WorldWideScience

Sample records for total risk integrated

  1. Total cardiovascular disease risk assessment: a review.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2011-09-01

    The high risk strategy for the prevention of cardiovascular disease (CVD) requires an assessment of an individual\\'s total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Here we review developments in the assessment and estimation of total CVD risk.

  2. Global Drought Total Economic Loss Risk Deciles

    Data.gov (United States)

    National Aeronautics and Space Administration — Global Drought Total Economic Loss Risk Deciles is a 2.5 minute grid of global drought total economic loss risks. A process of spatially allocating Gross Domestic...

  3. Global Landslide Total Economic Loss Risk Deciles

    Data.gov (United States)

    National Aeronautics and Space Administration — Global Landslide Total Economic Loss Risk Deciles is a 2.5 minute grid of global landslide total economic loss risks. A process of spatially allocating Gross...

  4. Imaging Total Stations - Modular and Integrated Concepts

    Science.gov (United States)

    Hauth, Stefan; Schlüter, Martin

    2010-05-01

    Keywords: 3D-Metrology, Engineering Geodesy, Digital Image Processing Initialized in 2009, the Institute for Spatial Information and Surveying Technology i3mainz, Mainz University of Applied Sciences, forces research towards modular concepts for imaging total stations. On the one hand, this research is driven by the successful setup of high precision imaging motor theodolites in the near past, on the other hand it is pushed by the actual introduction of integrated imaging total stations to the positioning market by the manufacturers Topcon and Trimble. Modular concepts for imaging total stations are manufacturer independent to a large extent and consist of a particular combination of accessory hardware, software and algorithmic procedures. The hardware part consists mainly of an interchangeable eyepiece adapter offering opportunities for digital imaging and motorized focus control. An easy assembly and disassembly in the field is possible allowing the user to switch between the classical and the imaging use of a robotic total station. The software part primarily has to ensure hardware control, but several level of algorithmic support might be added and have to be distinguished. Algorithmic procedures allow to reach several levels of calibration concerning the geometry of the external digital camera and the total station. We deliver insight in our recent developments and quality characteristics. Both the modular and the integrated approach seem to have its individual strengths and weaknesses. Therefore we expect that both approaches might point at different target applications. Our aim is a better understanding of appropriate applications for robotic imaging total stations. First results are presented. Stefan Hauth, Martin Schlüter i3mainz - Institut für Raumbezogene Informations- und Messtechnik FH Mainz University of Applied Sciences Lucy-Hillebrand-Straße 2, 55128 Mainz, Germany

  5. Integral risk assessment

    International Nuclear Information System (INIS)

    Chakraborty, S.; Yadigaroglu, G.

    1991-01-01

    The series of lectures which forms the basis of this book and took place in the winter of 1989/90 at the ETH in Zuerich were held for the purpose of discussing the stage of development of our system of ethics in view of the extremely fast pace of technological progress and the risks which accompany it. Legal, psychological and political aspects of the problem were examined, but the emphasis was placed on ethical aspects. The effects which are examined in conventional risk analyses can be considered as a part of the ethical and social aspects involved, and in turn, the consideration of ethical and social aspects can be viewed as an extension of the conventional form of risk analysis. In any case, among risk experts, the significance of ethical and social factors is uncontested, especially as regards activities which can have far-reaching repurcussions. Some objective difficulties interfere with this goal, however: - No generally acknowledged set of ethical values exists. - Cultural influences and personal motives can interfere. - Normally a risk assessment is carried out in reference to individual facilities and within a small, clearly defined framework. Under certain circumstances, generalizations which are made for complete technological systems can lead to completely different conclusions. One contribution deals with integral views of the risks of atomic energy from an ethical and social perspective. (orig.) [de

  6. Total Site Heat Integration Considering Pressure Drops

    Directory of Open Access Journals (Sweden)

    Kew Hong Chew

    2015-02-01

    Full Text Available Pressure drop is an important consideration in Total Site Heat Integration (TSHI. This is due to the typically large distances between the different plants and the flow across plant elevations and equipment, including heat exchangers. Failure to consider pressure drop during utility targeting and heat exchanger network (HEN synthesis may, at best, lead to optimistic energy targets, and at worst, an inoperable system if the pumps or compressors cannot overcome the actual pressure drop. Most studies have addressed the pressure drop factor in terms of pumping cost, forbidden matches or allowable pressure drop constraints in the optimisation of HEN. This study looks at the implication of pressure drop in the context of a Total Site. The graphical Pinch-based TSHI methodology is extended to consider the pressure drop factor during the minimum energy requirement (MER targeting stage. The improved methodology provides a more realistic estimation of the MER targets and valuable insights for the implementation of the TSHI design. In the case study, when pressure drop in the steam distribution networks is considered, the heating and cooling duties increase by 14.5% and 4.5%.

  7. TOWARDS TOTAL INTEGRATION IN DESIGN STUDIO

    Directory of Open Access Journals (Sweden)

    Shireesh A Deshpande

    2010-07-01

    Full Text Available Transmission of knowledge has been defined as “bringing the right knowledge by the right route at the right time to the right places.” In this context there is need to analyze the various pedagogical shifts associated with the decisive process of transmission and transaction of knowledge in design studio. Critical understanding of the importance of tangential knowledge and its integration within the design studio, leading to a comprehensive whole, is a significant aspect to be properly evolved and nourished in the studio. It can be argued that knowledge is not a substitute for architectural imagination but inadequate knowledge would handicap the general level of design. Being satisfied to manipulate formal configurations does not provide insights into the human experience. If the different types of knowledge that architecture requires are ignored, the profession will lose its credibility in the eyes of society. With the body of knowledge expanding diversely with the escalating wants of the user, and to further sustain the built environment with further progression, it’s quite certain to have an innovative design process that has a feel of antecedents yet is nourished by rationalism. Architectural Design is to an extent the yield of a creative process brought out through a refined approach, skill, and dexterity to suit the purpose. The assessors, the jury, or the teacher has created an aura of mystique around good design, without much explaining what good design is. Architectural education involves application of a theory of knowledge – what is known and how it is to be known. Nothing is taught unless it is learnt (Bono. Does the key to these issues lie in shifting from conventional mode to Total Integration Mode of Education?

  8. Total Ore Processing Integration and Management

    Energy Technology Data Exchange (ETDEWEB)

    Leslie Gertsch

    2006-05-15

    This report outlines the technical progress achieved for project DE-FC26-03NT41785 (Total Ore Processing Integration and Management) during the period 01 January through 31 March of 2006. (1) Work in Progress: Minntac Mine--Graphical analysis of drill monitor data moved from two-dimensional horizontal patterns to vertical variations in measured and calculated parameters. The rock quality index and the two dimensionless ({pi}) indices developed by Kewen Yin of the University of Minnesota are used by Minntac Mine to design their blasts, but the drill monitor data from any given pattern is obviously not available for the design of that shot. Therefore, the blast results--which are difficult to quantify in a short time--must be back-analyzed for comparison with the drill monitor data to be useful for subsequent blast designs. {pi}{sub 1} indicates the performance of the drill, while {pi}{sub 2} is a measure of the rock resistance to drilling. As would be expected, since a drill tends to perform better in rock that offers little resistance, {pi}{sub 1} and {pi}{sub 2} are strongly inversely correlated; the relationship is a power function rather than simply linear. Low values of each Pi index tend to be quantized, indicating that these two parameters may be most useful above certain minimum magnitudes. (2) Work in Progress: Hibtac Mine--Statistical examination of a data set from Hibtac Mine (Table 1) shows that incorporating information on the size distribution of material feeding from the crusher to the autogenous mills improves the predictive capability of the model somewhat (43% vs. 44% correlation coefficient), but a more important component is production data from preceding days (26% vs. 44% correlation coefficient), determined using exponentially weighted moving average predictive variables. This lag effect likely reflects the long and varied residence times of the different size fragments in the grinding mills. The rock sizes are also correlated with the geologic

  9. Managing the total cost of risk exposures through risk mapping techniques

    International Nuclear Information System (INIS)

    Unione, A.J.; Rode, D.M.

    1998-01-01

    In a competitive power market, power producers are exposed to an increasingly broad spectrum of financial risks. The cumulative impact of these financial risks is known collectively as the Total of Cost of Risk. The concept of Total of Cost of Risk presents the business reality of a company's exposure to potentially devastating financial consequences in an integrated and useful way. In this way, a strategy of managing Total Cost of Risk in the most cost effective way can become a means of ensuring long term business health and security. This paper will examine the use of risk mapping as a tool for visually understanding Total Cost of Risk, thus creating an enhanced situational awareness and an integrated basis for risk management decision. The evaluation process, available through the use of risk maps allows the power producers to pro-actively implement prudent business decisions concerning the design, operation and maintenance of power plants. Risk mapping is thus a means for harmonizing operational objectives, such as improved plant reliability, with corporate strategies and goals in terms of an effective risk management program

  10. Mortality After Total Knee and Total Hip Arthroplasty in a Large Integrated Health Care System.

    Science.gov (United States)

    Inacio, Maria C S; Dillon, Mark T; Miric, Alex; Navarro, Ronald A; Paxton, Elizabeth W

    2017-01-01

    The number of excess deaths associated with elective total joint arthroplasty in the US is not well understood. To evaluate one-year postoperative mortality among patients with elective primary and revision arthroplasty procedures of the hip and knee. A retrospective analysis was conducted of hip and knee arthroplasties performed in 2010. Procedure type, procedure volume, patient age and sex, and mortality were obtained from an institutional total joint replacement registry. An integrated health care system population was the sampling frame for the study subjects and was the reference group for the study. Standardized 1-year mortality ratios (SMRs) and 95% confidence intervals (CIs) were calculated. A total of 10,163 primary total knee arthroplasties (TKAs), 4963 primary total hip arthroplasties (THAs), 606 revision TKAs, and 496 revision THAs were evaluated. Patients undergoing primary THA (SMR = 0.6, 95% CI = 0.4-0.7) and TKA (SMR = 0.4, 95% CI = 0.3-0.5) had lower odds of mortality than expected. Patients with revision TKA had higher-than-expected mortality odds (SMR = 1.8, 95% CI = 1.1-2.5), whereas patients with revision THA (SMR = 0.9, 95% CI = 0.4-1.5) did not have higher-than-expected odds of mortality. Understanding excess mortality after joint surgery allows clinicians to evaluate current practices and to determine whether certain groups are at higher-than-expected mortality risk after surgery.

  11. Total Site Integration and paper machine technologies; Total site integration ja paperikoneteknologia - PMST 02

    Energy Technology Data Exchange (ETDEWEB)

    Puumalainen, T; Kaijaluoto, S; Tervonen, P; Edelmann, K [VTT Energy, Jyvaeskylae (Finland)

    1999-12-31

    During the last 30 years the production capacity of a paper machine has tripled. The fastest machines of today run over about 1600 m/min, the web width being around 10 m. The desire to further increase the production capacity is leading to more expensive paper machines and to larger buildings, if current pressing and drying techniques are used. New pressing and drying techniques will decrease the need of thermal energy. Closed water cycles reduce the need of secondary heat abundantly available from the dryer section based on cylinder drying. Total Site Integration studies are required when the effect of new process concepts are to be evaluated against energy efficiency and environmental impacts. A proto type tool has been developed and the effect of new paper machine concepts on energy consumption have been analysed. The utilisation possibilities of the surplus energy will be studied later in the course of this project. (orig.)

  12. Total Site Integration and paper machine technologies; Total site integration ja paperikoneteknologia - PMST 02

    Energy Technology Data Exchange (ETDEWEB)

    Puumalainen, T.; Kaijaluoto, S.; Tervonen, P.; Edelmann, K. [VTT Energy, Jyvaeskylae (Finland)

    1998-12-31

    During the last 30 years the production capacity of a paper machine has tripled. The fastest machines of today run over about 1600 m/min, the web width being around 10 m. The desire to further increase the production capacity is leading to more expensive paper machines and to larger buildings, if current pressing and drying techniques are used. New pressing and drying techniques will decrease the need of thermal energy. Closed water cycles reduce the need of secondary heat abundantly available from the dryer section based on cylinder drying. Total Site Integration studies are required when the effect of new process concepts are to be evaluated against energy efficiency and environmental impacts. A proto type tool has been developed and the effect of new paper machine concepts on energy consumption have been analysed. The utilisation possibilities of the surplus energy will be studied later in the course of this project. (orig.)

  13. Integrated Risk Information System (IRIS)

    Data.gov (United States)

    U.S. Environmental Protection Agency — EPA?s Integrated Risk Information System (IRIS) is a compilation of electronic reports on specific substances found in the environment and their potential to cause...

  14. Integrated supply chain risk management

    OpenAIRE

    Riaan Bredell; Jackie Walters

    2007-01-01

    Integrated supply chain risk management (ISCRM) has become indispensable to the theory and practice of supply chain management. The economic and political realities of the modern world require not only a different approach to supply chain management, but also bold steps to secure supply chain performance and sustainable wealth creation. Integrated supply chain risk management provides supply chain organisations with a level of insight into their supply chains yet to be achieved. If correctly ...

  15. The total theory about risk management

    International Nuclear Information System (INIS)

    Furuya, Shunsuke

    2003-01-01

    A general working procedure of risk management, some example of other countries, topics and problems in the future are described. A definition of risk, risk assessment, risk management process, setting of aim and definite policy are explained. As a fundamental way of thinking, risk is controlled by ALARP (As Low As Reasonably Practicable). The upper and lower limit of risk level is called as Quantitative Safety Goal and Target Level of Safety, respectively. These limits in the atomic power and airplane are decided. Evaluation of risk, countermeasure and practice are explained. For example, a permissible range of risk and practical use in England, U.S.A, Holland and Japan are stated. Recently, accountability risk, missing demand risk and control risk are important. (S.Y.)

  16. Integrating risks at contaminated sites

    International Nuclear Information System (INIS)

    MacDonell, M.; Habegger, L.; Nieves, L.; Schreiber, Z.; Travis, C.

    2000-01-01

    The U.S. Department of Energy (DOE) is responsible for a number of large sites across the country that were radioactively and chemically contaminated by past nuclear research, development, and production activities. Multiple risk assessments are being conducted for these sites to evaluate current conditions and determine what measures are needed to protect human health and the environment from today through the long term. Integrating the risks associated with multiple contaminants in different environmental media across extensive areas, over time periods that extend beyond 1,000 years, and for a number of different impact categories--from human health and ecological to social and economic--represents a considerable challenge. A central element of these integrated analyses is the ability to reflect key interrelationships among environmental resources and human communities that may be adversely affected by the actions or inactions being considered for a given site. Complicating the already difficult task of integrating many kinds of risk is the importance of reflecting the diverse values and preferences brought to bear by the multiple parties interested in the risk analysis process and outcome. An initial conceptual framework has been developed to provide an organized structure to this risk integration, with the aim of supporting effective environmental management decisions. This paper highlights key issues associated with comprehensive risk integration and offers suggestions developed from preliminary work at a complex DOE site

  17. Integrated supply chain risk management

    Directory of Open Access Journals (Sweden)

    Riaan Bredell

    2007-11-01

    Full Text Available Integrated supply chain risk management (ISCRM has become indispensable to the theory and practice of supply chain management. The economic and political realities of the modern world require not only a different approach to supply chain management, but also bold steps to secure supply chain performance and sustainable wealth creation. Integrated supply chain risk management provides supply chain organisations with a level of insight into their supply chains yet to be achieved. If correctly applied, this process may optimise management decision-making and assist in the protection and enhancement of shareholder value.

  18. One Team, One Fight, One Future, Total Army Integration

    National Research Council Canada - National Science Library

    1998-01-01

    ...; and, most important, our vision for maintaining a trained and ready force. As the ideas in One Team, One Fight, One Future unfold, you will find the key themes of Total Army integration emerging again and again...

  19. Integrated Foreign Exchange Risk Management

    DEFF Research Database (Denmark)

    Aabo, Tom; Høg, Esben; Kuhn, Jochen

    Empirical research has focused on export as a proxy for the exchange rate exposure and the use of foreign exchange derivatives as the instrument to deal with this exposure. This empirical study applies an integrated foreign exchange risk management approach with a particular focus on the role...

