Part-Time Higher Education: Employer Engagement under Threat?

Science.gov (United States)

Mason, Geoff

2014-01-01

Employer support for employees who are studying part-time for higher education qualifications constitutes a form of indirect employer engagement with higher education institutions that has contributed strongly to the development of work-related skills and knowledge over the years. However, this form of employer engagement with higher education…

A higher order space-time Galerkin scheme for time domain integral equations

KAUST Repository

Pray, Andrew J.

2014-12-01

Stability of time domain integral equation (TDIE) solvers has remained an elusive goal formany years. Advancement of this research has largely progressed on four fronts: 1) Exact integration, 2) Lubich quadrature, 3) smooth temporal basis functions, and 4) space-time separation of convolutions with the retarded potential. The latter method\\'s efficacy in stabilizing solutions to the time domain electric field integral equation (TD-EFIE) was previously reported for first-order surface descriptions (flat elements) and zeroth-order functions as the temporal basis. In this work, we develop the methodology necessary to extend the scheme to higher order surface descriptions as well as to enable its use with higher order basis functions in both space and time. These basis functions are then used in a space-time Galerkin framework. A number of results are presented that demonstrate convergence in time. The viability of the space-time separation method in producing stable results is demonstrated experimentally for these examples.

A higher order space-time Galerkin scheme for time domain integral equations

KAUST Repository

Pray, Andrew J.; Beghein, Yves; Nair, Naveen V.; Cools, Kristof; Bagci, Hakan; Shanker, Balasubramaniam

2014-01-01

Stability of time domain integral equation (TDIE) solvers has remained an elusive goal formany years. Advancement of this research has largely progressed on four fronts: 1) Exact integration, 2) Lubich quadrature, 3) smooth temporal basis functions, and 4) space-time separation of convolutions with the retarded potential. The latter method's efficacy in stabilizing solutions to the time domain electric field integral equation (TD-EFIE) was previously reported for first-order surface descriptions (flat elements) and zeroth-order functions as the temporal basis. In this work, we develop the methodology necessary to extend the scheme to higher order surface descriptions as well as to enable its use with higher order basis functions in both space and time. These basis functions are then used in a space-time Galerkin framework. A number of results are presented that demonstrate convergence in time. The viability of the space-time separation method in producing stable results is demonstrated experimentally for these examples.

Higher Education IT Compliance through the Prism of Risk Controls

Science.gov (United States)

Feehan, Patrick J.

2013-01-01

In 2013, compliance issues march, unceasingly, through every aspect of higher education. Yet the intricacies of privacy, information security, data governance, and IT policy as compliance and risk areas within the IT organization can reverberate and impact every other department within the higher education institution. The primary focus is always…

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)

Why does society accept a higher risk for alcohol than for other voluntary or involuntary risks?

Science.gov (United States)

Rehm, Jürgen; Lachenmeier, Dirk W; Room, Robin

2014-10-21

Societies tend to accept much higher risks for voluntary behaviours, those based on individual decisions (for example, to smoke, to consume alcohol, or to ski), than for involuntary exposure such as exposure to risks in soil, drinking water or air. In high-income societies, an acceptable risk to those voluntarily engaging in a risky behaviour seems to be about one death in 1,000 on a lifetime basis. However, drinking more than 20 g pure alcohol per day over an adult lifetime exceeds a threshold of one in 100 deaths, based on a calculation from World Health Organization data of the odds in six European countries of dying from alcohol-attributable causes at different levels of drinking. The voluntary mortality risk of alcohol consumption exceeds the risks of other lifestyle risk factors. In addition, evidence shows that the involuntary risks resulting from customary alcohol consumption far exceed the acceptable threshold for other involuntary risks (such as those established by the World Health Organization or national environmental agencies), and would be judged as not acceptable. Alcohol's exceptional status reflects vagaries of history, which have so far resulted in alcohol being exempted from key food legislation (no labelling of ingredients and nutritional information) and from international conventions governing all other psychoactive substances (both legal and illegal). This is along with special treatment of alcohol in the public health field, in part reflecting overestimation of its beneficial effect on ischaemic disease when consumed in moderation. A much higher mortality risk from alcohol than from other risk factors is currently accepted by high income countries.

Higher dimensional time-energy entanglement

International Nuclear Information System (INIS)

Richart, Daniel Lampert

2014-01-01

Judging by the compelling number of innovations based on taming quantum mechanical effects, such as the development of transistors and lasers, further research in this field promises to tackle further technological challenges in the years to come. This statement gains even more importance in the information processing scenario. Here, the growing data generation and the correspondingly higher need for more efficient computational resources and secure high bandwidth networks are central problems which need to be tackled. In this sense, the required CPU minituarization makes the design of structures at atomic levels inevitable, as foreseen by Moore's law. From these perspectives, it is necessary to concentrate further research efforts into controlling and manipulating quantum mechanical systems. This enables for example to encode quantum superposition states to tackle problems which are computationally NP hard and which therefore cannot be solved efficiently by classical computers. The only limitation affecting these solutions is the low scalability of existing quantum systems. Similarly, quantum communication schemes are devised to certify the secure transmission of quantum information, but are still limited by a low transmission bandwidth. This thesis follows the guideline defined by these research projects and aims to further increase the scalability of the quantum mechanical systems required to perform these tasks. The method used here is to encode quantum states into photons generated by spontaneous parametric down-conversion (SPDC). An intrinsic limitation of photons is that the scalability of quantum information schemes employing them is limited by the low detection efficiency of commercial single photon detectors. This is addressed by encoding higher dimensional quantum states into two photons, increasing the scalability of the scheme in comparison to multi-photon states. Further on, the encoding of quantum information into the emission-time degree of

Higher dimensional time-energy entanglement

Energy Technology Data Exchange (ETDEWEB)

Richart, Daniel Lampert

2014-07-08

Judging by the compelling number of innovations based on taming quantum mechanical effects, such as the development of transistors and lasers, further research in this field promises to tackle further technological challenges in the years to come. This statement gains even more importance in the information processing scenario. Here, the growing data generation and the correspondingly higher need for more efficient computational resources and secure high bandwidth networks are central problems which need to be tackled. In this sense, the required CPU minituarization makes the design of structures at atomic levels inevitable, as foreseen by Moore's law. From these perspectives, it is necessary to concentrate further research efforts into controlling and manipulating quantum mechanical systems. This enables for example to encode quantum superposition states to tackle problems which are computationally NP hard and which therefore cannot be solved efficiently by classical computers. The only limitation affecting these solutions is the low scalability of existing quantum systems. Similarly, quantum communication schemes are devised to certify the secure transmission of quantum information, but are still limited by a low transmission bandwidth. This thesis follows the guideline defined by these research projects and aims to further increase the scalability of the quantum mechanical systems required to perform these tasks. The method used here is to encode quantum states into photons generated by spontaneous parametric down-conversion (SPDC). An intrinsic limitation of photons is that the scalability of quantum information schemes employing them is limited by the low detection efficiency of commercial single photon detectors. This is addressed by encoding higher dimensional quantum states into two photons, increasing the scalability of the scheme in comparison to multi-photon states. Further on, the encoding of quantum information into the emission-time degree of

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.

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...

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

Directory of Open Access Journals (Sweden)

Poliany C. O. Rodrigues

2015-01-01

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

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...

Ecuador's higher education system in times of change

OpenAIRE

Van Hoof, Hubert B.; Estrella, Mateo; Eljuri, María Isabel; Torres León, Leonardo

2013-01-01

Ecuador’s higher education system is undergoing dramatic changes. The National Constitution of 2008 and the Higher Education Law of 2010 have changed the way Ecuador’s universities are funded, administered, and accredited. The importance of research was elevated and drastic changes were made to the academic qualifications and employment conditions of full-time faculty. This article describes the attempt to raise the level of Ecuador’s system of higher education and its impact on faculty and a...

Ecuador's Higher Education System in Times of Change

OpenAIRE

Van Hoof, Hubert

2013-01-01

Ecuador’s higher education system is undergoing dramatic changes. The National Constitution of 2008 and the Higher Education Law of 2010 have changed the way Ecuador’s universities are funded, administered, and accredited. The importance of research was elevated and drastic changes were made to the academic qualifications and employment conditions of full-time faculty. This article describes the attempt to raise the level of Ecuador’s system of higher education and its impact on faculty and a...

Geoinformation monitoring of the educational risk in educational institutions of higher education

Directory of Open Access Journals (Sweden)

Aleksandr N. Kolesenkov

2017-01-01

geoinformation technologies will ensure the integration of attributive and space-time data, taking into account geographical reference to the cartographic basis from the divisions of educational institutions, will allow quickly modeling the processes and evaluating the implementation of the educational programs.A mathematical model, a method and an algorithm for assessing the effectiveness of the implementation of educational programs in educational institutions have been developed. Evaluation of the characteristics of training directions is carried out through the application of the classification method, the decision tree is used, which allows to order many specialties and training directions in a hierarchical, consistent structure according to the established rules. The proposed model for assessing the educational risk in educational institutions will make a comprehensive evaluation of the processes, taking place in the divisions, since it takes into account pedagogical, economic and social aspects.The analysis of the components and functions of the educational risk was carried out. The program implementation of the proposed approaches in the database management system has been implemented. To implement the application, the following development tools are used: PostgreSQL database management system; integrated development environment Microsoft Visual Studio Community 2015; technology for creating ASP.NET 5 web applications; programming languages SQL, C #, JavaScript. The results of approbation of the proposed technology on the basis of the data of the admission committee of the educational institution are presented.In conclusion, we can note that the scientific approach to the assessment of educational risk leads to significant generalizations in the field of the outcome of the implementation of educational programs in higher education institutions.

Just in Time Research: Data Breaches in Higher Education

Science.gov (United States)

Grama, Joanna

2014-01-01

This "Just in Time" research is in response to recent discussions on the EDUCAUSE Higher Education Information Security Council (HEISC) discussion list about data breaches in higher education. Using data from the Privacy Rights Clearinghouse, this research analyzes data breaches attributed to higher education. The results from this…

Time-Discrete Higher-Order ALE Formulations: Stability

KAUST Repository

Bonito, Andrea

2013-01-01

Arbitrary Lagrangian Eulerian (ALE) formulations deal with PDEs on deformable domains upon extending the domain velocity from the boundary into the bulk with the purpose of keeping mesh regularity. This arbitrary extension has no effect on the stability of the PDE but may influence that of a discrete scheme. We examine this critical issue for higher-order time stepping without space discretization. We propose time-discrete discontinuous Galerkin (dG) numerical schemes of any order for a time-dependent advection-diffusion-model problem in moving domains, and study their stability properties. The analysis hinges on the validity of the Reynold\\'s identity for dG. Exploiting the variational structure and assuming exact integration, we prove that our conservative and nonconservative dG schemes are equivalent and unconditionally stable. The same results remain true for piecewise polynomial ALE maps of any degree and suitable quadrature that guarantees the validity of the Reynold\\'s identity. This approach generalizes the so-called geometric conservation law to higher-order methods. We also prove that simpler Runge-Kutta-Radau methods of any order are conditionally stable, that is, subject to a mild ALE constraint on the time steps. Numerical experiments corroborate and complement our theoretical results. © 2013 Society for Industrial and Applied Mathematics.

Adopting Consumer Time: Potential Issues for Higher Education

Science.gov (United States)

Gibbs, Paul

2009-01-01

Time and temporality have received little attention in the consumerism, marketing or, until recently, higher education literature. This paper attempts to compare the notions of timing implicit in education as "paideia" (transitional personal growth) with that implicit in consumerism and the marketing practices which foster it. This…

A stable higher order space time Galerkin marching-on-in-time scheme

KAUST Repository

Pray, Andrew J.

2013-07-01

We present a method for the stable solution of time-domain integral equations. The method uses a technique developed in [1] to accurately evaluate matrix elements. As opposed to existing stabilization schemes, the method presented uses higher order basis functions in time to improve the accuracy of the solver. The method is validated by showing convergence in temporal basis function order, time step size, and geometric discretization order. © 2013 IEEE.

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

Increased Eating Frequency Is Associated with Lower Obesity Risk, But Higher Energy Intake in Adults: A Meta-Analysis

Directory of Open Access Journals (Sweden)

Yue-Qiao Wang

2016-06-01

Full Text Available Body weight is regulated by energy intake which occurs several times a day in humans. In this meta-analysis, we evaluated whether eating frequency (EF is associated with obesity risk and energy intake in adults without any dietary restriction. Experimental and observational studies published before July 2015 were selected through English-language literature searches in several databases. These studies reported the association between EF and obesity risk (odd ratios, ORs in adults who were not in dietary restriction. R software was used to perform statistical analyses. Ten cross-sectional studies, consisting of 65,742 participants, were included in this analysis. ORs were considered as effect size for the analysis about the effect of EF on obesity risk. Results showed that the increase of EF was associated with 0.83 time lower odds of obesity (i.e., OR = 0.83, 95% confidence intervals (CI 0.70–0.99, p = 0.040. Analysis about the effect of EF on differences in participants’ energy intake revealed that increased EF was associated with higher energy intake (β = 125.36, 95% CI 21.76–228.97, p = 0.017. We conclude that increased EF may lead to lower obesity risk but higher energy intake. Clinical trials are warranted to confirm these results and to assess the clinical practice applicability.

Low External Workloads Are Related to Higher Injury Risk in Professional Male Basketball Games

Directory of Open Access Journals (Sweden)

Toni Caparrós, Martí Casals, Álvaro Solana, Javier Peña

2018-06-01

Full Text Available The primary purpose of this study was to identify potential risk factors for sports injuries in professional basketball. An observational retrospective cohort study involving a male professional basketball team, using game tracking data was conducted during three consecutive seasons. Thirty-three professional basketball players took part in this study. A total of 29 time-loss injuries were recorded during regular season games, accounting for 244 total missed games with a mean of 16.26 ± 15.21 per player and season. The tracking data included the following variables: minutes played, physiological load, physiological intensity, mechanical load, mechanical intensity, distance covered, walking maximal speed, maximal speed, sprinting maximal speed, maximal speed, average offensive speed, average defensive speed, level one acceleration, level two acceleration, level three acceleration, level four acceleration, level one deceleration, level two deceleration, level three deceleration, level four deceleration, player efficiency rating and usage percentage. The influence of demographic characteristics, tracking data and performance factors on the risk of injury was investigated using multivariate analysis with their incidence rate ratios (IRRs. Athletes with less or equal than 3 decelerations per game (IRR, 4.36; 95% CI, 1.78-10.6 and those running less or equal than 1.3 miles per game (lower workload (IRR, 6.42 ; 95% CI, 2.52-16.3 had a higher risk of injury during games (p < 0.01 in both cases. Therefore, unloaded players have a higher risk of injury. Adequate management of training loads might be a relevant factor to reduce the likelihood of injury according to individual profiles.

Splenectomy is associated with a higher risk for venous thromboembolism: A prospective cohort study.

Science.gov (United States)

Lee, Debora H; Barmparas, Galinos; Fierro, Nicole; Sun, Beatrice J; Ashrafian, Sogol; Li, Tong; Ley, Eric J

2015-12-01

Thrombocytosis following splenectomy is a common occurrence. Whether this thrombocytosis leads to a higher risk for venous thromboembolism (VTE) remains unclear. This investigation aimed to determine if splenectomy increases the risk for VTE. This was a prospective study conducted in the SICU between 1/2011 and 11/2013 investigating the VTE risk in patients undergoing a splenectomy compared with those undergoing any other abdominal procedure. In total 2503 patients were admitted to the SICU: 37 (2%) after a splenectomy and 638 (26%) after any other abdominal surgery. Splenectomy patients had a higher incidence of VTE compared to patients undergoing any other abdominal procedure (29.7% vs. 12.1%, p splenectomy was associated with a higher adjusted risk for VTE compared to the no-splenectomy group (AOR [95% CI]: 2.6 [1.2, 5.9], p = 0.02). Reactive thrombocytosis did not predict the development of VTE. Splenectomy increases the risk for VTE, however reactive thrombocytosis is not associated with this higher incidence. Further investigations are required to characterize the pathophysiologic mechanisms of VTE development following splenectomy. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

List of Higher Risk Countries and Territories (IDRC, September 2012 ...

International Development Research Centre (IDRC) Digital Library (Canada)

IDRC CRDI

List of Higher Risk Countries and Territories (IDRC, September 2012). Afghanistan. Belarus. Burundi. Central African Republic. Congo, Democratic Republic of. Chad. Cuba. Eastern Europe, countries of. Eritrea. Former Soviet Union, countries of. Iran. Iraq. Korea, Democratic People's Republic of. Liberia. Libya. Mali.

List of Higher Risk Countries and Territories (IDRC, April 2012 ...

International Development Research Centre (IDRC) Digital Library (Canada)

IDRC CRDI

List of Higher Risk Countries and Territories (IDRC, April 2012). Afghanistan. Belarus. Burundi. Central African Republic. Congo, Democratic Republic of. Chad. Cuba. Eastern Europe, countries of. Eritrea. Former Soviet Union, countries of. Iran. Iraq. Korea, Democratic People's Republic of. Liberia. Libya. Mali. Myanmar ...

List of Higher Risk Countries and Territories (IDRC, July 2013 ...

International Development Research Centre (IDRC) Digital Library (Canada)

IDRC CRDI

List of Higher Risk Countries and Territories (IDRC, July 2013). Afghanistan. Central African Republic. Congo, Brazzaville. Congo, Democratic Republic of. Chad. Cuba. Eastern Europe, countries of. Equatorial Guinea. Eritrea. Former Soviet Union, countries of. Gabon. Guinea-Bissau. Iran. Iraq. Korea, Democratic People's ...

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.

Charged fluid distribution in higher dimensional spheroidal space-time

Indian Academy of Sciences (India)

A general solution of Einstein field equations corresponding to a charged fluid distribution on the background of higher dimensional spheroidal space-time is obtained. The solution generates several known solutions for superdense star having spheroidal space-time geometry.

No higher risk for colorectal cancer in atrophic gastritis-related hypergastrinemia.

Science.gov (United States)

Lahner, Edith; Sbrozzi-Vanni, Andrea; Vannella, Lucy; Corleto, Vito Domenico; Di Giulio, Emilio; Delle Fave, Gianfranco; Annibale, Bruno

2012-09-01

Atrophic gastritis of the corporal mucosa is a frequent cause of hypergastrinemia. Hypergastrinemia is implicated in colorectal cancer development. To assess whether hypergastrinemic atrophic gastritis is associated with a higher risk of neoplastic colorectal lesions. Among 441 hypergastrinemic atrophic gastritis patients, 160 who were aged >40 and underwent colonoscopy for anaemia, diarrhoea or colorectal cancer-screening were retrospectively selected. Each patient was age- and gender-matched with a normogastrinemic control with healthy stomach. Controls had colonoscopy, gastroscopy with biopsies and gastrin assessment. 160 hypergastrinemic atrophic gastritis patients and 160 controls were included. 28 atrophic gastritis patients and 36 controls had neoplastic colorectal lesions (p=0.33). Patients and controls did not differ for frequency of colorectal adenomas (10.6% vs. 13.1%, p=0.60) or cancer (6.9% vs. 9.4%, p=0.54). Hypergastrinemic atrophic gastritis was not associated with a higher probability of developing colorectal cancer (OR 1.03, 95% CI 0.34-3.16). Age >50 years (OR 3.86) but not hypergastrinemia (OR 0.61) was associated with colorectal cancer. Hypergastrinemic atrophic gastritis is not associated with higher risk for colorectal cancer. Atrophic gastritis-related hypergastrinemia is not associated with an increased risk of neoplastic colorectal lesions. Closer surveillance of colonic neoplasia in atrophic gastritis patients seems not appropriate. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Employment status at time of first hospitalization for heart failure is associated with a higher risk of death and rehospitalization for heart failure

DEFF Research Database (Denmark)

Rørth, Rasmus; Fosbøl, Emil L; Mogensen, Ulrik M

2018-01-01

AIMS: Employment status at time of first heart failure (HF) hospitalization may be an indicator of both self-perceived and objective health status. In this study, we examined the association between employment status and the risk of all-cause mortality and recurrent HF hospitalization in a nation......AIMS: Employment status at time of first heart failure (HF) hospitalization may be an indicator of both self-perceived and objective health status. In this study, we examined the association between employment status and the risk of all-cause mortality and recurrent HF hospitalization...

A stable higher order space time Galerkin marching-on-in-time scheme

KAUST Repository

Pray, Andrew J.; Shanker, Balasubramaniam; Bagci, Hakan

2013-01-01

We present a method for the stable solution of time-domain integral equations. The method uses a technique developed in [1] to accurately evaluate matrix elements. As opposed to existing stabilization schemes, the method presented uses higher order

Naked singularities in higher dimensional Vaidya space-times

International Nuclear Information System (INIS)

Ghosh, S. G.; Dadhich, Naresh

2001-01-01

We investigate the end state of the gravitational collapse of a null fluid in higher-dimensional space-times. Both naked singularities and black holes are shown to be developing as the final outcome of the collapse. The naked singularity spectrum in a collapsing Vaidya region (4D) gets covered with the increase in dimensions and hence higher dimensions favor a black hole in comparison to a naked singularity. The cosmic censorship conjecture will be fully respected for a space of infinite dimension

Do adolescents who are night owls have a higher risk of dental caries? - a case-control study.

Science.gov (United States)

Lundgren, A-M; Öhrn, K; Jönsson, B

2016-08-01

The aim was to evaluate the association between circadian rhythm and the risk of caries in adolescents, as well as their dietary and toothbrushing habits. A group of 196 adolescents (15 and 16 years old) were divided into two equal groups based on caries risk (case = high risk; and control = low risk). Before their dental examinations, they were asked to complete a questionnaire. The questionnaire included questions on circadian rhythm, dietary and oral self-care habits, and demographic variables. The participants were divided into three circadian types: evening types who are alert in the evening and tired in the morning; morning types who are the opposite; and neutral types who are neither particularly alert in the evening nor extremely tired in the morning. The most common sleep-cycle group type was neutral (50%). After this came evening types (37%) and finally morning types (13%). Morning and neutral types reported more frequently than evening types that they had breakfast every morning and brushed their teeth twice a day. More evening types were categorized as at high risk of caries. Circadian rhythm, breakfast habits and toothbrushing frequency were associated with a high risk of caries. The predicted probability of being at high risk of caries was almost four times higher for evening types than for morning types (OR 3.8; 95% CI 1.3-10.9). Adolescents who belonged to the evening circadian rhythm group brushed their teeth more seldom, ate breakfast less regularly and had a higher risk of caries than morning types. A patient's circadian rhythm should be considered when planning oral health education for adolescents with a high risk of caries. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala hospital, eastern Sudan

Directory of Open Access Journals (Sweden)

Elbashir Mustafa I

2011-08-01

Full Text Available Abstract Background Anaemia during pregnancy is major health problem. There is conflicting literature regarding the association between anaemia and its severity and maternal and perinatal outcomes. Methods This is a retrospective case-control study conducted at Kassala hospital, eastern Sudan. Medical files of pregnant women with severe anaemia (haemoglobin (Hb 11 g/dl, n = 303. Logistic regression analysis was performed separately for each of the outcome measures: preeclampsia, eclampsia, preterm birth, low birth weight (LBW and stillbirth. Results There were 9578 deliveries at Kassala hospital, 4012 (41.8% women had anaemia and 303 (3.2% had severe anaemia. The corrected risk for preeclampsia increased only in severe anaemia (OR = 3.6, 95% CI: 1.4-9.1, P = 0.007. Compared with women with no anaemia, the risk of LBW was 2.5 times higher in women with mild/moderate anaemia (95% CI: 1.1-5.7, and 8.0 times higher in women with severe anaemia (95% CI: 3.8-16.0. The risk of preterm delivery increased significantly with the severity of anaemia (OR = 3.2 for women with mild/moderate anaemia and OR = 6.6 for women with severe anaemia, compared with women with no anaemia. The corrected risk for stillbirth increased only in severe anaemia (OR = 4.3, 95% CI: 1.9-9.1, P Conclusions The greater the severity of the anaemia during pregnancy, the greater the risk of preeclampsia, preterm delivery, LBW and stillbirth. Preventive measures should be undertaken to decrease the prevalence of anaemia in pregnancy.

Applying Service Performance Guarantees to Reduce Risk Perception in the Purchase and Consumption of Higher Education

Directory of Open Access Journals (Sweden)

Nooraini Mohamad Sheriff

2006-12-01

Full Text Available The intangible nature of education is one contributor to consumers’ perception of risk prior to their purchase and consumption. This risk includes: functional risk, financial risk, temporal risk, physical risk, psychological risk and social risk. The presence of these risks often makes consumer evaluation prior to purchase and consumption difficult. Invoking a service guarantee is a platform available to enable higher educational institutions to minimize such risk perception so as to induce purchase. Specifically, service guarantee for higher education entails the application of teaching performance guarantee. This form of guarantee focuses on two important customer groups of higher educational institutions namely, students and faculty members, and focuses only on a specific performance aspect such as instructor’s performance. Thus, if students are dissatisfied with an instructor’s performance they are entitled to receive their money back. The imposition of such a teaching performance guarantee would implicate instructor’s accountability for certain aspects of their performance. It also establishes a mechanism to solicit feedback to better understand why and how instructors fail. Consequently, service performance guarantee creates a high level of customer focus and signals instructors’ care towards students

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

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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.

Reduced Time in Therapeutic Range and Higher Mortality in Atrial Fibrillation Patients Taking Acenocoumarol.

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Rivera-Caravaca, José Miguel; Roldán, Vanessa; Esteve-Pastor, María Asunción; Valdés, Mariano; Vicente, Vicente; Marín, Francisco; Lip, Gregory Y H

2018-01-01

The efficacy and tolerability of vitamin K antagonists (VKAs) depends on the quality of anticoagulant control, reflected by the mean time in therapeutic range (TTR) of international normalized ratio 2.0 to 3.0. In the present study, we aimed to investigate the association between TTR and change in TTR (ΔTTR) with the risk of mortality and clinically significant events in a consecutive cohort of atrial fibrillation (AF) patients. We included 1361 AF patients stable on VKAs (international normalized ratio 2.0-3.0) during at least the previous 6 months. After 6 months of follow-up we recalculated TTR, calculated ΔTTR (ie, the difference between baseline and 6-month TTRs) and investigated the association of both with the risk of mortality and "clinically significant events" (defined as the composite of stroke or systemic embolism, major bleeding, acute coronary syndrome, acute heart failure, and all-cause deaths). The median ΔTTR at 6 months of entry was 20% (interquartile range 0-34%), 796 (58.5%) patients had a TTR reduction of at least 20%, while 330 (24.2%) had a TTR <65%. During follow-up, 34 (2.5% [4.16% per year]) patients died and 61 (4.5% [7.47% per year]) had a clinically significant event. Median ΔTTR was significantly higher in patients who died (35.5% vs 20%; P = 0.002) or sustained clinically significant events (28% vs 20%; P = 0.022). Based on Cox regression analyses, the overall risk of mortality at 6 months for each decrease point in TTR was 1.02 (95% CI, 1.01-1.04; P = 0.003), and the risk of clinically significant events was 1.01 (95% CI, 1.00-1.03; P = 0.028). Patients with TTR <65% at 6 months had higher risk of mortality (hazard ratio = 2.96; 95% CI, 1.51-5.81; P = 0.002) and clinically significant events (hazard ratio = 1.71; 95% CI, 1.01-2.88; P = 0.046). Our findings suggest that in AF patients anticoagulated with VKAs, a change in TTR over 6 months (ie, ΔTTR) is an independent risk factor for mortality and clinically significant events

Association between low education and higher global cardiovascular risk.

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Di Chiara, Tiziana; Scaglione, Alessandra; Corrao, Salvatore; Argano, Christiano; Pinto, Antonio; Scaglione, Rosario

2015-05-01

This study was designed to evaluate the impact of educational status on global cardiovascular risk in a southern Italian urban population. The study population consisted of 488 consecutive outpatients aged 18 years and older. Educational status was categorized according to the number of years of formal education as follows: (1) low education group (education group (10-15 years). In both groups, cardiometabolic comorbidities (obesity, visceral obesity, diabetes, dyslipidemia, metabolic syndrome, microalbuminuria, left ventricular hypertrophy) and global cardiovascular risk, according to international guidelines, were analyzed. Left ventricular mass index and ejection fraction by echocardiography and E/A ratio, by pulsed-wave Doppler, were calculated. The low education group was characterized by a significantly higher prevalence of patients with visceral obesity (P=.021), hypertension (P=.010), metabolic syndrome (P=.000), and microalbuminuria (P=.000) and greater global cardiovascular risk (P=.000). Significantly increased levels of microalbuminuria (P=.000) and significantly decreased values of E/A ratio (P=.000) were also detected in the low education group. Global cardiovascular risk correlated directly with waist-to-hip ratio (P=.010), microalbuminuria (P=.015), and the metabolic syndrome (P>.012) and inversely with educational status (P=.000). Education was independently (P=.000) associated with global cardiovascular risk. These data indicate a strong association between low education and cardiometabolic comorbidities suitable to influence the evolution of chronic degenerative diseases. Preventive strategies need to be more efficient and more effective in this patient population. ©2015 Wiley Periodicals, Inc.

Macroecology of parental care in arthropods: higher mortality risk leads to higher benefits of offspring protection in tropical climates.

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Santos, Eduardo S A; Bueno, Pedro P; Gilbert, James D J; Machado, Glauco

2017-08-01

The intensity of biotic interactions varies around the world, in such a way that mortality risk imposed by natural enemies is usually higher in the tropics. A major role of offspring attendance is protection against natural enemies, so the benefits of this behaviour should be higher in tropical regions. We tested this macroecological prediction with a meta-regression of field experiments in which the mortality of guarded and unguarded broods was compared in arthropods. Mortality of unguarded broods was higher, and parental care was more beneficial, in warmer, less seasonal environments. Moreover, in these same environments, additional lines of defence further reduced offspring mortality, implying that offspring attendance alone is not enough to deter natural enemies in tropical regions. These results help to explain the high frequency of parental care among tropical species and how biotic interactions influence the occurrence of parental care over large geographic scales. Finally, our findings reveal that additional lines of defences - an oftentimes neglected component of parental care - have an important effect on the covariation between the benefits of parental care and the climate-mediated mortality risk imposed by natural enemies. © 2016 Cambridge Philosophical Society.

Are female healthcare workers at higher risk of occupational injury?

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Alamgir, Hasanat; Yu, Shicheng; Drebit, Sharla; Fast, Catherine; Kidd, Catherine

2009-05-01

Differential risks of occupational injuries by gender have been examined across various industries. With the number of employees in healthcare rising and an overwhelming proportion of this workforce being female, it is important to address this issue in this growing sector. To determine whether compensated work-related injuries among females are higher than their male colleagues in the British Columbia healthcare sector. Incidents of occupational injury resulting in compensated days lost from work over a 1-year period for all healthcare workers were extracted from a standardized operational database and the numbers of productive hours were obtained from payroll data. Injuries were grouped into all injuries and musculoskeletal injuries (MSIs). Detailed analysis was conducted using Poisson regression modelling. A total of 42 332 employees were included in the study of whom 11% were male and 89% female. When adjusted for age, occupation, sub-sector, employment category, health region and facility, female workers had significantly higher risk of all injuries [rate ratio (95% CI) = 1.58 (1.24-2.01)] and MSIs [1.43 (1.11-1.85)] compared to their male colleagues. Occupational health and safety initiatives should be gender sensitive and developed accordingly.

Azacitidine improves outcome in higher-risk MDS patients with chromosome 7 abnormalities: a retrospective comparison of GESMD and GFM registries.

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Díez-Campelo, María; Lorenzo, Jose I; Itzykson, Raphael; Rojas, Silvia M; Berthon, Céline; Luño, Elisa; Beyne-Rauzy, Odile; Perez-Oteyza, Jaime; Vey, Norbert; Bargay, Joan; Park, Sophie; Cedena, Teresa; Bordessoule, Dominique; Muñoz, Juan A; Gyan, Emmanuel; Such, Esperanza; Visanica, Sorin; López-Cadenas, Félix; de Botton, Stéphane; Hernández-Rivas, Jesús M; Ame, Shanti; Stamatoullas, Aspasia; Delaunay, Jacques; Salanoubat, Celia; Isnard, Françoise; Guieze, Romain; Pérez Guallar, Joan; Badiella, Llorenc; Sanz, Guillermo; Cañizo, Consuelo; Fenaux, Pierre

2018-05-01

Treatment with azacitidine (AZA) has been suggested to be of benefit for higher-risk myelodysplastic syndrome (HR-MDS) patients with chromosome 7 abnormalities (Abn 7). This retrospective study of 235 HR-MDS patients with Abn 7 treated with AZA (n = 115) versus best supportive care (BSC; n = 120), assessed AZA treatment as a time-varying variable in multivariable analysis. A Cox Regression model with time-interaction terms of overall survival (OS) at different time points confirmed that, while chromosome 7 cytogenetic categories (complex karyotype [CK] versus non-CK) and International Prognostic Scoring System risk (high versus intermediate-2) retained poor prognosis over time, AZA treatment had a favourable impact on OS during the first 3 years of treatment compared to BSC (Hazard ratio [HR] 0·5 P MDS and cytogenetic abnormalities involving chromosome 7, especially for those with CK. © 2018 John Wiley & Sons Ltd.

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...

Programming real-time executives in higher order language

Science.gov (United States)

Foudriat, E. C.

1982-01-01

Methods by which real-time executive programs can be implemented in a higher order language are discussed, using HAL/S and Path Pascal languages as program examples. Techniques are presented by which noncyclic tasks can readily be incorporated into the executive system. Situations are shown where the executive system can fail to meet its task scheduling and yet be able to recover either by rephasing the clock or stacking the information for later processing. The concept of deadline processing is shown to enable more effective mixing of time and information synchronized systems.

