of physical activity for risk of coronary heart disease are well established, less is known about its effects on heart failure (HF). The risk of prolonged sedentary behavior on HF is unknown. The study cohort included 82 695 men aged≥45 years from the California Men's Health Study without prevalent HF who were followed up for 10 years. Physical activity, sedentary time, and behavioral covariates were obtained from questionnaires, and clinical covariates were determined from electronic medical records. Incident HF was identified through International Classification of Diseases, Ninth Revision codes recorded in electronic records. During a mean follow-up of 7.8 years (646 989 person-years), 3473 men were diagnosed with HF. Controlling for sedentary time, sociodemographics, hypertension, diabetes mellitus, unfavorable lipid levels, body mass index, smoking, and diet, the hazard ratio (95% confidence interval [CI]) of HF in the lowest physical activity category compared with those in the highest category was 1.52 (95% CI, 1.39-1.68). Those in the medium physical activity category were also at increased risk (hazard ratio, 1.17 [95% CI, 1.06-1.29]). Controlling for the same covariates and physical activity, the hazard ratio (95% CI) of HF in the highest sedentary category compared with the lowest was 1.34 (95% CI, 1.21-1.48). Medium sedentary time also conveyed risk (hazard ratio, 1.13 [95% CI, 1.04-1.24]). Results showed similar trends across white and Hispanic subgroups, body mass index categories, baseline hypertension status, and prevalent coronary heart disease. Both physical activity and sedentary time may be appropriate intervention targets for preventing HF.

  9. Ureteric stent dwelling time: a risk factor for post-ureteroscopy sepsis.

    Science.gov (United States)

    Nevo, Amihay; Mano, Roy; Baniel, Jack; Lifshitz, David A

    2017-07-01

    To evaluate the association between stent dwelling time and sepsis after ureteroscopy, and identify risk factors for sepsis in this setting. The prospectively collected database of a single institution was queried for all patients who underwent ureteroscopy for stone extraction between 2010 and 2016. Demographic, clinical, preoperative and operative data were collected. The primary study endpoint was sepsis within 48 h of ureteroscopy. Logistic regressions were performed to identify predictors of post-ureteroscopy sepsis in the ureteroscopy cohort and specifically in patients with prior stent insertion. Between October 2010 and April 2016, 1 256 patients underwent ureteroscopy for stone extraction. Risk factors for sepsis included prior stent placement, female gender and Charlson comorbidity index. A total of 601 patients had a ureteric stent inserted before the operation and were included in the study cohort, in which the median age was 56 years, 90 patients were women (30%), and 97 patients were treated for positive preoperative urine cultures (16.1%). Postoperative sepsis, Sepsis rates after stent dwelling times of 1, 2, 3 and >3 months were 1, 4.9, 5.5 and 9.2%, respectively. On multivariate analysis, stent dwelling time, stent insertion because of sepsis, and female gender were significantly associated with post-ureteroscopy sepsis in patients with prior stent placement. Patients who undergo ureteroscopy after ureteric stent insertion have a higher risk of postoperative sepsis. Prolonged stent dwelling time, sepsis as an indication for stent insertion, and female gender are independent risk factors. Stent placement should be considered cautiously, and if inserted, ureteroscopy should be performed within 1 month. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  10. A coupled weather generator - rainfall-runoff approach on hourly time steps for flood risk analysis

    Science.gov (United States)

    Winter, Benjamin; Schneeberger, Klaus; Dung Nguyen, Viet; Vorogushyn, Sergiy; Huttenlau, Matthias; Merz, Bruno; Stötter, Johann

    2017-04-01

    The evaluation of potential monetary damage of flooding is an essential part of flood risk management. One possibility to estimate the monetary risk is to analyze long time series of observed flood events and their corresponding damages. In reality, however, only few flood events are documented. This limitation can be overcome by the generation of a set of synthetic, physically and spatial plausible flood events and subsequently the estimation of the resulting monetary damages. In the present work, a set of synthetic flood events is generated by a continuous rainfall-runoff simulation in combination with a coupled weather generator and temporal disaggregation procedure for the study area of Vorarlberg (Austria). Most flood risk studies focus on daily time steps, however, the mesoscale alpine study area is characterized by short concentration times, leading to large differences between daily mean and daily maximum discharge. Accordingly, an hourly time step is needed for the simulations. The hourly metrological input for the rainfall-runoff model is generated in a two-step approach. A synthetic daily dataset is generated by a multivariate and multisite weather generator and subsequently disaggregated to hourly time steps with a k-Nearest-Neighbor model. Following the event generation procedure, the negative consequences of flooding are analyzed. The corresponding flood damage for each synthetic event is estimated by combining the synthetic discharge at representative points of the river network with a loss probability relation for each community in the study area. The loss probability relation is based on exposure and susceptibility analyses on a single object basis (residential buildings) for certain return periods. For these impact analyses official inundation maps of the study area are used. Finally, by analyzing the total event time series of damages, the expected annual damage or losses associated with a certain probability of occurrence can be estimated for

  11. Changes in triglyceride levels over time and risk of type 2 diabetes in young men.

    Science.gov (United States)

    Tirosh, Amir; Shai, Iris; Bitzur, Rafael; Kochba, Ilan; Tekes-Manova, Dorit; Israeli, Eran; Shochat, Tzippora; Rudich, Assaf

    2008-10-01

    The association between changes in triglyceride concentrations over time and diabetes is unknown. We assessed whether two triglyceride determinations obtained 5 years apart can predict incident type 2 diabetes. Triglyceride levels at baseline (time 1) and 5 years later (time 2), followed by subsequent follow-up of 5.5 years, were measured in 13,953 apparently healthy men (age 26-45 years) with triglycerides <300 mg/dl (<3.39 mmol/l). During 76,742 person-years, 322 cases of diabetes occurred. A multivariate model adjusted for age, BMI, total cholesterol-to-HDL cholesterol ratio, family history of diabetes, fasting glucose, blood pressure, physical activity, and smoking status revealed a continuous independent rise in incident diabetes with increasing time 1 triglyceride levels (P(trend) < 0.001). Men in the lowest tertile of time 1 triglyceride levels who progressed to the highest tertile over follow-up (low-high) exhibited a hazard ratio (HR) of 12.62 (95% CI 3.52-31.34) compared with those remaining in the lowest tertile at both time points (reference group: low-low). Whereas men who were at the top triglyceride level tertile throughout follow-up (high-high) had a HR for diabetes of 7.08 (2.52-14.45), those whose triglyceride level decreased to the lowest tertile (high-low) exhibited a HR of 1.97 (0.67-6.13). Alterations in triglyceride levels during follow-up were associated with changes in BMI, physical activity, and eating breakfast habit (P < 0.05), but remained an independent modifier of diabetes risk even after adjustment for such changes. Two measurements of fasting triglyceride levels obtained 5 years apart can assist in identifying apparently healthy young men at increased risk for diabetes, independent of traditional risk factors and of associated changes in BMI and lifestyle parameters.

  12. Quantifying and estimating the predictive accuracy for censored time-to-event data with competing risks.

    Science.gov (United States)

    Wu, Cai; Li, Liang

    2018-05-15

    This paper focuses on quantifying and estimating the predictive accuracy of prognostic models for time-to-event outcomes with competing events. We consider the time-dependent discrimination and calibration metrics, including the receiver operating characteristics curve and the Brier score, in the context of competing risks. To address censoring, we propose a unified nonparametric estimation framework for both discrimination and calibration measures, by weighting the censored subjects with the conditional probability of the event of interest given the observed data. The proposed method can be extended to time-dependent predictive accuracy metrics constructed from a general class of loss functions. We apply the methodology to a data set from the African American Study of Kidney Disease and Hypertension to evaluate the predictive accuracy of a prognostic risk score in predicting end-stage renal disease, accounting for the competing risk of pre-end-stage renal disease death, and evaluate its numerical performance in extensive simulation studies. Copyright © 2018 John Wiley & Sons, Ltd.

  13. Dynamic Value Engineering Method Optimizing the Risk on Real Time Operating System

    Directory of Open Access Journals (Sweden)

    Prashant Kumar Patra

    2014-04-01

    Full Text Available The value engineering is the umbrella of the many more sub-system like quality assurance, quality control, quality function design and development for manufacturability. The system engineering & value engineering is two part of the coin. The value engineering is the high level of technology management for every aspect of engineering fields. The value engineering is the high utilization of System Product (i.e. Processor, Memory & Encryption key, Services, Business and Resources at minimal cost. The high end operating system providing highest services at optimal cost & time. The value engineering provides the maximum performance, accountability, reliability, integrity and availability of processor, memory, encryption key and other inter dependency sub-components. The value engineering is the ratio of the maximum functionality of individual components to the optimal cost. VE=k [(P, M, E, C, A]/optimal cost. Where k is the proportionality constant. The VE is directly proportional to performance of individual components and inversely proportional to the minimal cost. The VE is directly proportional to the risk assessment. The VE maximize the business throughput & decision process mean while minimize the risk and down time. We have to develop the dynamic value engineering model & mechanism for risk optimization over a complex real time operating system This proposed composition model definite will be resolve our objective at top high level. Product

  14. Real-Time Risk Assessment Framework for Unmanned Aircraft System (UAS) Traffic Management (UTM)

    Science.gov (United States)

    Ancel, Ersin; Capristan, Francisco M.; Foster, John V.; Condotta, Ryan

    2017-01-01

    The new Federal Aviation Administration (FAA) Small Unmanned Aircraft rule (Part 107) marks the first national regulations for commercial operation of small unmanned aircraft systems (sUAS) under 55 pounds within the National Airspace System (NAS). Although sUAS flights may not be performed beyond visual line-of-sight or over non- participant structures and people, safety of sUAS operations must still be maintained and tracked at all times. Moreover, future safety-critical operation of sUAS (e.g., for package delivery) are already being conceived and tested. NASA's Unmanned Aircraft System Trac Management (UTM) concept aims to facilitate the safe use of low-altitude airspace for sUAS operations. This paper introduces the UTM Risk Assessment Framework (URAF) which was developed to provide real-time safety evaluation and tracking capability within the UTM concept. The URAF uses Bayesian Belief Networks (BBNs) to propagate off -nominal condition probabilities based on real-time component failure indicators. This information is then used to assess the risk to people on the ground by calculating the potential impact area and the effects of the impact. The visual representation of the expected area of impact and the nominal risk level can assist operators and controllers with dynamic trajectory planning and execution. The URAF was applied to a case study to illustrate the concept.

  15. Time Charters with Purchase Options in Shipping: Valuation and Risk Management

    DEFF Research Database (Denmark)

    Jørgensen, Peter Løchte; De Giovanni, Domenico

    The paper studies the valuation and optimal management of Time Charters with Purchase Options (T/C-POPs) which is a specific type of asset lease with embedded options that is common in shipping markets. T/C-POPs are economically significant and sometimes account for more than half of the stock...... market value of listed shipping companies. The main source of risk in markets for maritime transportation is the freight rate, and we therefore specify a single-factor continuous time model for the dynamic evolution of freight rates which allows us to price a wide variety of freight rate related...

  16. Time Charters with Purchase Options in Shipping: Valuation and Risk Management

    DEFF Research Database (Denmark)

    Jørgensen, Peter Løchte; De Giovanni, Domenico

    2010-01-01

    The article studies the valuation and optimal management of Time Charters with Purchase Options (T/C-POPs), which is a specific type of asset lease with embedded options that is common in shipping markets. T/C-POPs are economically significant and sometimes account for more than half of the stock...... market value of listed shipping companies. The main source of risk in markets for maritime transportation is the freight rate, and we therefore specify a single-factor continuous time model for the dynamic evolution of freight rates that allows us to price a wide variety of freight rate...

  17. Greater confinement disposal of radioactive wastes

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Gilbert, T.L.; Luner, C.; Merry-Libby, P.A.; Meshkov, N.K.; Yu, C.

    1985-01-01

    Low-level radioactive waste (LLW) includes a broad spectrum of different radionuclide concentrations, half-lives, and hazards. Standard shallow-land burial practice can provide adequate protection of public health and safety for most LLW. A small volume fraction (approx. 1%) containing most of the activity inventory (approx. 90%) requires specific measures known as greater-confinement disposal (GCD). Different site characteristics and different waste characteristics - such as high radionuclide concentrations, long radionuclide half-lives, high radionuclide mobility, and physical or chemical characteristics that present exceptional hazards - lead to different GCD facility design requirements. Facility design alternatives considered for GCD include the augered shaft, deep trench, engineered structure, hydrofracture, improved waste form, and high-integrity container. Selection of an appropriate design must also consider the interplay between basic risk limits for protection of public health and safety, performance characteristics and objectives, costs, waste-acceptance criteria, waste characteristics, and site characteristics

  18. Risk is still relevant: Time-varying associations between perceived risk and marijuana use among US 12th grade students from 1991 to 2016.

    Science.gov (United States)

    Terry-McElrath, Yvonne M; O'Malley, Patrick M; Patrick, Megan E; Miech, Richard A

    2017-11-01

    Perceived risk of harm has long been a key preventive factor for adolescent marijuana use. However, in recent years, perceived risk has decreased markedly and marijuana use has increased only slightly, leading to new questions about their association. This study investigates the magnitude and stability of the US adolescent marijuana risk/use association from 1991 to 2016, overall and by gender and race/ethnicity. Self-reported data on past 12-month marijuana use, perceived risk of regular marijuana use, gender, and race/ethnicity were obtained from 275,768 US 12th grade students participating in the nationally representative Monitoring the Future study. Time-varying effect modeling (TVEM) was used to examine the marijuana risk/use association over time. Both before and after controlling for gender and race/ethnicity, perceived risk was a strong protective factor against adolescent marijuana use. The magnitude of the great risk/use association strengthened for Hispanic students; remained generally stable over time for 12th graders overall, males, females, and White students; and weakened for Black students. The magnitude of the moderate risk/use association strengthened for 12th graders overall, males, females, White and Hispanic students, but did not continue to strengthen for Black students from 2005 onwards. In general, marijuana use prevalence decreased over time within all levels of perceived risk. Perceived risk remains a strong protective factor for adolescent marijuana use, and the protective association for moderate risk (vs. no/slight risk) is actually increasing over time. Results suggest that accurate and credible information on the risks associated with marijuana use should remain a key component of prevention efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Disadvantaged children at greater relative risk of thinness (as well as obesity): a secondary data analysis of the England National Child Measurement Programme and the UK Millennium Cohort Study.

    Science.gov (United States)

    Pearce, Anna; Rougeaux, Emeline; Law, Catherine

    2015-08-05

    Young children living in more disadvantaged socio-economic circumstances (SECs) are at an increased risk of overweight and obesity. However, there is scant research examining the prevalence and social distribution of thinness in early childhood, despite potential negative consequences for health and development across the life-course. We examined the social gradient in thinness (and overweight and obesity for comparison) for 2,620,422 four-to-five year olds attending state maintained primary schools from 2007/8 to 2011/12, in the England National Child Measurement Programme (NCMP), and 16,715 children from the UK Millennium Cohort Study (MCS), born in 2000-2002, and measured at ages of three, five and seven. Children were classified as being thin, healthy weight (and, for completeness, overweight or obese) using international age and sex adjusted cut-offs for body mass index (BMI). Prevalences (and 95% confidence intervals (CIs)) were estimated, overall, and according to SECs: area deprivation (NCMP, MCS); household income, and maternal social class and education (MCS only). Relative Risk Ratios (RRRs) and CIs for thinness, overweight and obesity were estimated in multinomial models by SECs (baseline healthy weight). In the MCS, standard errors were estimated using clustered sandwich estimators to account for repeated measures, and, for thinness, RRRs by SECs were also estimated adjusting for a range of early life characteristics. In 2007/8 to 2011/12, 5.20% of four-to-five year old girls (n = 66,584) and 5.88% of boys (78,934) in the NCMP were thin. In the MCS, the prevalence of thinness was 4.59% (693) at three, 4.21% (702) at five, and 5.84% (804) at seven years. In both studies, and for all measures of SECs, children from the most disadvantaged groups were more likely to be thin than those from the most advantaged groups. For example, MCS children whose mothers had no educational qualifications were fifty percent more likely to be thin (RRR 1.5 (CI: 1.24, 1

  20. Temporal variation of optimal UV exposure time over Korea: risks and benefits of surface UV radiation

    Science.gov (United States)

    Lee, Y. G.; Koo, J. H.

    2015-12-01

    Solar UV radiation in a wavelength range between 280 to 400 nm has both positive and negative influences on human body. Surface UV radiation is the main natural source of vitamin D, providing the promotion of bone and musculoskeletal health and reducing the risk of a number of cancers and other medical conditions. However, overexposure to surface UV radiation is significantly related with the majority of skin cancer, in addition other negative health effects such as sunburn, skin aging, and some forms of eye cataracts. Therefore, it is important to estimate the optimal UV exposure time, representing a balance between reducing negative health effects and maximizing sufficient vitamin D production. Previous studies calculated erythemal UV and vitamin-D UV from the measured and modelled spectral irradiances, respectively, by weighting CIE Erythema and Vitamin D3 generation functions (Kazantzidis et al., 2009; Fioletov et al., 2010). In particular, McKenzie et al. (2009) suggested the algorithm to estimate vitamin-D production UV from erythemal UV (or UV index) and determined the optimum conditions of UV exposure based on skin type Ⅱ according to the Fitzpatrick (1988). Recently, there are various demands for risks and benefits of surface UV radiation on public health over Korea, thus it is necessary to estimate optimal UV exposure time suitable to skin type of East Asians. This study examined the relationship between erythemally weighted UV (UVEry) and vitamin D weighted UV (UVVitD) over Korea during 2004-2012. The temporal variations of the ratio (UVVitD/UVEry) were also analyzed and the ratio as a function of UV index was applied in estimating the optimal UV exposure time. In summer with high surface UV radiation, short exposure time leaded to sufficient vitamin D and erythema and vice versa in winter. Thus, the balancing time in winter was enough to maximize UV benefits and minimize UV risks.

  1. Vigorous-intensity leisure-time physical activity and risk of major chronic disease in men.

    Science.gov (United States)

    Chomistek, Andrea K; Cook, Nancy R; Flint, Alan J; Rimm, Eric B

    2012-10-01

    Although studies have shown health benefits for moderate-intensity physical activity, there is limited evidence to support beneficial effects for high amounts of vigorous activity among middle-age and older men. The objective of this study was to examine the relationship between vigorous-intensity physical activity, compared with moderate-intensity activity, and risk of major chronic disease in men. We prospectively examined the associations between vigorous- and moderate-intensity physical activity and risk of major chronic disease among 44,551 men age 40-75 yr in 1986. Leisure-time physical activity was assessed biennially by questionnaire. During 22 yr of follow-up, we documented 14,162 incident cases of major chronic disease, including 4769 cardiovascular events, 6449 cancer events, and 2944 deaths from other causes. The HR of major chronic disease comparing ≥ 21 to 0 MET.h.wk(-1) of exercise was 0.86 (95% confidence interval (CI), 0.81-0.91) for vigorous-intensity activity and 0.85 (95% CI, 0.80-0.90) for moderate activity. For cardiovascular disease (CVD), the corresponding HRs were 0.78 (95% CI, 0.70-0.86) and 0.80 (95% CI, 0.72-0.88), respectively. When examined separately, running, tennis, and brisk walking were inversely associated with CVD risk. Furthermore, more vigorous activity was associated with lower disease risk; the HR comparing >70 to 0 MET.h.wk(-1) of vigorous-intensity exercise was 0.79 (95% CI, 0.68-0.92; P < 0.0001 for trend) for major chronic disease and 0.73 (95% CI, 0.56-0.96; P < 0.0001 for trend) for CVD. Vigorous- and moderate-intensity physical activities were associated with lower risk of major chronic disease and CVD. Increasing amounts of vigorous activity remained inversely associated with disease risk, even among men in the highest categories of exercise.

  2. Robust routing for hazardous materials transportation with conditional value-at-risk on time-dependent networks.

    Science.gov (United States)

    2012-11-01

    New methods are proposed for mitigating risk in hazardous materials (hazmat) transportation, based on Conditional : Value-at-Risk (CVaR) measure, on time-dependent vehicular networks. While the CVaR risk measure has been : popularly used in financial...

  3. Quantifying lead-time bias in risk factor studies of cancer through simulation.

    Science.gov (United States)

    Jansen, Rick J; Alexander, Bruce H; Anderson, Kristin E; Church, Timothy R

    2013-11-01

    Lead-time is inherent in early detection and creates bias in observational studies of screening efficacy, but its potential to bias effect estimates in risk factor studies is not always recognized. We describe a form of this bias that conventional analyses cannot address and develop a model to quantify it. Surveillance Epidemiology and End Results (SEER) data form the basis for estimates of age-specific preclinical incidence, and log-normal distributions describe the preclinical duration distribution. Simulations assume a joint null hypothesis of no effect of either the risk factor or screening on the preclinical incidence of cancer, and then quantify the bias as the risk-factor odds ratio (OR) from this null study. This bias can be used as a factor to adjust observed OR in the actual study. For this particular study design, as average preclinical duration increased, the bias in the total-physical activity OR monotonically increased from 1% to 22% above the null, but the smoking OR monotonically decreased from 1% above the null to 5% below the null. The finding of nontrivial bias in fixed risk-factor effect estimates demonstrates the importance of quantitatively evaluating it in susceptible studies. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Quantifying the predictive accuracy of time-to-event models in the presence of competing risks.

    Science.gov (United States)

    Schoop, Rotraut; Beyersmann, Jan; Schumacher, Martin; Binder, Harald

    2011-02-01

    Prognostic models for time-to-event data play a prominent role in therapy assignment, risk stratification and inter-hospital quality assurance. The assessment of their prognostic value is vital not only for responsible resource allocation, but also for their widespread acceptance. The additional presence of competing risks to the event of interest requires proper handling not only on the model building side, but also during assessment. Research into methods for the evaluation of the prognostic potential of models accounting for competing risks is still needed, as most proposed methods measure either their discrimination or calibration, but do not examine both simultaneously. We adapt the prediction error proposal of Graf et al. (Statistics in Medicine 1999, 18, 2529–2545) and Gerds and Schumacher (Biometrical Journal 2006, 48, 1029–1040) to handle models with competing risks, i.e. more than one possible event type, and introduce a consistent estimator. A simulation study investigating the behaviour of the estimator in small sample size situations and for different levels of censoring together with a real data application follows.

  5. Semiparametric accelerated failure time cure rate mixture models with competing risks.

    Science.gov (United States)

    Choi, Sangbum; Zhu, Liang; Huang, Xuelin

    2018-01-15

    Modern medical treatments have substantially improved survival rates for many chronic diseases and have generated considerable interest in developing cure fraction models for survival data with a non-ignorable cured proportion. Statistical analysis of such data may be further complicated by competing risks that involve multiple types of endpoints. Regression analysis of competing risks is typically undertaken via a proportional hazards model adapted on cause-specific hazard or subdistribution hazard. In this article, we propose an alternative approach that treats competing events as distinct outcomes in a mixture. We consider semiparametric accelerated failure time models for the cause-conditional survival function that are combined through a multinomial logistic model within the cure-mixture modeling framework. The cure-mixture approach to competing risks provides a means to determine the overall effect of a treatment and insights into how this treatment modifies the components of the mixture in the presence of a cure fraction. The regression and nonparametric parameters are estimated by a nonparametric kernel-based maximum likelihood estimation method. Variance estimation is achieved through resampling methods for the kernel-smoothed likelihood function. Simulation studies show that the procedures work well in practical settings. Application to a sarcoma study demonstrates the use of the proposed method for competing risk data with a cure fraction. Copyright © 2017 John Wiley & Sons, Ltd.

  6. Psychological aspects of nuclear waste disposal: Long time perception and the question of discounting of risks

    International Nuclear Information System (INIS)

    Karlsson, G.; Svenson, O.

    1988-01-01

    Subjects of different ages and basic training indicated how they perceived risks related to spent nuclear fuel storage and located at different points of time into the future. The results indicated that minorities in all groups, ranging from about 10 to 40%, did not want to discount risks into the future. Those who discounted exhibited great inter and intra group variability. The physical discounting curves for e.g. both total radiation and for Pu-239 and -240 are within the range of curves generated by the groups for subjective discounting of risk. Politicians and experts were attributed equal shares of responsibility for risks of spent nuclear fuel in the future. About 10% to 40% of the subjects did not wish to discount responsibility. Discounting rates for those discounting varied so that some subjects decreased the level of responsibility to less than half 10 000 years into the future while others attributed this level of responsibility for 100 000 years and more. (orig./HP)

  7. The risk of cardiovascular events during leisure time activities at altitude.

    Science.gov (United States)

    Burtscher, Martin; Ponchia, Andrea

    2010-01-01

    Annually, more than 100 million tourists are attracted by the mountainous areas around the world. On the one hand, leisure time activities at altitude may well contribute to the well-established beneficial effects of exercise; on the other hand, these activities are also associated with a relatively high risk of death. Sudden cardiac death (SCD) is the most frequent cause of nontraumatic death in males older than 34 years at altitude during leisure time activities such as downhill skiing and hiking. Whereas prior myocardial infarction is the most important risk factor for SCD, particularly relevant in downhill skiers, the unusual physical activity during the first days at altitude and the prolonged abstinence from food and fluid intake during exercise at altitude are the most important triggers. Unaccustomed physical activity seems more likely to trigger SCD than altitude per se. The detection of subjects at risk, evidence-based therapy, and advice on adequate behavior during the altitude sojourn will help to prevent SCD and to increase the health benefits generated by mountaineering activities.