  20. Managing IT Integration Risk in Acquisitions

    DEFF Research Database (Denmark)

    Henningsson, Stefan; Kettinger, William J.

    2016-01-01

    The article discusses a framework for evaluating risk of information technology (IT) integration in acquisitions. Topics include the use of the experience of serial acquirer Trelleborg AB to show the merits of the framework for managing the risk and to determine low-risk acquisitions......, the importance of managing IT integration risk, and various risk areas for acquisition IT integration....

  1. A system and approach for total pipeline integrity management

    Energy Technology Data Exchange (ETDEWEB)

    Porter, Todd; Neidhardt, Dietmar [Tuboscope Pipeline Services, Houston, TX (United States); Gonzalez, Oscar [Tuboscope Mexico S.A. de C.V., Mexico, D.F. (Mexico)

    2005-07-01

    Pipeline rehabilitation and maintenance decisions are made using a wide variety of data, criteria, and expertise. The goal is to arrive at an optimal plan that considers risk and best return on Repair and Maintenance (R and M) expenditures for aging pipeline systems in both regulated and non-regulated environments. In order to achieve these goals, historical, operations, and assessment data is gathered, aligned and integrated as part of a baseline assessment. Integrity threats are identified based on operations and industry experience, and combined with potential consequences to public safety, the environment, and business to clearly delineate high risk exposure segments in the system. Integrity assessments are conducted in a prioritized manner, using the most appropriate technology and methods to address the threats. These include In Line Inspection technologies: MFL, Deformation, UT, INS (combinations thereof), Direct Assessment for EC and SCC threats, Hydro testing, and other indirect methods. From these results, decisions are made and R and M plans developed. To arrive at an optimal R and M plan, proper use of existing data, new integrity assessment data, and decision risk models is required. This paper presentation will detail the tactical aspect of an effective integrity management platform. Experience in decision support, operations priorities and execution of a rehabilitation plan using LinaView Pro{sup TM} integrity management system with risk-based integrity tools and maintenance planning will be presented. A process overview, results, and benefits will be given using these examples from operating oil and gas transmission pipelines. (author)

  2. Integrated Communications at America's Leading Total Quality Management Corporations.

    Science.gov (United States)

    Gronstedt, Anders

    1996-01-01

    Examines how to create organizational processes that allow communication professionals with a variety of expertise to support each other through coordination and integration. Studies eight of America's leading total quality management corporations, including AT&T, Federal Express, Saturn, and Xerox. Explores how various total quality…

  3. Integrated risk information system (IRIS)

    Energy Technology Data Exchange (ETDEWEB)

    Tuxen, L. [Environmental Protection Agency, Washington, DC (United States)

    1990-12-31

    The Integrated Risk Information System (IRIS) is an electronic information system developed by the US Environmental Protection Agency (EPA) containing information related to health risk assessment. IRIS is the Agency`s primary vehicle for communication of chronic health hazard information that represents Agency consensus following comprehensive review by intra-Agency work groups. The original purpose for developing IRIS was to provide guidance to EPA personnel in making risk management decisions. This original purpose for developing IRIS was to guidance to EPA personnel in making risk management decisions. This role has expanded and evolved with wider access and use of the system. IRIS contains chemical-specific information in summary format for approximately 500 chemicals. IRIS is available to the general public on the National Library of Medicine`s Toxicology Data Network (TOXNET) and on diskettes through the National Technical Information Service (NTIS).

  4. Comparative risk assessment of total energy systems

    International Nuclear Information System (INIS)

    Soerensen, B.

    1982-01-01

    The paper discusses a methodology for total impact assessment of energy systems, ideally evaluating all the impacts that a given energy system has on the society in which it is imbedded or into which its introduction is being considered. Impacts from the entire energy conversion chain ('fuel cycle' if the system is fuel-based), including energy storage, transport and transmission, as well as the institutions formed in order to manage the system, should be compared on the basis of the energy service provided. A number of impacts are considered, broadly classified as impacts on satisfaction of biological needs, on health, on environment, on social relations and on the structure of society. Further considerations include impacts related to cost and resilience, and, last but not least, impacts on global relations. The paper discusses a number of published energy studies in the light of the comparative impact assessment methodology outlined above. (author)

  5. Managing total corporate electricity/energy market risks

    International Nuclear Information System (INIS)

    Henney, A.; Keers, G.

    1998-01-01

    The banking industry has developed a tool kit of very useful value at risk techniques for hedging risk, but these techniques must be adapted to the special complexities of the electricity market. This paper starts with a short history of the use of value-at-risk (VAR) techniques in banking risk management and then examines the specific and, in many instances, complex risk management challenges faced by electric companies from the behavior of prices in electricity markets and from the character of generation and electric retailing risks. The third section describes the main methods for making VAR calculations along with an analysis of their suitability for analyzing the risks of electricity portfolios and the case for using profit at risk and downside risk as measures of risk. The final section draws the threads together and explains how to look at managing total corporate electricity market risk, which is a big step toward managing total corporate energy market risk

  6. 'Awareness and attitudes towards total cardiovascular disease risk ...

    African Journals Online (AJOL)

    Microsoft account

    Corresponding author: Dr S Ofori, Department of Internal Medicine, ... regarding total CVD risk assessment in clinical practice among physicians in Port ..... cardiovascular risk for prevention and control of cardiovascular disease in low and.

  7. Integrating total quality management in a library setting

    CERN Document Server

    Jurow, Susan

    2013-01-01

    Improve the delivery of library services by implementing total quality management (TQM), a system of continuous improvement employing participative management and centered on the needs of customers. Although TQM was originally designed for and successfully applied in business and manufacturing settings, this groundbreaking volume introduces strategies for translating TQM principles from the profit-based manufacturing sector to the library setting. Integrating Total Quality Management in a Library Setting shows librarians how to improve library services by implementing strategies such as employ

  8. Relative Hom-Hopf modules and total integrals

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Shuangjian [School of Mathematics and Statistics, Guizhou University of Finance and Economics, Guiyang 550025 (China); Zhang, Xiaohui [Department of Mathematics, Southeast University, Nanjing 210096 (China); Wang, Shengxiang, E-mail: wangsx-math@163.com [School of Mathematics and Finance, Chuzhou University, Chuzhou 239000 (China); Department of Mathematics, Nanjing University, Nanjing 210093 (China)

    2015-02-15

    Let (H, α) be a monoidal Hom-Hopf algebra and (A, β) a right (H, α)-Hom-comodule algebra. We first investigate the criterion for the existence of a total integral of (A, β) in the setting of monoidal Hom-Hopf algebras. Also, we prove that there exists a total integral ϕ : (H, α) → (A, β) if and only if any representation of the pair (H, A) is injective in a functorial way, as a corepresentation of (H, α), which generalizes Doi’s result. Finally, we define a total quantum integral γ : H → Hom(H, A) and prove the following affineness criterion: if there exists a total quantum integral γ and the canonical map ψ : A⊗{sub B}A → A ⊗ H, a⊗{sub B}b ↦ β{sup −1}(a) b{sub [0]} ⊗ α(b{sub [1]}) is surjective, then the induction functor A⊗{sub B}−:ℋ{sup ~}(ℳ{sub k}){sub B}→ℋ{sup ~}(ℳ{sub k}){sub A}{sup H} is an equivalence of categories.

  9. Relative Hom-Hopf modules and total integrals

    International Nuclear Information System (INIS)

    Guo, Shuangjian; Zhang, Xiaohui; Wang, Shengxiang

    2015-01-01

    Let (H, α) be a monoidal Hom-Hopf algebra and (A, β) a right (H, α)-Hom-comodule algebra. We first investigate the criterion for the existence of a total integral of (A, β) in the setting of monoidal Hom-Hopf algebras. Also, we prove that there exists a total integral ϕ : (H, α) → (A, β) if and only if any representation of the pair (H, A) is injective in a functorial way, as a corepresentation of (H, α), which generalizes Doi’s result. Finally, we define a total quantum integral γ : H → Hom(H, A) and prove the following affineness criterion: if there exists a total quantum integral γ and the canonical map ψ : A⊗ B A → A ⊗ H, a⊗ B b ↦ β −1 (a) b [0] ⊗ α(b [1] ) is surjective, then the induction functor A⊗ B −:ℋ ~ (ℳ k ) B →ℋ ~ (ℳ k ) A H is an equivalence of categories

  10. Total Correlation Function Integrals and Isothermal Compressibilities from Molecular Simulations

    DEFF Research Database (Denmark)

    Wedberg, Rasmus; Peters, Günther H.j.; Abildskov, Jens

    2008-01-01

    Generation of thermodynamic data, here compressed liquid density and isothermal compressibility data, using molecular dynamics simulations is investigated. Five normal alkane systems are simulated at three different state points. We compare two main approaches to isothermal compressibilities: (1...... in approximately the same amount of time. This suggests that computation of total correlation function integrals is a route to isothermal compressibility, as accurate and fast as well-established benchmark techniques. A crucial step is the integration of the radial distribution function. To obtain sensible results...

  11. Risk management in radiotherapy: analysis for total body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Banguero, Y., E-mail: ybanguero@cin.edu.uy [Universidad de la República, Montevideo (Uruguay); Píriz, G.; Guerrero, L.; Cardozo, L.; Quarneti, A. [Centro Hospital Pereira Rossell, Montevideo (Uruguay); Nader, A. [Autoridad Reguladora Nacional de Radioprotección, Montevideo (Uruguay)

    2017-07-01

    Introduction: Management of risk in any technique that is using radiation energy is very important to prevent incidents and accidents. Pretending evaluate the risk in the all process of Total Body Irradiation (TBI), this work present a risk matrix with different possible events than could occur. Methods: SEVRRA-R platform that run in windows is using to build a risk matrix separating the process of TBI in commissioning, prescription, planning and delivering dose. Any stage has a procedure with different errors associated. We build a matrix using all this information to evaluate the kind of risk we have in the technique. Results: It was obtained a template that describes in general the process of TBI with principles events, barriers and consequences. Conclusion: Analyzing the risk in any stage of the process in Total Body irradiation is a useful tool to understand the key points to work in safety for this technique. (author)

  12. Considerations on Integrating Risk and Quality Management

    Directory of Open Access Journals (Sweden)

    Maria POPESCU

    2011-03-01

    Full Text Available This paper aims to highlight the links between risk management and quality management and to study the possibility of their integrated approach. The study reviews the evolution of risk approach within organizations and stresses the need to increase the effectiveness of this approach by incorporating risk management methodology in the quality management system. Starting from this idea, the authors present the current state of risk approach into quality management, basic rules of integrated quality-risk management and major difficulties which may arise in the implementation of integrated quality–risk systems.

  13. The Impact of Total Risk Management on Company's Performance

    OpenAIRE

    Mohammed, Hamdu Kedir; Knapkova, Adriana

    2016-01-01

    Traditionally risk management used to be considered as a means to alleviate perhaps eliminate negative outcomes of exposures. However, the result of this and other empirical studies shows the ability of risk management to go beyond this and respond to market factors which are out of management control in order to control volatilities in earning which ultimately improve corporate performance. The empirical study investigates the relationship between total risk management and company's performa...

  14. Total Dose Effects on Bipolar Integrated Circuits at Low Temperature

    Science.gov (United States)

    Johnston, A. H.; Swimm, R. T.; Thorbourn, D. O.

    2012-01-01

    Total dose damage in bipolar integrated circuits is investigated at low temperature, along with the temperature dependence of the electrical parameters of internal transistors. Bandgap narrowing causes the gain of npn transistors to decrease far more at low temperature compared to pnp transistors, due to the large difference in emitter doping concentration. When irradiations are done at temperatures of -140 deg C, no damage occurs until devices are warmed to temperatures above -50 deg C. After warm-up, subsequent cooling shows that damage is then present at low temperature. This can be explained by the very strong temperature dependence of dispersive transport in the continuous-time-random-walk model for hole transport. For linear integrated circuits, low temperature operation is affected by the strong temperature dependence of npn transistors along with the higher sensitivity of lateral and substrate pnp transistors to radiation damage.

  15. Development of a totally integrated severe accident training system

    International Nuclear Information System (INIS)

    Kim, Ko Ryu; Park, Sun Hee; Choi, Young; Kim, Dong Ha

    2006-01-01

    Recently KAERI has developed the severe accident management guidance to establish the Korea standard severe accident management system. On the other hand the PC-based severe accident training simulator SATS has been developed, which uses the MELCOR code as the simulation engine. The simulator SATS graphically displays and simulates the severe accidents with interactive user commands. Especially the control capability of SATS could make a severe accident training course more interesting and effective. In this paper we will describe the development and functions of the electrical guidance module, HyperKAMG, and the SATS-HyperKAMG linkage system designed for a totally integrated and automated severe accident training. (author)

  16. Total quality through computer integrated manufacturing in the pharmaceutical industry.

    Science.gov (United States)

    Ufret, C M

    1995-01-01

    The role of Computer Integrated Manufacturing (CIM) in the pursue of total quality in pharmaceutical manufacturing is assessed. CIM key objectives, design criteria, and performance measurements, in addition to its scope and implementation in a hierarchical structure, are explored in detail. Key elements for the success of each phase in a CIM project and a brief status of current CIM implementations in the pharmaceutical industry are presented. The role of World Class Manufacturing performance standards and other key issues to achieve full CIM benefits are also addressed.

  17. Integral bounds for N-body total cross sections

    International Nuclear Information System (INIS)

    Osborn, T.A.; Bolle, D.

    1979-01-01

    We study the behavior of the total cross sections in the three- and N-body scattering problem. Working within the framework of the time-dependent two-Hilbert space scattering theory, we give a simple derivation of integral bounds for the total cross section for all processes initiated by the collision of two clusters. By combining the optical theorem with a trace identity derived by Jauch, Sinha, and Misra, we find, roughly speaking, that if the local pairwise interaction falls off faster than r -3 , then sigma/sub tot/(E) must decrease faster than E/sup -1/2/ at high energy. This conclusion is unchanged if one introduces a class of well-behaved three-body interactions

  18. The Total Risk Analysis of Large Dams under Flood Hazards

    Directory of Open Access Journals (Sweden)

    Yu Chen

    2018-02-01

    Full Text Available Dams and reservoirs are useful systems in water conservancy projects; however, they also pose a high-risk potential for large downstream areas. Flood, as the driving force of dam overtopping, is the main cause of dam failure. Dam floods and their risks are of interest to researchers and managers. In hydraulic engineering, there is a growing tendency to evaluate dam flood risk based on statistical and probabilistic methods that are unsuitable for the situations with rare historical data or low flood probability, so a more reasonable dam flood risk analysis method with fewer application restrictions is needed. Therefore, different from previous studies, this study develops a flood risk analysis method for large dams based on the concept of total risk factor (TRF used initially in dam seismic risk analysis. The proposed method is not affected by the adequacy of historical data or the low probability of flood and is capable of analyzing the dam structure influence, the flood vulnerability of the dam site, and downstream risk as well as estimating the TRF of each dam and assigning corresponding risk classes to each dam. Application to large dams in the Dadu River Basin, Southwestern China, demonstrates that the proposed method provides quick risk estimation and comparison, which can help local management officials perform more detailed dam safety evaluations for useful risk management information.

  19. Risk factors for total hip arthroplasty aseptic revision.

    Science.gov (United States)

    Khatod, Monti; Cafri, Guy; Namba, Robert S; Inacio, Maria C S; Paxton, Elizabeth W

    2014-07-01

    The purpose of this study was to evaluate patient, operative, implant, surgeon, and hospital factors associated with aseptic revision after primary THA in patients registered in a large US Total Joint Replacement Registry. A total of 35,960 THAs registered from 4/2001-12/2010 were evaluated. The 8-year survival rate was 96.7% (95% CI 96.4%-97.0%). Females had a higher risk of aseptic revision than males. Hispanic and Asian patients had a lower risk of revision than white patients. Ceramic-on-ceramic, ceramic-on-conventional polyethylene, and metal-on-conventional polyethylene bearing surfaces had a higher risk of revision than metal-on-highly cross-linked polyethylene. Body mass index, health status, diabetes, diagnosis, fixation, approach, bilateral procedures, head size, surgeon fellowship training, surgeon and hospital volume were not revision risk factors. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Plasma Total Cysteine and Cardiovascular Risk Burden: Action and Interaction

    OpenAIRE

    De Chiara, Benedetta; Sedda, Valentina; Parolini, Marina; Campolo, Jonica; De Maria, Renata; Caruso, Raffaele; Pizzi, Gianluigi; Disoteo, Olga; Dellanoce, Cinzia; Corno, Anna Rosa; Cighetti, Giuliana; Parodi, Oberdan

    2012-01-01

    We hypothesized that redox analysis could provide sensitive markers of the oxidative pathway associated to the presence of an increasing number of cardiovascular risk factors (RFs), independently of type. We classified 304 subjects without cardiovascular disease into 4 groups according to the total number of RFs (smoking, hypertension, hypercholesterolaemia, hyperhomocysteinaemia, diabetes, obesity, and their combination). Oxidative stress was evaluated by measuring plasma total and reduced h...