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

Directory of Open Access Journals (Sweden)

Takeshi Yagyu

Full Text Available Patients with acute heart failure (AHF show various clinical courses during hospitalization. We aimed to identify time course predictors of in-hospital mortality and to establish a sequentially assessable risk model.We enrolled 1,035 consecutive AHF patients into derivation (n = 597 and validation (n = 438 cohorts. For risk assessments at admission, we utilized Get With the Guidelines-Heart Failure (GWTG-HF risk scores. We examined significant predictors of in-hospital mortality from 11 variables obtained during hospitalization and developed a risk stratification model using multiple logistic regression analysis. Across both cohorts, 86 patients (8.3% died during hospitalization. Using backward stepwise selection, we identified five time-course predictors: catecholamine administration, minimum platelet concentration, maximum blood urea nitrogen, total bilirubin, and C-reactive protein levels; and established a time course risk score that could sequentially assess a patient's risk status. The addition of a time course risk score improved the discriminative ability of the GWTG-HF risk score (c-statistics in derivation and validation cohorts: 0.776 to 0.888 [p = 0.002] and 0.806 to 0.902 [p<0.001], respectively. A calibration plot revealed a good relationship between observed and predicted in-hospital mortalities in both cohorts (Hosmer-Lemeshow chi-square statistics: 6.049 [p = 0.642] and 5.993 [p = 0.648], respectively. In each group of initial low-intermediate risk (GWTG-HF risk score <47 and initial high risk (GWTG-HF risk score ≥47, in-hospital mortality was about 6- to 9-fold higher in the high time course risk score group than in the low-intermediate time course risk score group (initial low-intermediate risk group: 20.3% versus 2.2% [p<0.001], initial high risk group: 57.6% versus 8.5% [p<0.001].A time course assessment related to in-hospital mortality during the hospitalization of AHF patients can clearly categorize a patient's on

The Times Higher Education Ranking Product: Visualising Excellence through Media

Science.gov (United States)

Stack, Michelle L.

2013-01-01

This paper will examine the Times Higher Education's (THE) World University Rankings as a corporate media product. A number of empirical studies have critiqued the methodology of the THE, yet individuals, Higher Education Institutions (HEIs) and governments continue to use them for decision-making. This paper analyses the influence of…

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

Simultaneous Health Risk Behaviors in Adolescents Associated with Higher Economic Class in the Northeast of Brazil

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Arley Santos Leão

2017-01-01

Full Text Available Design. The social, cultural, and economic context can be an important variable in the perception and adoption of risk behaviors in adolescents. Objective. The purpose of this study was to identify the prevalence of simultaneous health risk behaviors and associated socioeconomic factors in adolescents living in the metropolitan region of Aracaju, State of Sergipe, Brazil. Methods. The sample consisted of 2,207 high school students aged 13–18 years. The risk behaviors measured were “low levels of physical activity,” “excessive daily TV time,” “high consumption of alcoholic beverages on a single occasion,” “involvement in fights,” “smoking cigarettes,” “carrying firearms,” and “marijuana consumption.” Information was obtained through self-administered questionnaire. Results. Considering the results, it was observed that female adolescents and those aged up to 16 years were less likely to have two or more health risk behaviors compared to males and those aged 17 years or more, respectively. It was also found that both high- and middle-income level adolescents had higher prevalence of having two or more health risk behaviors. Conclusions. It was concluded that male adolescents older than 16 years with better socioeconomic level were more exposed to the simultaneous presence of several health risk behaviors.

Why do perfectionists have a higher burnout risk than others? The mediational effect of workaholism

OpenAIRE

van Beek, Ilona; Schaufeli, Wilmar B.; Taris, Toon W.

2010-01-01

Previous research has revealed that perfectionists have a higher burnout risk than others, but the mechanisms accounting for this association have rarely been examined. The present study proposes that workaholism mediates this relation, as previous research revealed that (a) perfectionists are more likely to be workaholics than others, and (b) workaholics have a higher burnout risk than others. Using cross-sectional data from 199 Dutch managers, regression analyses revealed that holding high ...

Day napping and short night sleeping are associated with higher risk of diabetes in older adults.

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Xu, Qun; Song, Yiqing; Hollenbeck, Albert; Blair, Aaron; Schatzkin, Arthur; Chen, Honglei

2010-01-01

To examine whether day napping or short night sleeping is associated with higher risk of diabetes. This was a prospective study of hours of day napping and night sleeping assessed in 1996-1997 in relation to diabetes diagnosed between 2000 and 2006 (n = 10,143) among 174,542 participants in the National Institutes of Health (NIH)-AARP Diet and Health Study. Odds ratios (ORs) and 95% CI were derived from multivariate logistic regression models. Longer day napping was associated with a higher risk of diabetes. After adjustment for potential confounders, ORs were 1.23 (95% CI 1.18-1.29) for those reporting or =1 h of napping compared with individuals who did not nap (P(trend) or =9 h. In both analyses, additional adjustment for BMI only modestly attenuated the associations. Further analysis showed a statistically significant interaction between hours of napping and sleeping on diabetes (P(interaction) napping, only short night sleeping was associated with higher occurrence of diabetes, whereas among those with > or =1 h of napping, both long and short sleeping was associated with higher risk. Day napping and short night sleeping are associated with higher risk of diabetes. The association between sleep duration and diabetes may be modified by napping habit.

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

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Jung-Im Shin

2017-11-01

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

A Linear-Elasticity Solver for Higher-Order Space-Time Mesh Deformation

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Diosady, Laslo T.; Murman, Scott M.

2018-01-01

A linear-elasticity approach is presented for the generation of meshes appropriate for a higher-order space-time discontinuous finite-element method. The equations of linear-elasticity are discretized using a higher-order, spatially-continuous, finite-element method. Given an initial finite-element mesh, and a specified boundary displacement, we solve for the mesh displacements to obtain a higher-order curvilinear mesh. Alternatively, for moving-domain problems we use the linear-elasticity approach to solve for a temporally discontinuous mesh velocity on each time-slab and recover a continuous mesh deformation by integrating the velocity. The applicability of this methodology is presented for several benchmark test cases.

Study finds stronger nicotine dependency associated with higher risk of lung cancer

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NCI headed study finds people who are highly addicted to nicotine -- those who smoke their first cigarette within five minutes after awakening -- are at higher risk of developing lung cancer than those who wait for an hour or more to smoke.

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.

Fire increases the risk of higher soil N2O emissions from Mediterranean Macchia ecosystems

DEFF Research Database (Denmark)

Karhu, Kristiina; Dannenmann, M.; Kitzler, B.

2015-01-01

on climate change. However, the potential importance of indirect GHG emissions due to changes in soil biological and chemical properties after fire is less well known. Increased soil mineral nitrogen (N) concentrations after fire pose a risk for increased emissions of gaseous N, but studies on the post......-fire N2O production and soil N turnover rates (mineralization, nitrification, microbial immobilization, denitrification) are still rare. We determined N2O production, rates of N turnover and pathways for N2O production from the soil of burned and unburned plots of a Macchia shrubland in central Spain...... using a 15N labelling approach. Measurements were initiated before the controlled burning and continued for up to half a year after fire. Fire markedly increased the risk of N2O emissions from soil through denitrification (N2O production rate was 3 to ≈30 times higher in burned soils compared to control...

Pregnant Women in Sport Climbing - Is there a Higher Risk for Preterm Birth?

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Drastig, Jan; Hillebrandt, David; Rath, Werner; Küpper, Thomas

2017-02-01

Sport climbing is a popular recreational sport with an increasing proportion of female athletes. International recommendations emphasize the physical and mental benefits of regular sport activity during any uncomplicated pregnancy. In this context, sport climbing is associated with a high risk potential.The aim of this study was to examine if there is a higher risk for preterm birth in active climbing athletes.Original manuscript.A retrospective self-report online survey in the German language collected data between September 2012 and November 2013. In addition to anthropometric and demographic data, data on climbing experience, preferred climbing discipline, skill level and changes of climbing habits during pregnancy, known risk factors for preterm birth and information on delivery and the newborn were requested. The rate of preterm birth of the survey was tested with Fisher's exact test with information from the German Federal Statistical Office.Sample size was 32. 72% had a university degree, 81% were primiparous, all were singleton pregnancies. A 33 rd questionnaire was excluded because of described preeclampsia. Age ranged between 21 and 39 years, climbing experience before pregnancy between 2 and 24 years, and skill level before pregnancy between 4 and 7 on the UIAA scale (International Climbing and Mountaineering Federation). Half of the women climbed until the 36 th week and 90% adjusted their climbing habits mostly by reducing climbing difficulty and doing more top roping. 2 preterm births in the 36 th week of gestation were found (2 from 15, p=0.36). According to the data from the German Federal Statistical Office, 8.9% births in the year 2013 in Germany were preterm.This is the first study investigating the risk of preterm birth in recreational sport climbing athletes. No significantly higher proportion of preterm birth could be found. Limitations are small sample size and high social status of participants. What is known about the subject: Sport

Cancer risk awareness and screening uptake in individuals at higher risk for colon cancer: a cross-sectional study.

Science.gov (United States)

Salimzadeh, Hamideh; Bishehsari, Faraz; Delavari, Alireza; Barzin, Gilda; Amani, Mohammad; Majidi, Azam; Sadjadi, Alireza; Malekzadeh, Reza

2016-12-20

We aimed to measure cancer knowledge and feasibility of a screening colonoscopy among a cohort of individuals at higher risk of colon cancer. This study was conducted as part of an ongoing screening cohort, in which first degree relatives (FDRs) of patients with colon cancer are invited to participate in a free of charge screening colonoscopy. We enrolled 1017 FDRs in the study between 2013 and 2014 measuring their data on demographics, cancer knowledge and colonoscopy uptake. A p value of aware of their increased risk for cancer, near 35.0% had ever heard about colonoscopy with 22% aware of the correct age to start screening. Comparing cancer knowledge of FDRs at high risk versus those at moderate risk, we recorded non-significant differences (p>0.05). Almost two-thirds of FDRs expressed willingness to undergo a colonoscopy and 49.2% completed the procedure, of which 12.8% had advanced neoplasm. Our data indicated that remarkable numbers of FDRs were not still informed of their cancer risk or never received a physician recommendation for screening. The desirable uptake at first invitation, which would be higher over successive invitations, supports the feasibility of a family-based recruitment approach for early screening. This has promising implications to introduce targeted screening colonoscopy into the healthcare system in Iran and other developing nations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Depression with melancholic features is associated with higher long-term risk for dementia.

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Simões do Couto, Frederico; Lunet, Nuno; Ginó, Sandra; Chester, Catarina; Freitas, Vanda; Maruta, Carolina; Figueira, Maria Luísa; de Mendonça, Alexandre

2016-09-15

Depression has been reported to increase the risk of subsequently developing dementia, but the nature of this relation remains to be elucidated. Depression can be a prodrome/manifestation of dementia or an early risk factor, and the effect may differ according to depression subtypes. Our aim was to study the association between early-onset depression and different depression subtypes, and the later occurrence of dementia. We conducted a cohort study including 322 subjects with depression, recruited between 1977 and 1984. A comparison cohort (non-exposed) was recruited retrospectively, to include 322 subjects admitted at the same hospital for routine surgery (appendicectomy or cholecystectomy), at the same period as the depressed cohort. Subjects were contacted again between 2009 and 2014, to assess their dementia status. We computed the risk for dementia in subjects with early onset depression and quantified the association between different depression subtypes (namely melancholic, anxious, and psychotic) and dementia. The odds of dementia were increased by 2.90 times (95% C.I. 1.61-5.21; pdepressed cohort when compared to the surgical cohort. When the analysis was restricted to patients younger than 45 years old at baseline, the odds for dementia in the depressed cohort were also significantly higher when compared to the surgical cohort (8.53; 95% C.I. 2.40-30.16). In the multivariate Cox analysis, subjects having depression with melancholic features had an increased risk for developing dementia compared to those without melancholic features (HR=3.64; 95% C.I. 1.78-11.26; p=0.025). About 59% of the participants with depression and 53% of those non-exposed were lost during follow up. The inclusion of biological biomarkers would strengthen the results. The sample included a low number of bipolar patients. These results support depression as an early risk factor for dementia. Depression with melancholic features was found as an important risk factor for dementia

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

DEFF Research Database (Denmark)

Strömberg, Ulf; Holmn, Anders; Magnusson, Kerstin

2012-01-01

Dental caries is unevenly distributed within populations with a higher burden in low socio-economy groups. Several attempts have been made to allocate resources to those that need them the most; there is a need for convenient approaches to population-based monitoring of caries risk over time...

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

Time as the Fourth Dimension in the Globalization of Higher Education

Science.gov (United States)

Walker, Judith

2009-01-01

This paper calls for an analysis of time to be integrated into the theories on the globalization of higher education. Specifically, the author argues that academic capitalism, fuelled by globalization, has led to changes in the university visible in time/space compression, time acceleration, the reification of time and our internalization of the…

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.

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.

Kidneys at Higher Risk of Discard: Expanding the Role of Dual Kidney Transplantation

Science.gov (United States)

Tanriover, B.; Mohan, S.; Cohen, D. J.; Radhakrishnan, J.; Nickolas, T. L.; Stone, P. W.; Tsapepas, D. S.; Crew, R. J.; Dube, G. K.; Sandoval, P. R.; Samstein, B.; Dogan, E.; Gaston, R. S.; Tanriover, J. N.; Ratner, L. E.; Hardy, M. A.

2014-01-01

Half of the recovered expanded criteria donor (ECD) kidneys are discarded in the United States. A new kidney allocation system offers kidneys at higher risk of discard, Kidney Donor Profile Index (KDPI) >85%, to a wider geographic area to promote broader sharing and expedite utilization. Dual kidney transplantation (DKT) based on the KDPI is a potential option to streamline allocation of kidneys which otherwise would have been discarded. To assess the clinical utility of the KDPI in kidneys at higher risk of discard, we analyzed the OPTN/UNOS Registry that included the deceased donor kidneys recovered between 2002 and 2012. The primary outcomes were allograft survival, patient survival and discard rate based on different KDPI categories (90%). Kidneys with KDPI >90% were associated with increased odds of discard (OR = 1.99, 95% CI 1.74–2.29) compared to ones with KDPI 90% were associated with lower overall allograft failure (HR = 0.74, 95% CI 0.62–0.89) and better patient survival (HR = 0.79, 95% CI 0.64–0.98) compared to single ECD kidneys with KDPI >90%. Kidneys at higher risk of discard may be offered in the up-front allocation system as a DKT. Further modeling and simulation studies are required to determine a reasonable KDPI cutoff percentile. PMID:24472195

Part-Time Higher Education in English Colleges: Adult Identities in Diminishing Spaces

Science.gov (United States)

Esmond, Bill

2015-01-01

Adult participation in higher education has frequently entailed mature students studying part time in lower-ranked institutions. In England, higher education policies have increasingly emphasised higher education provision in vocational further education colleges, settings which have extensive adult traditions but which mainly teach…

A Prolonged Time Interval Between Trauma and Prophylactic Radiation Therapy Significantly Increases the Risk of Heterotopic Ossification

Energy Technology Data Exchange (ETDEWEB)

Mourad, Waleed F., E-mail: Waleed246@gmail.com [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Department of Radiation Oncology, Beth Israel Medical Center, New York, NY (Israel); Packianathan, Satyaseelan [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Shourbaji, Rania A. [Department of Epidemiology and Biostatistics, Jackson State University, Jackson, MS (United States); Zhang Zhen; Graves, Mathew [Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States); Khan, Majid A. [Department of Radiology, University of Mississippi Medical Center, Jackson, MS (United States); Baird, Michael C. [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Russell, George [Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States); Vijayakumar, Srinivasan [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States)

2012-03-01

Purpose: To ascertain whether the time from injury to prophylactic radiation therapy (RT) influences the rate of heterotopic ossification (HO) after operative treatment of displaced acetabular fractures. Methods and Materials: This is a single-institution, retrospective analysis of patients referred for RT for the prevention of HO. Between January 2000 and January 2009, 585 patients with displaced acetabular fractures were treated surgically followed by RT for HO prevention. We analyzed the effect of time from injury on prevention of HO by RT. In all patients, 700 cGy was prescribed in a single fraction and delivered within 72 hours postsurgery. The patients were stratified into five groups according to time interval (in days) from the date of their accident to the date of RT: Groups A {<=}3, B {<=}7, C {<=}14, D {<=}21, and E >21days. Results: Of the 585 patients with displaced acetabular fractures treated with RT, (18%) 106 patients developed HO within the irradiated field. The risk of HO after RT increased from 10% for RT delivered {<=}3 days to 92% for treatment delivered >21 days after the initial injury. Wilcoxon test showed a significant correlation between the risk of HO and the length of time from injury to RT (p < 0.0001). Chi-square test and multiple logistic regression analysis showed no significant association between all other factors and the risk of HO (race, gender, cause and type of fracture, surgical approach, or the use of indomethacin). Conclusions: Our data suggest that there is higher incidence and risk of HO if prophylactic RT is significantly delayed after a displaced acetabular fracture. Thus, RT should be administered as early as clinically possible after the trauma. Patients undergoing RT >3 weeks from their displaced acetabular fracture should be informed of the higher risk (>90%) of developing HO despite prophylaxis.

The Relationship between Physical Activity and Screen Time with the Risk of Hypertension in Children and Adolescents with Intellectual Disability

Directory of Open Access Journals (Sweden)

Justyna Wyszyńska

2017-01-01

Full Text Available Introduction. Children and adolescents with intellectual disability (ID have significantly lower levels of physical activity compared to their peers without ID. Association between the level of physical activity and screen time with hypertension (HPT in children and adolescents with ID has not been reported yet. Aim. To assess the relationship between the level of physical activity and screen time with the prevalence of HPT in students with ID. Material and Methods. The study group consisted of 568 children with ID aged 7 to 18. The control group matched for age and gender consisted of 568 students without ID. Blood pressure (BP, body mass and height, level of physical activity, and screen time were assessed. Results. The level of physical activity in the study group was significantly lower than in the control group (score 1.99 versus 3.02, resp., in Physical Activity Questionnaire. The risk of HPT in the students with ID with low levels of physical activity was more than 4 times higher (OR = 4.40 and more than 2 times higher when screen time was ≥2 h/day. Conclusion. Low level of physical activity and long screen time were associated with significantly higher HPT risk among children and adolescents with ID.

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

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.

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.

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.

Shorter Perceived Outpatient MRI Wait Times Associated With Higher Patient Satisfaction.

Science.gov (United States)

Holbrook, Anna; Glenn, Harold; Mahmood, Rabia; Cai, Qingpo; Kang, Jian; Duszak, Richard

2016-05-01

The aim of this study was to assess differences in perceived versus actual wait times among patients undergoing outpatient MRI examinations and to correlate those times with patient satisfaction. Over 15 weeks, 190 patients presenting for outpatient MR in a radiology department in which "patient experience" is one of the stated strategic priorities were asked to (1) estimate their wait times for various stages in the imaging process and (2) state their satisfaction with their imaging experience. Perceived times were compared with actual electronic time stamps. Perceived and actual times were compared and correlated with standardized satisfaction scores using Kendall τ correlation. The mean actual wait time between patient arrival and examination start was 53.4 ± 33.8 min, whereas patients perceived a mean wait time of 27.8 ± 23.1 min, a statistically significant underestimation of 25.6 min (P perceived wait times at all points during patient encounters were correlated with higher satisfaction scores (P perceived and actual wait times were both correlated with higher satisfaction scores. As satisfaction surveys play a larger role in an environment of metric transparency and value-based payments, better understanding of such factors will be increasingly important. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Higher tier field research in ecological risk assessment: a case study

Energy Technology Data Exchange (ETDEWEB)

Faber, J. [Alterra, Wageningen (Netherlands)

2003-07-01

A newly developed basic procedure for site-specific ecological risk assessment in The Netherlands was followed in practice for the first time. In line with conventional Triade approaches, the procedure includes multidisciplinary parameters from environmental chemistry, toxicology and ecology to provide multiple weight of evidence. However, land use at the contaminated site and its vicinity is given more importance, and research parameters are selected in accordance to specific objectives for land use in order to test for harmful effects to underlying ecosystem services. Moreover, the approach is characterized by repetitive interactions between stakeholders and researching consultants, in particular with respect to the choice of parameters and criteria to assess the results. The approach was followed in an ecological risk assessment to test the assumptions underlying a soil management plant for a rural area in The Netherlands, called 'Krimpenerwaard'. Throughout this region some 5000 polder ditches have been filled with waste materials originating from local households, waterway sludge, industrial wastes, car shredders, and more. Several sites are severely polluted by heavy metals, cyanide, PAH or chlorinated hydrocarbons and require remediation or clean up. However, the exact distribution of these wastes over the entire region is scarcely known, and the Krimpenerwaard as a whole is treated as one case of serious soil pollution. A soil management plan was constructed by 13 stakeholding parties, aiming for a 'functional clean up' in view of land use, by means of covering 'suspected' categories of wastes with a 30-cm layer of local type soil. The ecological risk assessment aims to verify the assumptions in the soil management plan regarding the prevention of possible undesirable effects induced by the various waste materials. A tiered approach is followed, including a screening for bioavailable contaminants, a testing for general effects

"The Balancing Act"--Irish Part-Time Undergraduate Students in Higher Education

Science.gov (United States)

Darmody, Merike; Fleming, Bairbre

2009-01-01

While the numbers of part-time students has increased in higher education in Ireland, little is known about these students or about how they balance their study and other commitments. Drawing on a larger study on Irish students' experiences in higher education, this article attempts to address this gap in research and reports on Irish part-time…

Leisure time activities related to carcinogen exposure and lung cancer risk in never smokers. A case-control study

International Nuclear Information System (INIS)

Ruano-Ravina, Alberto; García-Lavandeira, José Antonio; Torres-Durán, María; Prini-Guadalupe, Luciana; Parente-Lamelas, Isaura; Leiro-Fernández, Virginia; Montero-Martínez, Carmen; González-Barcala, Francisco Javier; Golpe-Gómez, Antonio; Martínez, Cristina; Castro-Añón, Olalla; Mejuto-Martí, María José

2014-01-01

We aim to assess the relationship between leisure time activities related to exposure to carcinogenic substances and lung cancer risk in a hospital-based case-control study performed in never smokers. We included never smoking cases with anatomopathologically confirmed lung cancer and never smoking controls undergoing trivial surgery, at 8 Spanish hospitals. The study was conducted between January 2011 and June 2013. Participants were older than 30 and had no previous neoplasms. All were personally interviewed focusing on lifestyle, environmental tobacco smoke exposure, occupational history and leisure time activities (including duration of such activities). Results were analyzed through logistic regression and adjusted also by residential radon and education level. We included 513 never smokers, 191 cases and 322 controls. The OR for those performing the studied leisure time activities was 1.43 (95%CI 0.78–2.61). When we restricted the analysis to those performing do-it-yourself activities for more than 10 years the OR was 2.21 (95%CI 0.93–5.27). Environmental tobacco smoke exposure did not modify this association. The effect for the different lung cancer histological types was very close to significance for adenocarcinoma but only when these activities were performed for more than 10 years. We encourage health professionals to recommend protective measures for those individuals while performing these hobbies to reduce the risk of lung cancer. - Highlights: • Some leisure time activities are associated with the exposure to carcinogenic substances. • These activities are model-making, painting (artistic or not), furniture refinishing or wood working. • Few studies have assessed lung cancer risk due to these hobbies and none in never-smokers. • Leisure activities related to exposure to carcinogenic substances present higher lung cancer risk. • The risk is higher when these activities are performed for more than 10 years

Leisure time activities related to carcinogen exposure and lung cancer risk in never smokers. A case-control study

Energy Technology Data Exchange (ETDEWEB)

Ruano-Ravina, Alberto, E-mail: alberto.ruano@usc.es [Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (Spain); CIBER de Epidemiología y Salud Pública CIBERESP, Barcelona (Spain); García-Lavandeira, José Antonio [Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (Spain); Department of Preventive Medicine, A Coruña University Hospital Complex, Coruña (Spain); Torres-Durán, María [Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (Spain); Service of Neumology, University Hospital Complex of Vigo, Vigo (Spain); Prini-Guadalupe, Luciana [Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (Spain); Parente-Lamelas, Isaura [Service of Neumology, Ourense Hospital Complex, Ourense (Spain); Leiro-Fernández, Virginia [Service of Neumology, University Hospital Complex of Vigo, Vigo (Spain); Montero-Martínez, Carmen [Service of Neumology, University Hospital Complex of A Coruña, Coruña (Spain); González-Barcala, Francisco Javier; Golpe-Gómez, Antonio [Service of Neumology, Santiago de Compostela University Clinic Hospital, Santiago de Compostela (Spain); Martínez, Cristina [National Institute of Silicosis, University Hospital of Asturias, Oviedo, Asturias (Spain); Castro-Añón, Olalla [Service of Neumology, Hospital Lucus Augusti, Lugo (Spain); Mejuto-Martí, María José [Service of Neumology, Hospital Arquitecto Marcide, Ferrol (Spain); and others

2014-07-15

We aim to assess the relationship between leisure time activities related to exposure to carcinogenic substances and lung cancer risk in a hospital-based case-control study performed in never smokers. We included never smoking cases with anatomopathologically confirmed lung cancer and never smoking controls undergoing trivial surgery, at 8 Spanish hospitals. The study was conducted between January 2011 and June 2013. Participants were older than 30 and had no previous neoplasms. All were personally interviewed focusing on lifestyle, environmental tobacco smoke exposure, occupational history and leisure time activities (including duration of such activities). Results were analyzed through logistic regression and adjusted also by residential radon and education level. We included 513 never smokers, 191 cases and 322 controls. The OR for those performing the studied leisure time activities was 1.43 (95%CI 0.78–2.61). When we restricted the analysis to those performing do-it-yourself activities for more than 10 years the OR was 2.21 (95%CI 0.93–5.27). Environmental tobacco smoke exposure did not modify this association. The effect for the different lung cancer histological types was very close to significance for adenocarcinoma but only when these activities were performed for more than 10 years. We encourage health professionals to recommend protective measures for those individuals while performing these hobbies to reduce the risk of lung cancer. - Highlights: • Some leisure time activities are associated with the exposure to carcinogenic substances. • These activities are model-making, painting (artistic or not), furniture refinishing or wood working. • Few studies have assessed lung cancer risk due to these hobbies and none in never-smokers. • Leisure activities related to exposure to carcinogenic substances present higher lung cancer risk. • The risk is higher when these activities are performed for more than 10 years.

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.

Higher risk of offspring schizophrenia following antenatal maternal exposure to severe adverse life events

DEFF Research Database (Denmark)

Khashan, Ali; Abel, Kathryn; McNamee, R.

2008-01-01

CONTEXT: Most societies believe that a mother's psychological state can influence her unborn baby. Severe adverse life events during pregnancy have been consistently associated with an elevated risk of low birth weight and prematurity. Such events during the first trimester have also been...... associated with risk of congenital malformations. OBJECTIVE: To assess the effect in offspring of antenatal maternal exposure to an objective measure of stress on risk of adverse neurodevelopment, specifically schizophrenia. We hypothesized that the strongest relationship would be to maternal exposures...... not linked with a higher risk of schizophrenia. CONCLUSIONS: Our population-based study suggests that severe stress to a mother during the first trimester may alter the risk of schizophrenia in offspring. This finding is consistent with ecological evidence from whole populations exposed to severe stressors...

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

Science.gov (United States)

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

2009-01-01

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

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.

A Risk and Standards Based Approach to Quality Assurance in Australia's Diverse Higher Education Sector

Science.gov (United States)

Australian Government Tertiary Education Quality and Standards Agency, 2015

2015-01-01

The Australian Government Tertiary Education Quality and Standards Agency's (TEQSA's) role is to assure that quality standards are being met by all registered higher education providers. This paper explains how TEQSA's risk-based approach to assuring higher education standards is applied in broad terms to a diverse sector. This explanation is…

Outcomes of three universal eating disorder risk reduction programs by participants with higher and lower baseline shape and weight concern.

Science.gov (United States)

Wilksch, Simon M; Paxton, Susan J; Byrne, Susan M; Austin, S Bryn; O'Shea, Anne; Wade, Tracey D

2017-01-01

To investigate if baseline shape and weight concern (SWC) moderated outcomes in Prevention Across the Spectrum, a randomized-controlled trial (RCT) of 3 school-based programs aimed at reducing eating disorder and obesity risk factors. N = 1,316 Grade 7 and 8 girls and boys (M age = 13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; Helping, Encouraging, Listening and Protecting Peers Initiative (HELPP) or control (usual school class). Moderation was explored by testing interaction effects for group (Media Smart; Life Smart; HELPP; Control) × moderator (SWC: higher-SWC; lower-SWC) × time (post-program; 6-month follow-up; 12-month follow-up), with baseline risk factor scores entered as covariates. Moderation effects were found for shape concern, weight concern, eating concern, regular eating (i.e., meal skipping), physical activity, body dissatisfaction, dieting, and perfectionism. Post-hoc testing found eating concern at post-program was the only variable where higher-SWC Media Smart participants experienced a reduction in risk relative to controls. Both higher-SWC Life Smart and HELPP participants reported an increase in eating concern relative to controls and both groups were skipping more meals than controls at 12-month follow-up. Amongst lower-SWC participants, Media Smart was the only group to experience a benefit relative to controls (physical activity). This study highlights the need for moderator analyses to become more routinely conducted in universal trials, to ensure that participants across baseline risk levels are benefiting and not harmed from program participation. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:66-75). © 2016 Wiley Periodicals, Inc.

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....

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. ;

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.

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...

Time-discrete higher order ALE formulations: a priori error analysis

KAUST Repository

Bonito, Andrea

2013-03-16

We derive optimal a priori error estimates for discontinuous Galerkin (dG) time discrete schemes of any order applied to an advection-diffusion model defined on moving domains and written in the Arbitrary Lagrangian Eulerian (ALE) framework. Our estimates hold without any restrictions on the time steps for dG with exact integration or Reynolds\\' quadrature. They involve a mild restriction on the time steps for the practical Runge-Kutta-Radau methods of any order. The key ingredients are the stability results shown earlier in Bonito et al. (Time-discrete higher order ALE formulations: stability, 2013) along with a novel ALE projection. Numerical experiments illustrate and complement our theoretical results. © 2013 Springer-Verlag Berlin Heidelberg.

Conflicts at work are associated with a higher risk of cardiovascular disease

Science.gov (United States)

Jacob, Louis; Kostev, Karel

2017-01-01

Background: Only few authors have analyzed the impact of workplace conflicts and the resulting stress on the risk of developing cardiovascular disorders. The goal of this study was to analyze the association between workplace conflicts and cardiovascular disorders in patients treated by German general practitioners. Methods: Patients with an initial documentation of a workplace conflict experience between 2005 and 2014 were identified in 699 general practitioner practices (index date). We included only those who were between the ages of 18 and 65 years, had a follow-up time of at least 180 days after the index date, and had not been diagnosed with angina pectoris, myocardial infarction, coronary heart diseases, or stroke prior to the documentation of the workplace mobbing. In total, the study population consisted of 7,374 patients who experienced conflicts and 7,374 controls for analysis. The main outcome measure was the incidence of angina pectoris, myocardial infarction, and stroke correlated with workplace conflict experiences. Results: After a maximum of five years of follow-up, 2.9% of individuals who experienced workplace conflict were affected by cardiovascular diseases, while only 1.4% were affected in the control group (p-value <0.001). Workplace conflict was associated with a 1.63-fold increase in the risk of developing cardiovascular diseases. Finally, the impact of workplace conflict was higher for myocardial infarction (OR=2.03) than for angina pectoris (OR=1.79) and stroke (OR=1.56). Conclusions: Overall, we found a significant association between workplace conflicts and cardiovascular disorders. PMID:28496397

Conflicts at work are associated with a higher risk of cardiovascular disease

Directory of Open Access Journals (Sweden)

Jacob, Louis

2017-04-01

Full Text Available Background: Only few authors have analyzed the impact of workplace conflicts and the resulting stress on the risk of developing cardiovascular disorders. The goal of this study was to analyze the association between workplace conflicts and cardiovascular disorders in patients treated by German general practitioners. Methods: Patients with an initial documentation of a workplace conflict experience between 2005 and 2014 were identified in 699 general practitioner practices (index date. We included only those who were between the ages of 18 and 65 years, had a follow-up time of at least 180 days after the index date, and had not been diagnosed with angina pectoris, myocardial infarction, coronary heart diseases, or stroke prior to the documentation of the workplace mobbing. In total, the study population consisted of 7,374 patients who experienced conflicts and 7,374 controls for analysis. The main outcome measure was the incidence of angina pectoris, myocardial infarction, and stroke correlated with workplace conflict experiences. Results: After a maximum of five years of follow-up, 2.9% of individuals who experienced workplace conflict were affected by cardiovascular diseases, while only 1.4% were affected in the control group Workplace conflict was associated with a 1.63-fold increase in the risk of developing cardiovascular diseases. Finally, the impact of workplace conflict was higher for myocardial infarction (OR=2.03 than for angina pectoris (OR=1.79 and stroke (OR=1.56. Conclusions: Overall, we found a significant association between workplace conflicts and cardiovascular disorders.

Risk-reducing Salpingo-Oophorectomy in Women at Higher Risk of Ovarian and Breast Cancer: A Single Institution Prospective Series.

