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.

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

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.

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.

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

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...

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

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

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)

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.

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)

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.

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

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...

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.

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...

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

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

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.

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

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

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

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.

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

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.

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.

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. ;

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.

Participant characteristics associated with greater reductions in waist circumference during a four-month, pedometer-based, workplace health program.

Science.gov (United States)

Freak-Poli, Rosanne L A; Wolfe, Rory; Walls, Helen; Backholer, Kathryn; Peeters, Anna

2011-10-25

Workplace health programs have demonstrated improvements in a number of risk factors for chronic disease. However, there has been little investigation of participant characteristics that may be associated with change in risk factors during such programs. The aim of this paper is to identify participant characteristics associated with improved waist circumference (WC) following participation in a four-month, pedometer-based, physical activity, workplace health program. 762 adults employed in primarily sedentary occupations and voluntarily enrolled in a four-month workplace program aimed at increasing physical activity were recruited from ten Australian worksites in 2008. Seventy-nine percent returned at the end of the health program. Data included demographic, behavioural, anthropometric and biomedical measurements. WC change (before versus after) was assessed by multivariable linear and logistic regression analyses. Seven groupings of potential associated variables from baseline were sequentially added to build progressively larger regression models. Greater improvement in WC during the program was associated with having completed tertiary education, consuming two or less standard alcoholic beverages in one occasion in the twelve months prior to baseline, undertaking less baseline weekend sitting time and lower baseline total cholesterol. A greater WC at baseline was strongly associated with a greater improvement in WC. A sub-analysis in participants with a 'high-risk' baseline WC revealed that younger age, enrolling for reasons other than appearance, undertaking less weekend sitting time at baseline, eating two or more pieces of fruit per day at baseline, higher baseline physical functioning and lower baseline body mass index were associated with greater odds of moving to 'low risk' WC at the end of the program. While employees with 'high-risk' WC at baseline experienced the greatest improvements in WC, the other variables associated with greater WC improvement

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

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 (...

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 (...

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

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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.

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...

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

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

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

Participant characteristics associated with greater reductions in waist circumference during a four-month, pedometer-based, workplace health program

Directory of Open Access Journals (Sweden)

Freak-Poli Rosanne LA

2011-10-01

Full Text Available Abstract Background Workplace health programs have demonstrated improvements in a number of risk factors for chronic disease. However, there has been little investigation of participant characteristics that may be associated with change in risk factors during such programs. The aim of this paper is to identify participant characteristics associated with improved waist circumference (WC following participation in a four-month, pedometer-based, physical activity, workplace health program. Methods 762 adults employed in primarily sedentary occupations and voluntarily enrolled in a four-month workplace program aimed at increasing physical activity were recruited from ten Australian worksites in 2008. Seventy-nine percent returned at the end of the health program. Data included demographic, behavioural, anthropometric and biomedical measurements. WC change (before versus after was assessed by multivariable linear and logistic regression analyses. Seven groupings of potential associated variables from baseline were sequentially added to build progressively larger regression models. Results Greater improvement in WC during the program was associated with having completed tertiary education, consuming two or less standard alcoholic beverages in one occasion in the twelve months prior to baseline, undertaking less baseline weekend sitting time and lower baseline total cholesterol. A greater WC at baseline was strongly associated with a greater improvement in WC. A sub-analysis in participants with a 'high-risk' baseline WC revealed that younger age, enrolling for reasons other than appearance, undertaking less weekend sitting time at baseline, eating two or more pieces of fruit per day at baseline, higher baseline physical functioning and lower baseline body mass index were associated with greater odds of moving to 'low risk' WC at the end of the program. Conclusions While employees with 'high-risk' WC at baseline experienced the greatest improvements in

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

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

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

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.

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.

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

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…

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.

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

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.

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.

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.

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.

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.

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

Cigarettes, genetic background, and menopausal timing: the presence of single nucleotide polymorphisms in cytochrome P450 genes is associated with increased risk of natural menopause in European-American smokers.

Science.gov (United States)

Butts, Samantha F; Sammel, Mary D; Greer, Christine; Rebbeck, Timothy R; Boorman, David W; Freeman, Ellen W

2014-07-01

This study aims to evaluate associations between variations in genes involved in the metabolism of environmental chemicals and steroid hormones and risk of menopause in smokers. Survival analysis was performed on 410 eligible participants from the Penn Ovarian Aging study (ongoing for 14 years), a cohort study of late-reproductive-age women. Single nucleotide polymorphisms at the following loci were studied: COMT Val158Met, CYP1B1*4 Asn452Ser, CYP1B1*3 Leu432Val, and CYP3A4*1B. Significant interactions between smoking and single nucleotide polymorphisms were observed in European-American carriers of CYP3A4*1B and CYP1B1*3, supporting a greater risk of menopause entry compared with those not carrying these alleles. Among CYP1B1*3 carriers, smokers had a greater risk of menopause entry than nonsmokers (adjusted hazard ratio [HR], 2.26; 95% CI, 1.4-3.67; median time to menopause, 10.42 and 11.07 y, respectively). No association between smoking and menopause was identified in CYP1B1 wild types. Among CYP3A4*1B carriers, smokers were at greater risk for menopause entry than nonsmokers (adjusted HR, 15.1; 95% CI, 3.31-69.2; median time to menopause, 11.36 and 13.91 y, respectively). Risk of menopause entry in CYP3A4 wild types who smoked was far lower (adjusted HR, 1.59; 95% CI, 1.03-2.44). Heavily smoking CYP1B1*3 carriers (adjusted HR, 3.0; 95% CI, 1.54-5.84; median time to menopause, 10.41 y) and heavily smoking CYP3A4*1B carriers (adjusted HR, 17.79; 95% CI, 3.21-98.65; median time to menopause, 5.09 y) had the greatest risk of menopause entry. Our finding that the risk of menopause entry in European-American smokers varies depending on genetic background represents a novel gene-environment interaction in reproductive aging.

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.

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.

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.

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.

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.

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)

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.

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....

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...

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...

Risk of influenza transmission in a hospital emergency department during the week of highest incidence.

Science.gov (United States)

Esteve-Esteve, Miguel; Bautista-Rentero, Daniel; Zanón-Viguer, Vicente

2018-02-01

To estimate the risk of influenza transmission in patients coming to a hospital emergency department during the week of highest incidence and to analyze factors associated with transmission. Retrospective observational analysis of a cohort of patients treated in the emergency room during the 2014-2015 flu season. The following variables were collected from records: recorded influenza diagnosis, results of a rapid influenza confirmation test, point of exposure (emergency department, outpatient clinic, or the community), age, sex, flu vaccination or not, number of emergency visits, time spent in the waiting room, and total time in the hospital. We compiled descriptive statistics and performed bivariate and multivariate analyses by means of a Poisson regression to estimate relative risk (RR) and 95% CIs. The emergency department patients had a RR of contracting influenza 3.29 times that of the communityexposed population (95% CI, 1.53-7.08, P=.002); their risk was 2.05 times greater than that of outpatient clinic visitors (95% CI, 1.04-4.02, P=.036). Emergency patients under the age of 15 years had a 5.27 greater risk than older patients (95% CI, 1.59-17.51; P=.007). The RR of patients visiting more than once was 11.43 times greater (95% CI, 3.58-36.44; P<.001). The risk attributable to visiting the emergency department risk was 70.5%, whereas risk attributable to community exposure was 2%. The risk of contracting influenza is greater for emergency department patients than for the general population or for patients coming to the hospital for outpatient clinic visits. Patients under the age of 15 years incur greater risk.

Variability modifies life satisfaction's association with mortality risk in older adults

Science.gov (United States)

Boehm, Julia K.; Winning, Ashley; Segerstrom, Suzanne; Kubzansky, Laura D.

2015-01-01

Life satisfaction is associated with greater longevity, but its variability across time has not been examined relative to longevity. We investigated whether mean levels of life satisfaction across time, variability in life satisfaction across time, and their interaction were associated with mortality over 9 years of follow-up. Participants were 4,458 Australians initially ≥50 years old. During the follow-up, 546 people died. Adjusting for age, greater mean life satisfaction was associated with reduced risk and greater variability in life satisfaction was associated with increased risk of mortality. These findings were qualified by a significant interaction such that individuals with low mean satisfaction and high variability in satisfaction had the greatest risk of mortality over the follow-up period. In combination with mean levels of life satisfaction, variability in life satisfaction is relevant for mortality risk among older adults. Considering intraindividual variability provides additional insight into associations between psychological characteristics and health. PMID:26048888

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.

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.

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

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...

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...

Violence, abuse, alcohol and drug use, and sexual behaviors in street children of Greater Cairo and Alexandria, Egypt.

Science.gov (United States)

Nada, Khaled H; Suliman, El Daw A

2010-07-01

To measure the prevalence of HIV/AIDS risk behaviors and related factors in a large, probability-based sample of boys and girls aged 12-17 years living on the streets of Egypt's largest urban centers of Greater Cairo and Alexandria. Time-location sampling (TLS) was used to recruit a cross-sectional sample of street children. Procedures entailed using key informants and field observation to create a sampling frame of locations at predetermined time intervals of the day, where street children congregate in the two cities, selecting a random sample of time-locations from the complete list, and intercepting children in the selected time-locations to assess eligibility and conduct interviews. Interviews gathered basic demographic information, life events on the street (including violence, abuse, forced sex), sexual and drug use behaviors, and HIV/AIDS knowledge. A total of 857 street children were enrolled in the two cities, with an age, sex, and time-location composition matching the sampling frame. The majority of these children had faced harassment or abuse (93%) typically by police and other street children, had used drugs (62%), and, among the older adolescents, were sexually active (67%). Among the sexually active 15-17-year-olds, most reported multiple partners (54%) and never using condoms (52%). Most girls (53% in Greater Cairo and 90% in Alexandria) had experienced sexual abuse. The majority of street children experienced more than one of these risks. Overlaps with populations at highest risk for HIV were substantial, namely men who have sex with men, commercial sex workers, and injection drug users. Our study using a randomized TLS approach produced a rigorous, diverse, probability-based sample of street children and documented very high levels of multiple concurrent risks. Our findings strongly advocate for multiple services including those addressing HIV and STI prevention and care, substance use, shelters, and sensitization of authorities to the plight of

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...

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.

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

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.

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...

Suicidal and online: how do online behaviors inform us of this high-risk population?

Science.gov (United States)

Harris, Keith M; McLean, John P; Sheffield, Jeanie

2014-01-01

To assist suicide prevention we need a better understanding of how suicidal individuals act in their environment, and the online world offers an ideal opportunity to examine daily behaviors. This anonymous survey (N = 1,016) provides first-of-its-kind empirical evidence demonstrating suicide-risk people (n = 290) are unique in their online behaviors. Suicidal users reported more time online, greater likelihood of developing online personal relationships, and greater use of online forums. In addition, suicide-risk women reported more time browsing/surfing and social networking. The authors conclude that suicide prevention efforts should respond to suicide-risk users' greater demands for online interpersonal communications.

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.

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.

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.

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.

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)

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.

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.

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...

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)

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)

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.

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.

Intraseasonal variation in survival and probable causes of mortality in greater sage-grouse Centrocercus urophasianus

Science.gov (United States)

Blomberg, Erik J.; Gibson, Daniel; Sedinger, James S.; Casazza, Michael L.; Coates, Peter S.

2013-01-01

The mortality process is a key component of avian population dynamics, and understanding factors that affect mortality is central to grouse conservation. Populations of greater sage-grouse Centrocercus urophasianus have declined across their range in western North America. We studied cause-specific mortality of radio-marked sage-grouse in Eureka County, Nevada, USA, during two seasons, nesting (2008-2012) and fall (2008-2010), when survival was known to be lower compared to other times of the year. We used known-fate and cumulative incidence function models to estimate weekly survival rates and cumulative risk of cause-specific mortalities, respectively. These methods allowed us to account for temporal variation in sample size and staggered entry of marked individuals into the sample to obtain robust estimates of survival and cause-specific mortality. We monitored 376 individual sage-grouse during the course of our study, and investigated 87 deaths. Predation was the major source of mortality, and accounted for 90% of all mortalities during our study. During the nesting season (1 April - 31 May), the cumulative risk of predation by raptors (0.10; 95% CI: 0.05-0.16) and mammals (0.08; 95% CI: 0.03-013) was relatively equal. In the fall (15 August - 31 October), the cumulative risk of mammal predation was greater (M(mam) = 0.12; 95% CI: 0.04-0.19) than either predation by raptors (M(rap) = 0.05; 95% CI: 0.00-0.10) or hunting harvest (M(hunt) = 0.02; 95% CI: 0.0-0.06). During both seasons, we observed relatively few additional sources of mortality (e.g. collision) and observed no evidence of disease-related mortality (e.g. West Nile Virus). In general, we found little evidence for intraseasonal temporal variation in survival, suggesting that the nesting and fall seasons represent biologically meaningful time intervals with respect to sage-grouse survival.

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.

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.

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)

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.

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

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,

Retinopathy of Prematurity in Neonatal Patients with Birth Weight Greater than 1500 g in Taiwan

Directory of Open Access Journals (Sweden)

Yi-Hsing Chen

2013-04-01

Full Text Available Background: To understand the characteristics, ophthalmic outcomes, and risk factors of retinopathy of prematurity (ROP in patients with birth weight (BW greater than 1500 g. The applicability of the ROP screening criteria to the Taiwanese population was also examined. Methods: The study included 104 eyes from 54 ROP patients who had BW greater than 1500 g from 1981 to 2008. Demographic information, disease courses, ophthalmic outcomes, and possible systemic risk factors were recorded. The infants were divided into groups of mild and severe ROP for a risk factor analysis. Results: The mean gestational age (GA of the infants was 31 ± 1.3 weeks, and the mean BW was 1675 ± 249 g. Mild ROP regressed in 94 eyes (90%, and 10 eyes (10% developed severe ROP. After various treatments, the regression rates for prethreshold or threshold ROP (n = 8 and stage 4 ROP (n = 2 were 100% and 50%, respectively. Forty-eight patients (85% had at least three associated systemic risk factors. A multiple logistic regression analysis revealed that patients with an intraventricular hemorrhage were found to have an increased chance of developing severe ROP, especially those with BW greater than 1500 g (p = 0.015. There was also a significant association between patients who had severe ROP and an increased risk of having cerebral palsy (CP at 1.5 years of age (p = 0.013. Conclusion: The majority of patients with BW greater than 1500 g developed mild ROP. However, advanced ROP with poor visual outcome was also encountered in some patients.

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.

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.

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...

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....

Shutdown risk monitoring in TEPCO

International Nuclear Information System (INIS)

Sato, Hiroki; Masuda, Takahiro; Denda, Yasutaka; Yoneyama, Mitsuru; Imai, Shun-ichi; Miyata, Koichi

2009-01-01

At present, we are introducing risk monitors into our all three nuclear power stations; Fukushima Daiichi, Fukushima Daini and Kashiwazaki Kariwa, with technical support of TEPSYS. By monitoring shutdown risk of each unit, we are trying to optimize risks during outage inspection, and raising staff's awareness for reactor safety. This paper presents our recent shutdown risk monitoring activities in Fukushima Daiichi NPS. Shutdown risk monitoring has been carried out for the past five outages of Fukushima Daiichi NPS. Daily-changing shutdown risk is evaluated in the form of core damage frequency (CDF [/day/reactor]). We also examine high-risk point of outage plan if CDF is greater than the threshold at anytime of outage. The results are delivered to operational and maintenance staff before outage. The threshold value is set ten times as much as CDF of unit in operation. As CDF exceeds the threshold, we try to either change the system configuration, or let workers pay more attention to their works during the high-risk period. We already have some examples of outage plan modification to reduce CDF using the risk monitoring information. Greater number of station staff tends to pay more attention to shutdown risk thanks to these activities. (author)

The issue of risk dilution in risk assessments

International Nuclear Information System (INIS)

Wilmot, R.; Robinson, P.

2004-01-01

This paper explores an issue that was first highlighted more than 20 years ago during an inquiry concerning the Sizeweli B nuclear power station in the UK. In the probabilistic safety assessment for this plant, the proponent had apparently reduced its estimates of risk by admitting to increased uncertainty about the timing of certain events. This situation is counter-intuitive, since an increase in uncertainty about the factors contributing to safety would be expected to lead to less confidence and hence to greater risk. This paradoxical situation was termed 'risk dilution' and it has been a topic of interest to reviewers of safety cases since. The recent international peer review of the Yucca Mountain performance assessments concluded that there was a potential for risk dilution in the assumptions and calculations presented. The next section describes how assumptions about the timing of events and other aspects of an assessment may lead to risk dilution, and this is followed by two examples based on recent performance assessments. The final section discusses how potential problems can be identified in safety cases, and the types of response that a regulator might adopt as a result. (authors)

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.

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,

Occupational injury among full-time, part-time and casual health care workers.

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Alamgir, Hasanat; Yu, Shicheng; Chavoshi, Negar; Ngan, Karen

2008-08-01

Previous epidemiological studies have conflicting suggestions on the association of occupational injury risks with employment category across industries. This specific issue has not been examined for direct patient care occupations in the health care sector. To investigate whether work-related injury rates differ by employment category (part time, full time or casual) for registered nurses (RNs) in acute care and care aides (CAs) in long-term facilities. Incidents of occupational injury resulting in compensated time loss from work, over a 1-year period within three health regions in British Columbia (BC), Canada, were extracted from a standardized operational database. Detailed analysis was conducted using Poisson regression modeling. Among 8640 RNs in acute care, 37% worked full time, 24% part time and 25% casual. The overall rates of injuries were 7.4, 5.3 and 5.5 per 100 person-years, respectively. Among the 2967 CAs in long-term care, 30% worked full time, 20% part time and 40% casual. The overall rates of injuries were 25.8, 22.9 and 18.1 per 100 person-years, respectively. In multivariate models, having adjusted for age, gender, facility and health region, full-time RNs had significantly higher risk of sustaining injuries compared to part-time and casual workers. For CAs, full-time workers had significantly higher risk of sustaining injuries compared to casual workers. Full-time direct patient care occupations have greater risk of injury compared to part-time and casual workers within the health care sector.

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.

Predation risk shapes social networks in fission-fusion populations.