  8. Monitoring risk-adjusted medical outcomes allowing for changes over time.

    Science.gov (United States)

    Steiner, Stefan H; Mackay, R Jock

    2014-10-01

    We consider the problem of monitoring and comparing medical outcomes, such as surgical performance, over time. Performance is subject to change due to a variety of reasons including patient heterogeneity, learning, deteriorating skills due to aging, etc. For instance, we expect inexperienced surgeons to improve their skills with practice. We propose a graphical method to monitor surgical performance that incorporates risk adjustment to account for patient heterogeneity. The procedure gives more weight to recent outcomes and down-weights the influence of outcomes further in the past. The chart is clinically interpretable as it plots an estimate of the failure rate for a "standard" patient. The chart also includes a measure of uncertainty in this estimate. We can implement the method using historical data or start from scratch. As the monitoring proceeds, we can base the estimated failure rate on a known risk model or use the observed outcomes to update the risk model as time passes. We illustrate the proposed method with an example from cardiac surgery. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Benefits of leisure-time physical activity on the cardiovascular risk profile at older age.

    Science.gov (United States)

    Mensink, G B; Ziese, T; Kok, F J

    1999-08-01

    Intensity, frequency and duration of physical activity may contribute in different ways to the maintenance of cardiovascular health. Their relative importance may also change at different stages in life and this should be taken into account for activity recommendations. The relationship of frequency and duration of leisure-time physical activities with cardiovascular risk factors was studied in 4942 male and 5885 female participants aged 50-69, of the German Cardiovascular Prevention Study (1984-1991). After adjustment for several possible confounders, women with modest levels (2-12 times per month, 0.5-2 h per week) of moderate-to-vigorous activity (> or =5 kcal/kg/h) had significantly lower systolic blood pressure (-1.8%), resting heart rate (-3.1%) and body mass index (-3.2%) values than sedentary women. Beneficial differences increased with frequency and duration of activity. Light activities (3-4.5 kcal/kg/h), conducted > or =5 times a week, were significantly associated with favourable lower diastolic blood pressure (-1.4%), resting heart rate (-2.3%) among women, and body mass index (women -2.9%, men -2.2%) among both genders. Recommended activity levels (> or =5 times, > or =3.5 h weekly) were associated with a lower prevalence of multiple risk factors (odds ratio [OR] = 0.55, 95% CI: 0.41-0.75 for men and OR = 0.44 95% CI: 0.31-0.63 for women). For sedentary elderly, even less physical activity than currently recommended, is likely to improve the cardiovascular risk profile.

  10. The time to ruin in some additive risk models with random premium rates

    DEFF Research Database (Denmark)

    Jacobsen, Martin

    2012-01-01

    to have a Laplace transform that is a rational function. The main results describe the joint Laplace transform of the time at ruin and the deficit at ruin. The method used consists in finding partial eigenfunctions for the generator of the joint process consisting of the Markov process and the accumulated...... of the present value of the Markov process. The intensity for a claim to occur is another nonnegative function of the value of the Markov process. The claim arrival times are the regeneration times for the Markov process. Two-sided claims are allowed, but the distribution of the positive claims is assumed......The risk processes considered in this paper are generated by an underlying Markov process with a regenerative structure and an independent sequence of independent and identically distributed claims. Between the arrivals of claims the process increases at a rate which is a nonnegative function...

  11. Using ensemble weather forecast in a risk based real time optimization of urban drainage systems

    DEFF Research Database (Denmark)

    Courdent, Vianney Augustin Thomas; Vezzaro, Luca; Mikkelsen, Peter Steen

    2015-01-01

    Global Real Time Control (RTC) of urban drainage system is increasingly seen as cost-effective solution in order to respond to increasing performance demand (e.g. reduction of Combined Sewer Overflow, protection of sensitive areas as bathing water etc.). The Dynamic Overflow Risk Assessment (DORA......) strategy was developed to operate Urban Drainage Systems (UDS) in order to minimize the expected overflow risk by considering the water volume presently stored in the drainage network, the expected runoff volume based on a 2-hours radar forecast model and an estimated uncertainty of the runoff forecast....... However, such temporal horizon (1-2 hours) is relatively short when used for the operation of large storage facilities, which may require a few days to be emptied. This limits the performance of the optimization and control in reducing combined sewer overflow and in preparing for possible flooding. Based...

  12. 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

  13. Skin complications in deep brain stimulation for Parkinson's disease: frequency, time course, and risk factors.

    Science.gov (United States)

    Sixel-Döring, Friederike; Trenkwalder, Claudia; Kappus, Christoph; Hellwig, Dieter

    2010-02-01

    Deep brain stimulation (DBS) has been recognized as an efficacious treatment for movement disorders. Its beneficial effects however may be lost due to skin complications such as erosions or infections over the implanted foreign material. We sought to document skin complications in the entire Parkinson's disease patient population who received a DBS system at the Marburg/Kassel implantation centre since the start of our DBS program in January 2002 to analyze frequency, time course, and possible risk factors. We investigated 85 consecutive patients with Parkinson's disease (PD) from a single center/single surgeon DBS series for the occurrence of skin complications and analyzed localization, time course, and possible risk factors. Mean follow-up was 3 years (range 1-7 years). In total, 21/85 patients (24.7%) suffered a total of 30 single skin complications. Sixty percent of all incidents occurred within the first post-operative year. Forty percent of all incidents occurred later than the first year following primary implantation. Complications involved the burr hole cap in 37%, the course of the cables in 33%, and the impulse generator (IPG) site in 30%. Six of 21 patients suffered recurring skin complications. Eight patients permanently lost their DBS system. Factor analysis for age, gender, disease duration, disease severity, the incidence of hypertension or diabetes as well as a 2-day period with externalized electrodes for continuous test stimulation did not have any statistically significant impact on skin complications. We conclude that (1) PD patients have a risk for skin complications after DBS as long as the system remains in situ and (2) there are at present no identifiable risk factors for skin complications after DBS, other than PD itself.

  14. Sleep duration and cancer risk: time to use a "sleep-years" index?

    Science.gov (United States)

    Erren, Thomas C

    2012-09-01

    With a focus on melatonin, a recent paper in the Journal investigated the hypothesis that endometrial cancer might be associated with the duration, and ultimately, amount of sleep. The authors found that "[s]elf-reported sleep duration may not adequately represent melatonin levels." The authors also concluded that there was "weak evidence of an association between sleep duration and endometrial cancer risk." Overall, these are interesting observations because primarily experimental and mechanistic research from many angles supports the study's notion that inappropriate sleep may be a determinant of cancer risk. To find out whether this is so in man, rather than assigning study individuals to fixed or average "baseline sleep categories" i.e., ≤5, 6, 7, 8, ≥9 h of habitual sleep in the present study, the accumulated amount of sleep over decades should be reconstructed in retrospective or constructed in prospective studies. To achieve this end, future epidemiological studies may want to use a sleep-years index [SYI]. This simple exposure parameter promises to be a sensible, feasible, and affordable way to approximate cumulative time spent at sleep in critical time windows over many years which we should expect to be relevant for the development of cancer. The SYI could be tested and used in observational studies which promise to be comparable and can be merged. This commentary provides roots of the index and explains why and how it should be used and how it could be interpreted in rigorous studies of biologically plausible links between sleep, on the one hand, and the development of internal cancers, on the other. This commentary also points out limitations of interpreting the SYI. It is emphasized that, where possible, the SYI should be assessed independently of (a) other sleep facets--such as quality--and of (b) known or suspected cancer risk factors. The respective contribution of (a) and (b) to risk must then be assessed during the analyses. Overall, the

  15. Do you want the good news or the bad news? Gain- versus loss-framed messages following health risk information: The effects on leisure time physical activity beliefs and cognitions.

    Science.gov (United States)

    Bassett-Gunter, Rebecca L; Martin Ginis, Kathleen A; Latimer-Cheung, Amy E

    2013-12-01

    The primary purpose was to examine the relative effectiveness of chronic disease and psychological health risk information combined with gain- versus loss-framed leisure time physical activity (LTPA) messages for changing perceived personal risk, LTPA response efficacy (i.e., the belief that LTPA can effectively reduce risk), and LTPA intentions. A secondary purpose was to explore the relationship between message framing and cognitive processing. Baseline assessments of perceived risk for inactivity-related disease and psychological health problems, LTPA response efficacy, and intentions were measured among 96 individuals with spinal cord injury (SCI). Participants read population-specific information about the risk for inactivity-related disease and psychological health problems following SCI, and perceived risk was reassessed. Participants were then randomized to read LTPA response efficacy messages emphasizing the benefits of LTPA (gain framed) or the risks of inactivity (loss framed). Immediately following message exposure, cognitive processing (i.e., thought listing and message recall), LTPA response efficacy, and LTPA intentions were assessed. Changes in perceived risk were observed following exposure to health risk information. Changes in LTPA response efficacy and intentions were greater following loss-framed messages targeting psychological health compared with gain-framed messages. Greater cognitive processing was observed following loss-framed messages compared with gain-framed messages. Following exposure to psychological health risk information, loss-framed messages may be more effective than gain-framed messages for eliciting cognitive processing and changing LTPA beliefs and intentions.

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

    Science.gov (United States)

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

    2015-04-01

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

  17. Fall prevalence, time trend and its related risk factors among elderly people in China.

    Science.gov (United States)

    Wu, Hong; Ouyang, Peng

    2017-11-01

    To study the fall prevalence, time trends and related risk factors among elderly people in the Chinese mainland from 2011 to 2013. Our data were from China Health and Retirement Longitudinal Study in 2011 and 2013. The population sample included people aged 60 years and over. Whether the person had experienced fall accident in the last two years was used to measure fall incidence. The time trend and age groups were investigated through the chi-square test. The related risk factors were examined based on the binary logistic regression model. In 2011, 19.64% (95% CI, 18.66%, 20.67%) of elderly people experienced fall incidents and in 2013, 19.28% (95% CI, 18.46%, 20.13%) of elderly people experienced fall incidents. However, no significant difference was seen in the fall prevalence between 2011 and 2013. The fall prevalence among elderly people aged 66-70 declined significantly while that among people aged over 80 showed an increasing time trend. The fall prevalence was affected significantly by factors including age (66-70), gender, marital status, self-rated health, quantity of chronic diseases, quantity of disability items, activities of daily living and physical functioning. It is revealed the fall prevalence showed no increment from 2011 to 2013 but at a high level. More efforts should be made to reduce the fall prevalence, and special attention should be paid to the elderly people aged over 80 and older. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Risk profiles and peer violence in the context of school and leisure time.

    Science.gov (United States)

    Pulido Valero, Rosa; Martín Seoane, Gema; Lucas Molina, Beatriz

    2011-11-01

    Though violence at school is by no means a new phenomenon, there has been growing social and scientific concern about this issue in recent years. The present study builds on prior analysis of the roles adolescents play in peer harassment, and the relationship between violence occurring at school and during free time. A representative sample of students between the ages of 14 and 18 was selected in the Community of Madrid (N = 1622) through random cluster sampling (school was the unit of analysis). Participants completed the C.E.V.E.O. questionnaire, which presents fifteen situations involving peer violence. The results reveal a relationship between violent situations occurring at school and during free time, and between the roles of aggressor and victim during free time. A profile analysis yielded three different categories: the "minimal violence exposure" type (1126 adolescents), the "psychological violence exposure" type (413 adolescents), and the "high risk of violence" type (83 adolescents). Judging from these results, we posit that interventions must be designed which tailor to each group and their respective risk situations.

  19. Diet quality is associated with leisure-time physical activity in individuals at cardiometabolic risk.

    Science.gov (United States)

    Monfort-Pires, Milena; Salvador, Emanuel P; Folchetti, Luciana D; Siqueira-Catania, Antonela; Barros, Camila R; Ferreira, Sandra Roberta Gouvea

    2014-01-01

    We investigated whether diet quality was associated with leisure-time physical activity (LTPA) and television viewing and the associations of these variables with traditional cardiovascular risk factors and novel biomarkers in individuals at cardiometabolic risk. A total of 193 prediabetic adults (63.7% women, mean age 54.1 years), screened for a diabetes prevention program in Brazil, participated in this cross-sectional study. Clinical data and blood samples were collected for several determinations. Twenty-four-hour recalls were used to calculate the Healthy Eating Index (HEI) adapted to Brazilian dietary habits and the International Physical Activity Questionnaire to assess physical activity level. Analysis of covariance with adjustments for age and body mass index (BMI) was employed to test associations across categories of LTPA and television viewing. Stratifying according to LTPA categories, the most active subset (≥150 minutes/week) showed better HEI scores after adjustments (64.6 ± 11.0, 65.1 ± 10.3, and 68.6 ± 10.8, p = 0.02) and significant higher values of dark green and orange vegetables but not of whole grains (p = 0.06). Active individuals had lower BMI, waist circumference, inflammatory markers, and better insulin sensitivity (p physical activity [PA]), with those with unhealthy habits revealing better anthropometric and cardiometabolic profiles in the former group. Diet quality assessed by the HEI adapted for Brazilian eating habits attained significance in differentiating more active from inactive at-risk individuals during leisure time. Time watching television, as a surrogate of sedentary behavior, is not useful to detect unhealthy diet quality. LTPA is indicative of better cardiometabolic profile reflected by lipid and inflammatory markers and index of insulin resistance.

  20. Persistent organic pollutants in breast milk of primiparae and multiparae Mothers sampled from three health facilities in the Greater Accra and Central Regions of Ghana: Levels of Contamination, Influencing factors and infant risk assessment

    International Nuclear Information System (INIS)

    Blankson-Arthur, Sarah

    2016-07-01

    Human Breast milk is the optimal source of nutrition for babies and infants during the first six (6) months following birth. Breast milk protects the infants against diseases and infections. Interestingly, because breast milk is a lipid-rich tissue, it attracts, retains and accumulates lipophilic contaminants like persistent organic pollutants (POPs) from the ambient environment. The lipophilic contaminant load of the mother’s breast milk is subsequently, transferred to the breast-fed child. This makes breast milk an important biological matrix for the monitoring of the lactating mother’s body burden of persistent organic pollutants (POPs). The study, assessed the levels of persistent organic pollutants (POPs) [polychlorinated biphenyls (PCBs) and organochlorine pesticide (OCPs)] in the breast milk of lactating mothers (primiparae and multiparae) who reside within the catchment areas and attend child welfare clinic at one of three health facilities in Southern Ghana [Princess Marie Louis (PML) Children Hospital (Korle Wokon, Accra Central); GAEC Hospital (Kwabenya, Accra); and Gomoa Brofo Community based Health and Planning Services, (Gomoa Brofo, Gomoa West district, Central region)]. The study also evaluated the factors (age of lactating mothers, parity and area of residence) influencing the accumulation of the POPs; and, in addition, assessed the potential health risk associated with the ingestion of breast milk by the infants through estimation of the infant’s daily intakes and hazard quotient. A total of two hundred and eighty-eight (288) healthy lactating mothers between the ages of 17-38 years from the three sampling locations [PML (135), GAEC (112), CHPS (41)] were selected for the study based on questionnaires administered to obtain information on the mothers [personal characteristics, number of births (parity), age, weight, height and body mass index (BMI)]. The non-invasive sampling technique was used for the collection of breast milk samples. Gas

  1. Asphyxia-related risk factors and their timing in spastic cerebral palsy

    DEFF Research Database (Denmark)

    Nielsen, Lene F.; Schendel, Diana; Grove, Jakob

    2008-01-01

    Objective To investigate the association of asphyxia-related conditions (reducing blood flow or blood oxygen levels in the fetus) with spastic cerebral palsy (CP) considering different gestational age groups and the timing of risk. Design Population-based case-control study. Setting Danish Cerebral...... Palsy Register in eastern Denmark and Danish Medical Birth Register. Population or Sample 271 singletons with spastic CP and 217 singleton controls, frequency matched by gestational age group, born 1982-1990 in eastern Denmark. Methods Data were abstracted from medical records, and a priori asphyxia...

  2. Cost, Time, and Risk Assessment of Different Wave Energy Converter Technology Development Trajectories: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Jochem W [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Laird, Daniel [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Costello, Ronan [Wave Venture; Roberts, Jesse [Sandia National Laboratories; Bull, Diana [Sandia National Laboratories; Babarit, Aurelien [Ecole Centrale de Nantes; Nielsen, Kim [Ramboll; Ferreira, Claudio Bittencourt [DNV-GL; Kennedy, Ben [Wave Venture

    2017-09-14

    This paper presents a comparative assessment of three fundamentally different wave energy converter technology development trajectories. The three technology development trajectories are expressed and visualised as a function of technology readiness levels and technology performance levels. The assessment shows that development trajectories that initially prioritize technology readiness over technology performance are likely to require twice the development time, consume a threefold of the development cost, and are prone to a risk of technical or commercial failure of one order of magnitude higher than those development trajectories that initially prioritize technology performance over technology readiness.

  3. Identifying Some Risk Factors for the Time to Death of the Elderly Using the Semi-Parametric Blended Model of Survival Analysis With Competing Risks

    Directory of Open Access Journals (Sweden)

    Samane Hajiabbasi

    2018-01-01

    Conclusion In single-variable fitting, age, history of myocardial infarction, history of stroke, and kidney problems were identified to have significant effects on the time to death of the elderly. Based on one-variable semi-parametric competing risk mixture fitted models, more significant risk factors for the time to death of elderly was identified when compared with a fitted multivariate mode to the data. This implies that the role of some independent variables can be explained by other independent variables.

  4. Does the Duration and Time of Sleep Increase the Risk of Allergic Rhinitis? Results of the 6-Year Nationwide Korea Youth Risk Behavior Web-Based Survey

    OpenAIRE

    Kwon, Jeoung A.; Lee, Minjee; Yoo, Ki-Bong; Park, Eun-Cheol

    2013-01-01

    Allergic rhinitis (AR) is the most common chronic disorder in the pediatric population. Although several studies have investigated the correlation between AR and sleep-related issues, the association between the duration and time of sleep and AR has not been analyzed in long-term national data. This study investigated the relationship between sleep time and duration and AR risk in middle- and high-school students (adolescents aged 12-18). We analyzed national data from the Korea Youth Risk Be...

  5. Modelling BSE trend over time in Europe, a risk assessment perspective.

    Science.gov (United States)

    Ducrot, Christian; Sala, Carole; Ru, Giuseppe; de Koeijer, Aline; Sheridan, Hazel; Saegerman, Claude; Selhorst, Thomas; Arnold, Mark; Polak, Miroslaw P; Calavas, Didier

    2010-06-01

    BSE is a zoonotic disease that caused the emergence of variant Creuzfeldt-Jakob disease in the mid 1990s. The trend of the BSE epidemic in seven European countries was assessed and compared, using Age-Period-Cohort and Reproduction Ratio modelling applied to surveillance data 2001-2007. A strong decline in BSE risk was observed for all countries that applied control measures during the 1990s, starting at different points in time in the different countries. Results were compared with the type and date of the BSE control measures implemented between 1990 and 2001 in each country. Results show that a ban on the feeding of meat and bone meal (MBM) to cattle alone was not sufficient to eliminate BSE. The fading out of the epidemic started shortly after the complementary measures targeted at controlling the risk in MBM. Given the long incubation period, it is still too early to estimate the additional effect of the ban on the feeding of animal protein to all farm animals that started in 2001. These results provide new insights in the risk assessment of BSE for cattle and Humans, which will especially be useful in the context of possible relaxing BSE surveillance and control measures.

  6. A real-time heat strain risk classifier using heart rate and skin temperature

    International Nuclear Information System (INIS)

    Buller, Mark J; Latzka, William A; Yokota, Miyo; Tharion, William J; Moran, Daniel S

    2008-01-01

    Heat injury is a real concern to workers engaged in physically demanding tasks in high heat strain environments. Several real-time physiological monitoring systems exist that can provide indices of heat strain, e.g. physiological strain index (PSI), and provide alerts to medical personnel. However, these systems depend on core temperature measurement using expensive, ingestible thermometer pills. Seeking a better solution, we suggest the use of a model which can identify the probability that individuals are 'at risk' from heat injury using non-invasive measures. The intent is for the system to identify individuals who need monitoring more closely or who should apply heat strain mitigation strategies. We generated a model that can identify 'at risk' (PSI ≥ 7.5) workers from measures of heart rate and chest skin temperature. The model was built using data from six previously published exercise studies in which some subjects wore chemical protective equipment. The model has an overall classification error rate of 10% with one false negative error (2.7%), and outperforms an earlier model and a least squares regression model with classification errors of 21% and 14%, respectively. Additionally, the model allows the classification criteria to be adjusted based on the task and acceptable level of risk. We conclude that the model could be a valuable part of a multi-faceted heat strain management system. (note)

  7. Occupational and leisure time physical activity and the risk of nonfatal acute myocardial infarction in Italy.

    Science.gov (United States)

    Altieri, Andrea; Tavani, Alessandra; Gallus, Silvano; La Vecchia, Carlo

    2004-08-01

    Physical activity has long been related to a reduced risk of coronary heart disease (CHD), including acute myocardial infarction (AMI). However, the quantitative estimates of the possible protective role of physical activity appear to vary across studies and populations. A case-control study conducted in Italy between 1995 and 1999, including 507 incident cases below 79 years (378 men, 129 women) with a first episode of AMI, and 478 controls (297 men, 181 women) admitted to hospitals for acute conditions. Compared with the lowest level of occupational physical activity, the multivariate odds ratios (OR) of AMI for the highest level were 0.61 (95% confidence interval [CI], 0.38-0.97) at age 15 to 19 years, 0.57 (95% CI, 0.34-0.95) at age 30 to 39 years, and 0.51 (95% CI, 0.29-0.90) at age 50 to 59 years. The corresponding values for leisure time activity were 0.54 (95% CI, 0.38-0.77), 0.86 (95% CI, 0.57-1.30), and 1.00 (95% CI, 0.57-1.74), respectively. The association was consistent across strata of age, sex, education, smoking, and other selected covariates. The attributable risk for low occupational exercise at age 30 to 39 years was over 10%, indicating the scope for further intervention on this modifiable risk factor in this Italian population, particularly in consideration of the public health importance of CHD.

  8. Adverse radiation effect after stereotactic radiosurgery for brain metastases: incidence, time course, and risk factors.

    Science.gov (United States)

    Sneed, Penny K; Mendez, Joe; Vemer-van den Hoek, Johanna G M; Seymour, Zachary A; Ma, Lijun; Molinaro, Annette M; Fogh, Shannon E; Nakamura, Jean L; McDermott, Michael W

    2015-08-01

    The authors sought to determine the incidence, time course, and risk factors for overall adverse radiation effect (ARE) and symptomatic ARE after stereotactic radiosurgery (SRS) for brain metastases. All cases of brain metastases treated from 1998 through 2009 with Gamma Knife SRS at UCSF were considered. Cases with less than 3 months of follow-up imaging, a gap of more than 8 months in imaging during the 1st year, or inadequate imaging availability were excluded. Brain scans and pathology reports were reviewed to ensure consistent scoring of dates of ARE, treatment failure, or both; in case of uncertainty, the cause of lesion worsening was scored as indeterminate. Cumulative incidence of ARE and failure were estimated with the Kaplan-Meier method with censoring at last imaging. Univariate and multivariate Cox proportional hazards analyses were performed. Among 435 patients and 2200 brain metastases evaluable, the median patient survival time was 17.4 months and the median lesion imaging follow-up was 9.9 months. Calculated on the basis of 2200 evaluable lesions, the rates of treatment failure, ARE, concurrent failure and ARE, and lesion worsening with indeterminate cause were 9.2%, 5.4%, 1.4%, and 4.1%, respectively. Among 118 cases of ARE, approximately 60% were symptomatic and 85% occurred 3-18 months after SRS (median 7.2 months). For 99 ARE cases managed without surgery or bevacizumab, the probabilities of improvement observed on imaging were 40%, 57%, and 76% at 6, 12, and 18 months after onset of ARE. The most important risk factors for ARE included prior SRS to the same lesion (with 20% 1-year risk of symptomatic ARE vs 3%, 4%, and 8% for no prior treatment, prior whole brain radiotherapy [WBRT], or concurrent WBRT) and any of these volume parameters: target, prescription isodose, 12-Gy, or 10-Gy volume. Excluding lesions treated with repeat SRS, the 1-year probabilities of ARE were 2.1 cm, target volume > 1.2 cm(3), prescription isodose volume > 1.8 cm(3

  9. Storage time of platelet concentrates and risk of a positive blood culture

    DEFF Research Database (Denmark)

    Kreuger, Aukje L; Rostgaard, Klaus; Middelburg, Rutger A

    2018-01-01

    BACKGROUND: Concern of transfusion-transmitted bacterial infections has been the major hurdle to extend shelf life of platelet (PLT) concentrates. We aimed to investigate the association between storage time and risk of positive blood cultures at different times after transfusion. STUDY DESIGN...... AND METHODS: We performed a nationwide cohort study among PLT transfusion recipients in Denmark between 2010 and 2012, as recorded in the Scandinavian Donations and Transfusions (SCANDAT2) database. Linking with a nationwide database on blood cultures (MiBa), we compared the incidence of a positive blood......) of a positive blood culture the day after transfusion of at least one old PLT concentrate was 0.77 (95% confidence interval [CI], 0.54-1.09) compared to transfusion of fresh PLT concentrates. The incidence rate of a positive blood culture was lower the day after receiving one old compared to one fresh PLT...