  1. Industrial implementation issues of Total Site Heat Integration

    International Nuclear Information System (INIS)

    Chew, Kew Hong; Klemeš, Jiří Jaromír; Wan Alwi, Sharifah Rafidah; Abdul Manan, Zainuddin

    2013-01-01

    Heat Integration has been a well-established energy conservation strategy in the industry. Total Site Heat Integration (TSHI) has received growing interest since its inception in the 90s. The methodology has been used with certain simplifications to solve TSHI problems. This paper investigates the main issues that can influence the practical implementation of TSHI in the industry. The main aim is to provide an assessment and possible guidance for future development and extension of the TSHI methodology from the industrial perspective. Several key issues have been identified as being of vital importance for the industries: design, operation, reliability/availability/maintenance, regulatory/policy and economics. Design issues to consider include plant layout, pressure drop, etc. For operation, issues such as startup and shutdown need to be considered. Reliability, availability and maintenance (RAM) are important as they directly affect the production. Relevant government policy and incentives are also important when considering the options for TSHI. Finally, a TSHI system needs to be economically viable. This paper highlights the key issues to be considered for a successful implementation of TSHI. The impacts of these issues on TS integration are summarised in a matrix, which forms a basis for an improved and closer-to-real-life implementation of the TSHI methodology. Highlights: ► Current TSHI methodology has been used for solving models with certain simplifications. ► Several issues that can influence practical implementation of TSHI are identified. ► Impacts of these issues on safety, environment and economics are evaluated. ► The findings form a basis for an improved and practical implementation of TSHI

  2. The effect of integrated reporting on integrated thinking between risk ...

    African Journals Online (AJOL)

    IIRC (2013b: 3), integrated thinking takes into account the connectivity and ... historical information and provides investors and other stakeholders with .... in the disclosure of risks and opportunities by using a sample of the top 100 JSE-.

  3. A total risk assessment methodology for security assessment

    International Nuclear Information System (INIS)

    Auilar, Richard; Pless, Daniel J.; Kaplan, Paul Garry; Silva, Consuelo Juanita; Rhea, Ronald Edward; Wyss, Gregory Dane; Conrad, Stephen Hamilton

    2009-01-01

    Sandia National Laboratories performed a two-year Laboratory Directed Research and Development project to develop a new collaborative risk assessment method to enable decision makers to fully consider the interrelationships between threat, vulnerability, and consequence. A five-step Total Risk Assessment Methodology was developed to enable interdisciplinary collaborative risk assessment by experts from these disciplines. The objective of this process is promote effective risk management by enabling analysts to identify scenarios that are simultaneously achievable by an adversary, desirable to the adversary, and of concern to the system owner or to society. The basic steps are risk identification, collaborative scenario refinement and evaluation, scenario cohort identification and risk ranking, threat chain mitigation analysis, and residual risk assessment. The method is highly iterative, especially with regard to scenario refinement and evaluation. The Total Risk Assessment Methodology includes objective consideration of relative attack likelihood instead of subjective expert judgment. The 'probability of attack' is not computed, but the relative likelihood for each scenario is assessed through identifying and analyzing scenario cohort groups, which are groups of scenarios with comparable qualities to the scenario being analyzed at both this and other targets. Scenarios for the target under consideration and other targets are placed into cohort groups under an established ranking process that reflects the following three factors: known targeting, achievable consequences, and the resources required for an adversary to have a high likelihood of success. The development of these target cohort groups implements, mathematically, the idea that adversaries are actively choosing among possible attack scenarios and avoiding scenarios that would be significantly suboptimal to their objectives. An adversary who can choose among only a few comparable targets and scenarios (a

  4. The effect of integrated reporting on integrated thinking between risk ...

    African Journals Online (AJOL)

    ... between strategy and the risks and opportunities faced by the organisation. For this purpose, a web-based research questionnaire was sent to high-level implementers of integrated reporting at companies listed on the Johannesburg Stock Exchange (JSE) in South Africa, where integrated reporting is a listing requirement.

  5. RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Szabo Alina

    2012-12-01

    Full Text Available Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the ‘top 8-12’ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in the area and the professional expertise, this article outlines an integrated approach to risk assessment and risk management reporting processes, by separating the risk in two main categories: strategic and operational risks. The focus is on risk prioritization and scoring; the final output will comprise a mix of strategic and operational (‘top 8-12’ risks, which should be used to establish the annual Internal Audit plan. Originality/value: By using an integrated approach to risk assessment and risk management will eliminate the need for a separate Internal Audit risk assessment over prevailing risks. It will reduce the level of risk assessment overlap by different functions (Tax, Treasury, Information System over the same risk categories as a single methodology, is used and will align timings of risk assessment exercises. The risk prioritization by usage of risk and control scoring criteria highlights the combination between financial and non-financial impact criteria allowing risks that do not naturally lend themselves to a financial amount to be also assessed consistently. It is emphasized the usage of score method to prioritize the risks included in the annual audit plan in order to increase accuracy and timelines.

  6. Risk factors for renal dysfunction after total hip joint replacement

    DEFF Research Database (Denmark)

    Hassan, Basim Kamil; Sahlström, Arne; Dessau, Ram Benny Christian

    2015-01-01

    BACKGROUND AND PURPOSE OF THE STUDY: Renal injury and dysfunction are serious complications after major surgery, which may lead to increased morbidity and mortality. The objective of our study was to identify the possible risk factors for renal dysfunction after total hip joint replacement surger...... creatinine. Smoking, diabetes mellitus, high BMI, gender, and duration of surgery were not identified as significant risk factors........ METHODS: A retrospective study was conducted among 599 consecutive primary hip joint replacements performed between January 2011 and December 2013. According to the RIFLE criteria, increased postoperative serum creatinine was considered indicative of postoperative renal injury. The Welch two-sample test......, hypertension, general anesthesia, high ASA scores, low intra-operative systolic BP, and prophylactic dicloxacillin as significant risk factors. Low baseline systolic BP, low baseline diastolic blood pressure, and hip fracture diagnosis were independent risk factors for postoperative increase in serum...

  7. Methods of assessing total doses integrated across pathways

    International Nuclear Information System (INIS)

    Grzechnik, M.; Camplin, W.; Clyne, F.; Allott, R.; Webbe-Wood, D.

    2006-01-01

    Calculated doses for comparison with limits resulting from discharges into the environment should be summed across all relevant pathways and food groups to ensure adequate protection. Current methodology for assessments used in the radioactivity in Food and the Environment (R.I.F.E.) reports separate doses from pathways related to liquid discharges of radioactivity to the environment from those due to gaseous releases. Surveys of local inhabitant food consumption and occupancy rates are conducted in the vicinity of nuclear sites. Information has been recorded in an integrated way, such that the data for each individual is recorded for all pathways of interest. These can include consumption of foods, such as fish, crustaceans, molluscs, fruit and vegetables, milk and meats. Occupancy times over beach sediments and time spent in close proximity to the site is also recorded for inclusion of external and inhalation radiation dose pathways. The integrated habits survey data may be combined with monitored environmental radionuclide concentrations to calculate total dose. The criteria for successful adoption of a method for this calculation were: Reproducibility can others easily use the approach and reassess doses? Rigour and realism how good is the match with reality?Transparency a measure of the ease with which others can understand how the calculations are performed and what they mean. Homogeneity is the group receiving the dose relatively homogeneous with respect to age, diet and those aspects that affect the dose received? Five methods of total dose calculation were compared and ranked according to their suitability. Each method was labelled (A to E) and given a short, relevant name for identification. The methods are described below; A) Individual doses to individuals are calculated and critical group selection is dependent on dose received. B) Individual Plus As in A, but consumption and occupancy rates for high dose is used to derive rates for application in

  8. Economic Exposure and Integrated Risk Management

    OpenAIRE

    Miller, Kent D.

    1994-01-01

    Most corporate risk management research focuses on particular risk exposures to the exclusion of other interrelated exposures. By contrast, this study models corporate risk exposures using a multivariate approach integrating the distinct exposures of interest to finance and strategy researchers. The paper addresses the implications of multivariate modeling for corporate risk management, some key methodological issues arising in empirical estimation of corporate economic exposrues, and direc...

  9. Integrated climate change risk assessment:

    DEFF Research Database (Denmark)

    Kaspersen, Per Skougaard; Halsnæs, Kirsten

    2017-01-01

    Risk assessments of flooding in urban areas during extreme precipitation for use in, for example, decision-making regarding climate adaptation, are surrounded by great uncertainties stemming from climate model projections, methods of downscaling and the assumptions of socioeconomic impact models...... to address the complex linkages between the different kinds of data required in assessing climate adaptation. It emphasizes that the availability of spatially explicit data can reduce the overall uncertainty of the risk assessment and assist in identifying key vulnerable assets. The usefulness...... of such a framework is demonstrated by means of a risk assessment of flooding from extreme precipitation for the city of Odense, Denmark. A sensitivity analysis shows how the presence of particularly important assets, such as cultural and historical heritage, may be addressed in assessing such risks. The output...

  10. Total cholesterol and the risk of Parkinson disease.

    Science.gov (United States)

    Hu, G; Antikainen, R; Jousilahti, P; Kivipelto, M; Tuomilehto, J

    2008-05-20

    To examine the association between serum total cholesterol at baseline and the risk of Parkinson disease (PD). Study cohorts included 24,773 Finnish men and 26,153 women aged 25 to 74 years without a history of PD and stroke at baseline. Hazard ratios (HRs) of incident PD were estimated for different levels of total cholesterol. During a mean follow-up period of 18.1 years, 321 men and 304 women developed incident PD. After adjustment for confounding factors (age, study years, body mass index, systolic blood pressure, education, leisure-time physical activity, smoking, alcohol consumption, coffee and tea consumption, and history of diabetes), the HRs of PD at different levels of total cholesterol (or=7 mmol/L) were 1.00, 1.33, 1.53, and 1.84 (p for trend = 0.035) in men; 1.00, 1.55, 1.57, and 1.86 (p for trend = 0.113) in women; and 1.00, 1.42, 1.56, and 1.86 (p for trend = 0.002) in men and women combined (adjusted also for sex). In both sexes combined, the increased risk of PD associated with increasing levels of serum total cholesterol was present both in subjects aged 25-44 years and in subjects aged 45-54 years at baseline, and in never smokers and smokers; however, no association was found among subjects aged 55 years or older at baseline. This large prospective study suggests that high total cholesterol at baseline is associated with an increased risk of Parkinson disease.

  11. Preoperative Optimization of Total Joint Arthroplasty Surgical Risk: Obesity.

    Science.gov (United States)

    Fournier, Matthew N; Hallock, Justin; Mihalko, William M

    2016-08-01

    Obesity is a problem that is increasing in prevalence in the United States and in other countries, and it is a common comorbidity in patients seeking total joint arthroplasty for degenerative musculoskeletal diseases. Obesity, as well as commonly associated comorbidities such as diabetes mellitus, cardiovascular disease, and those contributing to the diagnosis of metabolic syndrome, have been shown to have detrimental effects on total joint arthroplasty outcomes. Although there are effective surgical and nonsurgical interventions which can result in weight loss in these patients, concomitant benefit on arthroplasty outcomes is not clear. Preoperative optimization of surgical risk in obese total joint arthroplasty patients is an important point of intervention to improve arthroplasty outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Integrated Risk Management Within NASA Programs/Projects

    Science.gov (United States)

    Connley, Warren; Rad, Adrian; Botzum, Stephen

    2004-01-01

    As NASA Project Risk Management activities continue to evolve, the need to successfully integrate risk management processes across the life cycle, between functional disciplines, stakeholders, various management policies, and within cost, schedule and performance requirements/constraints become more evident and important. Today's programs and projects are complex undertakings that include a myriad of processes, tools, techniques, management arrangements and other variables all of which must function together in order to achieve mission success. The perception and impact of risk may vary significantly among stakeholders and may influence decisions that may have unintended consequences on the project during a future phase of the life cycle. In these cases, risks may be unintentionally and/or arbitrarily transferred to others without the benefit of a comprehensive systemic risk assessment. Integrating risk across people, processes, and project requirements/constraints serves to enhance decisions, strengthen communication pathways, and reinforce the ability of the project team to identify and manage risks across the broad spectrum of project management responsibilities. The ability to identify risks in all areas of project management increases the likelihood a project will identify significant issues before they become problems and allows projects to make effective and efficient use of shrinking resources. By getting a total team integrated risk effort, applying a disciplined and rigorous process, along with understanding project requirements/constraints provides the opportunity for more effective risk management. Applying an integrated approach to risk management makes it possible to do a better job at balancing safety, cost, schedule, operational performance and other elements of risk. This paper will examine how people, processes, and project requirements/constraints can be integrated across the project lifecycle for better risk management and ultimately improve the

  13. Individualized Risk Model for Venous Thromboembolism After Total Joint Arthroplasty.

    Science.gov (United States)

    Parvizi, Javad; Huang, Ronald; Rezapoor, Maryam; Bagheri, Behrad; Maltenfort, Mitchell G

    2016-09-01

    Venous thromboembolism (VTE) after total joint arthroplasty (TJA) is a potentially fatal complication. Currently, a standard protocol for postoperative VTE prophylaxis is used that makes little distinction between patients at varying risks of VTE. We sought to develop a simple scoring system identifying patients at higher risk for VTE in whom more potent anticoagulation may need to be administered. Utilizing the National Inpatient Sample data, 1,721,806 patients undergoing TJA were identified, among whom 15,775 (0.9%) developed VTE after index arthroplasty. Among the cohort, all known potential risk factors for VTE were assessed. An initial logistic regression model using potential predictors for VTE was performed. Predictors with little contribution or poor predictive power were pruned from the data, and the model was refit. After pruning of variables that had little to no contribution to VTE risk, using the logistic regression, all independent predictors of VTE after TJA were identified in the data. Relative weights for each factor were determined. Hypercoagulability, metastatic cancer, stroke, sepsis, and chronic obstructive pulmonary disease had some of the highest points. Patients with any of these conditions had risk for postoperative VTE that exceeded the 3% rate. Based on the model, an iOS (iPhone operating system) application was developed (VTEstimator) that could be used to assign patients into low or high risk for VTE after TJA. We believe individualization of VTE prophylaxis after TJA can improve the efficacy of preventing VTE while minimizing untoward risks associated with the administration of anticoagulation. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Plasma Total Cysteine and Cardiovascular Risk Burden: Action and Interaction

    Directory of Open Access Journals (Sweden)

    Benedetta De Chiara

    2012-01-01

    Full Text Available We hypothesized that redox analysis could provide sensitive markers of the oxidative pathway associated to the presence of an increasing number of cardiovascular risk factors (RFs, independently of type. We classified 304 subjects without cardiovascular disease into 4 groups according to the total number of RFs (smoking, hypertension, hypercholesterolaemia, hyperhomocysteinaemia, diabetes, obesity, and their combination. Oxidative stress was evaluated by measuring plasma total and reduced homocysteine, cysteine (Cys, glutathione, cysteinylglycine, blood reduced glutathione, and malondialdehyde. Twenty-seven percent of subjects were in group 0 RF, 26% in 1 RF, 31% in 2 RF, and 16% in ≥3 RF. By multivariable ordinal regression analysis, plasma total Cys was associated to a higher number of RF (OR = 1.068; 95% CI = 1.027–1.110, =0.002. Total RF burden is associated with increased total Cys levels. These findings support a prooxidant effect of Cys in conjunction with RF burden, and shed light on the pathophysiologic role of redox state unbalance in preclinical atherosclerosis.