Directory of Open Access Journals (Sweden)

Jennifer L Kelley

Full Text Available Predation risk is often associated with group formation in prey, but recent advances in methods for analysing the social structure of animal societies make it possible to quantify the effects of risk on the complex dynamics of spatial and temporal organisation. In this paper we use social network analysis to investigate the impact of variation in predation risk on the social structure of guppy shoals and the frequency and duration of shoal splitting (fission and merging (fusion events. Our analyses revealed that variation in the level of predation risk was associated with divergent social dynamics, with fish in high-risk populations displaying a greater number of associations with overall greater strength and connectedness than those from low-risk sites. Temporal patterns of organisation also differed according to predation risk, with fission events more likely to occur over two short time periods (5 minutes and 20 minutes in low-predation fish and over longer time scales (>1.5 hours in high-predation fish. Our findings suggest that predation risk influences the fine-scale social structure of prey populations and that the temporal aspects of organisation play a key role in defining social systems.

Predation Risk Shapes Social Networks in Fission-Fusion Populations

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Kelley, Jennifer L.; Morrell, Lesley J.; Inskip, Chloe; Krause, Jens; Croft, Darren P.

2011-01-01

Predation risk is often associated with group formation in prey, but recent advances in methods for analysing the social structure of animal societies make it possible to quantify the effects of risk on the complex dynamics of spatial and temporal organisation. In this paper we use social network analysis to investigate the impact of variation in predation risk on the social structure of guppy shoals and the frequency and duration of shoal splitting (fission) and merging (fusion) events. Our analyses revealed that variation in the level of predation risk was associated with divergent social dynamics, with fish in high-risk populations displaying a greater number of associations with overall greater strength and connectedness than those from low-risk sites. Temporal patterns of organisation also differed according to predation risk, with fission events more likely to occur over two short time periods (5 minutes and 20 minutes) in low-predation fish and over longer time scales (>1.5 hours) in high-predation fish. Our findings suggest that predation risk influences the fine-scale social structure of prey populations and that the temporal aspects of organisation play a key role in defining social systems. PMID:21912627

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.

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)

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

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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.

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

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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.

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

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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.

Predictive Modeling and Concentration of the Risk of Suicide: Implications for Preventive Interventions in the US Department of Veterans Affairs.

Science.gov (United States)

McCarthy, John F; Bossarte, Robert M; Katz, Ira R; Thompson, Caitlin; Kemp, Janet; Hannemann, Claire M; Nielson, Christopher; Schoenbaum, Michael

2015-09-01

The Veterans Health Administration (VHA) evaluated the use of predictive modeling to identify patients at risk for suicide and to supplement ongoing care with risk-stratified interventions. Suicide data came from the National Death Index. Predictors were measures from VHA clinical records incorporating patient-months from October 1, 2008, to September 30, 2011, for all suicide decedents and 1% of living patients, divided randomly into development and validation samples. We used data on all patients alive on September 30, 2010, to evaluate predictions of suicide risk over 1 year. Modeling demonstrated that suicide rates were 82 and 60 times greater than the rate in the overall sample in the highest 0.01% stratum for calculated risk for the development and validation samples, respectively; 39 and 30 times greater in the highest 0.10%; 14 and 12 times greater in the highest 1.00%; and 6.3 and 5.7 times greater in the highest 5.00%. Predictive modeling can identify high-risk patients who were not identified on clinical grounds. VHA is developing modeling to enhance clinical care and to guide the delivery of preventive interventions.

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

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

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.

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

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.

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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.

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

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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.

Cognitively Engaging Activity is Associated with Greater Cortical and Subcortical Volumes

Directory of Open Access Journals (Sweden)

Talia R. Seider

2016-05-01

Full Text Available As the population ages and dementia becomes a growing healthcare concern, it is increasingly important to identify targets for intervention to delay or attenuate cognitive decline. Research has shown that the most successful interventions aim at altering lifestyle factors. Thus, this study examined how involvement in physical, cognitive, and social activity is related to brain structure in older adults. Sixty-five adults (mean age = 71.4 years, standard deviation = 8.9 received the Community Healthy Activities Model Program for Seniors (CHAMPS, a questionnaire that polls everyday activities in which older adults may be involved, and also underwent structural magnetic resonance imaging. Stepwise regression with backwards selection was used to predict weekly time spent in either social, cognitive, light physical, or heavy physical activity from the volume of one of the cortical or subcortical regions of interest (corrected by intracranial volume as well as age, education, and gender as control variables. Regressions revealed that more time spent in cognitive activity was associated with greater volumes of all brain regions studied: total cortex (β = .289, p = .014, frontal (β = .276, p = .019, parietal (β = .305, p = .009, temporal (β = .275, p = .020, and occipital (β = .256, p = .030 lobes, and thalamus (β = .310, p = .010, caudate (β = .233, p = .049, hippocampus (β = .286, p = .017, and amygdala (β = .336, p = .004. These effects remained even after accounting for the positive association between cognitive activity and education. No other activity variable was associated with brain volumes. Results indicate that time spent in cognitively engaging activity is associated with greater cortical and subcortical brain volume. Findings suggest that interventions aimed at increasing levels of cognitive activity may delay cognitive consequences of aging and decrease the risk of developing dementia.

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.

Modeling risk of pneumonia epizootics in bighorn sheep

Science.gov (United States)

Sells, Sarah N.; Mitchell, Michael S.; Nowak, J. Joshua; Lukacs, Paul M.; Anderson, Neil J.; Ramsey, Jennifer M.; Gude, Justin A.; Krausman, Paul R.

2015-01-01

Pneumonia epizootics are a major challenge for management of bighorn sheep (Ovis canadensis) affecting persistence of herds, satisfaction of stakeholders, and allocations of resources by management agencies. Risk factors associated with the disease are poorly understood, making pneumonia epizootics hard to predict; such epizootics are thus managed reactively rather than proactively. We developed a model for herds in Montana that identifies risk factors and addresses biological questions about risk. Using Bayesian logistic regression with repeated measures, we found that private land, weed control using domestic sheep or goats, pneumonia history, and herd density were positively associated with risk of pneumonia epizootics in 43 herds that experienced 22 epizootics out of 637 herd-years from 1979–2013. We defined an area of high risk for pathogen exposure as the area of each herd distribution plus a 14.5-km buffer from that boundary. Within this area, the odds of a pneumonia epizootic increased by >1.5 times per additional unit of private land (unit is the standardized % of private land where global  = 25.58% and SD = 14.53%). Odds were >3.3 times greater if domestic sheep or goats were used for weed control in a herd's area of high risk. If a herd or its neighbors within the area of high risk had a history of a pneumonia epizootic, odds of a subsequent pneumonia epizootic were >10 times greater. Risk greatly increased when herds were at high density, with nearly 15 times greater odds of a pneumonia epizootic compared to when herds were at low density. Odds of a pneumonia epizootic also appeared to decrease following increased spring precipitation (odds = 0.41 per unit increase, global  = 100.18% and SD = 26.97%). Risk was not associated with number of federal sheep and goat allotments, proximity to nearest herds of bighorn sheep, ratio of rams to ewes, percentage of average winter precipitation, or whether herds were of native versus mixed

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.

Demographic, Behavioural and Normative Risk Factors for Gambling Problems Amongst Sports Bettors.

Science.gov (United States)

Hing, Nerilee; Russell, Alex M T; Vitartas, Peter; Lamont, Matthew

2016-06-01

Sports betting is growing exponentially, is heavily marketed and successfully targets young adult males. Associated gambling problems are increasing. Therefore, understanding risk factors for problem gambling amongst sports bettors is an increasingly important area of research to inform the appropriate design and targeting of public health and treatment interventions. This study aimed to identify demographic, behavioural and normative risk factors for gambling problems amongst sports bettors. An online survey of 639 Australian sports bettors using online, telephone and retail betting channels was conducted. Results indicated that vulnerable sports bettors for higher risk gambling are those who are young, male, single, educated, and employed full-time or a full-time student. Risk of problem gambling was also found to increase with greater frequency and expenditure on sports betting, greater diversity of gambling involvement, and with more impulsive responses to betting opportunities, including in-play live action betting. Normative influences from media advertising and from significant others were also associated with greater problem gambling risk. The results of this study can inform a suite of intervention, protection and treatment initiatives targeted especially at young male adults and adolescents that can help to limit the harm from this gambling form.

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.

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.

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.

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.

Risks from radon

International Nuclear Information System (INIS)

Doll, Richard

1992-01-01

The best estimate of risk to which everyone is exposed from natural radon in buildings is now obtained by extrapolation from observations on men exposed to radon in mines. The relationship between dose and effect derived by the US National Research Council implies that about 6% of the current life-time risk of developing the disease in the UK is attributable to radon, but for residents of some houses it will be much greater. This estimate is dependent on many assumptions, some of which are certainly wrong, and reliable estimates can be obtained only by direct observations on people living in different houses. It is possible that radon may also cause some risk of other cancers, notably leukaemia, but such risks, if real, are certainly small. Studies in progress should provide reliable estimates of all radon induced risks within a few years. (author)

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.

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.

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.

Dynamical systems probabilistic risk assessment

Energy Technology Data Exchange (ETDEWEB)

Denman, Matthew R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ames, Arlo Leroy [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2014-03-01

Probabilistic Risk Assessment (PRA) is the primary tool used to risk-inform nuclear power regulatory and licensing activities. Risk-informed regulations are intended to reduce inherent conservatism in regulatory metrics (e.g., allowable operating conditions and technical specifications) which are built into the regulatory framework by quantifying both the total risk profile as well as the change in the risk profile caused by an event or action (e.g., in-service inspection procedures or power uprates). Dynamical Systems (DS) analysis has been used to understand unintended time-dependent feedbacks in both industrial and organizational settings. In dynamical systems analysis, feedback loops can be characterized and studied as a function of time to describe the changes to the reliability of plant Structures, Systems and Components (SSCs). While DS has been used in many subject areas, some even within the PRA community, it has not been applied toward creating long-time horizon, dynamic PRAs (with time scales ranging between days and decades depending upon the analysis). Understanding slowly developing dynamic effects, such as wear-out, on SSC reliabilities may be instrumental in ensuring a safely and reliably operating nuclear fleet. Improving the estimation of a plant's continuously changing risk profile will allow for more meaningful risk insights, greater stakeholder confidence in risk insights, and increased operational flexibility.

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....

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.

Building better environmental risk assessments

Directory of Open Access Journals (Sweden)

Raymond eLayton

2015-08-01

Full Text Available Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERA for genetically modified (GM crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems – examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data, and adapting advances in risk analysis from other relevant disciplines.

Building Better Environmental Risk Assessments

Science.gov (United States)

Layton, Raymond; Smith, Joe; Macdonald, Phil; Letchumanan, Ramatha; Keese, Paul; Lema, Martin

2015-01-01

Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision-making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERAs) for genetically modified (GM) crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems – examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data), and adapting advances in risk analysis from other relevant disciplines. PMID:26301217

Building Better Environmental Risk Assessments.

Science.gov (United States)

Layton, Raymond; Smith, Joe; Macdonald, Phil; Letchumanan, Ramatha; Keese, Paul; Lema, Martin

2015-01-01

Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision-making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERAs) for genetically modified (GM) crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems - examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data), and adapting advances in risk analysis from other relevant disciplines.

125I Monotherapy Using D90 Implant Doses of 180 Gy or Greater

International Nuclear Information System (INIS)

Kao, Johnny; Stone, Nelson N.; Lavaf, Amir; Dumane, Vishruta; Cesaretti, Jamie A.; Stock, Richard G.

2008-01-01

Purpose: The purpose of this study was to characterize the oncologic results and toxicity profile of patients treated with 125 I implants using the dose delivered to 90% of the gland from the dose-volume histogram (D90) of greater than 144 Gy. Methods and Materials: From June 1995 to Feb 2005, a total of 643 patients were treated with 125 I monotherapy for T1-T2 prostate cancer with a D90 of 180 Gy or greater (median, 197 Gy; range, 180-267 Gy). Implantations were performed using a real-time ultrasound-guided seed-placement method and intraoperative dosimetry to optimize target coverage and homogeneity by using modified peripheral loading. We analyzed biochemical disease-free survival (bDFS) of 435 patients who had a minimum 2-year prostate-specific antigen follow-up (median follow-up, 6.7 years; range, 2.0-11.1 years). Results: Five-year bDFS rates for the entire cohort using the American Society for Therapeutic Radiology and Oncology and Phoenix definitions were 96.9% and 96.5%, respectively. Using the Phoenix definition, 5-year bDFS rates were 97.3% for low-risk patients and 92.8% for intermediate/high-risk patients. The positive biopsy rate was 4.1%. The freedom rate from Grade 2 or higher rectal bleeding at 5 years was 88.5%. Acute urinary retention occurred in 10.7%, more commonly in patients with high pretreatment International Prostate Symptom Scores (p < 0.01). In patients who were potent before treatment, 73.4% remained potent at 5 years after implantation. Conclusions: Patients with a minimum D90 of 180 Gy had outstanding local control based on prostate-specific antigen control and biopsy data. Toxicity profiles, particularly for long-term urinary and sexual function, were excellent and showed that D90 doses of 180 Gy or greater performed using the technique described were feasible and tolerable

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.

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.

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.

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...

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.

Education-based disparities in knowledge of novel health risks: The case of knowledge gaps in HIV risk perceptions.

Science.gov (United States)

Kiviniemi, Marc T; Orom, Heather; Waters, Erika A; McKillip, Megan; Hay, Jennifer L

2018-05-01

Risk perception is a key determinant of preventive health behaviour, but when asked, some individuals indicate they do not know their health risk. Low education is associated with both lack of knowledge about health risk and with the persistence and exacerbation of gaps in knowledge about health issues. This study uses the context of an emerging infectious disease threat to explore the hypothesis that the education-don't know risk relation results from differences in knowledge about the health issue of interest. Specifically, we examine whether patterns of change over time follow theoretical predictions that disparities in risk knowledge would increase over time in less educated sectors of the population (knowledge gap hypothesis). Secondary analysis of population-representative behavioural surveillance survey. We analysed data from the 1993 to 2000 Behavior Risk Factor Surveillance System surveys, which measured education and perceived HIV/AIDS risk in a population sample collected separately in each survey year; don't know responses were coded. In each year, individuals with higher education were less likely to respond don't know. The absolute prevalence of don't know responding dropped over time; nonetheless, there was an increase over time in the magnitude of the pattern of lower education being associated with greater don't know responding. We found support for the knowledge gap hypothesis. Over time, populations with greater education gained more knowledge about their HIV risk than populations with lower education. Results highlight the need to carefully consider health communication strategies to reach and address those individuals with low education and health knowledge. Statement of contribution What is already known on this subject? A meaningful potion of the population answers 'don't know' when asked to report their risk for health problems, indicating a lack of risk perception in the domain. Previous studies have shown that level of education is

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

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.

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.

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

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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.

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

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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.

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

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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

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

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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.

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

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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.

Feasibility assessment of a risk-based approach to technical specifications

International Nuclear Information System (INIS)

Atefi, B.; Gallagher, D.W.

1991-05-01

To assess the potential use of risk and reliability techniques for improving the effectiveness of the technical specifications to control plant operational risk, the Technical Specifications Branch of the Nuclear Regulatory Commission initiated an effort to identify and evaluate alternative risk-based approaches that could bring greater risk perspective to these requirements. In the first phase four alternative approaches were identified and their characteristics were analyzed. Among these, the risk-based approach to technical specifications is the most promising approach for controlling plant operational risk using technical specifications. The second phase of the study concentrated on detailed characteristics of the real time risk-based approach. It is concluded that a real time risk-based approach to technical specifications has the potential to improve both plant safety and availability. 33 figs., 5 figs., 6 tabs

Life-time risk of mortality due to different levels of alcohol consumption in seven European countries: implications for low-risk drinking guidelines.

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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.

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

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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...

Sitting and television viewing: novel risk factors for sleep disturbance and apnea risk? results from the 2013 National Sleep Foundation Sleep in America Poll.

Science.gov (United States)

Buman, Matthew P; Kline, Christopher E; Youngstedt, Shawn D; Phillips, Barbara; Tulio de Mello, Marco; Hirshkowitz, Max

2015-03-01

Excess sitting is emerging as a novel risk factor for cardiovascular disease, diabetes, mental illness, and all-cause mortality. Physical activity, distinct from sitting, is associated with better sleep and lower risk for OSA, yet relationships among sitting behaviors and sleep/OSA remain unknown. We examined whether total sitting time and sitting while viewing television were associated with sleep duration and quality, OSA risk, and sleepiness. The 2013 National Sleep Foundation Sleep in America Poll was a cross-sectional study of 1,000 adults aged 23 to 60 years. Total sitting time, time watching television while sitting, sleep duration and quality, OSA risk, and daytime sleepiness were assessed. After adjusting for confounding factors (including BMI and physical activity), each additional hour per day of total sitting was associated with greater odds of poor sleep quality (OR [95% CI] = 1.06 [1.01, 1.11]) but not with other sleep metrics (including sleep duration), OSA risk, or daytime sleepiness. For television viewing while sitting, each additional hour per day was associated with greater odds of long sleep onset latency (≥ 30 min) (OR = 1.15 [1.04, 1.27]), waking up too early in the morning (OR = 1.12 [1.03, 1.23]), poor sleep quality (OR = 1.12 [1.02, 1.24]), and "high risk" for OSA (OR = 1.15 [1.04, 1.28]). Based upon an interaction analysis, regular physical activity was protective against OSA risk associated with television viewing (P = .04). Excess sitting was associated with relatively poor sleep quality. Sitting while watching television was associated with relatively poor sleep quality and OSA risk and may be an important risk factor for sleep disturbance and apnea risk.