Science.gov (United States)

Ricciardi, Enzo; Tomao, Federica; Aletti, Giovanni; Bazzurini, Luca; Bocciolone, Luca; Boveri, Sara; Landoni, Fabio; Lapresa, Maria Teresa; Maruccio, Matteo; Parma, Gabriella; Peccatori, Fedro; Petrella, Maria Cristina; Zanagnolo, Vanna; Colombo, Nicoletta; Maggioni, Angelo

2017-09-01

Occult cancers' reported rates vary from 2-12% and serous tubal intraepithelial carcinomas (STICs) have been identified in 3-12% of the prophylactically removed tubes of women carrying a BRCA mutation. The aim of this study was to evaluate the incidence of tubal minor epithelial atypia (STIL), STIC, and occult invasive cancer and to evaluate the cancer-specific mortality in a prospective series of women at higher risk of ovarian and breast cancer undergoing risk-reducing salpingo-oophorectomy (RRSO) n a tertiary cancer center. A series of RRSO specimens (including endometrial biopsy) from women carrying a BRCA mutation, BRCA-unknown and BRCA-negative were collected between January 1998 and April 2016 at the Division of Gynecology at the European Institute of Oncology. Inclusion criteria were: asymptomatic women who had a negative gynecologic screening within 3 months prior to RRSO. Exclusion criteria were: women with ovarian/tubal cancer prior to RRSO. A total of 411 women underwent RRSO. Median age at RRSO was 47.0 years (range=32-70 years); 75.2% had a history of breast cancer. Fifteen women were diagnosed with an occult cancer (7 STIC, 4 invasive cancers, 2 breast cancers metastatic to the adnexa, 2 endometrial cancer) (3.6%). Sixteen showed a STIL (3.9%). When excluding cases with preoperative positive markers, the occult invasive cancer rate drops to 1.5%. Our study, covering an 18-year period, shows a substantial low risk of occult cancer among a high-risk population of women undergoing RRSO. Our data still support the indication for RRSO in higher-risk patients. An endometrial biopsy should also be routinely obtained as it raises the chances of detecting occult endometrial cancers that may be otherwise missed. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Detrended fluctuation analysis based on higher-order moments of financial time series

Science.gov (United States)

Teng, Yue; Shang, Pengjian

2018-01-01

In this paper, a generalized method of detrended fluctuation analysis (DFA) is proposed as a new measure to assess the complexity of a complex dynamical system such as stock market. We extend DFA and local scaling DFA to higher moments such as skewness and kurtosis (labeled SMDFA and KMDFA), so as to investigate the volatility scaling property of financial time series. Simulations are conducted over synthetic and financial data for providing the comparative study. We further report the results of volatility behaviors in three American countries, three Chinese and three European stock markets by using DFA and LSDFA method based on higher moments. They demonstrate the dynamics behaviors of time series in different aspects, which can quantify the changes of complexity for stock market data and provide us with more meaningful information than single exponent. And the results reveal some higher moments volatility and higher moments multiscale volatility details that cannot be obtained using the traditional DFA method.

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.

Pregnant women carrying female fetuses are at higher risk of placental malaria infection.

Directory of Open Access Journals (Sweden)

Ishag Adam

Full Text Available The pathophysiology of the placental malaria is not fully understood. If there is a fetal sex-specific susceptibility to malaria infection, this might add to the previous knowledge on the immunology, endocrinology and pathophysiology of placental malaria infections.This study was conducted to assess whether the sex of the fetus was associated with placental malaria infections.A cross-sectional study was performed including a secondary analysis of a cohort of women who were investigated for prevalence and risk factors (including fetal sex for placental malaria in eastern Sudan. Placental histology was used to diagnose placental malaria infections.Among 339 women enrolled, the mean (SD age was 25.8 (6.7 years and parity was 2.7 (2.2. Among the new born babies, 157 (46.3% were male and 182 (53.7% were female. Five (1.5%, 9 (2.7% and 103 (30.4% of the 339 placentas had active, active-chronic, past-chronic malaria infection on histopathology examination respectively, while 222 (65.5% of them showed no malaria infection. Logistic regression analyses showed no associations between maternal age or parity and placental malaria infections. Women who have blood group O (OR = 1.95, 95% CI = 1.19-3.10; P = 0.007 and women who had female new born were at higher risk for placental malaria infections (OR = 2.55, 95% CI = 1.57-4.13; P< 0.001.Fetal gender may be a novel risk factor for placental malaria. In this work the female placentas were at higher risk for malaria infections than the male placentas.

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

Directory of Open Access Journals (Sweden)

Chen P

2017-09-01

Full Text Available Pengxiang Chen,1 Qingxu Song,1 Jie Han,2 Huapu Xu,3 Tong Chen,4 Jiaqi Xu,5 Yufeng Cheng1 1Department of Radiation Oncology, Qilu Hospital of Shandong University, 2Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, 3Department of Oncology, Pingyi Hospital of Traditional Chinese Medicine, Pingyi, 4Department of Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 5Department of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China Backgrounds: Sitting time and physical activity are associated with cancer risk; however, their roles in the development of esophageal squamous cell carcinoma (ESCC are inconclusive. This study aimed to investigate the effects of total sitting time, occupational activity time (OAT, and recreational activity time (RAT on ESCC risk. Methods: Five hundred fifty-seven ESCC patients and 543 healthy controls matched by sex and age were recruited for this study. Conditional logistic regression was performed to obtain odds ratios (ORs and 95% confidence intervals (CIs. Results: Longer total sitting time (adjusted OR [AOR] 2.54, 95% CI 1.58–4.09 and longer OAT (AOR 2.90, 95% CI 2.11–3.99 were associated with higher ESCC risk, while longer RAT (AOR 0.27, 95% CI 0.19–0.38 could reduce ESCC risk. When the body mass index was incorporated into the multivariable models, the results changed slightly. In risk estimation according to sex, the same trends were observed in both men and women. Furthermore, longer RAT could completely or partially diminish the impacts of longer sitting time and OAT on increasing ESCC risk.Conclusion: Long sitting time and long OAT can increase the risk of ESCC, while long RAT is significantly associated with decreased ESCC risk. Keywords: esophageal squamous cell carcinoma, sitting time, physical activity, cancer epidemiology

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.

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

Science.gov (United States)

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

2014-08-01

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

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...

Higher Education Is Associated with a Lower Risk of Dementia after a Stroke or TIA. The Rotterdam Study.

Science.gov (United States)

Mirza, Saira Saeed; Portegies, Marileen L P; Wolters, Frank J; Hofman, Albert; Koudstaal, Peter J; Tiemeier, Henning; Ikram, M Arfan

2016-01-01

Higher education is associated with a lower risk of dementia, possibly because of a higher tolerance to subclinical neurodegenerative pathology. Whether higher education also protects against dementia after clinical stroke or transient ischemic attack (TIA) remains unknown. Within the population-based Rotterdam Study, 12,561 participants free of stroke, TIA and dementia were followed for occurrence of stroke, TIA and dementia. Across the levels of education, associations of incident stroke or TIA with subsequent development of dementia and differences in cognitive decline following stroke or TIA were investigated. During 124,862 person-years, 1,463 persons suffered a stroke or TIA, 1,158 persons developed dementia, of whom 186 developed dementia after stroke or TIA. Risk of dementia after a stroke or TIA, compared to no stroke or TIA, was highest in the low education category (hazards ratio [HR] 1.46, 95% CI 1.18-1.81) followed by intermediate education category (HR 1.36, 95% CI 1.03-1.81). No significant association was observed in the high education category (HR 0.62, 95% CI 0.25-1.54). In gender stratified analyses, decrease in risk of dementia with increasing education was significant only in men. Higher education is associated with a lower risk of dementia after stroke or TIA, particularly in men, which might be explained by a higher cognitive reserve. © 2016 S. Karger AG, Basel.

Higher education is associated with a lower risk of dementia after a stroke or TIA : The Rotterdam study

NARCIS (Netherlands)

S.S. Mirza (Saira); M.L.P. Portegies (Marileen); F.J. Wolters (Frank J.); A. Hofman (Albert); P.J. Koudstaal (Peter Jan); H.W. Tiemeier (Henning); M.A. Ikram (Arfan)

2016-01-01

markdownabstract__Background:__ Higher education is associated with a lower risk of dementia, possibly because of a higher tolerance to subclinical neurodegenerative pathology. Whether higher education also protects against dementia after clinical stroke or transient ischemic attack (TIA) remains

Cardiovascular risk and stress in employees of a higher education institution

Directory of Open Access Journals (Sweden)

Eugênio Barbosa de Melo Júnior

2016-01-01

Full Text Available Objective: to analyze the association between high levels of stress and the frequency of cardiovascular risk factors in employees of a higher education institution. Methods: this is a cross-sectional study with 201 employees of a university. A form containing socioeconomic data, the International Physical Activity Questionnaire (short version, the Alcohol Use Disorders Identification Test and the Work Stress Scale were used for data collection. Data analysis was performed using the probability ratio and One-way analysis of variance tests. Results: worrisome frequencies of cardiovascular risk factors were identified, in which sedentary lifestyle, excess weight, and increased abdominal circumference presented the most expressive indexes. Regarding the stressors evaluated, some of the employees had increased stress indexes, distributed between the medium and high levels. Conclusion: sedentary lifestyle, excess weight, and increased abdominal circumference presented expressive high indexes, without statistically significant associations with the level of stress.

q-Gaussian distributions of leverage returns, first stopping times, and default risk valuations

Science.gov (United States)

Katz, Yuri A.; Tian, Li

2013-10-01

We study the probability distributions of daily leverage returns of 520 North American industrial companies that survive de-listing during the financial crisis, 2006-2012. We provide evidence that distributions of unbiased leverage returns of all individual firms belong to the class of q-Gaussian distributions with the Tsallis entropic parameter within the interval 1distributions imply a much higher probability of extreme movements in a company’s leverage ratio than forecasted by the normal distribution (q=1). Motivated by these findings, we develop a q-Gaussian generalization of traditional structural models of default. Derived exact analytical expressions for the probability distribution of a first stopping time and its intensity forecast significantly higher probability of default and much wider credit spreads at short time-horizons. Our findings are broadly consistent with the results of empirical studies in equity markets and are essential for single-name default forecasting as well as valuations of portfolio credit risk and economic capital, which might be underestimated by a classic theory of diversified portfolio optimization.

Reduced risk of Parkinson's disease associated with lower body mass index and heavy leisure-time physical activity.

Science.gov (United States)

Sääksjärvi, Katri; Knekt, Paul; Männistö, Satu; Lyytinen, Jukka; Jääskeläinen, Tuija; Kanerva, Noora; Heliövaara, Markku

2014-04-01

The risk factors for Parkinson's disease (PD) are not well established. We therefore examined the prediction of various lifestyle factors on the incidence of PD in a cohort drawn from the Finnish Mobile Clinic Health Examination Survey, conducted in 1973-1976. The study population comprised 6,715 men and women aged 50-79 years and free of PD at the baseline. All of the subjects completed a baseline health examination (including height and weight measurements) and a questionnaire providing information on leisure-time physical activity, smoking, and alcohol consumption. During a 22-year follow-up, 101 incident cases of PD occurred. The statistical analyses were based on Cox's model including age, sex, education, community density, occupation, coffee consumption, body mass index (BMI), leisure-time physical activity, smoking and alcohol consumption as independent variables. At first, BMI was not associated with PD risk, but after exclusion of the first 15 years of follow-up, an elevated risk appeared at higher BMI levels (P for trend 0.02). Furthermore, subjects with heavy leisure-time physical activity had a lower PD risk than those with no activity [relative risk (RR) 0.27, 95 % confidence interval (CI) 0.08-0.90]. In variance with findings for other chronic diseases, current smokers had a lower PD risk than those who had never smoked (RR 0.23, 95 % CI 0.08-0.67), and individuals with moderate alcohol intake (at the level of Parkinson's disease, but more research is needed.

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...

Descriptive Epidemiology of Sitting Time in Omani Men and Women: A Known Risk Factor for Non-Communicable Diseases

Directory of Open Access Journals (Sweden)

Ruth M. Mabry

2017-05-01

Full Text Available Objectives: Sedentary behaviors (too much sitting as distinct from too little exercise are associated with increased risk of non-communicable diseases. Identifying the prevalence and sociodemographic correlates of sitting time can inform public health policy and prevention strategies. Methods: A population-based national survey was carried out among Omani adults in 2008 (n = 2 977 using the Global Physical Activity Questionnaire, which included a measure of total sitting time. Bivariate and regression analyses examined the associations of total sitting time with sociodemographic correlates (gender, age, education, work status, marital status, place of residence, and wealth. Results: The proportion who sat for ≥ 7 hours/day was significantly higher in older than in younger adults (men: 22.0% vs. 14.6%, p < 0.010; women: 26.9% vs. 15.2%, p < 0.001, respectively. The odds ratio (OR for prolonged sitting was half for men who were not working compared to those who were (p < 0.050. For younger women, the OR for sitting ≥ 7 hours/day was nearly a third for educated women compared to least educated (p = 0.035. For older women, the OR for prolonged sitting was more than double for married women compared to unmarried (p < 0.001. Conclusions: One in five Omani adults was identified as sitting for prolonged periods, at levels understood to have deleterious health consequences. Higher-risk groups include older adults and working men. With sitting time identified as a key behavioral risk to be targeted for the prevention of non-communicable diseases, further research is needed to understand the factors associated with domain-specific sitting time in order to guide prevention programs and broader public health approaches.

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

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

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

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...

Time trends in osteoporosis risk factor profiles

DEFF Research Database (Denmark)

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

2016-01-01

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

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

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.

The peculiarities' study of higher education applicants' employment in pharmaceutical specialties of full-time training

Directory of Open Access Journals (Sweden)

A. A. Kotvitska

2017-08-01

Full Text Available Employment of applicants of pharmaceutical higher education has both positive and negative impact on the quality of educational services provided by institutions, especially in terms of knowledge and skills acquired by student. Objective is to study peculiarities of higher education employment, full-time training, and features driving them to conclude labor agreements. Materials and methods. During the study, we used juridical and comparative legal methods of analysis. Results. The study has defined the following features of the employment of applicants of higher education in the health care institutions, pharmaceutical enterprises and organizations. The current legislation provides the applicants of higher education enrolled in HEIs for full-time training with a right to make a free choice of the field of study, profession, type of occupation and work. The relationship developed between an applicant and higher education institutions are not to be regarded as an employment relationship. The working under the items of labor agreement for person who combine it with the full-time education is not a part or combination or sharing, and is considered the main place of job. Thus, it stipulates maintenance of records book of the employed worker according to the general procedure. An applicant of higher education has discretion to choose working hours (full- or part-time working day, full- or part-time working week with taking into consideration the HEIs schedule and only in the free time. When full-time operating in frameworks of collective agreement at enterprise, institution, or organization, having accounted peculiarities of operation, non-standardized working day for some positions can be set. The current legislation stipulates possibility of employment for persons without higher pharmaceutical education to the health care institutions on the clearly defined positions. Conclusions.The country authority has created and is providing favorable

Cost, Time, and Risk Assessment of Different Wave Energy Converter Technology Development Trajectories: Preprint

Energy Technology Data Exchange (ETDEWEB)

Weber, Jochem W [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Laird, Daniel [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Costello, Ronan [Wave Venture; Roberts, Jesse [Sandia National Laboratories; Bull, Diana [Sandia National Laboratories; Babarit, Aurelien [Ecole Centrale de Nantes; Nielsen, Kim [Ramboll; Ferreira, Claudio Bittencourt [DNV-GL; Kennedy, Ben [Wave Venture

2017-09-14

This paper presents a comparative assessment of three fundamentally different wave energy converter technology development trajectories. The three technology development trajectories are expressed and visualised as a function of technology readiness levels and technology performance levels. The assessment shows that development trajectories that initially prioritize technology readiness over technology performance are likely to require twice the development time, consume a threefold of the development cost, and are prone to a risk of technical or commercial failure of one order of magnitude higher than those development trajectories that initially prioritize technology performance over technology readiness.

High occupational physical activity and risk of ischaemic heart disease in women: the interplay with physical activity during leisure time.

Science.gov (United States)

Allesøe, Karen; Holtermann, Andreas; Aadahl, Mette; Thomsen, Jane F; Hundrup, Yrsa A; Søgaard, Karen

2015-12-01

Recent studies indicate that physically demanding work is a risk factor for heart disease among men, especially those with low or moderate physical activity during leisure time. Among women, present evidence is inconclusive. The design was a prospective cohort study. This investigation in the Danish Nurse Cohort Study included 12,093 female nurses aged 45-64 years, who answered a self-report questionnaire on physical activity at work and during leisure time, known risk factors for ischaemic heart disease (IHD) and occupational factors at baseline in 1993. Information on the 15-year incidence of IHD was obtained by individual linkage in the National Register of Hospital Discharges to 2008. During follow-up 580 participants were hospitalised with IHD. A significant interaction between occupational and leisure time physical activity was found with the lowest risk of IHD among nurses with the combination of moderate physical activity at work and vigorous physical activity during leisure time. Compared to this group high physical activity at work was associated with a higher risk of IHD at all levels of physical activity during leisure time increasing from hazard ratio 1.75 (95% confidence interval (CI) 1.10-2.80) among nurses with vigorous physical activity during leisure time to 2.65 (95% CI 1.44-4.88) among nurses being sedentary during leisure time. This study among Danish nurses suggests that high physical activity at work is a risk factor for IHD among women. Vigorous physical activity during leisure time lowered but did not completely counteract the adverse effect of occupational physical activity on risk of IHD. © The European Society of Cardiology 2014.

Youth screen-time behaviour is associated with cardiovascular risk in young adulthood

DEFF Research Database (Denmark)

Grøntved, Anders; Ried-Larsen, Mathias; Møller, Niels Christian

2014-01-01

= 435) followed for up to 12 years. Adiposity, blood pressure (BP), triglycerides, high-density lipoprotein (HDL), glucose, insulin, and self-reported TV viewing and computer use were obtained in adolescence and in young adulthood. A continuous metabolic syndrome z-score was calculated as the sum...... of standardized values of each risk factor (inverse of HDL). In multivariable-adjusted analyses, TV viewing and total screen time in adolescence were positively associated with adiposity, triglycerides, and metabolic syndrome z-score in young adulthood (p ..., computer use, or total screen time with more than 2 hours/day from adolescence to young adulthood had 0.90 (95% CI 0.12 to 1.69), 0.95 (95% CI 0.01 to 1.88), and 1.40 (95% CI 0.28 to 2.51) kg/m(2) higher body mass index, respectively, in young adulthood compared with individuals who remained stable...

Separate and joint associations of occupational and leisure-time sitting with cardio-metabolic risk factors in working adults: a cross-sectional study.

Directory of Open Access Journals (Sweden)

Madina Saidj

Full Text Available BACKGROUND: The workplace is a main setting for prolonged sitting for some occupational groups. Convincing evidence has recently accumulated on the detrimental cardio-metabolic health effects of leisure-time sitting. Yet, much less is known about occupational sitting, and the potential health risk attached compared to leisure-time sitting. OBJECTIVE: To explore the separate and joint associations of occupational and leisure-time sitting with cardio-metabolic risk factors in working adults. METHODS: All working adults (N = 2544 from the Health2006, a Danish population-based study, were included in this cross-sectional study. Participants reported hours of sitting during work, during leisure-time along with socio-demographic and behavioral characteristics, including physical activity. Cardio-metabolic risk factors (waist circumference, body mass index, body fat percentage, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, insulin, hemoglobin A1c and plasma glucose were measured. Associations were explored by linear regression for leisure-time, occupational, and overall sitting time. RESULTS: Statistically significant (p<.05 detrimental associations of leisure-time sitting were observed with all cardio-metabolic risk factors, except hemoglobin A1c and plasma glucose. Similarly, occupational sitting time was significantly detrimentally associated with HDL cholesterol, triglycerides, and insulin. For categories of sitting time, a joint adverse association of sitting much during both work-time and leisure-time was observed. CONCLUSION: The associations of occupational sitting time with cardio-metabolic risk factors were fewer and weaker compared to leisure-time sitting. Yet, the joint associations of occupational and leisure-time sitting with cardio-metabolic risk factors were higher than the separate. Our findings amplify the need for further focus in this area prior to making assumptions about equivalent health risks across

Separate and joint associations of occupational and leisure-time sitting with cardio-metabolic risk factors in working adults: a cross-sectional study.

Science.gov (United States)

Saidj, Madina; Jørgensen, Torben; Jacobsen, Rikke K; Linneberg, Allan; Aadahl, Mette

2013-01-01

The workplace is a main setting for prolonged sitting for some occupational groups. Convincing evidence has recently accumulated on the detrimental cardio-metabolic health effects of leisure-time sitting. Yet, much less is known about occupational sitting, and the potential health risk attached compared to leisure-time sitting. To explore the separate and joint associations of occupational and leisure-time sitting with cardio-metabolic risk factors in working adults. All working adults (N = 2544) from the Health2006, a Danish population-based study, were included in this cross-sectional study. Participants reported hours of sitting during work, during leisure-time along with socio-demographic and behavioral characteristics, including physical activity. Cardio-metabolic risk factors (waist circumference, body mass index, body fat percentage, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, insulin, hemoglobin A1c and plasma glucose) were measured. Associations were explored by linear regression for leisure-time, occupational, and overall sitting time. Statistically significant (pleisure-time sitting were observed with all cardio-metabolic risk factors, except hemoglobin A1c and plasma glucose. Similarly, occupational sitting time was significantly detrimentally associated with HDL cholesterol, triglycerides, and insulin. For categories of sitting time, a joint adverse association of sitting much during both work-time and leisure-time was observed. The associations of occupational sitting time with cardio-metabolic risk factors were fewer and weaker compared to leisure-time sitting. Yet, the joint associations of occupational and leisure-time sitting with cardio-metabolic risk factors were higher than the separate. Our findings amplify the need for further focus in this area prior to making assumptions about equivalent health risks across sedentary behaviors. To our knowledge, this is the first study to contrast the deleterious associations of

Anti-inflammatory treatment and risk for depression after first-time stroke in a cohort of 147 487 Danish patients

DEFF Research Database (Denmark)

Wium-Andersen, Ida Kim; Wium-Andersen, Marie Kim; Jørgensen, Martin Balslev

2017-01-01

after stroke. METHODS: A register-based cohort including all patients admitted to hospital with a first-time stroke from Jan. 1, 2001, through Dec. 31, 2011, and a nonstroke population with a similar age and sex distribution was followed for depression until Dec. 31, 2014. Depression was defined...... stroke but a higher risk for late depression. This suggests that inflammation contributes differently to the development of depression after stroke depending on the time of onset.......BACKGROUND: Depression is a common complication after stroke, and inflammation may be a pathophysiological mechanism. This study examines whether anti-inflammatory treatment with acetylsalicylic acid (ASA), nonsteroid anti-inflammatory drugs (NSAIDs) or statins influence the risk of depression...

Term-time Employment and Student Attainment in Higher Education

Directory of Open Access Journals (Sweden)

Cath Dennis

2018-04-01

Full Text Available The number of UK full-time university students engaging in term-time employment (TTE is rising. Students engaging in TTE have previously been found to achieve less well academically than those who do not. This study aimed to explore patterns of TTE and academic achievement of undergraduates at a large UK higher education institution. Self-reported TTE hours were matched to attainment data for 1304 undergraduate students in levels 1-4 of study (SQCF levels 7-10. The majority of students in TTE (71%, n=621 reported undertaking TTE to cover essential living expenses. Compared to students not undertaking TTE, attainment was significantly better at low levels of TTE (1-10 hours, and only significantly worse when TTE was >30 hours/week. This pattern was magnified when job type was taken into account – students employed in skilled roles for ≤10 hours/week on average attained grades 7% higher than those not in TTE; students working >10 hours/week in unskilled positions showed a mean 1.6% lower grade. The impact of ‘academic potential’ (measured via incoming UCAS tariff was accounted for in the model. The finding that students engaging in some categories of TTE achieve better academic outcomes than their non-employed peers is worthy of further investigation. This study is unable to provide direct evidence of possible causation, but would tentatively suggest that students may benefit from taking on 10 or fewer hours of TTE per week.

The Supply of Part-Time Higher Education in the UK. Research Report

Science.gov (United States)

Callender, Claire; Birkbeck, Anne Jamieson; Mason, Geoff

2010-01-01

This report explores the supply of part-time higher education in the UK, with particular consideration to the study of part-time undergraduate provision in England. It is the final publication in the series of reports on individual student markets that were commissioned by Universities UK following the publication of the reports on the Future size…

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)

Risk and Threat via Online Social Network among Academia at Higher Education

Science.gov (United States)

Shaker Hussain, Hanizan; Din, Roshidi; Zulkarnaen Khidzir, Nik; Azhar Mat Daud, Khairul; Ahmad, Suzastri

2018-05-01

The evolution of information and communication technologies (ICT) nowadays has changed the life style of human living. The current modern societies have adopted ICT as an important thing that they are really needed in their life, especially as a tool to be used for communications activity. However, unfortunately ICT also exposed its user in circumstances of risk, threats and vulnerability. This paper will discuss the risk and threats to the users who are using social media as a medium to communicate. In this paper, the fraction of user will be divided by two types which are gender and working experience. The data that obtained from the distributed of questionnaires among respondent will be analysed by using SPSS. Data will be analysed by using two-way ANOVA statistic in order to examine the significant level in between gender and working experience as an independent variable in this study with the level of threats in cybersecurity risk towards lecturers who are working in higher education institutions in Malaysia. This article also will provide an empirical data and will be referred to another researcher in the future for their further research perhaps.

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

Science.gov (United States)

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.

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)

Weight patterns in children with higher risk ALL: A report from the Children's Oncology Group (COG) for CCG 1961.

Science.gov (United States)

Withycombe, Janice S; Post-White, Janice E; Meza, Jane L; Hawks, Ria G; Smith, Lynette M; Sacks, Nancy; Seibel, Nita L

2009-12-15

This retrospective analysis defined and described patterns and predictors of weight change during treatment in children with acute lymphocytic leukemia (ALL) with high-risk features who received treatment on Children's Cancer Group protocol CCG 1961. Patients (1,638) were enrolled in CCG 1961 from November 1996 to May 2002. Weight was measured as BMI percent (%), specific for age and gender, and defined as 100 x ln(BMI/median BMI). By the end of treatment, 23% of children were obese (BMI >or=95%), compared with 14% at diagnosis. Children who received post-induction intensified therapy (arms C, D, SER with Doxorubicin or Idarubicin) had higher gastrointestinal toxicities and lower BMI% from consolidation through interim maintenance 1. BMI% then increased for all arms between delayed intensification and maintenance 1 or 2. Children who were of Black or Hispanic race, obese at diagnosis, or who had grade 3 or 4 pancreatitis/glucose toxicities during induction had higher BMI% throughout treatment. Children were more likely to be obese at the end of the study if they were aged 5-9 years at diagnosis or female gender. Cranial radiation was not a predictor of obesity. Successful treatment of higher risk childhood ALL was associated with obesity, independent of cranial irradiation. The beginning of maintenance therapy may be the best time to intervene with nutritional and behavioral interventions, particularly for children who are obese or aged 5-9 years at diagnosis, female, Black or Hispanic, or those with metabolic toxicities during induction. (c) 2009 Wiley-Liss, Inc.

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

[Association of T174M polymorphism of the angiotensinogen gene with the higher risk of cerebral stroke in women].

Science.gov (United States)

Stetskaia, T A; Bushueva, O Iu; Bulgakova, I V; Vialykh, E K; Shuteeva, T V; Biriukov, A E; Ivanov, V P; Polonikov, A V

2014-01-01

To study the association of M235T (rs699) and T174M (rs4762) polymorphisms of the angiotensinogen (AGT) gene with the risk of cerebral stroke (CS) in the Russians of the Central Chernozem Region. A total of 638 DNA samples obtained from 353 patients with CS and 285 sex- and age-matched healthy individuals were examined. The polymorphisms were genotyped by polymerase chain reaction (T174M) and TaqMan allelic discrimination (M235T) assays. Heterozygous AGT 174TM genotype carriers were found to be at a higher risk for CS (odd ratio (OR) = 1.52; 95% confidence interval (CI), 1.08-2.15; p = 0.02). A gender-stratified analysis showed that the mutant 174M allele (OR = 1.86; 95% CI, 1.14-3.03, p = 0.01) and variant 174TM and 174MM genotypes (OR = 1.86; 95% CI, 1.09-3.20; p = 0.02) were associated with the higher risk of cerebral stroke in women. The association of AGT T174M polymorphism with the risk of CS was first found; but the higher risk of the disease in the carriers of variant alleles and genotypes was observed in the women only.

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,

Efficacy of adjuvant therapy with 3.7 GBq radioactive iodine in intermediate-risk patients with 'higher risk features' and predictive value of postoperative nonstimulated thyroglobulin.

Science.gov (United States)

Rosario, Pedro W; Mourão, Gabriela F; Calsolari, Maria Regina

2016-11-01

This study evaluated the efficacy of adjuvant therapy with 3.7 GBq radioactive iodine (RAI) in patients with papillary thyroid carcinoma (PTC) of intermediate risk with higher risk features and determined the predictive value of postoperative nonstimulated thyroglobulin (Tg). This was a prospective study including 85 patients with PTC of intermediate risk and higher risk features: tumor greater than 1 cm and aggressive histological subtype or vascular invasion; and/or more than three positive lymph node (LN) or LN greater than 1.5 cm or showing macroscopic extracapsular extension; and/or a combination of tumor greater than 4 cm, microscopic extrathyroidal extension, aggressive histology, and LN metastases (cN1). After thyroidectomy, all patients had nonstimulated Tg of at least 0.3 ng/ml and ultrasonography showed no anomalies. When evaluated 12 months after RAI therapy, an excellent response to initial therapy was achieved in 61 patients (71.7%). Structural disease was detected in five patients (5.9%). During follow-up, 6/80 patients (7.5%) without structural disease 1 year after RAI developed relapse. In the last assessment, 80 patients (94.1%) had nonstimulated Tg less than 1 ng/ml and no evidence of structural disease. There was no case of death because of the tumor. Postoperative nonstimulated Tg was a predictive factor of the main outcome (structural disease 1 year after RAI or recurrence) and the best cut-off was 1.8 ng/ml (sensitivity: 72.7%, specificity: 83.4%, negative predictive value: 95.4%). In patients with PTC of intermediate risk with higher risk features treated with 3.7 GBq RAI, postoperative nonstimulated Tg up to 1.8 ng/ml was a predictor of low risk of structural disease 1 year after therapy or recurrence.

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.

Higher Education Institution Leaders' Identity Constructions in Times of Changing Structures and Legislation

Science.gov (United States)

Tigerstedt, Christa

2016-01-01

The focus in this paper is on the leadership of higher education institutions (HEI) in Finland and more specifically on the rector's leadership. The higher education sector is undergoing many changes and has been so for a long time. How, then, do the current changes become visible from a leadership perspective? The leadership discourse is here…

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...

Time-dependent risks of cancer clustering among couples: a nationwide population-based cohort study in Taiwan.

Science.gov (United States)

Wang, Jong-Yi; Liang, Yia-Wen; Yeh, Chun-Chen; Liu, Chiu-Shong; Wang, Chen-Yu

2018-02-21

Spousal clustering of cancer warrants attention. Whether the common environment or high-age vulnerability determines cancer clustering is unclear. The risk of clustering in couples versus non-couples is undetermined. The time to cancer clustering after the first cancer diagnosis is yet to be reported. This study investigated cancer clustering over time among couples by using nationwide data. A cohort of 5643 married couples in the 2002-2013 Taiwan National Health Insurance Research Database was identified and randomly matched with 5643 non-couple pairs through dual propensity score matching. Factors associated with clustering (both spouses with tumours) were analysed by using the Cox proportional hazard model. Propensity-matched analysis revealed that the risk of clustering of all tumours among couples (13.70%) was significantly higher than that among non-couples (11.84%) (OR=1.182, 95% CI 1.058 to 1.321, P=0.0031). The median time to clustering of all tumours and of malignant tumours was 2.92 and 2.32 years, respectively. Risk characteristics associated with clustering included high age and comorbidity. Shared environmental factors among spouses might be linked to a high incidence of cancer clustering. Cancer incidence in one spouse may signal cancer vulnerability in the other spouse. Promoting family-oriented cancer care in vulnerable families and preventing shared lifestyle risk factors for cancer are suggested. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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....

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,

ON THE EMPIRICAL FINDING OF A HIGHER RISK OF POVERTY IN RURAL AREAS: IS RURAL RESIDENCE ENDOGENOUS TO POVERTY?

OpenAIRE

Fisher, Monica G.

2004-01-01

Includes: On the Empirical Finding of a Higher Risk of Poverty in Rural Areas: Is Rural Residence Endogenous to Poverty?:COMMENT, by Thomas A. Hirschl; On the Empirical Finding of a Higher Risk of Poverty in Rural Areas: Is Rural Residence Endogenous to Poverty?: REPLY, by Monica Fisher. Research shows people are more likely to be poor in rural versus urban America. Does this phenomenon partly reflect that people who choose rural residence have unmeasured attributes related to human impoveris...

Why do perfectionists have a higher burnout risk than others? The mediational effect of workaholism

Directory of Open Access Journals (Sweden)

van Beek, Ilona

2010-04-01

Full Text Available Previous research has revealed that perfectionists have a higher burnout risk than others, but the mechanisms accounting for this association have rarely been examined. The present study proposes that workaholism mediates this relation, as previous research revealed that (a perfectionists are more likely to be workaholics than others, and (b workaholics have a higher burnout risk than others. Using cross-sectional data from 199 Dutch managers, regression analyses revealed that holding high standards towards oneself (a self-directed indicator of perfectionism was unrelated to any of the three dimensions of the Maslach Burnout Inventory. However, high concern over making mistakes in the face of others (representing socially prescribed perfectionism was systematically associated with high levels of burnout and workaholism. Moreover, workaholism was positively associated with high levels of exhaustion. Subsequent mediation analysis revealed that the association between (the socially prescribed aspect of perfectionism and burnout (emotional exhaustion was mediated by workaholism.

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

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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.

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)

Diet quality is associated with leisure-time physical activity in individuals at cardiometabolic risk.

Science.gov (United States)

Monfort-Pires, Milena; Salvador, Emanuel P; Folchetti, Luciana D; Siqueira-Catania, Antonela; Barros, Camila R; Ferreira, Sandra Roberta Gouvea

2014-01-01

We investigated whether diet quality was associated with leisure-time physical activity (LTPA) and television viewing and the associations of these variables with traditional cardiovascular risk factors and novel biomarkers in individuals at cardiometabolic risk. A total of 193 prediabetic adults (63.7% women, mean age 54.1 years), screened for a diabetes prevention program in Brazil, participated in this cross-sectional study. Clinical data and blood samples were collected for several determinations. Twenty-four-hour recalls were used to calculate the Healthy Eating Index (HEI) adapted to Brazilian dietary habits and the International Physical Activity Questionnaire to assess physical activity level. Analysis of covariance with adjustments for age and body mass index (BMI) was employed to test associations across categories of LTPA and television viewing. Stratifying according to LTPA categories, the most active subset (≥150 minutes/week) showed better HEI scores after adjustments (64.6 ± 11.0, 65.1 ± 10.3, and 68.6 ± 10.8, p = 0.02) and significant higher values of dark green and orange vegetables but not of whole grains (p = 0.06). Active individuals had lower BMI, waist circumference, inflammatory markers, and better insulin sensitivity (p physical activity [PA]), with those with unhealthy habits revealing better anthropometric and cardiometabolic profiles in the former group. Diet quality assessed by the HEI adapted for Brazilian eating habits attained significance in differentiating more active from inactive at-risk individuals during leisure time. Time watching television, as a surrogate of sedentary behavior, is not useful to detect unhealthy diet quality. LTPA is indicative of better cardiometabolic profile reflected by lipid and inflammatory markers and index of insulin resistance.