  15. Risk assessment of integrated electronic health records.

    Science.gov (United States)

    Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

    2010-01-01

    The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

  16. Integrated risk analysis of global climate change

    International Nuclear Information System (INIS)

    Shlyakhter, Alexander; Wilson, Richard; Valverde A, L.J. Jr.

    1995-01-01

    This paper discusses several factors that should be considered in integrated risk analyses of global climate change. We begin by describing how the problem of global climate change can be subdivided into largely independent parts that can be linked together in an analytically tractable fashion. Uncertainty plays a central role in integrated risk analyses of global climate change. Accordingly, we consider various aspects of uncertainty as they relate to the climate change problem. We also consider the impacts of these uncertainties on various risk management issues, such as sequential decision strategies, value of information, and problems of interregional and intergenerational equity. (author)

  17. Total Risk Management for Low Dose Radiation Exposures

    International Nuclear Information System (INIS)

    Simic, Z.; Mikulicic, V.; Sterc, D.

    2012-01-01

    health. This view is supported with numerous evidences, and explained with beneficial effects from the increased activity of immune system activated with small radiation exposures. Finally, theory in between is that small doses are less than linearly proportionally harmful and that they are presenting a much smaller risks than according to the LNT. This view is derived from the use of different evidences. Difficulties to find one single theory about effects of small radiation doses are related to existence of huge variability and uncertainty in the evidence data. This is very hard experimental and theoretical problem. It will require lots of additional research to reduce these uncertainties and find final theory. This might be too late for the number of people affected in different ways with current single most conservative LNT approach. The problem with the conservative LNT regulatory approach is resulting in enormous additional costs of nuclear energy and medical applications. Which is reasonable and acceptable during the regular operation when source is high and concentrated. But, this becomes unreasonable huge economic burden after accidents and for cleanups with nuclear facilities. Similar problem arises with restriction of medical examinations and treatments based on over conservative risk estimate. Special circumstances are with evacuated people from contaminated areas where they are on the one side saved from small radiation exposures, and on the other side exposed to years of life away from their home and with numerous direct and indirect additional risks (i.e., stress, social problems, etc.). It seems reasonable that some alternative (total) risk management approach might be much more suitable for this situation. Evacuation of people from contaminated area with small doses sources should not be done when that induces larger risks from even what is expected from radiation based on LNT. Similar total risk management could be also applied for with medical

  18. Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences

    Directory of Open Access Journals (Sweden)

    Dimitrios K. Manatakis

    2016-01-01

    Full Text Available Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors. Methods. Patients who underwent total thyroidectomy between January 2006 and December 2015 were retrospectively analyzed. Pathology reports were reviewed to identify those cases who had an incidental parathyroidectomy and these were compared to patients with no parathyroidectomy, in terms of clinical (age, sex, and symptoms of hypocalcemia, pathological (thyroid specimen weight, Hashimoto thyroiditis, and malignancy, and biochemical (serum calcium and phosphate levels factors. Results. 281 patients underwent total thyroidectomy during the study period. Incidental parathyroidectomy was noticed in 24.9% of cases, with 44.3% of parathyroid glands found in an intrathyroidal location. Evidence of postoperative biochemical hypocalcemia was noticed in 28.6% of patients with parathyroidectomy, compared with 13.3% in the no-parathyroidectomy group (p=0.003. Symptomatic hypocalcemia was observed in 5.7% and 3.8%, respectively (p=0.49. Age, sex, thyroid specimen weight, Hashimoto thyroiditis, and malignancy did not differ significantly between the two groups. Conclusions. Our study found an association of incidental parathyroidectomy with transient postoperative biochemical hypocalcemia, but not with clinically symptomatic disease. Age, sex, thyroid gland weight, Hashimoto thyroiditis, and malignancy were not identified as risk factors.

  19. Effects of total dose of ionizing radiation on integrated circuits

    Energy Technology Data Exchange (ETDEWEB)

    Silveira, Marcilei A.G.; Cirne, K.H.; Gimenez, S.; Santos, R.B.B. [Centro Universitario da FEI, Sao Bernardo do Campo, SP (Brazil); Added, N.; Barbosa, M.D.L.; Medina, N.H.; Tabacniks, M.H. [Universidade de Sao Paulo (IF/USP), SP (Brazil). Inst. de Fisica; Lima, J.A. de; Seixas Junior, L.E.; Melo, W. [Centro de Tecnologia da Informacao Paulo Archer, Sao Paulo, SP (Brazil)

    2011-07-01

    Full text: The study of ionizing radiation effects on materials used in electronic devices is of great relevance for the progress of global technological development and, particularly, it is a necessity in some strategic areas in Brazil. Electronic circuits are strongly influenced by radiation and the need for IC's featuring radiation hardness is largely growing to meet the stringent environment in space electronics. On the other hand, aerospace agencies are encouraging both scientific community and semiconductors industry to develop hardened-by-design components using standard manufacturing processes to achieve maximum performance, while significantly reducing costs. To understand the physical phenomena responsible for changes in devices exposed to ionizing radiation several kinds of radiation should then be considered, among them alpha particles, protons, gamma and X-rays. Radiation effects on the integrated circuits are usually divided into two categories: total ionizing dose (TID), a cumulative dose that shifts the threshold voltage and increases transistor's off-state current; single events effects (SEE), a transient effect which can deposit charge directly into the device and disturb the properties of electronic circuits. TID is one of the most common effects and may generate degradation in some parameters of the CMOS electronic devices, such as the threshold voltage oscillation, increase of the sub-threshold slope and increase of the off-state current. The effects of ionizing radiation are the creation of electron-hole pairs in the oxide layer changing operation mode parameters of the electronic device. Indirectly, there will be also changes in the device due to the formation of secondary electrons from the interaction of electromagnetic radiation with the material, since the charge carriers can be trapped both in the oxide layer and in the interface with the oxide. In this work we have investigated the behavior of MOSFET devices fabricated with

  20. RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

    OpenAIRE

    Szabo Alina

    2012-01-01

    Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the ‘top 8-12’ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in ...

  1. Risk factors for acute nerve injury after total knee arthroplasty.

    Science.gov (United States)

    Shetty, Teena; Nguyen, Joseph T; Sasaki, Mayu; Wu, Anita; Bogner, Eric; Burge, Alissa; Cogsil, Taylor; Dalal, Aashka; Halvorsen, Kristin; Cummings, Kelianne; Su, Edwin P; Lyman, Stephen

    2018-06-01

    In this we study identified potential risk factors for post-total knee arthroplasty (TKA) nerve injury, a catastrophic complication with a reported incidence of 0.3%-1.3%. Patients who developed post-TKA nerve injury from 1998 to 2013 were identified, and each was matched with 2 controls. A multivariable logistic regression model was built to calculate odds ratios (ORs). Sixty-five nerve injury cases were identified in 39,990 TKAs (0.16%). Females (OR 3.28, P = 0.003) and patients with history of lumbar pathology (OR 6.12, P = 0.026) were associated with increased risk of nerve injury. Tourniquet pressure nerve injury was unexpected and requires further investigation. Muscle Nerve 57: 946-950, 2018. © 2017 Wiley Periodicals, Inc.

  2. RISK INTEGRATION MECHANISMS AND APPROACHES IN BANKING INDUSTRY

    OpenAIRE

    JIANPING LI; JICHUANG FENG; XIAOLEI SUN; MINGLU LI

    2012-01-01

    Recently, the number of consultative documents and research papers that discuss risk integration has grown considerably. This paper presents a comprehensive review of the work done on risk integration in the banking industry. This survey includes: (1) risk integration methods within regulatory frameworks and the banking industry; (2) challenges of risk integration; (3) risk interaction mechanisms; (4) development of risk integration approaches; (5) risk interaction results: diversification ve...

  3. Risk-sensitivity in Bayesian sensorimotor integration.

    Directory of Open Access Journals (Sweden)

    Jordi Grau-Moya

    Full Text Available Information processing in the nervous system during sensorimotor tasks with inherent uncertainty has been shown to be consistent with Bayesian integration. Bayes optimal decision-makers are, however, risk-neutral in the sense that they weigh all possibilities based on prior expectation and sensory evidence when they choose the action with highest expected value. In contrast, risk-sensitive decision-makers are sensitive to model uncertainty and bias their decision-making processes when they do inference over unobserved variables. In particular, they allow deviations from their probabilistic model in cases where this model makes imprecise predictions. Here we test for risk-sensitivity in a sensorimotor integration task where subjects exhibit Bayesian information integration when they infer the position of a target from noisy sensory feedback. When introducing a cost associated with subjects' response, we found that subjects exhibited a characteristic bias towards low cost responses when their uncertainty was high. This result is in accordance with risk-sensitive decision-making processes that allow for deviations from Bayes optimal decision-making in the face of uncertainty. Our results suggest that both Bayesian integration and risk-sensitivity are important factors to understand sensorimotor integration in a quantitative fashion.

  4. Increasing risk of prosthetic joint infection after total hip arthroplasty

    DEFF Research Database (Denmark)

    Dale, Håvard; Fenstad, Anne M; Hallan, Geir

    2012-01-01

    Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods The...... explain this increase. We believe that there has been an actual increase in the incidence of prosthetic joint infections after THA.......Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods...... The study was based on the Nordic Arthroplasty Register Association (NARA) dataset. 432,168 primary THAs from 1995 to 2009 were included (Denmark: 83,853, Finland 78,106, Norway 88,455, and Sweden 181,754). Adjusted survival analyses were performed using Cox regression models with revision due to infection...

  5. Risk Informed Structural Systems Integrity Management

    DEFF Research Database (Denmark)

    Nielsen, Michael Havbro Faber

    2017-01-01

    The present paper is predominantly a conceptual contribution with an appraisal of major developments in risk informed structural integrity management for offshore installations together with a discussion of their merits and the challenges which still lie ahead. Starting point is taken in a selected...... overview of research and development contributions which have formed the basis for Risk Based Inspection Planning (RBI) as we know it today. Thereafter an outline of the methodical basis for risk informed structural systems integrity management, i.e. the Bayesian decision analysis is provided in summary....... The main focus is here directed on RBI for offshore facilities subject to fatigue damages. New ideas and methodical frameworks in the area of robustness and resilience modeling of structural systems are then introduced, and it is outlined how these may adequately be utilized to enhance Structural Integrity...

  6. Preoperative risk factors in total thyroidectomy of substernal goiter

    Directory of Open Access Journals (Sweden)

    Bove A

    2016-11-01

    Full Text Available Aldo Bove, Raffaella Maria Di Renzo, Gauro D’Urbano, Manuela Bellobono, Vincenzo D’ Addetta, Alfonso Lapergola, Giuseppe Bongarzoni Department of Medicine, Dentistry and Biotechnology, University “G. d’Annunzio” Chieti-Pescara, Chieti Scalo, Italy Abstract: The definition of substernal goiter (SG is based on variable criteria leading to a considerable variation in the reported incidence (from 0.2% to 45%. The peri- and postoperative complications are higher in total thyroidectomy (TT for SG than that for cervical goiter. The aim of this study was to evaluate the preoperative risk factors associated with postoperative complications. From 2002 to 2014, 142 (8.5%; 98 women and 44 men of the 1690 patients who underwent TT had a SG. We retrospectively evaluated the following parameters: sex, age, histology, pre- and retrovascular position, recurrence, and extension beyond the carina. These parameters were then related to the postoperative complications: seroma/hematoma, transient and permanent hypocalcemia, transient and permanent laryngeal nerve palsy, and the length of surgery. The results were further compared with a control group of 120 patients operated on in the same period with TT for cervical goiter. All but two procedures were terminated via cervicotomy, where partial sternotomies were required. No perioperative mortality was observed. Results of the statistical analysis (Student’s t-test and Fisher’s exact test indicated an association between recurrence and extension beyond the carina with all postoperative complications. The group that underwent TT of SG showed a statistically significant higher risk for transient hypocalcemia (relative risk =1.767 with 95% confidence interval: 1.131–2.7605, P=0.0124, and need to treat =7.1 and a trend toward significance for transient recurrent laryngeal nerve palsy (relative risk =6.7806 with 95% confidence interval: 0.8577–53.2898, P=0.0696, and need to treat =20.8 compared to the

  7. Integration of virtual control units in the total vehicle simulation; Integration virtueller Steuergeraete in die Gesamtfahrzeugsimulation

    Energy Technology Data Exchange (ETDEWEB)

    Soppa, Andreas; Lund, Christoph [Volkswagen AG, Wolfsburg (Germany)

    2012-11-01

    In this article the simulation of information and energetics of vehicles with model-integration of electronic control units (ECU) in a simulation, based on the coupling of physical and control components of the total vehicle are investigated. For that simplified models of ECU's, simulating the functionally of the real ECU's, were used. The integration of virtual EUC's in models of full vehicles makes it possible to simulate the energetics for different driving cycles in a realistic way. By better simulation results an evaluation of physical components and the amount of functions are possible. In the area of the thermal management of vehicles by this analyses and optimizations of functions become possible. This article shows the advantages of embedding virtual ECU's in simulations of full vehicles. (orig.)

  8. Total site integration of light hydrocarbons separation process

    OpenAIRE

    Ulyev, L.; Vasilyev, M.; Maatouk, A.; Duic, Neven; Khusanovc, Alisher

    2016-01-01

    Ukraine is the largest consumer of hydrocarbons per unit of production in Europe (Ukraine policy review, 2006). The most important point is a reduction of energy consumption in chemical and metallurgical industries as a biggest consumer. This paper deals with energy savings potential of light hydrocarbons separation process. Energy consumption of light hydrocarbons separation process processes typical of Eastern European countries were analysed. Process Integration (PI) was used to perform a ...

  9. Micro Total Analysis Systems: Microfluidic aspects, integration concept and applications

    NARCIS (Netherlands)

    van den Berg, Albert; Lammerink, Theodorus S.J.

    1997-01-01

    In this contribution three aspects of miniaturized total analysis systems (µTAS) are described and discussed in detail. First, an overview of microfabricated components for fluid handling is given. A description of the importance of sampling- and fluid-handling techniques is followed by details of

  10. Integrating spaceflight human system risk research

    Science.gov (United States)

    Mindock, Jennifer; Lumpkins, Sarah; Anton, Wilma; Havenhill, Maria; Shelhamer, Mark; Canga, Michael

    2017-10-01

    NASA is working to increase the likelihood of exploration mission success and to maintain crew health, both during exploration missions and long term after return to Earth. To manage the risks in achieving these goals, a system modelled after a Continuous Risk Management framework is in place. ;Human System Risks; (Risks) have been identified, and 32 are currently being actively addressed by NASA's Human Research Program (HRP). Research plans for each of HRP's Risks have been developed and are being executed. Inter-disciplinary ties between the research efforts supporting each Risk have been identified; however, efforts to identify and benefit from these connections have been mostly ad hoc. There is growing recognition that solutions developed to address the full set of Risks covering medical, physiological, behavioural, vehicle, and organizational aspects of exploration missions must be integrated across Risks and disciplines. This paper discusses how a framework of factors influencing human health and performance in space is being applied as the backbone for bringing together sometimes disparate information relevant to the individual Risks. The resulting interrelated information enables identification and visualization of connections between Risks and research efforts in a systematic and standardized manner. This paper also discusses the applications of the visualizations and insights into research planning, solicitation, and decision-making processes.

  11. Assessing Extinction Risk: Integrating Genetic Information

    Directory of Open Access Journals (Sweden)

    Jason Dunham

    1999-06-01

    Full Text Available Risks of population extinction have been estimated using a variety of methods incorporating information from different spatial and temporal scales. We briefly consider how several broad classes of extinction risk assessments, including population viability analysis, incidence functions, and ranking methods integrate information on different temporal and spatial scales. In many circumstances, data from surveys of neutral genetic variability within, and among, populations can provide information useful for assessing extinction risk. Patterns of genetic variability resulting from past and present ecological and demographic events, can indicate risks of extinction that are otherwise difficult to infer from ecological and demographic analyses alone. We provide examples of how patterns of neutral genetic variability, both within, and among populations, can be used to corroborate and complement extinction risk assessments.