  10. Youth screen-time behaviour is associated with cardiovascular risk in young adulthood

    DEFF Research Database (Denmark)

    Grøntved, Anders; Ried-Larsen, Mathias; Møller, Niels Christian

    2014-01-01

    = 435) followed for up to 12 years. Adiposity, blood pressure (BP), triglycerides, high-density lipoprotein (HDL), glucose, insulin, and self-reported TV viewing and computer use were obtained in adolescence and in young adulthood. A continuous metabolic syndrome z-score was calculated as the sum...... of standardized values of each risk factor (inverse of HDL). In multivariable-adjusted analyses, TV viewing and total screen time in adolescence were positively associated with adiposity, triglycerides, and metabolic syndrome z-score in young adulthood (p ..., computer use, or total screen time with more than 2 hours/day from adolescence to young adulthood had 0.90 (95% CI 0.12 to 1.69), 0.95 (95% CI 0.01 to 1.88), and 1.40 (95% CI 0.28 to 2.51) kg/m(2) higher body mass index, respectively, in young adulthood compared with individuals who remained stable...

  11. Accelerated failure time models for semi-competing risks data in the presence of complex censoring.

    Science.gov (United States)

    Lee, Kyu Ha; Rondeau, Virginie; Haneuse, Sebastien

    2017-12-01

    Statistical analyses that investigate risk factors for Alzheimer's disease (AD) are often subject to a number of challenges. Some of these challenges arise due to practical considerations regarding data collection such that the observation of AD events is subject to complex censoring including left-truncation and either interval or right-censoring. Additional challenges arise due to the fact that study participants under investigation are often subject to competing forces, most notably death, that may not be independent of AD. Towards resolving the latter, researchers may choose to embed the study of AD within the "semi-competing risks" framework for which the recent statistical literature has seen a number of advances including for the so-called illness-death model. To the best of our knowledge, however, the semi-competing risks literature has not fully considered analyses in contexts with complex censoring, as in studies of AD. This is particularly the case when interest lies with the accelerated failure time (AFT) model, an alternative to the traditional multiplicative Cox model that places emphasis away from the hazard function. In this article, we outline a new Bayesian framework for estimation/inference of an AFT illness-death model for semi-competing risks data subject to complex censoring. An efficient computational algorithm that gives researchers the flexibility to adopt either a fully parametric or a semi-parametric model specification is developed and implemented. The proposed methods are motivated by and illustrated with an analysis of data from the Adult Changes in Thought study, an on-going community-based prospective study of incident AD in western Washington State. © 2017, The International Biometric Society.

  12. Risk assessment of environmentally influenced airway diseases based on time-series analysis.

    Science.gov (United States)

    Herbarth, O

    1995-09-01

    Threshold values are of prime importance in providing a sound basis for public health decisions. A key issue is determining threshold or maximum exposure values for pollutants and assessing their potential health risks. Environmental epidemiology could be instrumental in assessing these levels, especially since the assessment of ambient exposures involves relatively low concentrations of pollutants. This paper presents a statistical method that allows the determination of threshold values as well as the assessment of the associated risk using a retrospective, longitudinal study design with a prospective follow-up. Morbidity data were analyzed using the Fourier method, a time-series analysis that is based on the assumption of a high temporal resolution of the data. This method eliminates time-dependent responses like temporal inhomogeneity and pseudocorrelation. The frequency of calls for respiratory distress conditions to the regional Mobile Medical Emergency Service (MMES) in the city of Leipzig were investigated. The entire population of Leipzig served as a pool for data collection. In addition to the collection of morbidity data, air pollution measurements were taken every 30 min for the entire study period using sulfur dioxide as the regional indicator variable. This approach allowed the calculation of a dose-response curve for respiratory diseases and air pollution indices in children and adults. Significantly higher morbidities were observed above a 24-hr mean value of 0.6 mg SO2/m3 air for children and 0.8 mg SO2/m3 for adults.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Risk-based design of process systems using discrete-time Bayesian networks

    International Nuclear Information System (INIS)

    Khakzad, Nima; Khan, Faisal; Amyotte, Paul

    2013-01-01

    Temporal Bayesian networks have gained popularity as a robust technique to model dynamic systems in which the components' sequential dependency, as well as their functional dependency, cannot be ignored. In this regard, discrete-time Bayesian networks have been proposed as a viable alternative to solve dynamic fault trees without resort to Markov chains. This approach overcomes the drawbacks of Markov chains such as the state-space explosion and the error-prone conversion procedure from dynamic fault tree. It also benefits from the inherent advantages of Bayesian networks such as probability updating. However, effective mapping of the dynamic gates of dynamic fault trees into Bayesian networks while avoiding the consequent huge multi-dimensional probability tables has always been a matter of concern. In this paper, a new general formalism has been developed to model two important elements of dynamic fault tree, i.e., cold spare gate and sequential enforcing gate, with any arbitrary probability distribution functions. Also, an innovative Neutral Dependency algorithm has been introduced to model dynamic gates such as priority-AND gate, thus reducing the dimension of conditional probability tables by an order of magnitude. The second part of the paper is devoted to the application of discrete-time Bayesian networks in the risk assessment and safety analysis of complex process systems. It has been shown how dynamic techniques can effectively be applied for optimal allocation of safety systems to obtain maximum risk reduction.

  14. Public awareness and disaster risk reduction: just-in-time networks and learning.

    Science.gov (United States)

    Ardalan, Ali; Linkov, Faina; Shubnikov, Eugene; LaPorte, Ronald E

    2008-01-01

    Improving public awareness through education has been recognized widely as a basis for reducing the risk of disasters. Some of the first disaster just-in-time (JIT) education modules were built within 3-6 days after the south Asia tsunami, Hurricane Katrina, and the Bam, Pakistan, and Indonesia earthquakes through a Supercourse. Web monitoring showed that visitors represented a wide spectrum of disciplines and educational levels from 120 developed and developing countries. Building disaster networks using an educational strategy seizes the opportunity of increased public interest to teach and find national and global expertise in hazard and risk information. To be effective, an expert network and a template for the delivery of JIT education must be prepared before an event occurs, focusing on developing core materials that could be customized rapidly, and then be based on the information received from a recent disaster. The recyclable process of the materials would help to improve the quality of the teaching, and decrease the time required for preparation. The core materials can be prepared for disasters resulting from events such as earthquakes, hurricanes, tsunamis, floods, and bioterrorism.

  15. A simple model for discounting radiation health effects risks with time

    International Nuclear Information System (INIS)

    Sandquist, G.M.; Rogers, V.C.

    1988-01-01

    In estimating human health effects resulting from ionizing radiation exposures, it is often assumed that the age of the person at the time of exposure and the latency period for the appearance of any associated health effects are values that maximize the consequences of the exposure. Such assumptions are obviously conservative, but they can result in distortions and errors when nondiscounted radiation-related health effects arising from nonradiation-related risks. Human life expectancy obviously decreases with age, and the latency period for radiation-related health effects can range from a few years to several decades. For example, if a man is 45 yr old at the time of exposure and this exposure results in a lethal health effect 20 yr after exposure, then the expected number of years of life loss is ∼5 yr and not 70 yr, as is commonly assumed in radiation risk assessment studies. If one full-health effect is equivalent to 70 person-yr, then this example exposure results in only 0.07 full-health effects

  16. Model-based measurement of latent risk in time series with applications.

    NARCIS (Netherlands)

    Bijleveld, F.D. Commandeur, J.J.F. Gould, P. & Koopman, S.J.

    2008-01-01

    Risk is at the centre of many policy decisions in companies, governments and other institutions.The risk of road fatalities concerns local governments in planning countermeasures, the risk and severity of counterparty default concerns bank risk managers daily and the risk of infection has actuarial

  17. Model-based measurement of latent risk in time series with applications.

    NARCIS (Netherlands)

    Bijleveld, F.D. Commandeur, J.J.F. Gould, P. & Koopman, S.J.

    2006-01-01

    Risk is at the center of many policy decisions in companies, governments and other institutions. The risk of road fatalities concerns local governments in planning counter- measures, the risk and severity of counterparty default concerns bank risk managers on a daily basis and the risk of infection

  18. Protective effect of time spent walking on risk of stroke in older men.

    Science.gov (United States)

    Jefferis, Barbara J; Whincup, Peter H; Papacosta, Olia; Wannamethee, S Goya

    2014-01-01

    Older adults have the highest risks of stroke and the lowest physical activity levels. It is important to quantify how walking (the predominant form of physical activity in older age) is associated with stroke. A total of 4252 men from a UK population-based cohort reported usual physical activity (regular walking, cycling, recreational activity, and sport) in 1998 to 2000. Nurses took fasting blood samples and made anthropometric measurements. Among 3435 ambulatory men free from cardiovascular disease and heart failure in 1998 to 2000, 195 first strokes occurred during 11-year follow-up. Men walked a median of 7 (interquartile range, 3-12) hours/wk; walking more hours was associated with lower heart rate, D-dimer, and higher forced expiratory volume in 1 second. Compared with men walking 0 to 3 hours/wk, men walking 4 to 7, 8 to 14, 15 to 21, and >22 hours had age- and region-adjusted hazard ratios (95% confidence intervals) for stroke of 0.89 (0.60-1.31), 0.63 (0.40-1.00), 0.68 (0.35-1.32), and 0.36 (0.14-0.91), respectively, P (trend)=0.006. Hazard ratios were somewhat attenuated by adjustment for established and novel risk markers (inflammatory and hemostatic markers and cardiac function [N-terminal pro-brain natriuretic peptide]) and walking pace, but linear trends remained. There was little evidence for a dose-response relationship between walking pace and stroke; comparing average pace or faster to a baseline of slow pace, the hazard ratio for stroke was 0.65 (95% confidence interval, 0.44-0.97), which was fully mediated by time spent walking. Time spent walking was associated with reduced risk of onset of stroke in dose-response fashion, independent of walking pace. Walking could form an important part of stroke-prevention strategies in older people.

  19. Workplace exposure to nanoparticles and the application of provisional nanoreference values in times of uncertain risks

    Science.gov (United States)

    van Broekhuizen, Pieter; van Broekhuizen, Fleur; Cornelissen, Ralf; Reijnders, Lucas

    2012-03-01

    Nano reference values (NRVs) for occupational use of nanomaterials were tested as provisional substitute for Occupational Exposure Limits (OELs). NRVs can be used as provisional limit values until Health-Based OELs or derived no-effect levels (DNEL) become available. NRVs were defined for 8 h periods (time weighted average) and for short-term exposure periods (15 min-time weighted average). To assess the usefulness of these NRVs, airborne number concentrations of nanoparticles (NPs) in the workplace environment were measured during paint manufacturing, electroplating, light equipment manufacturing, non-reflective glass production, production of pigment concentrates and car refinishing. Activities monitored were handling of solid engineered NPs (ENP), abrasion, spraying and heating during occupational use of nanomaterials (containing ENPs) and machining nanosurfaces. The measured concentrations are often presumed to contain ENPs as well as process-generated NPs (PGNP). The PGNP are found to be a significant source for potential exposure and cannot be ignored in risk assessment. Levels of NPs identified in workplace air were up to several millions of nanoparticles/cm3. Conventional components in paint manufacturing like CaCO3 and talc may contain a substantial amount of nanosized particulates giving rise to airborne nanoparticle concentrations. It is argued that risk assessments carried out for e.g. paint manufacturing processes using conventional non-nano components should take into account potential nanoparticle emissions as well. The concentrations measured were compared with particle-based NRVs and with mass-based values that have also been proposed for workers protection. It is concluded that NRVs can be used for risk management for handling or processing of nanomaterials at workplaces provided that the scope of NRVs is not limited to ENPs only, but extended to the exposure to process-generated NPs as well.

  20. Workplace exposure to nanoparticles and the application of provisional nanoreference values in times of uncertain risks

    International Nuclear Information System (INIS)

    Broekhuizen, Pieter van; Broekhuizen, Fleur van; Cornelissen, Ralf; Reijnders, Lucas

    2012-01-01

    Nano reference values (NRVs) for occupational use of nanomaterials were tested as provisional substitute for Occupational Exposure Limits (OELs). NRVs can be used as provisional limit values until Health-Based OELs or derived no-effect levels (DNEL) become available. NRVs were defined for 8 h periods (time weighted average) and for short-term exposure periods (15 min-time weighted average). To assess the usefulness of these NRVs, airborne number concentrations of nanoparticles (NPs) in the workplace environment were measured during paint manufacturing, electroplating, light equipment manufacturing, non-reflective glass production, production of pigment concentrates and car refinishing. Activities monitored were handling of solid engineered NPs (ENP), abrasion, spraying and heating during occupational use of nanomaterials (containing ENPs) and machining nanosurfaces. The measured concentrations are often presumed to contain ENPs as well as process-generated NPs (PGNP). The PGNP are found to be a significant source for potential exposure and cannot be ignored in risk assessment. Levels of NPs identified in workplace air were up to several millions of nanoparticles/cm 3 . Conventional components in paint manufacturing like CaCO 3 and talc may contain a substantial amount of nanosized particulates giving rise to airborne nanoparticle concentrations. It is argued that risk assessments carried out for e.g. paint manufacturing processes using conventional non-nano components should take into account potential nanoparticle emissions as well. The concentrations measured were compared with particle-based NRVs and with mass-based values that have also been proposed for workers protection. It is concluded that NRVs can be used for risk management for handling or processing of nanomaterials at workplaces provided that the scope of NRVs is not limited to ENPs only, but extended to the exposure to process-generated NPs as well.

  1. Cold Ischemia Time is an Important Risk Factor for Post-Liver Transplant Prolonged Length of Stay.

    Science.gov (United States)

    Pan, Evelyn T; Yoeli, Dor; Galvan, N Thao N; Kueht, Michael L; Cotton, Ronald T; O'Mahony, Christine A; Goss, John A; Rana, Abbas

    2018-02-24

    Risk analysis of cold ischemia time (CIT) in liver transplantation has largely focused on patient and graft survival. Post-transplant length of stay is a sensitive marker of morbidity and cost. We hypothesize that CIT is a risk factor for post-transplant prolonged length of stay (PLOS) and aim to conduct an hour-by-hour analysis of CIT and PLOS. We retrospectively reviewed all adult, first-time liver transplants between March 2002 and September 2016 in the United Network for Organ Sharing database. 67,426 recipients were categorized by hourly CIT increments. Multivariable logistic regression of PLOS (defined as > 30 days), CIT groups, and an extensive list of confounding variables was performed. Linear regression between length of stay and CIT as continuous variables was also performed. CIT 1-6 hours was protective against PLOS, while CIT greater than 7 hours was associated with increased odds for PLOS. The lowest odds for PLOS were observed with 1-2 (odds ratio (OR) = 0.65, 95% confidence interval (CI) 0.45-0.92) and 2-3 hours (OR = 0.65, 95% CI 0.55-0.78) of CIT. OR for PLOS steadily increased with increasing CIT, reaching the greatest odds for PLOS with 13-14 hours (OR = 2.05, 95% CI 1.57-2.67) and 15-16 hours (OR = 2.06, 95% CI 1.27-3.33) of CIT. Linear regression revealed a positive correlation between length of stay and cold ischemia time with a correlation coefficient of +0.35 (p < 0.001). Post-liver transplant length of stay is sensitive to CIT, with substantial increase in the odds of PLOS observed with nearly every additional hour of cold ischemia. We conclude that CIT should be minimized to protect against the morbidity and cost associated with post-transplant PLOS. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

  2. Appetite course over time and the risk of death in patients on chronic hemodialysis.

    Science.gov (United States)

    Bossola, Maurizio; Di Stasio, Enrico; Rosa, Fausto; Dominici, Loredana; Antocicco, Manuela; Pazzaglia, Costanza; Aprile, Irene; Tazza, Luigi

    2013-08-01

    Appetite in patients on chronic hemodialysis (HD) may be constantly very good/good or fair/poor or may fluctuate up and down over time. When constantly fair/poor, appetite has been shown to be associated with older age, more comorbidities, and more hospitalizations; however, it is unknown if it predicts survival. The aim of the present study was to assess appetite monthly for 6 months in patients on chronic HD and to determine if the course of appetite over time predicts mortality. Ninety-two HD patients were evaluated at baseline for appetite, nutritional and inflammatory markers, comorbid conditions, and Charlson's comorbidity index. Appetite assessment was repeated monthly for 6 consecutive months. Survival in relation with the course of appetite over time was determined. Appetite was constantly very good/good in 45 patients (Group 1), fair/poor/very poor in 30 (Group 2), and fluctuated in 17 (Group 3). Twenty-seven (29.3 %) patients died after a mean period of 28 ± 13 months. Overall, the mean survival time was 42.1 ± 1.2 months. For Groups 1, 2, and 3, the mean survival time was 46.1 ± 0.92, 37.9 ± 2.5, and 39.1 ± 3.7 months, respectively (p appetite over time was not found to be an independent risk factor for mortality. The course of appetite over time does not seem to predict mortality in patients on chronic hemodialysis. Considering that the study included a relatively small number of patients, larger similar studies are desirable.

  3. Time from first detectable PSA following radical prostatectomy to biochemical recurrence: A competing risk analysis

    Science.gov (United States)

    de Boo, Leonora; Pintilie, Melania; Yip, Paul; Baniel, Jack; Fleshner, Neil; Margel, David

    2015-01-01

    Introduction: In this study, we estimated the time from first detectable prostate-specific antigen (PSA) following radical prostatectomy (RP) to commonly used definitions of biochemical recurrence (BCR). We also identified the predictors of time to BCR. Methods: We identified subjects who underwent a RP and had an undetectable PSA after surgery followed by at least 1 detectable PSA between 2000 and 2011. The primary outcome was time to BCR (PSA ≥0.2 and successive PSA ≥0.2) and prediction of the rate of PSA rise. Outcomes were calculated using a competing risk analysis, with univariable and multivariable Fine and Grey models. We employed a mixed effect model to test clinical predictors that are associated with the rate of PSA rise. Results: The cohort included 376 patients. The median follow-up from surgery was 60.5 months (interquartile range [IQR] 40.8–91.5) and from detectable PSA was 18 months (IQR 11–32). Only 45.74% (n = 172) had PSA values ≥0.2 ng/mL, while 15.16% (n = 57) reached the PSA level of ≥0.4 ng/mL and rising. On multivariable analysis, the values of the first detectable PSA and pathologic Gleason grade 8 or higher were consistently independent predictors of time to BCR. In the mixed effect model rate, the PSA rise was associated with time from surgery to first detectable PSA, Gleason score, and prostate volume. The main limitation of this study is the large proportion of patients that received treatment without reaching BCR. It is plausible that shorter estimated median times would occur at a centre that does not use salvage therapy at such an early state. Conclusion: The time from first detectable PSA to BCR may be lengthy. Our analyses of the predictors of the rate of PSA rise can help determine a personalized approach for patients with a detectable PSA after surgery. PMID:25624961

  4. Greater saphenous vein anomaly and aneurysm with subsequent pulmonary embolism

    OpenAIRE

    Ma, Truong; Kornbau, Craig

    2017-01-01

    Abstract Venous aneurysms often present as painful masses. They can present either in the deep or superficial venous system. Deep venous system aneurysms have a greater risk of thromboembolism. Though rare, there have been case reports of superficial aneurysms and thrombus causing significant morbidity such as pulmonary embolism. We present a case of an anomalous greater saphenous vein connection with an aneurysm and thrombus resulting in a pulmonary embolism. This is the only reported case o...

  5. Life-time risk of mortality due to different levels of alcohol consumption in seven European countries: implications for low-risk drinking guidelines.

    Science.gov (United States)

    Shield, Kevin D; Gmel, Gerrit; Gmel, Gerhard; Mäkelä, Pia; Probst, Charlotte; Room, Robin; Rehm, Jürgen

    2017-09-01

    Low-risk alcohol drinking guidelines require a scientific basis that extends beyond individual or group judgements of risk. Life-time mortality risks, judged against established thresholds for acceptable risk, may provide such a basis for guidelines. Therefore, the aim of this study was to estimate alcohol mortality risks for seven European countries based on different average daily alcohol consumption amounts. The maximum acceptable voluntary premature mortality risk was determined to be one in 1000, with sensitivity analyses of one in 100. Life-time mortality risks for different alcohol consumption levels were estimated by combining disease-specific relative risk and mortality data for seven European countries with different drinking patterns (Estonia, Finland, Germany, Hungary, Ireland, Italy and Poland). Alcohol consumption data were obtained from the Global Information System on Alcohol and Health, relative risk data from meta-analyses and mortality information from the World Health Organization. The variation in the life-time mortality risk at drinking levels relevant for setting guidelines was less than that observed at high drinking levels. In Europe, the percentage of adults consuming above a risk threshold of one in 1000 ranged from 20.6 to 32.9% for women and from 35.4 to 54.0% for men. Life-time risk of premature mortality under current guideline maximums ranged from 2.5 to 44.8 deaths per 1000 women in Finland and Estonia, respectively, and from 2.9 to 35.8 deaths per 1000 men in Finland and Estonia, respectively. If based upon an acceptable risk of one in 1000, guideline maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men. If low-risk alcohol guidelines were based on an acceptable risk of one in 1000 premature deaths, then maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men, and some of the current European guidelines would require downward revision. © 2017 Society for the Study of Addiction.

  6. Cancer in adolescents and young adults: Who remains at risk of poor social functioning over time?

    Science.gov (United States)

    Husson, Olga; Zebrack, Bradley J; Aguilar, Christine; Hayes-Lattin, Brandon; Cole, Steve

    2017-07-15

    The objective of the current study was to examine social functioning among adolescents and young adults (AYAs) within the first 2 years after a cancer diagnosis and compare their scores with population norms and identify trajectories of social functioning over time and its correlates. A multicenter, longitudinal study was conducted among 215 AYA patients with cancer aged 14 to 39 years. A total of 141 patients completed a self-report measure of social functioning within the first 4 months of diagnosis and again at 12 months and 24 months later. AYA patients with cancer were found to have significantly worse social functioning scores around the time of diagnosis (52.0 vs 85.1; Pcancer who had consistently low social functioning were more often off treatment at the time of follow-up, reported more physical symptoms and higher levels of distress at baseline and follow-up, and perceived less social support at baseline compared with the other 3 groups. Although improved over time, social functioning still was found to be compromised 24 months after the primary diagnosis. Nearly one-third of these patients remain at risk of poor social functioning. Reducing physical symptoms and psychological distress and enhancing social support by interventions during the period after treatment may potentially help these young survivors to better reintegrate into society. Cancer 2017;123:2743-51. © 2017 American Cancer Society. © 2017 American Cancer Society.

  7. Evaluation of the clinical performance of the Abbott RealTime High-Risk HPV for carcinogenic HPV detection.

    Science.gov (United States)

    Halfon, Philippe; Benmoura, Dominique; Agostini, Aubert; Khiri, Hacene; Penaranda, Guillaume; Martineau, Agnes; Blanc, Bernard

    2010-08-01

    Abbott RealTime (RT) High-Risk (HR) HPV assay is a new qualitative real-time polymerase chain reaction (PCR) based assay for the detection of 14 HR HPV DNA. The assay can differentiate between the infection by HPV 16, HPV 18 and non-HPV 16/18 types through the distinct fluorescent labels on the type specific probes. To evaluate the clinical performance of the Abbott RT HR HPV test, in comparison with biopsy, Hybrid Capture II (HCII), and Linear Array (LA), for detection of high-grade disease (CIN2+). The study population consisted of 143 women who were included in three referral gynecology clinics in Marseilles (France) between March 2007 and June 2008. The clinical performance of the RT HR HPV assay, performed on the fully automated m2000 system, was compared with HCII and LA. HR HPV positivity rate was similar for all tests (Abbott RT HR HPV and HCII, 62%, and LA 63%). All tests had high sensitivities and negative predictive values for CIN2+ detection (>90%). The agreement between HCII and Abbott RT HR HPV, and between HCII and LA were 93% (k=0.85) and 96% (k=0.91) respectively. As expected, HPV16 or HPV18 positivity was greater in advanced grades of disease, especially in CIN2+ patients: 85% in CIN2+ vs. 33% in Abbott RT HR HPV assay is good and closely correlated with the two other assays. The automation and ability to identify type 16 and 18 make this a very attractive option for HPV testing in laboratories and potentially provides improved patient management. Copyright 2010. Published by Elsevier B.V.