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

Science.gov (United States)

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

2016-10-07

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

Mainstreaming disaster risk management in higher education

Directory of Open Access Journals (Sweden)

MARCIA VILLASANA

Full Text Available Universities should actively participate in disseminating and fostering a culture for disaster risk management (DRM among students and the community. Particularly in countries with high levels of risk, education plays a key role in raising awareness on the importance of preventing and implementing conscious risk management. Though the incorporation of DRM into the curricula, education programs become a mechanism to prepare students from a perspective of strengthening of values, citizenship, and social sensibility towards how disaster represents a disruption of the functioning of a community and impairs business activity. This paper presents the proposal for the integration of DRM of a private university in Mexico, one of the countries particularly susceptible to extreme hydrometereological and geological events. The proposal includes a concentration area for undergraduate business students, a mandatory introductory course for all business majors, and for the business community an executive education program for SMEs

Gender inequality in the risk of violence: material deprivation is linked to higher risk for adolescent girls.

Science.gov (United States)

Nasr, Inas; Sivarajasingam, Vaseekaran; Jones, Sarah; Shepherd, Jonathan

2010-11-01

To investigate the association between material deprivation and injury sustained in violence by adolescents aged 11-17 years. Computerised data relating to gender, attendance date and resident postcode of all patients aged 11-17 years who received treatment for violence-related injuries at seven emergency departments (ED) in South Wales over 12 months, 1 October 2005 to 30 September 2006, were studied. The resident populations, by electoral division of three unitary authorities in Wales, Cardiff, Swansea and Newport, were obtained from the NHS administrative register. The relationships between demographic variables and material deprivation as measured by the Townsend deprivation index were analysed. Altogether 699 (475 boys; 224 girls) adolescents aged 11-17 years resident in Cardiff, Swansea and Newport attended ED in South Wales following violence. Boys and girls living in the most deprived areas had higher assault injury rates compared with those living in the most affluent areas. In the context of sustaining violence-related injury, material deprivation affected girls aged 11-17 years to a much greater extent (Cardiff most deprived vs most affluent rate ratio 6.31, Swansea 10.11, Newport 2.90) than boys of the same age group (Cardiff most deprived vs most affluent rate ratio 2.02, Swansea 7.74, Newport 1.74). Material deprivation was associated with a higher risk of violence-related injury for adolescent girls compared with adolescent boys. Risk-taking behaviour for adolescent boys and girls may be different under different socioeconomic conditions. Violence prevention efforts should focus more on tackling neighbourhood inequalities, particularly those related to material deprivation in adolescent girls.

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 assessment of environmentally influenced airway diseases based on time-series analysis.

Science.gov (United States)

Herbarth, O

1995-09-01

Threshold values are of prime importance in providing a sound basis for public health decisions. A key issue is determining threshold or maximum exposure values for pollutants and assessing their potential health risks. Environmental epidemiology could be instrumental in assessing these levels, especially since the assessment of ambient exposures involves relatively low concentrations of pollutants. This paper presents a statistical method that allows the determination of threshold values as well as the assessment of the associated risk using a retrospective, longitudinal study design with a prospective follow-up. Morbidity data were analyzed using the Fourier method, a time-series analysis that is based on the assumption of a high temporal resolution of the data. This method eliminates time-dependent responses like temporal inhomogeneity and pseudocorrelation. The frequency of calls for respiratory distress conditions to the regional Mobile Medical Emergency Service (MMES) in the city of Leipzig were investigated. The entire population of Leipzig served as a pool for data collection. In addition to the collection of morbidity data, air pollution measurements were taken every 30 min for the entire study period using sulfur dioxide as the regional indicator variable. This approach allowed the calculation of a dose-response curve for respiratory diseases and air pollution indices in children and adults. Significantly higher morbidities were observed above a 24-hr mean value of 0.6 mg SO2/m3 air for children and 0.8 mg SO2/m3 for adults.(ABSTRACT TRUNCATED AT 250 WORDS)

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.

The interplay between physical activity at work and during leisure time - risk of ischemic heart disease and all-cause mortality in middle-aged Caucasian men

DEFF Research Database (Denmark)

Holtermann, A.; Mortensen, O.S.; Burr, H.

2009-01-01

Objective our aim was to test the hypothesis that a high level of physical activity during leisure time increases the risk of ischemic heart disease (IHD) mortality among men with high physical work demands. Methods We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 caueasian......, male workers aged 40-59 years; 274 men with overt cardiovascular disease were excluded from the follow-up. Results During the follow-up period, 591 men (11.9%) died from IIID. Cox analyses of men with low (N=1236), medium (N=2651), and high (N=858) physical work demands showed that those with high...... demands had a higher risk of IHD mortality compared to men with low demands [age-adjusted hazard ratio 1.51, 95% confidence interval (95% CI) 1 18-1.94]. In all three groups, men with a low level of physical activity during leisure time had a higher risk of IHD than men with a medium or high level Overall...

The interplay between physical activity at work and during leisure time--risk of ischemic heart disease and all-cause mortality in middle-aged Caucasian men

DEFF Research Database (Denmark)

Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann

2009-01-01

OBJECTIVE: Our aim was to test the hypothesis that a high level of physical activity during leisure time increases the risk of ischemic heart disease (IHD) mortality among men with high physical work demands. METHODS: We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 caucasian......, male workers aged 40-59 years; 274 men with overt cardiovascular disease were excluded from the follow-up. RESULTS: During the follow-up period, 591 men (11.9%) died from IHD. Cox analyses of men with low (N=1236), medium (N=2651), and high (N=858) physical work demands showed that those with high...... demands had a higher risk of IHD mortality compared to men with low demands [age-adjusted hazard ratio 1.51, 95% confidence interval (95% CI) 1.18-1.94]. In all three groups, men with a low level of physical activity during leisure time had a higher risk of IHD than men with a medium or high level...

Risky Business: An Integrated Institutional Theory for Understanding High-Risk Decision Making in Higher Education

Science.gov (United States)

Turner, Lauren A.; Angulo, A. J.

2018-01-01

Lauren A. Turner and A. J. Angulo explore how institutional theory can be applied to explain variance in higher education organizational strategies. Given strong regulatory, normative, and cultural-cognitive pressures to conform, they ask, why do some colleges engage in high-risk decision making? To answer this, they bring together classic and…

Does the duration and time of sleep increase the risk of allergic rhinitis? Results of the 6-year nationwide Korea youth risk behavior web-based survey.

Directory of Open Access Journals (Sweden)

Jeoung A Kwon

Full Text Available Allergic rhinitis (AR is the most common chronic disorder in the pediatric population. Although several studies have investigated the correlation between AR and sleep-related issues, the association between the duration and time of sleep and AR has not been analyzed in long-term national data. This study investigated the relationship between sleep time and duration and AR risk in middle- and high-school students (adolescents aged 12-18. We analyzed national data from the Korea Youth Risk Behavior Web-based Survey by the Korea Centers for Disease Control and Prevention from 2007-2012. The sample size was 274,480, with an average response rate of 96.2%. Multivariate logistic regression analyses were conducted to determine the relationship between sleep and AR risk. Furthermore, to determine the best-fitted model among independent variables such as sleep duration, sleep time, and the combination of sleep duration and sleep time, we used Akaike Information Criteria (AIC to compare models. A total of 43,337 boys and 41,665 girls reported a diagnosis of AR at baseline. The odds ratio increased with age and with higher education and economic status of the parents. Further, students in mid-sized and large cities had stronger relationships to AR than those in small cities. In both genders, AR was associated with depression and suicidal ideation. In the analysis of sleep duration and sleep time, the odds ratio increased in both genders when sleep duration was <7 hours, and when the time of sleep was later than 24:00 hours. Our results indicate an association between sleep time and duration and AR. This study is the first to focus on the relationship between sleep duration and time and AR in national survey data collected over 6 years.

Does Smoking History Confer a Higher Risk for Reconstructive Complications in Nipple-Sparing Mastectomy?

Science.gov (United States)

Frey, Jordan D; Alperovich, Michael; Levine, Jamie P; Choi, Mihye; Karp, Nolan S

2017-07-01

History of smoking has been implicated as a risk factor for reconstructive complications in nipple-sparing mastectomy (NSM), however there have been no direct analyses of outcomes in smokers and nonsmokers. All patients undergoing NSM at New York University Langone Medical Center from 2006 to 2014 were identified. Outcomes were compared for those with and without a smoking history and stratified by pack-year smoking history and years-to-quitting (YTQ). A total of 543 nipple-sparing mastectomies were performed from 2006 to 2014 with a total of 49 in patients with a history of smoking. Reconstructive outcomes in NSM between those with and without a smoking history were equivalent. Those with a smoking history were not significantly more likely to have mastectomy flap necrosis (p = 0.6251), partial (p = 0.8564), or complete (p = 0.3365) nipple-areola complex (NAC) necrosis. Likewise, active smokers alone did not have a higher risk of complications compared to nonsmokers or those with smoking history. Comparing nonsmokers and those with a less or greater than 10 pack-year smoking history, those with a > 10 pack-year history had significantly more complete NAC necrosis (p = 0.0114, smoking history or >5 YTQ prior to NSM were equivalent to those without a smoking history. We demonstrate that NSM may be safely offered to those with a smoking history although a > 10 pack-year smoking history or <5 YTQ prior to NSM may impart a higher risk of reconstructive complications, including complete NAC necrosis. © 2017 Wiley Periodicals, Inc.

Orthopedic Surgery among Patients with Rheumatoid Arthritis: A Population-based study to Identify Risk factors, Sex differences, and Time trends.

Science.gov (United States)

Richter, Michael; Crowson, Cynthia S; Matteson, Eric L; Makol, Ashima

2017-12-20

To identify risk factors for large joint (LJS) versus small joint surgery (SJS) in rheumatoid arthritis (RA) and evaluate trends in surgery rates over time. A retrospective medical record review was performed of all orthopedic surgeries following first fulfillment of 1987 ACR criteria for adult-onset RA among residents of Olmsted County, Minnesota, USA in 1980-2013. Risk factors were examined using Cox models adjusted for age, sex and calendar year of RA incidence. Trends in incidence of joint surgeries were examined using Poisson regression models. A total of 1077 patients with RA (mean age 56 years, 69% female, 66% seropositive) were followed for a median of 10.7 years during which 112 (90 women) underwent at least one SJS and 204 (141 women) underwent at least one LJS. Risk factors included advanced age, rheumatoid factor and anti-CCP antibody positivity for both SJS and LJS, and BMI≥30 kg/m 2 for LJS. Risk factors for SJS and LJS at any time during follow-up included the presence of radiographic erosions, large joint swelling, and methotrexate use. SJS rates decreased by calendar year of incidence (hazard ratio 0.53; p=0.001), with significant decline in SJS after 1995. The cumulative incidence of SJS was higher in women than men (p=0.008). In recent years, there has been a significant decline in rates of SJS but not LJS in patients with RA. The incidence of SJS is higher among women. Traditional RA risk factors are strong predictors for SJS and LJS. Increasing age and obesity are predictive of LJS. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

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.

Getting Your Ducks in a Row: IT Governance, Risk, and Compliance Programs in Higher Education

Science.gov (United States)

Bichsel, Jacqueline; Feehan, Patrick

2014-01-01

Higher education IT governance, risk, and compliance (GRC) programs are in the development stage. Few institutions have all three programs in place, and many institutions are unclear where they should start when instituting or maturing their IT GRC programs. In addition, they are often uncertain as to whether GRC programs should be developed in…

Risks and perceptions

International Nuclear Information System (INIS)

Lee, T.

1987-01-01

The article on the risks and perceptions of nuclear power was previously published in the Times Higher Education Supplement, May 1987. The public attitude towards risks associated with nuclear power, compared with other risks in everyday life, is examined. Results of psychological studies of the perceived risk of nuclear power are also discussed. The author argues that fear of nuclear catastrophe is not one which can be brushed aside by statistics or punditry. (UK)

Higher morale is associated with lower risk of depressive disorders five years later among very old people.

Science.gov (United States)

Niklasson, Johan; Näsman, Marina; Nyqvist, Fredrica; Conradsson, Mia; Olofsson, Birgitta; Lövheim, Hugo; Gustafson, Yngve

The aim of this study was to investigate whether higher morale, i.e. future-oriented optimism, at baseline was associated with lower risk of depressive disorders five years later among very old people.Methods The Umeå85+/GErontological Regional Database, a population-based study with a longitudinal design, recruited participants in Sweden and Finland aged 85, 90 and ≥95 years. The sample in the present study included 647 individuals (89.1±4.4 years (Mean±SD), range 85-103). After five years, 216 were alive and agreed to a follow-up (92.6±3.4 years, range 90-104). The Philadelphia Geriatric Center Morale Scale (PGCMS) was used to assess morale. The depressive disorder diagnosis was determined according to DSM-IV based on medical records and interview data including assessment scales for depressive disorders. A number of sociodemographic, functional and health-related variables were analysed as possible confounders.Results For those with no depressive disorders at baseline, the only baseline variable significantly associated with depressive disorders five years later was the PGCMS score. A logistic regression model showed lower risk of depressive disorders five years later with higher baseline PGCMS scores (odds ratio 0.779 for one point increase in PGCMS, pfive years later).Conclusion Our results indicate that the higher the morale, the lower the risk of depressive disorders five years later among very old people. The PGCMS seems to identify those very old individuals at increased risk of depressive disorders five years later. Preventive measures could befocused on this group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

On a higher order multi-term time-fractional partial differential equation involving Caputo-Fabrizio derivative

OpenAIRE

Pirnapasov, Sardor; Karimov, Erkinjon

2017-01-01

In the present work we discuss higher order multi-term partial differential equation (PDE) with the Caputo-Fabrizio fractional derivative in time. We investigate a boundary value problem for fractional heat equation involving higher order Caputo-Fabrizio derivatives in time-variable. Using method of separation of variables and integration by parts, we reduce fractional order PDE to the integer order. We represent explicit solution of formulated problem in particular case by Fourier series.

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

The Prevalence of Cardiovascular Disease Risk Factors and the Framingham Risk Score in Patients Undergoing Percutaneous Intervention Over the Last 17 Years by Gender: Time-trend Analysis From the Mayo Clinic PCI Registry

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Moo-Sik Lee

2014-07-01

Full Text Available Objectives: This study aims to investigate trends of cardiovascular disease (CVD risk factor profiles over 17 years in percutaneous coronary intervention (PCI patients at the Mayo Clinic. Methods: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Results: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for β-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Conclusions: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.

Does the duration and time of sleep increase the risk of allergic rhinitis? Results of the 6-year nationwide Korea youth risk behavior web-based survey.

Science.gov (United States)

Kwon, Jeoung A; Lee, Minjee; Yoo, Ki-Bong; Park, Eun-Cheol

2013-01-01

Allergic rhinitis (AR) is the most common chronic disorder in the pediatric population. Although several studies have investigated the correlation between AR and sleep-related issues, the association between the duration and time of sleep and AR has not been analyzed in long-term national data. This study investigated the relationship between sleep time and duration and AR risk in middle- and high-school students (adolescents aged 12-18). We analyzed national data from the Korea Youth Risk Behavior Web-based Survey by the Korea Centers for Disease Control and Prevention from 2007-2012. The sample size was 274,480, with an average response rate of 96.2%. Multivariate logistic regression analyses were conducted to determine the relationship between sleep and AR risk. Furthermore, to determine the best-fitted model among independent variables such as sleep duration, sleep time, and the combination of sleep duration and sleep time, we used Akaike Information Criteria (AIC) to compare models. A total of 43,337 boys and 41,665 girls reported a diagnosis of AR at baseline. The odds ratio increased with age and with higher education and economic status of the parents. Further, students in mid-sized and large cities had stronger relationships to AR than those in small cities. In both genders, AR was associated with depression and suicidal ideation. In the analysis of sleep duration and sleep time, the odds ratio increased in both genders when sleep duration was sleep was later than 24:00 hours. Our results indicate an association between sleep time and duration and AR. This study is the first to focus on the relationship between sleep duration and time and AR in national survey data collected over 6 years.

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

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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.

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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.

Risk-associated health disorders occuring in junior schoolchildren who attend schools with higher stress and intensity of educational process

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N.V. Zaitseva

2017-03-01

Full Text Available We performed comparative sanitary-hygienic assessment of regime, stress and intensity of educational process in different educational establishments, a comprehensive secondary school and an innovative educational establishment - lyceum. We detected that studying regime tended to be tight, classes were longer and more intense than in an ordinary school, and educational process involved considerable intellectual, sensory and emotional loads for children; such loads reached "1st category intense" level. Schoolchildren attending lyceums are also busy with additional educational programs and it significantly increases length of total educational load on them. By the end of a school year 20% of lyceum pupils suffer from sympathoadrenal system overstress and it doesn't only determine emotional tonus level in children but also leads to disorders in concentration and decision-making speed, lower reading speed and articulation, slower motor reactions. 15% of lyceum pupils have higher activity of autonomous nervous system and lower adaptation of cardiovascular system to psycho emotional and physical loads. Lyceum pupils also run 2.5 times higher risk of chronic nervous system diseases evolvement than school children attending ordinary schools. Autonomous nervous system disorders, posture disorders and nutrition disorders are predominant nosologic pathology forms in lyceum pupils as they occur in them 1.6-2.9 times more frequent than in schoolchildren of the same age who attend an ordinary comprehensive school. We detected direct correlation between higher intellectual and emotional components of educational process, and total educational intensity as well, and frequency of autonomous system disorders and musculoskeletal system diseases in pupils.

Melanoma Risk Prediction Models

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Developing statistical models that estimate the probability of developing melanoma cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

YAOPBM-II: extension to higher degrees and to shorter time series

Energy Technology Data Exchange (ETDEWEB)

Korzennik, S G [Harvard-Smithsonian Center for Astrophysics, Cambridge, MA (United States)], E-mail: skorzennik@cfa.harvard.edu

2008-10-15

In 2005, I presented a new fitting methodology (Yet AnOther Peak Bagging Method -YAOPBM), derived for very-long time series (2088-day-long) and applied it to low degree modes, {iota} {<=} 25. That very-long time series was also sub-divided into shorter segments (728-day-long) that were each fitted over the same range of degrees, to estimate changes with solar activity levels. I present here the extension of this method in several 'directions': a) to substantially higher degrees ({iota} {<=} 125); b) to shorter time series (364- and 182-day-long); and c) to additional 728-day-long segments, covering now some 10 years of observations. I discuss issues with the fitting, namely the leakage matrix, and the f- and p1 mode at very low frequencies, and I present some of the characteristics of the observed temporal changes.

Capital Market Integration and Consumption Risk Sharing over the Long Run

DEFF Research Database (Denmark)

Rangvid, Jesper; Santa-Clara, Pedro; Schmeling, Maik

integration. We also calculate the welfare costs of imperfect capital market integration and risk sharing and find that these costs vary a lot over time. Finally, we show that consumption risk sharing is higher during times of crises, i.e. at times when marginal utility is high and risk sharing is most......We empirically investigate time variation in capital market integration and consumption risk sharing using data for 16 countries from 1875 to 2012. We show that there has been considerable variation over time in the degrees of capital market integration and consumption risk sharing and that higher...... capital market integration forecasts more consumption risk sharing in the future. This finding is robust is to controlling for trade openness and exchange rate volatilities. Hence, financial integration seems to drive consumption risk sharing whereas we find no evidence that risk sharing forecasts market...

Higher Birthweight and Maternal Pre-pregnancy BMI Persist with Obesity Association at Age 9 in High Risk Latino Children.

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Kjaer, Thora Wesenberg; Faurholt-Jepsen, Daniel; Medrano, Rosalinda; Elwan, Deena; Mehta, Kala; Christensen, Vibeke Brix; Wojcicki, Janet M

2018-02-03

Childhood obesity is increasing especially in Latinos and early intervention is essential to prevent later obesity complications. Latino children (n = 201) recruited at two San Francisco hospitals were assessed at birth including infant anthropometrics and feeding practices and followed to age 9 with annual anthropometric assessments. We evaluated the relationship between perinatal risk factors and obesity at age 9 and chronic obesity (obesity at both 5 and 9 years). Higher birthweight [odds ratio (OR) 2.48, 95% confidence interval (CI) 1.06-5.81] and maternal pre-pregnancy body mass index (BMI) (OR 1.09, 95% CI 1.00-1.18) were associated with increased risk for obesity at 9 years. Higher maternal pre-pregnancy BMI (OR 1.10, 95% CI 1.01-1.20) was associated with chronic obesity. Additionally, prenatal depression symptoms were protective (OR 0.33, 95% CI 0.11-0.94) against chronic obesity. We found no association between maternal age and education, exclusive breastfeeding at 4-6 weeks, rapid infant weight gain, and obesity or chronic obesity. Perinatal risk factors for obesity including higher birthweight and maternal pre-pregnancy BMI persisted until age 9, whereas, other variables significant at age 5 in our cohort and other populations including exclusive breastfeeding and rapid infant weight gain were no longer associated with increased risk.

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

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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.

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....

Higher Education: A Time for Triage?

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Lagowski, J. J.

1995-10-01

Higher education faces unprecedented challenges. The confluence of changing economic and demographic tends; new patterns of federal and state spending; more explicit expectations by students and their families for affordable, accessible education; and heightened scrutiny by those who claim a legitimate interest in higher education is inescapably altering the environment in which this system operates. Higher education will never again be as it was before. Further, many believe that tinkering around the margins is no longer an adequate response to the new demands. Fundamental change is deemed necessary to meet the challenge of this melange of pressures. A number of commentators have observed that political and corporate America have responded to their challenges by instituting a fundamental restructuring of those institutions. The medical community is also in the midst of a similar basic restructuring of the health care delivery system in this country. Now its education's turn. People are questioning the historically expressed mission of higher education. They make the claim that we cost too much, spend carelessly, teach poorly, plan myopically, and when questioned, act defensively. Educational administrators, from department chairs up, are confronted with the task of simultaneously reforming and cutting back. They have no choice. They must establish politically sophisticated priority settings and effect a hard-nosed reallocation of resources in a social environment where competing public needs have equivalent--or stronger--emotional pulls. Triage in a medical context involves confronting an emergency in which the demand for attention far outstrips available assistance by establishing a sequence of care in which one key individual orchestrates the application of harsh priorities which have been designed to maximize the number of survivors. In recent years, the decisions that have been made in some centers of higher education bear a striking similarity. The literature

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

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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

Higher glucose, insulin and insulin resistance (HOMA-IR) in childhood predict adverse cardiovascular risk in early adulthood: the Pune Children's Study.

Science.gov (United States)

Yajnik, Chittaranjan S; Katre, Prachi A; Joshi, Suyog M; Kumaran, Kalyanaraman; Bhat, Dattatray S; Lubree, Himangi G; Memane, Nilam; Kinare, Arun S; Pandit, Anand N; Bhave, Sheila A; Bavdekar, Ashish; Fall, Caroline H D

2015-07-01

The Pune Children's Study aimed to test whether glucose and insulin measurements in childhood predict cardiovascular risk factors in young adulthood. We followed up 357 participants (75% follow-up) at 21 years of age who had undergone detailed measurements at 8 years of age (glucose, insulin, HOMA-IR and other indices). Oral glucose tolerance, anthropometry, plasma lipids, BP, carotid intima-media thickness (IMT) and arterial pulse wave velocity (PWV) were measured at 21 years. Higher fasting glucose, insulin and HOMA-IR at 8 years predicted higher glucose, insulin, HOMA-IR, BP, lipids and IMT at 21 years. A 1 SD change in 8 year variables was associated with a 0.10-0.27 SD change at 21 years independently of obesity/adiposity at 8 years of age. A greater rise in glucose-insulin variables between 8 and 21 years was associated with higher cardiovascular risk factors, including PWV. Participants whose HOMA-IR measurement remained in the highest quartile (n = 31) had a more adverse cardiovascular risk profile compared with those whose HOMA-IR measurement remained in the lowest quartile (n = 28). Prepubertal glucose-insulin metabolism is associated with adult cardiovascular risk and markers of atherosclerosis. Our results support interventions to improve glucose-insulin metabolism in childhood to reduce cardiovascular risk in later life.

Acute Kidney Injury in Mechanically Ventilated Patients: The Risk Factor Profile Depends on the Timing of Aki Onset.

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Lombardi, Raúl; Nin, Nicolás; Peñuelas, Oscar; Ferreiro, Alejandro; Rios, Fernando; Marin, Maria Carmen; Raymondos, Konstantinos; Lorente, Jose A; Koh, Younsuck; Hurtado, Javier; Gonzalez, Marco; Abroug, Fekri; Jibaja, Manuel; Arabi, Yaseen; Moreno, Rui; Matamis, Dimitros; Anzueto, Antonio; Esteban, Andres

2017-10-01

Acute kidney injury (AKI) is a frequent complication in patients under mechanical ventilation (MV). We aimed to assess the risk factors for AKI with particular emphasis on those potentially preventable. Retrospective analysis of a large, multinational database of MV patients with >24 h of MV and normal renal function at admission. AKI was defined according to creatinine-based KDIGO criteria. Risk factors were analyzed according to the time point at which AKI occurred: early (≤48 h after ICU admission, AKIE) and late (day 3 to day 7 of ICU stay, AKIL). A conditional logistic regression model was used to identify variables independently associated with AKI. Three thousand two hundred six patients were included. Seven hundred patients had AKI (22%), the majority of them AKIE (547/704). The risk factor profile was highly dependent upon the timing of AKI onset. In AKIE risk factors were older age; SAPS II score; postoperative and cardiac arrest as the reasons for MV; worse cardiovascular SOFA, pH, serum creatinine, and platelet count; higher level of peak pressure and Vt/kg; and fluid overload at admission. In contrast, AKIL was linked mostly to events that occurred after admission (lower platelet count and pH; ICU-acquired sepsis; and fluid overload). None ventilation-associated parameters were identify as risk factors for AKIL. In the first 48 h, risk factors are associated with the primary disease and the patient's condition at admission. Subsequently, emergent events like sepsis and organ dysfunction appear to be predictive factors making prevention a challenge.

The Benefits of Part-Time Undergraduate Study and UK Higher Education Policy: A Literature Review

Science.gov (United States)

Bennion, Alice; Scesa, Anna; Williams, Ruth

2011-01-01

Part-time study in the UK is significant: nearly 40 per cent of higher education students study part-time. This article reports on a literature review that sought to understand the economic and social benefits of part-time study in the UK. It concludes that there are substantial and wide-ranging benefits from studying part-time. The article also…

Young Children in Immigrant Families Face Higher Risk of Food Insecurity. Research Brief. Publication #2009-07

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Capps, Randy; Horowitz, Allison; Fortuny, Karina; Bronte-Tinkew, Jacinta; Zaslow, Martha

2009-01-01

Children in immigrant families are more likely than children in native-born families to face a number of risk factors for poor developmental outcomes, including higher poverty rates, lower household incomes, and linguistic isolation, (for example, when older children and adults in a household have difficulty speaking English). Previous research…

Protective effect of time spent walking on risk of stroke in older men.

Science.gov (United States)

Jefferis, Barbara J; Whincup, Peter H; Papacosta, Olia; Wannamethee, S Goya

2014-01-01

Older adults have the highest risks of stroke and the lowest physical activity levels. It is important to quantify how walking (the predominant form of physical activity in older age) is associated with stroke. A total of 4252 men from a UK population-based cohort reported usual physical activity (regular walking, cycling, recreational activity, and sport) in 1998 to 2000. Nurses took fasting blood samples and made anthropometric measurements. Among 3435 ambulatory men free from cardiovascular disease and heart failure in 1998 to 2000, 195 first strokes occurred during 11-year follow-up. Men walked a median of 7 (interquartile range, 3-12) hours/wk; walking more hours was associated with lower heart rate, D-dimer, and higher forced expiratory volume in 1 second. Compared with men walking 0 to 3 hours/wk, men walking 4 to 7, 8 to 14, 15 to 21, and >22 hours had age- and region-adjusted hazard ratios (95% confidence intervals) for stroke of 0.89 (0.60-1.31), 0.63 (0.40-1.00), 0.68 (0.35-1.32), and 0.36 (0.14-0.91), respectively, P (trend)=0.006. Hazard ratios were somewhat attenuated by adjustment for established and novel risk markers (inflammatory and hemostatic markers and cardiac function [N-terminal pro-brain natriuretic peptide]) and walking pace, but linear trends remained. There was little evidence for a dose-response relationship between walking pace and stroke; comparing average pace or faster to a baseline of slow pace, the hazard ratio for stroke was 0.65 (95% confidence interval, 0.44-0.97), which was fully mediated by time spent walking. Time spent walking was associated with reduced risk of onset of stroke in dose-response fashion, independent of walking pace. Walking could form an important part of stroke-prevention strategies in older people.

Measuring Stratigraphic Congruence Across Trees, Higher Taxa, and Time.

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O'Connor, Anne; Wills, Matthew A

2016-09-01

The congruence between the order of cladistic branching and the first appearance dates of fossil lineages can be quantified using a variety of indices. Good matching is a prerequisite for the accurate time calibration of trees, while the distribution of congruence indices across large samples of cladograms has underpinned claims about temporal and taxonomic patterns of completeness in the fossil record. The most widely used stratigraphic congruence indices are the stratigraphic consistency index (SCI), the modified Manhattan stratigraphic measure (MSM*), and the gap excess ratio (GER) (plus its derivatives; the topological GER and the modified GER). Many factors are believed to variously bias these indices, with several empirical and simulation studies addressing some subset of the putative interactions. This study combines both approaches to quantify the effects (on all five indices) of eight variables reasoned to constrain the distribution of possible values (the number of taxa, tree balance, tree resolution, range of first occurrence (FO) dates, center of gravity of FO dates, the variability of FO dates, percentage of extant taxa, and percentage of taxa with no fossil record). Our empirical data set comprised 647 published animal and plant cladograms spanning the entire Phanerozoic, and for these data we also modeled the effects of mean age of FOs (as a proxy for clade age), the taxonomic rank of the clade, and the higher taxonomic group to which it belonged. The center of gravity of FO dates had not been investigated hitherto, and this was found to correlate most strongly with some measures of stratigraphic congruence in our empirical study (top-heavy clades had better congruence). The modified GER was the index least susceptible to bias. We found significant differences across higher taxa for all indices; arthropods had lower congruence and tetrapods higher congruence. Stratigraphic congruence-however measured-also varied throughout the Phanerozoic, reflecting

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

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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.

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

Science.gov (United States)

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

2017-01-01

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

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

Directory of Open Access Journals (Sweden)

Maria Patrizia Carrieri

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

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.

Higher prevalence of risk factors for type 2 diabetes mellitus and subsequent higher incidence in men

DEFF Research Database (Denmark)

Almdal, Thomas; Scharling, Henrik; Jensen, Jan Skov

2008-01-01

, non-fasting blood glucose and triglycerides. Significantly more men (242, 5.4%) than women (152, 2.5%) developed type 2 DM. The odds ratio (OR) for developing diabetes with a BMI above 30 kg/m(2) compared to a BMI of 20-25 kg/m(2) was 8.1 in women and 6.3 in men; for a non-fasting plasma glucose of 8.......4-11.0 mmol/l compared to a plasma glucose of 5.5-6.4, the ORs were 7.8 in women and 4.7 in men. The OR for developing diabetes in persons with a non-fasting triglyceride level above 2.0 mmol/l compared to 1.0-2.0 mmol/l was 1.8 in both sexes; women with non -fasting triglycerides below 1.0 mmol/l had...... or non-fasting plasma glucose >11.1 mmol/l) were excluded. Some 6154 women and 4733 men were studied and followed up in 1981-1983 or in 1991-1994. The significance of risk factors was examined by multiple logistic regression analysis. RESULTS: Initially, a higher proportion of men than women had high...

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...

Obese with higher FNDC5/Irisin levels have a better metabolic profile, lower lipopolysaccharide levels and type 2 diabetes risk.

Science.gov (United States)

Bonfante, Ivan Luiz Padilha; Chacon-Mikahil, Mara Patricia Traina; Brunelli, Diego Trevisan; Gáspari, Arthur Fernandes; Duft, Renata Garbellini; Oliveira, Alexandre Gabarra; Araujo, Tiago Gomes; Saad, Mario Jose Abdalla; Cavaglieri, Cláudia Regina

2017-12-01

Thus, the aim of this study was to compare if higher or smaller fibronectin type 3 domain-containing protein 5 (FNDC5)/irisin levels are associated with inflammatory and metabolic markers, caloric/macronutrient intake, physical fitness and type 2 diabetes mellitus (T2DM) risk in obese middle-aged men, and also to correlate all variables analyzed with FNDC5/irisin. On the basis of a cluster study, middle-aged obese men (IMC: 31.01 ± 1.64 kg/m2) were divided into groups of higher and smaller levels of FNDC5/irisin. The levels of leptin, resistin, adiponectin, tumor necrosis factor alpha (TNFα), interleukin 6 and 10 (IL6, IL10), lipopolysaccharide (LPS), glucose, insulin, glycated hemoglobin, insulin resistance and sensibility, lipid profile, risk of T2DM development, body composition, rest energy expenditure, caloric/macronutrient intake and physical fitness were measured. The higher FNDC5/ irisin group presented improved insulin sensibility (homeostasis model assessment - sensibility (HOMA-S) (p = 0.01) and QUICKI index (p risk of T2DM development (p = 0.02), tendency to decrease serum resistin (p = 0.08) and significant lower LPS levels (p = 0.02). Inverse correlations between FNDC5/irisin and body weight (r -0.46, p = 0.04), neck circumference (r -0.51, p = 0.02), free fat mass (r -0.49, p = 0.02), triglycerides (r -0.43, p = 0.05) and risk of developing T2DM (r -0.61, p = 0.04) were observed. These results suggest that higher FNDC5/irisin levels in obese middle-aged men are related to a better metabolic profile and lower risk of T2DM development and serum LPS, a potential inducer of insulin resistance.