  12. Measurement of total risk of spontaneous abortion: the virtue of conditional risk estimation

    DEFF Research Database (Denmark)

    Modvig, J; Schmidt, L; Damsgaard, M T

    1990-01-01

    The concepts, methods, and problems of measuring spontaneous abortion risk are reviewed. The problems touched on include the process of pregnancy verification, the changes in risk by gestational age and maternal age, and the presence of induced abortions. Methods used in studies of spontaneous...... abortion risk include biochemical assays as well as life table technique, although the latter appears in two different forms. The consequences of using either of these are discussed. It is concluded that no study design so far is appropriate for measuring the total risk of spontaneous abortion from early...... conception to the end of the 27th week. It is proposed that pregnancy may be considered to consist of two or three specific periods and that different study designs should concentrate on measuring the conditional risk within each period. A careful estimate using this principle leads to an estimate of total...

  13. Employee satisfaction: an integral component of total quality.

    Science.gov (United States)

    Gvazdinskas, L C; Maffetone, M A

    1995-01-01

    As part of the Total Quality Management process, the leadership of Rush Medical Laboratories, with a staff of 400, made an initial commitment to focus on their own employees as the most important customers. Only after the employees' development, their help, their support, and their empowerment could Rush Medical Laboratories make the improvements in customer relationships and obtain the operations improvement, cost savings, and productivity necessary to maintain a competitive edge. This article outlines the numerous employee initiatives that have resulted from this commitment. All of these initiatives were successful at some point during the 5 or more years since the incorporation of TQM within Rush Medical Laboratories. In the spirit of continuous improvement, some have been modified or discontinued and replaced by others. This article provides an overview of the many improvements that are possible when employees are provided a forum in which to voice their needs, and it challenges the management and employees of all laboratories to focus on this vital component of total quality.

  14. Safety culture' is integrating 'human' into risk assessment

    International Nuclear Information System (INIS)

    Sugimoto, Taiji

    2014-01-01

    Significance of Fukushima nuclear power accident requested reconsideration of safety standards, of which we had usually no doubt. Risk assessment standard (JIS B 9702), Which was used for repetition of database preparation and cumulative assessment, defined allowable risk and residual risk. However, work site and immediate assessment was indispensable beside such assessment so as to ensure safety. Risk of casualties was absolutely not acceptable in principle and judgments to approve allowable risk needed accountability, which was reminded by safety culture proposed by IAEA and also identified by investigation of organizational cause of Columbia accident. Actor of safety culture would be organization and individual, and mainly individual. Realization of safety culture was conducted by personnel having moral consciousness and firm sense of mission in the course of jobs and working daily with sweat pouring. Safety engineering/technology should have framework integrating human as such totality. (T. Tanaka)

  15. Integrating Total Quality Management (TQM) and hazardous waste management

    Energy Technology Data Exchange (ETDEWEB)

    Kirk, Nancy [Colorado State Univ., Fort Collins, CO (United States)

    1993-11-01

    The Resource Conservation and Recovery Act (RCRA) of 1976 and its subsequent amendments have had a dramatic impact on hazardous waste management for business and industry. The complexity of this law and the penalties for noncompliance have made it one of the most challenging regulatory programs undertaken by the Environmental Protection Agency (EPA). The fundamentals of RCRA include ``cradle to grave`` management of hazardous waste, covering generators, transporters, and treatment, storage, and disposal facilities. The regulations also address extensive definitions and listing/identification mechanisms for hazardous waste along with a tracking system. Treatment is favored over disposal and emphasis is on ``front-end`` treatment such as waste minimization and pollution prevention. A study of large corporations such as Xerox, 3M, and Dow Chemical, as well as the public sector, has shown that well known and successful hazardous waste management programs emphasize pollution prevention and employment of techniques such as proactive environmental management, environmentally conscious manufacturing, and source reduction. Nearly all successful hazardous waste programs include some aspects of Total Quality Management, which begins with a strong commitment from top management. Hazardous waste management at the Rocky Flats Plant is further complicated by the dominance of ``mixed waste`` at the facility. The mixed waste stems from the original mission of the facility, which was production of nuclear weapons components for the Department of Energy (DOE). A Quality Assurance Program based on the criterion in DOE Order 5700.6C has been implemented at Rocky Flats. All of the elements of the Quality Assurance Program play a role in hazardous waste management. Perhaps one of the biggest waste management problems facing the Rocky Flats Plant is cleaning up contamination from a forty year mission which focused on production of nuclear weapon components.

  16. Integrating Total Quality Management (TQM) and hazardous waste management

    International Nuclear Information System (INIS)

    Kirk, N.

    1993-01-01

    The Resource Conservation and Recovery Act (RCRA) of 1976 and its subsequent amendments have had a dramatic impact on hazardous waste management for business and industry. The complexity of this law and the penalties for noncompliance have made it one of the most challenging regulatory programs undertaken by the Environmental Protection Agency (EPA). The fundamentals of RCRA include ''cradle to grave'' management of hazardous waste, covering generators, transporters, and treatment, storage, and disposal facilities. The regulations also address extensive definitions and listing/identification mechanisms for hazardous waste along with a tracking system. Treatment is favored over disposal and emphasis is on ''front-end'' treatment such as waste minimization and pollution prevention. A study of large corporations such as Xerox, 3M, and Dow Chemical, as well as the public sector, has shown that well known and successful hazardous waste management programs emphasize pollution prevention and employment of techniques such as proactive environmental management, environmentally conscious manufacturing, and source reduction. Nearly all successful hazardous waste programs include some aspects of Total Quality Management, which begins with a strong commitment from top management. Hazardous waste management at the Rocky Flats Plant is further complicated by the dominance of ''mixed waste'' at the facility. The mixed waste stems from the original mission of the facility, which was production of nuclear weapons components for the Department of Energy (DOE). A Quality Assurance Program based on the criterion in DOE Order 5700.6C has been implemented at Rocky Flats. All of the elements of the Quality Assurance Program play a role in hazardous waste management. Perhaps one of the biggest waste management problems facing the Rocky Flats Plant is cleaning up contamination from a forty year mission which focused on production of nuclear weapon components

  17. Integrated Reliability and Risk Analysis System (IRRAS)

    International Nuclear Information System (INIS)

    Russell, K.D.; McKay, M.K.; Sattison, M.B.; Skinner, N.L.; Wood, S.T.; Rasmuson, D.M.

    1992-01-01

    The Integrated Reliability and Risk Analysis System (IRRAS) is a state-of-the-art, microcomputer-based probabilistic risk assessment (PRA) model development and analysis tool to address key nuclear plant safety issues. IRRAS is an integrated software tool that gives the user the ability to create and analyze fault trees and accident sequences using a microcomputer. This program provides functions that range from graphical fault tree construction to cut set generation and quantification. Version 1.0 of the IRRAS program was released in February of 1987. Since that time, many user comments and enhancements have been incorporated into the program providing a much more powerful and user-friendly system. This version has been designated IRRAS 4.0 and is the subject of this Reference Manual. Version 4.0 of IRRAS provides the same capabilities as Version 1.0 and adds a relational data base facility for managing the data, improved functionality, and improved algorithm performance

  18. Baseline development, economic risk, and schedule risk: An integrated approach

    International Nuclear Information System (INIS)

    Tonkinson, J.A.

    1994-01-01

    The economic and schedule risks of Environmental Restoration (ER) projects are commonly analyzed toward the end of the baseline development process. Risk analysis is usually performed as the final element of the scheduling or estimating processes for the purpose of establishing cost and schedule contingency. However, there is an opportunity for earlier assessment of risks, during development of the technical scope and Work Breakdown Structure (WBS). Integrating the processes of risk management and baselining provides for early incorporation of feedback regarding schedule and cost risk into the proposed scope of work. Much of the information necessary to perform risk analysis becomes available during development of the technical baseline, as the scope of work and WBS are being defined. The analysis of risk can actually be initiated early on during development of the technical baseline and continue throughout development of the complete project baseline. Indeed, best business practices suggest that information crucial to the success of a project be analyzed and incorporated into project planning as soon as it is available and usable

  19. A Notion of Total Dual Integrality for Convex, Semidefinite, and Extended Formulations

    OpenAIRE

    Silva, Marcel K. de Carli; Tunçel, Levent

    2018-01-01

    Total dual integrality is a powerful and unifying concept in polyhedral combinatorics and integer programming that enables the refinement of geometric min-max relations given by linear programming Strong Duality into combinatorial min-max theorems. The definition of total dual integrality (TDI) revolves around the existence of optimal dual solutions that are integral, and thus naturally applies to a host of combinatorial optimization problems that are cast as integer programs whose LP relaxat...

  20. A multilayered integrated sensor for three-dimensional, micro total analysis systems

    International Nuclear Information System (INIS)

    Xiao, Jing; Song, Fuchuan; Seo, Sang-Woo

    2013-01-01

    This paper presents a layer-by-layer integration approach of different functional devices and demonstrates a heterogeneously integrated optical sensor featuring a micro-ring resonator and a high-speed thin-film InGaAs-based photodetector co-integrated with a microfluidic droplet generation device. A thin optical device structure allows a seamless integration with other polymer-based devices on a silicon platform. The integrated sensor successfully demonstrates its transient measurement capability of two-phase liquid flow in a microfluidic droplet generation device. The proposed approach represents an important step toward fully integrated micro total analysis systems. (paper)

  1. Optimal solution of full fuzzy transportation problems using total integral ranking

    Science.gov (United States)

    Sam’an, M.; Farikhin; Hariyanto, S.; Surarso, B.

    2018-03-01

    Full fuzzy transportation problem (FFTP) is a transportation problem where transport costs, demand, supply and decision variables are expressed in form of fuzzy numbers. To solve fuzzy transportation problem, fuzzy number parameter must be converted to a crisp number called defuzzyfication method. In this new total integral ranking method with fuzzy numbers from conversion of trapezoidal fuzzy numbers to hexagonal fuzzy numbers obtained result of consistency defuzzyfication on symmetrical fuzzy hexagonal and non symmetrical type 2 numbers with fuzzy triangular numbers. To calculate of optimum solution FTP used fuzzy transportation algorithm with least cost method. From this optimum solution, it is found that use of fuzzy number form total integral ranking with index of optimism gives different optimum value. In addition, total integral ranking value using hexagonal fuzzy numbers has an optimal value better than the total integral ranking value using trapezoidal fuzzy numbers.

  2. Totally "Online” High School for People at Educational Risk

    Directory of Open Access Journals (Sweden)

    Giancarlo De Agostini

    2010-02-01

    Full Text Available The Iberoamerican Virtual Foundation (http://fuvia.org is dedicated to providing e-learning solutions to universities and other institutions that may require it. It is develops a pedagogical, methodological and technological online High School model based on WEB2 tools, which could be easily replicated elsewhere, and is delivered completely through an online ICT technological GNU open source platform, implemented completely online through the “Colegio Virtual Iberoamericano” (http://cvi.edu.ec, which caters to vulnerable students at pedagogical risk who for different reasons were not able to finish their secondary education. The selected students receive scholarships, thus tuition is totally free. The Iberoamerican online High School Project started on October 2004 with UNESCO support, implementing the last six years of High School in four specialties, with student ages being between 16 and 65, located in almost 50 communities both rural and urban-marginal. We are also working in four detention centers of young law violators and with young men and women from street gangs through community centers. Thus far our strategic alliances (over 20 are with central and local governments, and national and international Foundations. In the near future we plan to: extend the online High School coverage to the rest of the Country in order to help decrease the digital divide gap and the student drop out rate from high school (nearly 80 %; replicate the experience in the rest of the region and in other countries in Africa and Asia; and develop a complete professional online digital Library service and a functional online student orientation Department.La Fondation Virtuelle Ibéro-américaine (http://fuvia.org est spécialisée dans la fourniture de solutions d’apprentissage en ligne aux universités et autres institutions. Elle développe un modèle d’enseignement secondaire en ligne à la fois pédagogique, méthodologique et technologique, et bas

  3. Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.

    Science.gov (United States)

    Ndindjock, Roger; Gedeon, Jude; Mendis, Shanthi; Paccaud, Fred; Bovet, Pascal

    2011-04-01

    To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.

  4. Risk Assessment and Integration Team (RAIT) Portfolio Risk Analysis Strategy

    Science.gov (United States)

    Edwards, Michelle

    2010-01-01

    Impact at management level: Qualitative assessment of risk criticality in conjunction with risk consequence, likelihood, and severity enable development of an "investment policy" towards managing a portfolio of risks. Impact at research level: Quantitative risk assessments enable researchers to develop risk mitigation strategies with meaningful risk reduction results. Quantitative assessment approach provides useful risk mitigation information.

  5. Risk factors for postoperative complications after total laryngectomy following radiotherapy or chemoradiation

    DEFF Research Database (Denmark)

    Wulff, N B; Kristensen, C.A.; Andersen, E

    2015-01-01

    OBJECTIVES: To determine the rates of and risk factors for postoperative complications following total laryngectomy in patients treated with radiotherapy or chemoradiation. DESIGN: Retrospective longitudinal study. SETTING: Tertiary medical centres. PARTICIPANTS: A total of 143 patients undergoin...

  6. Three-tiered integration of PACS and HIS toward next generation total hospital information system.

    Science.gov (United States)

    Kim, J H; Lee, D H; Choi, J W; Cho, H I; Kang, H S; Yeon, K M; Han, M C

    1998-01-01

    The Seoul National University Hospital (SNUH) started a project to innovate the hospital information facilities. This project includes installation of high speed hospital network, development of new HIS, OCS (order communication system), RIS and PACS. This project aims at the implementation of the first total hospital information system by seamlessly integrating these systems together. To achieve this goal, we took three-tiered systems integration approach: network level, database level, and workstation level integration. There are 3 loops of networks in SNUH: proprietary star network for host computer based HIS, Ethernet based hospital LAN for OCS and RIS, and ATM based network for PACS. They are linked together at the backbone level to allow high speed communication between these systems. We have developed special communication modules for each system that allow data interchange between different databases and computer platforms. We have also developed an integrated workstation in which both the OCS and PACS application programs run on a single computer in an integrated manner allowing the clinical users to access and display radiological images as well as textual clinical information within a single user environment. A study is in progress toward a total hospital information system in SNUH by seamlessly integrating the main hospital information resources such as HIS, OCS, and PACS. With the three-tiered systems integration approach, we could successfully integrate the systems from the network level to the user application level.

  7. The role of risk-based prioritization in total quality management

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, C.T.

    1994-10-01

    The climate in which government managers must make decisions grows more complex and uncertain. All stakeholders - the public, industry, and Congress - are demanding greater consciousness, responsibility, and accountability of programs and their budgets. Yet, managerial decisions have become multifaceted, involve greater risk, and operate over much longer time periods. Over the last four or five decades, as policy analysis and decisions became more complex, scientists from psychology, operations research, systems science, and economics have developed a more or less coherent process called decision analysis to aid program management. The process of decision analysis - a systems theoretic approach - provides the backdrop for this paper. The Laboratory Integrated Prioritization System (LIPS) has been developed as a systems analytic and risk-based prioritization tool to aid the management of the Tri-Labs` (Lawrence Livermore, Los Alamos, and Sandia) operating resources. Preliminary analyses of the effects of LIPS has confirmed the practical benefits of decision and systems sciences - the systematic, quantitative reduction in uncertainty. To date, the use of LIPS - and, hence, its value - has been restricted to resource allocation within the Tri-Labs` operations budgets. This report extends the role of risk-based prioritization to the support of DOE Total Quality Management (TQM) programs. Furthermore, this paper will argue for the requirement to institutionalize an evolutionary, decision theoretic approach to the policy analysis of the Department of Energy`s Program Budget.

  8. Integrated, regional approach to risk management of industrial systems

    International Nuclear Information System (INIS)

    Chakraborty, S.