Value-at-Risk analysis using ARMAX GARCHX approach for estimating risk of banking subsector stock return’s

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Dewi Ratih, Iis; Sutijo Supri Ulama, Brodjol; Prastuti, Mike

2018-03-01

Value at Risk (VaR) is one of the statistical methods used to measure market risk by estimating the worst losses in a given time period and level of confidence. The accuracy of this measuring tool is very important in determining the amount of capital that must be provided by the company to cope with possible losses. Because there is a greater losses to be faced with a certain degree of probability by the greater risk. Based on this, VaR calculation analysis is of particular concern to researchers and practitioners of the stock market to be developed, thus getting more accurate measurement estimates. In this research, risk analysis of stocks in four banking sub-sector, Bank Rakyat Indonesia, Bank Mandiri, Bank Central Asia and Bank Negara Indonesia will be done. Stock returns are expected to be influenced by exogenous variables, namely ICI and exchange rate. Therefore, in this research, stock risk estimation are done by using VaR ARMAX-GARCHX method. Calculating the VaR value with the ARMAX-GARCHX approach using window 500 gives more accurate results. Overall, Bank Central Asia is the only bank had the estimated maximum loss in the 5% quantile.

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...

Air pollution and respiratory hospital admissions in greater Paris: exploring sex differences.

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Granados-Canal, D J; Chardon, B; Lefranc, A; Gremy, I

2005-01-01

The subject of sex and gender differences is relevant to the study of health effects of environmental exposures. In this study the authors aim at assessing the differences that may exist between males and females regarding short-term air pollution health effects. They studied the short-term relationships between air pollution levels and respiratory hospital admissions in greater Paris area for patients older than 15 years between 2000 and 2003. They also conducted time series analyses by using generalized additive models. For an increase of 10 microg/m3 in the air pollutant levels, the increase in relative risk of hospitalization was higher for males than for females and was significant only for males. These differences may not result solely from differences in biological susceptibility to air pollution because other factors related to gender (differences in individual exposures, in health care management, and so on) may play a role.

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

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.

Physical activity can lower risk of 13 types of cancer

Science.gov (United States)

A new study of the relationship between physical activity and cancer has shown that greater levels of leisure-time physical activity were associated with a lower risk of developing 13 different types of cancer; the risk of developing seven cancer types was 20 percent lower among the most active participants as compared with the least active participants.

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

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.

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.

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.

Is all risk bad? Young adult cigarette smokers fail to take adaptive risk in a laboratory decision-making test.

Science.gov (United States)

Dean, Andy C; Sugar, Catherine A; Hellemann, Gerhard; London, Edythe D

2011-06-01

Cigarette smoking has been linked to real-world risky behavior, but this association has been based largely on retrospective self-reports. Limitations of self-report data can be avoided by using laboratory, performance-based measures, such as the Balloon Analogue Risk Task (BART; Lejuez et al., J Exp Psychol Appl 8:75-84, 2002). Initial studies have suggested that smokers display greater risk-taking on this task than nonsmokers, but these studies did not account for drug abuse and psychiatric comorbidities, which are commonplace among smokers. We sought to examine the performance of smokers and nonsmokers on the BART after excluding drug abuse and psychiatric comorbidities. We conducted a study of late adolescent/young adult (age 18 to 21) smokers (n = 26) and nonsmokers (n = 38) performing the BART and excluded individuals with positive drug or alcohol toxicology screens, substance abuse or dependence diagnoses, and/or current psychiatric conditions. Contrary to previous findings, smokers did not display greater risk-taking on the BART than nonsmokers. In fact, when performance was examined trial-by-trial, the nonsmokers displayed progressively greater pumping relative to smokers over time (p adaptive.

Associations of objectively assessed physical activity and sedentary time with all-cause mortality in US adults: the NHANES study.

Science.gov (United States)

Schmid, Daniela; Ricci, Cristian; Leitzmann, Michael F

2015-01-01

Sedentary behavior is related to increased mortality risk. Whether such elevated risk can be offset by enhanced physical activity has not been examined using accelerometry data. We examined the relations of sedentary time and physical activity to mortality from any cause using accelerometry data among 1,677 women and men aged 50 years or older from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 cycle with follow-up through December 31, 2006. During an average follow-up of 34.67 months and 4,845.42 person-years, 112 deaths occurred. In multivariate Cox proportional hazard models, greater sedentary time (≥ median of 8.60 hours/day) was associated with increased risk of mortality from any cause (relative risk (RR) = 2.03; 95% confidence interval (CI) = 1.09-3.81). Low level of moderate to vigorous physical activity (physical activity predicted a substantially elevated all-cause mortality risk. As compared with the combination of a low sedentary level and a high level of moderate to vigorous physical activity, the risks of mortality from all causes were 4.38 (95% CI = 1.26-15.16) for low levels of both sedentary time and physical activity, 2.79 (95% CI = 0.77-10.12) for greater time spent sedentary and high physical activity level, and 7.79 (95% CI = 2.26-26.82) for greater time spent sedentary and low physical activity level. The interaction term between sedentary time and moderate to vigorous physical activity was not statistically significant (p = 0.508). Both high levels of sedentary time and low levels of moderate to vigorous physical activity are strong and independent predictors of early death from any cause. Whether a high physical activity level removes the increased risk of all-cause mortality related to sedentariness requires further investigation.

Affect, risk perception and future optimism after the tsunami disaster

Directory of Open Access Journals (Sweden)

Daniel Vastfjall

2008-01-01

Full Text Available Environmental events such as natural disasters may influence the public's affective reactions and decisions. Shortly after the 2004 Tsunami disaster we assessed how affect elicited by thinking about this disaster influenced risk perceptions and future time perspective in Swedish undergraduates not directly affected by the disaster. An experimental manipulation was used to increase the salience of affect associated with the disaster. In Study 1 we found that participants reminded about the tsunami had a sense that their life was more finite and included fewer opportunities than participants in the control condition (not reminded about the tsunami. In Study 2 we found similar effects for risk perceptions. In addition, we showed that manipulations of ease-of-thought influenced the extent to which affect influenced these risk perceptions, with greater ease of thoughts being associated with greater perceived risks.

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

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.

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.

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.

Birth order and risk taking in athletics: a meta-analysis and study of major league baseball.

Science.gov (United States)

Sulloway, Frank J; Zweigenhaft, Richard L

2010-11-01

According to expectations derived from evolutionary theory, younger siblings are more likely than older siblings to participate in high-risk activities. The authors test this hypothesis by conducting a meta-analysis of 24 previous studies involving birth order and participation in dangerous sports. The odds of laterborns engaging in such activities were 1.48 times greater than for firstborns (N = 8,340). The authors also analyze performance data on 700 brothers who played major league baseball. Consistent with their greater expected propensity for risk taking, younger brothers were 10.6 times more likely to attempt the high-risk activity of base stealing and 3.2 times more likely to steal bases successfully (odds ratios). In addition, younger brothers were significantly superior to older brothers in overall batting success, including two measures associated with risk taking. As expected, significant heterogeneity among various performance measures for major league baseball players indicated that older and younger brothers excelled in different aspects of the game.

The role of the affect and availability heuristics in risk communication.

Science.gov (United States)

Keller, Carmen; Siegrist, Michael; Gutscher, Heinz

2006-06-01

Results of past research suggest that affect plays an important role in risk perception. Because affect may also increase the availability of risks, affect and availability are closely related concepts. Three studies tested the hypothesis that evoking negative affect (fear), either through past experience or through experimental manipulation, results in greater perceived risk. The present research focused on perception of flooding risk. Study 1 and Study 2 showed that participants who received risk information concerning a longer time period (e.g., 30 years) perceived more danger compared with participants who received risk information for one year. Study 2 showed that the interpretation of risk information was influenced by participants' own experiences with flooding. In Study 3, affect was experimentally manipulated. After looking at photographs depicting houses in a flooded region, participants perceived greater risk compared with participants in a control group. Taken together, the results of these three studies suggest that affect is important for successful risk communication. Results of the present research are in line with the affect heuristic proposed by Slovic and colleagues.

Persistent hemifacial spasm after microvascular decompression: a risk assessment model.

Science.gov (United States)

Shah, Aalap; Horowitz, Michael

2017-06-01

Microvascular decompression (MVD) for hemifacial spasm (HFS) provides resolution of disabling symptoms such as eyelid twitching and muscle contractions of the entire hemiface. The primary aim of this study was to evaluate the predictive value of patient demographics and spasm characteristics on long-term outcomes, with or without intraoperative lateral spread response (LSR) as an additional variable in a risk assessment model. A retrospective study was undertaken to evaluate the associations of pre-operative patient characteristics, as well as intraoperative LSR and need for a staged procedure on the presence of persistent or recurrent HFS at the time of hospital discharge and at follow-up. A risk assessment model was constructed with the inclusion of six clinically or statistically significant variables from the univariate analyses. A receiving operator characteristic curve was generated, and area under the curve was calculated to determine the strength of the predictive model. A risk assessment model was first created consisting of significant pre-operative variables (Model 1) (age >50, female gender, history of botulinum toxin use, platysma muscle involvement). This model demonstrated borderline predictive value for persistent spasm at discharge (AUC .60; p=.045) and fair predictive value at follow-up (AUC .75; p=.001). Intraoperative variables (e.g. LSR persistence) demonstrated little additive value (Model 2) (AUC .67). Patients with a higher risk score (three or greater) demonstrated greater odds of persistent HFS at the time of discharge (OR 1.5 [95%CI 1.16-1.97]; p=.035), as well as greater odds of persistent or recurrent spasm at the time of follow-up (OR 3.0 [95%CI 1.52-5.95]; p=.002) Conclusions: A risk assessment model consisting of pre-operative clinical characteristics is useful in prognosticating HFS persistence at follow-up.

Risk perception influences athletic pacing strategy.

Science.gov (United States)

Micklewright, Dominic; Parry, David; Robinson, Tracy; Deacon, Greg; Renfree, Andrew; St Clair Gibson, Alan; Matthews, William J

2015-05-01

The objective of this study is to examine risk taking and risk perception associations with perceived exertion, pacing, and performance in athletes. Two experiments were conducted in which risk perception was assessed using the domain-specific risk taking (DOSPERT) scale in 20 novice cyclists (experiment 1) and 32 experienced ultramarathon runners (experiment 2). In experiment 1, participants predicted their pace and then performed a 5-km maximum effort cycling time trial on a calibrated Kingcycle mounted bicycle. Split times and perceived exertion were recorded every kilometer. In experiment 2, each participant predicted their split times before running a 100-km ultramarathon. Split times and perceived exertion were recorded at seven checkpoints. In both experiments, higher and lower risk perception groups were created using median split of DOSPERT scores. In experiment 1, pace during the first kilometer was faster among lower risk perceivers compared with higher risk perceivers (t(18) = 2.0, P = 0.03) and faster among higher risk takers compared with lower risk takers (t(18) = 2.2, P = 0.02). Actual pace was slower than predicted pace during the first kilometer in both the higher risk perceivers (t(9) = -4.2, P = 0.001) and lower risk perceivers (t(9) = -1.8, P = 0.049). In experiment 2, pace during the first 36 km was faster among lower risk perceivers compared with higher risk perceivers (t(16) = 2.0, P = 0.03). Irrespective of risk perception group, actual pace was slower than predicted pace during the first 18 km (t(16) = 8.9, P risk perception groups. Initial pace is associated with an individual's perception of risk, with low perceptions of risk being associated with a faster starting pace. Large differences between predicted and actual pace suggest that the performance template lacks accuracy, perhaps indicating greater reliance on momentary pacing decisions rather than preplanned strategy.

What diagnoses may make patients more seriously ill than they first appear? Mortality according to the Simple Clinical Score Risk Class at the time of admission compared to the observed mortality of different ICD9 codes identified on death or discharge.

LENUS (Irish Health Repository)

Kellett, John

2009-01-01

The Simple Clinical Score (SCS) determined at the time of admission places acutely ill general medical patients into one of five risk classes associated with an increasing risk of death within 30 days. The cohort of acute medical patient that the SCS was derived from had, on average, four combinations of 74 groupings of ICD9 codes. This paper reports the ICD9 codes associated with the different SCS risk classes and identifies those ICD9 codes with a greater observed mortality than that of other patients in the same SCS risk class.

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)

Novel risk stratification with time course assessment of in-hospital mortality in patients with acute heart failure.

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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

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

Encounters with Pinyon-Juniper influence riskier movements in Greater Sage-Grouse across the Great Basin

Science.gov (United States)

Prochazka, Brian; Coates, Peter S.; Ricca, Mark; Casazza, Michael L.; Gustafson, K. Ben; Hull, Josh M.

2016-01-01

Fine-scale spatiotemporal studies can better identify relationships between individual survival and habitat fragmentation so that mechanistic interpretations can be made at the population level. Recent advances in Global Positioning System (GPS) technology and statistical models capable of deconstructing high-frequency location data have facilitated interpretation of animal movement within a behaviorally mechanistic framework. Habitat fragmentation due to singleleaf pinyon (Pinus monophylla; hereafter pinyon) and Utah juniper (Juniperus osteosperma; hereafter juniper) encroachment into sagebrush (Artemisia spp.) communities is a commonly implicated perturbation that can adversely influence greater sage-grouse (Centrocercus urophasianus; hereafter sage-grouse) demographic rates. Using an extensive GPS data set (233 birds and 282,954 locations) across 12 study sites within the Great Basin, we conducted a behavioral change point analysis and subsequently constructed Brownian bridge movement models from each behaviorally homogenous section. We found a positive relationship between modeled movement rate and probability of encountering pinyon-juniper with significant variation among age classes. The probability of encountering pinyon-juniper among adults was two and three times greater than that of yearlings and juveniles, respectively. However, the movement rate in response to the probability of encountering pinyon-juniper trees was 1.5 times greater for juveniles. We then assessed the risk of mortality associated with an interaction between movement rate and the probability of encountering pinyon-juniper using shared frailty models. During pinyon-juniper encounters, on average, juvenile, yearling, and adult birds experienced a 10.4%, 0.2%, and 0.3% reduction in annual survival probabilities. Populations that used pinyon-juniper habitats with a frequency ≥ 3.8 times the overall mean experienced decreases in annual survival probabilities of 71.1%, 0.9%, and 0.9%. This

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.

Mortality in NHS Greater Glasgow and Clyde employees: 2007-2009.

Science.gov (United States)

Freer, K; Waclawski, E

2013-09-01

Just over a fifth of all deaths in Scotland occur in those under the age of 65. This study examined deaths in service in employees of the National Health Service Greater Glasgow and Clyde (NHS GG&C) Health Board over a 3-year period. To assess crude death rates by occupational group, the main causes of death and evidence of causes that could have been prevented or modified by lifestyle changes. Demographic details, occupational grouping and death certificate data were obtained for all NHS GG&C employees who died in service between 2007 and 2009. A total of 138 employees died in this period. The occupational groups in which most deaths occurred were support services (porters, domestic and catering staff; 35%) and nurses (34%). The commonest causes of death were lung cancer (15%), ischaemic heart disease (9%) and suicide (9%). The overall crude death rate was 1.2/1000 persons/year (females 1.0 and males 1.7) and was highest among support services employees (2.4) and lowest among medical staff (0.5). The relative risk of death in support services was significantly greater than the majority of occupational groups. These findings suggest health inequality within this workforce. The main causes of death identified in the support services group could potentially be modified through workplace risk factor screening and health promotion.

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.

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.

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.

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

Greater-confinement disposal of low-level 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 wastes include a broad spectrum of wastes that have different radionuclide concentrations, half-lives, and physical and chemical properties. Standard shallow-land burial practice can provide adequate protection of public health and safety for most low-level wastes, but a small volume fraction (about 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. This paper presents an overview of the factors that must be considered in planning the application of methods proposed for providing greater confinement of low-level wastes. 27 refs

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.

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

Status on disposal of greater-than-Class C

Energy Technology Data Exchange (ETDEWEB)

Plummer, T.L.

1995-12-31

The Department of Energy (DOE) has developed a plan for the management and disposal of commercially generated greater-than-Class C (GTCC) low-level radioactive waste. The Low-Level Radioactive Waste Policy Amendments Act of 1985 made DOE responsible for disposal of GTCC waste. The act requires that GTCC waste be disposed in a Nuclear Regulatory Commission (NRC)-licensed facility. The NRC has amended 10 CFR 61 to express a preference for geologic disposal of GTCC waste. Based on reassessment studies, legislative guidance, and stakeholder involvement, a revised plan has been formulated to provide for total management of GTCC waste. The plan has four major thrusts: (1) plan for GTCC waste storage at the generator site until disposal is available, (2) establish storage for GTCC sealed sources posing health and safety risk to the public, (3) facilitate storage for other GTCC waste posing health and safety risk to the public, and (4) plan for co-disposal of GTCC waste in a geologic disposal site with similar waste types. The revised plan focuses on applying available resources to near- and long-term needs.

Dynamic Relationships Between Parental Monitoring, Peer Risk Involvement and Sexual Risk Behavior Among Bahamian Mid-Adolescents.

Science.gov (United States)

Wang, Bo; Stanton, Bonita; Deveaux, Lynette; Li, Xiaoming; Lunn, Sonja

2015-06-01

Considerable research has examined reciprocal relationships between parenting, peers and adolescent problem behavior; however, such studies have largely considered the influence of peers and parents separately. It is important to examine simultaneously the relationships between parental monitoring, peer risk involvement and adolescent sexual risk behavior, and whether increases in peer risk involvement and changes in parental monitoring longitudinally predict adolescent sexual risk behavior. Four waves of sexual behavior data were collected between 2008/2009 and 2011 from high school students aged 13-17 in the Bahamas. Structural equation and latent growth curve modeling were used to examine reciprocal relationships between parental monitoring, perceived peer risk involvement and adolescent sexual risk behavior. For both male and female youth, greater perceived peer risk involvement predicted higher sexual risk behavior index scores, and greater parental monitoring predicted lower scores. Reciprocal relationships were found between parental monitoring and sexual risk behavior for males and between perceived peer risk involvement and sexual risk behavior for females. For males, greater sexual risk behavior predicted lower parental monitoring; for females, greater sexual risk behavior predicted higher perceived peer risk involvement. According to latent growth curve models, a higher initial level of parental monitoring predicted decreases in sexual risk behavior, whereas both a higher initial level and a higher growth rate of peer risk involvement predicted increases in sexual risk behavior. Results highlight the important influence of peer risk involvement on youths' sexual behavior and gender differences in reciprocal relationships between parental monitoring, peer influence and adolescent sexual risk behavior.

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.

Cerebral Palsy in Children as a Risk Factor for Malnutrition.