Physical activity, sedentary behavior time and lipid levels in the Observation of Cardiovascular Risk Factors in Luxembourg study.

Science.gov (United States)

Crichton, Georgina E; Alkerwi, Ala'a

2015-08-11

Recently attention has been drawn to the health impacts of time spent engaging in sedentary behaviors. While many studies have investigated general physical activity (PA) in relation to blood lipid levels, the current study aimed to examine the intensity of activity, including sedentary behavior time, and time spent engaging in moderate and intense PA, with concentrations of HDL and LDL-cholesterol, total cholesterol, and triglycerides. Participants comprised 1331 individuals, aged 18 to 70 years, from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study, who underwent objective cardiovascular health assessments and completed the International Physical Activity Questionnaire (IPAQ). Time spent engaging in sedentary behaviors (screen time on a workday and a day off, and total sitting time on a work day), and moderate and intense PA, were related to levels of HDL and LDL-cholesterol, total cholesterol, and triglycerides. Analyses were conducted in the whole sample, and then with stratification according to BMI (normal weight versus overweight/obese). Both lower screen time during days off and higher intense PA time were significantly associated with higher HDL-cholesterol after full adjustment for socio-demographic factors, dietary factors and smoking (both p sedentary behavior time variables were observed (all p sedentary behavior time variable and lipid levels in those overweight or obese. Spending less time in sedentary behaviors, and engaging in medium levels of intense physical activity may be associated with a more favorable blood lipid profile, particularly with regard to levels of HDL and triglycerides.

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.

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.

Managing Reputation Risk and Situational Crisis in Higher Institutions of Learning

OpenAIRE

Effiong, Andem Ita

2014-01-01

Extant literature on crisis and corporate reputation management has presented the Situational Crisis Communication Theory (SCCT) model as a valid and reliable framework for managing crisis and predicting stakeholders’perceptions of organizations’ reputation in times of crisis. In order to verifythe applicability of the model in higher institutions of learning in adeveloping country context, a study was conducted in September, 2011 in twopublic universities in Nigeria. The findings of the stud...

One-Hour Postload Hyperglycemia Confers Higher Risk of Hepatic Steatosis to HbA1c-Defined Prediabetic Subjects.

Science.gov (United States)

Fiorentino, Teresa Vanessa; Andreozzi, Francesco; Mannino, Gaia Chiara; Pedace, Elisabetta; Perticone, Maria; Sciacqua, Angela; Perticone, Francesco; Sesti, Giorgio

2016-11-01

Individuals with glycated hemoglobin (HbA1c)-defined prediabetes (HbA1c value of 5.7-6.4%) and 1-hour plasma glucose ≥155 mg/dL during an oral glucose tolerance test have an increased risk of developing type 2 diabetes. To evaluate the degree to which HbA1c-defined prediabetes and 1-hour postload glucose ≥155 mg/dL individually and jointly associate with hepatic steatosis and related biomarkers. A cross-sectional analysis was performed on 1108 White individuals. Ambulatory care. Anthropometric and metabolic characteristics including hepatic steatosis assessed by ultrasonography. Compared with the normal group (HbA1c prediabetic and diabetic individuals exhibit higher values of fasting, 1-hour, and 2-hour postload glucose; fasting and 2-hour postload insulin; triglycerides; uric acid; homeostasis model of assessment for insulin resistance; liver insulin resistance index; liver enzymes; and inflammatory biomarkers; and lower levels of high-density lipoprotein cholesterol and IGF-1. Prediabetic and diabetic subjects have increased risk of hepatic steatosis (1.5- and 2.46-fold, respectively). Stratifying participants according to HbA1c and 1-hour postload glucose, we found that individuals with HbA1c-defined prediabetes and 1-hour postload glucose ≥155 mg/dL have significantly higher risk of hepatic steatosis as compared with individuals with HbA1c-defined prediabetes but 1-hour postload glucose prediabetes and 1-hour postload glucose ≥155 mg/dL exhibit higher values of liver enzymes; fasting, 1-hour, and 2-hour postload glucose; insulin; triglycerides; uric acid; and inflammatory biomarkers; and lower levels of high-density lipoprotein and IGF-1. These data suggest that a value of 1-hour postload glucose ≥155 mg/dL may be helpful to identify a subset of individuals within HbA1c-defined glycemic categories at higher risk of hepatic steatosis.

The Motivations and Outcomes of Studying for Part-Time Mature Students in Higher Education

Science.gov (United States)

Swain, Jon; Hammond, Cathie

2011-01-01

This paper examines the motivations and outcomes for mature students who study part-time in higher education (HE) in the UK. Although many students in HE are mature part-time learners, they have not been the specific focus of much research or policy interest. In-depth narrative interviews were carried out with 18 graduates who had studied…

Exploring Perceived Risk and Risk Reduction Strategies in the Pursuit of Higher Education Abroad

Science.gov (United States)

Lam, Jason M. S.; Tong, David Yoon Kin; Ariffin, Ahmad Azmi M.

2017-01-01

While past studies have merely focused on perceived risks that influence how students select the destination of international education best suited to their needs, research on perceived risk regarding post-purchase behavior remains limited. This study attempts to extend and redefine the perceived risk paradigm by uncovering the underlying elements…

Personality prototype as a risk factor for eating disorders

Directory of Open Access Journals (Sweden)

Antonio J. Sanchez-Guarnido

2015-01-01

Full Text Available Objective:To establish whether the risk of suffering from an eating disorder (ED is associated with the high-functioning, undercontrolled, or overcontrolled personality prototype groups.Method:The Revised NEO Personality Inventory (NEO-PI-R and the Eating Disorder Inventory 2 (EDI-2 were administered to 69 patients diagnosed as suffering from EDs (cases and 89 people free of any ED symptoms (control group. A cluster analysis was carried out to divide the participants into three groups based on their scores in the Big Five personality dimensions. A logistic regression model was then created.Results:Participants in the undercontrolled group had a risk of suffering from an ED 6.517 times higher than those in the high-functioning group (p = 0.019; odds ratio [OR] = 6.517, while those in the overcontrolled subgroup had a risk of ED 15.972 times higher than those in the high-functioning group.Conclusions:Two personality subtypes were identified in which the risk of EDs was six times higher (the undercontrolled group and almost 16 times higher (the overcontrolled group. Prevention and treatment programs for ED could benefit from focusing on the abovementioned personality profiles.

Prostate Cancer Risk Prediction Models

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Developing statistical models that estimate the probability of developing prostate cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Liver Cancer Risk Prediction Models

Science.gov (United States)

Developing statistical models that estimate the probability of developing liver cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Colorectal Cancer Risk Prediction Models

Science.gov (United States)

Developing statistical models that estimate the probability of developing colorectal cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Esophageal Cancer Risk Prediction Models

Science.gov (United States)

Developing statistical models that estimate the probability of developing esophageal cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Bladder Cancer Risk Prediction Models

Science.gov (United States)

Developing statistical models that estimate the probability of developing bladder cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Lung Cancer Risk Prediction Models

Science.gov (United States)

Developing statistical models that estimate the probability of developing lung cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Breast Cancer Risk Prediction Models

Science.gov (United States)

Developing statistical models that estimate the probability of developing breast cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Pancreatic Cancer Risk Prediction Models

Science.gov (United States)

Developing statistical models that estimate the probability of developing pancreatic cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Ovarian Cancer Risk Prediction Models

Science.gov (United States)

Developing statistical models that estimate the probability of developing ovarian cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Cervical Cancer Risk Prediction Models

Science.gov (United States)

Developing statistical models that estimate the probability of developing cervical cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Testicular Cancer Risk Prediction Models

Science.gov (United States)

Developing statistical models that estimate the probability of testicular cervical cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

An analysis of timing and frequency of malaria infection during pregnancy in relation to the risk of low birth weight, anaemia and perinatal mortality in Burkina Faso

Directory of Open Access Journals (Sweden)

Valea Innocent

2012-03-01

Full Text Available Abstract Background A prospective study aiming at assessing the effect of adding a third dose sulphadoxine-pyrimethamine (SP to the standard two-dose intermittent preventive treatment for pregnant women was carried out in Hounde, Burkina Faso, between March 2006 and July 2008. Pregnant women were identified as earlier as possible during pregnancy through a network of home visitors, referred to the health facilities for inclusion and followed up until delivery. Methods Study participants were enrolled at antenatal care (ANC visits and randomized to receive either two or three doses of SP at the appropriate time. Women were visited daily and a blood slide was collected when there was fever (body temperature > 37.5°C or history of fever. Women were encouraged to attend ANC and deliver in the health centre, where the new-born was examined and weighed. The timing and frequency of malaria infection was analysed in relation to the risk of low birth weight, maternal anaemia and perinatal mortality. Results Data on birth weight and haemoglobin were available for 1,034 women. The incidence of malaria infections was significantly lower in women having received three instead of two doses of SP. Occurrence of first malaria infection during the first or second trimester was associated with a higher risk of low birth weight: incidence rate ratios of 3.56 (p p = 0.034, respectively. After adjusting for possible confounding factors, the risk remained significantly higher for the infection in the first trimester of pregnancy (adjusted incidence rate ratio = 2.07, p = 0.002. The risk of maternal anaemia and perinatal mortality was not associated with the timing of first malaria infection. Conclusion Malaria infection during first trimester of pregnancy is associated to a higher risk of low birth weight. Women should be encouraged to use long-lasting insecticidal nets before and throughout their pregnancy.

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

Science.gov (United States)

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

2017-01-01

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

Knowledge sharing behaviour among non-academic staff in higher learning institutes: The role of trust and perceived risk

Directory of Open Access Journals (Sweden)

Muhammad Sabbir Rahman

2018-03-01

Full Text Available The purpose of the paper is to analyse knowledge sharing behaviour among non-academic staff of higher learning institutions. This research focuses on the mediation impact of perceived risk on trust and knowledge sharing behaviour. The research also proposes actions that can be taken by higher learning institutions to enhance trust among the staff in order to create a knowledge sharing environment at the workplace. This research applied confirmatory factor analysis and Structural Equation Modeling (SEM to evaluate the proposed measurement model and proved the research hypotheses. The findings from the research show that perceived risk plays a strong mediating role between trust and knowledge sharing behaviour among the non-academic staff of higher learning institutions. The SEM analysis also confirmed that the research model shows a good fit. This research highlights issues concerning knowledge sharing practices among non-academic staff and provides some recommendations to the managers to address these issues. The researchers agreed that more research needs to be done in this area as there are aspects that are yet to be explored. The findings of this research serve to add to the literature on knowledge sharing focussing on non-academic staff of higher learning institutions.

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

Directory of Open Access Journals (Sweden)

Usama Hamed Issa

2013-12-01

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

Higher spins tunneling from a time dependent and spherically symmetric black hole

International Nuclear Information System (INIS)

Siahaan, Haryanto M.

2016-01-01

The discussions of Hawking radiation via tunneling method have been performed extensively in the case of scalar particles. Moreover, there are also several works in discussing the tunneling method for Hawking radiation by using higher spins, e.g. neutrino, photon, and gravitino, in the background of static black holes. Interestingly, it is found that the Hawking temperature for static black holes using the higher spins particles has no difference compared to the one computed using scalars. In this paper, we study the Hawking radiation for a spherically symmetric and time dependent black holes using the tunneling of Dirac particles, photon, and gravitino. We find that the obtained Hawking temperature is similar to the one derived in the tunneling method by using scalars. (orig.)

Higher spins tunneling from a time dependent and spherically symmetric black hole

Energy Technology Data Exchange (ETDEWEB)

Siahaan, Haryanto M. [Parahyangan Catholic University, Physics Department, Bandung (Indonesia)

2016-03-15

The discussions of Hawking radiation via tunneling method have been performed extensively in the case of scalar particles. Moreover, there are also several works in discussing the tunneling method for Hawking radiation by using higher spins, e.g. neutrino, photon, and gravitino, in the background of static black holes. Interestingly, it is found that the Hawking temperature for static black holes using the higher spins particles has no difference compared to the one computed using scalars. In this paper, we study the Hawking radiation for a spherically symmetric and time dependent black holes using the tunneling of Dirac particles, photon, and gravitino. We find that the obtained Hawking temperature is similar to the one derived in the tunneling method by using scalars. (orig.)

Dying in their prime: determinants and space-time risk of adult mortality in rural South Africa

Science.gov (United States)

Sartorius, Benn; Kahn, Kathleen; Collinson, Mark A.; Sartorius, Kurt; Tollman, Stephen M.

2013-01-01

A longitudinal dataset was used to investigate adult mortality in rural South Africa in order to determine location, trends, high impact determinants and policy implications. Adult (15-59 years) mortality data for the period 1993-2010 were extracted from the health and socio-demographic surveillance system (HDSS) in the rural sub-district of Agincourt. A Bayesian geostatistical frailty survival model was used to quantify significant associations between adult mortality and various multilevel (individual, household and community) variables. It was found that adult mortality significantly increased over time with a reduction observed late in the study period. Non-communicable disease mortality appeared to increase and decrease in parallel with communicable mortality, whilst deaths due to external causes remained constant. Male gender, unemployment, circular (labour) migrant status, age and gender of household heads, partner and/or other household death, low education and low household socioeconomic status (SES) were identified as significant and highly attributable determinants of adult mortality. Health facility remoteness was also a risk for adult mortality and households falling outside a critical buffering zone were identified. Spatial foci of higher adult mortality risk were observed indicating a strong non-random pattern. Communicable diseases differed from non-communicable diseases with respect to spatial distribution of mortality. Areas with significant excess mortality risk (hotspots) were found to be part of a complex interaction of highly attributable factors that continues to drive differential space-time risk patterns of communicable (HIV/AIDS and Tuberculosis) mortality in Agincourt. The impact of HIV mortality and its subsequent lowering due to the introduction of antiretroviral therapy (ART) was found to be clearly evident in this rural population. PMID:23733287

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

Science.gov (United States)

Shield, Kevin D; Gmel, Gerrit; Gmel, Gerhard; Mäkelä, Pia; Probst, Charlotte; Room, Robin; Rehm, Jürgen

2017-09-01

Low-risk alcohol drinking guidelines require a scientific basis that extends beyond individual or group judgements of risk. Life-time mortality risks, judged against established thresholds for acceptable risk, may provide such a basis for guidelines. Therefore, the aim of this study was to estimate alcohol mortality risks for seven European countries based on different average daily alcohol consumption amounts. The maximum acceptable voluntary premature mortality risk was determined to be one in 1000, with sensitivity analyses of one in 100. Life-time mortality risks for different alcohol consumption levels were estimated by combining disease-specific relative risk and mortality data for seven European countries with different drinking patterns (Estonia, Finland, Germany, Hungary, Ireland, Italy and Poland). Alcohol consumption data were obtained from the Global Information System on Alcohol and Health, relative risk data from meta-analyses and mortality information from the World Health Organization. The variation in the life-time mortality risk at drinking levels relevant for setting guidelines was less than that observed at high drinking levels. In Europe, the percentage of adults consuming above a risk threshold of one in 1000 ranged from 20.6 to 32.9% for women and from 35.4 to 54.0% for men. Life-time risk of premature mortality under current guideline maximums ranged from 2.5 to 44.8 deaths per 1000 women in Finland and Estonia, respectively, and from 2.9 to 35.8 deaths per 1000 men in Finland and Estonia, respectively. If based upon an acceptable risk of one in 1000, guideline maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men. If low-risk alcohol guidelines were based on an acceptable risk of one in 1000 premature deaths, then maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men, and some of the current European guidelines would require downward revision. © 2017 Society for the Study of Addiction.

Factors influencing maternal decision-making for the infant sleep environment in families at higher risk of SIDS: a qualitative study.

Science.gov (United States)

Pease, Anna; Ingram, Jenny; Blair, Peter S; Fleming, Peter J

2017-01-01

Qualitative interviews with mothers of babies at higher risk of sudden infant death syndrome (SIDS) were carried out to understand their views and decision-making process on the infant sleep environment and safe sleep messages. Twenty semi-structured interviews were conducted between February and November 2014 in deprived areas of Bristol, UK. Mothers were asked about their decision-making for the infant sleep environment and safe sleep messages including infant sleep position, co-sleeping, smoking, dummy use, feeding and disrupted routines. The interviews were transcribed, coded and thematic analysis carried out. Participants were invited based on an algorithm developed in a previous SIDS case control study that identified an increased risk of SIDS from four demographic characteristics: young maternal age, smoking during pregnancy, three or more children, and a measure of deprivation. The presence of three, or more characteristics led to being invited to take part in the qualitative study. Factors influencing mothers' adherence to the safe sleep messages included previous experience and the credibility of the advice given. They described disrupted routines that led to risky scenarios with a belief that occasional risks were acceptable. Where circumstances made following the advice more difficult they found alternative strategies to reduce the risk, including the use of movement monitors, regular checking and a belief that lighter maternal sleep in the presence of a baby was protective. Safer sleep messages should be tailored to fit with the lived realities of mothers, especially those at higher risk. The traditional list of 'do's' and 'don'ts' was not well accepted by this group. Interventions that seek to influence this higher-risk group should acknowledge mothers' own protective instincts and consider their beliefs and understanding behind the safer sleep messages if they are to be effective and encourage this group to change.

Calculating Higher-Order Moments of Phylogenetic Stochastic Mapping Summaries in Linear Time

Science.gov (United States)

Dhar, Amrit

2017-01-01

Abstract Stochastic mapping is a simulation-based method for probabilistically mapping substitution histories onto phylogenies according to continuous-time Markov models of evolution. This technique can be used to infer properties of the evolutionary process on the phylogeny and, unlike parsimony-based mapping, conditions on the observed data to randomly draw substitution mappings that do not necessarily require the minimum number of events on a tree. Most stochastic mapping applications simulate substitution mappings only to estimate the mean and/or variance of two commonly used mapping summaries: the number of particular types of substitutions (labeled substitution counts) and the time spent in a particular group of states (labeled dwelling times) on the tree. Fast, simulation-free algorithms for calculating the mean of stochastic mapping summaries exist. Importantly, these algorithms scale linearly in the number of tips/leaves of the phylogenetic tree. However, to our knowledge, no such algorithm exists for calculating higher-order moments of stochastic mapping summaries. We present one such simulation-free dynamic programming algorithm that calculates prior and posterior mapping variances and scales linearly in the number of phylogeny tips. Our procedure suggests a general framework that can be used to efficiently compute higher-order moments of stochastic mapping summaries without simulations. We demonstrate the usefulness of our algorithm by extending previously developed statistical tests for rate variation across sites and for detecting evolutionarily conserved regions in genomic sequences. PMID:28177780

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...

High prevalence of suicide risk in people living with HIV: who is at higher risk?

Science.gov (United States)

Passos, Susane Müller Klug; Souza, Luciano Dias de Mattos; Spessato, Bárbara Coiro

2014-01-01

A cross-sectional study was developed to evaluate suicide risk and associated factors in HIV/AIDS patients at a regional reference center for the treatment of HIV/AIDS in southern Brazil. We assessed 211 patients in regard to suicide risk, clinical and sociodemographic characteristics, drug use, depression, and anxiety. Suicide risk was assessed with Mini International Neuropsychiatric Interview, Module C. Multivariate analysis was performed using Poisson regression. Of the total sample, 34.1% were at risk of suicide. In the multivariate analysis, the following variables were independently associated with suicide risk: female gender; age up to 47 years; unemployment; indicative of anxiety; indicative of depression; and abuse or addiction on psychoactive substances. Suicide risk is high in this population. Psychosocial factors should be included in the physical and clinical evaluation, given their strong association with suicide risk.

Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis

DEFF Research Database (Denmark)

Abdulla, Jawdat; Nielsen, Jens Rokkedal; Abdulla, Jawdat

2009-01-01

AIMS: The aim of this study was to examine by a systematic literature review and meta-analysis whether the risk of atrial fibrillation (AF) is higher in athletes compared with not athletes. METHODS AND RESULTS: A comprehensive systematic search was conducted for case-control studies that examined....... There were 147 (23%) vs. 116 (12.5%) cases of AF among athletes compared with controls. The overall risk of AF was significantly higher in athletes than in controls with odds ratio (95% confidence interval)=5.29 (3.57-7.85), P=0.0001, and Z-score=8.08. For heterogeneity, the calculated chi2=2.92, P=0...

Global analysis of threat status reveals higher extinction risk in tropical than in temperate bird sister species

Directory of Open Access Journals (Sweden)

Reif Jiří

2016-06-01

Full Text Available Given increasing pressures upon biodiversity, identification of species’ traits related to elevated extinction risk is useful for more efficient allocation of limited resources for nature conservation. Despite its need, such a global analysis was lacking in the case of birds. Therefore, we performed this exercise for avian sister species using information about their global extinction risk from IUCN Red List. We focused on 113 pairs of sister species, each containing a threatened and an unthreatened species to factor out the effects of common evolutionary history on the revealed relationship. We collected data on five traits with expected relationships to species’ extinction risk based on previous studies performed at regional or national levels: breeding habitat (recognizing forest, grassland, wetland and oceanic species, latitudinal range position (temperate and tropics species, migration strategy (migratory and resident species, diet (carnivorous, insectivorous, herbivorous and omnivorous species and body mass. We related the extinction risk using IUCN threat level categories to species’ traits using generalised linear mixed effects models expecting lower risk for forest, temperate, omnivorous and smaller-bodied species. Our expectation was confirmed only in the case of latitudinal range position, as we revealed higher threat level for tropical than for temperate species. This relationship was robust to different methods of threat level expression and cannot be explained by a simple association of high bird species richness with the tropical zone. Instead, it seems that tropical species are more threatened because of their intrinsic characteristics such as slow life histories, adaptations to stable environments and small geographic ranges. These characteristics are obviously disadvantageous in conditions of current human-induced environmental perturbations. Moreover, given the absence of habitat effects, our study indicates that such

A Real-Time Offshore Weather Risk Advisory System

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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

Ecuador's Higher Education System in Times of Change

Science.gov (United States)

Van Hoof, Hubert B.; Estrella, Mateo; Eljuri, Marie-Isabel; León, Leonardo Torres

2013-01-01

Ecuador's higher education system is undergoing dramatic changes. The National Constitution of 2008 and the Higher Education Law of 2010 have changed the way Ecuador's universities are funded, administered, and accredited. The importance of research was elevated and drastic changes were made to the academic qualifications and employment conditions…

Employers' Demand for and the Provision of Part-Time Higher Education for Employees.

Science.gov (United States)

Trotman-Dickenson, Danusia

1987-01-01

A study of public and private employers' demand for part-time higher education for their employees and the response of institutions is reported. The study focuses on Wales and on the regional economic and social trends affecting educational demand and supply. Improved communication between employers, employees, and institutions is recommended.…

Higher order multi-term time-fractional partial differential equations involving Caputo-Fabrizio derivative

OpenAIRE

Erkinjon Karimov; Sardor Pirnafasov

2017-01-01

In this work we discuss higher order multi-term partial differential equation (PDE) with the Caputo-Fabrizio fractional derivative in time. Using method of separation of variables, we reduce fractional order partial differential equation to the integer order. We represent explicit solution of formulated problem in particular case by Fourier series.

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

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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.

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

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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.

Newborns of mothers with intellectual disability have a higher risk of perinatal death and being small for gestational age.

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Höglund, Berit; Lindgren, Peter; Larsson, Margareta

2012-12-01

To study mode of birth, perinatal health and death in children born to mothers with intellectual disability (ID) in Sweden. Population-based register study. National registers; the National Patient Register linked to the Medical Birth Register. Children of first-time mothers with ID (n = 326; classified in the International Classification of Diseases 8-10) were identified and compared with 340 624 children of first-time mothers without ID or any other psychiatric diagnosis between 1999 and 2007. Population-based data were extracted from the National Patient Register and the Medical Birth Register. Mode of birth, preterm birth, small for gestational age, Apgar score, stillbirth and perinatal death. Children born to mothers with ID were more often stillborn (1.2 vs. 0.3%) or died perinatally (1.8 vs. 0.4%) than children born to mothers without ID. They had a higher proportion of cesarean section birth (24.5 vs. 17.7%) and preterm birth (12.2 vs. 6.1%), were small for gestational age (8.4 vs. 3.1%) and had lower Apgar scores (mothers without ID. Logistic regression adjusted for maternal characteristics confirmed an increased risk of small for gestational age (odds ratio 2.25), stillbirth (odds ratio 4.53) and perinatal death (odds ratio 4.25) in children born to mothers with ID. Unborn and newborn children of mothers with ID should be considered a risk group, and their mothers may need better individual-based care and support. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Low bone density risk is higher in exercising women with multiple triad risk factors.

Science.gov (United States)

Gibbs, Jenna C; Nattiv, Aurelia; Barrack, Michelle T; Williams, Nancy I; Rauh, Mitchell J; Nichols, Jeanne F; De Souza, Mary Jane

2014-01-01

The cumulative effect of the female athlete triad (Triad) risk factors on the likelihood of low bone mineral density (BMD) in exercising women is unclear. This study aimed to determine the risk of low BMD in exercising women with multiple Triad risk factors. We retrospectively examined cross-sectional data from 437 exercising women (mean ± SD age of 18.0 ± 3.5 yr, weighed 57.5 ± 7.1 kg with 24.5% ± 6.1% body fat) obtained at baseline from 4 prospective cohort studies examining Triad risk factors. Questionnaires were completed to obtain information on demographic characteristics, self-reported eating attitudes/behaviors, menstrual function, sport/activity participation, and medication use. Height and body weight were measured. BMD was measured using dual energy x-ray absorptiometry. Low BMD was defined as z-scores of exercising women. Further research should be conducted to develop a user-friendly algorithm integrating these indicators of risk for low BMD in exercising women (particularly factors associated with low BMI/body weight, menstrual dysfunction, lean sport/activity participation, and elevated dietary restraint).

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

Higher order multi-term time-fractional partial differential equations involving Caputo-Fabrizio derivative

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Erkinjon Karimov

2017-10-01

Full Text Available In this work we discuss higher order multi-term partial differential equation (PDE with the Caputo-Fabrizio fractional derivative in time. Using method of separation of variables, we reduce fractional order partial differential equation to the integer order. We represent explicit solution of formulated problem in particular case by Fourier series.

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.

Higher Risk of Abdominal Obesity, Elevated LDL Cholesterol and Hypertriglyceridemia, but not of Hypertension, in People Living with HIV

DEFF Research Database (Denmark)

Gelpi, Marco; Afzal, Shoaib; Lundgren, Jens

2018-01-01

Background: People living with HIV (PLWH) have lower life expectancy than uninfected individuals, partly explained by excess risk of cardiovascular diseases (CVD) and CVD risk factors. We investigated the association between HIV infection and abdominal obesity, elevated LDL cholesterol (LDL...... and underwent blood pressure, waist-, hip-, weight-, and height-measurements. Non-fasting blood samples were obtained from all participants. We assessed whether HIV was independently associated with abdominal obesity, elevated LDL-C, hypertriglyceridemia and hypertension using logistic regression models...... adjusted for known risk factors. Results: HIV infection was associated with higher risk of abdominal obesity (adjusted odds ratio (aOR): 1.92[1.60-2.30]) for a given BMI, elevated LDL-C (aOR: 1.32[1.09-1.59]), hypertriglyceridemia (aOR 1.76[1.49-2.08]), and lower risk of hypertension (aOR: 0.63[0.54 - 0...

Contextual factors associated with treatment-seeking and higher-risk sexual behaviour in Botswana among men with symptoms of sexually transmitted infections.

Science.gov (United States)

Langeni, Tabitha

2007-11-01

This study investigates contextual factors associated with treatment-seeking behaviour and higher-risk sexual conduct of men symptomatic of sexually transmitted infections (STIs) in Botswana. Data were drawn from a randomly selected, nationally representative sample of 8 222 men, aged 15-64 years, who had reported having symptoms suggestive of an STI during the previous twelve months. Higher-risk behaviour continues to sustain the HIV epidemic in Botswana. At the heart of Botswana's epidemic lies men's reluctance to seek medical treatment, engaging in unprotected sex, and having sex with multiple partners while symptomatic of an STI. The odds of engaging in unprotected sex while symptomatic of an STI were significantly higher among teenage males and males in urban households. For every year's increase in the age difference between partners there was a 28% increase in the odds of the male having had unprotected sex. Being married and having had more than one sexual partner in the last year multiplied the odds of having unprotected sex while symptomatic of an STI by three times. The longer an infected man remained with symptoms before seeking help, the more likely it was to have unprotected sex while infected and the more likely to seek treatment from a traditional healer. Notably, having sought medical treatment from hospitals, clinics and health workers, as opposed to consulting traditional healers, significantly reduced the odds of having had unprotected sex while infected with an STI by 48%. The results indicate the need to encourage men to utilise public healthcare services. The public health sector in Botswana needs to provide healthcare services that are user-friendly for men. Increasing the number of treatment sites may also contribute to preventing onward transmission of STIs. Special attention needs to be paid to boys' socialisation towards gender norms, and men are to be encouraged to play a responsible role in HIV prevention.

Risk for maternal harsh parenting in high-risk families from birth to age three: does ethnicity matter?

Science.gov (United States)

Martin, Christina Gamache; Fisher, Philip A; Kim, Hyoun K

2012-02-01

Child maltreatment prevention programs typically identify at-risk families by screening for risk with limited consideration of how risk might vary by ethnicity. In this study, longitudinal data from mothers who participated in a randomized clinical trial of a home-visitation, child maltreatment prevention program (N = 262) were examined to determine whether risk for harsh parenting differed among mothers who identified themselves as Spanish-speaking Latinas (n = 64), English-speaking Latinas (n = 102), or non-Latina Caucasians (n = 96). The majority of the participants were first-time mothers (58.4%), and the average age of all participants was 23.55 years (SD = 6.04). At the time of their infants' births, the Spanish-speaking Latina mothers demonstrated higher SES risk, whereas the English-speaking Latina and non-Latina Caucasian mothers demonstrated higher psychosocial risk. Three years later, the English-speaking Latina and non-Latina Caucasian mothers reported harsher parenting behaviors than the Spanish-speaking Latina mothers. The need for prevention programs to consider how risk and protective factors differ by ethnic group membership when identifying at-risk mothers is discussed.

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.

Lower zinc bioavailability may be related to higher risk of subclinical atherosclerosis in Korean adults.

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Su Kyoung Jung

Full Text Available BACKGROUND: There is a proposed link between dietary zinc intake and atherosclerosis, but this relationship remains unclear. Phytate may contribute to this relationship by influencing zinc bioavailability. OBJECTIVE: The aim of this study is to examine the relationship between zinc bioavailability and subclinical atherosclerosis in healthy Korean adults. MATERIALS AND METHODS: The present cross-sectional analysis used baseline data from the Korean multi-Rural Communities Cohort Study (MRCohort, which is a part of The Korean Genome Epidemiology Study (KoGES. A total of 5,532 subjects (2,116 men and 3,416 women aged 40 years and older were recruited from rural communities in South Korea between 2005 and 2010. Phytate:zinc molar ratio, estimated from a food-based food frequency questionnaire (FFQ of 106 food items, was used to determine zinc bioavailability, and carotid intima media thickness (cIMT and pulse wave velocity (PWV were measured to calculate the subclinical atherosclerotic index. RESULTS: We found that phytate:zinc molar ratio is positively related to cIMT in men. A higher phytate:zinc molar ratio was significantly related to an increased risk of atherosclerosis in men, defined as the 80(th percentile value of cIMT (5(th vs. 1(st quintile, OR = 2.11, 95% CI 1.42-3.15, P for trend = 0.0009, and especially in elderly men (5(th vs. 1(st quintile, OR = 2.58, 95% CI 1.52-4.37, P for trend = 0.0021. We found a positive relationship between phytate:zinc molar ratio and atherosclerosis risk among women aged 65 years or younger. Phytate:zinc molar ratio was not found to be related to PWV. CONCLUSIONS: Lower zinc bioavailability may be related to higher atherosclerosis risk.

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)

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

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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.

"Times Higher Education" 100 under 50 Ranking: Old Wine in a New Bottle?

Science.gov (United States)

Soh, Kaycheng

2013-01-01

"Times Higher Education" 100 under 50 ranking is a new twist to the university ranking. It focuses on universities that have a history of 50 years or less with the purpose of offsetting the advantage of prestige of the older ones. This article re-analysed the data publicly available and looked into relevant conceptual and statistical issues. The…

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.

Interactions among Candidate Genes Selected by Meta-Analyses Resulting in Higher Risk of Ischemic Stroke in a Chinese Population.

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Man Luo

Full Text Available Ischemic stroke (IS is a multifactorial disorder caused by both genetic and environmental factors. The combined effects of multiple susceptibility genes might result in a higher risk for IS than a single gene. Therefore, we investigated whether interactions among multiple susceptibility genes were associated with an increased risk of IS by evaluating gene polymorphisms identified in previous meta-analyses, including methylenetetrahydrofolate reductase (MTHFR C677T, beta fibrinogen (FGB, β-FG A455G and T148C, apolipoprotein E (APOE ε2-4, angiotensin-converting enzyme (ACE insertion/deletion (I/D, and endothelial nitric oxide synthase (eNOS G894T. In order to examine these interactions, 712 patients with IS and 774 controls in a Chinese Han population were genotyped using the SNaPshot method, and multifactor dimensionality reduction analysis was used to detect potential interactions among the candidate genes. The results of this study found that ACE I/D and β-FG T148C were significant synergistic contributors to IS. In particular, the ACE DD + β-FG 148CC, ACE DD + β-FG 148CT, and ACE ID + β-FG 148CC genotype combinations resulted in higher risk of IS. After adjusting for potential confounding IS risk factors (age, gender, family history of IS, hypertension history and history of diabetes mellitus using a logistic analysis, a significant correlation between the genotype combinations and IS patients persisted (overall stroke: adjusted odds ratio [OR] = 1.57, 95% confidence interval [CI]: 1.22-2.02, P < 0.001, large artery atherosclerosis subtype: adjusted OR = 1.50, 95% CI: 1.08-2.07, P = 0.016, small-artery occlusion subtype: adjusted OR = 2.04, 95% CI: 1.43-2.91, P < 0.001. The results of this study indicate that the ACE I/D and β-FG T148C combination may result in significantly higher risk of IS in this Chinese population.