    1992-01-01

    This paper focuses on the following four main issues: (1) necessity for an integrated, regional approach to risk management of industrial systems; (2) principles of risk management; (3) integrated approach and overall methodology; and (4) implementation of risk management strategies on a regional basis. The U.N. Interagency project on risk management for large industrial areas, which is a pioneer type of international initiative for an integrated approach to risk management, is discussed in this context. Another encouraging activity for further development of overall methodologies for risk management is the ongoing project on the risk and safety of technical systems at the Swiss Federal Institute of Technology in Aurich. The concept of integral risk management takes into account multidimensional factors including technical, economic, political, social, and ethical considerations to allow a well-balanced decision-making process

  9. Circulating Total Bilirubin and Risk of Incident Cardiovascular Disease in the General Population

    NARCIS (Netherlands)

    Kunutsor, Setor K.; Bakker, Stephan J. L.; Gansevoort, Ronald T.; Chowdhury, Rajiv; Dullaart, Robin P. F.

    OBJECTIVE: To assess the association of circulating total bilirubin and cardiovascular disease (CVD) risk in a new prospective study and to determine whether adding information on total bilirubin values to established cardiovascular risk factors is associated with improvement in prediction of CVD

  10. Total Quality Management and Organizational Behavior Management: An Integration for Continual Improvement.

    Science.gov (United States)

    Mawhinney, Thomas C.

    1992-01-01

    The history and main features of organizational behavior management (OBM) are compared and integrated with those of total quality management (TQM), with emphasis on W.E. Deming's 14 points and OBM's operant-based approach to performance management. Interventions combining OBM, TQM, and statistical process control are recommended. (DB)

  11. Overcoming barriers to integrating economic analysis into risk assessment.

    Science.gov (United States)

    Hoffmann, Sandra

    2011-09-01

    Regulatory risk analysis is designed to provide decisionmakers with a clearer understanding of how policies are likely to affect risk. The systems that produce risk are biological, physical, and social and economic. As a result, risk analysis is an inherently interdisciplinary task. Yet in practice, risk analysis has been interdisciplinary in only limited ways. Risk analysis could provide more accurate assessments of risk if there were better integration of economics and other social sciences into risk assessment itself. This essay examines how discussions about risk analysis policy have influenced the roles of various disciplines in risk analysis. It explores ways in which integrated bio/physical-economic modeling could contribute to more accurate assessments of risk. It reviews examples of the kind of integrated economics-bio/physical modeling that could be used to enhance risk assessment. The essay ends with a discussion of institutional barriers to greater integration of economic modeling into risk assessment and provides suggestions on how these might be overcome. © 2011 Society for Risk Analysis.

  12. Pipeline integrity handbook risk management and evaluation

    CERN Document Server

    Singh, Ramesh

    2013-01-01

    Based on over 40 years of experience in the field, Ramesh Singh goes beyond corrosion control, providing techniques for addressing present and future integrity issues. Pipeline Integrity Handbook provides pipeline engineers with the tools to evaluate and inspect pipelines, safeguard the life cycle of their pipeline asset and ensure that they are optimizing delivery and capability. Presented in easy-to-use, step-by-step order, Pipeline Integrity Handbook is a quick reference for day-to-day use in identifying key pipeline degradation mechanisms and threats to pipeline integrity. The book begins

  13. Integrated project risk management of nuclear power projects

    International Nuclear Information System (INIS)

    Wang Xiaohui; Xu Yuanhui

    2001-01-01

    The concept and the features of risks in nuclear power projects are introduced, and in terms of nuclear power projects' own features, the Nuclear Power Project Integrated Risk Management Model is presented. The identification, estimation, evaluation, response plan development, control of risks and the theoretical basis of risk management are discussed. The model has feedback and control functions in order to control and manage the risks dynamically

  14. Development and Validation of Perioperative Risk-Adjustment Models for Hip Fracture Repair, Total Hip Arthroplasty, and Total Knee Arthroplasty.

    Science.gov (United States)

    Schilling, Peter L; Bozic, Kevin J

    2016-01-06

    Comparing outcomes across providers requires risk-adjustment models that account for differences in case mix. The burden of data collection from the clinical record can make risk-adjusted outcomes difficult to measure. The purpose of this study was to develop risk-adjustment models for hip fracture repair (HFR), total hip arthroplasty (THA), and total knee arthroplasty (TKA) that weigh adequacy of risk adjustment against data-collection burden. We used data from the American College of Surgeons National Surgical Quality Improvement Program to create derivation cohorts for HFR (n = 7000), THA (n = 17,336), and TKA (n = 28,661). We developed logistic regression models for each procedure using age, sex, American Society of Anesthesiologists (ASA) physical status classification, comorbidities, laboratory values, and vital signs-based comorbidities as covariates, and validated the models with use of data from 2012. The derivation models' C-statistics for mortality were 80%, 81%, 75%, and 92% and for adverse events were 68%, 68%, 60%, and 70% for HFR, THA, TKA, and combined procedure cohorts. Age, sex, and ASA classification accounted for a large share of the explained variation in mortality (50%, 58%, 70%, and 67%) and adverse events (43%, 45%, 46%, and 68%). For THA and TKA, these three variables were nearly as predictive as models utilizing all covariates. HFR model discrimination improved with the addition of comorbidities and laboratory values; among the important covariates were functional status, low albumin, high creatinine, disseminated cancer, dyspnea, and body mass index. Model performance was similar in validation cohorts. Risk-adjustment models using data from health records demonstrated good discrimination and calibration for HFR, THA, and TKA. It is possible to provide adequate risk adjustment using only the most predictive variables commonly available within the clinical record. This finding helps to inform the trade-off between model performance and data

  15. An integrated framework for health and ecological risk assessment

    International Nuclear Information System (INIS)

    Suter, Glenn W.; Vermeire, Theo; Munns, Wayne R.; Sekizawa, Jun

    2005-01-01

    The worldHealth Organization's (WHO's) International Program for Chemical Safety has developed a framework for performing risk assessments that integrate the assessment of risks to human health and risks to nonhuman organisms and ecosystems. The WHO's framework recognizes that stakeholders and risk managers have their own processes that are parallel to the scientific process of risk assessment and may interact with the risk assessment at various points, depending on the context. Integration of health and ecology provides consistent expressions of assessment results, incorporates the interdependence of humans and the environment, uses sentinel organisms, and improves the efficiency and quality of assessments relative to independent human health and ecological risk assessments. The advantage of the framework to toxicologists lies in the opportunity to use understanding of toxicokinetics and toxicodynamics to inform the integrated assessment of all exposed species

  16. Stock Market Integration: Are Risk Premiums of International Assets Equal?

    Directory of Open Access Journals (Sweden)

    Kusdhianto Setiawan

    2014-02-01

    Full Text Available This paper studies previous research on capital market integration and applies a simple international capital asset pricing model by considering the incompleteness in market integration and heteroscedasticity of the market returns. When we disregarded those two factors, we found that stock markets were integrated and the law of one price on risk premiums prevails. However, when the factors were considered, the markets were just partially integrated.

  17. Supply chain integration, risk management and manufacturing flexibility

    DEFF Research Database (Denmark)

    Chaudhuri, Atanu; Boer, Harry; Taran, Yariv

    2018-01-01

    , respectively, and manufacturing flexibility. Design/methodology/approach – Using hierarchical regression, data are analyzed from a sample of 343 manufacturing plants in Asia collected in 2013-2014 as part of the International Manufacturing Strategy Survey (IMSS VI). Findings – Internal integration and supply......Purpose – The purpose of this paper is to investigate the impact of internal integration, external integration and supply chain risk management on manufacturing flexibility, and the moderating effect of supply chain risk management on the relationships between internal and external integration...... chain risk management have a direct effect on manufacturing flexibility. Supply chain risk management moderates the relationship between external integration and flexibility. Research limitations/implications – Further research is needed to generalize beyond the flexibility performance of discrete...

  18. An integrated risk assessment approach: Risk assessment in the programmatic environmental impact statement

    International Nuclear Information System (INIS)

    Morris, J.M.

    1994-01-01

    The following paper is an informal summary of salient points made in the presentation entitled open-quotes An Integrated Risk Assessment Approach: Risk Assessment in the Programmatic Environmental Impact Statement (PEIS).close quotes. This presentation was given at the U.S. DOE Integrated Planning Workshop in Denver, Colorado on June 2, 1994. Integrated decision analysis is very important in environmental restoration and waste management in the evaluation of such things as land use planning, waste load forecasting, cost analyses, and technology development activities. Integrated risk assessment is an approach that addresses multiple components of risk, including: risks from surplus facilities as well as typical environmental restoration sites, risks to the public, risks to workers, ecological risk, risks before, during and after remediation activities, and others

  19. Integration of electrochemistry in micro-total analysis systems for biochemical assays: recent developments.

    Science.gov (United States)

    Xu, Xiaoli; Zhang, Song; Chen, Hui; Kong, Jilie

    2009-11-15

    Micro-total analysis systems (microTAS) integrate different analytical operations like sample preparation, separation and detection into a single microfabricated device. With the outstanding advantages of low cost, satisfactory analytical efficiency and flexibility in design, highly integrated and miniaturized devices from the concept of microTAS have gained widespread applications, especially in biochemical assays. Electrochemistry is shown to be quite compatible with microanalytical systems for biochemical assays, because of its attractive merits such as simplicity, rapidity, high sensitivity, reduced power consumption, and sample/reagent economy. This review presents recent developments in the integration of electrochemistry in microdevices for biochemical assays. Ingenious microelectrode design and fabrication methods, and versatility of electrochemical techniques are involved. Practical applications of such integrated microsystem in biochemical assays are focused on in situ analysis, point-of-care testing and portable devices. Electrochemical techniques are apparently suited to microsystems, since easy microfabrication of electrochemical elements and a high degree of integration with multi-analytical functions can be achieved at low cost. Such integrated microsystems will play an increasingly important role for analysis of small volume biochemical samples. Work is in progress toward new microdevice design and applications.

  20. Cirrhosis is a risk factor for total hip arthroplasty for avascular necrosis

    DEFF Research Database (Denmark)

    Deleuran, Thomas; Overgaard, Søren; Vilstrup, Hendrik

    2016-01-01

    Background and purpose - There are limited data on risk factors for avascular necrosis of the hip, but cirrhosis has been proposed as a risk factor. We examined the association between cirrhosis and incidence of total hip arthroplasty for avascular necrosis. Methods - We used nationwide healthcare......,052 reference individuals. Their median age was 57 years, and 65% were men. 45 cirrhosis patients and 44 reference individuals underwent total hip arthroplasty for avascular necrosis. Cirrhosis patients' HR for a total hip arthroplasty for avascular necrosis was 10 (95% CI: 6-17), yet their 5-year risk...... of avascular necrosis was only 0.2%. For the reference individuals, the 5-year risk was 0.02%. Interpretation - Cirrhosis is a strong risk factor for avascular necrosis of the hip, but it is rare even in cirrhosis patients....

  1. Total and Direct Correlation Function Integrals from Molecular Simulation of Binary Systems

    DEFF Research Database (Denmark)

    Wedberg, Nils Hejle Rasmus Ingemar; O’Connell, John P.; Peters, Günther H.J.

    2011-01-01

    The possibility for obtaining derivative properties for mixtures from integrals of spatial total and direct correlation functions obtained from molecular dynamics simulations is explored. Theoretically well-supported methods are examined to extend simulation radial distribution functions to long...... are consistent with an excess Helmholtz energy model fitted to available simulations. In addition, simulations of water/methanol and water/t-butanol mixtures have been carried out. The method yields results for partial molar volumes, activity coefficient derivatives, and individual correlation function integrals...... in reasonable agreement with smoothed experimental data. The proposed method for obtaining correlation function integrals is shown to perform at least as well as or better than two previously published approaches....

  2. QUALITY MANAGEMENT AND INTEGRATED TOTAL QUALITY IN SPANISH MINING: RESULTS OF AN EMPIRICAL STUDY

    OpenAIRE

    ESCANCIANO, CARMEN; IGLESIAS-RODRÍGUEZ, FRANCISCO-JAVIER

    2012-01-01

    This paper presents the results of an empirical study conducted in Spain among mining companies that hold ISO 9001 certification. This study aimed at reflecting upon quality management in Spanish mining; and discovering whether the certification of a quality management system provides companies with a framework for integrating total quality management with other management systems, such as environmental management or occupational health and safety management. En este artículo se presentan ...

  3. Test methods of total dose effects in very large scale integrated circuits

    International Nuclear Information System (INIS)

    He Chaohui; Geng Bin; He Baoping; Yao Yujuan; Li Yonghong; Peng Honglun; Lin Dongsheng; Zhou Hui; Chen Yusheng

    2004-01-01

    A kind of test method of total dose effects (TDE) is presented for very large scale integrated circuits (VLSI). The consumption current of devices is measured while function parameters of devices (or circuits) are measured. Then the relation between data errors and consumption current can be analyzed and mechanism of TDE in VLSI can be proposed. Experimental results of 60 Co γ TDEs are given for SRAMs, EEPROMs, FLASH ROMs and a kind of CPU

  4. Evaluation of Total Cardiovascular Risk in Patients with Hypertension and Impaired Glucose Tolerance

    Directory of Open Access Journals (Sweden)

    I.V. Cherniavska

    2016-11-01

    Full Text Available Aim. Timely reveal of the patients at high risk of cardiovascular diseases for whom earlier intervention for cardiovascular risk correction is the most effective. Materials and methods. Seventy patients aged 30–55 years old with stage 2 hypertension, impaired glucose tolerance (IGT and high cardiovascular risk were examined according to Framingham criteria. Cardiovascular risk was compared by SCORE and PROCAM results. Results. Percentage ratio of males with high cardiovascular risk was higher by 52.3 % in comparison to females by SCORE and by 2.3 % in comparison to females by PROCAM. Males did not present any significant discrepancy by evaluation of cardiovascular risk by both scores unlike females. Obtained results showed that total cardiovascular risk in females was twofold higher by PROCAM compared to SCORE scale. Conclusions. Total cardiovascular risk level in patients with stage 2 hypertension and IGT is influenced by age, systolic blood pressure level, smoking, lipid storage disease and carbohydrate metabolism disorder. When we evaluate total cardiovascular risk, we should not be limited only by determination of factors determined in SCORE. It is reasonable to evaluate risk factors by PROCAM, too, especially for females.

  5. TWRS safety and technical integration risk management plan

    International Nuclear Information System (INIS)

    Fordham, R.A.

    1996-01-01

    The objectives of the Tank Waste Remediation System (TWRS) Safety and Technical Integration (STI) programmatic risk management program are to assess, analyze, and handle risks associated with TWRS STI responsibilities and to communicate information about the actions being taken and the results to enable decision making. The objective of this TWRS STI Risk Management Plan is to communicate a consistent approach to risk management that will be used by the organization

  6. Forests at risk: integrating risk science into fuel management strategies.

    Science.gov (United States)

    Jonathan. Thompson

    2008-01-01

    The threat from wildland fire continues to grow across many regions of the Western United States. Drought, urbanization, and a buildup of fuels over the last century have contributed to increasing wildfire risk to property and highly valued natural resources. Fuel treatments, including thinning overly dense forests to reduce fuel and lower fire risk, have become a...

  7. Integrating and Prioritizing Environmental Risks in China's Risk Management Discourse

    NARCIS (Netherlands)

    Zhang, L.; Zhong, L.

    2010-01-01

    Human society faces a growing number of risks, including both natural disasters and risks that stem from human behavior. This is particularly true in China, which is experiencing rapid social, economic and political transitions. Since the 1970s, China's modernization process has been accompanied by

  8. Risk management integration into complex project organizations

    Science.gov (United States)

    Fisher, K.; Greanias, G.; Rose, J.; Dumas, R.

    2002-01-01

    This paper describes the approach used in designing and adapting the SIRTF prototype, discusses some of the lessons learned in developing the SIRTF prototype, and explains the adaptability of the risk management database to varying levels project complexity.

  9. Application of Total Quality Management (TQM Requirements in Risk Management in Construction Projects in Iraq

    Directory of Open Access Journals (Sweden)

    Entisar K. Al-Geelawee

    2016-06-01

    Full Text Available Total quality management considers one of the modern scientific entrances which practiced by productivity service organizations alike to provide appropriate quality required outputs according to the needs and desires of customers manage , enable the organization seeking to continue and grow in light of the increasing competition from the satisfy and provide the appropriate total quality management requirements whenever led to face risks that they may have in a manner in which they can be addressed and find ways to avoid them in the future when repeated. The research has consist of two main parts firstly have included a review of the most important concepts of total quality management in addition to the concept of risk analysis and management in construction projects and how to apply the concept of total quality management in the risk analysis and management. Second part included the practical part of the research, which was open and closed questionnaire for experts in the construction industry to obtain required informations for the application of total quality management requirements in risk management in construction projects in Iraq. One of the main findings of the research is that top management support has a high impact on risk management in addition to continuous improvement, training and education, while the participation of all employees in the organization and constant stimulation and focusing on the customer as one of the total quality management requirements had a moderate impact on risk management.