  8. Consumer Food Safety Risk Attitudes and Perceptions Over Time: The Case of BSE Crisis

    OpenAIRE

    Kalogeras, Nikos; Pennings, Joost M.E.; van Ittersum, Koert

    2008-01-01

    Recent research has shown that by decoupling the risk response behaviour of consumers into the separate components of risk perception and risk attitude, a more robust conceptualization and prediction of consumers’ reactions to food safety issues is possible. Furthermore, it has been argued that the influence of risk attitudes and risk perceptions on consumer risk behaviour for contaminated food products can be used to formulate effective agricultural policies and strategies in case of a food ...

  9. Novel risk stratification with time course assessment of in-hospital mortality in patients with acute heart failure.

    Directory of Open Access Journals (Sweden)

    Takeshi Yagyu

    Full Text Available Patients with acute heart failure (AHF show various clinical courses during hospitalization. We aimed to identify time course predictors of in-hospital mortality and to establish a sequentially assessable risk model.We enrolled 1,035 consecutive AHF patients into derivation (n = 597 and validation (n = 438 cohorts. For risk assessments at admission, we utilized Get With the Guidelines-Heart Failure (GWTG-HF risk scores. We examined significant predictors of in-hospital mortality from 11 variables obtained during hospitalization and developed a risk stratification model using multiple logistic regression analysis. Across both cohorts, 86 patients (8.3% died during hospitalization. Using backward stepwise selection, we identified five time-course predictors: catecholamine administration, minimum platelet concentration, maximum blood urea nitrogen, total bilirubin, and C-reactive protein levels; and established a time course risk score that could sequentially assess a patient's risk status. The addition of a time course risk score improved the discriminative ability of the GWTG-HF risk score (c-statistics in derivation and validation cohorts: 0.776 to 0.888 [p = 0.002] and 0.806 to 0.902 [p<0.001], respectively. A calibration plot revealed a good relationship between observed and predicted in-hospital mortalities in both cohorts (Hosmer-Lemeshow chi-square statistics: 6.049 [p = 0.642] and 5.993 [p = 0.648], respectively. In each group of initial low-intermediate risk (GWTG-HF risk score <47 and initial high risk (GWTG-HF risk score ≥47, in-hospital mortality was about 6- to 9-fold higher in the high time course risk score group than in the low-intermediate time course risk score group (initial low-intermediate risk group: 20.3% versus 2.2% [p<0.001], initial high risk group: 57.6% versus 8.5% [p<0.001].A time course assessment related to in-hospital mortality during the hospitalization of AHF patients can clearly categorize a patient's on

  10. A near real time scenario at regional scale for the hydrogeological risk

    Science.gov (United States)

    Ponziani, F.; Stelluti, M.; Zauri, R.; Berni, N.; Brocca, L.; Moramarco, T.; Salciarini, D.; Tamagnini, C.

    2012-04-01

    satellite data daily download, used for the derivation of a soil water content index (SWI): these data are compared with instrumental ones from the TDR stations and the results of the water balance model that evaluates the contributions of water infiltration, percolation, evapotranspiration, etc. using physically based parameters obtained through a long process of characterization of soil and rock types, for each grid point; b) The assessment of the contribution due to the melting of the snow; c) the physically based - coupling model slope stability analysis, GIS-based, developed by the Department of Civil and Environmental Engineering, University of Perugia, with the aim to introduce also the actual mechanical and physical characteristics of slopes in the analysis. As result of the system, is the daily creation of near real-time and 24, 48, 72h forecast risk scenarios, that, under the intention of the Department of Civil Protection Service, will be used by the Functional Centre for the institutional tasks of hydrogeological risk evaluation and management, but also by local Administrations involved in the monitoring and assessment of landslide risk, in order to receive feedback on the effectiveness of the scenarios produced.

  11. Androgen insensitivity syndrome: Risk of malignancy and timing of surgery in a paediatric and adolescent population

    Directory of Open Access Journals (Sweden)

    Dragan Kravarusic

    2011-01-01

    Full Text Available Background: Management of female phenotype XY disorders poses a series of problems for the treating clinician. Even after a series of investigations and imaging modalities, there are lingering doubts about the exact nature of the disease and the correct management option. Optimal timing and necessity for removal of their testes have been a debated issue by physicians. There is a generally accepted opinion among physicians that the risk of malignancy in androgen insensitivity syndrome (AIS is considerably lower than with other intersex disorders and occurs at a later age. Objective: The highlight of this presentation is to reinforce the value of laparoscopic gonadectomy in management of AIS in correlation with data suggesting higher risk of malignancy. Patients and Methods: A retrospective review of 11 phenotypic females with XY karyotype was carried out. The patients were evaluated by a diagnostic protocol which included clinical, hormonal, sonographic and cytogenetic examinations. Patients/parents were counselled by the team concerning the different treatment modalities and contrary to the assigned gender, laparoscopy was offered to them. Uneventful bilateral gonadectomy was performed in all the patients and gonads submitted for histopathological examination. Results: A total of 11 patients (mean age, 10.4 ΁ 4.1 years, including six with complete AIS and five with partial AIS (PAIS were reviewed. In two patients with PAIS (18.1%, histopathology revealed malignancy (bilateral seminoma and gonadoblastoma and in an additional patient, a benign hamartoma was found. Literature evidence suggests that AIS female phenotype patients retaining their testes through puberty have a 5% chance for developing malignant tumours. Reviewing our results in correlation with literature, we found that PAIS patients may harbour a higher risk of malignancy. Conclusions: In complementation to hormonal tests and cytogenetic techniques, laparoscopic gonadectomy is

  12. Total sitting time, leisure time physical activity and risk of hospitalization due to low back pain: The Danish Health Examination Survey cohort 2007-2008.

    Science.gov (United States)

    Balling, Mie; Holmberg, Teresa; Petersen, Christina B; Aadahl, Mette; Meyrowitsch, Dan W; Tolstrup, Janne S

    2018-02-01

    This study aimed to test the hypotheses that a high total sitting time and vigorous physical activity in leisure time increase the risk of low back pain and herniated lumbar disc disease. A total of 76,438 adults answered questions regarding their total sitting time and physical activity during leisure time in the Danish Health Examination Survey 2007-2008. Information on low back pain diagnoses up to 10 September 2015 was obtained from The National Patient Register. The mean follow-up time was 7.4 years. Data were analysed using Cox regression analysis with adjustment for potential confounders. Multiple imputations were performed for missing values. During the follow-up period, 1796 individuals were diagnosed with low back pain, of whom 479 were diagnosed with herniated lumbar disc disease. Total sitting time was not associated with low back pain or herniated lumbar disc disease. However, moderate or vigorous physical activity, as compared to light physical activity, was associated with increased risk of low back pain (HR = 1.16, 95% CI: 1.03-1.30 and HR = 1.45, 95% CI: 1.15-1.83). Moderate, but not vigorous physical activity was associated with increased risk of herniated lumbar disc disease. The results suggest that total sitting time is not associated with low back pain, but moderate and vigorous physical activity is associated with increased risk of low back pain compared with light physical activity.

  13. Time to Appendectomy and Risk of Complicated Appendicitis and Adverse Outcomes in Children.

    Science.gov (United States)

    Serres, Stephanie K; Cameron, Danielle B; Glass, Charity C; Graham, Dionne A; Zurakowski, David; Karki, Mahima; Anandalwar, Seema P; Rangel, Shawn J

    2017-08-01

    Management of appendicitis as an urgent rather than emergency procedure has become an increasingly common practice in children. Controversy remains as to whether this practice is associated with increased risk of complicated appendicitis and adverse events. To examine the association between time to appendectomy (TTA) and risk of complicated appendicitis and postoperative complications. In this retrospective cohort study using the Pediatric National Surgical Quality Improvement Program appendectomy pilot database, 2429 children younger than 18 years who underwent appendectomy within 24 hours of presentation at 23 children's hospitals from January 1, 2013, through December 31, 2014, were studied. The main exposure was TTA, defined as the time from emergency department presentation to appendectomy. Patients were further categorized into early and late TTA groups based on whether their TTA was shorter or longer than their hospital's median TTA. Exposures were defined in this manner to compare rates of complicated appendicitis within a time frame sensitive to each hospital's existing infrastructure and diagnostic practices. The primary outcome was complicated appendicitis documented at operation. The association between treatment delay and complicated appendicitis was examined across all hospitals by using TTA as a continuous variable and at the level of individual hospitals by using TTA as a categorical variable comparing outcomes between late and early TTA groups. Secondary outcomes included length of stay (LOS) and postoperative complications (incisional and organ space infections, percutaneous drainage procedures, unplanned reoperation, and hospital revisits). Of the 6767 patients who met the inclusion criteria, 2429 were included in the analysis (median age, 10 years; interquartile range, 8-13 years; 1467 [60.4%] male). Median hospital TTA was 7.4 hours (range, 5.0-19.2 hours), and 574 patients (23.6%) were diagnosed with complicated appendicitis (range, 5

  14. Comparison of Health Risks and Changes in Risks over Time Among a Sample of Lesbian, Gay, Bisexual, and Heterosexual Employees at a Large Firm.

    Science.gov (United States)

    Mitchell, Rebecca J; Ozminkowski, Ronald J

    2017-04-01

    The objective of this study was to estimate the prevalence of health risk factors by sexual orientation over a 4-year period within a sample of employees from a large firm. Propensity score-weighted generalized linear regression models were used to estimate the proportion of employees at high risk for health problems in each year and over time, controlling for many factors. Analyses were conducted with 6 study samples based on sex and sexual orientation. Rates of smoking, stress, and certain other health risk factors were higher for lesbian, gay, and bisexual (LGB) employees compared with rates of these risks among straight employees. Lesbian, gay, and straight employees successfully reduced risk levels in many areas. Significant reductions were realized for the proportion at risk for high stress and low life satisfaction among gay and lesbian employees, and for the proportion of smokers among gay males. Comparing changes over time for sexual orientation groups versus other employee groups showed that improvements and reductions in risk levels for most health risk factors examined occurred at similar rates among individuals employed by this firm, regardless of sexual orientation. These results can help improve understanding of LGB health and provide information on where to focus workplace health promotion efforts to meet the health needs of LGB employees.

  15. Web-Based Real Time Earthquake Forecasting and Personal Risk Management

    Science.gov (United States)

    Rundle, J. B.; Holliday, J. R.; Graves, W. R.; Turcotte, D. L.; Donnellan, A.

    2012-12-01

    Earthquake forecasts have been computed by a variety of countries and economies world-wide for over two decades. For the most part, forecasts have been computed for insurance, reinsurance and underwriters of catastrophe bonds. One example is the Working Group on California Earthquake Probabilities that has been responsible for the official California earthquake forecast since 1988. However, in a time of increasingly severe global financial constraints, we are now moving inexorably towards personal risk management, wherein mitigating risk is becoming the responsibility of individual members of the public. Under these circumstances, open access to a variety of web-based tools, utilities and information is a necessity. Here we describe a web-based system that has been operational since 2009 at www.openhazards.com and www.quakesim.org. Models for earthquake physics and forecasting require input data, along with model parameters. The models we consider are the Natural Time Weibull (NTW) model for regional earthquake forecasting, together with models for activation and quiescence. These models use small earthquakes ('seismicity-based models") to forecast the occurrence of large earthquakes, either through varying rates of small earthquake activity, or via an accumulation of this activity over time. These approaches use data-mining algorithms combined with the ANSS earthquake catalog. The basic idea is to compute large earthquake probabilities using the number of small earthquakes that have occurred in a region since the last large earthquake. Each of these approaches has computational challenges associated with computing forecast information in real time. Using 25 years of data from the ANSS California-Nevada catalog of earthquakes, we show that real-time forecasting is possible at a grid scale of 0.1o. We have analyzed the performance of these models using Reliability/Attributes and standard Receiver Operating Characteristic (ROC) tests. We show how the Reliability and

  16. Exposure amount and timing of solar irradiation during pregnancy and the risk of sensitization in children.

    Science.gov (United States)

    Koh, Hyun Yong; Cho, Eunhae; Lee, So-Yeon; Kim, Woo Kyung; Park, Yong Mean; Kim, Jihyun; Ahn, Kangmo; Lee, Seung Won; Kim, Mi Ae; Hahm, Myung-Il; Chae, Yoomi; Lee, Kee-Jae; Kwon, Ho-Jang; Han, Man Yong

    2018-04-01

    Solar irradiation affects sensitization to aeroallergens and the prevalence of allergic diseases. Little is known, however, about how the time and amount of solar irradiation during pregnancy affects such risks in children. We aimed to find out how solar irradiation during pregnancy affects sensitization to aero-allergens and the prevalence of allergic diseases in children. This population-based cross-sectional study involved 7301 aged 6 years and aged 12 years children. Maternal exposure to solar irradiation during pregnancy was evaluated using data from weather stations closest to each child's birthplace. Monthly average solar irradiation during the second and third trimesters was calculated with rank by quartiles. Risks of allergic sensitization and allergic disease were estimated. Relative to the first (lowest) quartile, the adjusted odds ratio (aOR) for allergic sensitization in the fourth (highest) quartile was lowest within solar irradiation during pregnancy months 5-6 (aOR = 0.823, 95% CI 0.720-0.942, p solar irradiation (aOR = 1.167, 95% CI 1.022-1.333, p solar irradiation was analyzed as a continuous variable during months 5 (aOR = 0.975, 95% CI 0.962-0.989, p solar irradiation during months 7-8 increased the risk of asthma (aOR = 1.309, 95% CI 1.024-1.674, p = 0.032). Maternal exposure to solar irradiation during the second trimester of pregnancy associated with reduced aeroallergen sensitization, whereas solar irradiation during the third trimester was related to increased sensitization to aeroallergens. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  17. Real-time 3D radiation risk assessment supporting simulation of work in nuclear environments

    International Nuclear Information System (INIS)

    Szoke, I; Louka, M N; Bryntesen, T R; Bratteli, J; Edvardsen, S T; RøEitrheim, K K; Bodor, K

    2014-01-01

    This paper describes the latest developments at the Institute for Energy Technology (IFE) in Norway, in the field of real-time 3D (three-dimensional) radiation risk assessment for the support of work simulation in nuclear environments. 3D computer simulation can greatly facilitate efficient work planning, briefing, and training of workers. It can also support communication within and between work teams, and with advisors, regulators, the media and public, at all the stages of a nuclear installation’s lifecycle. Furthermore, it is also a beneficial tool for reviewing current work practices in order to identify possible gaps in procedures, as well as to support the updating of international recommendations, dissemination of experience, and education of the current and future generation of workers. IFE has been involved in research and development into the application of 3D computer simulation and virtual reality (VR) technology to support work in radiological environments in the nuclear sector since the mid 1990s. During this process, two significant software tools have been developed, the VRdose system and the Halden Planner, and a number of publications have been produced to contribute to improving the safety culture in the nuclear industry. This paper describes the radiation risk assessment techniques applied in earlier versions of the VRdose system and the Halden Planner, for visualising radiation fields and calculating dose, and presents new developments towards implementing a flexible and up-to-date dosimetric package in these 3D software tools, based on new developments in the field of radiation protection. The latest versions of these 3D tools are capable of more accurate risk estimation, permit more flexibility via a range of user choices, and are applicable to a wider range of irradiation situations than their predecessors. (paper)

  18. Real-time 3D radiation risk assessment supporting simulation of work in nuclear environments.

    Science.gov (United States)

    Szőke, I; Louka, M N; Bryntesen, T R; Bratteli, J; Edvardsen, S T; RøEitrheim, K K; Bodor, K

    2014-06-01

    This paper describes the latest developments at the Institute for Energy Technology (IFE) in Norway, in the field of real-time 3D (three-dimensional) radiation risk assessment for the support of work simulation in nuclear environments. 3D computer simulation can greatly facilitate efficient work planning, briefing, and training of workers. It can also support communication within and between work teams, and with advisors, regulators, the media and public, at all the stages of a nuclear installation's lifecycle. Furthermore, it is also a beneficial tool for reviewing current work practices in order to identify possible gaps in procedures, as well as to support the updating of international recommendations, dissemination of experience, and education of the current and future generation of workers.IFE has been involved in research and development into the application of 3D computer simulation and virtual reality (VR) technology to support work in radiological environments in the nuclear sector since the mid 1990s. During this process, two significant software tools have been developed, the VRdose system and the Halden Planner, and a number of publications have been produced to contribute to improving the safety culture in the nuclear industry.This paper describes the radiation risk assessment techniques applied in earlier versions of the VRdose system and the Halden Planner, for visualising radiation fields and calculating dose, and presents new developments towards implementing a flexible and up-to-date dosimetric package in these 3D software tools, based on new developments in the field of radiation protection. The latest versions of these 3D tools are capable of more accurate risk estimation, permit more flexibility via a range of user choices, and are applicable to a wider range of irradiation situations than their predecessors.

  19. The Evaluation of Mutual Fund Performance in Lithuania Considering Risk and Timing Ability

    Directory of Open Access Journals (Sweden)

    Irma Gavrilova

    2011-07-01

    Full Text Available Over the last decade, Lithuania has witnessed a growing interest in investment promoted by the need to successfully manage available funds. Direct investments (e. g. buying and selling stocks require a specific knowledge of investment instruments. Therefore, an ordinary investor finds investment in mutual funds easier and cheaper. Usually the most important questions to the investor include measuring the results of a fund and the quality of the actions performed by the fund managers. The article evaluates the rates of mutual fund performance and identifies their shortages. The methods for evaluating investment return according to the level of risk and timing ability of the fund managers are presented using the Sharpe ratio and Treynor-Mazuy model on the basis of which mutual funds in Lithuania are analyzed.Article in Lithuanian

  20. Time distortion when users at-risk for social media addiction engage in non-social media tasks.

    Science.gov (United States)

    Turel, Ofir; Brevers, Damien; Bechara, Antoine

    2018-02-01

    There is a growing concern over the addictiveness of Social Media use. Additional representative indicators of impaired control are needed in order to distinguish presumed social media addiction from normal use. (1) To examine the existence of time distortion during non-social media use tasks that involve social media cues among those who may be considered at-risk for social media addiction. (2) To examine the usefulness of this distortion for at-risk vs. low/no-risk classification. We used a task that prevented Facebook use and invoked Facebook reflections (survey on self-control strategies) and subsequently measured estimated vs. actual task completion time. We captured the level of addiction using the Bergen Facebook Addiction Scale in the survey, and we used a common cutoff criterion to classify people as at-risk vs. low/no-risk of Facebook addiction. The at-risk group presented significant upward time estimate bias and the low/no-risk group presented significant downward time estimate bias. The bias was positively correlated with Facebook addiction scores. It was efficacious, especially when combined with self-reported estimates of extent of Facebook use, in classifying people to the two categories. Our study points to a novel, easy to obtain, and useful marker of at-risk for social media addiction, which may be considered for inclusion in diagnosis tools and procedures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Leisure-time exercise, physical activity during work and commuting, and risk of metabolic syndrome.

    Science.gov (United States)

    Kuwahara, Keisuke; Honda, Toru; Nakagawa, Tohru; Yamamoto, Shuichiro; Akter, Shamima; Hayashi, Takeshi; Mizoue, Tetsuya

    2016-09-01

    Data are limited regarding effect of intensity of leisure-time physical activity on metabolic syndrome. Furthermore, no prospective data are available regarding effect of occupational and commuting physical activity on metabolic syndrome. We compared metabolic syndrome risk by intensity level of leisure-time exercise and by occupational and commuting physical activity in Japanese workers. We followed 22,383 participants, aged 30-64 years, without metabolic syndrome until 2014 March (maximum, 5 years of follow-up). Physical activity was self-reported. Metabolic syndrome was defined by the Joint Statement criteria. We used Cox regression models to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of metabolic syndrome. During a mean follow-up of 4.1 years, 5361 workers developed metabolic syndrome. After adjustment for covariates, compared with engaging in no exercise, the HRs (95 % CIs) for metabolic equivalent hours of exercise per week were 0.99 (0.90, 1.08), 0.99 (0.90, 1.10), and 0.95 (0.83, 1.08), respectively, among individuals engaging in moderate-intensity exercise alone; 0.93 (0.75, 1.14), 0.81 (0.64, 1.02), and 0.84 (0.66, 1.06), among individuals engaging in vigorous-intensity exercise alone; and 0.90 (0.70, 1.17), 0.74 (0.62, 0.89), and 0.81 (0.69, 0.96) among individuals engaging in the two intensities. Higher occupational physical activity was weakly but significantly associated with lower risk of metabolic syndrome. Walking to and from work was not associated with metabolic syndrome. Vigorous-intensity exercise alone or vigorous-intensity combined with moderate-intensity exercise and worksite intervention for physical activity may help prevent metabolic syndrome for Japanese workers.

  2. Time of Concentration equations: the role of morphometric uncertainties in flood risk analysis and management

    Science.gov (United States)

    Martins, Luciano; Díez-Herrero, Andrés; Bodoque, Jose M.; Bateira, Carlos

    2016-04-01

    The perception of flood risk by the responsible authorities on the flood management disasters and mitigation strategies should be based on an overall evaluation of the uncertainties associated with the procedures for risk assessment and mapping production. This contribution presents the results of the development of mapping evaluation of the time of concentration (tc). This parameter reflects the time-space at which a watershed responds to rainfall events and is the most frequently utilized time parameter, and is of great importance in many hydrologic analysis. Accurate estimates of the tc are very important, for instance, if tc is under-estimated, the result is an over-estimated peak discharge and vice versa, resulting significant variations on the flooded areas, and could have important consequences in terms of the land use and occupation of territory, as management's own flood risk. The methology used evaluate 20 different empirical, semi-empirical and kinematics equations of tc calculation, due to different cartographic scales (1:200000; 1:100000; 1:25000; LIDAR 5x5m &1x1m) in in two hydrographic basins with distinct dimensions and geomorphological characteristics, located in the Gredos Mountain range (Spain). The results suggest that the changes in the cartographic scale, has not influence as significant as one might expect. The most important variations occur in the characteristics of the fequations, use different morphometricparameters in the calculations. Some just are based on geomorphological criteria and other magnify the hydraulic characteristics of the channels, resulting in very different tc values. However, we highlighting the role of cartographic scale particularly in the application of semi-empirical equations that take into account changes in land use and occupation. In this case, the determination of parameters, such as flow coefficient, curve number and roughness coefficient are very sensitive to cartographic scale. Sensitivity analysis

  3. Professional Skepticism and Auditors’ Assessment of Misstatement Risks: The Moderating Effect of Experience and Time Budget Pressure

    OpenAIRE

    Sayed Alwee Hussnie Sayed Hussin; Takiah Mohd Iskandar; Norman Mohd Saleh; Romlah Jaffar

    2017-01-01

    Background: This study employs a field experiment to examine the relationship between professional skepticism, experience, and time budget pressure on auditors’ assessment of risk of misstatement. In addition, the study examines the moderating effect of experience and time budget pressure on the relationship between professional skepticism and auditors’ assessment of risk from material misstatements; 2) Method: This study employs a multiple regression analysis on 248 auditors from both Big4 a...

  4. Sitting time and occupational and recreational physical activity in relation to the risk of esophageal squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Chen P

    2017-09-01

    Full Text Available Pengxiang Chen,1 Qingxu Song,1 Jie Han,2 Huapu Xu,3 Tong Chen,4 Jiaqi Xu,5 Yufeng Cheng1 1Department of Radiation Oncology, Qilu Hospital of Shandong University, 2Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, 3Department of Oncology, Pingyi Hospital of Traditional Chinese Medicine, Pingyi, 4Department of Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 5Department of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China Backgrounds: Sitting time and physical activity are associated with cancer risk; however, their roles in the development of esophageal squamous cell carcinoma (ESCC are inconclusive. This study aimed to investigate the effects of total sitting time, occupational activity time (OAT, and recreational activity time (RAT on ESCC risk. Methods: Five hundred fifty-seven ESCC patients and 543 healthy controls matched by sex and age were recruited for this study. Conditional logistic regression was performed to obtain odds ratios (ORs and 95% confidence intervals (CIs. Results: Longer total sitting time (adjusted OR [AOR] 2.54, 95% CI 1.58–4.09 and longer OAT (AOR 2.90, 95% CI 2.11–3.99 were associated with higher ESCC risk, while longer RAT (AOR 0.27, 95% CI 0.19–0.38 could reduce ESCC risk. When the body mass index was incorporated into the multivariable models, the results changed slightly. In risk estimation according to sex, the same trends were observed in both men and women. Furthermore, longer RAT could completely or partially diminish the impacts of longer sitting time and OAT on increasing ESCC risk.Conclusion: Long sitting time and long OAT can increase the risk of ESCC, while long RAT is significantly associated with decreased ESCC risk. Keywords: esophageal squamous cell carcinoma, sitting time, physical activity, cancer epidemiology

  5. Long-term cardiovascular risk of nonsteroidal anti-inflammatory drug use according to time passed after first-time myocardial infarction: a nationwide cohort study.