Science.gov (United States)

Perenc, Lidia; Przysada, Grzegorz; Trzeciak, Jadwiga

2015-01-01

The main aim of this study was to determine some malnutrition risk factors among children with cerebral palsy (CP). Children with CP often require the assistance of physical therapy centers. Experience suggests that, apart from physical disabilities, this group often suffers from malnutrition. Data were gathered in the hospital among 128 children aged 3-18 years who were suffering from CP. The children were admitted from 2011 to 2013 to the Center for Neurological Physical Therapy for children in the Regional Hospital No. 2. St. Queen Jadwiga in Rzeszow (RORE). Statistical analyses were conducted for data on gender, age, type of CP, motor function level according to Gross Motor Function Classification Scale (GMFCS), body mass index (BMI) and hemoglobin levels in blood. The risk of anemia differs based on gender--the risk is 6 times greater among boys than among girls (p = 0.0398). Risk of malnutrition is 3.5 times higher in children with tetraplegia than in children with diplegia or hemiplegia (p = 0.0043). Higher GMFCS scores are connected to greater proportions of malnourished children (for BMI z-score children with CP, malnourishment risk factors are male gender for anemia and tetraplegia and high GMFCS values. 2015 S. Karger AG, Basel.

Change in risk factors for eating disorder symptomatology in Malay students sojourning in the United Kingdom.

Science.gov (United States)

Swami, Viren

2016-07-01

The purpose of this investigation was to examine change in risk for eating disorders in higher education students sojourning in the United Kingdom (UK), as well as associations between such risk and experiences in the host culture. Participants were 98 female students from Malaysia, who completed a measure of risk factors for eating disorder symptomatology (the Eating Disorder Inventory-3 subscales of drive for thinness, body dissatisfaction, and bulimia symptoms) at two time points: two months prior to beginning their sojourn in the UK (Time 1) and four months after the sojourn began (Time 2). At Time 2, participants also completed measures of sociocultural adjustment, cultural distance between home and host cultures, and perceived discrimination in the host culture. Analyses indicated that, compared to scores at Time 1, participants had significantly higher drive for thinness (d = 0.64), body dissatisfaction (d = 0.54), and bulimia symptoms (d = 0.29) at Time 2. Poorer sociocultural adjustment and greater perceived discrimination significantly predicted greater risk of eating disorders at Time 2. The stress associated with culture change may place sojourning students at risk for disordered eating. Further research is needed to determine the extent to which this risk is related to culture-change specifically, as opposed to a general set of factors associated with transition-related psychopathology more broadly. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:695-700). © 2016 Wiley Periodicals, Inc.

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...

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.

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.

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.

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...

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

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.

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.

Data requirements of GREAT-ER: Modelling and validation using LAS in four UK catchments

International Nuclear Information System (INIS)

Price, Oliver R.; Munday, Dawn K.; Whelan, Mick J.; Holt, Martin S.; Fox, Katharine K.; Morris, Gerard; Young, Andrew R.

2009-01-01

Higher-tier environmental risk assessments on 'down-the-drain' chemicals in river networks can be conducted using models such as GREAT-ER (Geography-referenced Regional Exposure Assessment Tool for European Rivers). It is important these models are evaluated and their sensitivities to input variables understood. This study had two primary objectives: evaluate GREAT-ER model performance, comparing simulated modelled predictions for LAS (linear alkylbenzene sulphonate) with measured concentrations, for four rivers in the UK, and investigate model sensitivity to input variables. We demonstrate that the GREAT-ER model is very sensitive to variability in river discharges. However it is insensitive to the form of distributions used to describe chemical usage and removal rate in sewage treatment plants (STPs). It is concluded that more effort should be directed towards improving empirical estimates of effluent load and reducing uncertainty associated with usage and removal rates in STPs. Simulations could be improved by incorporating the effect of river depth on dissipation rates. - Validation of GREAT-ER.

Data requirements of GREAT-ER: Modelling and validation using LAS in four UK catchments

Energy Technology Data Exchange (ETDEWEB)

Price, Oliver R., E-mail: oliver.price@unilever.co [Safety and Environmental Assurance Centre, Unilever, Colworth Science Park, Sharnbrook, Bedfordshire MK44 1LQ (United Kingdom); Munday, Dawn K. [Safety and Environmental Assurance Centre, Unilever, Colworth Science Park, Sharnbrook, Bedfordshire MK44 1LQ (United Kingdom); Whelan, Mick J. [Department of Natural Resources, School of Applied Sciences, Cranfield University, College Road, Cranfield, Bedfordshire MK43 0AL (United Kingdom); Holt, Martin S. [ECETOC, Ave van Nieuwenhuyse 4, Box 6, B-1160 Brussels (Belgium); Fox, Katharine K. [85 Park Road West, Birkenhead, Merseyside CH43 8SQ (United Kingdom); Morris, Gerard [Environment Agency, Phoenix House, Global Avenue, Leeds LS11 8PG (United Kingdom); Young, Andrew R. [Wallingford HydroSolutions Ltd, Maclean building, Crowmarsh Gifford, Wallingford, Oxon OX10 8BB (United Kingdom)

2009-10-15

Higher-tier environmental risk assessments on 'down-the-drain' chemicals in river networks can be conducted using models such as GREAT-ER (Geography-referenced Regional Exposure Assessment Tool for European Rivers). It is important these models are evaluated and their sensitivities to input variables understood. This study had two primary objectives: evaluate GREAT-ER model performance, comparing simulated modelled predictions for LAS (linear alkylbenzene sulphonate) with measured concentrations, for four rivers in the UK, and investigate model sensitivity to input variables. We demonstrate that the GREAT-ER model is very sensitive to variability in river discharges. However it is insensitive to the form of distributions used to describe chemical usage and removal rate in sewage treatment plants (STPs). It is concluded that more effort should be directed towards improving empirical estimates of effluent load and reducing uncertainty associated with usage and removal rates in STPs. Simulations could be improved by incorporating the effect of river depth on dissipation rates. - Validation of GREAT-ER.

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...

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.

Perceived risk of female infidelity moderates the relationship between objective risk of female infidelity and sexual coercion in humans (Homo sapiens).

Science.gov (United States)

McKibbin, William F; Starratt, Valerie G; Shackelford, Todd K; Goetz, Aaron T

2011-08-01

Female extrapair copulation (EPC) can be costly to a woman's long-term romantic partner. If a woman has copulated recently with a man other than her long-term partner, her reproductive tract may contain the sperm of both men, initiating sperm competition (whereby sperm from multiple males compete to fertilize an egg). Should the woman become pregnant, her long-term partner is at risk of cuckoldry-investing unwittingly in offspring to whom he is not genetically related. Previous research in humans (Homo sapiens) and in nonhuman animals suggests that males have evolved tactics such as partner-directed sexual coercion that reduce the risk of cuckoldry. The current research provides preliminary evidence that mated men (n = 223) at greater risk of partner EPC, measured as having spent a greater proportion of time apart from their partner since the couple's last in-pair copulation, more frequently perform partner-directed sexually coercive behaviors. This relationship is moderated, however, by men's perceived risk of partner EPC, such that the correlation between the proportion of time spent apart since last in-pair copulation and sexually coercive behaviors remains significant only for those men who perceive themselves to be at some risk of partner EPC. Discussion addresses limitations of this research and highlights directions for future research investigating the relationship between female EPC and men's partner-directed sexual coercion. PsycINFO Database Record (c) 2011 APA, all rights reserved.

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.

Seismic hazard assessment based on the Unified Scaling Law for Earthquakes: the Greater Caucasus

Science.gov (United States)

Nekrasova, A.; Kossobokov, V. G.

2015-12-01

Losses from natural disasters continue to increase mainly due to poor understanding by majority of scientific community, decision makers and public, the three components of Risk, i.e., Hazard, Exposure, and Vulnerability. Contemporary Science is responsible for not coping with challenging changes of Exposures and their Vulnerability inflicted by growing population, its concentration, etc., which result in a steady increase of Losses from Natural Hazards. Scientists owe to Society for lack of knowledge, education, and communication. In fact, Contemporary Science can do a better job in disclosing Natural Hazards, assessing Risks, and delivering such knowledge in advance catastrophic events. We continue applying the general concept of seismic risk analysis in a number of seismic regions worldwide by constructing regional seismic hazard maps based on the Unified Scaling Law for Earthquakes (USLE), i.e. log N(M,L) = A - B•(M-6) + C•log L, where N(M,L) is the expected annual number of earthquakes of a certain magnitude M within an seismically prone area of linear dimension L. The parameters A, B, and C of USLE are used to estimate, first, the expected maximum magnitude in a time interval at a seismically prone cell of a uniform grid that cover the region of interest, and then the corresponding expected ground shaking parameters including macro-seismic intensity. After a rigorous testing against the available seismic evidences in the past (e.g., the historically reported macro-seismic intensity), such a seismic hazard map is used to generate maps of specific earthquake risks (e.g., those based on the density of exposed population). The methodology of seismic hazard and risks assessment based on USLE is illustrated by application to the seismic region of Greater Caucasus.

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.

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.

Application of risk spectrum code to ''Living PSA''

International Nuclear Information System (INIS)

Carretero Fernandino, J.A.; Berg, U.

1995-01-01

Probabilistic Safety Analyses have a number of characteristics which make them suitable for a series of applications which are beneficial to nuclear power plants. The development of these applications requires the use of software which is increasingly adaptable and powerful on account of reduced running times and greater flexibility. This can result in a greater capacity to perform and evaluate modifications to models and may require an integrated software package that provides all the information necessary for the Reliability Analyses. RISK SPECTRUM is an integrated software package that has been used in a large number of probabilistic analyses in different countries, however, it is most suitable for use in Probabilistic Risk Analysis application. In particular it is being used in most eastern European countries (the Czech Republic, Slovakia, Hungary, Russia, Lithuanian, etc.)

Risk Perception of Plastic Pollution: Importance of Stakeholder Involvement and Citizen Science

DEFF Research Database (Denmark)

Syberg, Kristian; Hansen, Steffen Foss; Christensen, Thomas Budde

2017-01-01

, the public, and policy makers and elaborate on how the eight risk drivers have influenced this process. Plastic pollution has several of the characteristics that can enhance people’s perception of the risk as being important and which has generated great awareness of the problem. The chapter finally...... discusses how risk perception can be improved by greater stakeholder involvement and utilization of citizen science and thereby improve the foundation for timely and efficient societal measures....

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...

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

Toddlers with Early Behavioral Problems at Higher Family Demographic Risk Benefit the Most from Maternal Emotion Talk.

Science.gov (United States)

Brophy-Herb, Holly E; Bocknek, Erika London; Vallotton, Claire D; Stansbury, Kathy E; Senehi, Neda; Dalimonte-Merckling, Danielle; Lee, Young-Eun

2015-09-01

To test the hypothesis that toddlers at highest risk for behavioral problems from the most economically vulnerable families will benefit most from maternal talk about emotions. This study included 89 toddlers and mothers from low-income families. Behavioral problems were rated at 2 time points by masters-level trained Early Head Start home visiting specialists. Maternal emotion talk was coded from a wordless book-sharing task. Coding focused on mothers' emotion bridging, which included labeling emotions, explaining the context of emotions, noting the behavioral cues of emotions, and linking emotions to toddlers' own experiences. Maternal demographic risk reflected a composite score of 5 risk factors. A significant 3-way interaction between Time 1 toddler behavior problems, maternal emotion talk, and maternal demographic risk (p = .001) and examination of slope difference tests revealed that when maternal demographic risk was greater, more maternal emotion talk buffered associations between earlier and later behavior problems. Greater demographic risk and lower maternal emotion talk intensified Time 1 behavior problems as a predictor of Time 2 behavior problems. The model explained 54% of the variance in toddlers' Time 2 behavior problems. Analyses controlled for maternal warmth to better examine the unique contributions of emotion bridging to toddlers' behaviors. Toddlers at highest risk, those with more early behavioral problems from higher demographic-risk families, benefit the most from mothers' emotion talk. Informing parents about the use of emotion talk may be a cost-effective, simple strategy to support at-risk toddlers' social-emotional development and reduce behavioral problems.

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

Problems and fall risk determinants of quality of life in older adults with increased risk of falling.

Science.gov (United States)

Lin, Sang-I; Chang, Ku-Chou; Lee, Hsuei-Chen; Yang, Yi-Ching; Tsauo, Jau-Yih

2015-05-01

Determine quality of life and its association with fall risk factors in older adults with increased risk of falling. A total of 597 community-dwelling Taiwanese older adults who were screened to have increased risk of falling participated in the present study. The fall risk factors included sociodemographics, physical and psychological function, Timed Up and Go, past fall/medical histories, fear of falling and medications. The Euro QOL EQ-5D was used to measure health-related quality of life. Pain/discomfort was the EQ-5D dimension most frequently reported to be impaired (35%), regardless of the level of fall risk or age groups, followed by mobility (25%). Hierarchical regression analysis showed that Geriatric Depression Scale, Mini-Mental State Examination, physiological function, up-and-go, fear of falling and psychotropic medication were independent predictors for total EQ-5D, explaining 68.37% of the variance. Logistic regression analysis showed that for the five EQ-5D dimensions, Geriatric Depression Scale and Up and Go time were the most common determinants. Pain/discomfort was the leading impairment, and greater Geriatric Depression Scale and longer up-and-go time were the main contributing factors in declines in quality of life in older adults with increased risk of falling. These factors are often modifiable, and their management might be considered a priority in falls prevention. © 2014 Japan Geriatrics Society.

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.

Environmental Risk Assessment of Selected Antibiotics in Iran

Directory of Open Access Journals (Sweden)

A Alighardashi

2014-08-01

Full Text Available In recent years the increasing use of pharmaceuticals and personal-care products (PPCPs, especially antibiotics, has become a particular concern because of their undesirable potential ecological and human health effects. This study presents an environmental risk assessment for the aquatic environment of some frequently used antibiotics in Iran in three stages including; a short literature review about antibiotic consumption in Iran, a comprehensive estimation regarding acute toxicity of selected antibiotics and finally calculation of Risk Quotient (RQ using the predicted environmental concentration (PEC and the predicted no-effect concentration (PNEC. According to recently published data, the consumption of antibiotics in Iran is several times greater than European countries and in case of antibiotics (e.g. Penicillin is approximately 10 times greater than Scandinavian region. The calculated PECs were ranged from 0.0071 to 0.8570 and the PNECs value based on ecotoxicity data was found for all studied antibiotics (varied from 0.0037 to 177. The RQ exceeded one for Amoxicillin, Penicillin G, Sulfamethoxazole, and Erythromycin. Amoxicillin has the highest risk to aquatic organisms based on this study. With respect to the emergence of microbial resistance, it is important to begin monitoring the most frequently used antibiotics

Political risk in fair market value estimates

International Nuclear Information System (INIS)

Gruy, H.J.; Hartsock, J.H.

1996-01-01

Political risk arises from unstable governments, commercial establishments and infrastructure as well as labor unrest. All these factors vary from country to country and from time to time. Banks and insurance companies quantify these risks, but they are reluctant to divulge their opinions for fear of alienating possible customers that have been assigned a high risk. An investment in a fixed property such as an oil and gas lease, concession or other mineral interest is subject to political risk. No one will deny that money to be received several years in the future has a greater value today in a country with a stable government, stable tax regime, a sound economy and reliable labor force than in a Third World country where a revolution is brewing. Even in stable countries, the risk of tax law changes, exorbitant environmental production regulations and cleanup costs may vary. How do these factors affect fair market value and how are these calculations made? An important consideration discussed in this paper is the treatment of capital investments

Spatial Interpolation of Daily Rainfall Data for Local Climate Impact Assessment over Greater Sydney Region

Directory of Open Access Journals (Sweden)

Xihua Yang

2015-01-01

Full Text Available This paper presents spatial interpolation techniques to produce finer-scale daily rainfall data from regional climate modeling. Four common interpolation techniques (ANUDEM, Spline, IDW, and Kriging were compared and assessed against station rainfall data and modeled rainfall. The performance was assessed by the mean absolute error (MAE, mean relative error (MRE, root mean squared error (RMSE, and the spatial and temporal distributions. The results indicate that Inverse Distance Weighting (IDW method is slightly better than the other three methods and it is also easy to implement in a geographic information system (GIS. The IDW method was then used to produce forty-year (1990–2009 and 2040–2059 time series rainfall data at daily, monthly, and annual time scales at a ground resolution of 100 m for the Greater Sydney Region (GSR. The downscaled daily rainfall data have been further utilized to predict rainfall erosivity and soil erosion risk and their future changes in GSR to support assessments and planning of climate change impact and adaptation in local scale.

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

A new perspective on human health risk assessment: Development of a time dependent methodology and the effect of varying exposure durations

Energy Technology Data Exchange (ETDEWEB)

Siirila, Erica R., E-mail: esiirila@mymail.mines.edu [Hydrologic Science and Engineering Program, Colorado School of Mines, 1500 Illinois St., Golden, CO 80401 (United States); Department of Geology and Geological Engineering, Colorado School of Mines, 1500 Illinois St., Golden, CO 80401 (United States); Maxwell, Reed M., E-mail: rmaxwell@mines.edu [Hydrologic Science and Engineering Program, Colorado School of Mines, 1500 Illinois St., Golden, CO 80401 (United States); Integrated Groundwater Modeling Center (IGWMC), Colorado School of Mines, 1500 Illinois St., Golden, CO 80401 (United States); Department of Geology and Geological Engineering, Colorado School of Mines, 1500 Illinois St., Golden, CO 80401 (United States)

2012-08-01

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: Black-Right-Pointing-Pointer A human health, Time Dependent Risk Assessment (TDRA) methodology is presented. Black-Right-Pointing-Pointer TDRA relays information on the magnitude, duration, and fluxes of risk in time. Black-Right-Pointing-Pointer Kinetic and equilibrium concentration signals show

Adolescent gambling in greater Athens area: a cross-sectional study.