  10. Development of Improved Caprock Integrity and Risk Assessment Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Bruno, Michael [Geomechanics Technologies, Incorporated, Monrovia, CA (United States)

    2014-09-30

    GeoMechanics Technologies has completed a geomechanical caprock integrity analysis and risk assessment study funded through the US Department of Energy. The project included: a detailed review of historical caprock integrity problems experienced in the natural gas storage industry; a theoretical description and documentation of caprock integrity issues; advanced coupled transport flow modelling and geomechanical simulation of three large-scale potential geologic sequestration sites to estimate geomechanical effects from CO₂ injection; development of a quantitative risk and decision analysis tool to assess caprock integrity risks; and, ultimately the development of recommendations and guidelines for caprock characterization and CO₂ injection operating practices. Historical data from gas storage operations and CO₂ sequestration projects suggest that leakage and containment incident risks are on the order of 10-1 to 10-2, which is higher risk than some previous studies have suggested for CO₂. Geomechanical analysis, as described herein, can be applied to quantify risks and to provide operating guidelines to reduce risks. The risk assessment tool developed for this project has been applied to five areas: The Wilmington Graben offshore Southern California, Kevin Dome in Montana, the Louden Field in Illinois, the Sleipner CO₂ sequestration operation in the North Sea, and the In Salah CO₂ sequestration operation in North Africa. Of these five, the Wilmington Graben area represents the highest relative risk while the Kevin Dome area represents the lowest relative risk.

  11. Risk Informed Design Using Integrated Vehicle Rapid Assessment Tools

    Data.gov (United States)

    National Aeronautics and Space Administration — A successful proof of concept was performed in FY 2012 integrating the Envision tool for parametric estimates of vehicle mass and the Rapid Response Risk Assessment...

  12. Integrating risk management into the baselining process

    International Nuclear Information System (INIS)

    Jennett, N.; Tonkinson, A.

    1994-01-01

    These processes work together in building the project (comprised of the technical, schedule, and cost baselines) against which performance is measured and changes to the scope, schedule and cost of a project are managed and controlled. Risk analysis is often performed as the final element of the scheduling or estimating processes, a precursor to establishing cost and schedule contingency. However, best business practices dictate that information that may be crucial to the success of a project be analyzed and incorporated into project planning as soon as it is available and usable. The purpose or risk management is not to eliminate risk. Neither is it intended to suggest wholesale re-estimating and re-scheduling of a project. Rather, the intent is to make provisions to reduce and control the schedule and/or cost ramifications of risk by anticipating events and conditions that cannot be reliably planned for and which have the potential to negatively impact accomplishment of the technical objectives and requirements of the project

  13. Integrating Risk Management and Strategic Planning

    Science.gov (United States)

    Achampong, Francis K.

    2010-01-01

    Strategic planning is critical to ensuring that institutions of higher education thoughtfully and systematically position themselves to accomplish their mission, vision, and strategic goals, particularly when these institutions face a myriad of risks that can negatively impact their continued financial viability and compromise their ability to…

  14. Integration of transport concepts for risk assessment of pesticide erosion.

    Science.gov (United States)

    Yang, Xiaomei; Van Der Zee, Sjoerd E A T M; Gai, Lingtong; Wesseling, Jan G; Ritsema, Coen J; Geissen, Violette

    2016-05-01

    Environmental contamination by agrochemicals has been a large problem for decades. Pesticides are transported in runoff and remain attached to eroded soil particles, posing a risk to water and soil quality and human health. We have developed a parsimonious integrative model of pesticide displacement by runoff and erosion that explicitly accounts for water infiltration, erosion, runoff, and pesticide transport and degradation in soil. The conceptual framework was based on broadly accepted assumptions such as the convection-dispersion equation and lognormal distributions of soil properties associated with transport, sorption, degradation, and erosion. To illustrate the concept, a few assumptions are made with regard to runoff in relatively flat agricultural fields: dispersion is ignored and erosion is modelled by a functional relationship. A sensitivity analysis indicated that the total mass of pesticide associated with soil eroded by water scouring increased with slope, rain intensity, and water field capacity of the soil. The mass of transported pesticide decreased as the micro-topography of the soil surface became more distinct. The timing of pesticide spraying and rate of degradation before erosion negatively affected the total amount of transported pesticide. The mechanisms involved in pesticide displacement, such as runoff, infiltration, soil erosion, and pesticide transport and decay in the topsoil, were all explicitly accounted for, so the mathematical complexity of their description can be high, depending on the situation. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Pigging the unpiggable: a total integrated maintenance approach of the Progreso Process Pipelines in Yucatan, Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez Graciano, Luis [PEMEX Refinacion, Mexico, MX (Mexico); Gonzalez, Oscar L. [NDT Systems and Services, Stutensee (Germany)

    2009-07-01

    Pemex Refinacion and NDT Systems and Services, executed a Total Integrated Maintenance Program of the Process Pipeline System in the Yucatan Peninsula in Mexico, in order to modernize, enhance and bring the pipeline system up to the best industry standards and ensure the integrity, reliability and safe operation of the system. This approach consisted in using multi-diameter ultrasonic inspection technology to determine the current status of the pipelines, repair every 'integrity diminishing' feature present on the system and establish a Certified Maintenance Program to ensure the future reliability and safety of the pipelines. Due to the complex nature of the pipeline construction, dated from 1984, several special modifications, integrations and solutions were necessary to improve the in line inspection survey as for all traditionally unpiggable systems. The Progreso Pipeline System consists in 3 major pipelines which transport diesel, jet fuel and gasoline respectively. The outside diameter of two pipelines varies along its length between 12 inches - 14 inches - 16 inches, making the inspection survey more difficult and particularly demanding an Inspection Tool solution. It is located on the coast of the Yucatan Peninsula, at the Mexican Caribbean, and its main purpose is to transport the product from the docked tanker ships to the Pemex Storage and Distribution Terminal. (author)

  16. Integrated and Total HIV-1 DNA Predict Ex Vivo Viral Outgrowth.

    Directory of Open Access Journals (Sweden)

    Maja Kiselinova

    2016-03-01

    Full Text Available The persistence of a reservoir of latently infected CD4 T cells remains one of the major obstacles to cure HIV. Numerous strategies are being explored to eliminate this reservoir. To translate these efforts into clinical trials, there is a strong need for validated biomarkers that can monitor the reservoir over time in vivo. A comprehensive study was designed to evaluate and compare potential HIV-1 reservoir biomarkers. A cohort of 25 patients, treated with suppressive antiretroviral therapy was sampled at three time points, with median of 2.5 years (IQR: 2.4-2.6 between time point 1 and 2; and median of 31 days (IQR: 28-36 between time point 2 and 3. Patients were median of 6 years (IQR: 3-12 on ART, and plasma viral load (<50 copies/ml was suppressed for median of 4 years (IQR: 2-8. Total HIV-1 DNA, unspliced (us and multiply spliced HIV-1 RNA, and 2LTR circles were quantified by digital PCR in peripheral blood, at 3 time points. At the second time point, a viral outgrowth assay (VOA was performed, and integrated HIV-1 DNA and relative mRNA expression levels of HIV-1 restriction factors were quantified. No significant change was found for long- and short-term dynamics of all HIV-1 markers tested in peripheral blood. Integrated HIV-1 DNA was associated with total HIV-1 DNA (p<0.001, R² = 0.85, us HIV-1 RNA (p = 0.029, R² = 0.40, and VOA (p = 0.041, R2 = 0.44. Replication-competent virus was detected in 80% of patients by the VOA and it correlated with total HIV-1 DNA (p = 0.039, R² = 0.54. The mean quantification difference between Alu-PCR and VOA was 2.88 log10, and 2.23 log10 between total HIV-1 DNA and VOA. The levels of usHIV-1 RNA were inversely correlated with mRNA levels of several HIV-1 restriction factors (TRIM5α, SAMHD1, MX2, SLFN11, pSIP1. Our study reveals important correlations between the viral outgrowth and total and integrated HIV-1 DNA measures, suggesting that the total pool of HIV-1 DNA may predict the size of the

  17. Total luminous flux measurement for flexible surface sources with an integrating sphere photometer

    International Nuclear Information System (INIS)

    Yu, Hsueh-Ling; Liu, Wen-Chun

    2014-01-01

    Applying an integrating sphere photometer for total luminous flux measurement is a widely used method. However, the measurement accuracy depends on the spatial uniformity of the integrating sphere, especially when the test sample has a different light distribution from that of the standard source. Therefore, spatial correction is needed to eliminate the effect caused by non-uniformity. To reduce the inconvenience of spatial correction but retain the measurement accuracy, a new type of working standard is designed for flexible and curved surface sources. Applying this new type standard source, the measurement deviation due to different orientations is reduced by an order of magnitude compared with using a naked incandescent lamp as the standard source. (paper)

  18. Enchanced total dose damage in junction field effect transistors and related linear integrated circuits

    International Nuclear Information System (INIS)

    Flament, O.; Autran, J.L.; Roche, P.; Leray, J.L.; Musseau, O.

    1996-01-01

    Enhanced total dose damage of Junction Field-effect Transistors (JFETs) due to low dose rate and/or elevated temperature has been investigated for elementary p-channel structures fabricated on bulk and SOI substrates as well as for related linear integrated circuits. All these devices were fabricated with conventional junction isolation (field oxide). Large increases in damage have been revealed by performing high temperature and/or low dose rate irradiations. These results are consistent with previous studies concerning bipolar field oxides under low-field conditions. They suggest that the transport of radiation-induced holes through the oxide is the underlying mechanism. Such an enhanced degradation must be taken into account for low dose rate effects on linear integrated circuits

  19. Integrating human behaviour dynamics into flood disaster risk assessment

    Science.gov (United States)

    Aerts, J. C. J. H.; Botzen, W. J.; Clarke, K. C.; Cutter, S. L.; Hall, J. W.; Merz, B.; Michel-Kerjan, E.; Mysiak, J.; Surminski, S.; Kunreuther, H.

    2018-03-01

    The behaviour of individuals, businesses, and government entities before, during, and immediately after a disaster can dramatically affect the impact and recovery time. However, existing risk-assessment methods rarely include this critical factor. In this Perspective, we show why this is a concern, and demonstrate that although initial efforts have inevitably represented human behaviour in limited terms, innovations in flood-risk assessment that integrate societal behaviour and behavioural adaptation dynamics into such quantifications may lead to more accurate characterization of risks and improved assessment of the effectiveness of risk-management strategies and investments. Such multidisciplinary approaches can inform flood-risk management policy development.

  20. Cirrhosis is a risk factor for total hip arthroplasty for avascular necrosis.

    Science.gov (United States)

    Deleuran, Thomas; Overgaard, Søren; Vilstrup, Hendrik; Jepsen, Peter

    2016-06-01

    Background and purpose - There are limited data on risk factors for avascular necrosis of the hip, but cirrhosis has been proposed as a risk factor. We examined the association between cirrhosis and incidence of total hip arthroplasty for avascular necrosis. Methods - We used nationwide healthcare data to identify all Danish residents diagnosed with cirrhosis in 1994-2011, and matched them 1:5 by age and sex to non-cirrhotic reference individuals from the general population. We excluded people with a previous total hip arthroplasty, a previous hip fracture, or a previous diagnosis of avascular necrosis. We used stratified Cox regression to estimate the hazard ratio (HR) for cirrhosis patients relative to reference individuals, adjusting for potential confounders. We used the cumulative incidence function to compute 5-year risks. Results - We included 25,421 cirrhosis patients and 114,052 reference individuals. Their median age was 57 years, and 65% were men. 45 cirrhosis patients and 44 reference individuals underwent total hip arthroplasty for avascular necrosis. Cirrhosis patients' HR for a total hip arthroplasty for avascular necrosis was 10 (95% CI: 6-17), yet their 5-year risk of avascular necrosis was only 0.2%. For the reference individuals, the 5-year risk was 0.02%. Interpretation - Cirrhosis is a strong risk factor for avascular necrosis of the hip, but it is rare even in cirrhosis patients.

  1. Train integrity detection risk analysis based on PRISM

    Science.gov (United States)

    Wen, Yuan

    2018-04-01

    GNSS based Train Integrity Monitoring System (TIMS) is an effective and low-cost detection scheme for train integrity detection. However, as an external auxiliary system of CTCS, GNSS may be influenced by external environments, such as uncertainty of wireless communication channels, which may lead to the failure of communication and positioning. In order to guarantee the reliability and safety of train operation, a risk analysis method of train integrity detection based on PRISM is proposed in this article. First, we analyze the risk factors (in GNSS communication process and the on-board communication process) and model them. Then, we evaluate the performance of the model in PRISM based on the field data. Finally, we discuss how these risk factors influence the train integrity detection process.

  2. 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...

  3. Nuclear safety culture and integrated risk management

    International Nuclear Information System (INIS)

    Joksimovich, V.; Orvis, D.D.

    1993-01-01

    A primary focus of nuclear safety is the prevention of large releases of radioactivity in the case of low-probability severe accidents. An analysis of the anatomy of nuclear (Chernobyl, Three Mile Island Unit 2) and nonnuclear (Challenger, Bhopal, Piper Alpha, etc.) severe accidents yields four broad categories of root causes: human (operating crew response), machine (design with its basic flaws), media (natural phenomena, operational considerations, political environment, commercial pressures, etc.)-providing triggering events, and management (basic organizational safety culture flaws). A strong management can minimize the contributions of humans, machines, and media to the risk arising from the operation of hazardous facilities. One way that management can have a powerful positive influence is through the establishment of a proper safety culture. The term safety culture is used as defined by the International Atomic Energy Agency's International Safety Advisory Group

  4. Lifetime risk of primary total hip replacement surgery for osteoarthritis from 2003-2013

    DEFF Research Database (Denmark)

    Ackerman, Ilana N; Bohensky, Megan A; de Steiger, Richard

    2017-01-01

    OBJECTIVE: To compare the lifetime risk of total hip replacement surgery (THR) for osteoarthritis (OA) between countries, and over time. METHODS: Data on primary THR procedures performed for OA in 2003 and 2013 were extracted from national arthroplasty registries in Australia, Denmark, Finland, N....... These multi-national risk estimates can inform resource planning for OA service delivery. This article is protected by copyright. All rights reserved....

  5. Integrated Risk Framework for Onsite Wastewater Treatment Systems

    Science.gov (United States)

    Carroll, Steven; Goonetilleke, Ashantha; Thomas, Evan; Hargreaves, Megan; Frost, Ray; Dawes, Les

    2006-08-01

    Onsite wastewater treatment systems (OWTS) are becoming increasingly important for the treatment and dispersal of effluent in new urbanised developments that are not serviced by centralised wastewater collection and treatment systems. However, the current standards and guidelines adopted by many local authorities for assessing suitable site and soil conditions for OWTS are increasingly coming under scrutiny due to the public health and environmental impacts caused by poorly performing systems, in particular septic tank-soil adsorption systems. In order to achieve sustainable onsite wastewater treatment with minimal impacts on the environment and public health, more appropriate means of assessment are required. This paper highlights an integrated risk based approach for assessing the inherent hazards associated with OWTS in order to manage and mitigate the environmental and public health risks inherent with onsite wastewater treatment. In developing a sound and cohesive integrated risk framework for OWTS, several key issues must be recognised. These include the inclusion of relevant stakeholders throughout framework development, the integration of scientific knowledge, data and analysis with risk assessment and management ideals, and identification of the appropriate performance goals for successful management and mitigation of associated risks. These issues were addressed in the development of the risk framework to provide a generic approach to assessing risk from OWTS. The utilisation of the developed risk framework for achieving more appropriate assessment and management techniques for OWTS is presented in a case study for the Gold Coast region, Queensland State, Australia.