On the Anonymity Risk of Time-Varying User Profiles

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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.

Adult Arabs have higher risk for diabetes mellitus than Jews in Israel.

Science.gov (United States)

Jaffe, Anat; Giveon, Shmuel; Wulffhart, Liat; Oberman, Bernice; Baidousi, Maslama; Ziv, Arnona; Kalter-Leibovici, Ofra

2017-01-01

Diabetes mellitus is an emerging epidemic in the Arab world. Although high diabetes prevalence is documented in Israeli Arabs, information from cohort studies is scant. This is a population study, based on information derived between 2007-2011, from the electronic database of the largest health fund in Israel, among Arabs and Jews. Prevalence, 4-year-incidence and diabetes hazard ratios [HRs], adjusted for sex and the metabolic-syndrome [MetS]-components, were determined in 3 age groups (Arabs (males: 49%, age: 39.4±17.3) and 16,012 Jews (males: 50%, age: 40.5 ±17.6). The overall age and sex-adjusted diabetes prevalence rates were much higher among Arabs 18.4% (95%CI: 17.6-19.1); and 10.3% (95%CI: 9.7-10.9) among Jews. Arab females had higher prevalence rates 20.0% (95%CI: 19-21) than Arab males 16.7% (95%CI: 15.7-17.8). Annual incidence rates were also significantly higher among Arabs 2.9% (95%CI: 2.7-3.1) than among Jews 1.7% (95%CI: 1.6-1.8). This held true across all age and sex subgroups. Adjustment for body mass index [BMI] attenuated HR estimates associated with Arab ethnicity across all age subgroups, mainly in the Arabs than Jews. Males, however, did not differ by ethnicity. Arabs, mainly female, have high incidence and prevalence of diabetes. This excess risk is only partially explained by the high prevalence of obesity. Effective culturally-congruent diabetes prevention and treatment and an effective engagement partnership with the Arab community are of paramount need.

Randomized trial addressing risk features and time factors of surgery plus radiotherapy in advanced head-and-neck cancer

International Nuclear Information System (INIS)

Ang, K. Kian; Trotti, Andy; Brown, Barry W.; Garden, Adam S.; Foote, Robert L.; Morrison, William H.; Geara, Fady B.; Klotch, Douglas W.; Goepfert, Helmuth; Peters, Lester J.

2001-01-01

Purpose: A multi-institutional, prospective, randomized trial was undertaken in patients with advanced head-and-neck squamous cell carcinoma to address (1) the validity of using pathologic risk features, established from a previous study, to determine the need for, and dose of, postoperative radiotherapy (PORT); (2) the impact of accelerating PORT using a concomitant boost schedule; and (3) the importance of the overall combined treatment duration on the treatment outcome. Methods and Materials: Of 288 consecutive patients with advanced disease registered preoperatively, 213 fulfilled the trial criteria and went on to receive therapy predicated on a set of pathologic risk features: no PORT for the low-risk group (n=31); 57.6 Gy during 6.5 weeks for the intermediate-risk group (n=31); and, by random assignment, 63 Gy during 5 weeks (n=76) or 7 weeks (n=75) for the high-risk group. Patients were irradiated with standard techniques appropriate to the site of disease and likely areas of spread. The study end points were locoregional control (LRC), survival, and morbidity. Results: Patients with low or intermediate risks had significantly higher LRC and survival rates than those with high-risk features (p=0.003 and p=0.0001, respectively), despite receiving no PORT or lower dose PORT, respectively. For high-risk patients, a trend toward higher LRC and survival rates was noted when PORT was delivered in 5 rather than 7 weeks. A prolonged interval between surgery and PORT in the 7-week schedule was associated with significantly lower LRC (p=0.03) and survival (p=0.01) rates. Consequently, the cumulative duration of combined therapy had a significant impact on the LRC (p=0.005) and survival (p=0.03) rates. A 2-week reduction in the PORT duration by using the concomitant boost technique did not increase the late treatment toxicity. Conclusions: This Phase III trial established the power of risk assessment using pathologic features in determining the need for, and dose of

Is Anesthesia Technique Associated With a Higher Risk of Mortality or Complications Within 90 Days of Surgery for Geriatric Patients With Hip Fractures?

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Desai, Vimal; Chan, Priscilla H; Prentice, Heather A; Zohman, Gary L; Diekmann, Glenn R; Maletis, Gregory B; Fasig, Brian H; Diaz, Diana; Chung, Elena; Qiu, Chunyuan

2018-06-01

Postoperative mortality and complications after geriatric hip fracture surgery remain high despite efforts to improve perioperative care for these patients. One factor of particular interest is anesthetic technique, but prior studies on this are limited by sample selection, competing risks, and incomplete followup. (1) Among older patients undergoing surgery for hip fracture, does 90-day mortality differ depending on the type of anesthesia received? (2) Do 90-day emergency department returns and hospital readmissions differ based on anesthetic technique after geriatric hip fracture repairs? (3) Do 90-day Agency for Healthcare Research and Quality (AHRQ) outcomes differ according to anesthetic techniques used during hip fracture surgery? We conducted a retrospective study on geriatric patients (65 years or older) with hip fractures between 2009 and 2014 using the Kaiser Permanente Hip Fracture Registry. A total of 1995 (11%) of the surgically treated patients with hip fracture were excluded as a result of missing anesthesia information. The final study sample consisted of 16,695 patients. Of these, 2027 (12%) died and 98 (< 1%) terminated membership during followup, which were handled as competing events and censoring events, respectively. Ninety-day mortality, emergency department returns, hospital readmission, deep vein thrombosis (DVT) or pulmonary embolism (PE), myocardial infarction (MI), and pneumonia were evaluated using multivariable competing risk proportional subdistribution hazard regression according to type of anesthesia technique: general anesthesia, regional anesthesia, or conversion from regional to general. Of the 16,695 patients, 58% (N = 9629) received general anesthesia, 40% (N = 6597) received regional anesthesia, and 2.8% (N = 469) patients were converted from regional to general. Compared with regional anesthesia, patients treated with general anesthesia had a higher likelihood of overall 90-day mortality (hazard ratio [HR], 1.22; 95

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

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.

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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

A Practical and Time-Efficient High-Intensity Interval Training Program Modifies Cardio-Metabolic Risk Factors in Adults with Risk Factors for Type II Diabetes

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Bethan E. Phillips

2017-09-01

Full Text Available IntroductionRegular physical activity (PA can reduce the risk of developing type 2 diabetes, but adherence to time-orientated (150 min week−1 or more PA guidelines is very poor. A practical and time-efficient PA regime that was equally efficacious at controlling risk factors for cardio-metabolic disease is one solution to this problem. Herein, we evaluate a new time-efficient and genuinely practical high-intensity interval training (HIT protocol in men and women with pre-existing risk factors for type 2 diabetes.Materials and methodsOne hundred eighty-nine sedentary women (n = 101 and men (n = 88 with impaired glucose tolerance and/or a body mass index >27 kg m−2 [mean (range age: 36 (18–53 years] participated in this multi-center study. Each completed a fully supervised 6-week HIT protocol at work-loads equivalent to ~100 or ~125% V˙O2 max. Change in V˙O2 max was used to monitor protocol efficacy, while Actiheart™ monitors were used to determine PA during four, weeklong, periods. Mean arterial (blood pressure (MAP and fasting insulin resistance [homeostatic model assessment (HOMA-IR] represent key health biomarker outcomes.ResultsThe higher intensity bouts (~125% V˙O2 max used during a 5-by-1 min HIT protocol resulted in a robust increase in V˙O2 max (136 participants, +10.0%, p < 0.001; large size effect. 5-by-1 HIT reduced MAP (~3%; p < 0.001 and HOMA-IR (~16%; p < 0.01. Physiological responses were similar in men and women while a sizeable proportion of the training-induced changes in V˙O2 max, MAP, and HOMA-IR was retained 3 weeks after cessation of training. The supervised HIT sessions accounted for the entire quantifiable increase in PA, and this equated to 400 metabolic equivalent (MET min week−1. Meta-analysis indicated that 5-by-1 HIT matched the efficacy and variability of a time-consuming 30-week PA program on V˙O2 max, MAP, and HOMA-IR.ConclusionWith a total time-commitment of

Real-time web-based assessment of total population risk of future emergency department utilization: statewide prospective active case finding study.

Science.gov (United States)

Hu, Zhongkai; Jin, Bo; Shin, Andrew Y; Zhu, Chunqing; Zhao, Yifan; Hao, Shiying; Zheng, Le; Fu, Changlin; Wen, Qiaojun; Ji, Jun; Li, Zhen; Wang, Yong; Zheng, Xiaolin; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

2015-01-13

An easily accessible real-time Web-based utility to assess patient risks of future emergency department (ED) visits can help the health care provider guide the allocation of resources to better manage higher-risk patient populations and thereby reduce unnecessary use of EDs. Our main objective was to develop a Health Information Exchange-based, next 6-month ED risk surveillance system in the state of Maine. Data on electronic medical record (EMR) encounters integrated by HealthInfoNet (HIN), Maine's Health Information Exchange, were used to develop the Web-based surveillance system for a population ED future 6-month risk prediction. To model, a retrospective cohort of 829,641 patients with comprehensive clinical histories from January 1 to December 31, 2012 was used for training and then tested with a prospective cohort of 875,979 patients from July 1, 2012, to June 30, 2013. The multivariate statistical analysis identified 101 variables predictive of future defined 6-month risk of ED visit: 4 age groups, history of 8 different encounter types, history of 17 primary and 8 secondary diagnoses, 8 specific chronic diseases, 28 laboratory test results, history of 3 radiographic tests, and history of 25 outpatient prescription medications. The c-statistics for the retrospective and prospective cohorts were 0.739 and 0.732 respectively. Integration of our method into the HIN secure statewide data system in real time prospectively validated its performance. Cluster analysis in both the retrospective and prospective analyses revealed discrete subpopulations of high-risk patients, grouped around multiple "anchoring" demographics and chronic conditions. With the Web-based population risk-monitoring enterprise dashboards, the effectiveness of the active case finding algorithm has been validated by clinicians and caregivers in Maine. The active case finding model and associated real-time Web-based app were designed to track the evolving nature of total population risk, in a

Adult Arabs have higher risk for diabetes mellitus than Jews in Israel.

Directory of Open Access Journals (Sweden)

Anat Jaffe

Full Text Available Diabetes mellitus is an emerging epidemic in the Arab world. Although high diabetes prevalence is documented in Israeli Arabs, information from cohort studies is scant.This is a population study, based on information derived between 2007-2011, from the electronic database of the largest health fund in Israel, among Arabs and Jews. Prevalence, 4-year-incidence and diabetes hazard ratios [HRs], adjusted for sex and the metabolic-syndrome [MetS]-components, were determined in 3 age groups (<50 years, 50-59 years, and ≥60 years.The study cohort included 17,044 Arabs (males: 49%, age: 39.4±17.3 and 16,012 Jews (males: 50%, age: 40.5 ±17.6. The overall age and sex-adjusted diabetes prevalence rates were much higher among Arabs 18.4% (95%CI: 17.6-19.1; and 10.3% (95%CI: 9.7-10.9 among Jews. Arab females had higher prevalence rates 20.0% (95%CI: 19-21 than Arab males 16.7% (95%CI: 15.7-17.8. Annual incidence rates were also significantly higher among Arabs 2.9% (95%CI: 2.7-3.1 than among Jews 1.7% (95%CI: 1.6-1.8. This held true across all age and sex subgroups. Adjustment for body mass index [BMI] attenuated HR estimates associated with Arab ethnicity across all age subgroups, mainly in the <50yrs age group from HR 2.04 (95%CI: 1.74-2.40 to 1.64 (95%CI: 1.40-1.92. BMI at incident diabetes among females was higher in Arabs than Jews. Males, however, did not differ by ethnicity.Arabs, mainly female, have high incidence and prevalence of diabetes. This excess risk is only partially explained by the high prevalence of obesity. Effective culturally-congruent diabetes prevention and treatment and an effective engagement partnership with the Arab community are of paramount need.

Euclidean scalar Green function in a higher dimensional global monopole space-time

International Nuclear Information System (INIS)

Bezerra de Mello, E.R.

2002-01-01

We construct the explicit Euclidean scalar Green function associated with a massless field in a higher dimensional global monopole space-time, i.e., a (1+d)-space-time with d≥3 which presents a solid angle deficit. Our result is expressed in terms of an infinite sum of products of Legendre functions with Gegenbauer polynomials. Although this Green function cannot be expressed in a closed form, for the specific case where the solid angle deficit is very small, it is possible to develop the sum and obtain the Green function in a more workable expression. Having this expression it is possible to calculate the vacuum expectation value of some relevant operators. As an application of this formalism, we calculate the renormalized vacuum expectation value of the square of the scalar field, 2 (x)> Ren , and the energy-momentum tensor, μν (x)> Ren , for the global monopole space-time with spatial dimensions d=4 and d=5

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

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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.

78 FR 10367 - Appraisals for Higher-Priced Mortgage Loans

Science.gov (United States)

2013-02-13

... the current sale. A creditor of a ``higher-risk mortgage'' must also: Provide the applicant, at the... addition, the final rule implements the Act's requirement that the creditor of a ``higher-risk mortgage... provision requiring appraisals for ``higher-risk mortgages'' that was added to TILA by the Dodd-Frank Wall...

Risk Factors for Brachial Plexus Birth Injury

Science.gov (United States)

Louden, Emily; Marcotte, Michael; Mehlman, Charles; Lippert, William; Huang, Bin; Paulson, Andrea

2018-01-01

Over the course of decades, the incidence of brachial plexus birth injury (BPBI) has increased despite advances in healthcare which would seem to assist in decreasing the rate. The aim of this study is to identify previously unknown risk factors for BPBI and the risk factors with potential to guide preventative measures. A case control study of 52 mothers who had delivered a child with a BPBI injury and 132 mothers who had delivered without BPBI injury was conducted. Univariate, multivariable and logistic regressions identified risk factors and their combinations. The odds of BPBI were 2.5 times higher when oxytocin was used and 3.7 times higher when tachysystole occurred. The odds of BPBI injury are increased when tachysystole and oxytocin occur during the mother’s labor. Logistic regression identified a higher risk for BPBI when more than three of the following variables (>30 lbs gained during the pregnancy, stage 2 labor >61.5 min, mother’s age >26.4 years, tachysystole, or fetal malpresentation) were present in any combination. PMID:29596309

Risk Factors for Brachial Plexus Birth Injury

Directory of Open Access Journals (Sweden)

Emily Louden

2018-03-01

Full Text Available Over the course of decades, the incidence of brachial plexus birth injury (BPBI has increased despite advances in healthcare which would seem to assist in decreasing the rate. The aim of this study is to identify previously unknown risk factors for BPBI and the risk factors with potential to guide preventative measures. A case control study of 52 mothers who had delivered a child with a BPBI injury and 132 mothers who had delivered without BPBI injury was conducted. Univariate, multivariable and logistic regressions identified risk factors and their combinations. The odds of BPBI were 2.5 times higher when oxytocin was used and 3.7 times higher when tachysystole occurred. The odds of BPBI injury are increased when tachysystole and oxytocin occur during the mother’s labor. Logistic regression identified a higher risk for BPBI when more than three of the following variables (>30 lbs gained during the pregnancy, stage 2 labor >61.5 min, mother’s age >26.4 years, tachysystole, or fetal malpresentation were present in any combination.

Azacitidine in the 'real-world': an evaluation of 1101 higher-risk myelodysplastic syndrome/low blast count acute myeloid leukaemia patients in Ontario, Canada.

Science.gov (United States)

Mozessohn, Lee; Cheung, Matthew C; Fallahpour, Saber; Gill, Tripat; Maloul, Asmaa; Zhang, Liying; Lau, Olivia; Buckstein, Rena

2018-06-01

The outcome of myelodysplastic syndrome (MDS) patients with uniformly higher-risk disease treated with azacitidine (AZA) in the 'real-world' remains largely unknown. We evaluated 1101 consecutive higher-risk MDS patients (International Prognostic Scoring System intermediate-2/high) and low-blast count acute myeloid leukaemia (AML; 21-30% blasts) patients treated in Ontario, Canada. By dosing schedule, 24·7% received AZA for seven consecutive days, 12·4% for six consecutive days and 62·9% by 5-2-2. Overall, median number of cycles was 6 (range 1-67) and 8 (range 6-14) when restricted to the 692 (63%) patients who received at least 4 cycles. The actuarial median survival was 11·6 months [95% confidence interval (CI) 10·7-12·4) for the entire cohort and 18·0 months (landmark analysis; 95% CI 16·6-19·1 months) for those receiving at least 4 cycles. There was no difference in overall survival (OS) between the 3 dosing schedules (P = 0·87). In our large 'real-world' evaluation of AZA in higher-risk MDS/low-blast count AML, we demonstrated a lower than expected OS. Reassuringly, survival did not differ by dosing schedules. The OS was higher in the 2/3 of patients who received at least 4 cycles of treatment, reinforcing the necessity of sustained administration until therapeutic benefits are realised. This represents the largest 'real-world' evaluation of AZA in higher-risk MDS/low-blast count AML. © 2018 John Wiley & Sons Ltd.

Managing Reputation Risk and Situational Crisis in Higher Institutions of Learning

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Andem Ita Effiong

2014-05-01

Full Text Available Extant literature on crisis and corporate reputation management has presented the Situational Crisis Communication Theory (SCCT model as a valid and reliable framework for managing crisis and predicting stakeholders’perceptions of organizations’ reputation in times of crisis. In order to verifythe applicability of the model in higher institutions of learning in adeveloping country context, a study was conducted in September, 2011 in twopublic universities in Nigeria. The findings of the study revealed thatalthough the institutions did not fully implement the core tenets of SCCT, thestrategies adopted in each of the two crisis situations were similar to some ofthe recommendations of the SCCT in different ways. While one institutionfocused on a strategy similar to what the SCCT model describes as “rebuildcrisis response strategy” with informing and adjusting tactics, the secondinstitution utilized a victimization or “Victimage” strategy with strongattribution of blames; and frequent reminder of the stakeholders of the extentof losses that the institution would incur from the crisis. The outcome wasthat the institution with high emphasis on rebuilding and informationadjustment strategy recorded very little damage to its reputation capital, duringand after the crises. Conversely, the second institution which believed invictimization and high attribution recorded significant losses in reputation assets,which included withdrawal of key stakeholders and loss of recognition ofprograms by some professional agencies. The implication for crisis managers in thetwo institutions includes the need to always approach situational crises in aholistic manner. Such holistic approach would involve a refocus, critical analysis,planning and implementation of crisis response strategies based on the relevantsituations, events, and the people concerned. The research was designed as acase study with focus group discussions as the data collection method

Glycemic control paradox: Poor glycemic control associated with higher one-year and eight-year risks of all-cause hospitalization but lower one-year risk of hypoglycemia in patients with type 2 diabetes.

Science.gov (United States)

Li, Tsai-Chung; Kardia, Sharon L R; Li, Chia-Ing; Chen, Ching-Chu; Liu, Chiu-Shong; Yang, Sing-Yu; Muo, Chin-Shin; Peyser, Patricia A; Lin, Cheng-Chieh

2015-09-01

The relationship between glycemic control and adverse outcomes found in a population with diabetes has seldom been evaluated in patients with type 2 diabetes. We explored the association between hemoglobin A1c (HbA1c) and hospitalization risks within one-year and eight-year follow-up periods. We conducted a retrospective cohort study on 57,061 patients with type 2 diabetes from National Diabetes Case Management Program during 2002-2004 in Taiwan. HbA1c at baseline and in-hospital mortality, all-cause and cause-specific hospitalization over one year and eight years were analyzed. After multivariate adjustment, one-year risk was higher for cases with HbA1c level risk of hypoglycemia hospitalization (0.81, 95% CI: 0.74-0.88). For eight-year risk, subjects with HbA1c level risks of all-cause and diabetes-related hospitalization (1.04, 1.03-1.05, and 1.15, 1.14-1.17, respectively). Higher HbA1c level correlated with lower one-year risk due to hypoglycemia hospitalization but increased one-year and eight-year risks due to all-cause and diabetes-specific hospitalization among Chinese people with type 2 diabetes in Taiwan. Future study must ascertain how to meet HbA1c targets and improve outcome without risk to this population. Copyright © 2015 Elsevier Inc. All rights reserved.

Androgen insensitivity syndrome: Risk of malignancy and timing of surgery in a paediatric and adolescent population

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Dragan Kravarusic

2011-01-01

Full Text Available Background: Management of female phenotype XY disorders poses a series of problems for the treating clinician. Even after a series of investigations and imaging modalities, there are lingering doubts about the exact nature of the disease and the correct management option. Optimal timing and necessity for removal of their testes have been a debated issue by physicians. There is a generally accepted opinion among physicians that the risk of malignancy in androgen insensitivity syndrome (AIS is considerably lower than with other intersex disorders and occurs at a later age. Objective: The highlight of this presentation is to reinforce the value of laparoscopic gonadectomy in management of AIS in correlation with data suggesting higher risk of malignancy. Patients and Methods: A retrospective review of 11 phenotypic females with XY karyotype was carried out. The patients were evaluated by a diagnostic protocol which included clinical, hormonal, sonographic and cytogenetic examinations. Patients/parents were counselled by the team concerning the different treatment modalities and contrary to the assigned gender, laparoscopy was offered to them. Uneventful bilateral gonadectomy was performed in all the patients and gonads submitted for histopathological examination. Results: A total of 11 patients (mean age, 10.4 ΁ 4.1 years, including six with complete AIS and five with partial AIS (PAIS were reviewed. In two patients with PAIS (18.1%, histopathology revealed malignancy (bilateral seminoma and gonadoblastoma and in an additional patient, a benign hamartoma was found. Literature evidence suggests that AIS female phenotype patients retaining their testes through puberty have a 5% chance for developing malignant tumours. Reviewing our results in correlation with literature, we found that PAIS patients may harbour a higher risk of malignancy. Conclusions: In complementation to hormonal tests and cytogenetic techniques, laparoscopic gonadectomy is

Leisure-time physical activity from mid- to late life, body mass index, and risk of dementia.

Science.gov (United States)

Tolppanen, Anna-Maija; Solomon, Alina; Kulmala, Jenni; Kåreholt, Ingemar; Ngandu, Tiia; Rusanen, Minna; Laatikainen, Tiina; Soininen, Hilkka; Kivipelto, Miia

2015-04-01

Physical activity may be beneficial for cognition, but the effect may vary depending on personal characteristics. We investigated the associations between leisure-time physical activity (LTPA) from mid- to late life, the risk of dementia, and the role of body mass index, sex, and APOE in the CAIDE study during 28-year follow-up. Cognitive function of a random subsample was assessed at a mean age of 78.8 years (n = 1511), and dementia/Alzheimer's disease (AD) diagnoses were identified from national registers for the entire target population (n = 3559). Moderate (hazard ratio [HR], 1.46; 95% confidence interval [CI], 1.08-1.99) and low levels of midlife LTPA (HR, 1.39; 95% CI, 0.99-1.95) were associated with higher risk of dementia in comparison with the most active category. The benefits were more pronounced among men, overweight individuals, and APOE ε4 noncarriers. Maintaining high LTPA (HR, 0.16; 95% CI, 0.06-0.41) or increasing LTPA (HR, 0.19; 95% CI, 0.09-0.40) after midlife was associated with lower dementia risk. Similar results were observed for AD. The window of opportunity for preventive physical activity interventions may extend from midlife to older ages. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Ventricular arrhythmia risk stratification in patients with tetralogy of Fallot at the time of pulmonary valve replacement.

Science.gov (United States)

Sabate Rotes, Anna; Connolly, Heidi M; Warnes, Carole A; Ammash, Naser M; Phillips, Sabrina D; Dearani, Joseph A; Schaff, Hartzell V; Burkhart, Harold M; Hodge, David O; Asirvatham, Samuel J; McLeod, Christopher J

2015-02-01

Most patients with repaired tetralogy of Fallot require pulmonary valve replacement (PVR), but the evaluation for and management of ventricular arrhythmia remain unclear. This study is aimed at clarifying the optimal approach to this potentially life-threatening issue at the time of PVR. A retrospective analysis was performed on 205 patients with repaired tetralogy of Fallot undergoing PVR at our institution between 1988 and 2010. Median age was 32.9 (range, 25.6) years. Previous ventricular tachycardia occurred in 16 patients (8%) and 37 (16%) had left ventricular dysfunction, defined as left ventricular ejection fraction tetralogy of Fallot undergoing PVR with history of ventricular tachycardia or left ventricular dysfunction appear to be associated with a higher risk of arrhythmic events after operation. Events in the first year after PVR are rare, and in select high-risk patients, surgical cryoablation does not seem to increase arrhythmic events and may be protective. © 2014 American Heart Association, 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...

Higher risk of developing a subsequent migraine in adults with nonapnea sleep disorders: A nationwide population-based cohort study.

Science.gov (United States)

Harnod, Tomor; Wang, Yu-Chiao; Kao, Chia-Hung

2015-05-01

This nationwide population-based cohort study evaluated the effect of nonapnea sleep disorders (NSDs) on the subsequent development of a migraine. We identified 46,777 patients aged 20 years and older who were diagnosed with an NSD (ICD-9-CM: 307.4 or 780.5) and without coding for apnea-sleep disorders (ICD-9-CM: 780.51, 780.53, or 780.57) between 2000 and 2002 as the sleep disorder (SD) cohort. A comparison cohort of 93,552 people was enrolled. We calculated the adjusted hazard ratio (aHR) for developing a migraine (ICD-9-CM: 346) after adjusting for age, sex, comorbidity, and drug use. A Kaplan-Meier analysis was used to measure the cumulative incidence of a migraine between 2 curves until the end of 2011. The cumulative incidence of a migraine was significantly higher in the SD cohort. The aHR for developing a migraine in the SD cohort was 3.52 (95% CI=3.28-3.79). The risk of developing a migraine with an NSD was higher in men (aHR=4.31) than in women (aHR=3.35). The age-stratified effect of an NSD on developing a migraine was highest among patients aged 55 years and younger. Higher risks of developing a migraine were observed among the participants without any comorbidity and without any drug treatment for their insomnia. The findings of this population-based cohort study indicate a higher risk of developing a subsequent migraine in patients with an NSD, which could be considered an independent, predisposing factor for developing subsequent a migraine in adulthood. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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

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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

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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.

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.

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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.

Time of highest tuberculosis death risk and associated factors: an observation of 12 years in Northern Thailand

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Saiyud Moolphate

2011-02-01

patients at higher risk for TB death. These findings would be useful for prioritizing interventions in order to diminish TB-related deaths globally. Studies based on these findings are necessary for the introduction of newer intervention strategies.Keywords: tuberculosis, TB death, Thailand, time of death

Radiofrequency ablation assisted by real-time virtual sonography for hepatocellular carcinoma inconspicuous under sonography and high-risk locations

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Cheng-Han Lee

2015-08-01

Full Text Available Radiofrequency ablation (RFA is an effective and real-time targeting modality for small hepatocellular carcinomas (HCCs. However, mistargeting may occur when the target tumor is confused with cirrhotic nodules or because of the poor conspicuity of the index tumor under ultrasonography (US. Real-time virtual sonography (RVS can provide the same reconstruction computed tomography images as US images. The aim of this study is to investigate the usefulness of RVS-assisted RFA for HCCs that are inconspicuous or conspicuous under US. A total of 21 patients with 28 HCC tumors—divided into US inconspicuous and high-risk subgroup (3 tumors in 3 patients, US inconspicuous and nonhigh-risk subgroup (5 tumors in 4 patients, US conspicuous and high-risk subgroup (16 tumors in 14 patients, and US conspicuous and nonhigh-risk subgroup (4 tumors in 3 patients—underwent RVS-assisted RFA between May 2012 and June 2014 in our institution. The mean diameter of the nodules was 2.0 ± 1.1 cm. The results showed that the complete ablation rate is 87.5% (7/8 in the US undetectable group and 75% (15/20 in the US detectable group. A comparison between six tumors with incomplete ablation and 22 tumors with complete ablation showed higher alpha-fetoprotein level (mean, 1912 ng/mL vs. 112 ng/mL and larger tumor size (mean diameter, 26 mm vs. 16 mm in the incomplete ablation nodules (both p < 0.05. In conclusion, RVS-assisted RFA is useful for tumors that are difficult to detect under conventional US and may also be useful for tumors in high-risk locations because it may prevent complication induced by mistargeting.

Quantification of excess risk for diabetes for those born in times of hunger, in an entire population of a nation, across a century.

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Thurner, Stefan; Klimek, Peter; Szell, Michael; Duftschmid, Georg; Endel, Gottfried; Kautzky-Willer, Alexandra; Kasper, David C

2013-03-19

Based on a unique dataset comprising all 325,000 Austrian patients that were under pharmaceutical treatment for diabetes during 2006 and 2007, we measured the excess risk of developing diabetes triggered by undernourishment in early life. We studied the percentage of all diabetes patients in the total population specifically for each year of birth, from 1917 to 2007. We found a massive excess risk of diabetes in people born during the times of the three major famines and immediately after, which occurred in Austria in the 20th century: 1918-1919, 1938, and 1946-1947. Depending on the region, there was an up to 40% higher chance of having diabetes when born in 1919-1921, compared with 1918 or 1922, where age-specific typical diabetes ratios are observed. The excess risk for diabetes was practically absent in those provinces of Austria that were less affected by the famines. We show that diabetes rates exhibit nontrivial, age-specific sex differences, and correlate with the economic wealth of the region. Our results might be of relevance for establishing higher awareness in the health system for those born in high-risk years, and underline the importance of ensuring sufficient nutrition in prenatal and early stages of life.

Longitudinal AddiQoL scores may identify higher risk for adrenal crises in Addison's disease.

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Meyer, Gesine; Koch, Maike; Herrmann, Eva; Bojunga, Jörg; Badenhoop, Klaus

2018-05-01

Several studies have shown a reduced quality of life (QoL) in patients with Addison's disease (AD), but investigations of QoL over a long-term course are lacking. Adrenal crises (AC) are life-threatening complications in AD. The purpose of this prospective study was to test whether the repeated use of QoL-questionnaires can detect prodromal periods of an AC. 110 patients with AD were asked to complete the disease specific-QoL questionnaire AddiQoL and a short questionnaire about adverse events once monthly over a period of ten months. AC was defined if at least two of the following symptoms were reported: (a) hypotension, (b) nausea or vomiting, (c) severe fatigue, (d) documented hyponatremia, hyperkalemia, or hypoglycemia, and subsequent parenteral glucocorticoid administration was carried out. Prevalence of AC was 10.9/100 patient years. AddiQoL scores in patients with AC showed a trend (p = 0,08) to a wider fluctuation over time. Subjective precrises not meeting the criteria for AC were reported by 31 patients who had significantly lower AddiQoL scores (p = 0,018). These are the first data showing the course of QoL during a period of ten months in patients with AD. Incidence of AC exceeds previous data. Our data show, that subjective precrises in AD associate with lower QoL. AC, as well as precrises affect intraindividual AddiQol-scores over time with a trend to a stronger fluctuation. Longitudinal AddiQol scores and self-reporting of precrises via patient diaries are additional clinical tools to identify higher risk for critical events.

Does antimicrobial usage before meningitis lead to a higher risk of adult postsurgical Acinetobacter baumannii meningitis than that of Enterobacteriaceae meningitis?

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Demiraslan, Hayati; Ulutabanca, Halil; Ercal, Baris Derya; Metan, Gokhan; Alp, Emine

2016-12-01

Acinetobacter baumannii and Enterobacteriaceae are two pathogens responsible for postneurosurgical meningitis. The aim of this retrospective study was to evaluate the factors that influenced the outcomes in patients with postneurosurgical meningitis caused by A. baumannii and Enterobacteriaceae. Patients with post-surgical meningitis were identified from infection control committee charts between 2007 and 2015. Subjects over 16 years old who had positive cerebral spinal fluid cultures for A. baumannii or Enterobacteriaceae were enrolled in the study. Clinical and laboratory data for 30 patients with A. baumannii meningitis were compared with those of 12 patients with Enterobacteriaceae meningitis. The mean age of patients was 51.9 years and 57.1% were male. Eleven patients had comorbidities, the most common being diabetes mellitus. Most patients were due to intracranial haemorrhage (78.6%). The rate of the patients who received an appropriate antimicrobial therapy was 35.7%, and the crude mortality rate was 64.3%. In univariate analysis, previous antibiotic use, an infection before meningitis and mechanical ventilation had an increased risk of A. baumannii meningitis. Moreover, intrathecal antimicrobial use, inappropriate empirical antimicrobial use, antimicrobial resistance and alanine aminotransferase elevation were significantly higher in patients with A. baumannii meningitis than in those with Enterobacteriaceae meningitis. Antimicrobial use before meningitis (8.84 times) and mechanical ventilation (7.28 times) resulted in an increased risk of A. baumannii meningitis. None of the results affected 30-day mortality. Avoidance of unnecessarily prolonged antimicrobial usage may help to prevent a selection of A. baumannii.

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...