Science.gov (United States)

Anagnostopoulos, Dimitris C; Lazaratou, Helen; Paleologou, Mina P; Peppou, Lily E; Economou, Marina; Malliori, Melpomeni; Papadimitriou, George N; Papageorgiou, Charalampos

2017-11-01

Problem gambling in adolescents has recently emerged as a pressing public health concern. In this context and in light of the pervasive financial crisis in Greece, the present study aimed to explore adolescents' gambling involvement in Athens region to estimate the prevalence of its problematic form and to identify its risk/protective factors. A total of 2141 students were recruited from a representative sample of 51 schools located in greater Athens area. The presence of problem gambling was assessed through the use of the DSM-IV-MR-J questionnaire. Data were collected in the form of a self-reported questionnaire during one school hour. Results indicate that 1-year prevalence of high severity problem gambling was found to be 5.6%. Regarding the risk factors for problem gambling; male gender, parental engagement with gambling activities, living without the parents, low grades at school, foreign nationality and the referent absence of availability of food in the household, increased the risk of suffering from the disorder. Gambling behavior among adolescents constitutes a problem in Greece and highlights the need for designing and implementing appropriate preventive interventions, especially amid the ongoing financial crisis.

Incidence and Risk of Concussions in Youth Athletes: Comparisons of Age, Sex, Concussion History, Sport, and Football Position.

Science.gov (United States)

Tsushima, William T; Siu, Andrea M; Ahn, Hyeong Jun; Chang, Bolin L; Murata, Nathan M

2018-03-15

This study was designed to determine concussion incidence, risk, and relative risk among middle and high school athletes participating in various sports. Data were retrospectively obtained from 10,334 athletes of 12 different sports in Hawaii. In addition to determining the overall concussion incidence, comparisons of incidence, risk, and relative risk were made according to age, sex, concussion history, sport, and football position. The overall incidence of concussion among youth athletes was 1,250 (12.1%). The relative risk for a concussion was almost two times greater in 18-year olds than in 13-year-old athletes. In comparable sports, girls had a 1.5 times higher concussion risk than boys. Athletes with a prior concussion had 3-5 times greater risk to sustain a concussion than those with no history of a concussion. Among varied sports, wrestling and martial arts had the highest relative risk of a concussion, followed by cheerleading, football, and track and field. No differences in concussion risks were found among the football players in different positions. Older youths, females, those with a history of concussion, and those participating in high contact sports were found to have higher risks of sustaining a concussion. The findings increase awareness of concussion patterns in young athletes and raise concerns regarding protective strategies and concussion management in youth sports.

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.

Analysis of research ethics board approval times in an academic department of medicine.

Science.gov (United States)

Tsang, Teresa S M; Jones, Meaghan; Meneilly, Graydon S

2015-04-01

As part of an ongoing effort to better understand barriers to academic research, we reviewed and analyzed the process of research ethics applications, focusing on ethics approval time, within the Department of Medicine from 2006 to 2011. A total of 1,268 applications for approval to use human subjects in research were included in our analysis. Three variables, risk category (minimal vs. non-minimal risk), type of funding, and year of submission, were statistically significant for prediction of ethics approval time, with risk status being the most important of these. The covariate-adjusted mean time for approval for minimal risk studies (35.7 days) was less than half that of non-minimal risk protocols (76.5 days). Studies funded through a for-profit sponsor had significantly longer approval times than those funded through other means but were also predominantly (87%) non-minimal risk protocols. Further investigations of the reasons underlying the observed differences are needed to determine whether improved training for research ethics board (REB) members and/or greater dialogue with investigators may reduce the lengthy approval times associated with non-minimal risk protocols. © The Author(s) 2015.

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.

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.

Overview of Milestone E activities, greater confinement than shallow land burial

International Nuclear Information System (INIS)

Mezga, L.J.

1981-01-01

In summary, the objective of Milestone E is to provide the technology and documentation needed to open a site providing greater confinement than shallow land burial. To that end, ORNL has prepared a technical position paper defining greater confinement disposal, options for achieving it, and the need for this disposal technology. In order to meet the objective of the milestones, the LLWMP evaluated the full range of options to shallow land burial and decided to focus on a combination of greater depth solidification containment and engineered barriers. The program identified a series of research needs and then focused program efforts on resolving those needs. These tasks are proceeding on schedule at this time but budget reductions may have an impact on our ability to maintain the schedule

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)

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.

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...

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...

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.

[Maternal death: unequal risks].

Science.gov (United States)

Defossez, A C; Fassin, D

1989-01-01

Nearly 99% of maternal deaths in the world each year occur in developing countries. New efforts have recently been undertaken to combat maternal mortality through research and action. The medical causes of such deaths are coming to be better understood, but the social mechanisms remain poorly grasped. Maternal mortality rates in developing countries are difficult to interpret because they tend to exclude all deaths not occurring in health care facilities. The countries of Europe and North America have an average maternal mortality rate of 30/100,000 live births, representing about 6000 deaths each year. The developing countries of Asia, Africa, and Latin America have rates of 270-640/100,000, representing some 492,000 deaths annually. For a true comparison of the risks of maternal mortality in different countries, the risk itself and the average number of children per woman must both be considered. A Nigerian woman has 375 times greater risk of maternal death than a Swedish woman, but since she has about 4 times more children, her lifetime risk of maternal death is over 1500 times greater than that of the Swedish woman. The principal medical causes of maternal death are known: hemorrhages due to placenta previa or retroplacental hematoma, mechanical dystocias responsible for uterine rupture, toxemia with eclampsia, septicemia, and malaria. The exact weight of abortion in maternal mortality is not known but is probably large. The possible measures for improving such rates are of 3 types: control of fertility to avoid early, late, or closely spaced pregnancies; effective medical surveillance of the pregnancy to reduce the risk of malaria, toxemia, and hemorrhage, and delivery in an obstetrical facility, especially for high-risk pregnancies. Differential access to high quality health care explains much of the difference between mortality rates in urban and rural, wealthy and impoverished areas of the same country. The social determinants of high maternal mortality

A perspective on risks from radon

International Nuclear Information System (INIS)

Higson, D. J.

2010-10-01

In its Statement on Radon (November 2009), the International Commission on Radiological Protection (ICRP) has reduced the upper reference level for radon gas in dwellings to 300 Bq m -3 . The recommended level for workplaces is 1000 Bq m -3 . A risk coefficient of 8 x 10 -10 per Bq h m -3 is recommended without reference to smoking habits. On the basis of these figures: 1) The estimated risk of fatal cancer from exposure to radon at home and at work could be greater than the observed risk of accidental death from travelling by car, which would be surprising if true. 2) The estimated risk of lung cancer from radon could be greater than the observed risk of lung cancer from all causes, which is actually known to be dominated by smoking. The author is not aware of any direct evidence of risks from inhaling radon in Australian dwellings, 99% of which have radon levels below 50 Bq m -3 . Evidence available from other countries shows that: 1) The effects of radon in the incidences of lung cancer are uncertain at levels less then about 50-100 Bq m -3 . 2) The estimation of risks at levels below 200 Bq m -3 depends on extrapolation from risks observed at higher levels. 3) Risks to non-smokers from radon are 25 times less than risks to smokers. Its concluded that the ICRP Statement on Radon and radon policies in the US and UK have the potential to cause unwarranted concern. Some people may be made to feel they need to spend money modifying their homes and workplaces to protect occupants from exposure to radon when there is no compelling reason to show that this is necessary. The vast majority of non-smokers do not need to be protected from radon. (Author)

A perspective on risks from radon

International Nuclear Information System (INIS)

Higson, D.J.

2011-01-01

In its Statement on Radon (November 2009), the ICRP has reduced the upper reference level for radon gas in dwellings to 300 Bq m -3 . The recommended level for workplaces is 1000 Bq m -3 . A risk coefficient of 8x10 -10 per Bq h m is recommended without reference to smoking habits. On the basis of these figures,the estimated risk of fatal cancer from exposure to radon at home and at work could be greater than the observed risk of accidental death from travelling by car, which would be surprising if true. Also the estimated risk of lung cancer from radon could be greater than the observed risk of lung cancer from all causes, which is actually known to be dominated by smoking. The author is not aware of any direct evidence of risks from inhaling radon in Australian dwellings, 99% of which have radon levels below 50 Bq m -3 . Evidence available from other countries shows that: effects on the incidences of lung cancer are uncertain at radon levels below 100 Bq m -3 ; the estimation of risks at levels below 200 Bq m -3 depends on extrapolation from risks observed at higher levels, and risks to non-smokers from radon are 25 times less than risks to smokers. It is concluded that the ICRP Statement on Radon and radon policies in the US and UK have the potential to cause unwarranted concern. Some people may be made to feel they need to spend money modifying their homes and workplaces to protect occupants from exposure to radon when there is no compelling reason to show that this is necessary. The vast majority of non-smokers do not need to be protected from radon.

A perspective on risks from radon

Energy Technology Data Exchange (ETDEWEB)

Higson, D. J., E-mail: higsond@bigpond.net.a [Australasian Radiation Protection Society, PO Box 7108, Upper Ferntree Gully, Victoria 3156 (Australia)

2010-10-15

In its Statement on Radon (November 2009), the International Commission on Radiological Protection (ICRP) has reduced the upper reference level for radon gas in dwellings to 300 Bq m{sup -3}. The recommended level for workplaces is 1000 Bq m{sup -3}. A risk coefficient of 8 x 10{sup -10} per Bq h m{sup -3} is recommended without reference to smoking habits. On the basis of these figures: 1) The estimated risk of fatal cancer from exposure to radon at home and at work could be greater than the observed risk of accidental death from travelling by car, which would be surprising if true. 2) The estimated risk of lung cancer from radon could be greater than the observed risk of lung cancer from all causes, which is actually known to be dominated by smoking. The author is not aware of any direct evidence of risks from inhaling radon in Australian dwellings, 99% of which have radon levels below 50 Bq m{sup -3}. Evidence available from other countries shows that: 1) The effects of radon in the incidences of lung cancer are uncertain at levels less then about 50-100 Bq m{sup -3}. 2) The estimation of risks at levels below 200 Bq m{sup -3} depends on extrapolation from risks observed at higher levels. 3) Risks to non-smokers from radon are 25 times less than risks to smokers. Its concluded that the ICRP Statement on Radon and radon policies in the US and UK have the potential to cause unwarranted concern. Some people may be made to feel they need to spend money modifying their homes and workplaces to protect occupants from exposure to radon when there is no compelling reason to show that this is necessary. The vast majority of non-smokers do not need to be protected from radon. (Author)

[Respiratory disease risk factors in the 5-14 year-old population in an area of Bogota, 2012-2013].

Science.gov (United States)

Rodríguez-Moreno, Natalia; Martínez-Morales, Viviana; Sarmiento-Suarez, Rodrigo; Medina-Palacios, Katalina; Hernández, Luis J

2013-01-01

Establishing the prevalence of respiratory symptoms, asthma and rhinitis, possibly associated with air pollution, in 5- to 14-year-old children in Bosa (a conurbation of Bogota), between 2012 and 2013. A sample was taken of 553 children living in the conurbation. The results indicated that when a child lives with people who smoke there was a 1.5 times risk of coughing at night (compared to living in a non-smoking home) such night-time coughing being different to that produced by respiratory infections such as colds, bronchitis and pneumonia. Children living in homes having fireplaces/open cooking areas located less than 100 m apart had 1.6 times greater probability of presenting symptoms. Children attending schools having greater PM10 exposure and living near buildings being constructed or having roads in a poor state of repair less than 100 meters from their homes were 2.5 times more likely to suffer respiratory disease. Children living in damp rooms were 4 times more likely to have wheezed during the past year. The risk of wheezing became increased by 80 % when a child lived within 100 meters of buildings being constructed or near unpaved roads and attended a school having greater exposure. Government intervention is critical for changing respiratory disease-associated extramural risk factors, such as improvements benefitting children which should be carried out in urban areas.

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

Predictive risk modelling under different data access scenarios: who is identified as high risk and for how long?

Science.gov (United States)

Johnson, Tracy L; Kaldor, Jill; Sutherland, Kim; Humphries, Jacob; Jorm, Louisa R; Levesque, Jean-Frederic

2018-01-01

Objective This observational study critically explored the performance of different predictive risk models simulating three data access scenarios, comparing: (1) sociodemographic and clinical profiles; (2) consistency in high-risk designation across models; and (3) persistence of high-risk status over time. Methods Cross-sectional health survey data (2006–2009) for more than 260 000 Australian adults 45+ years were linked to longitudinal individual hospital, primary care, pharmacy and mortality data. Three risk models predicting acute emergency hospitalisations were explored, simulating conditions where data are accessed through primary care practice management systems, or through hospital-based electronic records, or through a hypothetical ‘full’ model using a wider array of linked data. High-risk patients were identified using different risk score thresholds. Models were reapplied monthly for 24 months to assess persistence in high-risk categorisation. Results The three models displayed similar statistical performance. Three-quarters of patients in the high-risk quintile from the ‘full’ model were also identified using the primary care or hospital-based models, with the remaining patients differing according to age, frailty, multimorbidity, self-rated health, polypharmacy, prior hospitalisations and imminent mortality. The use of higher risk prediction thresholds resulted in lower levels of agreement in high-risk designation across models and greater morbidity and mortality in identified patient populations. Persistence of high-risk status varied across approaches according to updated information on utilisation history, with up to 25% of patients reassessed as lower risk within 1 year. Conclusion/implications Small differences in risk predictors or risk thresholds resulted in comparatively large differences in who was classified as high risk and for how long. Pragmatic predictive risk modelling design decisions based on data availability or projected

The risk of fracture in patients with multiple sclerosis: The UK general practice research database

DEFF Research Database (Denmark)

Bazelier, Marloes T; van Staa, Tjeerd; Uitdehaag, Bernard Mj

2011-01-01

Patients with multiple sclerosis (MS) may be at an increased risk of fracture owing to a greater risk of falling and decreased bone mineral density when compared with the general population. This study was designed to estimate the relative and absolute risk of fracture in patients with MS. We...... were used to derive adjusted hazard ratios (HRs) for fracture associated with MS. Time-dependent adjustments were made for age, comorbidity, and drug use. Absolute 5- and 10-year risks of fracture were estimated for MS patients as a function of age. Compared with controls, MS patients had an almost...... threefold increased risk of hip fracture [HR = 2.79,95% confidence interval (CI) 1.83-4.26] and a risk of osteoporotic fracture that was increased 1.4-fold (HR = 1.35,95% CI 1.13-1.62). Risk was greater in patients who had been prescribed oral/intravenous glucocorticoids (GCs; HR = 1.85, 95% CI 1...

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.

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....

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.

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.

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

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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.

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...

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.

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

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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

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.

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.

Burn related mortality in Greater Manchester: 11-year review of Regional Coronial Department Data.

Science.gov (United States)

Hussain, Amer; Dunn, Ken

2015-03-01

The Coroners Department (CD) records hold important demographic, injury and death details for victims of burn injuries derived from various sources yet this rich source of data has been infrequently utilised previously in describing the epidemiology of burn related mortality. The aim of this study was to use CD data to comprehensively investigate burn related mortality in the Greater Manchester region of United Kingdom. A retrospective study design was used to collect data for deceased demographics, injury details, site of death and cause of death from four CD offices in GM over an 11-year period (2000-2010 inclusive). Office of National Statistics (ONS) population metrics were used to calculate age- and gender-specific population denominators and mortality rates. Index of Multiple Deprivation (IMD) was used to correlate mortality with deprivation. Linear regression and Pearson's/Spearman's rank correlation were used to calculate trends and correlations. Poisson regression was used to calculate relative risk (IRR) between age- and gender groups. There were 314 recorded deaths in the region over the study period and thermal injury was 3-times less likely to result in death in 2010 compared to 2000. The largest proportion of these deaths (24.8%) was comprised of individuals ≥75 years in age. The relative risk of mortality in males was nearly 1.5-times higher and a significant majority of victims (77%) sustained their burn injury at their own home/residence. Inhalation injury without cutaneous burns was the most frequent type of injury (33%) and accidental house fires caused nearly half (49%) the injuries resulting in death. Sixty-five percent of deaths during this period were recorded to have occurred outside of regional burn service (RBS) hospitals and the commonest cause of immediate death on the death certificates was "inhalation of products of combustion" (32.1%). Within the >75 years age group the risk of death significantly increased with every quintile

Economic inequality increases risk taking.

Science.gov (United States)

Payne, B Keith; Brown-Iannuzzi, Jazmin L; Hannay, Jason W

2017-05-02

Rising income inequality is a global trend. Increased income inequality has been associated with higher rates of crime, greater consumer debt, and poorer health outcomes. The mechanisms linking inequality to poor outcomes among individuals are poorly understood. This research tested a behavioral account linking inequality to individual decision making. In three experiments ( n = 811), we found that higher inequality in the outcomes of an economic game led participants to take greater risks to try to achieve higher outcomes. This effect of unequal distributions on risk taking was driven by upward social comparisons. Next, we estimated economic risk taking in daily life using large-scale data from internet searches. Risk taking was higher in states with greater income inequality, an effect driven by inequality at the upper end of the income distribution. Results suggest that inequality may promote poor outcomes, in part, by increasing risky behavior.

Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities.

Science.gov (United States)

Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

2015-01-01

Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65). A long time-series (2001-2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using "Crichton's Risk Triangle" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat

Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities.

Directory of Open Access Journals (Sweden)

Marco Morabito

Full Text Available Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks.Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65.A long time-series (2001-2013 of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m daytime and night-time land surface temperatures (LST. LST was estimated pixel-wise by applying two statistical model approaches: 1 the Linear Regression Model (LRM; 2 the Generalized Additive Model (GAM. Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m from the 2001 census (Eurostat source, and processed together using "Crichton's Risk Triangle" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI.The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities.This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat

A two-stage method of quantitative flood risk analysis for reservoir real-time operation using ensemble-based hydrologic forecasts

Science.gov (United States)

Liu, P.