    Science.gov (United States)

    Olsen, Anne-Marie Schjerning; Fosbøl, Emil L; Lindhardsen, Jesper; Folke, Fredrik; Charlot, Mette; Selmer, Christian; Bjerring Olesen, Jonas; Lamberts, Morten; Ruwald, Martin H; Køber, Lars; Hansen, Peter R; Torp-Pedersen, Christian; Gislason, Gunnar H

    2012-10-16

    The cardiovascular risk after the first myocardial infarction (MI) declines rapidly during the first year. We analyzed whether the cardiovascular risk associated with using nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with the time elapsed following first-time MI. We identified patients aged 30 years or older admitted with first-time MI in 1997 to 2009 and subsequent NSAID use by individual-level linkage of nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark. We calculated the incidence rates of death and a composite end point of coronary death or nonfatal recurrent MIs associated with NSAID use in 1-year time intervals up to 5 years after inclusion and analyzed risk by using multivariable adjusted time-dependent Cox proportional hazards models. Of the 99 187 patients included, 43 608 (44%) were prescribed NSAIDs after the index MI. There were 36 747 deaths and 28 693 coronary deaths or nonfatal recurrent MIs during the 5 years of follow-up. Relative to noncurrent treatment with NSAIDs, the use of any NSAID in the years following MI was persistently associated with an increased risk of death (hazard ratio 1.59 [95% confidence interval, 1.49-1.69]) after 1 year and hazard ratio 1.63 [95% confidence interval, 1.52-1.74] after 5 years) and coronary death or nonfatal recurrent MI (hazard ratio, 1.30 [95% confidence interval,l 1.22-1.39] and hazard ratio, 1.41 [95% confidence interval, 1.28-1.55]). The use of NSAIDs is associated with persistently increased coronary risk regardless of time elapsed after first-time MI. We advise long-term caution in the use of NSAIDs for patients after MI.

  6. Associations between prolonged sedentary time and breaks in sedentary time with cardiometabolic risk in 10-14-year-old children: The HAPPY study.

    Science.gov (United States)

    Bailey, Daniel P; Charman, Sarah J; Ploetz, Thomas; Savory, Louise A; Kerr, Catherine J

    2017-11-01

    This study examines the association between prolonged sedentary time and breaks in sedentary time with cardiometabolic risk in 10-14-year-old children. This cross-sectional design study analysed accelerometry-determined sedentary behaviour and physical activity collected over 7 days from 111 (66 girls) UK schoolchildren. Objective outcome measures included waist circumference, fasting lipids, fasting glucose, blood pressure, and cardiorespiratory fitness. Logistic regression was used for the main data analysis. After adjustment for confounders, the odds of having hypertriglyceridaemia (P = 0.03) and an increased clustered cardiometabolic risk score (P = 0.05) were significantly higher in children who engaged in more prolonged sedentary bouts per day. The number of breaks in sedentary time per day was not associated with any cardiometabolic risk factor, but longer mean duration of daily breaks in sedentary time were associated with a lower odds of having abdominal adiposity (P = 0.04) and elevated diastolic blood pressure (P = 0.01). These associations may be mediated by engagement in light activity. This study provides evidence that avoiding periods of prolonged uninterrupted sedentary time may be important for reducing cardiometabolic disease risk in children.

  7. Job-Sharing at the Greater Victoria Public Library.

    Science.gov (United States)

    Miller, Don

    1978-01-01

    Describes the problems associated with the management of part-time library employees and some solutions afforded by a job sharing arrangement in use at the Greater Victoria Public Library. This is a voluntary work arrangement, changing formerly full-time positions into multiple part-time positions. (JVP)

  8. Time dependence of risks and benefits in pediatric primary prevention implantable cardioverter-defibrillator therapy.

    Science.gov (United States)

    DeWitt, Elizabeth S; Triedman, John K; Cecchin, Frank; Mah, Doug Y; Abrams, Dominic J; Walsh, Edward P; Gauvreau, Kimberlee; Alexander, Mark E

    2014-12-01

    Implantable cardioverter defibrillators (ICDs) used to prevent sudden cardiac arrest in children not only provide appropriate therapy in 25% of patients but also result in a significant incidence of inappropriate shocks and other device complications. ICDs placed for secondary prevention have higher rates of appropriate therapy than those placed for primary prevention. Pediatric patients with primary prevention ICDs were studied to determine time-dependent incidence of appropriate use and adverse events. A total of 140 patients aged prevention were retrospectively identified. Demographics and times to first appropriate shock; adverse events (including inappropriate shock, lead failure, reintervention, and complication); generator replacement and follow-up were noted. During mean follow-up of 4 years, appropriate shock occurred in 19% patients and first adverse event (excluding death/transplant) occurred in 36%. Risk of death or transplant was ≈1% per year and was not related to receiving appropriate therapy. Conditional survival analysis showed rates of appropriate therapy and adverse events decrease soon after implantation, but adverse events are more frequent than appropriate therapy throughout follow-up. Primary prevention ICDs were associated with appropriate therapy in 19% and adverse event in 36% in this cohort. The incidence of both first appropriate therapy and device-related adverse events decreased during longer periods of follow-up after implantation. This suggests that indications for continued device therapy in pediatric primary prevention ICD patients might be reconsidered after a period of nonuse. © 2014 American Heart Association, Inc.

  9. Working the night shift: a necessary time for training or a risk to health and safety?

    Science.gov (United States)

    Morrison, I; Flower, D; Hurley, J; McFadyen, R J

    2013-01-01

    The European Working Time Directive (EWTD) limits excessive night shifts and restricts the working week to no more than 48 hours. The underlying rationale is to minimise the health risks to all workers. Here we debate the impact of night rotas for doctors-in-training on patient safety and medical education; when the EWTD was agreed these topics may not have been considered, either systematically or objectively. The impacts of diurnal rhythms on human functions affect all night workers, but the nature of rostered medical and surgical work has little precedent in other industries or even in the contracts of other healthcare staff. For example, rostered night duties need to be distinguished from permanent night shift work. On-call medical night work from training doctors is generally required for short periods and usually involves fewer patients. It is an important time in training, where clinical responsibility and decision-making can be matured in a supervised setting. To comply with the EWTD most hospitals have adopted rota patterns that aim to cover the clinical needs, while ensuring no doctor works for more than 48 hours in an average working week. To monitor this process longterm studies are necessary to evaluate effects on a doctor's health and on patient care generally. The EWTD has also led to a loss of continuity of patient care; does this really matter?

  10. q-Gaussian distributions of leverage returns, first stopping times, and default risk valuations

    Science.gov (United States)

    Katz, Yuri A.; Tian, Li

    2013-10-01

    We study the probability distributions of daily leverage returns of 520 North American industrial companies that survive de-listing during the financial crisis, 2006-2012. We provide evidence that distributions of unbiased leverage returns of all individual firms belong to the class of q-Gaussian distributions with the Tsallis entropic parameter within the interval 1distributions imply a much higher probability of extreme movements in a company’s leverage ratio than forecasted by the normal distribution (q=1). Motivated by these findings, we develop a q-Gaussian generalization of traditional structural models of default. Derived exact analytical expressions for the probability distribution of a first stopping time and its intensity forecast significantly higher probability of default and much wider credit spreads at short time-horizons. Our findings are broadly consistent with the results of empirical studies in equity markets and are essential for single-name default forecasting as well as valuations of portfolio credit risk and economic capital, which might be underestimated by a classic theory of diversified portfolio optimization.

  11. Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women.

    Directory of Open Access Journals (Sweden)

    Andreas Nilsson

    Full Text Available Whether amount of time spent in sedentary activities influences on clustered metabolic risk in elderly, and to what extent such an influence is independent of physical activity behavior, remain unclear. Therefore, the aim of the study was to examine cross-sectional associations of objectively assessed physical activity and sedentary behavior on metabolic risk outcomes in a sample of elderly community-dwelling women.Metabolic risk outcomes including waist circumference, systolic and diastolic blood pressures, fasting levels of plasma glucose, HDL-cholesterol and triglycerides were assessed in 120 community-dwelling older women (65-70 yrs. Accelerometers were used to retrieve daily sedentary time, breaks in sedentary time, daily time in light (LPA and moderate-to-vigorous physical activity (MVPA, and total amount of accelerometer counts. Multivariate regression models were used to examine influence of physical activity and sedentary behavior on metabolic risk outcomes including a clustered metabolic risk score.When based on isotemporal substitution modeling, replacement of a 10-min time block of MVPA with a corresponding time block of either LPA or sedentary activities was associated with an increase in clustered metabolic risk score (β = 0.06 to 0.08, p < 0.05, and an increase in waist circumference (β = 1.78 to 2.19 p < 0.01. All associations indicated between sedentary time and metabolic risk outcomes were lost once variation in total accelerometer counts was adjusted for.Detrimental influence of a sedentary lifestyle on metabolic health is likely explained by variations in amounts of physical activity rather than amount of sedentary time per se. Given our findings, increased amounts of physical activity with an emphasis on increased time in MVPA should be recommended in order to promote a favorable metabolic health profile in older women.

  12. Is there a U-shaped relationship between physical activity in leisure time and risk of chronic low back pain? A follow-up in the HUNT Study

    Directory of Open Access Journals (Sweden)

    Ingrid Heuch

    2016-04-01

    Full Text Available Abstract Background Physical activity in leisure time is often considered to have favourable effects on the risk of low back pain (LBP, but demonstrating a definite association in epidemiological studies has proven difficult. The purpose of the present study was to explore associations between physical activity and risk of chronic LBP in an adult population and to investigate whether relationships are limited to certain age groups or to females or males. A particular objective was to determine whether support could be found for a U-shaped relationship, with both low and high activity levels carrying greater risk. Methods The relationship between physical activity and risk of chronic LBP was examined in a Norwegian prospective study using data from the community-based HUNT2 and HUNT3 surveys. Participants were 9616 women and 8452 men without LBP at baseline, who reported after 11 years whether they suffered from LBP. Associations between baseline physical activity in leisure time and risk of chronic LBP at end of follow-up were evaluated by generalized linear modelling with adjustment for potential confounders. Results Significant associations between leisure time physical activity and risk were observed in both sexes after age adjustment, mainly suggesting inverse relationships. Women participating in hard physical activity 1–2 h per week had a relative risk (RR of chronic LBP of 0.81 (95 % CI 0.71–0.93 compared to those with only light physical activity less than 1 h per week. The corresponding RR in men was 0.71 (95 % CI 0.60–0.85. After adjustment for education, employment, occupational activity, body mass index (BMI and smoking, significant relationships could only be demonstrated in those aged 50 years or more at baseline. The associations differed between female educational groups, with more U-shaped relationships being observed among women with basic education only. Conclusion No strong support was found overall for U

  13. Zika pandemic online trends, incidence and health risk communication: a time trend study.

    Science.gov (United States)

    Adebayo, Gbenga; Neumark, Yehuda; Gesser-Edelsburg, Anat; Abu Ahmad, Wiessam; Levine, Hagai

    2017-01-01

    We aimed to describe the online search trends of Zika and examine their association with Zika incidence, assess the content of Zika-related press releases issued by leading health authorities and examine the association between online trends and press release timing. Using Google Trends, the 1 May 2015 to 30 May 2016 online trends of Zika and associated search terms were studied globally and in the five countries with the highest numbers of suspected cases. Correlations were then examined between online trends and Zika incidence in these countries. All Zika-related press releases issued by WHO/Pan America Health Organization (PAHO) and Centers for Disease Control and Prevention (CDC) during the study period were assessed for transparency, uncertainty and audience segmentation. Witte's Extended Parallel Process Model was applied to assess self-efficacy, response efficacy, susceptibility and severity. AutoRegressive Integrated Moving Average with an eXogenous predictor variable (ARIMAX) (p,d,q) regression modelling was used to quantify the association between online trends and the timing of press releases. Globally, Zika online search trends were low until the beginning of 2016, when interest rose steeply. Strong correlations (r=0.748-0.922; ponline trends and the number of suspected Zika cases in four of the five countries studied. Compared with press releases issued by WHO/PAHO, CDC press releases were significantly more likely to provide contact details and links to other resources, include figures/graphs, be risk-advisory in nature and be more readable and briefer. ARIMAX modelling results indicate that online trends preceded by 1 week press releases by WHO (stationary-R 2 =0.345; ponline trends can aid in pandemic surveillance. Identification of shortcomings in the content and timing of Zika press releases can help guide health communication efforts in the current pandemic and future public health emergencies.

  14. A competing risks approach for time estimation of household WEEE disposal

    International Nuclear Information System (INIS)

    Gutierrez, E.; Adenso-Diaz, B.; Lozano, S.; Gonzalez-Torre, P.

    2010-01-01

    The recent growth in the number of electrical and electronic devices is viewed as one the priority waste streams in European Union waste management policy. This paper presents the findings of a survey to study domestic habits with respect to Waste Electrical and Electronic Equipment (WEEE) in Spain. A specific problem when performing this estimation arises from the fact that consumers quite often store old appliances at home when they are no longer used. Focusing on four different types of appliance, survival analysis (SA) is used to study both the usage span and the reasons for no longer using each device. The time that the discarded products were kept at home before being disposed of was studied using competing risks (CR) analysis. The results of the analysis provide information on the distribution of the studied variables for the different outcomes as well as the influence exerted by the socio-demographic variables considered. Relations between these characteristics and the storage time of the appliances before disposal emerge based on survey data. For instance, the CR model finds that the storage time of the some appliances (i.e. refrigerator) is related to these social-demographics factors. However, other appliances (i.e. microwave oven) are less influenced by these factors. The attitude and motivation of the respondents to the survey as regards the End-of-Life of appliances were also analysed. A majority of respondents do not store discarded appliances at home. The first reason for storing appliances at home is the possibility of it being useful in the future and the second that the respondents did not know what to do with them.

  15. Changes in crash risk following re-timing of traffic signal change intervals.

    Science.gov (United States)

    Retting, Richard A; Chapline, Janella F; Williams, Allan F

    2002-03-01

    More than I million motor vehicle crashes occur annually at signalized intersections in the USA. The principal method used to prevent crashes associated with routine changes in signal indications is employment of a traffic signal change interval--a brief yellow and all-red period that follows the green indication. No universal practice exists for selecting the duration of change intervals, and little is known about the influence of the duration of the change interval on crash risk. The purpose of this study was to estimate potential crash effects of modifying the duration of traffic signal change intervals to conform with values associated with a proposed recommended practice published by the Institute of Transportation Engineers. A sample of 122 intersections was identified and randomly assigned to experimental and control groups. Of 51 eligible experimental sites, 40 (78%) needed signal timing changes. For the 3-year period following implementation of signal timing changes, there was an 8% reduction in reportable crashes at experimental sites relative to those occurring at control sites (P = 0.08). For injury crashes, a 12% reduction at experimental sites relative to those occurring at control sites was found (P = 0.03). Pedestrian and bicycle crashes at experimental sites decreased 37% (P = 0.03) relative to controls. Given these results and the relatively low cost of re-timing traffic signals, modifying the duration of traffic signal change intervals to conform with values associated with the Institute of Transportation Engineers' proposed recommended practice should be strongly considered by transportation agencies to reduce the frequency of urban motor vehicle crashes.

  16. Time trend and risk factors of avascular bone necrosis in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Tse, Sau Mei; Mok, Chi Chiu

    2017-06-01

    Objectives The objective of this paper is to study the time trend and risk factors of avascular bone necrosis (AVN) in patients with systemic lupus erythematosus (SLE). Methods Between 1999 and 2014, patients who fulfilled the ACR criteria for SLE and developed symptomatic AVN were identified from our cohort database and compared with those without AVN, matched for age, sex and SLE duration. The standardized incidence ratios (SIRs) of AVN in different SLE age groups were calculated from data derived from our hospital registry and population census. Risk factors for AVN were studied by logistic regression, adjusted by a propensity score for ever use of high-dose glucocorticoids (GCs). Results Fifty-five SLE patients with AVN and 220 SLE patients without AVN were studied. There were 104 AVN sites involved, with the hips being most commonly affected (82%). The point prevalence of AVN in our SLE cohort was 7.4%. The SIRs of AVN in our SLE patients were 131 (86.6-199; p < 0.001) and 56.0 (34.3-91.4; p < 0.001), respectively, in the periods 1995-2004 and 2005-2014. In both decades, the age-stratified SIR was highest in the youngest age group (<19 years). AVN patients were more likely to be treated with GCs and had received a significantly higher cumulative dose of prednisolone since SLE diagnosis (16.5 vs 10.7 grams; p = 0.001). The SLE damage score (excluding AVN) was also significantly higher in AVN than non-AVN patients (2.5 vs 0.4; p < 0.001). Logistic regression revealed that preceding septic arthritis of the involved joint (odds ratio (OR) 17.7 (1.5-205); p = 0.02), cushingoid body habitus (OR 2.4 (1.1-5.2); p = 0.04), LDL cholesterol level (OR 1.4 (1.0-1.9); p = 0.04), maximum daily dose of prednisolone (OR 6.4 (1.2-33.3); p = 0.03) and cumulative dose of prednisolone received in the first six months of the first lupus flare (OR 1.3 (1.0-1.8); p = 0.046) were independently associated with AVN. Conclusions AVN is prevalent in SLE

  17. Consumer Food Safety Risk Attitudes and Perceptions Over Time: The Case of BSE Crisis

    NARCIS (Netherlands)

    Kalogeras, N.; Pennings, J.M.E.; Ittersum, van K.

    2009-01-01

    Recent research has shown that by decoupling the risk response behaviour of consumers into the separate components of risk perception and risk attitude, a more robust conceptualization and prediction of consumers’ reactions to food safety issues is possible. Furthermore, it has been argued that the

  18. 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.

  19. 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.

  20. Real-time flood forecasts & risk assessment using a possibility-theory based fuzzy neural network

    Science.gov (United States)

    Khan, U. T.

    2016-12-01

    Globally floods are one of the most devastating natural disasters and improved flood forecasting methods are essential for better flood protection in urban areas. Given the availability of high resolution real-time datasets for flood variables (e.g. streamflow and precipitation) in many urban areas, data-driven models have been effectively used to predict peak flow rates in river; however, the selection of input parameters for these types of models is often subjective. Additionally, the inherit uncertainty associated with data models along with errors in extreme event observations means that uncertainty quantification is essential. Addressing these concerns will enable improved flood forecasting methods and provide more accurate flood risk assessments. In this research, a new type of data-driven model, a quasi-real-time updating fuzzy neural network is developed to predict peak flow rates in urban riverine watersheds. A possibility-to-probability transformation is first used to convert observed data into fuzzy numbers. A possibility theory based training regime is them used to construct the fuzzy parameters and the outputs. A new entropy-based optimisation criterion is used to train the network. Two existing methods to select the optimum input parameters are modified to account for fuzzy number inputs, and compared. These methods are: Entropy-Wavelet-based Artificial Neural Network (EWANN) and Combined Neural Pathway Strength Analysis (CNPSA). Finally, an automated algorithm design to select the optimum structure of the neural network is implemented. The overall impact of each component of training this network is to replace the traditional ad hoc network configuration methods, with one based on objective criteria. Ten years of data from the Bow River in Calgary, Canada (including two major floods in 2005 and 2013) are used to calibrate and test the network. The EWANN method selected lagged peak flow as a candidate input, whereas the CNPSA method selected lagged

  1. Greater trochanteric pain syndrome diagnosis and treatment.

    Science.gov (United States)

    Mallow, Michael; Nazarian, Levon N

    2014-05-01

    Lateral hip pain, or greater trochanteric pain syndrome, is a commonly seen condition; in this article, the relevant anatomy, epidemiology, and evaluation strategies of greater trochanteric pain syndrome are reviewed. Specific attention is focused on imaging of this syndrome and treatment techniques, including ultrasound-guided interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Gait initiation time is associated with the risk of multiple falls-A population-based study.

    Science.gov (United States)

    Callisaya, Michele L; Blizzard, Leigh; Martin, Kara; Srikanth, Velandai K

    2016-09-01

    In a population-based study of older people to examine whether 1) overall gait initiation (GI) time or its components are associated with falls and 2) GI under dual-task is a stronger predictor of falls risk than under single-task. Participants aged 60-85 years were randomly selected from the electoral roll. GI was obtained with a force platform under both single and dual-task conditions. Falls were ascertained prospectively over a 12-month period. Log multinomial regression was used to examine the association between GI time (total and its components) and risk of single and multiple falls. Age, sex and physiological and cognitive falls risk factors were considered as confounders. The mean age of the sample (n=124) was 71.0 (SD 6.8) years and 58.9% (n=73) were male. Over 12 months 21.8% (n=27) of participants reported a single fall and 16.1% (n=20) reported multiple falls. Slower overall GI time under both single (RR all per 100ms 1.28, 95%CI 1.03, 1.58) and dual-task (RR 1.14, 95%CI 1.02, 1.27) was associated with increased risk of multiple, but not single falls (pfalls were also associated with slower time to first lateral movement under single-task (RR 1.90 95%CI 0.59, 1.51) and swing time under dual-task condition (RR 1.44 95%CI 1.08, 1.94). Slower GI time is associated with the risk of multiple falls independent of other risk factors, suggesting it could be used as part of a comprehensive falls assessment. Time to the first lateral movement under single-task may be the best measures of this risk. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Professional Skepticism and Auditors’ Assessment of Misstatement Risks: The Moderating Effect of Experience and Time Budget Pressure

    Directory of Open Access Journals (Sweden)

    Sayed Alwee Hussnie Sayed Hussin

    2017-12-01

    Full Text Available Background: This study employs a field experiment to examine the relationship between professional skepticism, experience, and time budget pressure on auditors’ assessment of risk of misstatement. In addition, the study examines the moderating effect of experience and time budget pressure on the relationship between professional skepticism and auditors’ assessment of risk from material misstatements; 2 Method: This study employs a multiple regression analysis on 248 auditors from both Big4 and non-Big4 firms; 3 The results indicate that professional skepticism and experience have positive effects while time budget pressure has a negative effect on auditors’ assessment of risk from material misstatements; and 4 The positive effect of professional skepticism on auditors’ assessment of risk from material misstatement is stronger among more experienced auditors than that among less experienced. On the other hand, the positive effect of professional skepticism on risk assessment is weaker when auditors work under high time budget pressure than that when they work under low time budget pressure. Additional analysis on the samples from the two selected areas, Kuala Lumpur and Selangor, produces consistent results indicating that the use of separate models for different samples is not necessary. Hence, the study uses a single model for the final analysis. The results provide a better understanding on whether the auditors are able to sustain professional skepticism with a given amount of relevant audit experience and under different levels of time budget pressure.

  4. Computer/Mobile Device Screen Time of Children and Their Eye Care Behavior: The Roles of Risk Perception and Parenting.

    Science.gov (United States)

    Chang, Fong-Ching; Chiu, Chiung-Hui; Chen, Ping-Hung; Miao, Nae-Fang; Chiang, Jeng-Tung; Chuang, Hung-Yi

    2018-03-01

    This study assessed the computer/mobile device screen time and eye care behavior of children and examined the roles of risk perception and parental practices. Data were obtained from a sample of 2,454 child-parent dyads recruited from 30 primary schools in Taipei city and New Taipei city, Taiwan, in 2016. Self-administered questionnaires were collected from students and parents. Fifth-grade students spend more time on new media (computer/smartphone/tablet: 16 hours a week) than on traditional media (television: 10 hours a week). The average daily screen time (3.5 hours) for these children exceeded the American Academy of Pediatrics recommendations (≤2 hours). Multivariate analysis results showed that after controlling for demographic factors, the parents with higher levels of risk perception and parental efficacy were more likely to mediate their child's eye care behavior. Children who reported lower academic performance, who were from non-intact families, reported lower levels of risk perception of mobile device use, had parents who spent more time using computers and mobile devices, and had lower levels of parental mediation were more likely to spend more time using computers and mobile devices; whereas children who reported higher academic performance, higher levels of risk perception, and higher levels of parental mediation were more likely to engage in higher levels of eye care behavior. Risk perception by children and parental practices are associated with the amount of screen time that children regularly engage in and their level of eye care behavior.

  5. Separate and Joint Associations of Occupational and Leisure-Time Sitting with Cardio-Metabolic Risk Factors in Working Adults

    DEFF Research Database (Denmark)

    Saidj, Madina; Jørgensen, Torben; Jacobsen, Rikke K

    2013-01-01

    The workplace is a main setting for prolonged sitting for some occupational groups. Convincing evidence has recently accumulated on the detrimental cardio-metabolic health effects of leisure-time sitting. Yet, much less is known about occupational sitting, and the potential health risk attached...... compared to leisure-time sitting....