VOICE DISORDERS AMONG TEACHERS IN SLOVENIA: PREVALENCE AND SOME RISK FACTORS

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Tanja Soklič

2004-06-01

Full Text Available Background. Teachers as voice professionals with heavy vocal load represent a population at high risk of vocal problems. Until now there has not been any study evaluating prevalence and risk factors for voice disorders among teachers in Slovenia.Methods. Questionnaires about voice disorders and vocal habits were sent to randomly chosen 10% of elementary, middle schools and kindergarten in Slovenia. Answers from 1509 completed questionnaires were analyzed by statistical program SPSS 11.0.Results. In the school year 2002/03 51% of teachers occasionally experienced voice disorders and 15% did frequently. The prevalence of transient voice problems was therefore about 66%. By univariate χ 2 test we found statistically significant relationship to frequent voice disorders for female sex (p < 0.02, middle school teachers (p < 0.02, age over 40 years (p < 0.0005 and atopic constitution (p < 0.006; voice disorders during study showed borderline significance (p < 0.07. There was no significant relationship to voice problems for yelling, talking loudly or rapidly, using chalk while talking, cigarette smoking, water intake and gastroesophageal reflux. Statistically significant variates were included in the multivariate logistic regression model. There was 1.9-times higher risk of experiencing frequent voice disorders in females than for males (p < 0.003. Risk of vocal problems in middle school teachers was 1.5-times higher than in kindergarten teachers (p < 0.01 and 1.8-times higher than in elementary school teachers (p < 0.0005. Age over 40 years carried 2,3-times higher risk for hoarseness than age under 40 years (p < 0.0005. Voice disorders during study showed 1.7-times higher risk for later occupational vocal problems (p < 0.02. Atopic constitution had 1.6-times higher risk for frequent vocal problems (p < 0.008. The questionaire also showed how unfamiliar to vocal hygiene Slovene teachers are.Conclusions. The prevalence of voice disorders among

Heavy Smoking Is Associated With Lower Age at First Episode of Acute Pancreatitis and a Higher Risk of Recurrence.

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Munigala, Satish; Conwell, Darwin L; Gelrud, Andres; Agarwal, Banke

2015-08-01

There is limited data on cigarette smoking and the risk of acute pancreatitis (AP). We evaluated the influence of cigarette smoking on AP risk and clinical presentation in a large cohort of Veteran's Administration (VA) patients. Retrospective study of VA patients from 1998 to 2007. Exclusion criteria included (1) history of chronic pancreatitis (n = 3222) or gallstones (n = 14,574) and (2) age younger than 15 years (n = 270). A 2-year washout period was used to exclude patients with pre-existing recurrent AP. The study included 484,624 patients. From 2001 to 2007, a total of 6799 (1.4%) patients had AP. Alcohol (risk ratio, 4.20) and smoking (risk ratio, 1.78) were independent significant risk factors of AP on multiple regression analysis. Smoking increased the risk of AP in both nonalcoholics (0.57% vs 1.1%) and alcoholics (2.6% vs 4.1%). Smoking was associated with younger mean age at first episode of AP and higher likelihood of recurrent AP (≥4 episodes) in both nonalcoholics and alcoholics. The interval between recurrent episodes was not altered by alcohol or smoking. In a large cohort of VA patients, smoking is an independent risk factor for AP and augmented the effect of alcohol on the risk, age of onset, and recurrence of AP.

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.

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...

Longitudinal social-interpersonal functioning among higher-risk responders to acute-phase cognitive therapy for recurrent major depressive disorder.

Science.gov (United States)

Vittengl, Jeffrey R; Clark, Lee Anna; Thase, Michael E; Jarrett, Robin B

2016-07-15

Social-interpersonal dysfunction increases disability in major depressive disorder (MDD). Here we clarified the durability of improvements in social-interpersonal functioning made during acute-phase cognitive therapy (CT), whether continuation CT (C-CT) or fluoxetine (FLX) further improved functioning, and relations of functioning with depressive symptoms and relapse/recurrence. Adult outpatients (N=241) with recurrent MDD who responded to acute-phase CT with higher risk of relapse (due to unstable or partial remission) were randomized to 8 months of C-CT, FLX, or pill placebo plus clinical management (PBO) and followed 24 additional months. We analyzed repeated measures of patients' social adjustment, interpersonal problems, dyadic adjustment, depressive symptoms, and major depressive relapse/recurrence. Large improvements in social-interpersonal functioning occurring during acute-phase CT (median d=1.4) were maintained, with many patients (median=66%) scoring in normal ranges for 32 months. Social-interpersonal functioning did not differ significantly among C-CT, FLX, and PBO arms. Beyond concurrently measured residual symptoms, deterioration in social-interpersonal functioning preceded and predicted upticks in depressive symptoms and major depressive relapse/recurrence. Results may not generalize to other patient populations, treatment protocols, or measures of social-interpersonal functioning. Mechanisms of risk connecting poorer social-interpersonal functioning with depression were not studied. Average improvements in social-interpersonal functioning among higher-risk responders to acute phase CT are durable for 32 months. After acute-phase CT, C-CT or FLX may not further improve social-interpersonal functioning. Among acute-phase CT responders, deteriorating social-interpersonal functioning provides a clear, measurable signal of risk for impending major depressive relapse/recurrence and opportunity for preemptive intervention. Copyright © 2016 Elsevier B

Real-Time Optimal Flood Control Decision Making and Risk Propagation Under Multiple Uncertainties

Science.gov (United States)

Zhu, Feilin; Zhong, Ping-An; Sun, Yimeng; Yeh, William W.-G.

2017-12-01

Multiple uncertainties exist in the optimal flood control decision-making process, presenting risks involving flood control decisions. This paper defines the main steps in optimal flood control decision making that constitute the Forecast-Optimization-Decision Making (FODM) chain. We propose a framework for supporting optimal flood control decision making under multiple uncertainties and evaluate risk propagation along the FODM chain from a holistic perspective. To deal with uncertainties, we employ stochastic models at each link of the FODM chain. We generate synthetic ensemble flood forecasts via the martingale model of forecast evolution. We then establish a multiobjective stochastic programming with recourse model for optimal flood control operation. The Pareto front under uncertainty is derived via the constraint method coupled with a two-step process. We propose a novel SMAA-TOPSIS model for stochastic multicriteria decision making. Then we propose the risk assessment model, the risk of decision-making errors and rank uncertainty degree to quantify the risk propagation process along the FODM chain. We conduct numerical experiments to investigate the effects of flood forecast uncertainty on optimal flood control decision making and risk propagation. We apply the proposed methodology to a flood control system in the Daduhe River basin in China. The results indicate that the proposed method can provide valuable risk information in each link of the FODM chain and enable risk-informed decisions with higher reliability.

Risk and associated risk factors of hospitalization for specific health problems over time in childhood cancer survivors : a medical record linkage study

NARCIS (Netherlands)

Font-Gonzalez, Anna; Feijen, Elizabeth Lieke A.M.; Geskus, Ronald B; Dijkgraaf, Marcel G. W.; van der Pal, Helena J.H.; Heinen, Richard C.; Jaspers, Monique W; van Leeuwen, Flora E.; Reitsma, J. B.Johannes; Caron, Hubert N; Sieswerda, Elske; Kremer, Leontien C M

2017-01-01

Childhood cancer survivors (CCS) experience higher hospitalization rates compared to the general population for neoplasms, circulatory diseases, endocrine/nutritional/metabolic diseases and eye disorders. We studied trends in hospitalization rates and associated patient and treatment-specific risk

Metabolic Risk Factors, Leisure Time Physical Activity, and Nutrition in German Children and Adolescents

Science.gov (United States)

Haas, Gerda-Maria; Liepold, Evelyn; Schwandt, Peter

2012-01-01

Purpose. We assessed the five components of the metabolic syndrome (MetS) as defined by the International Diabetes Federation (IDF) in 6040 (3158 males) youths aged 6–16 years who participated in the Präventions-Erziehungs-Programm (PEP Family Heart Study) in Nuernberg between 2000 and 2007. The purpose of this cross-sectional study was to examine associations with lifestyle habits. Results and Discussion. The prevalence of MetS was low in children (1.6%) and adolescents (2.3%). High waist circumference (WC) and low HDL-C were slightly higher in females (9.5% and 7.5%, resp.) than in males (8.8% and 5.7%, resp.). Low leisure time physical activity (LTPA) was significantly associated with low HDL-C (odds ratio [OR] 2.4; 95% CI 1.2–5.0) and inversely associated with hypertension (r = −0.146), hypertriglyceridemia (r = −0.141), and central adiposity (r = −0.258). The risk for low HDL-C (≤1.3 mmol/L) was 1.7-fold (CI 1.0–2.6) higher in youth with high (≥33%) saturated fat consumption. A low polyunsaturated/saturated fat ratio (P/S ratio) was significantly associated with fasting hyperglycemia (OR 1.4; 95% CI 1.0–1.2). PMID:22778928

Sterol 27-Hydroxylase Polymorphism Significantly Associates With Shorter Telomere, Higher Cardiovascular and Type-2 Diabetes Risk in Obese Subjects

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Sofia Pavanello

2018-06-01

Full Text Available Background/objectivesThe pathologic relationship linking obesity and lipid dismetabolism with earlier onset of aging-related disorders, including cardiovascular disease (CVD and type-2 diabetes (T2D, is not fully elucidate. Chronic inflammatory state, in obese individuals, may accelerate cellular aging. However, leukocyte telomere length (LTL, the cellular biological aging indicator, is elusively linked with obesity. Recent studies indicate that sterol 27-hydroxylase (CYP27A1 is an emerging antiatherogenic enzyme, that, by converting extrahepatic cholesterol to 27-hydroxycholesterol, facilitates cholesterol removal via high-density lipoprotein-cholesterol (HDL-C. We tested the hypothesis that obese subjects who carry at least three copies of CYP27A1 low-hydroxylation (LH activity genome-wide-validated alleles (rs4674345A, rs1554622A, and rs4674338G present premature aging, as reflected in shorter LTL and higher levels of CVD/T2D risk factors, including reduced HDL-C.Subjects/methodsObese subjects from SPHERE project {n = 1,457; overweight [body mass index (BMI 25–30 kg/m2] 65.8% and severe-obese (BMI > 30 kg/m2 34.2%} were characterized for the presence from 0 to 6 LH-CYP27A1 allele copy number. Univariate and multivariable sex–age–smoking-adjusted linear-regression models were performed to compare CVD/T2D risk factors and biological aging (LTL in relation to the combined BMI-LH groups: overweight-LH: 0–2, overweight-LH: 3–6, severe-obese-LH: 0–2, and severe-obese-LH: 3–6.ResultsHigher LTL attrition was found in severe-obese than overweight individuals (p < 0.001. Multivariable model reveals that among severe-obese patients those with LH: 3–6 present higher LTL attrition than LH: 0–2 (p < 0.05. Univariate and multivariable models remarkably show that insulin resistance is higher both in overweight-LH: 3–6 vs overweight-LH: 0–2 (p < 0.001 and in severe-obese-LH: 3–6 vs severe-obese-LH: 0–2 (p�

Flight time, number of sectors and risk of low back pain among short and medium haul commercial female flight attendants in Indonesia

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Irma Khrisnapandit

2016-07-01

with LBP among short and medium haul commercial female flight attendants in Indonesia. Methods: Cross-sectional study with purposive sampling among short and medium haul commercial female flight attendants who conduct medical examination on May 5-26th 2014 at Civil Aviation Medical Center. Demographic, job and LBP data collected using questionnaire and physical examination. Definition of LBP was historically pain that ever or still felt in lower back in the last month, non-neural, and no non-working related acute injury. Cox regression analysis used to identify risk factor associated LBP. Results: Among 333 female flight attendants who were conducting medical examination, 287 attendants willing to participate, and 240 meet inclusion criteria. There are 37.9% flight attendants experienced LBP. The dominant factors increasing LBP risk were flight time and number of sectors in the last 24 consecutive hours. Female flight attendant with 9 hours or more flight time compared with less have 82% higher LBP risk [adjusted relative risk (RRa = 1.82; p = 0.000]. Review from number of sectors in the last 24 consecutive hours, female flight attendant with 4 sectors or more compared with less have 53% higher LBP risk (RRa = 1.53; p = 0.034.   Conclusion: Nine hours or more flight time and 4 sectors or more in the last 24 consecutive hours have higher risk of LBP Key words: low back pain, female flight attendant, flight time, number of sectors, short and medium haul flight

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.

Hepatocellular carcinoma risk in relation to atomic-bomb radiation and hepatitis virus infections

International Nuclear Information System (INIS)

Fujiwara, S.; Cologne, J.B.; Hattori, N.; Suzuki, G.

2003-01-01

In Japan, most cases of hepatocellular carcinoma (HCC) are related to chronic hepatitis C (HCV) or B (HBV) virus infections. Increased liver cancer risk among atomic-bomb survivors has been reported based on mortality studies or tumor registries, but virus infection status-particularly B, which is associated with radiation dose-was not taken account. The objectives of this study were to determine HCC risk in relation to radiation exposure, after adjusting for virus infection in a cohort follow-up study. The study subjects were 6,121 Adult Health Study participants who received tests for hepatitis C and B virus antigen or antibody in 1993-5. A total of 58 HCC cases were newly diagnosed during 1993-2002. As of August 2002, 8% of individuals positive for HCV antibody subsequently developed HCC, compared with less than 1% of individuals who were negative for HCV antibody. Cox regression analysis revealed that the incidence of HCC was 27 times higher among HCV antibody positive individuals and 7 times higher among HBV surface antigen positive individuals. Men had 1.6 times higher risk than women. The risk of HCC increased with age at exam overall but declined with age at exam among the HCV-infected persons. Risk of HCC was 1.3 times higher on average among individuals exposed to radiation, but persons who were younger at the time of bombing had a higher risk of HCC for radiation. There was no evidence of interaction between HCV and radiation exposure. In conclusion, hepatocellular carcinoma risk increased with radiation exposure among persons exposed at young ages, even after adjusting for hepatitis virus infection. There was no evidence of synergy between radiation and HCV infection in this late follow-up. Further study including earlier diagnosed cases is needed to clarify this issue

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

Joint association of physical activity/screen time and diet on CVD risk factors in 10-year-old children.

Science.gov (United States)

Drenowatz, Clemens; Carlson, Joseph J; Pfeiffer, Karin A; Eisenmann, Joey C

2012-12-01

The increasing prevalence of childhood overweight and obesity has been associated with an increased risk for cardiovascular disease (CVD). While several studies examined the effect of single behaviors such as physical activity (PA), sedentary behavior or diet on CVD risk, there is a lack of research on combined associations, specifically in children. Therefore, the purpose of this study was to examine the joint association of PA or screen time (ST) and diet on CVD risk factors in children. PA, STand diet were assessed via questionnaire in 210 fifth grade students (age: 10.6 ± 0.4 years). The healthy eating index (HEI) was subsequently calculated as indicator for diet quality. Height, weight, % body fat, and resting blood pressure were measured according to standard procedures and blood samples obtained via fingerprick were assayed for blood lipids. Total cholesterol HDL ratio (TC:HDL), mean arterial pressure (MAP), and % body fat were used as indicators of CVD risk. 55% of children did not meet current PA recommendations on at least 5 days/week and 70% exceeded current recommendations for ST. Further, only 2.5% possessed a "good" diet (HEI> 80). There was no significant association of PA or STand diet on CVD risk score. Neither TC:HDL, MAP, and % body fat nor the total CVD risk score was significantly correlated with diet, PA, or ST. Children in the high PA group, however, had significantly better diet scores. Despite the fact that self-reported PA, ST, or dietary intake were not directly related to CVD risk in this sample, higher activity levels were associated with a healthier diet and lower ST indicating an overall healthier lifestyle of this subgroup.

The Cancer of the Prostate Risk Assessment (CAPRA) in patients treated with external beam radiation therapy: Evaluation and optimization in patients at higher risk of relapse

International Nuclear Information System (INIS)

Halverson, Schuyler; Schipper, Matthew; Blas, Kevin; Lee, Vivien; Sabolch, Aaron; Olson, Karin; Sandler, Howard M.; Feng, Felix Y.; Hamstra, Daniel A.

2011-01-01

Background: The Cancer of the Prostate Risk Assessment (CAPRA) was developed to predict freedom from biochemical failure (FFBF) following radical prostatectomy (RP). Its utility following external beam radiation therapy (EBRT) has not been externally evaluated. Methods: A retrospective study of 612 patients treated with dose-escalated EBRT at University of Michigan Medical Center. Results: Compared to the derivation cohort, EBRT treated patients had higher-risk disease (28% with CAPRA of 6–10 vs. 5%, respectively). A total of 114 patients (19%) had BF with 5-year BF ranging from 7% with CAPRA 0–3 to 35% with CAPRA 7–10. For RT patients the risk of BF at 5-year was similar to 4 surgical cohorts for CAPRA scores 0–2 but lower for all CAPRA scores ⩾ 3. The difference favoring RT increased with increasing CAPRA score reaching a 27–50% absolute improved at 5-years for CAPRA scores of 6–10. On multivariate analysis each CAPRA point increased the risk of BF (p < 0.0001) while Gleason pattern 5 in the biopsy also increased BF (p = 0.01) and long-term androgen deprivation therapy (ADT) significantly reduced the risk of BF (p = 0.015). Conclusions: Compared to surgical series the risk of BF was lower with dose-escalated EBRT with the greatest difference at the highest CAPRA scores.

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.

Improving Spiking Dynamical Networks: Accurate Delays, Higher-Order Synapses, and Time Cells.

Science.gov (United States)

Voelker, Aaron R; Eliasmith, Chris

2018-03-01

Researchers building spiking neural networks face the challenge of improving the biological plausibility of their model networks while maintaining the ability to quantitatively characterize network behavior. In this work, we extend the theory behind the neural engineering framework (NEF), a method of building spiking dynamical networks, to permit the use of a broad class of synapse models while maintaining prescribed dynamics up to a given order. This theory improves our understanding of how low-level synaptic properties alter the accuracy of high-level computations in spiking dynamical networks. For completeness, we provide characterizations for both continuous-time (i.e., analog) and discrete-time (i.e., digital) simulations. We demonstrate the utility of these extensions by mapping an optimal delay line onto various spiking dynamical networks using higher-order models of the synapse. We show that these networks nonlinearly encode rolling windows of input history, using a scale invariant representation, with accuracy depending on the frequency content of the input signal. Finally, we reveal that these methods provide a novel explanation of time cell responses during a delay task, which have been observed throughout hippocampus, striatum, and cortex.

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.

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.

Risk for obesity in adolescence starts in early childhood.

Science.gov (United States)

Shankaran, S; Bann, C; Das, A; Lester, B; Bada, H; Bauer, C R; La Gasse, L; Higgins, R D

2011-11-01

The objective of this study was to assess the predictive value of body mass index (BMI) at earlier ages on risk of overweight/obesity at age of 11 years. This is a longitudinal study of 907 children from birth to age of 11 years. Predictors include BMI at earlier ages and outcome is overweight/obesity status at age of 11 years. Analyses were adjusted for covariates known to affect BMI. At 11 years, 17% were overweight and 25% were obese. Children whose BMI was measured as ≥85th percentile once at preschool age had a twofold risk for overweight/obesity at 11 years of age. Risk increased by 11-fold if a child's BMI measured was noted more than once during this age. During early elementary years, if a child's BMI was>85th percentile once, risk for overweight/obesity at 11 years was fivefold and increased by 72-fold if noted more than two times. During late elementary years, if a child's BMI was>85th percentile once, risk for overweight/obesity was 26-fold and increased by 351-fold if noted more than two times. Risk of overweight/obesity at 11 years was noted with higher maternal prepregnancy weight, higher birth weight, female gender and increased television viewing. Children in higher BMI categories at young ages have a higher risk of overweight/obesity at 11 years of age. Effect size was greater for measurements taken closer to 11 years of age. Pediatricians need to identify children at-risk for adolescent obesity and initiate counseling and intervention at earlier ages.

Higher perceived risk of antimicrobials is related to lower antimicrobial usage among pig farmers in four European countries.

Science.gov (United States)

Visschers, V H M; Postma, M; Sjölund, M; Backhans, A; Collineau, L; Loesken, S; Belloc, C; Dewulf, J; Emanuelson, U; Grosse Beilage, E; Siegrist, M; Stärk, K D C

2016-11-12

The prudent use of antimicrobials (AMs) should be widened in pig farming to reduce the risk of AM resistance (AMR) in human and veterinary medicine. It is therefore important to understand pig farmers' motivators and the barriers to AM usage (AMU) on their farms. The authors investigated pig farmers' self-estimated levels of AMU, their perceived benefits and risks and the need for AMs in a cross-sectional survey in Belgium, France, Germany and Sweden. The authors also compared these perceptions between the four countries and related them to pig farmers' actual AMU. The results showed that farmers who used more AMs also estimated their own usage as higher. Farmers perceived many benefits but relatively few risks of AMU in pig farming. Some significant cross-country differences in farmers' perceptions were found, but they were relatively small. After controlling for country differences and farm differences, only perceived risks had a significant association with AMU. The authors therefore conclude that in order to promote prudent AMU, it seems most promising to focus on the structural differences in pig farming and veterinary medicine (e.g. legislation, role of the veterinarian) among countries. In addition, interventions which aim at reducing AMU should increase farmers' awareness of the risks of extensive AMU. British Veterinary Association.

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.

78 FR 78519 - Appraisals for Higher-Priced Mortgage Loans

Science.gov (United States)

2013-12-26

... where the holder of the credit risk of the existing obligation remains the same on the refinancing. The....'' Specifically, new TILA section 129H prohibits a creditor from extending credit in the form of a ``higher-risk... rule.\\8\\ The term ``higher-risk mortgage'' generally encompasses a closed-end consumer credit...

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.

An analysis of timing and frequency of malaria infection during pregnancy in relation to the risk of low birth weight, anaemia and perinatal mortality in Burkina Faso.

Science.gov (United States)

Valea, Innocent; Tinto, Halidou; Drabo, Maxime K; Huybregts, Lieven; Sorgho, Hermann; Ouedraogo, Jean-Bosco; Guiguemde, Robert T; van Geertruyden, Jean Pierre; Kolsteren, Patrick; D'Alessandro, Umberto

2012-03-16

A prospective study aiming at assessing the effect of adding a third dose sulphadoxine-pyrimethamine (SP) to the standard two-dose intermittent preventive treatment for pregnant women was carried out in Hounde, Burkina Faso, between March 2006 and July 2008. Pregnant women were identified as earlier as possible during pregnancy through a network of home visitors, referred to the health facilities for inclusion and followed up until delivery. Study participants were enrolled at antenatal care (ANC) visits and randomized to receive either two or three doses of SP at the appropriate time. Women were visited daily and a blood slide was collected when there was fever (body temperature > 37.5°C) or history of fever. Women were encouraged to attend ANC and deliver in the health centre, where the new-born was examined and weighed. The timing and frequency of malaria infection was analysed in relation to the risk of low birth weight, maternal anaemia and perinatal mortality. Data on birth weight and haemoglobin were available for 1,034 women. The incidence of malaria infections was significantly lower in women having received three instead of two doses of SP. Occurrence of first malaria infection during the first or second trimester was associated with a higher risk of low birth weight: incidence rate ratios of 3.56 (p pregnancy (adjusted incidence rate ratio = 2.07, p = 0.002). The risk of maternal anaemia and perinatal mortality was not associated with the timing of first malaria infection. Malaria infection during first trimester of pregnancy is associated to a higher risk of low birth weight. Women should be encouraged to use long-lasting insecticidal nets before and throughout their pregnancy.

Long sleep duration and afternoon napping are associated with higher risk of incident diabetes in middle-aged and older Chinese: the Dongfeng-Tongji cohort study.

Science.gov (United States)

Han, Xu; Liu, Bing; Wang, Jing; Pan, An; Li, Yaru; Hu, Hua; Li, Xiulou; Yang, Kun; Yuan, Jing; Yao, Ping; Miao, Xiaoping; Wei, Sheng; Wang, Youjie; Liang, Yuan; Zhang, Xiaomin; Guo, Huan; Yang, Handong; Hu, Frank B; Wu, Tangchun; He, Meian

2016-01-01

In this study, we investigated the independent and combined effects of sleep duration and afternoon napping on the risk of incident diabetes among a cohort of middle-aged and older Chinese adults. Information of sleep and napping was obtained by questionnaires during face-to-face interviews. We categorized sleep duration into napping was divided into no napping (0 min) (reference), 1-30 min, 31-60 min, 61-90 min, and > 90 min. Cox proportional hazard regression models were used. Compared with referential sleeping group, subjects sleeping ≥10 h had a 42% higher risk of developing diabetes. The HR was 1.28 for napping > 90 min when compared with no napping. These associations were more pronounced in individuals without hypertension. Combined effects of long sleep duration and afternoon napping were further identified. Individuals with both sleep duration ≥ 10 h and napping > 60 min had a 72% higher risk of incident diabetes than those with sleeping 7∼napping 0 min (all above p napping were independently and jointly associated with higher risk of incident diabetes. Key messages Sleep duration was associated with diabetes, but whether it is a real cause of incident diabetes especially in Chinese still remains to be elucidated. The association of afternoon napping and diabetes was not consistent and definite, we clarified this association in a large prospective study. Long sleep duration and afternoon napping were independently and jointly associated with higher risk of incident diabetes.

Time-resolved photoemission micro-spectrometer using higher-order harmonics of Ti:sapphire laser

International Nuclear Information System (INIS)

Azuma, J.; Kamada, M.; Kondo, Y.

2004-01-01

Full text: A new photoemission spectrometer is under construction for the photoemission microscopy and the time-resolved pump- probe experiment. The higher order harmonics of the Ti:sapphire laser is used as the light source of the VUV region in this system. Because the fundamental laser is focused tightly into the rare gas jet to generate the higher order harmonics, the spot size of the laser, in other words, the spot size of the VUV light source is smaller than a few tens of micrometer. This smallness of the spot size has advantage for the microscopy. In order to compensate the low flux of the laser harmonics, a multilayer-coated schwaltzshild optics was designed. The multilayers play also as the monochromatic filter. The spatial resolution of this schwaltzshild system is found to be less than 1 micrometer by the ray-tracing calculations. A main chamber of the system is equipped with a time-of-flight energy analyzer to improve the efficiency of the electron detection. The main chamber and the gas chamber are separated by a differential pumping chamber and a thin Al foil. The system is designed for the study of the clean surface. It will be capable to perform the sub-micron photoemission microscopy and the femto-second pump-probe photoemission study for the various photo-excited dynamics on clean surfaces

Higher freshwater fish and sea fish intake is inversely associated with colorectal cancer risk among Chinese population: a case-control study.

Science.gov (United States)

Xu, Ming; Fang, Yu-Jing; Chen, Yu-Ming; Lu, Min-Shan; Pan, Zhi-Zhong; Yan, Bo; Zhong, Xiao; Zhang, Cai-Xia

2015-08-12

The association between specific fish intake and colorectal cancer risk remains controversial. This study aimed to examine the association between specific fish intake and colorectal cancer risk in Chinese population in a large case control study. During July 2010 to November 2014, 1189 eligible colorectal cancer cases and 1189 frequency-matched controls (age and sex) completed in-person interviews. A validated food frequency questionnaire was used to estimate dietary intake. Multivariate logistical regression models were used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) after adjusting for various confounders. A strong inverse association was found between freshwater fish intake and colorectal cancer risk. Compared with the lowest quartile, the highest quartile intake showed a risk reduction of 53% (OR 0.47, 95% CI = 0.36-0.60, Ptrend colorectal cancer risk. These results indicate that higher consumption of freshwater fish, sea fish and fresh fish is associated with a lower risk of colorectal caner.

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.

Poor nutritional status is associated with a higher risk of falling and fracture in elderly people living at home in France: the Three-City cohort study.

Science.gov (United States)

Torres, M J; Féart, C; Samieri, C; Dorigny, B; Luiking, Y; Berr, C; Barberger-Gateau, P; Letenneur, L

2015-08-01

Falling and fractures are a public health problem in elderly people. The aim of our study was to investigate whether nutritional status is associated with the risk of falling or fracture in community-dwelling elderly. Poor nutritional status was significantly associated with a higher risk of both falling and fractures. Nutrition could play a role to prevent falls and fractures. The purpose of this study is to investigate whether a poor nutritional status is associated with the risk of falling and of fracture in community dwelling elderly. Baseline nutritional status of participants was assessed using the Mini Nutritional Assessment (MNA). After a follow-up of 12 years, 6040 individuals with available data for falls and 6839 for fracture were included. People who presented the outcomes at baseline were excluded. Cox models were used to evaluate the associations between nutritional status and the risks of fall or fracture. The frequency of poor nutritional status (MNA ≤ 23.5), at baseline, was respectively 12.0% in the "fall study sample" and 12.8% in the "fracture study sample." Incident fall and fracture over 12 years were reported in 55.8 and 18.5% of the respective samples, respectively. In multivariate models controlled for sociodemographic data and several baseline health indicators, poor nutritional status was significantly associated with a higher risk of falling (hazard ratio (HR) = 1.66, 95% confidence interval (95% CI) 1.35-2.04 in men and HR = 1.20, 95% CI 1.07-1.34 in women) and with a higher risk of fracture (HR = 1.28, 95% CI 1.09-1.49). Poor nutritional status was associated with a higher risk of both falling and fractures in French elderly community-dwellers. Early screening and management of the nutritional status may be useful to reduce the frequency of these events in older people.

An instrumented timed up and go: the added value of an accelerometer for identifying fall risk in idiopathic fallers

International Nuclear Information System (INIS)

Weiss, A; Herman, T; Plotnik, M; Brozgol, M; Giladi, N; Hausdorff, J M

2011-01-01

The Timed Up and Go (TUG) test is a widely used measure of mobility and fall risk among older adults that is typically scored using a stopwatch. We tested the hypothesis that a body-fixed accelerometer can enhance the ability of the TUG to identify community-living older adults with a relatively high fall risk of unknown origin. Twenty-three community-living elderly fallers (76.0 ± 3.9 years) and 18 healthy controls (68.3 ± 9.1 years) performed the TUG while wearing a 3D-accelerometer on the lower back. Acceleration-derived parameters included Sit-to-Stand and Stand-to-Sit times, amplitude range (Range), and slopes (Jerk). Average step duration, number of steps, average step length, gait speed, acceleration-median, and standard-deviation were also calculated. While the stopwatch-based TUG duration was not significantly different between the groups, acceleration-derived TUG duration was significantly higher (p = 0.007) among the fallers. Fallers generally exhibited lower Range and Jerk (p < 0.01). While TUG stopwatch duration successfully identified 63% of the subjects, an accelerometer-derived three-measure-combination correctly classified 87% of the subjects. Accelerometer-derived measures were generally not correlated with TUG duration. These findings demonstrate that fallers have difficulty with specific TUG aspects that can be quantified using an accelerometer. Without compromising simplicity of testing, an accelerometer can apparently be combined with TUG duration to provide complementary, objective measures that allow for a more complete, sensitive TUG-based fall risk assessment

Higher Prevalence of Left-Handedness in Twins? Not After Controlling Birth Time Confounders.

Science.gov (United States)

Heikkilä, Kauko; Vuoksimaa, Eero; Saari-Kemppainen, Aulikki; Kaprio, Jaakko; Rose, Richard J; Haukka, Jari; Pitkäniemi, Janne; Iivanainen, Matti

2015-10-01

Pregnancy- and birth-related factors may have an effect on handedness. Compared with singletons, twins have a lower birth weight, shorter gestational age, and are at higher risk for birth complications. We tested whether the prevalence of left-handedness is higher among twins than singletons, and if so, whether that difference is fully explained by pregnancy and birth-related differences between twins and singletons. We analyzed Finnish population-based datasets; included were 8,786 twins and 5,892 singletons with information on birth weight (n = 12,381), Apgar scores (n = 11,129), and gestational age (n = 11,811). Two twin cohorts were involved: FinnTwin12 included twins born during 1983-1987, and FinnTwin16 included twins born during 1974-1979. We had two comparison groups of singletons: 4,101 individuals born during 1986-1988 and enrolled in the Helsinki Ultrasound Trial, and 1,791 individuals who were partners of FinnTwin16 twins. We used logistic regression models with writing hand as the outcome for comparison and evaluating effects of covariates. Left-handedness was more common in twins (9.67%) than in singletons (8.27%; p = .004). However, Apgar scores were associated with handedness, and after controlling for covariates, we found no difference in the prevalence of left-handedness between twins and singletons. Increased left-handedness among twins, often reported by others, was evident in our data, but only among our older twin cohorts, and that association disappeared after removing effects of perinatal covariates.

Wavelet Transform Based Higher Order Statistical Analysis of Wind and Wave Time Histories

Science.gov (United States)

Habib Huseni, Gulamhusenwala; Balaji, Ramakrishnan

2017-10-01

Wind, blowing on the surface of the ocean, imparts the energy to generate the waves. Understanding the wind-wave interactions is essential for an oceanographer. This study involves higher order spectral analyses of wind speeds and significant wave height time histories, extracted from European Centre for Medium-Range Weather Forecast database at an offshore location off Mumbai coast, through continuous wavelet transform. The time histories were divided by the seasons; pre-monsoon, monsoon, post-monsoon and winter and the analysis were carried out to the individual data sets, to assess the effect of various seasons on the wind-wave interactions. The analysis revealed that the frequency coupling of wind speeds and wave heights of various seasons. The details of data, analysing technique and results are presented in this paper.

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.

[Gastro-Esophageal Reflux Disease and Malignant Progression - Equal Risk for Men and Women?

Science.gov (United States)

Pech, O

2016-12-01

Gastroesophageal reflux disease (GERD) is highly prevalent in the Western world. Patients with GERD have a 10-fold increased risk to develop a Barrett's esophagus. Patients with Barrett's esophagus have a higher risk for an esophageal adenocarcinoma. Men have more severe reflux with a higher grade of inflammation and acid reflux. This seems to be the reason why men develop a Barrett's esophagus more frequently - the risk is approximately 2-3-fold and the risk for an esophageal adenocarcinoma is even 3-6 times higher. © Georg Thieme Verlag KG Stuttgart · New York.

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...

Risk Factors for Hip Fracture in Japanese Older Adults

Directory of Open Access Journals (Sweden)

Takashi Yamashita

2012-09-01

Full Text Available Risk factors for hip fracture in Japanese older populations are understudied compared with Western countries arguably due to the relatively lower prevalence rates in Japan. Nationally representative data from the Nihon University Japanese Longitudinal Study of Aging were analyzed using logistic regression to examine possible risk factors of hip fractures, separately for older women (n = 2,859 and older men (n = 2,108. Results showed that older Japanese women with difficulty bending their knees (OR = 1.9, with diabetes (OR = 1.7 times, and/or with more activity of daily living limitations (OR = 1.1 had higher risks of hip fracture. Older Japanese men with difficulty bending their knees (OR = 2.6, who use more external prescription drugs (OR = 1.9, and with cancer (OR = 2.0 times had higher risks of hip fracture. Further considerations of gender- and culture-specific factors along with the identified risk factors may provide insights into future intervention programs for hip fracture in Japanese older populations.