2013-12-01

Quantitative analysis of the risk for reservoir real-time operation is a hard task owing to the difficulty of accurate description of inflow uncertainties. The ensemble-based hydrologic forecasts directly depict the inflows not only the marginal distributions but also their persistence via scenarios. This motivates us to analyze the reservoir real-time operating risk with ensemble-based hydrologic forecasts as inputs. A method is developed by using the forecast horizon point to divide the future time into two stages, the forecast lead-time and the unpredicted time. The risk within the forecast lead-time is computed based on counting the failure number of forecast scenarios, and the risk in the unpredicted time is estimated using reservoir routing with the design floods and the reservoir water levels of forecast horizon point. As a result, a two-stage risk analysis method is set up to quantify the entire flood risks by defining the ratio of the number of scenarios that excessive the critical value to the total number of scenarios. The China's Three Gorges Reservoir (TGR) is selected as a case study, where the parameter and precipitation uncertainties are implemented to produce ensemble-based hydrologic forecasts. The Bayesian inference, Markov Chain Monte Carlo, is used to account for the parameter uncertainty. Two reservoir operation schemes, the real operated and scenario optimization, are evaluated for the flood risks and hydropower profits analysis. With the 2010 flood, it is found that the improvement of the hydrologic forecast accuracy is unnecessary to decrease the reservoir real-time operation risk, and most risks are from the forecast lead-time. It is therefore valuable to decrease the avarice of ensemble-based hydrologic forecasts with less bias for a reservoir operational purpose.

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.

Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women.

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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.

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.

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

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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.

Obesity and trauma mortality: Sizing up the risks in motor vehicle crashes.

Science.gov (United States)

Joseph, Bellal; Hadeed, Steven; Haider, Ansab A; Ditillo, Michael; Joseph, Aly; Pandit, Viraj; Kulvatunyou, Narong; Tang, Andrew; Latifi, Rifat; Rhee, Peter

Protective effects of safety devices in obese motorists in motor vehicle collisions (MVC) remain unclear. Aim of our study is to assess the association between morbid obesity and mortality in MVC, and to determine the efficacy of protective devices. We hypothesised that patients with morbid obesity will be at greater risk of death after MVC. A retrospective analysis of MVC patients (age ≥16 y.o.) was performed using the National Trauma Data Bank from 2007 to 2010. Patients with recorded comorbidity of morbid obesity (BMI≥40) were identified. Patients dead on arrival, with isolated traumatic brain injury, or incomplete data were excluded. The primary outcome was in-hospital mortality. Multivariate logistic regression was performed. Our sample of 214,306 MVC occupants included 10,260 (4.8%) morbidly obese patients. Mortality risk was greatest among occupants with morbid obesity (OR crude 1.74 [1.54-1.98]). After adjusting for patient demographics, safety device and physiological severity, odds of death was 1.52 [1.33-1.74] times greater in motorists with morbid obesity. Motorists with morbid obesity were at greater risk of death if no restraint (OR 1.84 [1.47-2.31]), seatbelt only (OR 1.48 [1.17-1.86]), or both seatbelt and airbag were present (OR 1.49 [1.13-1.97]). No significant differences in the odds of death exist between drivers with morbid obesity and non-morbidly obese drivers with only airbag deployment (OR 0.99 [0.65-1.51]). Motorists with morbid obesity are at greater risk of MVC. Regardless of safety device use, occupants with morbid obesity remained at greater risk of death. Further research examining the effectiveness of vehicle restraints in drivers with morbid obesity is warranted. Copyright © 2016. Published by Elsevier Ltd.

Factors that influence soft tissue thickness over the greater trochanter: application to understanding hip fractures.

Science.gov (United States)

Levine, Iris C; Minty, Lauren E; Laing, Andrew C

2015-03-01

Fall-related hip injuries are a concern for the growing population of older adults. Evidence suggests that soft tissue overlying the greater trochanter attenuates the forces transmitted to the proximal femur during an impact, reducing mechanical risk of hip fracture. However, there is limited information about the factors that influence trochanteric soft tissue thickness. The current study used ultrasonography and electromyography to determine whether trochanteric soft tissue thickness could be quantified reproducibly and whether it was influenced by: (1) gender; (2) hip postures associated with potential falling configurations in the sagittal plane (from 30° of extension to 60° of flexion, at 15° intervals), combined adduction-flexion, and combined adduction-extension; and (3) activation levels of the tensor fascia lata (TFL) and gluteus medius (GM) muscles. Our results demonstrated that soft tissue thickness can be measured reliably in nine hip postures and three muscle activation conditions (for all conditions, ICC >0.98). Mean (SD) thickness in quiet stance was 2.52 cm. Thickness was 27.0% lower for males than females during quiet stance. It was 16.4% greater at maximum flexion than quiet standing, 27.2% greater at maximum extension, and 12.5% greater during combined adduction-flexion. However, there was no significant difference between combined adduction-extension and quiet standing. Thickness was not affected by changes in muscle activity. Forces applied to the femoral neck during a lateral fall decrease as trochanteric soft tissue thickness increases; gender and postural configuration at impact could influence the loads applied to the proximal femur (and thus hip fracture risk) during falls on the hip. © 2014 Wiley Periodicals, Inc.

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.

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

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...

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

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.

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.

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.

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.

Risk Aversion and Engagement in the Sharing Economy

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Jessica Santana

2015-10-01

Full Text Available The sharing economy is a new online community that has important implications for offline behavior. This study evaluates whether engagement in the sharing economy is associated with an actor’s aversion to risk. Using a web-based survey and a field experiment, we apply an adaptation of Holt and Laury’s (2002 risk lottery game to a representative sample of sharing economy participants. We find that frequency of activity in the sharing economy predicts risk aversion, but only in interaction with satisfaction. While greater satisfaction with sharing economy websites is associated with a decrease in risk aversion, greater frequency of usage is associated with greater risk aversion. This analysis shows the limitations of a static perspective on how risk attitudes relate to participation in the sharing economy.

Climate change and coastal environmental risk perceptions in Florida.

Science.gov (United States)

Carlton, Stuart J; Jacobson, Susan K

2013-11-30

Understanding public perceptions of climate change risks is a prerequisite for effective climate communication and adaptation. Many studies of climate risk perceptions have either analyzed a general operationalization of climate change risk or employed a case-study approach of specific adaptive processes. This study takes a different approach, examining attitudes toward 17 specific, climate-related coastal risks and cognitive, affective, and risk-specific predictors of risk perception. A survey of 558 undergraduates revealed that risks to the physical environment were a greater concern than economic or biological risks. Perceptions of greater physical environment risks were significantly associated with having more pro-environmental attitudes, being female, and being more Democratic-leaning. Perceptions of greater economic risks were significantly associated with having more negative environmental attitudes, being female, and being more Republican-leaning. Perceptions of greater biological risks were significantly associated with more positive environmental attitudes. The findings suggest that focusing on physical environment risks maybe more salient to this audience than communications about general climate change adaptation. The results demonstrate that climate change beliefs and risk perceptions are multifactorial and complex and are shaped by individuals' attitudes and basic beliefs. Climate risk communications need to apply this knowledge to better target cognitive and affective processes of specific audiences, rather than providing simple characterizations of risks. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

Velocity Drives Greater Power Observed During Back Squat Using Cluster Sets.

Science.gov (United States)

Oliver, Jonathan M; Kreutzer, Andreas; Jenke, Shane C; Phillips, Melody D; Mitchell, Joel B; Jones, Margaret T

2016-01-01

This investigation compared the kinetics and kinematics of cluster sets (CLU) and traditional sets (TRD) during back squat in trained (RT) and untrained (UT) men. Twenty-four participants (RT = 12, 25 ± 1 year, 179.1 ± 2.2 cm, 84.6 ± 2.1 kg; UT = 12, 25 ± 1 year, 180.1 ± 1.8 cm, 85.4 ± 3.8 kg) performed TRD (4 × 10, 120-second rest) and CLU (4 × (2 × 5) 30 seconds between clusters; 90 seconds between sets) with 70% one repetition maximum, randomly. Kinematics and kinetics were sampled through force plate and linear position transducers. Resistance-trained produced greater overall force, velocity, and power; however, similar patterns were observed in all variables when comparing conditions. Cluster sets produced significantly greater force in isolated repetitions in sets 1-3, while consistently producing greater force due to a required reduction in load during set 4 resulting in greater total volume load (CLU, 3302.4 ± 102.7 kg; TRD, 3274.8 ± 102.8 kg). Velocity loss was lessened in CLU resulting in significantly higher velocities in sets 2 through 4. Furthermore, higher velocities were produced by CLU during later repetitions of each set. Cluster sets produced greater power output for an increasing number of repetitions in each set (set 1, 5 repetitions; sets 2 and 3, 6 repetitions; set 4, 8 repetitions), and the difference between conditions increased over subsequent sets. Time under tension increased over each set and was greater in TRD. This study demonstrates greater power output is driven by greater velocity when back squatting during CLU; therefore, velocity may be a useful measure by which to assess power.

Reliability, resilience and vulnerability criteria for the evaluation of time-dependent health risks: A hypothetical case study of wellhead protection

Science.gov (United States)

Rodak, C. M.; Silliman, S. E.; Bolster, D.

2012-12-01

A hypothetical case study of groundwater contaminant protection was carried out using time-dependent health risk calculations. The case study focuses on a hypothetical zoning project for parcels of land around a well field in northern Indiana, where the control of cancer risk relative to a mandated cancer risk threshold is of concern in the management strategy. Within our analysis, we include both uncertainty in the subsurface transport and variability in population behavior in the calculation of time-dependent health risks. From these results we introduce risk maps, a visual representation of the probability of an unacceptable health risk as a function of population behavior and the time at which exposure to the contaminant begins. We also evaluate the time-dependent risks with three criteria from water resource literature: reliability, resilience, and vulnerability (RRV). With respect to health risk from a groundwater well, the three criteria determine: the probability that a well produces safe water (reliability), the probability that a contaminated well returns to an uncontaminated state within a specified time interval (resilience), and the overall severity in terms of health impact of the contamination at a well head (vulnerability). The results demonstrate that the distributions of RRV values for each parcel of land are linked to the time-dependent concentration profile of the contaminant at the well, and the toxicological characteristics of the contaminant. The proposed time-dependent risk calculation expands on current techniques to include a continuous exposure start time, capable of reproducing the maximum risk while providing information on the severity and duration of health risks. Overall this study suggests that, especially in light of the inherent complexity of health-groundwater systems, RRV are viable criteria for relatively simple and effective evaluation of time-dependent health risk. It is argued that the RRV approach, as applied to

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.

Multiple challenges of risk management in EU credit institutions

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Constantinescu, A.

2011-01-01

Full Text Available This paper is intended to be a significant insight into risk management issues by describing the main types of such risks and by providing management and evaluation procedures of significant risks into some active banking companies in Romania. In times of crisis, risk management in the banking system has a greater importance than in the normal economic times. The 2011 was a year in which Romania has been hit by the repercussions of the international economic crisis. Using strategies against risks, implementing procedures to monitor and control risks, risk assessment and quantification can substantially reduce the financial losses of a company or those of a financial institution. Risk management is an integral part of all decision making and business processes from credit institutions, its purpose being to protect their sustainable development. The innovations on the financial market, the internationalization of the specific operations, and the pressure of the competition are just a few arguments that impose a permanent supervision of the general and specific risks. This is the main reason why is compulsory to find new methods of managing risks, to keep in consideration the identification, evaluation of the management and the control of the banking system and of each bank.

Adolescent self-harm and risk factors.

Science.gov (United States)

Zhang, Jixiang; Song, Jianwei; Wang, Jing

2016-12-01

This study aims to define the characteristics of adolescents who have engaged in self-harm behavior and ascertain the risk factors. From January 2013 to January 2014, 4,176 adolescents from senior middle schools in Linyi, China, were administered four questionnaire surveys to ascertain the following: incidence of self-harm behavior regarding the frequency of different self-harm behaviors by group (never/one to five times/greater than five times in the last 6 months) and then comparing the self-harm behavior of the different subgroups; symptom self-check, comparing the differences between the adolescents with self-harm behavior and without in nine subscales (somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoid, and psychosis); Adolescent Self-Rating Life Events Check List scores; and Egna Minnenav Barndoms Uppfostran (EMBU) scores. Multivariate logistic regression analysis was used to determine the risk factors of self-harm in adolescents. The incidence of adolescent self-harm was 27.60%; the occurrence of adolescent self-harm was closely related to their mental health status, stressful life events, and EMBU. Being female, an urban student, or an only child; having poor school performance or experiences of stressful life events, harsh parenting styles, or excessive interference; and poor mental health were the risk factors for adolescent self-harm. The incidence of adolescent self-harm was high, and their mental health status, stressful life events, and EMBU affected the occurrence of adolescent self-harm, which is an issue that needs greater attention. © 2016 John Wiley & Sons Australia, Ltd.

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....

The risk of melanoma and hematologic cancers in patients with psoriasis.

Science.gov (United States)

Reddy, Shivani P; Martires, Kathryn; Wu, Jashin J

2017-04-01

The risk of melanoma and hematologic cancers in patients with psoriasis is controversial. We sought to assess the risk of melanoma and hematologic cancers in patients with psoriasis, and the association with different treatments. We used case-control and retrospective cohort designs to determine melanoma or hematologic cancer risk in patients with psoriasis. Risk with treatment type was assessed using Fisher exact test. Patients with psoriasis had 1.53 times greater risk of developing a malignancy compared with patients without psoriasis (P < .01). There were no significant differences in malignancy risk among patients treated with topicals, phototherapy, systemics, or biologic agents. Patients with psoriasis and malignancy did not have significantly worse survival than patients without psoriasis. It is possible that patients developed malignancy subsequent to the follow-up time included in the study. Patients with psoriasis may experience an elevated risk of melanoma and hematologic cancers, compared with the general population. The risk is not increased by systemic or biologic psoriasis therapies. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Sitting time and occupational and recreational physical activity in relation to the risk of esophageal squamous cell carcinoma

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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

Medication Exposure and Risk of Recurrent Clostridium difficile Infection in Community-Dwelling Older People and Nursing Home Residents.

Science.gov (United States)

Haran, John P; Bradley, Evan; Howe, Emily; Wu, Xun; Tjia, Jennifer

2018-02-01

It is unclear how medication exposures differ in their association with recurrent Clostridium difficile infection (rCDI) in elderly nursing home (NH) residents and community-dwelling individuals. This study examined these exposures to determine whether the risk of rCDI differs according to living environment. Retrospective. Academic and community healthcare settings. Individuals aged 65 and older with CDI (N = 616). Information on participant characteristics and medications was extracted from the electronic medical record (EMR). We used separate extended Cox models according to living environment to identify the association between medication use and risk of rCDI. Of the 616 elderly adults treated for CDI, 24.1% of those living in the community and 28.1% of NH residents experienced recurrence within 1 year. For community-dwelling participants, the risk of rCDI was 1.6 times as high with antibiotic exposure and 2.5 times as high with acid-reducing medication exposure, but corticosteroid exposure was associated with a 39% lower risk of recurrence. For NH residents, the risk of rCDI was 2.9 times as high with acid-reducing medication exposure and 5.9 times as high with corticosteroid medication exposure. Antibiotic exposure was associated with an increased risk of recurrence only in community-dwelling participants (adjusted hazard ratio = 1.63, 95% confidence interval = 1.00-2.67). Risk of rCDI is greater with acid-reducing medication use than antibiotic use after initial CDI treatment, although the risk varied depending on living environment. Corticosteroid use is associated with greater risk of recurrence in NH residents but lower risk in community-dwelling elderly adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

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.

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.

Depression and Risk of Developing Dementia

OpenAIRE

Byers, Amy L.; Yaffe, Kristine

2011-01-01

Depression is highly common throughout the life course and dementia is common in late life. The literature suggests an association between depression and dementia, and growing evidence implies that timing of depression may be important to defining the nature of the association. In particular, earlier-life depression or depressive symptoms consistently have been shown to be associated with a 2-fold or greater increase in risk of dementia. In contrast, studies of late-life depression have been ...

Risk-factors for surgical delay following hip fracture.

Science.gov (United States)

Sanz-Reig, J; Salvador Marín, J; Ferrández Martínez, J; Orozco Beltrán, D; Martínez López, J F

To identify pre-operative risk factors for surgical delay of more than 2 days after admission in patients older than 65 years with a hip fracture. A prospective observational study was conducted on 180 hip fractures in patients older than 65 years of age admitted to our hospital from January 2015 to April 2016. The data recorded included, patient demographics, day of admission, pre-fracture comorbidities, mental state, level of mobility and physical function, type of fracture, antiaggregant and anticoagulant medication, pre-operative haemoglobin value, type of treatment, and surgical delay. The mean age of the patients was 83.7 years. The mean Charlson Index was 2.8. The pre-fracture baseline co-morbidities were equal or greater than 2 in 70% of cases. Mean timing of surgery was 3.1 days. At the time of admission, 122 (67.7%) patients were fit for surgery, of which 80 (44.4%) underwent surgery within 2 days. A Charlson index greater than 2, anticoagulant therapy, and admission on Thursday to Saturday, were independently associated with a surgical delay greater than 2 days. The rate of hip fracture patients undergoing surgery within 2 days is low. Risk factors associated to surgical delay are non-modifiable. However, their knowledge should allow the development of protocols that can reduce surgical delay in this group of patients. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

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,…

Time-dependent analysis of incidence, risk factors and clinical significance of pneumothorax after percutaneous lung biopsy.

Science.gov (United States)

Lim, Woo Hyeon; Park, Chang Min; Yoon, Soon Ho; Lim, Hyun-Ju; Hwang, Eui Jin; Lee, Jong Hyuk; Goo, Jin Mo

2018-03-01

To evaluate the time-dependent incidence, risk factors and clinical significance of percutaneous lung biopsy (PLB)-related pneumothorax. From January 2012-November 2015, 3,251 patients underwent 3,354 cone-beam CT-guided PLBs for lung lesions. Cox, logistic and linear regression analyses were performed to identify time-dependent risk factors of PLB-related pneumothorax, risk factors of drainage catheter insertion and those of prolonged catheter placement, respectively. Pneumothorax occurred in 915/3,354 PLBs (27.3 %), with 230/915 (25.1 %) occurring during follow-ups. Risk factors for earlier occurrence of PLB-related pneumothorax include emphysema (HR=1.624), smaller target (HR=0.922), deeper location (HR=1.175) and longer puncture time (HR=1.036), while haemoptysis (HR=0.503) showed a protective effect against earlier development of pneumothorax. Seventy-five cases (8.2 %) underwent chest catheter placement. Mean duration of catheter placement was 3.2±2.0 days. Emphysema (odds ratio [OR]=2.400) and longer puncture time (OR=1.053) were assessed as significant risk factors for catheter insertion, and older age (parameter estimate=1.014) was a predictive factor for prolonged catheter placement. PLB-related pneumothorax occurred in 27.3 %, of which 25.1 % developed during follow-ups. Smaller target size, emphysema, deeply-located lesions were significant risk factors of PLB-related pneumothorax. Emphysema and older age were related to drainage catheter insertion and prolonged catheter placement, respectively. • One-fourth of percutaneous lung biopsy (PLB)-related pneumothorax occurs during follow-up. • Smaller, deeply-located target and emphysema lead to early occurrence of pneumothorax. • Emphysema is related to drainage catheter insertion for PLB-related pneumothorax. • Older age may lead to prolonged catheter placement for PLB-related pneumothorax. • Tailored management can be possible with time-dependent information of PLB-related pneumothorax.