  6. MITRA Virtual laboratory for operative application of satellite time series for land degradation risk estimation

    Science.gov (United States)

    Nole, Gabriele; Scorza, Francesco; Lanorte, Antonio; Manzi, Teresa; Lasaponara, Rosa

    2015-04-01

    This paper aims to present the development of a tool to integrate time series from active and passive satellite sensors (such as of MODIS, Vegetation, Landsat, ASTER, COSMO, Sentinel) into a virtual laboratory to support studies on landscape and archaeological landscape, investigation on environmental changes, estimation and monitoring of natural and anthropogenic risks. The virtual laboratory is composed by both data and open source tools specifically developed for the above mentioned applications. Results obtained for investigations carried out using the implemented tools for monitoring land degradation issues and subtle changes ongoing on forestry and natural areas are herein presented. In detail MODIS, SPOT Vegetation and Landsat time series were analyzed comparing results of different statistical analyses and the results integrated with ancillary data and evaluated with field survey. The comparison of the outputs we obtained for the Basilicata Region from satellite data analyses and independent data sets clearly pointed out the reliability for the diverse change analyses we performed, at the pixel level, using MODIS, SPOT Vegetation and Landsat TM data. Next steps are going to be implemented to further advance the current Virtual Laboratory tools, by extending current facilities adding new computational algorithms and applying to other geographic regions. Acknowledgement This research was performed within the framework of the project PO FESR Basilicata 2007/2013 - Progetto di cooperazione internazionale MITRA "Remote Sensing tecnologies for Natural and Cultural heritage Degradation Monitoring for Preservation and valorization" funded by Basilicata Region Reference 1. A. Lanorte, R Lasaponara, M Lovallo, L Telesca 2014 Fisher-Shannon information plane analysis of SPOT/VEGETATION Normalized Difference Vegetation Index (NDVI) time series to characterize vegetation recovery after fire disturbance International Journal of Applied Earth Observation and

  7. A new perspective on human health risk assessment: Development of a time dependent methodology and the effect of varying exposure durations

    International Nuclear Information System (INIS)

    Siirila, Erica R.; Maxwell, Reed M.

    2012-01-01

    We present a new Time Dependent Risk Assessment (TDRA) that stochastically considers how joint uncertainty and inter-individual variability (JUV) associated with human health risk change as a function of time. In contrast to traditional, time independent assessments of risk, this new formulation relays information on when the risk occurs, how long the duration of risk is, and how risk changes with time. Because the true exposure duration (ED) is often uncertain in a risk assessment, we also investigate how varying the magnitude of fixed size durations (ranging between 5 and 70 years) of this parameter affects the distribution of risk in both the time independent and dependent methodologies. To illustrate this new formulation and to investigate these mechanisms for sensitivity, an example of arsenic contaminated groundwater is used in conjunction with two scenarios of different environmental concentration signals resulting from rate dependencies in geochemical reactions. Cancer risk is computed and compared using environmental concentration ensembles modeled with sorption as 1) a linear equilibrium assumption (LEA) and 2) first order kinetics (Kin). Results show that the information attained in the new time dependent methodology reveals how the uncertainty in other time-dependent processes in the risk assessment may influence the uncertainty in risk. We also show that individual susceptibility also affects how risk changes in time, information that would otherwise be lost in the traditional, time independent methodology. These results are especially pertinent for forecasting risk in time, and for risk managers who are assessing the uncertainty of risk. - Highlights: ► A human health, Time Dependent Risk Assessment (TDRA) methodology is presented. ► TDRA relays information on the magnitude, duration, and fluxes of risk in time. ► Kinetic and equilibrium concentration signals show sensitivity in TDRA results. ► In the TDRA results, individual susceptibility

  8. Pancreatic cellular injury after cardiac surgery with cardiopulmonary bypass: frequency, time course and risk factors.

    Science.gov (United States)

    Nys, Monique; Venneman, Ingrid; Deby-Dupont, Ginette; Preiser, Jean-Charles; Vanbelle, Sophie; Albert, Adelin; Camus, Gérard; Damas, Pierre; Larbuisson, Robert; Lamy, Maurice

    2007-05-01

    Although often clinically silent, pancreatic cellular injury (PCI) is relatively frequent after cardiac surgery with cardiopulmonary bypass; and its etiology and time course are largely unknown. We defined PCI as the simultaneous presence of abnormal values of pancreatic isoamylase and immunoreactive trypsin (IRT). The frequency and time evolution of PCI were assessed in this condition using assays for specific exocrine pancreatic enzymes. Correlations with inflammatory markers were searched for preoperative risk factors. One hundred ninety-three patients submitted to cardiac surgery were enrolled prospectively. Blood IRT, amylase, pancreatic isoamylase, lipase, and markers of inflammation (alpha1-protease inhibitor, alpha2-macroglobulin, myeloperoxidase) were measured preoperatively and postoperatively until day 8. The postoperative increase in plasma levels of pancreatic enzymes and urinary IRT was biphasic in all patients: early after surgery and later (from day 4 to 8 after surgery). One hundred thirty-three patients (69%) experienced PCI, with mean IRT, isoamylase, and alpha1-protease inhibitor values higher for each sample than that in patients without PCI. By multiple regression analysis, we found preoperative values of plasma IRT >or=40 ng/mL, amylase >or=42 IU/mL, and pancreatic isoamylase >or=20 IU/L associated with a higher incidence of postsurgery PCI (P < 0.005). In the PCI patients, a significant correlation was found between the 4 pancreatic enzymes and urinary IRT, total calcium, myeloperoxidase, alpha1-protease inhibitor, and alpha2-macroglobulin. These data support a high prevalence of postoperative PCI after cardiac surgery with cardiopulmonary bypass, typically biphasic and clinically silent, especially when pancreatic enzymes were elevated preoperatively.

  9. Metabolic Risk Factors, Leisure Time Physical Activity, and Nutrition in German Children and Adolescents

    Science.gov (United States)

    Haas, Gerda-Maria; Liepold, Evelyn; Schwandt, Peter

    2012-01-01

    Purpose. We assessed the five components of the metabolic syndrome (MetS) as defined by the International Diabetes Federation (IDF) in 6040 (3158 males) youths aged 6–16 years who participated in the Präventions-Erziehungs-Programm (PEP Family Heart Study) in Nuernberg between 2000 and 2007. The purpose of this cross-sectional study was to examine associations with lifestyle habits. Results and Discussion. The prevalence of MetS was low in children (1.6%) and adolescents (2.3%). High waist circumference (WC) and low HDL-C were slightly higher in females (9.5% and 7.5%, resp.) than in males (8.8% and 5.7%, resp.). Low leisure time physical activity (LTPA) was significantly associated with low HDL-C (odds ratio [OR] 2.4; 95% CI 1.2–5.0) and inversely associated with hypertension (r = −0.146), hypertriglyceridemia (r = −0.141), and central adiposity (r = −0.258). The risk for low HDL-C (≤1.3 mmol/L) was 1.7-fold (CI 1.0–2.6) higher in youth with high (≥33%) saturated fat consumption. A low polyunsaturated/saturated fat ratio (P/S ratio) was significantly associated with fasting hyperglycemia (OR 1.4; 95% CI 1.0–1.2). PMID:22778928

  10. Leisure-time physical activity and risk of type 2 diabetes in patients with established vascular disease or poorly controlled vascular risk factors

    NARCIS (Netherlands)

    Brouwer, B.G.; Graaf, van der Y.; Soedamah-Muthu, S.S.; Wassink, A.M.J.; Visseren, F.L.J.

    2010-01-01

    AIM: To investigate the effect of leisure-time physical activity on the incidence of type 2 diabetes (T2DM) in patients with manifest arterial disease, or poorly controlled risk factors. METHODS: We examined 3940 patients with manifest arterial disease, hypertension or hyperlipidemia, aged

  11. High occupational physical activity and risk of ischaemic heart disease in women: the interplay with physical activity during leisure time.

    Science.gov (United States)

    Allesøe, Karen; Holtermann, Andreas; Aadahl, Mette; Thomsen, Jane F; Hundrup, Yrsa A; Søgaard, Karen

    2015-12-01

    Recent studies indicate that physically demanding work is a risk factor for heart disease among men, especially those with low or moderate physical activity during leisure time. Among women, present evidence is inconclusive. The design was a prospective cohort study. This investigation in the Danish Nurse Cohort Study included 12,093 female nurses aged 45-64 years, who answered a self-report questionnaire on physical activity at work and during leisure time, known risk factors for ischaemic heart disease (IHD) and occupational factors at baseline in 1993. Information on the 15-year incidence of IHD was obtained by individual linkage in the National Register of Hospital Discharges to 2008. During follow-up 580 participants were hospitalised with IHD. A significant interaction between occupational and leisure time physical activity was found with the lowest risk of IHD among nurses with the combination of moderate physical activity at work and vigorous physical activity during leisure time. Compared to this group high physical activity at work was associated with a higher risk of IHD at all levels of physical activity during leisure time increasing from hazard ratio 1.75 (95% confidence interval (CI) 1.10-2.80) among nurses with vigorous physical activity during leisure time to 2.65 (95% CI 1.44-4.88) among nurses being sedentary during leisure time. This study among Danish nurses suggests that high physical activity at work is a risk factor for IHD among women. Vigorous physical activity during leisure time lowered but did not completely counteract the adverse effect of occupational physical activity on risk of IHD. © The European Society of Cardiology 2014.

  12. [Delivery during time of shift change is not a risk factor for obstetric complication: a historical cohort study].

    Science.gov (United States)

    Reichman, Orna; Samueloff, Arnon; Gdansky, Efraim; Yekel, Yael; Calderon-Margalit, Ronit

    2015-03-01

    The time of shift change is a unique time because the continuity of routine care is interrupted. The association between delivery during time of shift change and obstetric complications has not been evaluated. We hypothesized that delivery during time of shift change is at risk for obstetric complications. A historical cohort study was performed of all women with a singleton pregnancy undergoing a trial of labor at term during 2006-2010. Data was extracted from a computerized database that is continuously updated during Labor. The hour of delivery was divided into two categories: "morning shift" (09:30-15:00) and "time of shift change" which was defined 30 minutes prior to and 90 minutes past the official time of shift change, which occurs twice daily at 07:30 and 15:30. Multivariate logistic regression models were implemented to estimate the association between deliveries during "time of shift change" compared to "morning weekdays", with instrumental delivery (primary outcome) and prolonged second stage, unplanned cesarean section, postpartum hemorrhage, 5 minutes Apgar score deliveries were included in the cohort. No statistical difference in instrumental vaginal delivery was documented for women delivering during "time of shift change compared to morning shift weekdays (OR = 0.96, 95% CI: 0.83- 1.11, p = 0.605). None of the secondary outcomes were found at risk for women delivering during "time of shift change". Delivery during "time of shift change" does not pose additional risk for obstetric complications.

  13. Three essays on productivity and risk, marketing decisions, and changes in well-being over time

    OpenAIRE

    Larochelle, Catherine

    2011-01-01

    This dissertation is composed of three essays; the first two examine the decision-making of potato producing households in Bolivia and the third examines well-being changes among Zimbabwe households. The first essay entitled â The role of risk mitigation in production efficiency: A case study of potato cultivation in the Bolivian Andesâ estimates the costs of self-managing environmental risk through activity and environmental diversification. Risk management has the potential to reduce in...

  14. Rationale and study design for a randomised controlled trial to reduce sedentary time in adults at risk of type 2 diabetes mellitus: project stand (Sedentary Time ANd diabetes

    Directory of Open Access Journals (Sweden)

    Wilmot Emma G

    2011-12-01

    Full Text Available Abstract Background The rising prevalence of Type 2 Diabetes Mellitus (T2DM is a major public health problem. There is an urgent need for effective lifestyle interventions to prevent the development of T2DM. Sedentary behaviour (sitting time has recently been identified as a risk factor for diabetes, often independent of the time spent in moderate-to-vigorous physical activity. Project STAND (Sedentary Time ANd Diabetes is a study which aims to reduce sedentary behaviour in younger adults at high risk of T2DM. Methods/Design A reduction in sedentary time is targeted using theory driven group structured education. The STAND programme is subject to piloting and process evaluation in line with the MRC framework for complex interventions. Participants are encouraged to self-monitor and self-regulate their behaviour. The intervention is being assessed in a randomised controlled trial with 12 month follow up. Inclusion criteria are a aged 18-40 years with a BMI in the obese range; b 18-40 years with a BMI in the overweight range plus an additional risk factor for T2DM. Participants are randomised to the intervention (n = 89 or control (n = 89 arm. The primary outcome is a reduction in sedentary behaviour at 12 months as measured by an accelerometer (count Conclusions This is the first UK trial to address sedentary behaviour change in a population of younger adults at risk of T2DM. The results will provide a platform for the development of a range of future multidisciplinary interventions in this rapidly expanding high-risk population. Trial registration Current controlled trials ISRCTN08434554, MRC project 91409.

  15. Projection of radiation-induced cancer risks across time and populations

    International Nuclear Information System (INIS)

    Muirhead, C.R.

    1991-01-01

    Various methods can be used to project the risks of radiation-induced cancer estimated in cohort studies beyond the period of follow-up and to other populations. The choice of risk projection model is reviewed based on data from studies such as those of the Japanese atomic bomb survivors and UK ankylosing spondylitis patients given X ray therapy. Risk estimates applicable to a UK population are calculated on the basis of various models, including those developed by the BEIR V Committee. It is emphasised that the continued follow-up of populations such as the Japanese atomic bomb survivors is of great importance in estimating lifetime risks. (author)

  16. Frequency and Circadian Timing of Eating May Influence Biomarkers of Inflammation and Insulin Resistance Associated with Breast Cancer Risk

    OpenAIRE

    Marinac, Catherine R.; Sears, Dorothy D.; Natarajan, Loki; Gallo, Linda C.; Breen, Caitlin I.; Patterson, Ruth E.

    2015-01-01

    Emerging evidence suggests that there is interplay between the frequency and circadian timing of eating and metabolic health. We examined the associations of eating frequency and timing with metabolic and inflammatory biomarkers putatively associated with breast cancer risk in women participating in the National Health and Nutrition Examination 2009-2010 Survey. Eating frequency and timing variables were calculated from 24-hour food records and included (1) proportion of calories consumed in ...

  17. Differences in time course activation of dorsolateral prefrontal cortex associated with low or high risk choicesin a gambling task

    Directory of Open Access Journals (Sweden)

    Stefano eBembich

    2014-06-01

    Full Text Available Prefrontal cortex plays an important role in decision making (DM, supporting choices in the ordinary uncertainty of everyday life. To assess DM in an unpredictable situation, a playing card task, such as the Iowa Gambling Task (IGT, has been proposed. This task is supposed to specifically test emotion-based learning, linked to the integrity of the ventromedial prefrontal cortex (VMPFC. However, the dorsolateral prefrontal cortex (DLPFC has demonstrated a role in IGT performance too. Our aim was to study, by multichannel near-infrared spectroscopy, the contribution of DLPFC to the IGT execution over time. We tested the hypothesis that low and high risk choices would differentially activate DLPFC, as IGT execution progressed. We enrolled 11 healthy adults. To identify DLPFC activation associated with IGT choices, we compared regional differences in oxy-haemoglobin variation, from baseline to the event. The time course of task execution was divided in four periods, each one consisting of 25 choices, and DLPFC activation was distinctly analyzed for low and high risk choices in each period. We found different time courses in DLPFC activation, associated with low or high risk choices. During the first period, a significant DLPFC activation emerged with low risk choices, whereas, during the second period, we found a cortical activation with high risk choices. Then, DLPFC activation decreased to non-significant levels during the third and fourth period. This study shows that DLPFC involvement in IGT execution is differentiated over time and according to choice risk level. DLPFC is activated only in the first half of the task, earlier by low risk and later by high risk choices. We speculate that DLPFC may sustain initial and more cognitive functions, such as attention shifting and response inhibition. The lack of DLPFC activation, as the task progresses, may be due to VMPFC activation, not detectable by fNIRS, which takes over the IGT execution in its

  18. Quantifying risk over the life course - latency, age-related susceptibility, and other time-varying exposure metrics.

    Science.gov (United States)

    Wang, Molin; Liao, Xiaomei; Laden, Francine; Spiegelman, Donna

    2016-06-15

    Identification of the latency period and age-related susceptibility, if any, is an important aspect of assessing risks of environmental, nutritional, and occupational exposures. We consider estimation and inference for latency and age-related susceptibility in relative risk and excess risk models. We focus on likelihood-based methods for point and interval estimation of the latency period and age-related windows of susceptibility coupled with several commonly considered exposure metrics. The method is illustrated in a study of the timing of the effects of constituents of air pollution on mortality in the Nurses' Health Study. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Quantifying Risk Over the Life Course – Latency, Age-Related Susceptibility, and Other Time-Varying Exposure Metrics

    Science.gov (United States)

    Wang, Molin; Liao, Xiaomei; Laden, Francine; Spiegelman, Donna

    2016-01-01

    Identification of the latency period and age-related susceptibility, if any, is an important aspect of assessing risks of environmental, nutritional and occupational exposures. We consider estimation and inference for latency and age-related susceptibility in relative risk and excess risk models. We focus on likelihood-based methods for point and interval estimation of the latency period and age-related windows of susceptibility coupled with several commonly considered exposure metrics. The method is illustrated in a study of the timing of the effects of constituents of air pollution on mortality in the Nurses’ Health Study. PMID:26750582

  20. Just-in-Time Training for High-Risk Low-Volume Therapies: An Approach to Ensure Patient Safety.

    Science.gov (United States)

    Helman, Stephanie; Lisanti, Amy Jo; Adams, Ann; Field, Cynthia; Davis, Katherine Finn

    2016-01-01

    High-risk low-volume therapies are those therapies that are practiced infrequently and yet carry an increased risk to patients because of their complexity. Staff nurses are required to competently manage these therapies to treat patients' unique needs and optimize outcomes; however, maintaining competence is challenging. This article describes implementation of Just-in-Time Training, which requires validation of minimum competency of bedside nurses managing high-risk low-volume therapies through direct observation of a return-demonstration competency checklist.

  1. A time consistent risk averse three-stage stochastic mixed integer optimization model for power generation capacity expansion

    International Nuclear Information System (INIS)

    Pisciella, P.; Vespucci, M.T.; Bertocchi, M.; Zigrino, S.

    2016-01-01

    We propose a multi-stage stochastic optimization model for the generation capacity expansion problem of a price-taker power producer. Uncertainties regarding the evolution of electricity prices and fuel costs play a major role in long term investment decisions, therefore the objective function represents a trade-off between expected profit and risk. The Conditional Value at Risk is the risk measure used and is defined by a nested formulation that guarantees time consistency in the multi-stage model. The proposed model allows one to determine a long term expansion plan which takes into account uncertainty, while the LCoE approach, currently used by decision makers, only allows one to determine which technology should be chosen for the next power plant to be built. A sensitivity analysis is performed with respect to the risk weighting factor and budget amount. - Highlights: • We propose a time consistent risk averse multi-stage model for capacity expansion. • We introduce a case study with uncertainty on electricity prices and fuel costs. • Increased budget moves the investment from gas towards renewables and then coal. • Increased risk aversion moves the investment from coal towards renewables. • Time inconsistency leads to a profit gap between planned and implemented policies.

  2. Real-Time Optimal Flood Control Decision Making and Risk Propagation Under Multiple Uncertainties

    Science.gov (United States)

    Zhu, Feilin; Zhong, Ping-An; Sun, Yimeng; Yeh, William W.-G.

    2017-12-01

    Multiple uncertainties exist in the optimal flood control decision-making process, presenting risks involving flood control decisions. This paper defines the main steps in optimal flood control decision making that constitute the Forecast-Optimization-Decision Making (FODM) chain. We propose a framework for supporting optimal flood control decision making under multiple uncertainties and evaluate risk propagation along the FODM chain from a holistic perspective. To deal with uncertainties, we employ stochastic models at each link of the FODM chain. We generate synthetic ensemble flood forecasts via the martingale model of forecast evolution. We then establish a multiobjective stochastic programming with recourse model for optimal flood control operation. The Pareto front under uncertainty is derived via the constraint method coupled with a two-step process. We propose a novel SMAA-TOPSIS model for stochastic multicriteria decision making. Then we propose the risk assessment model, the risk of decision-making errors and rank uncertainty degree to quantify the risk propagation process along the FODM chain. We conduct numerical experiments to investigate the effects of flood forecast uncertainty on optimal flood control decision making and risk propagation. We apply the proposed methodology to a flood control system in the Daduhe River basin in China. The results indicate that the proposed method can provide valuable risk information in each link of the FODM chain and enable risk-informed decisions with higher reliability.

  3. Time-varying betas and Cross-Sectional Return-Risk Relation: Evidence from the UK

    NARCIS (Netherlands)

    Fraser, P; MacGregor, B.; Hoesli, M.; Hamelink, F.

    2004-01-01

    The seminal study by Fama and MacBeth in 1973 initiated a stream of papers testing for the cross-sectional relation between return and risk. The debate as to whether beta is a valid measure of risk was reanimated by Fama and French and subsequent studies. Rather than focusing on exogenous variables

  4. The importance of data collection for timely and accurate risk assessment

    Science.gov (United States)

    Gilsenan, MB

    2017-09-01

    The European Food Safety Authority (EFSA) is responsible for food safety risk assessments at EU level. It provides independent scientific advice on risks associated with the food chain to support EU risk management decisions. Since its establishment, EFSA has amassed a wealth of data to underpin its risk assessments, such as food consumption data, monitoring data and experimental data. Increasing transparency of its risk assessments is a core objective of EFSA. EFSA aims to enhance the quality and transparency of its outputs by giving insofar as possible access to data and methods underpinning its scientific outputs. This paper provides an overview of the role of EFSA, its core data collections and their regulatory framework, as well as data quality and standardisation aspects. Finally, the paper elaborates on EFSA’s 2020 strategy in relation to data, and describes EFSA scientific data warehouse and Knowledge Junction in this regard.

  5. Leisure-Time Physical Activity, but not Commuting Physical Activity, is Associated with Cardiovascular Risk among ELSA-Brasil Participants.

    Science.gov (United States)

    Pitanga, Francisco José Gondim; Matos, Sheila M A; Almeida, Maria da Conceição; Barreto, Sandhi Maria; Aquino, Estela M L

    2018-01-01

    Despite reports in the literature that both leisure-time physical activity (LTPA) and commuting physical activity (CPA) can promote health benefits, the literature lacks studies comparing the associations of these domains of physical activity with cardiovascular risk scores. To investigate the association between LTPA and CPA with different cardiovascular risk scores in the cohort of the Longitudinal Study of Adult Health ELSA-Brasil. Cross-sectional study with data from 13,721 participants of both genders, aged 35-74 years, free of cardiovascular disease, from ELSA Brazil. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ). Five cardiovascular risk scores were used: Framingham score - coronary heart disease (cholesterol); Framingham score - coronary heart disease (LDL-C); Framingham score - cardiovascular disease (cholesterol); Framingham score - cardiovascular disease (body mass index, BMI); and pooled cohort equations for atherosclerotic cardiovascular disease (ASCVD). Associations adjusted for confounding variables between physical activity and different cardiovascular risk scores were analyzed by logistic regression. Confidence interval of 95% (95%CI) was considered. LTPA is inversely associated with almost all cardiovascular risk scores analyzed, while CPA shows no statistically significant association with any of them. Dose-response effect in association between LTPA and cardiovascular risk scores was also found, especially in men. LTPA was shown to be associated with the cardiovascular risk scores analyzed, but CPA not. The amount of physical activity (duration and intensity) was more significantly associated, especially in men, with cardiovascular risk scores in ELSA-Brasil.

  6. Natural Time, Nowcasting and the Physics of Earthquakes: Estimation of Seismic Risk to Global Megacities

    Science.gov (United States)

    Rundle, John B.; Luginbuhl, Molly; Giguere, Alexis; Turcotte, Donald L.

    2018-02-01

    Natural Time ("NT") refers to the concept of using small earthquake counts, for example of M > 3 events, to mark the intervals between large earthquakes, for example M > 6 events. The term was first used by Varotsos et al. (2005) and later by Holliday et al. (2006) in their studies of earthquakes. In this paper, we discuss ideas and applications arising from the use of NT to understand earthquake dynamics, in particular by use of the idea of nowcasting. Nowcasting differs from forecasting, in that the goal of nowcasting is to estimate the current state of the system, rather than the probability of a future event. Rather than focus on an individual earthquake faults, we focus on a defined local geographic region surrounding a particular location. This local region is considered to be embedded in a larger regional setting from which we accumulate the relevant statistics. We apply the nowcasting idea to the practical development of methods to estimate the current state of risk for dozens of the world's seismically exposed megacities, defined as cities having populations of over 1 million persons. We compute a ranking of these cities based on their current nowcast value, and discuss the advantages and limitations of this approach. We note explicitly that the nowcast method is not a model, in that there are no free parameters to be fit to data. Rather, the method is simply a presentation of statistical data, which the user can interpret. Among other results, we find, for example, that the current nowcast ranking of the Los Angeles region is comparable to its ranking just prior to the January 17, 1994 Northridge earthquake.