Pancreatic cellular injury after cardiac surgery with cardiopulmonary bypass: frequency, time course and risk factors.

Science.gov (United States)

Nys, Monique; Venneman, Ingrid; Deby-Dupont, Ginette; Preiser, Jean-Charles; Vanbelle, Sophie; Albert, Adelin; Camus, Gérard; Damas, Pierre; Larbuisson, Robert; Lamy, Maurice

2007-05-01

Although often clinically silent, pancreatic cellular injury (PCI) is relatively frequent after cardiac surgery with cardiopulmonary bypass; and its etiology and time course are largely unknown. We defined PCI as the simultaneous presence of abnormal values of pancreatic isoamylase and immunoreactive trypsin (IRT). The frequency and time evolution of PCI were assessed in this condition using assays for specific exocrine pancreatic enzymes. Correlations with inflammatory markers were searched for preoperative risk factors. One hundred ninety-three patients submitted to cardiac surgery were enrolled prospectively. Blood IRT, amylase, pancreatic isoamylase, lipase, and markers of inflammation (alpha1-protease inhibitor, alpha2-macroglobulin, myeloperoxidase) were measured preoperatively and postoperatively until day 8. The postoperative increase in plasma levels of pancreatic enzymes and urinary IRT was biphasic in all patients: early after surgery and later (from day 4 to 8 after surgery). One hundred thirty-three patients (69%) experienced PCI, with mean IRT, isoamylase, and alpha1-protease inhibitor values higher for each sample than that in patients without PCI. By multiple regression analysis, we found preoperative values of plasma IRT >or=40 ng/mL, amylase >or=42 IU/mL, and pancreatic isoamylase >or=20 IU/L associated with a higher incidence of postsurgery PCI (P < 0.005). In the PCI patients, a significant correlation was found between the 4 pancreatic enzymes and urinary IRT, total calcium, myeloperoxidase, alpha1-protease inhibitor, and alpha2-macroglobulin. These data support a high prevalence of postoperative PCI after cardiac surgery with cardiopulmonary bypass, typically biphasic and clinically silent, especially when pancreatic enzymes were elevated preoperatively.

Earlier school start times are associated with higher rates of behavioral problems in elementary schools.

Science.gov (United States)

Keller, Peggy S; Gilbert, Lauren R; Haak, Eric A; Bi, Shuang; Smith, Olivia A

2017-04-01

Early school start times may curtail children's sleep and inadvertently promote sleep restriction. The current study examines the potential implications for early school start times for behavioral problems in public elementary schools (student ages 5-12 years) in Kentucky. School start times were obtained from school Web sites or by calling school offices; behavioral and disciplinary problems, along with demographic information about schools, were obtained from the Kentucky Department of Education. Estimated associations controlled for teacher/student ratio, racial composition, school rank, enrollment, and Appalachian location. Associations between early school start time and greater behavioral problems (harassment, in-school removals, suspensions, and expulsions) were observed, although some of these associations were found only for schools serving the non-Appalachian region. Findings support the growing body of research showing that early school start times may contribute to student problems, and extend this research through a large-scale examination of elementary schools, behavioral outcomes, and potential moderators of risk. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Prashant Kumar Patra

2014-04-01

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

Higher Levels of Serum Zonulin May Rather Be Associated with Increased Risk of Obesity and Hyperlipidemia, Than with Gastrointestinal Symptoms or Disease Manifestations.

Science.gov (United States)

Ohlsson, Bodil; Orho-Melander, Marju; Nilsson, Peter M

2017-03-08

Zonulin is considered a biomarker of increased intestinal permeability, and elevated levels have been found in celiac disease. The primary aim of this study was to examine the association between serum zonulin levels and gastrointestinal (GI) symptoms, and secondarily, between zonulin levels and anthropometric and metabolic factors. The offspring ( n = 363) of the participants of the Malmö Diet and Cancer cardiovascular cohort (MDC-CV) were invited to an anthropometric and clinical examination, where fasting plasma glucose levels were measured. Questionnaires about lifestyle factors and medical history were completed along with the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS). Zonulin levels were measured in serum by ELISA. Neither GI symptoms nor GI diseases had any influence on zonulin levels. Higher zonulin levels were associated with higher waist circumference ( p = 0.003), diastolic blood pressure ( p = 0.003), and glucose levels ( p = 0.036). Higher zonulin levels were associated with increased risk of overweight ( p zonulin levels among individuals reporting GI symptoms or GI diseases, but higher zonulin levels are associated with higher waist circumference, diastolic blood pressure, fasting glucose, and increased risk of metabolic diseases.

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.

Perceptions of Time and Long Time Intervals

International Nuclear Information System (INIS)

Drottz-Sjoeberg, Britt-Marie

2006-01-01

There are certainly many perspectives presented in the literature on time and time perception. This contribution has focused on perceptions of the time frames related to risk and danger of radiation from a planned Swedish repository for spent nuclear fuel. Respondents from two municipalities judged SSI's reviews of the entrepreneur's plans and work of high importance, and more important the closer to our time the estimate was given. Similarly were the consequences of potential leakage from a repository perceived as more serious the closer it would be to our time. Judgements of risks related to the storage of spent nuclear fuel were moderately large on the used measurement scales. Experts are experts because they have more knowledge, and in this context they underlined e.g. the importance of reviews of the radiation situation of time periods up to 100,000 years. It was of interest to note that 55% of the respondents from the municipalities did not believe that the future repository would leak radioactivity. They were much more pessimistic with respect to world politics, i.e. a new world war. However, with respect to the seriousness of the consequences given a leakage from the repository, the public group consistently gave high risk estimates, often significantly higher than those of the expert group. The underestimations of time estimates, as seen in the tasks of pinpointing historic events, provide examples of the difficulty of making estimations involving long times. Similar results showed that thinking of 'the future' most often involved about 30 years. On average, people reported memories of about 2.5 generations back in time, and emotional relationships stretching approximately 2.5 generations into the future; 94% of the responses, with respect to how many future generations one had an emotional relationship, were given in the range of 1-5 generations. Similarly, Svenson and Nilsson found the opinion that the current generations' general responsibility for

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.

Leisure-time exercise, physical activity during work and commuting, and risk of metabolic syndrome.

Science.gov (United States)

Kuwahara, Keisuke; Honda, Toru; Nakagawa, Tohru; Yamamoto, Shuichiro; Akter, Shamima; Hayashi, Takeshi; Mizoue, Tetsuya

2016-09-01

Data are limited regarding effect of intensity of leisure-time physical activity on metabolic syndrome. Furthermore, no prospective data are available regarding effect of occupational and commuting physical activity on metabolic syndrome. We compared metabolic syndrome risk by intensity level of leisure-time exercise and by occupational and commuting physical activity in Japanese workers. We followed 22,383 participants, aged 30-64 years, without metabolic syndrome until 2014 March (maximum, 5 years of follow-up). Physical activity was self-reported. Metabolic syndrome was defined by the Joint Statement criteria. We used Cox regression models to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of metabolic syndrome. During a mean follow-up of 4.1 years, 5361 workers developed metabolic syndrome. After adjustment for covariates, compared with engaging in no exercise, the HRs (95 % CIs) for metabolic equivalent hours of exercise per week were 0.99 (0.90, 1.08), 0.99 (0.90, 1.10), and 0.95 (0.83, 1.08), respectively, among individuals engaging in moderate-intensity exercise alone; 0.93 (0.75, 1.14), 0.81 (0.64, 1.02), and 0.84 (0.66, 1.06), among individuals engaging in vigorous-intensity exercise alone; and 0.90 (0.70, 1.17), 0.74 (0.62, 0.89), and 0.81 (0.69, 0.96) among individuals engaging in the two intensities. Higher occupational physical activity was weakly but significantly associated with lower risk of metabolic syndrome. Walking to and from work was not associated with metabolic syndrome. Vigorous-intensity exercise alone or vigorous-intensity combined with moderate-intensity exercise and worksite intervention for physical activity may help prevent metabolic syndrome for Japanese workers.

Association of Genetic Risk for Schizophrenia With Nonparticipation Over Time in a Population-Based Cohort Study.

Science.gov (United States)

Martin, Joanna; Tilling, Kate; Hubbard, Leon; Stergiakouli, Evie; Thapar, Anita; Davey Smith, George; O'Donovan, Michael C; Zammit, Stanley

2016-06-15

Progress has recently been made in understanding the genetic basis of schizophrenia and other psychiatric disorders. Longitudinal studies are complicated by participant dropout, which could be related to the presence of psychiatric problems and associated genetic risk. We tested whether common genetic variants implicated in schizophrenia were associated with study nonparticipation among 7,867 children and 7,850 mothers from the Avon Longitudinal Study of Parents and Children (ALSPAC; 1991-2007), a longitudinal population cohort study. Higher polygenic risk scores for schizophrenia were consistently associated with noncompletion of questionnaires by study mothers and children and nonattendance at data collection throughout childhood and adolescence (ages 1-15 years). These associations persisted after adjustment for other potential correlates of nonparticipation. Results suggest that persons at higher genetic risk for schizophrenia are likely to be underrepresented in cohort studies, which will underestimate risk of this and related psychiatric, cognitive, and behavioral phenotypes in the population. Statistical power to detect associations with these phenotypes will be reduced, while analyses of schizophrenia-related phenotypes as outcomes may be biased by the nonrandom missingness of these phenotypes, even if multiple imputation is used. Similarly, in complete-case analyses, collider bias may affect associations between genetic risk and other factors associated with missingness. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

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.

Diversity in Risk Communication

Directory of Open Access Journals (Sweden)

Agung Nur Probohudono

2013-03-01

Full Text Available This study analyses the communication of the five major categories of risk (business, strategy, market and credit risk disclosure over the volatile 2007-2009 Global Financial Crisis (GFC time period in key South East Asian countries’ manufacturing listed companies. This study is important as it contributes to the literature by providing insights into the voluntary risk disclosure practices using sample countries with different economic scenarios. Key findings are that business risk is the most disclosed category and strategy risk is the least disclosed. Business and credit risk disclosure consistently increase over the three year period, while operating, market and strategy risk disclosure increase in 2008, but then decrease slightly in 2009. Statistical analysis reveals that country of incorporation and size help predict risk disclosure levels. The overall low disclosure levels (26-29% highlight the potential for far higher communication of key risk factors.

Short repeats in the heme oxygenase 1 gene promoter is associated with increased levels of inflammation, ferritin and higher risk of type-2 diabetes mellitus.

Science.gov (United States)

Andrews, Mónica; Leiva, Elba; Arredondo-Olguín, Miguel

2016-09-01

We evaluated the relationship between the HO1 genotype, ferritin levels and the risk of type-2 diabetes and inflammation. Eight hundred thirty-five individuals were evaluated and classified according to their nutritional status and the presence of type-2 diabetes: 153 overweight (OW); 62 obese (OB); 55 type-2 diabetes mellitus (DM); 202 OWDM; 239 OBDM and 124 controls (C). We studied biochemical (glycemia, insulin, lipid profile, liver enzyme, creatinine, hsCRP), hematological (hemoglobin, free erythrocyte protoporphyrin, transferrin receptor and serum Fe and ferritin) and oxidative stress (SOD, GHS and TBARS) parameters. We determined heme oxygenase activity and the (GT)n polymorphism in its gene promoter. Individuals with diabetes, independent of nutritional status, showed high levels of ferritin and HO activity compared to control subjects. Allelic frequency was not different between the groups (Chi(2), NS) however, genotypes were different (Chi(2), P1). The SS (short-short) genotype was higher in all DM individuals compared to controls and MM was higher in controls. SM (short-medium) genotype was an independent risk factor for DM in logistic regression analysis. We observed high risk for type-2 diabetes mellitus in the presence of SM genotype and high levels of ferritin (OR adjusted: 2.7; 1.9-3.6; p1; compared to control group). It was also significantly related to inflammation. The SM genotype in HO1 gene promoter and ferritin levels were associated with higher risk for type-2 diabetes and for having a higher marker of inflammation, which is the main risk factor for the development of chronic diseases. Copyright © 2016 Elsevier GmbH. All rights reserved.

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.

Timing and risk of mood disorders requiring psychotropics in long-term survivors of adult cancers: A nationwide cohort study.

Science.gov (United States)

Huang, Wen-Kuan; Juang, Yeong-Yuh; Chung, Chia-Chi; Chang, Shu-Hao; Chang, John Wen-Cheng; Lin, Yung-Chang; Wang, Hung-Ming; Chang, Hsien-Kun; Chen, Jen-Shi; Tsai, Chieh-Sheng; Yu, Kuang-Hui; Kuo, Chang-Fu; See, Lai-Chu

2018-08-15

The increasing number of long-term cancer survivors over the past few decades poses the challenge of mental health care needs. However, little is known about risks of mood disorders in long-term cancer survivors. Long-term survivors (≥5 years) of adult cancers (LSAC) (n = 190,748) newly diagnosed between January 1, 2000 and December 31, 2007 were matched with one control. The primary outcome was diagnosis of mood disorders requiring psychotropics. Cumulative incidences and sub-hazard ratios (SHR) were calculated and multivariate analyses were conducted after accounting for mortality. The mood disorder risk was significantly higher in the LSAC cohort than in the control cohort (adjusted SHR = 1.16, 95% confidence interval [CI] = 1.13-1.18, P < 0.001). Patients with certain cancer types were at increased risk, particularly in the first 2 years after diagnosis. However, patients with head and neck cancers or esophageal cancers had a higher risk after the 5-year follow-up period. Multivariate analysis indicated that being female, aged 40-59 years, with more than two primary cancers, receiving two or more treatment modalities, having CCI scores higher than 3, a higher urbanization level, and lower monthly income were independently associated with an increased risk of mood disorders. Some potential confounders such as lifestyle factors were not available in the study. These findings call for increased mental health awareness not only in the early years after the cancer diagnosis, but also during long-term follow-up for certain cancer subtypes. Copyright © 2018 Elsevier B.V. All rights reserved.

Hallmarks of Alzheimer disease are evolving relentlessly in Metropolitan Mexico City infants, children and young adults. APOE4 carriers have higher suicide risk and higher odds of reaching NFT stage V at ≤ 40 years of age.

Science.gov (United States)

Calderón-Garcidueñas, Lilian; Gónzalez-Maciel, Angélica; Reynoso-Robles, Rafael; Delgado-Chávez, Ricardo; Mukherjee, Partha S; Kulesza, Randy J; Torres-Jardón, Ricardo; Ávila-Ramírez, José; Villarreal-Ríos, Rodolfo

2018-07-01

Exposures to fine particulate matter (PM 2.5 ) and ozone (O 3 ) above USEPA standards are associated with Alzheimer's disease (AD) risk. Metropolitan Mexico City (MMC) residents have life time exposures to PM 2.5 and O 3 above USEPA standards. We investigated AD intra and extracellular protein aggregates and ultrastructural neurovascular pathology in 203 MMC residents age 25.36 ± 9.23 y. Immunohistochemical methods were used to identify AT8 hyperphosphorilated tau (Htau) and 4G8 (amyloid β 17-24). Primary outcomes: staging of Htau and amyloid, per decade and cumulative PM 2.5 (CPM 2.5 ) above standard. Apolipoprotein E allele 4 (APOE4), age and cause of death were secondary outcomes. Subcortical pretangle stage b was identified in an 11month old baby. Cortical tau pre-tangles, neurofibrillary tangles (NFT) Stages I-II, amyloid phases 1-2, Htau in substantia nigrae, auditory, oculomotor, trigeminal and autonomic systems were identified by the 2nd decade. Progression to NFT stages III-V was present in 24.8% of 30-40 y old subjects. APOE4 carriers have 4.92 times higher suicide odds (p = 0.0006), and 23.6 times higher odds of NFT V (p < 0.0001) v APOE4 non-carriers having similar CPM 2.5 exposure and age. Age (p = 0.0062) and CPM 2.5 (p = 0.0178) were significant for developing NFT V. Combustion-derived nanoparticles were associated with early and progressive damage to the neurovascular unit. Alzheimer's disease starting in the brainstem of young children and affecting 99.5% of young urbanites is a serious health crisis. Air pollution control should be prioritised. Childhood relentless Htau makes a fundamental target for neuroprotective interventions and the first two decades are critical. We recommend the concept of preclinical AD be revised and emphasize the need to define paediatric environmental, nutritional, metabolic and genetic risk factor interactions of paramount importance to prevent AD. AD evolving from childhood is threating the

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

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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.

Directory of Open Access Journals (Sweden)

Andreas Nilsson

Full Text Available Whether amount of time spent in sedentary activities influences on clustered metabolic risk in elderly, and to what extent such an influence is independent of physical activity behavior, remain unclear. Therefore, the aim of the study was to examine cross-sectional associations of objectively assessed physical activity and sedentary behavior on metabolic risk outcomes in a sample of elderly community-dwelling women.Metabolic risk outcomes including waist circumference, systolic and diastolic blood pressures, fasting levels of plasma glucose, HDL-cholesterol and triglycerides were assessed in 120 community-dwelling older women (65-70 yrs. Accelerometers were used to retrieve daily sedentary time, breaks in sedentary time, daily time in light (LPA and moderate-to-vigorous physical activity (MVPA, and total amount of accelerometer counts. Multivariate regression models were used to examine influence of physical activity and sedentary behavior on metabolic risk outcomes including a clustered metabolic risk score.When based on isotemporal substitution modeling, replacement of a 10-min time block of MVPA with a corresponding time block of either LPA or sedentary activities was associated with an increase in clustered metabolic risk score (β = 0.06 to 0.08, p < 0.05, and an increase in waist circumference (β = 1.78 to 2.19 p < 0.01. All associations indicated between sedentary time and metabolic risk outcomes were lost once variation in total accelerometer counts was adjusted for.Detrimental influence of a sedentary lifestyle on metabolic health is likely explained by variations in amounts of physical activity rather than amount of sedentary time per se. Given our findings, increased amounts of physical activity with an emphasis on increased time in MVPA should be recommended in order to promote a favorable metabolic health profile in older women.

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.

Occupational risk and chronic kidney disease: a population-based study in the United States adult population.

Science.gov (United States)

Rubinstein, Sofia; Wang, Chengwei; Qu, Wenchun

2013-01-01

Previous studies on occupational risk for chronic kidney disease (CKD) have analyzed a limited range of occupations and focused on nephrotoxins. The primary purpose of this study was to examine the relative risk for the occurrence of CKD between different occupations in the US adult population. This was a population-based survey study of 91,340 participants in the US, who completed the National Health Interview Survey, 2004 through 2008. The outcome variable, CKD, was defined as having weakening/failing kidneys in the past 12 months, as diagnosed by a physician. The predictor variable, occupation, was obtained using the census occupational codes, regrouped according to North American Industrial Classification System. After controlling for age, gender, hypertension, and education, and with the category Life, Physical, and Social Science Occupations as a reference group, the likelihood of developing CKD was 4.3 times higher in respondents working in Building, Grounds Cleaning and Maintenance Occupations, 4.4 times higher in Healthcare Practitioners and Technical Occupations, 4.7 times higher in Transportation and Material Moving Occupations and in Computer and Mathematical Occupations, 4.8 times higher in Production Occupations, 5.3 times higher in Food Preparation and Serving Related Occupations, and 6.1 times higher in Healthcare Support Occupations and in Legal Occupations. This study identified occupation groups in US adult population with increased risk for CKD. Alleviation of workplace stress is suggested as a goal for behavioral intervention in high-risk occupations.

High nutrition risk is associated with higher risk of dysphagia in advanced age adults newly admitted to hospital.

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Popman, Amy; Richter, Marilize; Allen, Jacqueline; Wham, Carol

2018-02-01

To establish the prevalence of nutrition risk and associated risk factors among adults of advanced age newly admitted to hospital. A cross-sectional study was undertaken in adults aged over 85 years admitted to one of two hospital wards in Auckland within the previous 5 days. An interviewer-administered questionnaire was used to establish participant's socio-demographic and health characteristics. Markers of body composition and muscle strength were collected. Nutrition risk was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF), dysphagia risk using the 10-Item Eating Assessment Tool (EAT-10) and level of cognition using the Montreal Cognitive Assessment. A total of 88 participants with a mean age of 90.0 ± 3.7 years completed the assessments. A third (28.4%) of the participants were categorised by the MNA-SF as malnourished and 43.2% were classified at risk of malnutrition. A third (29.5%) were at risk of dysphagia as assessed by EAT-10. Malnourished participants were more likely to be at risk of dysphagia (P = 0.015). The MNA-SF score was positively correlated with body mass index (r = 0.484, P strength (r = 0.250, P = 0.026) and negatively correlated with risk of dysphagia (r = -0.383, P strength and negatively correlated with dysphagia risk. Findings highlight the importance of screening for dysphagia risk, especially in those identified to be malnourished or at nutrition risk. © 2017 Dietitians Association of Australia.

Interim data monitoring to enroll higher-risk participants in HIV prevention trials

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Umo-Otong John

2009-06-01

Full Text Available Abstract Background Lower-than-expected incidence of HIV undermines sample size calculations and compromises the power of a HIV prevention trial. We evaluated the effectiveness of interim monitoring of HIV infection rates and on-going modification of recruitment strategies to enroll women at higher risk of HIV in the Cellulose Sulfate Phase III study in Nigeria. Methods We analyzed prevalence and incidence of HIV and other sexually transmitted infections, demographic and sexual behavior characteristics aggregated over the treatment groups on a quarterly basis. The site investigators were advised on their recruitment strategies based on the findings of the interim analyses. Results A total of 3619 women were screened and 1644 enrolled at the Ikeja and Apapa clinics in Lagos, and at the Central and Peripheral clinics in Port Harcourt. Twelve months after study initiation, the overall incidence of HIV was less than one-third of the pre-study assumption, with rates of HIV that varied substantially between clinics. Due to the low prevalence and incidence rates of HIV, it was decided to close the Ikeja clinic in Lagos and to find new catchment areas in Port Harcourt. This strategy was associated with an almost two-fold increase in observed HIV incidence during the second year of the study. Conclusion Given the difficulties in estimating HIV incidence, a close monitoring of HIV prevalence and incidence rates during a trial is warranted. The on-going modification of recruitment strategies based on the regular analysis of HIV rates appeared to be an efficient method for targeting populations at greatest risk of HIV infection and increasing study power in the Nigeria trial. Trial Registration The trial was registered with the ClinicalTrials.gov registry under #NCT00120770 http://clinicaltrials.gov/ct2/show/NCT00120770

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.

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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...

The Relationship between Musculoskeletal Symptoms and Work-related Risk Factors in Hotel Workers.

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Lee, Jin Woo; Lee, Ju Jong; Mun, Hyeon Je; Lee, Kyung-Jae; Kim, Joo Ja

2013-10-11

To identify work-related musculoskeletal symptoms and any associated work-related risk factors, focusing on structural labor factors among hotel workers. A total of 1,016 hotel workers (620 men and 396 women) were analyzed. The questionnaire surveyed participants' socio-demographics, health-related behaviors, job-related factors, and work-related musculoskeletal symptoms. Work-related musculoskeletal symptoms were assessed using the Nordic musculoskeletal questionnaire. All analyses were stratified by gender, and multiple logistic regression modeling was used to determine associations between work-related musculoskeletal symptoms and work-related risk factors. The risk of developing work-related musculoskeletal symptoms was 1.9 times higher among male workers in the kitchen department than males in the room department (OR = 1.92, 95% CI = 1.03-3.79), and 2.5 times higher among male workers with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.52, 95% CI = 1.57-4.04). All of the aforementioned cases demonstrated a statistically significant association with work-related musculoskeletal symptoms. Moreover, the risk of developing work-related musculoskeletal symptoms was 3.3 times higher among female workers aged between 30 and 34 than those aged 24 or younger (OR = 3.32, 95% CI = 1.56-7.04); 0.3 times higher among females in the back office department than those in the room department (OR = 0.34, 95% CI = 0.12-0.91); 1.6 times higher among females on shift schedules than those who were not (OR = 1.60, 95% CI = 1.02-2.59); 1.8 times higher among females who performed more intensive work than those who performed less intensive work (OR = 1.88, 95% CI = 1.17-3.02), and; 2.1 times higher among females with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.17, 95% CI = 1.34-3.50). All of the aforementioned cases also displayed a statistically significant association with work-related musculoskeletal symptoms. This study

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.

Carbohydrates from Sources with a Higher Glycemic Index during Adolescence: Is Evening Rather than Morning Intake Relevant for Risk Markers of Type 2 Diabetes in Young Adulthood?

Science.gov (United States)

Diederichs, Tanja; Herder, Christian; Roßbach, Sarah; Roden, Michael; Wudy, Stefan A; Nöthlings, Ute; Alexy, Ute; Buyken, Anette E

2017-06-10

This study investigated whether glycemic index (GI) or glycemic load (GL) of morning or evening intake and morning or evening carbohydrate intake from low- or higher-GI food sources (low-GI-CHO, higher-GI-CHO) during adolescence are relevant for risk markers of type 2 diabetes in young adulthood. Methods: Analyses included DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study participants who had provided at least two 3-day weighed dietary records (median: 7 records) during adolescence and one blood sample in young adulthood. Using multivariable linear regression analyses, estimated morning and evening GI, GL, low-GI-CHO (GI adolescence were not associated with any of the adult risk markers. A higher evening GI during adolescence was related to an increased HSI in young adulthood ( p = 0.003). A higher consumption of higher-GI-CHO in the evening was associated with lower insulin sensitivity ( p = 0.046) and an increased HSI ( p = 0.006), while a higher evening intake of low-GI-CHO was related to a lower HSI ( p = 0.009). Evening intakes were not related to FLI or the pro-inflammatory-score (all p > 0.1). Conclusion: Avoidance of large amounts of carbohydrates from higher-GI sources in the evening should be considered in preventive strategies to reduce the risk of type 2 diabetes in adulthood.

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 Prediction Models for Other Cancers or Multiple Sites

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Developing statistical models that estimate the probability of developing other multiple cancers over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

[Gastro-esophageal Reflux Disease and malignant progression--equal risk for men and women?].

Science.gov (United States)

Pech, O

2015-08-01

Gastroesophageal reflux disease (GERD) is highly prevalent in the Western world. Patients with GERD have a 10 fold increased risk to develop a Barrett's esophagus. Patients with Barrett's esophagus have a higher risk for an esophageal adenocarcinoma. Men have more severe reflux with a higher grade of inflammation and acid reflux. This seems to be the reason why men develop a Barrett's esophagus more frequently--the risk is approximately 2 to 3 fold and the risk for an esophageal adenocarcinoma is even 3 to 6 times higher. © Georg Thieme Verlag KG Stuttgart · New York.

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

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

Capital Market Integration and Consumption Risk Sharing over the Long Run

DEFF Research Database (Denmark)

Rangvid, Jesper; Santa-Clara, Pedro; Schmeling, Maik

2016-01-01

capital market integration forecasts more consumption risk sharing in the future. This finding is robust to controlling for trade openness and exchange rate volatility as alternative drivers of risk sharing. Finally, we calculate the welfare costs of imperfect consumption risk sharing and find......We empirically investigate time variation in capital market integration and consumption risk sharing using data for 16 countries from 1875 to 2012. We show that there has been considerable variation over time in the degrees of capital market integration and consumption risk sharing and that higher...

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.

Development, Validation and Deployment of a Real Time 30 Day Hospital Readmission Risk Assessment Tool in the Maine Healthcare Information Exchange.

Science.gov (United States)

Hao, Shiying; Wang, Yue; Jin, Bo; Shin, Andrew Young; Zhu, Chunqing; Huang, Min; Zheng, Le; Luo, Jin; Hu, Zhongkai; Fu, Changlin; Dai, Dorothy; Wang, Yicheng; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

2015-01-01

Identifying patients at risk of a 30-day readmission can help providers design interventions, and provide targeted care to improve clinical effectiveness. This study developed a risk model to predict a 30-day inpatient hospital readmission for patients in Maine, across all payers, all diseases and all demographic groups. Our objective was to develop a model to determine the risk for inpatient hospital readmission within 30 days post discharge. All patients within the Maine Health Information Exchange (HIE) system were included. The model was retrospectively developed on inpatient encounters between January 1, 2012 to December 31, 2012 from 24 randomly chosen hospitals, and then prospectively validated on inpatient encounters from January 1, 2013 to December 31, 2013 using all HIE patients. A risk assessment tool partitioned the entire HIE population into subgroups that corresponded to probability of hospital readmission as determined by a corresponding positive predictive value (PPV). An overall model c-statistic of 0.72 was achieved. The total 30-day readmission rates in low (score of 0-30), intermediate (score of 30-70) and high (score of 70-100) risk groupings were 8.67%, 24.10% and 74.10%, respectively. A time to event analysis revealed the higher risk groups readmitted to a hospital earlier than the lower risk groups. Six high-risk patient subgroup patterns were revealed through unsupervised clustering. Our model was successfully integrated into the statewide HIE to identify patient readmission risk upon admission and daily during hospitalization or for 30 days subsequently, providing daily risk score updates. The risk model was validated as an effective tool for predicting 30-day readmissions for patients across all payer, disease and demographic groups within the Maine HIE. Exposing the key clinical, demographic and utilization profiles driving each patient's risk of readmission score may be useful to providers in developing individualized post discharge

Gait Training with Real-Time Augmented Toe-Ground Clearance Information Decreases Tripping Risk in Older Adults and a Person with Chronic Stroke

Directory of Open Access Journals (Sweden)

Rezaul K Begg

2014-05-01

Full Text Available Falls risk increases with ageing but is substantially higher in people with stroke. Tripping-related balance loss is the primary cause of falls, and Minimum Toe Clearance (MTC during walking is closely linked to tripping risk. The aim of this study was to determine whether real-time augmented information of toe-ground clearance at MTC can increase toe clearance, and reduce tripping risk. Nine healthy older adults (76±9 years and one 71 year old female stroke patient participated. Vertical toe displacement was displayed in real-time such that participants could adjust their toe clearance during treadmill walking. Participants undertook a session of unconstrained walking (no-feedback baseline and, in a subsequent Feedback condition, were asked to modify their swing phase trajectory to match a target increased MTC. Tripping probability (PT pre- and post-training was calculated by modelling MTC distributions. Older adults showed significantly higher mean MTC for the post-training retention session (27.7 ±3.79mm compared to the normal walking trial (14.1± 8.3 mm. The PT on a 1cm obstacle for the older adults reduced from 1 in 578 strides to 1 in 105,988 strides. With gait training the stroke patient increased MTC and reduced variability (baseline 16±12 mm, post-training 24±8 mm which reduced obstacle contact probability from 1 in 3 strides in baseline to 1 in 161 strides post-training. The findings confirm that concurrent visual feedback of a lower limb kinematic gait parameter is effective in changing foot trajectory control and reducing tripping probability in older adults. There is potential for further investigation of augmented feedback training across a range of gait-impaired populations, such as stroke.

Higher direct bilirubin levels during mid-pregnancy are associated with lower risk of gestational diabetes mellitus.

Science.gov (United States)

Liu, Chaoqun; Zhong, Chunrong; Zhou, Xuezhen; Chen, Renjuan; Wu, Jiangyue; Wang, Weiye; Li, Xiating; Ding, Huisi; Guo, Yanfang; Gao, Qin; Hu, Xingwen; Xiong, Guoping; Yang, Xuefeng; Hao, Liping; Xiao, Mei; Yang, Nianhong

2017-01-01

Bilirubin concentrations have been recently reported to be negatively associated with type 2 diabetes mellitus. We examined the association between bilirubin concentrations and gestational diabetes mellitus. In a prospective cohort study, 2969 pregnant women were recruited prior to 16 weeks of gestation and were followed up until delivery. The value of bilirubin was tested and oral glucose tolerance test was conducted to screen gestational diabetes mellitus. The relationship between serum bilirubin concentration and gestational weeks was studied by two-piecewise linear regression. A subsample of 1135 participants with serum bilirubin test during 16-18 weeks gestation was conducted to research the association between serum bilirubin levels and risk of gestational diabetes mellitus by logistic regression. Gestational diabetes mellitus developed in 8.5 % of the participants (223 of 2969). Two-piecewise linear regression analyses demonstrated that the levels of bilirubin decreased with gestational week up to the turning point 23 and after that point, levels of bilirubin were increased slightly. In multiple logistic regression analysis, the relative risk of developing gestational diabetes mellitus was lower in the highest tertile of direct bilirubin than that in the lowest tertile (RR 0.60; 95 % CI, 0.35-0.89). The results suggested that women with higher serum direct bilirubin levels during the second trimester of pregnancy have lower risk for development of gestational diabetes mellitus.

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....

Higher Levels of Serum Zonulin May Rather Be Associated with Increased Risk of Obesity and Hyperlipidemia, Than with Gastrointestinal Symptoms or Disease Manifestations

Directory of Open Access Journals (Sweden)

Bodil Ohlsson

2017-03-01

Full Text Available Zonulin is considered a biomarker of increased intestinal permeability, and elevated levels have been found in celiac disease. The primary aim of this study was to examine the association between serum zonulin levels and gastrointestinal (GI symptoms, and secondarily, between zonulin levels and anthropometric and metabolic factors. The offspring (n = 363 of the participants of the Malmö Diet and Cancer cardiovascular cohort (MDC-CV were invited to an anthropometric and clinical examination, where fasting plasma glucose levels were measured. Questionnaires about lifestyle factors and medical history were completed along with the Visual Analog Scale for Irritable Bowel Syndrome (VAS-IBS. Zonulin levels were measured in serum by ELISA. Neither GI symptoms nor GI diseases had any influence on zonulin levels. Higher zonulin levels were associated with higher waist circumference (p = 0.003, diastolic blood pressure (p = 0.003, and glucose levels (p = 0.036. Higher zonulin levels were associated with increased risk of overweight (p < 0.001, obesity (p = 0.047, and hyperlipidemia (p = 0.048. We cannot detect altered zonulin levels among individuals reporting GI symptoms or GI diseases, but higher zonulin levels are associated with higher waist circumference, diastolic blood pressure, fasting glucose, and increased risk of metabolic diseases.

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.

Flexible Learning and Teaching: Looking Beyond the Binary of Full-time/Part-time Provision in South African Higher Education