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

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.

Evidence of greater health care needs among older veterans of the Vietnam War.

Science.gov (United States)

Brooks, Matthew S; Laditka, Sarah B; Laditka, James N

2008-08-01

This study examined self-rated health, impairments in activities of daily living, and treatment for eight health conditions among Vietnam War-era veterans, comparing those who served in Vietnam with those who served elsewhere. Data were from the nationally representative 2001 National Survey of Veterans (N = 7,907; 3,923 veterans served in Vietnam). Age-stratified ( or =60 years) analyses included multivariate logistic regression. In adjusted analyses, among those Vietnam had notably poorer self-rated health and higher stroke risk (odds ratio, 1.51; 95% confidence interval, 1.48-1.53); odds of most other conditions were lower. Among those > or =60 years of age, those who served in Vietnam had poorer self-rated health, higher cancer risk (odds ratio, 1.33; 95% confidence interval, 1.32-1.35), and more treatment for hypertension, lung conditions, stroke, and hearing loss. Results suggest greater resource use among older veterans who served in Vietnam. Clinicians and the Department of Veterans Affairs should especially note their substantially higher cancer risk.

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

Operationalization and Validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) Fall Risk Algorithm in a Nationally Representative Sample

Science.gov (United States)

Lohman, Matthew C.; Crow, Rebecca S.; DiMilia, Peter R.; Nicklett, Emily J.; Bruce, Martha L.; Batsis, John A.

2017-01-01

Background Preventing falls and fall-related injuries among older adults is a public health priority. The Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool was developed to promote fall risk screening and encourage coordination between clinical and community-based fall prevention resources; however, little is known about the tool’s predictive validity or adaptability to survey data. Methods Data from five annual rounds (2011–2015) of the National Health and Aging Trends Study (NHATS), a representative cohort of adults age 65 and older in the US. Analytic sample respondents (n=7,392) were categorized at baseline as having low, moderate, or high fall risk according to the STEADI algorithm adapted for use with NHATS data. Logistic mixed-effects regression was used to estimate the association between baseline fall risk and subsequent falls and mortality. Analyses incorporated complex sampling and weighting elements to permit inferences at a national level. Results Participants classified as having moderate and high fall risk had 2.62 (95% CI: 2.29, 2.99) and 4.76 (95% CI: 3.51, 6.47) times greater odds of falling during follow-up compared to those with low risk, respectively, controlling for sociodemographic and health related risk factors for falls. High fall risk was also associated with greater likelihood of falling multiple times annually but not with greater risk of mortality. Conclusion The adapted STEADI clinical fall risk screening tool is a valid measure for predicting future fall risk using survey cohort data. Further efforts to standardize screening for fall risk and to coordinate between clinical and community-based fall prevention initiatives are warranted. PMID:28947669

[Hearing loss in urban transportation workers in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil].

Science.gov (United States)

Medeiros, Adriane Mesquita de; Assunção, Ada Ávila; Santos, Juliana Nunes

2015-09-01

This study analyzed the association between self-reported diagnosis of hearing loss and individual and occupational factors among urban transportation workers in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil. The sample size was calculated by quotas and stratified by occupation (drivers and fare collectors) in the urban transportation companies in Belo Horizonte, Betim, and Contagem. Data were collected with face-to-face interviews and recorded by the interviewers on netbooks. The dependent variable was defined as an affirmative response to the question on prevailing medical diagnosis of hearing loss. The independent variables were organized in three blocks: social and demographic characteristics, lifestyle, and work aspects. Diagnosis of hearing loss was reported by 213 of the 1,527 workers and was associated with age and diagnosis of tinnitus. At the occupational level, hearing loss was associated with history of sick leave, time-on-the-job, and two environmental risks, unbearable noise and whole-body vibration. Measures to prevent hearing loss are needed for urban transportation workers.

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.

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

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)

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

Complexities in gauging time-dependency of proliferation resistance

International Nuclear Information System (INIS)

Avens, L.R.; Eller, P.G.; Stanbro, W.D.

2004-01-01

To a considerable extent, policy decisions on nuclear fuel cycle issues depend upon how decision makers recognize and weigh 'long-term' and 'short-term' nuclear proliferation risk factors. Priorities and structures of advanced fuel cycle and safeguards research and development programs are affected similarly. Unfortunately, there is a diversity of understanding of the precise meanings of these proliferation risk terms, leading to lack of precision in their usage. In addition, proliferation risk evaluation fundamentally involves value judgments on the relative importance of time-dependent risks. Poor communication and diverse conclusions often result. This paper explores some complexities in gauging 'long-term' and 'short-term' proliferation risk in the context of advanced nuclear fuel cycles. A convenient vehicle for this purpose is a commonly used notional plot of some proliferation resistance attribute of spent fuel or separated plutonium versus years from reactor discharge, often overlain with similar notional curves denoting multiple fuel irradiation and recycle. A common basis for misuse of such plots is failure to clearly define the range of proliferation threats being evaluated, as illustrated by several common examples of such omissions. Partial arguments of this type can be misleading and provide a disservice to policy makers who must have a clear picture of the tradeoffs being made. This paper concludes with a call for much greater care to avoid overly simplistic interpretations of notional proliferation-related concepts and greater precision in general in use of proliferation-related terminology.

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.

Greater impairment of postprandial triacylglycerol than glucose response in metabolic syndrome subjects with fasting hyperglycaemia.

Science.gov (United States)

Jackson, Kim G; Walden, Charlotte M; Murray, Peter; Smith, Adrian M; Minihane, Anne M; Lovegrove, Julie A; Williams, Christine M

2013-08-01

Studies have started to question whether a specific component or combinations of metabolic syndrome (MetS) components may be more important in relation to cardiovascular disease risk. Our aim was to examine the impact of the presence of raised fasting glucose as a MetS component on postprandial lipaemia. Men classified with the MetS underwent a sequential test meal investigation, in which blood samples were taken at regular intervals after a test breakfast (t=0 min) and lunch (t=330 min). Lipids, glucose and insulin were measured in the fasting and postprandial samples. MetS subjects with 3 or 4 components were subdivided into those without (n=34) and with (n=23) fasting hyperglycaemia (≥5.6 mmol/l), irrespective of the combination of components. Fasting lipids and insulin were similar in the two groups, with glucose significantly higher in the men with glucose as a MetS component (Pcurve (AUC) and incremental AUC (P ≤0.016) for the postprandial triacylglycerol (TAG) response in men with fasting hyperglycaemia. Greater glucose AUC (Pglucose to be an important predictor of the postprandial TAG and glucose response. Our data analysis has revealed a greater impairment of postprandial TAG than glucose response in MetS subjects with raised fasting glucose. The worsening of postprandial lipaemic control may contribute to the greater CVD risk reported in individuals with MetS component combinations which include hyperglycaemia. Copyright © 2013 Elsevier Inc. All rights reserved.

Temporal Trends in Disease Severity and Predicted Surgical Risk at the Time of Referral for Echocardiography in Patients Diagnosed with Aortic Stenosis

DEFF Research Database (Denmark)

Ersboll, Mads; Samad, Zainab; Al Enezi, Fawaz

2015-01-01

BACKGROUND: Calcific aortic stenosis (AS) is the most common underlying pathology in patients undergoing heart valve surgery, with an expected increasing prevalence among the aging population. METHODS AND RESULTS: We identified the temporal trends in referral patterns, disease severity, and assoc......BACKGROUND: Calcific aortic stenosis (AS) is the most common underlying pathology in patients undergoing heart valve surgery, with an expected increasing prevalence among the aging population. METHODS AND RESULTS: We identified the temporal trends in referral patterns, disease severity......, and associated surgical risk among patients with AS between January 1, 1995 and December 31, 2012 at the Duke University Hospital. A total of 6103 patients had a finding of mild (n = 3303), moderate (n = 1648), or severe AS (n = 1152) in a native aortic valve. Overall presence of severe AS increased...... with a finding of severe AS, the proportion of patients aged older than 80 years increased to 51.0% in the most recent time period (2010-2012) compared with 32.6% in the preceding time period (P proportion of patients with a logistic EuroSCORE greater than 20...

The Puerto Rico Cardiovascular Risk-Estimation Study (PRCaRES): an exploratory assessment of new patients in physicians' offices.

Science.gov (United States)

Monsanto, Homero A; Renta-Muñoz, Antonio; Dones, Wistremundo; Comulada, Angel; Cidre, Carlos; Orengo, Juan Carlos

2014-06-01

To determine the risk of developing coronary heart disease (CHD) in a cross-sectional sample of Puerto Rico residents through an analysis of the 10-year Framingham risk score. An exploratory, retrospective, cross-sectional study of the medical records of patients 35 years or older who each visited the office of 1 of the 4 participating physicians on or after July 1, 2007. Data for 453 patients were extracted from the medical records, but 96 cases were excluded because of incomplete data or the patients' not fulfilling the inclusion criteria, thus yielding a total sample of 357 patients. The average patient age was 58 years old (+/- 11.8); the majority (58%) was female. Eight of 10 patients were either overweight or obese. Eighty-five percent reported having at least 1 cardio-metabolic condition. Of these, 72.3% self-reported having hypertension; 38.4%, dyslipidemia; and 37.8%, diabetes. Many patients were not at goal for blood pressure or for lipid and glucose parameters nor were these patients taking any medication for these conditions. Nearly one-third of the participants had a 10% or greater 10-year risk of developing CHD. Compared with women, men were 3.3 times more likely to have a 10-year CHD risk of 10% or greater and 4.2 times more likely to have a risk of 20% or greater. A substantial number of patients had risk factors for developing CHD and were not at goal for specific parameters. Larger scale epidemiological studies should be conducted to assess CHD risk in Puerto Rico so that public health initiatives to reduce this risk might be proposed.

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.

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

The contribution of office work to sedentary behaviour associated risk

OpenAIRE

Parry, Sharon; Straker, Leon

2013-01-01

Background Sedentary time has been found to be independently associated with poor health and mortality. Further, a greater proportion of the workforce is now employed in low activity occupations such as office work. To date, there is no research that specifically examines the contribution of sedentary work to overall sedentary exposure and thus risk. The purpose of the study was to determine the total exposure and exposure pattern for sedentary time, light activity and moderate/vigorous physi...

Laryngotracheal Stenosis: Risk Factors for Tracheostomy Dependence and Dilation Interval

Science.gov (United States)

Gadkaree, Shekhar K; Pandian, Vinciya; Best, Simon; Motz, Kevin M; Allen, Clint; Kim, Young; Akst, Lee; Hillel, Alexander T

2017-02-01

Objective Laryngotracheal stenosis (LTS) is a fibrotic process that narrows the upper airway and has a significant impact on breathing and phonation. Iatrogenic injury from endotracheal and/or tracheostomy tubes is the most common etiology. This study investigates differences in LTS etiologies as they relate to tracheostomy dependence and dilation interval. Study Design Case series with chart review. Setting Single-center tertiary care facility. Subjects and Methods Review of adult patients with LTS was performed between 2004 and 2015. The association of patient demographics, comorbidities, disease etiology, and treatment modalities with patient outcomes was assessed. Multiple logistic regression analysis and Kaplan-Meier analysis were performed to determine factors associated with tracheostomy dependence and time to second procedure, respectively. Results A total of 262 patients met inclusion criteria. Iatrogenic patients presented with greater stenosis ( P = .023), greater length of stenosis ( P = .004), and stenosis farther from the vocal folds ( P tracheostomy dependence. Nonsmokers, patients without tracheostomy, and idiopathic LTS patients had a significantly longer time to second dilation procedure. Conclusion Iatrogenic LTS presents with a greater disease burden and higher risk of tracheostomy dependence when compared with other etiologies of LTS. Comorbid conditions promoting microvascular injury-including smoking, COPD, and diabetes-were prevalent in the iatrogenic cohort. Changes in hospital practice patterns to promote earlier tracheostomy in high-risk patients could reduce the incidence of LTS.

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

Risk perception of obesity and bariatric surgery in patients seeking treatment for obesity.

Science.gov (United States)

Prasad, Chaithra; Batsis, John A; Lopez-Jimenez, Francisco; Clark, Matthew M; Somers, Virend K; Sarr, Michael G; Collazo-Clavell, Maria L

2014-06-01

Bariatric surgery (BSx) produces clinically relevant weight loss that translates into improved quality of life, decreased mortality, and reduction in medical comorbidities, including cardiovascular (CV) risk. Little is known about patients' decision-making process to undergo BSx, but risk perception is known to influence medical decision-making. This study examined CV and BSx risk perception in obese subjects undergoing BSx (n = 268) versus those managed medically (MM) (n = 273). This retrospective population-based survey of subjects evaluated for BSx had 148 (55%) and 88 (32%) responders in the BSx and MM groups, respectively. Survey questions assessed risk perceptions and habits prior to weight loss intervention. CV risk was calculated using the Framingham Risk Score (FRS). At baseline, BSx subjects had a greater body mass index and greater prevalence of diabetes and depression. Follow-up mean weight loss was greater in the BSx group. BSx subjects perceived obesity as a greater risk to their overall health than the surgical risk. FRS declined in the BSx group (10 to 5%; p risk had a greater tendency to perceive the risk of BSx as greater than that of obesity. Obese subjects undergoing BSx are more likely than MM subjects to perceive obesity as a greater risk to their health than BSx. MM subjects generally underestimate their CV risk and overestimate the risk of BSx. Active discussion of CV risk using the FRS and the perception of risk associated with bariatric surgery can enhance patients' ability to make an informed decision regarding their management. © The European Society of Cardiology 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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.

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.

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...

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...

Credit risk transfer

OpenAIRE

Bank for International Settlements

2003-01-01

Executive summary Techniques for transferring credit risk, such as financial guarantees and credit insurance, have been a long-standing feature of financial markets. In the past few years, however, the range of credit risk transfer (CRT) instruments and the circumstances in which they are used have widened considerably. A number of factors have contributed to this growth, including: greater focus by banks and other financial institutions on risk management; a more rigorous approach to risk/re...

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.

The effects of husband's alcohol consumption on married women in three low-income areas of Greater Mumbai.

Science.gov (United States)

Berg, Marlene J; Kremelberg, David; Dwivedi, Purva; Verma, Supriya; Schensul, Jean J; Gupta, Kamla; Chandran, Devyani; Singh, S K

2010-08-01

Gender-based violence rooted in norms, socialization practices, structural factors, and policies that underlie men's abusive practices against married women in India is exacerbated by alcohol. The intersection of domestic violence, childhood exposure to alcohol and frustration, which contribute to drinking and its consequences including forced sex is explored through analysis of data obtained from 486 married men living with their wives in a low-income area of Greater Mumbai. SEM shows pathways linking work-related stress, greater exposure to alcohol as a child, being a heavy drinker, and having more sexual partners (a proxy for HIV risk). In-depth ethnographic interviews with 44 married women in the study communities reveal the consequences of alcohol on women's lives showing how married women associate alcohol use and violence with different patterns of drinking. The study suggests ways alcohol use leads from physical and verbal abuse to emotional and sexual violence in marriage. Implications for gendered multi-level interventions addressing violence and HIV risk are explored.

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

Sagebrush, greater sage-grouse, and the occurrence and importance of forbs

Science.gov (United States)

Pennington, Victoria E.; Schlaepfer, Daniel R.; Beck, Jeffrey L.; Bradford, John B.; Palmquist, Kyle A.; Lauenroth, William K.

2016-01-01

Big sagebrush (Artemisia tridentata Nutt.) ecosystems provide habitat for sagebrush-obligate wildlife species such as the Greater Sage-Grouse (Centrocercus urophasianus). The understory of big sagebrush plant communities is composed of grasses and forbs that are important sources of cover and food for wildlife. The grass component is well described in the literature, but the composition, abundance, and habitat role of forbs in these communities is largely unknown. Our objective was to synthesize information about forbs and their importance to Greater Sage-Grouse diets and habitats, how rangeland management practices affect forbs, and how forbs respond to changes in temperature and precipitation. We also sought to identify research gaps and needs concerning forbs in big sagebrush plant communities. We searched for relevant literature including journal articles and state and federal agency reports. Our results indicated that in the spring and summer, Greater Sage-Grouse diets consist of forbs (particularly species in the Asteraceae family), arthropods, and lesser amounts of sagebrush. The diets transition to sagebrush in fall and winter. Forbs provide cover for Greater Sage-Grouse individuals at their lekking, nesting, and brood-rearing sites, and the species has a positive relationship with arthropod presence. The effect of grazing on native forbs may be compounded by invasion of nonnative species and differs depending on grazing intensity. The effect of fire on forbs varies greatly and may depend on time elapsed since burning. In addition, chemical and mechanical treatments affect annual and perennial forbs differently. Temperature and precipitation influence forb phenology, biomass, and abundance differently among species. Our review identified several uncertainties and research needs about forbs in big sagebrush ecosystems. First, in many cases the literature about forbs is reported only at the genus or functional type level. Second, information about forb

Identifying Some Risk Factors for the Time to Death of the Elderly Using the Semi-Parametric Blended Model of Survival Analysis With Competing Risks

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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.

Higher cortisol levels at diurnal trough predict greater attentional bias towards threat in healthy young adults.