  7. A time-motion study of cardiovascular disease risk factor screening integrated into HIV clinic visits in Swaziland.

    Science.gov (United States)

    Palma, Anton M; Rabkin, Miriam; Simelane, Samkelo; Gachuhi, Averie B; McNairy, Margaret L; Nuwagaba-Biribonwoha, Harriet; Bongomin, Pido; Okello, Velephi N; Bitchong, Raymond A; El-Sadr, Wafaa M

    2018-03-01

    Screening of modifiable cardiovascular disease (CVD) risk factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without screening and measured time spent on HIV and CVD risk factor screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with screening. We observed 172 patient visits (122 with CVD risk factor screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p < 0.01). Time spent on HIV care was not affected: 4 (2 to 10) versus 4 (2 to 11) (p = 0.57). We recruited 126 patients for exit interviews, all of whom indicated that they would recommend screening to others. Provision of CVD risk factor screening more than tripled the length of routine HIV clinic visits but did not reduce the time spent on HIV services. Programme managers need to take longer visit duration into account in order to effectively integrate CVD risk factor screening and counselling into HIV programmes. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

  8. Does the duration and time of sleep increase the risk of allergic rhinitis? Results of the 6-year nationwide Korea youth risk behavior web-based survey.

    Directory of Open Access Journals (Sweden)

    Jeoung A Kwon

    Full Text Available Allergic rhinitis (AR is the most common chronic disorder in the pediatric population. Although several studies have investigated the correlation between AR and sleep-related issues, the association between the duration and time of sleep and AR has not been analyzed in long-term national data. This study investigated the relationship between sleep time and duration and AR risk in middle- and high-school students (adolescents aged 12-18. We analyzed national data from the Korea Youth Risk Behavior Web-based Survey by the Korea Centers for Disease Control and Prevention from 2007-2012. The sample size was 274,480, with an average response rate of 96.2%. Multivariate logistic regression analyses were conducted to determine the relationship between sleep and AR risk. Furthermore, to determine the best-fitted model among independent variables such as sleep duration, sleep time, and the combination of sleep duration and sleep time, we used Akaike Information Criteria (AIC to compare models. A total of 43,337 boys and 41,665 girls reported a diagnosis of AR at baseline. The odds ratio increased with age and with higher education and economic status of the parents. Further, students in mid-sized and large cities had stronger relationships to AR than those in small cities. In both genders, AR was associated with depression and suicidal ideation. In the analysis of sleep duration and sleep time, the odds ratio increased in both genders when sleep duration was <7 hours, and when the time of sleep was later than 24:00 hours. Our results indicate an association between sleep time and duration and AR. This study is the first to focus on the relationship between sleep duration and time and AR in national survey data collected over 6 years.

  9. Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab).

    Science.gov (United States)

    Healy, Genevieve N; Wijndaele, Katrien; Dunstan, David W; Shaw, Jonathan E; Salmon, Jo; Zimmet, Paul Z; Owen, Neville

    2008-02-01

    We examined the associations of objectively measured sedentary time and physical activity with continuous indexes of metabolic risk in Australian adults without known diabetes. An accelerometer was used to derive the percentage of monitoring time spent sedentary and in light-intensity and moderate-to-vigorous-intensity activity, as well as mean activity intensity, in 169 Australian Diabetes, Obesity and Lifestyle Study (AusDiab) participants (mean age 53.4 years). Associations with waist circumference, triglycerides, HDL cholesterol, resting blood pressure, fasting plasma glucose, and a clustered metabolic risk score were examined. Independent of time spent in moderate-to-vigorous-intensity activity, there were significant associations of sedentary time, light-intensity time, and mean activity intensity with waist circumference and clustered metabolic risk. Independent of waist circumference, moderate-to-vigorous-intensity activity time was significantly beneficially associated with triglycerides. These findings highlight the importance of decreasing sedentary time, as well as increasing time spent in physical activity, for metabolic health.

  10. Obesity as a Possible Risk Factor for Lost-time Injury in Registered Nurses: A Literature Review

    Directory of Open Access Journals (Sweden)

    Gillian Jordan

    2015-03-01

    Full Text Available Time-loss injuries are still a major occurrence in Canada, injuring thousands of Canadian workers each year. With obesity rates on the rise across the country, as well as around the world, it is important that the possible effects of obesity in the workplace be fully understood, especially those effects linked to lost-time injuries. The aim of this paper was to evaluate predictors of workplace lost-time injuries and how they may be related to obesity or high body mass index by examining factors associated with lost-time injuries in the health care sector, a well-studied industry with the highest number of reported time loss injuries in Canada. A literature review focusing on lost-time injuries in Registered Nurses (RNs was conducted using the keywords and terms: lost time injury, workers' compensation, occupational injury, workplace injury, injury, injuries, work, workplace, occupational, nurse, registered nurse, RN, health care, predictors, risk factors, risk, risks, cause, causes, obese, obesity, and body mass index. Data on predictors or factors associated with lost-time injuries in RNs were gathered and organized using Loisel's Work Disability Prevention Management Model and extrapolated upon using existing literature surrounding obesity in the Canadian workplace.

  11. Nuclear financial risk

    International Nuclear Information System (INIS)

    Heising, C.D.; George, V.P.

    1986-01-01

    This study examines the economy-wide financial risk associated with reactor accidents as a result of various regulatory response options that might be imposed after a serious accident, including partial or complete nuclear moratoria. The authors find that such risks may be two to three times greater than the plant-specific financial risk estimates that have previously been calculated by others (ie 500 million (1985) dollars per reactor year versus 5 to 50 million dollars). (author)

  12. Screening youth for suicide risk in medical settings: time to ask questions.

    Science.gov (United States)

    Horowitz, Lisa M; Bridge, Jeffrey A; Pao, Maryland; Boudreaux, Edwin D

    2014-09-01

    This paper focuses on the National Action Alliance for Suicide Prevention's Research Prioritization Task Force's Aspirational Goal 2 (screening for suicide risk) as it pertains specifically to children, adolescents, and young adults. Two assumptions are forwarded: (1) strategies for screening youth for suicide risk need to be tailored developmentally; and (2) we must use instruments that were created and tested specifically for suicide risk detection and developed specifically for youth. Recommendations for shifting the current paradigm include universal suicide screening for youth in medical settings with validated instruments. Published by Elsevier Inc.

  13. AFFECT AND THE FRAMING EFFECT WITHIN INDIVIDUALS OVER TIME: RISK TAKING IN A DYNAMIC INVESTMENT SIMULATION.

    Science.gov (United States)

    Seo, Myeong-Gu; Goldfarb, Brent; Barrett, Lisa Feldman

    2010-04-01

    We examined the role of affect (pleasant or unpleasant feelings) and decision frames (gains or losses) in risk taking in a 20-day stock investment simulation in which 101 participants rated their current feelings while making investment decisions. As predicted, affect attenuated the relationships between decision frames and risk taking. After experiencing losses, individuals made more risky choices, in keeping with the framing effect. However, this tendency decreased and/or disappeared when loss was simultaneously experienced with either pleasant or unpleasant feelings. Similarly, individuals' tendency to avoid risk after experiencing gains disappeared or even reversed when they simultaneously experienced pleasant feelings.

  14. Risk-based technical specifications: Development and application of an approach to the generation of a plant specific real-time risk model

    International Nuclear Information System (INIS)

    Puglia, B.; Gallagher, D.; Amico, P.; Atefi, B.

    1992-10-01

    This report describes a process developed to convert an existing PRA into a model amenable to real time, risk-based technical specification calculations. In earlier studies (culminating in NUREG/CR-5742), several risk-based approaches to technical specification were evaluated. A real-time approach using a plant specific PRA capable of modeling plant configurations as they change was identified as the most comprehensive approach to control plant risk. A master fault tree logic model representative of-all of the core damage sequences was developed. Portions of the system fault trees were modularized and supercomponents comprised of component failures with similar effects were developed to reduce the size of the model and, quantification times. Modifications to the master fault tree logic were made to properly model the effect of maintenance and recovery actions. Fault trees representing several actuation systems not modeled in detail in the existing PRA were added to the master fault tree logic. This process was applied to the Surry NUREG-1150 Level 1 PRA. The master logic mode was confirmed. The model was then used to evaluate frequency associated with several plant configurations using the IRRAS code. For all cases analyzed computational time was less than three minutes. This document Volume 2, contains appendices A, B, and C. These provide, respectively: Surry Technical Specifications Model Database, Surry Technical Specifications Model, and a list of supercomponents used in the Surry Technical Specifications Model

  15. Association Between Leisure Time Physical Activity, Cardiopulmonary Fitness, Cardiovascular Risk Factors, and Cardiovascular Workload at Work in Firefighters.

    Science.gov (United States)

    Yu, Clare C W; Au, Chun T; Lee, Frank Y F; So, Raymond C H; Wong, John P S; Mak, Gary Y K; Chien, Eric P; McManus, Alison M

    2015-09-01

    Overweight, obesity, and cardiovascular disease risk factors are prevalent among firefighters in some developed countries. It is unclear whether physical activity and cardiopulmonary fitness reduce cardiovascular disease risk and the cardiovascular workload at work in firefighters. The present study investigated the relationship between leisure-time physical activity, cardiopulmonary fitness, cardiovascular disease risk factors, and cardiovascular workload at work in firefighters in Hong Kong. Male firefighters (n = 387) were randomly selected from serving firefighters in Hong Kong (n = 5,370) for the assessment of cardiovascular disease risk factors (obesity, hypertension, diabetes mellitus, dyslipidemia, smoking, known cardiovascular diseases). One-third (Target Group) were randomly selected for the assessment of off-duty leisure-time physical activity using the short version of the International Physical Activity Questionnaire. Maximal oxygen uptake was assessed, as well as cardiovascular workload using heart rate monitoring for each firefighter for four "normal" 24-hour working shifts and during real-situation simulated scenarios. Overall, 33.9% of the firefighters had at least two cardiovascular disease risk factors. In the Target Group, firefighters who had higher leisure-time physical activity had a lower resting heart rate and a lower average working heart rate, and spent a smaller proportion of time working at a moderate-intensity cardiovascular workload. Firefighters who had moderate aerobic fitness and high leisure-time physical activity had a lower peak working heart rate during the mountain rescue scenario compared with firefighters who had low leisure-time physical activities. Leisure-time physical activity conferred significant benefits during job tasks of moderate cardiovascular workload in firefighters in Hong Kong.

  16. Simultaneous bilateral isolated greater trochanter fracture

    Directory of Open Access Journals (Sweden)

    Maruti Kambali

    2013-01-01

    Full Text Available A 48-year-old woman sustained simultaneous isolated bilateral greater trochanteric fracture, following a road traffic accident. The patient presented to us 1 month after the injury. She presented with complaints of pain in the left hip and inability to walk. Roentgenograms revealed displaced comminuted bilateral greater trochanter fractures. The fracture of the left greater trochanter was reduced and fixed internally using the tension band wiring technique. The greater trochanter fracture on the right side was asymptomatic and was managed conservatively. The patient regained full range of motion and use of her hips after a postoperative follow-up of 6 months. Isolated fractures of the greater trochanter are unusual injuries. Because of their relative rarity and the unsettled controversy regarding their etiology and pathogenesis, several methods of treatment have been advocated. Furthermore, the reports of this particular type of injury are not plentiful and the average textbook coverage afforded to this entity is limited. In our study we discuss the mechanism of injury and the various treatment options available.

  17. Does the duration and time of sleep increase the risk of allergic rhinitis? Results of the 6-year nationwide Korea youth risk behavior web-based survey.

    Science.gov (United States)

    Kwon, Jeoung A; Lee, Minjee; Yoo, Ki-Bong; Park, Eun-Cheol

    2013-01-01

    Allergic rhinitis (AR) is the most common chronic disorder in the pediatric population. Although several studies have investigated the correlation between AR and sleep-related issues, the association between the duration and time of sleep and AR has not been analyzed in long-term national data. This study investigated the relationship between sleep time and duration and AR risk in middle- and high-school students (adolescents aged 12-18). We analyzed national data from the Korea Youth Risk Behavior Web-based Survey by the Korea Centers for Disease Control and Prevention from 2007-2012. The sample size was 274,480, with an average response rate of 96.2%. Multivariate logistic regression analyses were conducted to determine the relationship between sleep and AR risk. Furthermore, to determine the best-fitted model among independent variables such as sleep duration, sleep time, and the combination of sleep duration and sleep time, we used Akaike Information Criteria (AIC) to compare models. A total of 43,337 boys and 41,665 girls reported a diagnosis of AR at baseline. The odds ratio increased with age and with higher education and economic status of the parents. Further, students in mid-sized and large cities had stronger relationships to AR than those in small cities. In both genders, AR was associated with depression and suicidal ideation. In the analysis of sleep duration and sleep time, the odds ratio increased in both genders when sleep duration was sleep was later than 24:00 hours. Our results indicate an association between sleep time and duration and AR. This study is the first to focus on the relationship between sleep duration and time and AR in national survey data collected over 6 years.

  18. 77 FR 37803 - Customer Clearing Documentation, Timing of Acceptance for Clearing, and Clearing Member Risk...

    Science.gov (United States)

    2012-06-25

    ..., 202-418-6703, [email protected] , Division of Clearing and Risk, and Camden Nunery, Economist, 202-418-5723, Office of the Chief Economist, Commodity Futures Trading Commission, Three Lafayette Centre, 1155...

  19. Formation of potential radiation risk groups to render timely targeted medical care: Lessons of Chernobyl

    International Nuclear Information System (INIS)

    Ivanov, V. K.; Kashcheev, V. V.; Zamulaeva, I. A.; Saenko, A. S.; Orlova, N. V.; Smirnova, S. G.; Korelo, A. M.; Gorsky, A. I.; Maksioutov, M. A.

    2012-01-01

    The paper discusses technology for establishing potential cancer risk groups, based on methods of molecular and radiation epidemiology. Assay of gene mutations at the T-cell receptor (TCR) locus as the method of molecular epidemiology was used for measuring the frequency of TCR-mutations in 320 nuclear workers of the Inst. of Physics and Power Engineering (IPPE). The method of radiation epidemiology was applied to the estimation of attributable risk fraction (ARF) for solid cancers in these groups. The main estimates of radiation risk after the Chernobyl accident are in close agreement with the International Commission on Radiological Protection (ICRP) Publication, 103 models published in 2007. In nuclear workers of the IPPE with ARF ≥ 10%, the increased level of TCR-mutations occurs more often (risk ratio=9.7; 95% CI: 2.9; 32.1). (authors)

  20. Real-time Risk Assessment for Aids to Navigation Using Fuzzy-FSA on Three-Dimensional Simulation System

    Directory of Open Access Journals (Sweden)

    Jinbiao Chen

    2014-06-01

    Full Text Available The risk level of the Aids to Navigation (AtoNs can reflect the ship navigation safety level in the channel to some extent. In order to appreciate the risk level of the aids to navigation (AtoNs in a navigation channel and to provide some decision-making suggestions for the AtoNs Maintenance and Management Department, the risk assessment index system of the AtoNs was built considering the advanced experience of IALA. Under the Formal Safety Assessment frame, taking the advantages of the fuzzy comprehensive evaluation method, the fuzzy-FSA model of risk assessment for aids to navigation was established. The model was implemented for the assessment of aids to navigation in Shanghai area based on the aids to navigation three-dimensional simulation system. The real-time data were extracted from the existing information system of aids to navigation, and the real-time risk assessment for aids to navigation of the chosen channel was performed on platform of the three-dimensional simulation system, with the risk assessment software. Specifically, the deep-water channel of the Yangtze River estuary was taken as an example to illustrate the general assessment procedure. The method proposed presents practical significance and application prospect on the maintenance and management of the aids to navigation.

  1. Nongenetic causes of childhood cancers: evidence from international variation, time trends, and risk factor studies

    International Nuclear Information System (INIS)

    Bunin, Greta R.

    2004-01-01

    Ionizing radiation and a variety of genetic conditions are thought to explain 5-10% of childhood cancers. Infection with Epstein-Barr virus (EBV) in parts of Africa and human immunodeficiency virus (HIV) increase the risk of Burkitt's lymphoma and Kaposi's sarcoma, respectively. Other risk factors have not been conclusively identified. A review of the data on international variation in incidence, recent changes in incidence, and risk factors suggests that many childhood cancers are likely to have nongenetic causes. The pattern of international variation and associations with surrogates of infection suggest an infectious etiology for acute lymphoblastic leukemia, although no agent has been identified. The biologic plausibility is strong that maternal consumption of food containing DNA topoisomerase II inhibitors may increase the risk of acute myeloid leukemia, although the data are limited now. For brain tumors, cured meats, polyomaviruses, and farm exposures may have etiologic roles. Changes in the incidence and characteristics of children with hepatoblastoma as well as risk factor studies suggest a role for an exposure of very low birth weight babies. High birth weight, tea or coffee consumption, and certain paternal occupations have shown some consistency in their association with Wilms' tumor. For most of the other cancers, very few epidemiologic studies have been conducted, so it is not surprising that nongenetic risk factors have not been detected. The most important difference between the cancers for which there are good etiologic clues and those for which there are not may be the number of relevant studies

  2. Change of exposure response over time and long-term risk of silicosis among a cohort of Chinese pottery workers.

    Science.gov (United States)

    Sun, Yi; Bochmann, Frank; Morfeld, Peter; Ulm, Kurt; Liu, Yuewei; Wang, Heijiao; Yang, Lei; Chen, Weihong

    2011-07-01

    An analysis was conducted on a cohort of Chinese pottery workers to estimate the exposure-response relationship between respirable crystalline silica dust exposure and the incidence of radiographically diagnosed silicosis, and to estimate the long-term risk of developing silicosis until the age of 65. The cohort comprised 3,250 employees with a median follow-up duration of around 37 years. Incident cases of silicosis were identified via silicosis registries (Chinese X-ray stage I, similar to International Labor Organisation classification scheme profusion category 1/1). Individual exposure to respirable crystalline silica dust was estimated based on over 100,000 historical dust measurements. The association between dust exposure, incidence and long-time risk of silicosis was quantified by Poisson regression analysis adjusted for age and smoking. The risk of silicosis depended not only on the cumulative respirable crystalline silica dust exposures, but also on the time-dependent respirable crystalline silica dust exposure pattern (long-term average concentration, highest annual concentration ever experienced and time since first exposure). A long-term "excess" risk of silicosis of approximately 1.5/1,000 was estimated among workers with all annual respirable crystalline silica dust concentration estimates less than 0.1 mg/m(3), using the German measurement strategy. This study indicates the importance of proper consideration of exposure information in risk quantification in epidemiological studies.

  3. Change of Exposure Response over Time and Long-Term Risk of Silicosis among a Cohort of Chinese Pottery Workers

    Directory of Open Access Journals (Sweden)

    Yuewei Liu

    2011-07-01

    Full Text Available An analysis was conducted on a cohort of Chinese pottery workers to estimate the exposure-response relationship between respirable crystalline silica dust exposure and the incidence of radiographically diagnosed silicosis, and to estimate the long-term risk of developing silicosis until the age of 65. The cohort comprised 3,250 employees with a median follow-up duration of around 37 years. Incident cases of silicosis were identified via silicosis registries (Chinese X-ray stage I, similar to International Labor Organisation classification scheme profusion category 1/1. Individual exposure to respirable crystalline silica dust was estimated based on over 100,000 historical dust measurements. The association between dust exposure, incidence and long-time risk of silicosis was quantified by Poisson regression analysis adjusted for age and smoking. The risk of silicosis depended not only on the cumulative respirable crystalline silica dust exposures, but also on the time-dependent respirable crystalline silica dust exposure pattern (long-term average concentration, highest annual concentration ever experienced and time since first exposure. A long-term “excess” risk of silicosis of approximately 1.5/1,000 was estimated among workers with all annual respirable crystalline silica dust concentration estimates less than 0.1 mg/m3, using the German measurement strategy. This study indicates the importance of proper consideration of exposure information in risk quantification in epidemiological studies.

  4. Driving under the influence among frequent ecstasy consumers in Australia: trends over time and the role of risk perceptions.

    Science.gov (United States)

    Matthews, Allison Jane; Bruno, Raimondo; Dietze, Paul; Butler, Kerryn; Burns, Lucy

    2014-11-01

    Driving under the influence (DUI) of alcohol and illicit drugs is a serious road safety concern. This research aimed to examine trends in DUI across time and changes in attitudes towards the risks (crash and legal) associated with DUI among regular ecstasy users (REU) interviewed in Australia. Participants were regular (at least monthly) ecstasy users surveyed in 2007 (n=573) or 2011 (n=429) who had driven a car in the last six months. Face to face interviews comprised questions about recent engagement of DUI and roadside breath (alcohol) and saliva (drug) testing. Participants also reported the risk of crash and of being apprehended by police if DUI of alcohol, cannabis, ecstasy, and methamphetamine. There were significant reductions in DUI of psychostimulants (ecstasy, methamphetamine, cocaine, LSD) but not alcohol or cannabis between 2007 and 2011. This was accompanied by increased experience of roadside saliva testing and increases in crash and legal risk perceptions for ecstasy and methamphetamine, but not alcohol or cannabis. When the relationship between DUI and risk variables was examined, low crash risk perceptions were associated with DUI of all substances and low legal risk perceptions were associated with DUI of ecstasy. The observed reduction in DUI of psychostimulants among frequent ecstasy consumers may be related to increased risk awareness stemming from educational campaigns and the introduction of saliva testing on Australian roads. Such countermeasures may be less effective in relation to deterring or changing attitudes towards DUI of cannabis and alcohol among this group. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Building Assets Reducing Risks: Academic Success for All Students through Positive Relationships and Use of Real-Time Data

    Science.gov (United States)

    Corsello, Maryann; Sharma, Anu; Jerabek, Angela

    2015-01-01

    Building Assets Reducing Risks (BARR) is a social emotional model that achieves academic outcomes through combining use of real-time student data with proven relationship-building strategies and intensive teacher collaboration to prevent course failure. BARR is a recipient of US Department of Education "Investing in Innovation (i3)"…

  6. Towards a Practical and Scientifically Sound Tool for Measuring Time and Risk Preferences in Pension Savings Decisions

    NARCIS (Netherlands)

    Potters, Jan; Riedl, A.; Smeets, Paul

    We present a recently developed experimental method to estimate individuals’ time and risk preferences and test it for its suitability in the pension context. Participants allocate money between an account that pays out at an earlier date and an account that pays out at later dates. Money allocated

  7. Identification of the timing-of-events model with multiple competing exit risks from single-spell data

    DEFF Research Database (Denmark)

    Drepper, Bettina; Effraimidis, G.

    2016-01-01

    The identification result of the timing-of-events model (Abbring and Van den Berg, 2003b) is extended to a model with several competing exit risk equations. This extension allows e.g. to simultaneously identify the different effects a benefit sanction has on the rate of finding work and leaving t...

  8. Objectively measured physical activity and sedentary time are associated with cardiometabolic risk factors in adults with prediabetes

    DEFF Research Database (Denmark)

    Swindell, Nils; Mackintosh, Kelly; McNarry, Melitta

    2018-01-01

    OBJECTIVE: The aim of the present cross-sectional study was to examine the association among physical activity (PA), sedentary time (ST), and cardiometabolic risk in adults with prediabetes. RESEARCH DESIGN AND METHODS: Participants (n = 2,326; 25-70 years old, 67% female) from eight countries...

  9. Geo-mapping of time trends in childhood caries risk--a method for assessment of preventive care

    DEFF Research Database (Denmark)

    Strömberg, Ulf; Holmn, Anders; Magnusson, Kerstin

    2012-01-01

    Dental caries is unevenly distributed within populations with a higher burden in low socio-economy groups. Several attempts have been made to allocate resources to those that need them the most; there is a need for convenient approaches to population-based monitoring of caries risk over time...

  10. Field Efficacy and application timing of methoxyfenozide, a reduced risk treatment for control of navel orangeworm (Lepidpotera: Pyralidae) in almonds

    Science.gov (United States)

    Large-scale field efficacy trials of methoxyfenozide (Intrepid®), a reduced-risk molting agonist insecticide, were conducted in 2004 and 2005 in an orchard containing ‘Nonpareil’ and ‘Sonora’ variety almonds located in Kern County, California. Methoxyfenozide applied one to three times, and the orga...

  11. How many or how much? Testing the relative influence of the number of social network risks versus the amount of time exposed to social network risks on post-treatment substance use.

    Science.gov (United States)

    Eddie, David; Kelly, John F

    2017-06-01

    Having high-risk, substance-using friends is associated with young adult substance use disorder (SUD) relapse. It is unclear, however, whether it is the total number of high-risk friends, or the amount of time spent with high-risk friends that leads to relapse. Unclear also, is to what extent low-risk friends buffer risk. This study examined the influence of number of high-risk and low-risk friends, and the amount time spent with these friends on post-treatment percent days abstinent (PDA). Young adult inpatients (N=302) were assessed at intake, and 3, 6, and 12 months on social network measures and PDA. Mixed models tested for effects of number of high- and low-risk friends, and time spent with these friends on PDA, and for net-risk friend effects to test whether low-risk friends offset risk. Within and across assessments, number of, and time spent with high-risk friends was negatively associated with PDA, while the inverse was true for low-risk friends. Early post-treatment, time spent with friends more strongly predicted PDA than number of friends. Participants were more deleteriously affected by time with high-risk friends the longer they were out of treatment, while contemporaneously protection conferred by low-risk friends increased. This interaction effect, however, was not observed with number of high- or low-risk friends, or number of friends net-risk. Young adult SUD patients struggling to break ties with high-risk friends should be encouraged to minimize time with them. Clinicians should also encourage patients to grow their social network of low-risk friends. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Real-time risk assessment in seismic early warning and rapid response: a feasibility study in Bishkek (Kyrgyzstan)

    Science.gov (United States)

    Picozzi, M.; Bindi, D.; Pittore, M.; Kieling, K.; Parolai, S.