Science.gov (United States)

Hakamata, Yuko; Izawa, Shuhei; Sato, Eisuke; Komi, Shotaro; Murayama, Norio; Moriguchi, Yoshiya; Hanakawa, Takashi; Inoue, Yusuke; Tagaya, Hirokuni

2013-11-01

Attentional bias (AB), selective information processing towards threat, can exacerbate anxiety and depression. Despite growing interest, physiological determinants of AB are yet to be understood. We examined whether stress hormone cortisol and its diurnal variation pattern contribute to AB. Eighty-seven healthy young adults underwent assessments for AB, anxious personality traits, depressive symptoms, and attentional function. Salivary cortisol was collected at three time points daily (at awakening, 30 min after awakening, and bedtime) for 2 consecutive days. We performed: (1) multiple regression analysis to examine the relationships between AB and the other measures and (2) analysis of variance (ANOVA) between groups with different cortisol variation patterns for the other measures. Multiple regression analysis revealed that higher cortisol levels at bedtime (pattention and cortisol measurement at three time points daily. We showed that higher cortisol levels at bedtime and blunted cortisol variation are associated with greater AB. Individuals who have higher cortisol levels at diurnal trough might be at risk of clinical anxiety or depression but could also derive more benefits from the attentional-bias-modification program. © 2013 Elsevier B.V. All rights reserved.

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.)

Unknown Risks: Parental Hesitation about Vaccination.

Science.gov (United States)

Blaisdell, Laura L; Gutheil, Caitlin; Hootsmans, Norbert A M; Han, Paul K J

2016-05-01

This qualitative study of a select sample of vaccine-hesitant parents (VHPs) explores perceived and constructed personal judgments about the risks and uncertainties associated with vaccines and vaccine-preventable diseases (VPDs) and how these subjective risk judgments influence parents' decisions about childhood vaccination. The study employed semistructured focus group interviews with 42 VHPs to elicit parents' perceptions and thought processes regarding the risks associated with vaccination and nonvaccination, the sources of these perceptions, and their approach to decision making about vaccination for their children. VHPs engage in various reasoning processes and tend to perceive risks of vaccination as greater than the risks of VPDs. At the same time, VHPs engage in other reasoning processes that lead them to perceive ambiguity in information about the harms of vaccination-citing concerns about the missing, conflicting, changing, or otherwise unreliable nature of information. VHPs' refusal of vaccination may reflect their aversion to both the risk and ambiguity they perceive to be associated with vaccination. Mitigating this vaccine hesitancy likely requires reconstructing the risks and ambiguities associated with vaccination-a challenging task that requires providing parents with meaningful evidence-based information on the known risks of vaccination versus VPDs and explicitly acknowledging the risks that remain truly unknown. © The Author(s) 2015.

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.

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.

Urban-Hazard Risk Analysis: Mapping of Heat-Related Risks in the Elderly in Major Italian Cities

Science.gov (United States)

Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

2015-01-01

Background Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Objectives Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥65). Methods A long time-series (2001–2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using “Crichton’s Risk Triangle” hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). Results The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. Conclusions This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public

Use of the GREAT-ER model to estimate mass fluxes of chemicals, carried into the Western Scheldt estuary from the Rupel basin

OpenAIRE

Schowanek, D.

2002-01-01

The poster illustrates the application of the GREAT-ER model to estimate the mass flux of chemicals carried from a river basin into an estuary. GREAT-ER (Geo-referenced Regional Exposure Assessment Tool for European Rivers) is a newly developed model (1999) for management and risk assessment of chemicals in river basins (see www.great-er.org). Recently the Rupel basin has been made available for use within GREAT-ER. This now allows to make a reliable estimation of the contribution of pollu...

Operationalisation and validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk algorithm in a nationally representative sample.

Science.gov (United States)

Lohman, Matthew C; Crow, Rebecca S; DiMilia, Peter R; Nicklett, Emily J; Bruce, Martha L; Batsis, John A

2017-12-01

Preventing falls and fall-related injuries among older adults is a public health priority. The Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool was developed to promote fall risk screening and encourage coordination between clinical and community-based fall prevention resources; however, little is known about the tool's predictive validity or adaptability to survey data. Data from five annual rounds (2011-2015) of the National Health and Aging Trends Study (NHATS), a representative cohort of adults age 65 years and older in the USA. Analytic sample respondents (n=7392) were categorised at baseline as having low, moderate or high fall risk according to the STEADI algorithm adapted for use with NHATS data. Logistic mixed-effects regression was used to estimate the association between baseline fall risk and subsequent falls and mortality. Analyses incorporated complex sampling and weighting elements to permit inferences at a national level. Participants classified as having moderate and high fall risk had 2.62 (95% CI 2.29 to 2.99) and 4.76 (95% CI 3.51 to 6.47) times greater odds of falling during follow-up compared with those with low risk, respectively, controlling for sociodemographic and health-related risk factors for falls. High fall risk was also associated with greater likelihood of falling multiple times annually but not with greater risk of mortality. The adapted STEADI clinical fall risk screening tool is a valid measure for predicting future fall risk using survey cohort data. Further efforts to standardise screening for fall risk and to coordinate between clinical and community-based fall prevention initiatives are warranted. © 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.

People's Risk Recognition Preceding Evacuation and Its Role in Demand Modeling and Planning.

Science.gov (United States)

Urata, Junji; Pel, Adam J

2018-05-01

Evacuation planning and management involves estimating the travel demand in the event that such action is required. This is usually done as a function of people's decision to evacuate, which we show is strongly linked to their risk awareness. We use an empirical data set, which shows tsunami evacuation behavior, to demonstrate that risk recognition is not synonymous with objective risk, but is instead determined by a combination of factors including risk education, information, and sociodemographics, and that it changes dynamically over time. Based on these findings, we formulate an ordered logit model to describe risk recognition combined with a latent class model to describe evacuation choices. Our proposed evacuation choice model along with a risk recognition class can evaluate quantitatively the influence of disaster mitigation measures, risk education, and risk information. The results obtained from the risk recognition model show that risk information has a greater impact in the sense that people recognize their high risk. The results of the evacuation choice model show that people who are unaware of their risk take a longer time to evacuate. © 2017 Society for Risk Analysis.

Adverse child health impacts resulting from food adulterations in the Greater China Region.

Science.gov (United States)

Li, Wai Chin; Chow, Chin Fung

2017-09-01

Food adulteration has a long history in human society, and it still occurs in modern times. Because children are relatively vulnerable to food adulterants, studying the health impacts of food adulteration on children is important. This article provides an overview of the child health impacts of food adulterants in two recent food adulteration incidents in the Greater China Region: (1) a plasticizer incident in Taiwan and (2) a 2,4,6-triamino-1,3,5-triazine (melamine)-tainted milk incident in China. The involved food adulterants, di-(2-ethylhexyl) phthalate (DEHP), diisononyl phthalate (DiNP) and melamine, are harmful to the hippocampus, kidneys, reproductive organs and immune system of children, and they also increase the risk of cancer. To detect food adulteration and to avoid further harm caused by food adulteration, simple screening methods have been developed, and they have recently emerged as a new focus area for research. This article also summarizes the simple screening methods used to analyse the aforementioned food adulterants and reports how governments reacted to the recent food incidents. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Geo-mapping of time trends in childhood caries risk a method for assessment of preventive care

Directory of Open Access Journals (Sweden)

Strömberg Ulf

2012-06-01

Full Text Available Abstract Background 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. The aim of this study was to develop the geo-map concept, addressing time trends in caries risk, and demonstrate the novel approach by analyzing epidemiological data from preschool residents in the region of Halland, Sweden. Methods The study population consisted of 9,973 (2006 and 10,927 (2010 children between 3 to 6years of age (~77% of the eligible population from whom caries data were obtained. Reported dmfs>0 for a child was considered as the primary caries outcome. Each study individual was geo-coded with respect to his/her residence parish (66 parishes in the region. Smoothed caries risk geo-maps, along with corresponding statistical certainty geo-maps, were produced by using the free software Rapid Inquiry Facility and the ESRI ArcGIS system. Parish-level socioeconomic data were available. Results The overall proportion of caries-free (dmfs=0 children improved from 84.0% in 2006 to 88.6% in 2010. The ratio of maximum and minimum (parish-level smoothed relative risks (SmRRs increased from 1.76/0.44=4.0 in 2006 to 2.37/0.33=7.2 in 2010, which indicated an increased geographical polarization of early childhood caries in the population. Eight parishes showed evidential, positional changes in caries risk between 2006 and 2010; their corresponding SmRRs and statistical certainty ranks changed markedly. No considerable parallel changes in parish-level socioeconomic characteristics were seen during the same time period. Conclusion Geo-maps based on caries risk can be used to monitor changes in caries risk over time. Thus, geo-mapping offers a convenient tool for evaluating the effectiveness of tailored health promotion and preventive

Real interest rates, leverage, and bank risk-taking

NARCIS (Netherlands)

Dell’Ariccia, G.; Laeven, L.; Marquez, R.

2014-01-01

Do low interest rate environments lead to greater bank risk-taking? We show that, when banks can adjust their capital structures, reductions in real interest rates lead to greater leverage and higher risk for any downward sloping loan demand function. However, if the capital structure is fixed, the

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.

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.

[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.

Greater body mass index is a better predictor of subclinical cardiac damage at long-term follow-up in men than is insulin sensitivity

DEFF Research Database (Denmark)

Nielsen, Mette Lundgren; Pareek, Manan; Gerke, Oke

2015-01-01

-aged, otherwise healthy males. METHODS: Prospective population-based cohort study with a median (IQR) follow-up time of 28 (27-28) years, in which traditional cardiovascular risk factors, including HOMA-%S and BMI, were assessed at baseline, and echocardiographic determination of LVM and LV diastolic function...... was performed at follow-up. Associations between risk factors and echocardiographic variables were tested using multivariable linear and binary logistic regression. RESULTS: The study population comprised 247 men with a median (IQR) age of 47 (47-48) years. Mean (SD) BMI was 25.1 +/- 3.0 kg/m(2), and median......-up, mean (SD) LVM and LVMI were 202 +/- 61 g and 103 +/- 31 g/m(2), respectively, whereas median (IQR) E/é was 10 (8-12). Moreover, 36 % had grade 2 or 3 diastolic dysfunction. In multivariable analyses, greater BMI, but not low insulin sensitivity was independently associated with later detection...

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

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.

Cumulative Risk Assessment (CRA): transforming the way we assess health risks.

Science.gov (United States)

Williams, Pamela R D; Dotson, G Scott; Maier, Andrew

2012-10-16

Human health risk assessments continue to evolve and now focus on the need for cumulative risk assessment (CRA). CRA involves assessing the combined risk from coexposure to multiple chemical and nonchemical stressors for varying health effects. CRAs are broader in scope than traditional chemical risk assessments because they allow for a more comprehensive evaluation of the interaction between different stressors and their combined impact on human health. Future directions of CRA include greater emphasis on local-level community-based assessments; integrating environmental, occupational, community, and individual risk factors; and identifying and implementing common frameworks and risk metrics for incorporating multiple stressors.

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

Risks of Leveraged Products

NARCIS (Netherlands)

A. Di Cesare (Antonio)

2012-01-01

textabstractLeveraged investments have become a fundamental feature of modern economies. The new financial products allow people to take greater-than-usual exposures to risk factors. This thesis analyzes several different aspects of the risks involved by some frequently used leveraged products:

Metabolic predictors of post-partum disease and culling risk in dairy cattle.

Science.gov (United States)

Seifi, Hesam A; Leblanc, Stephen J; Leslie, Ken E; Duffield, Todd F

2011-05-01

A retrospective study was conducted to determine the relationship between serum non-esterified fatty acids (NEFA), β-hydroxybutyrate (BHBA), glucose and calcium (Ca) with the occurrence of displaced abomasum (DA), clinical ketosis and culling in Holstein cows. Eight hundred and forty-nine cows from 16 farms were sampled weekly for the first 3 weeks post-partum. The cows were under clinical observation from calving until 60 days in milk (DIM) and during this time there were 22 cases of DA, 31 cases of clinical ketosis and 39 cows were culled. Elevated concentrations of BHBA were associated with DA, clinical ketosis and culling. In the first week after calving, cows with serum BHBA ≥1000μmol/L had 13.6 times greater odds of developing DA than cows with lower values. Serum NEFA and BHBA concentrations during week 1 were associated with the subsequent occurrence of clinical ketosis. The odds of clinical ketosis were 6.3 times greater in cows with serum NEFA ≥ 1.0mmol/L in the first week after calving. In addition, cows with BHB ≥1200μmol/L in the first week after calving, were at 4.7 times greater risk of developing clinical ketosis. In the first and second weeks after calving the serum Ca concentration was associated with subsequent culling. In addition, cows with NEFA concentration ≥ 1.0mmol/L were 3.6 times more likely to be culled within the following 2 months. The study indicated that early post-partum serum BHBA, NEFA and Ca concentrations have potential as indicators of disease and culling risk in dairy cows. Copyright © 2010 Elsevier Ltd. All rights reserved.

Risk factors for postoperative retropharyngeal hematoma after anterior cervical spine surgery.

Science.gov (United States)

O'Neill, Kevin R; Neuman, Brian; Peters, Colleen; Riew, K Daniel

2014-02-15

Retrospective review of prospective database. To investigate risk factors involved in the development of anterior cervical hematomas and determine any impact on patient outcomes. Postoperative (PO) hematomas after anterior cervical spine surgery require urgent recognition and treatment to avoid catastrophic patient morbidity or death. Current studies of PO hematomas are limited. Cervical spine surgical procedures performed on adults by the senior author at a single academic institution from 1995 to 2012 were evaluated. Demographic data, surgical history, operative data, complications, and neck disability index (NDI) scores were recorded prospectively. Cases complicated by PO hematoma were reviewed, and time until hematoma development and surgical evacuation were determined. Patients who developed a hematoma (HT group) were compared with those that did not (no-HT group) to identify risk factors. NDI outcomes were compared at early (11 mo) time points. There were 2375 anterior cervical spine surgical procedures performed with 17 occurrences (0.7%) of PO hematoma. In 11 patients (65%) the hematoma occurred within 24 hours PO, whereas 6 patients (35%) presented at an average of 6 days postoperatively. All underwent hematoma evacuation, with 2 patients (12%) requiring emergent cricothyroidotomy. Risk factors for hematoma were found to be (1) the presence of diffuse idiopathic skeletal hyperostosis (relative risk = 13.2, 95% confidence interval = 3.2-54.4), (2) presence of ossification of the posterior longitudinal ligament (relative risk = 6.8, 95% confidence interval = 2.3-20.6), (3) therapeutic heparin use (relative risk 148.8, 95% confidence interval = 91.3-242.5), (4) longer operative time, and (5) greater number of surgical levels. The occurrence of a PO hematoma was not found to have a significant impact on either early (HT: 30, no-HT: 28; P = 0.86) or late average NDI scores (HT: 28, no-HT 31; P = 0.76). With fast recognition and treatment, no long-term detriment

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

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

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.)

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.

Joint Effects of Physical Activity and BMI on Risk of Hypertension in Women: A Longitudinal Study

Directory of Open Access Journals (Sweden)

Caroline Jackson

2014-01-01

Full Text Available Introduction. There is debate as to whether physical activity counteracts the adverse effect of weight on health outcomes. We investigated how physical activity modifies the effect of body mass index (BMI on hypertension risk. Methods. BMI, physical activity, and hypertension were measured at baseline and at three-year interval for 14 years (from 1996 to 2010, in 10,339 participants in the Australian Longitudinal Study on Women’s Health. Generalised estimating equation models for binary repeated measures were performed to determine the individual and joint effects of BMI and physical activity on incident hypertension. Results. At baseline (mean age 47.6±1.5 SD, 57% were healthy weight, 28% overweight, and 14% obese. Increasing BMI and decreasing physical activity were associated with increased risk of hypertension. Physical activity attenuated the positive association between weight and risk of hypertension, especially for obese women. Compared to healthy weight high active women, risk of hypertension in obese high active women was 3.4 times greater (OR 3.43, 95% CI 2.68, 4.39 and in obese inactive women 4.9 times greater (OR 4.91, 95% CI 3.92, 6.13. Conclusions. Both physical activity and maintenance of a healthy body weight are associated with lower risk of hypertension. Physical activity reduced but did not remove the effect of obesity on hypertension risk.

Forecast model of landslides in a short time

International Nuclear Information System (INIS)

Sanchez Lopez, Reinaldo

2006-01-01

The IDEAM in development of their functions as member of the national technical committee for the prevention and disasters attention (SNPAD) accomplishes the follow-up, monitoring and forecast in real time of the environmental dynamics that in extreme situations constitute threats and natural risks. One of the frequent dynamics and of greater impact is related to landslides, those that affect persistently the life of the persons, the infrastructure, the socioeconomic activities and the balance of the environment. The landslide in Colombia and in the world are caused mainly by effects of the rain, due to that, IDEAM has come developing forecast model, as an instrument for risk management in a short time. This article presents aspects related to their structure, operation, temporary space resolution, products, results, achievements and projections of the model. Conceptually, the model is support by the principle of the dynamic temporary - space, of the processes that consolidate natural hazards, particularly in areas where the man has come building the risk. Structurally, the model is composed by two sub-models; the general susceptibility of the earthly model and the critical rain model as a denotative factor, that consolidate the hazard process. In real time, the model, works as a GIS, permitting the automatic zoning of the landslides hazard for issue public advisory warming to help makers decisions on the risk that cause frequently these events, in the country

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

Cross-cultural differences in risk perceptions of disasters.

Science.gov (United States)

Gierlach, Elaine; Belsher, Bradley E; Beutler, Larry E

2010-10-01

Public risk perceptions of mass disasters carry considerable influences, both psychologically and economically, despite their oft-times imprecise nature. Prior research has identified the presence of an optimistic bias that affects risk perception, but there is a dearth of literature examining how these perceptions differ among cultures-particularly with regard to mass disasters. The present study explores differences among Japanese, Argentinean, and North American mental health workers in their rates of the optimistic bias in risk perceptions as contrasted between natural disasters and terrorist events. The results indicate a significant difference among cultures in levels of perceived risk that do not correspond to actual exposure rates. Japanese groups had the highest risk perceptions for both types of hazards and North Americans and Argentineans had the lowest risk perceptions for terrorism. Additionally, participants across all cultures rated risk to self as lower than risk to others (optimistic bias) across all disaster types. These findings suggest that cultural factors may have a greater influence on risk perception than social exposure, and that the belief that one is more immune to disasters compared to others may be a cross-cultural phenomenon. © 2010 Society for Risk Analysis.

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.