    2013-04-01

    Earthquake early warning systems (EEWS) are considered to be an effective, pragmatic, and viable tool for seismic risk reduction in cities. While standard EEWS approaches focus on the real-time estimation of an earthquake's location and magnitude, innovative developments in EEWS include the capacity for the rapid assessment of damage. Clearly, for all public authorities that are engaged in coordinating emergency activities during and soon after earthquakes, real-time information about the potential damage distribution within a city is invaluable. In this work, we present a first attempt to design an early warning and rapid response procedure for real-time risk assessment. In particular, the procedure uses typical real-time information (i.e., P-wave arrival times and early waveforms) derived from a regional seismic network for locating and evaluating the size of an earthquake, information which in turn is exploited for extracting a risk map representing the potential distribution of damage from a dataset of predicted scenarios compiled for the target city. A feasibility study of the procedure is presented for the city of Bishkek, the capital of Kyrgyzstan, which is surrounded by the Kyrgyz seismic network by mimicking the ground motion associated with two historical events that occurred close to Bishkek, namely the 1911 Kemin ( M = 8.2; ±0.2) and the 1885 Belovodsk ( M = 6.9; ±0.5) earthquakes. Various methodologies from previous studies were considered when planning the implementation of the early warning and rapid response procedure for real-time risk assessment: the Satriano et al. (Bull Seismol Soc Am 98(3):1482-1494, 2008) approach to real-time earthquake location; the Caprio et al. (Geophys Res Lett 38:L02301, 2011) approach for estimating moment magnitude in real time; the EXSIM method for ground motion simulation (Motazedian and Atkinson, Bull Seismol Soc Am 95:995-1010, 2005); the Sokolov (Earthquake Spectra 161: 679-694, 2002) approach for estimating

  13. Fall Risk Score at the Time of Discharge Predicts Readmission Following Total Joint Arthroplasty.

    Science.gov (United States)

    Ravi, Bheeshma; Nan, Zhang; Schwartz, Adam J; Clarke, Henry D

    2017-07-01

    Readmission among Medicare recipients is a leading driver of healthcare expenditure. To date, most predictive tools are too coarse for direct clinical application. Our objective in this study is to determine if a pre-existing tool to identify patients at increased risk for inpatient falls, the Hendrich Fall Risk Score, could be used to accurately identify Medicare patients at increased risk for readmission following arthroplasty, regardless of whether the readmission was due to a fall. This study is a retrospective cohort study. We identified 2437 Medicare patients who underwent a primary elective total joint arthroplasty (TJA) of the hip or knee for osteoarthritis between 2011 and 2014. The Hendrich Fall Risk score was recorded for each patient preoperatively and postoperatively. Our main outcome measure was hospital readmission within 30 days of discharge. Of 2437 eligible TJA recipients, there were 226 (9.3%) patients who had a score ≥6. These patients were more likely to have an unplanned readmission (unadjusted odds ratio 2.84, 95% confidence interval 1.70-4.76, P 3 days (49.6% vs 36.6%, P = .0001), and were less likely to be sent home after discharge (20.8% vs 35.8%, P fall risk score after TJA is strongly associated with unplanned readmission. Application of this tool will allow hospitals to identify these patients and plan their discharge. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Improving greater trochanteric reattachment with a novel cable plate system.

    Science.gov (United States)

    Baril, Yannick; Bourgeois, Yan; Brailovski, Vladimir; Duke, Kajsa; Laflamme, G Yves; Petit, Yvan

    2013-03-01

    Cable-grip systems are commonly used for greater trochanteric reattachment because they have provided the best fixation performance to date, even though they have a rather high complication rate. A novel reattachment system is proposed with the aim of improving fixation stability. It consists of a Y-shaped fixation plate combined with locking screws and superelastic cables to reduce cable loosening and limit greater trochanter movement. The novel system is compared with a commercially available reattachment system in terms of greater trochanter movement and cable tensions under different greater trochanteric abductor application angles. A factorial design of experiments was used including four independent variables: plate system, cable type, abductor application angle, and femur model. The test procedure included 50 cycles of simultaneous application of an abductor force on the greater trochanter and a hip force on the femoral head. The novel plate reduces the movements of a greater trochanter fragment within a single loading cycle up to 26%. Permanent degradation of the fixation (accumulated movement based on 50-cycle testing) is reduced up to 46%. The use of superelastic cables reduces tension loosening up to 24%. However this last improvement did not result in a significant reduction of the grater trochanter movement. The novel plate and cables present advantages over the commercially available greater trochanter reattachment system. The plate reduces movements generated by the hip abductor. The superelastic cables reduce cable loosening during cycling. Both of these positive effects could decrease the risks related to grater trochanter non-union. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  15. Greater trochanteric fracture with occult intertrochanteric extension.

    Science.gov (United States)

    Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph

    2013-10-01

    Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

  16. Butterfly valves: greater use in power plants

    International Nuclear Information System (INIS)

    McCoy, M.

    1975-01-01

    Improvements in butterfly valves, particularly in the areas of automatic control and leak tightness are described. The use of butterfly valves in nuclear power plants is discussed. These uses include service in component cooling, containment cooling, and containment isolation. The outlook for further improvements and greater uses is examined. (U.S.)

  17. Greater Somalia, the never-ending dream?

    DEFF Research Database (Denmark)

    Zoppi, Marco

    2015-01-01

    This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost...

  18. Psychosocial risk factors, pre-motor symptoms and first-time hospitalization with Parkinson's disease

    DEFF Research Database (Denmark)

    Clark, Alice Jessie; Ritz, B; Prescott, E

    2013-01-01

    ), as well as to identify potential pre-motor symptoms for PD in a large prospective cohort study. METHODS: In 1991-1993, a total of 9955 women and men free of PD from the Copenhagen City Heart Study were asked about major life events, economic hardship, social network, impaired sleep and vital exhaustion...... social network in the current study. CONCLUSIONS: Overall, the hypothesis that psychosocial risk factors affect the risk of PD is not supported. The results, however, suggest that vital exhaustion may be a pre-motor marker of the neurodegenerative process eventually leading to motor symptoms and clinical......BACKGROUND AND PURPOSE: Experimental studies support a link between stress and development of parkinsonian symptoms, but prospective population studies are lacking. The aim of the current study is to determine the effects of several psychosocial factors on the risk of Parkinson's disease (PD...

  19. The control, at the design stage, of risks related to buildings management over time

    Directory of Open Access Journals (Sweden)

    Claudio Martani

    2013-10-01

    Full Text Available In the present paper an apparatus of tools and methods is presented to evaluate, at the design stage, the risks over a set of objectives through buildings lifetime. To this purpose a tool is first presented to relate technological requirements of each technical elements to the pertinent maintenance interventions. Then a process is also proposed to estimate the risks on user requirements runningMonte Carlo simulations. The risk management process proposed in the present work aims to support designers and promoters in making predictions on the outcomes of long, not standardized, multivariable dependent processes – as the building process is – in order to indicate the attitude of a designed building to meet a framework of important objectives through its lifetime.

  20. Risk

    Science.gov (United States)

    Cole, Stephen R.; Hudgens, Michael G.; Brookhart, M. Alan; Westreich, Daniel

    2015-01-01

    The epidemiologist primarily studies transitions between states of health and disease. The purpose of the present article is to define a foundational parameter for such studies, namely risk. We begin simply and build to the setting in which there is more than 1 event type (i.e., competing risks or competing events), as well as more than 1 treatment or exposure level of interest. In the presence of competing events, the risks are a set of counterfactual cumulative incidence functions for each treatment. These risks can be depicted visually and summarized numerically. We use an example from the study of human immunodeficiency virus to illustrate concepts. PMID:25660080

  1. Bayesian Algorithm Implementation in a Real Time Exposure Assessment Model on Benzene with Calculation of Associated Cancer Risks

    Directory of Open Access Journals (Sweden)

    Pavlos A. Kassomenos

    2009-02-01

    Full Text Available The objective of the current study was the development of a reliable modeling platform to calculate in real time the personal exposure and the associated health risk for filling station employees evaluating current environmental parameters (traffic, meteorological and amount of fuel traded determined by the appropriate sensor network. A set of Artificial Neural Networks (ANNs was developed to predict benzene exposure pattern for the filling station employees. Furthermore, a Physiology Based Pharmaco-Kinetic (PBPK risk assessment model was developed in order to calculate the lifetime probability distribution of leukemia to the employees, fed by data obtained by the ANN model. Bayesian algorithm was involved in crucial points of both model sub compartments. The application was evaluated in two filling stations (one urban and one rural. Among several algorithms available for the development of the ANN exposure model, Bayesian regularization provided the best results and seemed to be a promising technique for prediction of the exposure pattern of that occupational population group. On assessing the estimated leukemia risk under the scope of providing a distribution curve based on the exposure levels and the different susceptibility of the population, the Bayesian algorithm was a prerequisite of the Monte Carlo approach, which is integrated in the PBPK-based risk model. In conclusion, the modeling system described herein is capable of exploiting the information collected by the environmental sensors in order to estimate in real time the personal exposure and the resulting health risk for employees of gasoline filling stations.

  2. Bayesian algorithm implementation in a real time exposure assessment model on benzene with calculation of associated cancer risks.

    Science.gov (United States)

    Sarigiannis, Dimosthenis A; Karakitsios, Spyros P; Gotti, Alberto; Papaloukas, Costas L; Kassomenos, Pavlos A; Pilidis, Georgios A

    2009-01-01

    The objective of the current study was the development of a reliable modeling platform to calculate in real time the personal exposure and the associated health risk for filling station employees evaluating current environmental parameters (traffic, meteorological and amount of fuel traded) determined by the appropriate sensor network. A set of Artificial Neural Networks (ANNs) was developed to predict benzene exposure pattern for the filling station employees. Furthermore, a Physiology Based Pharmaco-Kinetic (PBPK) risk assessment model was developed in order to calculate the lifetime probability distribution of leukemia to the employees, fed by data obtained by the ANN model. Bayesian algorithm was involved in crucial points of both model sub compartments. The application was evaluated in two filling stations (one urban and one rural). Among several algorithms available for the development of the ANN exposure model, Bayesian regularization provided the best results and seemed to be a promising technique for prediction of the exposure pattern of that occupational population group. On assessing the estimated leukemia risk under the scope of providing a distribution curve based on the exposure levels and the different susceptibility of the population, the Bayesian algorithm was a prerequisite of the Monte Carlo approach, which is integrated in the PBPK-based risk model. In conclusion, the modeling system described herein is capable of exploiting the information collected by the environmental sensors in order to estimate in real time the personal exposure and the resulting health risk for employees of gasoline filling stations.

  3. Combined risk assessment of nonstationary monthly water quality based on Markov chain and time-varying copula.

    Science.gov (United States)

    Shi, Wei; Xia, Jun

    2017-02-01

    Water quality risk management is a global hot research linkage with the sustainable water resource development. Ammonium nitrogen (NH 3 -N) and permanganate index (COD Mn ) as the focus indicators in Huai River Basin, are selected to reveal their joint transition laws based on Markov theory. The time-varying moments model with either time or land cover index as explanatory variables is applied to build the time-varying marginal distributions of water quality time series. Time-varying copula model, which takes the non-stationarity in the marginal distribution and/or the time variation in dependence structure between water quality series into consideration, is constructed to describe a bivariate frequency analysis for NH 3 -N and COD Mn series at the same monitoring gauge. The larger first-order Markov joint transition probability indicates water quality state Class V w , Class IV and Class III will occur easily in the water body of Bengbu Sluice. Both marginal distribution and copula models are nonstationary, and the explanatory variable time yields better performance than land cover index in describing the non-stationarities in the marginal distributions. In modelling the dependence structure changes, time-varying copula has a better fitting performance than the copula with the constant or the time-trend dependence parameter. The largest synchronous encounter risk probability of NH 3 -N and COD Mn simultaneously reaching Class V is 50.61%, while the asynchronous encounter risk probability is largest when NH 3 -N and COD Mn is inferior to class V and class IV water quality standards, respectively.

  4. Risk Balancing of Cold Ischemic Time against Night Shift Surgery Possibly Reduces Rates of Reoperation and Perioperative Graft Loss

    Directory of Open Access Journals (Sweden)

    Nikos Emmanouilidis

    2017-01-01

    Full Text Available Background. This retrospective cohort study evaluates the advantages of risk balancing between prolonged cold ischemic time (CIT and late night surgery. Methods. 1262 deceased donor kidney transplantations were analyzed. Multivariable regression was used to determine odds ratios (ORs for reoperation, graft loss, delayed graft function (DGF, and discharge on dialysis. CIT was categorized according to a forward stepwise pattern ≤1h/>1h, ≤2h/>2h, ≤3h/>3h,…, ≤nh/>nh. ORs for DGF were plotted against CIT and a nonlinear regression function with best R2 was identified. First and second derivative were then implemented into the curvature formula k(x=f′′(x/(1+f′x23/2 to determine the point of highest CIT-mediated risk acceleration. Results. Surgery between 3 AM and 6 AM is an independent risk factor for reoperation and graft loss, whereas prolonged CIT is only relevant for DGF. CIT-mediated risk for DGF follows an exponential pattern fx=A·(1+k·eI·x with a cut-off for the highest risk increment at 23.5 hours. Conclusions. The risk of surgery at 3 AM–6 AM outweighs prolonged CIT when confined within 23.5 hours as determined by a new mathematical approach to calculate turning points of nonlinear time related risks. CIT is only relevant for the endpoint of DGF but had no impact on discharge on dialysis, reoperation, or graft loss.

  5. Leisure-time physical activity and breast cancer risk by hormone receptor status: effective life periods and exercise intensity.

    Science.gov (United States)

    Suzuki, Reiko; Iwasaki, Motoki; Kasuga, Yoshio; Yokoyama, Shiro; Onuma, Hiroshi; Nishimura, Hideki; Kusama, Ritsu; Shimazu, Taichi; Tsugane, Shoichiro

    2010-11-01

    Physical activity may decrease breast cancer risk. However, it is unclear what intensity of exercise and during which life periods this effect on decreasing risk is efficiently expressed, and whether the associations differ by the estrogen-/progesterone- receptor (ER/PR) status of tumors. We investigated associations between age- and intensity-specific leisure-time physical activity and ER/PR-defined breast cancer risk. We conducted a hospital-based case-control study in Nagano, Japan. Subjects were 405 cases newly diagnosed (>99% known ER/PR) from 2001 to 2005, who were age-/area-matched with 405 controls. Activity was assessed with a self-reported questionnaire which considered intensity level (moderate and/or strenuous) at different ages (at 12 and 20 years, and in the previous 5 years). Odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression. Strenuous but not moderate physical activity at age 12 was inversely associated with pre- and postmenopausal breast cancer risk across ER/PR subtypes [overall OR(≥ 5 days/week vs. none) = 0.24 (0.14-0.43)]. Moderate physical activity in the previous 5 years was significantly associated with a decrease in risk for postmenopausal ER + PR + tumors only [OR(≥ 1 day/week vs. none) = 0.35 (0.18-0.67)]. Strenuous activity in teens and moderate activity after menopause may contribute to a reduction in breast cancer risk.

  6. Reduced risk of Parkinson's disease associated with lower body mass index and heavy leisure-time physical activity.

    Science.gov (United States)

    Sääksjärvi, Katri; Knekt, Paul; Männistö, Satu; Lyytinen, Jukka; Jääskeläinen, Tuija; Kanerva, Noora; Heliövaara, Markku

    2014-04-01

    The risk factors for Parkinson's disease (PD) are not well established. We therefore examined the prediction of various lifestyle factors on the incidence of PD in a cohort drawn from the Finnish Mobile Clinic Health Examination Survey, conducted in 1973-1976. The study population comprised 6,715 men and women aged 50-79 years and free of PD at the baseline. All of the subjects completed a baseline health examination (including height and weight measurements) and a questionnaire providing information on leisure-time physical activity, smoking, and alcohol consumption. During a 22-year follow-up, 101 incident cases of PD occurred. The statistical analyses were based on Cox's model including age, sex, education, community density, occupation, coffee consumption, body mass index (BMI), leisure-time physical activity, smoking and alcohol consumption as independent variables. At first, BMI was not associated with PD risk, but after exclusion of the first 15 years of follow-up, an elevated risk appeared at higher BMI levels (P for trend 0.02). Furthermore, subjects with heavy leisure-time physical activity had a lower PD risk than those with no activity [relative risk (RR) 0.27, 95 % confidence interval (CI) 0.08-0.90]. In variance with findings for other chronic diseases, current smokers had a lower PD risk than those who had never smoked (RR 0.23, 95 % CI 0.08-0.67), and individuals with moderate alcohol intake (at the level of Parkinson's disease, but more research is needed.

  7. One Family at a Time: A Prevention Program for At-Risk Parents.

    Science.gov (United States)

    Nicholson, Bonnie; Anderson, Michelle; Fox, Robert; Brenner, Viktor

    2002-01-01

    Examines the effectiveness of a psychoeducational parenting program with at-risk parents of young children. Results showed that compared with the control group, parents participating in the program significantly decreased their levels of verbal and corporal punishment, anger, stress, and reported child behavior problems; results were maintained at…

  8. Time-varying individual risk attitudes over the Great Recession: A comparison of Germany and Ukraine

    NARCIS (Netherlands)

    Dohmen, T.J.; Lehmann, H.; Pignatti, N.

    We use the panel data of the German Socio-Economic Panel (SOEP) and of the Ukrainian Longitudinal Monitoring Survey (ULMS) to investigate whether risk attitudes have primary (exogenous) determinants that are valid in different stages of economic development and in a different structural context,

  9. Modifiable risk factors of coronary heart disease in male first time ...

    African Journals Online (AJOL)

    The following parameters were recorded: personal details, health status, smoking habits, mass, height, body composition, blood pressure, total cholesterol, physical working capacity and predicted aerobic capacity. The majority of subjects (50.9 %) displayed two or more, 27.3 % three or more and 8.2 % four or more, risk ...

  10. Changing Incidence and Risk Factors for Kaposi Sarcoma by Time Since Starting Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Wyss, Natascha; Zwahlen, Marcel; Bohlius, Julia

    2016-01-01

    BACKGROUND:  Kaposi sarcoma (KS) remains a frequent cancer in human immunodeficiency virus (HIV)-positive patients starting combination antiretroviral therapy (cART). We examined incidence rates and risk factors for developing KS in different periods after starting cART in patients from European...

  11. Leisure‐time physical activity and cardiometabolic risk among children and adolescents

    Directory of Open Access Journals (Sweden)

    Luz M. Cárdenas‐Cárdenas

    2015-03-01

    Conclusion: Mild LTPA was positively associated with cardiometabolic risk in overweight and obese children and adolescents. Given the emerging childhood obesity epidemic in Mexico, these results may be useful in the design of strategies and programs to increase physical activity levels in order to achieve better health.

  12. Tuberculosis among HIV-positive patients across Europe: changes over time and risk factors

    DEFF Research Database (Denmark)

    Kruk, Alexey; Bannister, Wendy; Podlekareva, Daria N

    2011-01-01

    OBJECTIVE:: To describe temporal changes in the incidence rate of tuberculosis (TB) (pulmonary or extrapulmonary) among HIV-positive patients in western Europe and risk factors of TB across Europe. METHODS:: Poisson regression models were used to determine temporal changes in incidence rate of TB...

  13. Tuberculosis among HIV-positive patients across Europe: changes over time and risk factors

    NARCIS (Netherlands)

    Kruk, Alexey; Bannister, Wendy; Podlekareva, Daria N.; Chentsova, Nelly P.; Rakhmanova, Aza G.; Horban, Andrzej; Domingo, Perre; Mocroft, Amanda; Lundgren, Jens D.; Kirk, Ole; Losso, M.; Elias, C.; Vetter, N.; Zangerle, R.; Karpov, I.; Vassilenko, A.; Mitsura, V. M.; Suetnov, O.; Clumeck, N.; de Wit, S.; Delforge, M.; Colebunders, R.; Vandekerckhove, L.; Hadziosmanovic, V.; Kostov, K.; Begovac, J.; Machala, L.; Sedlacek, D.; Nielsen, J.; Kronborg, G.; Benfield, T.; Larsen, M.; Gerstoft, J.; Katzenstein, T.; Hansen, A.-B. E.; Skinhøj, P.; Pedersen, C.; Ostergaard, L.; Zilmer, K.; Ristola, M.; Katlama, C.; Viard, J.-P.; Girard, P.-M.; Livrozet, J. M.; Vanhems, P.; Pradier, C.; Dabis, F.; Neau, D.; Rockstroh, J.; Reiss, P.

    2011-01-01

    To describe temporal changes in the incidence rate of tuberculosis (TB) (pulmonary or extrapulmonary) among HIV-positive patients in western Europe and risk factors of TB across Europe. Poisson regression models were used to determine temporal changes in incidence rate of TB among 11,952 patients

  14. Review Article: Clinical risk management: time for a paradigm shift in ...

    African Journals Online (AJOL)

    Searches were conducted on the Cochrane Library, PubMed and African Journals On line. Publications were also sourced from cited references and reports. The search engine used was Google. Results: NationalPolicies that provide direction in clinical risk management in Nigeria are lacking even against the background ...

  15. Time to improve statin prescription guidelines in low-risk patients?

    NARCIS (Netherlands)

    Balder, Jan W.; de Vries, Jeroen K.; Mulder, Douwe J.; Kamphuisen, Pieter W.

    Background The challenge of the primary prevention of cardiovascular disease (CVD) is to identify patients who would benefit from treatment with statins. Statins are currently prescribed to many patients, even those at a low 10-year risk of CVD. These latter patients may not be eligible for statins

  16. Physical activity, sedentary time, TV viewing, physical fitness and cardiovascular disease risk in adolescents: The HELENA study.

    Science.gov (United States)

    Barker, Alan R; Gracia-Marco, Luis; Ruiz, Jonatan R; Castillo, Manuel J; Aparicio-Ugarriza, Raquel; González-Gross, Marcela; Kafatos, Anthony; Androutsos, Odysseas; Polito, Angela; Molnar, Dénes; Widhalm, Kurt; Moreno, Luis A

    2018-03-01

    To examine the independent associations between physical activity (PA) intensities, sedentary time (ST), TV viewing, cardiorespiratory fitness (CRF) and muscular fitness (MF) with cardiovascular disease (CVD) risk in youth. A cross-sectional study on 534 European adolescents (252 males, 282 females, 12.5-17.5years). Minutes per day of light (LPA), moderate (MPA) and vigorous (VPA) PA and total ST were measured using accelerometers. TV viewing time was measured using a questionnaire. CRF and MF were measured using the 20m shuttle run test and a hand dynamometer respectively. CVD outcomes included markers of body composition (body mass index (BMI), waist circumference (WC), WC/height (Ht) and sum of skinfolds (SumSF)), blood pressure, blood lipids and insulin resistance (HOMA-IR). Clustered CVD risk was calculated using SumSF, HOMA-IR, blood lipids and blood pressure. LPA had a significant positive independent relationship with all body composition outcomes (P0.10). MPA had a negative independent relationship with only WC (P=0.029) and ST was not significantly related to CVD risk (P>0.16). TV viewing had a significant positive independent relationship with HOMA-IR (PTV viewing time to lower CVD risk in youth. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  17. Don't put all your eggs in one nest: spread them and cut time at risk.

    Science.gov (United States)

    Andersson, Malte; Åhlund, Matti

    2012-09-01

    In many egg-laying animals, some females spread their clutch among several nests. The fitness effects of this reproductive tactic are obscure. Using mathematical modeling and field observations, we analyze an unexplored benefit of egg spreading in brood parasitic and other breeding systems: reduced time at risk for offspring. If a clutch takes many days to lay until incubation and embryo development starts after the last egg, by spreading her eggs a parasitic female can reduce offspring time in the vulnerable nest at risk of predation or other destruction. The model suggests that she can achieve much of this benefit by spreading her eggs among a few nests, even if her total clutch is large. Field data from goldeneye ducks Bucephala clangula show that egg spreading enables a fecund female to lay a clutch that is much larger than average without increasing offspring time at risk in a nest. This advantage increases with female condition (fecundity) and can markedly raise female reproductive success. These results help explain the puzzle of nesting parasites in some precocial birds, which lay eggs in the nests of other females before laying eggs in their own nest. Risk reduction by egg spreading may also play a role in the evolution of other breeding systems and taxa-for instance, polyandry with male parental care in some birds and fishes.