  6. Application of Total Quality Management (TQM) Requirements in Risk Management in Construction Projects in Iraq

    OpenAIRE

    Entisar K. Al-Geelawee; Anfal Nadhel Mohammed

    2016-01-01

    Total quality management considers one of the modern scientific entrances which practiced by productivity service organizations alike to provide appropriate quality required outputs according to the needs and desires of customers manage , enable the organization seeking to continue and grow in light of the increasing competition from the satisfy and provide the appropriate total quality management requirements whenever led to face risks that they may have in a manner in which they can be a...

  7. Route assessment using comparative risk factors integrated through a GIS

    International Nuclear Information System (INIS)

    Toth, D.M.; O'Connell, W.J.

    1996-01-01

    The assessment of potential alternative routes for the shipment of spent nuclear fuel was simplified through the use of comparative risk factors evaluated using detailed route and environmental attributes. The route characteristics, integrated into risk measures, vary strongly with location and were developed from national, state, and local sources. The route data and evaluation were managed using a geographic information system (GIS). An assessment of four real North Florida routes was performed and an interstate highway route exhibited the lowest risk based on the application of the risk factors

  8. Managing Key Risks in Post-Merger IS Integration

    DEFF Research Database (Denmark)

    Alaranta, Mar; Mathiassen, L

    2014-01-01

    Mergers and acquisitions (M&A) require organizations to blend together different information system (IS) configurations. Unfortunately, less than 50 percent of M&A's achieve their goals, with IS integration being a major problem. Here, the authors offer a framework to help managers prepare for......, analyze, and mitigate risks during post-merger IS integration. They identify key risks relating to IS integration content, process, and context, and present five strategies for mitigating those risks. Their framework aims to help managers proactively reduce the impact of adverse events. Adopting...... the framework supported by their templates is straightforward and the time and resources required are minimal. When properly executed, adoption increases the likelihood of successful merger outcomes; the framework is thus a valuable addition to the management tool box and can be applied in collaboration...

  9. Simplified risk model support for environmental management integration

    International Nuclear Information System (INIS)

    Eide, S.A.; Jones, J.L.; Wierman, T.E.

    1998-01-01

    This paper summarizes the process and results of human health risk assessments of the US Department of Energy (DOE) complex-wide programs for high-level waste, transuranic waste, low-level, mixed low-level waste, and spent nuclear fuel. The DOE baseline programs and alternatives for these five material types were characterized by disposition maps (material flow diagrams) and supporting information in the May 1997 report 'A Contractor Report to the Department of Energy on Environmental Baseline Programs and Integration Opportunities' (Discussion Draft). Risk analyses were performed using the Simplified Risk Model (SRM), developed to support DOE Environmental Management Integration studies. The SRM risk analyses consistently and comprehensively cover the life cycle programs for the five material types, from initial storage through final disposition. Risk results are presented at several levels: DOE complex-wide, material type program, individual DOE sites, and DOE site activities. The detailed risk results are documented in the February 1998 report 'Human Health Risk Comparisons for Environmental Management Baseline Programs and Integration Opportunities' (Discussion Draft)

  10. Integrated Risk Research. Case of Study: Motozintla, Chiapas, Mexico

    Science.gov (United States)

    Novelo-Casanova, D. A.; Jaimes, M.

    2015-12-01

    This integrated risk research include the analysis of all components of individual constituents of risk such hazard identification, hazard exposure, and vulnerability. We determined risk to natural hazards in the community of Motozintla located in southern Mexico in the state of Chiapas (15.37ºN, 92.25ºW. Due to its geographical and geological location, this community is continuously exposed mainly to earthquakes, landslides and floods. We developed integrated studies and analysis of seismic zonation, landslides and flood susceptibility using standard methodologies. Vulnerability was quantified from data collected from local families interviews considering five social variables: characteristics of housing construction, availability of basic public services, family economic conditions, existing community plans for disaster preparedness, and risk perception. Local families surveyed were randomly selected considering a sample statistically significant. Our results were spatially represented using a Geographical Information System (GIS). Structural vulnerability curves were generated for typical housing constructions. Our integrated risk analysis demonstrates that the community of Motozintla has a high level of structural and socio-economical risk to floods and earthquakes. More than half of the population does not know any existing Civil Protection Plan and perceive that they are in high risk to landslides and floods. Although the community is located in a high seismic risk zone, most of the local people believe that cannot be impacted by a large earthquake. These natural and social conditions indicate that the community of Motozintla has a very high level of risk to natural hazards. This research will support local decision makers in developing an integrated comprehensive natural hazards mitigation and prevention program.

  11. Integrated spatial assessment of wind erosion risk in Hungary

    Directory of Open Access Journals (Sweden)

    L. Pásztor

    2016-11-01

    Full Text Available Wind erosion susceptibility of Hungarian soils was mapped on the national level integrating three factors of the complex phenomenon of deflation (physical soil features, wind characteristics, and land use and land cover. Results of wind tunnel experiments on erodibility of representative soil samples were used for the parametrization of a countrywide map of soil texture compiled for the upper 5 cm layer of soil, which resulted in a map representing threshold wind velocity exceedance. Average wind velocity was spatially estimated with 0.5′ resolution using the Meteorological Interpolation based on Surface Homogenised Data Basis (MISH method elaborated for the spatial interpolation of surface meteorological elements. The probability of threshold wind velocity exceedance was determined based on values predicted by the soil texture map at the grid locations. Ratio values were further interpolated to a finer 1 ha resolution using sand and silt content of the uppermost (0–5 cm layer of soil as spatial co-variables. Land cover was also taken into account, excluding areas that are not relevant to wind erosion (forests, water bodies, settlements, etc., to spatially assess the risk of wind erosion. According to the resulting map of wind erosion susceptibility, about 10 % of the total area of Hungary can be identified as susceptible to wind erosion. The map gives more detailed insight into the spatial distribution of wind-affected areas in Hungary compared to previous studies.

  12. Integrated Waste Treatment Unit GFSI Risk Management Plan

    International Nuclear Information System (INIS)

    W. A. Owca

    2007-01-01

    This GFSI Risk Management Plan (RMP) describes the strategy for assessing and managing project risks for the Integrated Waste Treatment Unit (IWTU) that are specifically within the control and purview of the U.S. Department of Energy (DOE), and identifies the risks that formed the basis for the DOE contingency included in the performance baseline. DOE-held contingency is required to cover cost and schedule impacts of DOE activities. Prior to approval of the performance baseline (Critical Decision-2) project cost contingency was evaluated during a joint meeting of the Contractor Management Team and the Integrated Project Team for both contractor and DOE risks to schedule and cost. At that time, the contractor cost and schedule risk value was $41.3M and the DOE cost and schedule risk contingency value is $39.0M. The contractor cost and schedule risk value of $41.3M was retained in the performance baseline as the contractor's management reserve for risk contingency. The DOE cost and schedule risk value of $39.0M has been retained in the performance baseline as the DOE Contingency. The performance baseline for the project was approved in December 2006 (Garman 2006). The project will continue to manage to the performance baseline and change control thresholds identified in PLN-1963, ''Idaho Cleanup Project Sodium-Bearing Waste Treatment Project Execution Plan'' (PEP)

  13. Pre-Operative Patient Education is Associated With Decreased Risk of Arthrofibrosis After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Livbjerg, Anna Emilie; Frøkjær, Sara; Simonsen, Ole

    2013-01-01

    The purpose was to investigate risk factors for postoperative stiffness and long-term outcome following manipulation under anaesthesia (MUA). In one of the five Danish regions, all patients in a 4-year period who received MUA following total knee arthroplasty (N=36) were included in two case-cont...

  14. Risk factors for accelerated polyethylene wear and osteolysis in ABG I total hip arthroplasty

    Czech Academy of Sciences Publication Activity Database

    Gallo, J.; Havránek, Vítězslav; Zapletová, J.

    2013-01-01

    Roč. 34, č. 1 (2013), 19-26 ISSN 0341-2695 Grant - others:GA MŠk(CZ) OC 168 Program:OC Institutional research plan: CEZ:AV0Z10100522 Keywords : risk * factors * accelerated * polyethylene * wear * osteolysis * ABG * total * arthroplasty Subject RIV: FI - Traumatology, Orthopedics Impact factor: 2.019, year: 2013

  15. BMI, total and abdominal fat distribution, and cardiovascular risk factors in school-age children.

    Science.gov (United States)

    Gishti, Olta; Gaillard, Romy; Durmus, Busra; Abrahamse, Marieke; van der Beek, Eline M; Hofman, Albert; Franco, Oscar H; de Jonge, Layla L; Jaddoe, Vincent W V

    2015-05-01

    More specific total body and abdominal fat mass measures might be stronger associated with cardiovascular risk factors in childhood, than BMI. We examined the independent associations of total and abdominal fat measures with cardiovascular risk factors in school age children. We performed a population-based cohort study among 6,523 children. At the age of 6 y, we measured childhood BMI, and general and abdominal fat mass, using dual-energy X-ray absorptiometry, and ultrasound and cardiovascular risk factors. Conditional on BMI, higher fat mass percentage and abdominal fat mass were associated with higher blood pressure, total- and low-density lipoprotein (LDL)-cholesterol, insulin and c-peptide levels, but with lower left ventricular mass and high-density lipoprotein (HDL)-cholesterol (P values children. Higher childhood adiposity measures were associated with increased odds of cardiovascular risk factors clustering, with the strongest effect for fat mass percentage (odds ratios: 3.01 (95% confidence interval: 2.67, 3.9). Our results suggest that general and abdominal fat measures are associated with cardiovascular risk factors in childhood, independent from BMI. These measures may provide additional information for identification of children with an adverse cardiovascular profile.

  16. Diagnosis and proposal for an integrated risk management en el Valle de Aburra: red risks

    International Nuclear Information System (INIS)

    Aristizabal, Edier; Vargas, Richard

    2008-01-01

    From the analysis of the organizational situation of different institutions of the Aburra Valley oriented to reduce disasters and emergencies of natural and anthropological origin, a system for the prevention, relief and recovery, Area metropolitana del Valle de Aburra, environmental authority and planning institution, has made to the region a pro pose which try to integrate all governmental and private organizations through an integral risk management, denominated: The Regional Risk Management Network in the Aburra Valley, Risk Network. Risk Network is an open organizational system of inter institutional character to direct and co-ordinate policies and actions of analysis and risk reduction, as well as the preparation and execution of the response and recovery of disaster and emergencies. in the Aburra Valley. Two are the strategic instruments of the Network: The Risk Management Regional Plan in the Aburra Valley, and the Integrated Information System which was designed to support the different management processes of the Network.

  17. Blood trihalomethane levels and the risk of total cancer mortality in US adults

    International Nuclear Information System (INIS)

    Min, Jin-Young; Min, Kyoung-Bok

    2016-01-01

    Background: Although animal data have suggested the carcinogenic activity of trihalomethanes (THMs), there is inconsistent evidence supporting the link between THM exposure and cancers in humans. Objectives: We investigated the association between specific and total blood THM levels with the risk of total cancer mortality in adults. Methods: We analyzed data from the 1999–2004 Third National Health and Nutrition Examination Survey and the Linked Mortality File of the United States. A total of 933 adults (20–59 years of age) with available blood THM levels and no missing data for other variables were included. Four different THM species (chloroform, bromodichloromethane (BDCM), dibromochloromethane (DBCM) and bromoform) were included, and the codes associated with cancer (malignant neoplasm) were C00 through C97, based on the underlying causes of death listed in the International Classification of Disease 10the Revision. Results: Compared with adults in the lowest DBCM, bromoform, and total brominated THM tertiles, those in the highest DBCM, bromoform, and total brominated THM tertiles exhibited adjusted hazard ratios (HR) of total cancer mortality of 4.97 (95% confidence interval (CI) = 1.59–15.50), 4.94 (95% CI = 1.56–15.61), and 3.42 (95% CI = 1.21–15.43) respectively. The risk of total cancer mortality was not associated with increases in blood chloroform and total THM levels. Conclusions: We found that the baseline blood THM species, particularly brominated THMs, were significantly associated with total cancer mortality in adults. Although this study should be confirm by other studies, our findings suggest a possible link between THM exposures and cancer. - Highlights: • Trihalomethanes (THM) are classified as either probable or possible carcinogens. • Limited evidence on the link between THM and the incidence of cancer in humans. • We investigated the association between blood THM levels and the risk of total cancer mortality. • High

  18. Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk

    DEFF Research Database (Denmark)

    Sanikini, Harinakshi; Dik, Vincent K; Siersema, Peter D

    2015-01-01

    Prospective studies examining the association between coffee and tea consumption and gastric cancer risk have shown inconsistent results. We investigated the association between coffee (total, caffeinated and decaffeinated) and tea consumption and the risk of gastric cancer by anatomical site...... and histological type in the EPIC study. Coffee and tea consumption was assessed by dietary questionnaires at baseline. Adjusted hazard ratios (HRs) were calculated using Cox regression models. During 11.6 years of follow up, 683 gastric adenocarcinoma cases were identified among 477,312 participants. We found......) and tea (HR 0.81, 95%-CI: 0.59-1.09; quartile 4 vs. non/quartile 1). When stratified by anatomical site, we observed a significant positive association between gastric cardia cancer risk and total coffee consumption per increment of 100mL/day (HR 1.06, 95%-CI: 1.03-1.11). Similarly, a significant positive...

  19. Towards risk-based structural integrity methods for PWRs

    International Nuclear Information System (INIS)

    Chapman, O.J.V.; Lloyd, R.B.

    1992-01-01

    This paper describes the development of risk-based structural integrity assurance methods and their application to Pressurized Water Reactor (PWR) plant. In-service inspection is introduced as a way of reducing the failure probability of high risk sites and the latter are identified using reliability analysis; the extent and interval of inspection can also be optimized. The methodology is illustrated by reference to the aspect of reliability of weldments in PWR systems. (author)

  20. High dietary protein intake is associated with an increased body weight and total death risk.

    Science.gov (United States)

    Hernández-Alonso, Pablo; Salas-Salvadó, Jordi; Ruiz-Canela, Miguel; Corella, Dolores; Estruch, Ramón; Fitó, Montserrat; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Basora, Josep; Serra-Majem, Lluis; Muñoz, Miguel Ángel; Buil-Cosiales, Pilar; Saiz, Carmen; Bulló, Mònica

    2016-04-01

    High dietary protein diets are widely used to manage overweight and obesity. However, there is a lack of consensus about their long-term efficacy and safety. Therefore, the aim of this study was to assess the effect of long-term high-protein consumption on body weight changes and death outcomes in subjects at high cardiovascular risk. A secondary analysis of the PREDIMED trial was conducted. Dietary protein was assessed using a food-frequency questionnaire during the follow-up. Cox proportional hazard models were used to estimate the multivariate-adjusted hazard ratio (HR) and 95% confidence intervals (95%CI) for protein intake in relation to the risk of body weight and waist circumference changes, cardiovascular disease, cardiovascular death, cancer death and total death. Higher total protein intake, expressed as percentage of energy, was significantly associated with a greater risk of weight gain when protein replaced carbohydrates (HR: 1.90; 95%CI: 1.05, 3.46) but not when replaced fat (HR: 1.69; 95%CI: 0.94, 3.03). However, no association was found between protein intake and waist circumference. Contrary, higher total protein intake was associated with a greater risk of all-cause death in both carbohydrate and fat substitution models (HR: 1.59; 95%CI: 1.08, 2.35; and HR: 1.66; 95%CI: 1.13, 2.43, respectively). A higher consumption of animal protein was associated with an increased risk of fatal and non-fatal outcomes when protein substituted carbohydrates or fat. Higher dietary protein intake is associated with long-term increased risk of body weight gain and overall death in a Mediterranean population at high cardiovascular risk. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  1. Total integrated performance excellence system (TIPES): A true north direction for a clinical trial support center.

    Science.gov (United States)

    Sather, Mike R; Parsons, Sherry; Boardman, Kathy D; Warren, Stuart R; Davis-Karim, Anne; Griffin, Kevin; Betterton, Jane A; Jones, Mark S; Johnson, Stanley H; Vertrees, Julia E; Hickey, Jan H; Salazar, Thelma P; Huang, Grant D

    2018-03-01

    This paper presents the quality journey taken by a Federal organization over more than 20 years. These efforts have resulted in the implementation of a Total Integrated Performance Excellence System (TIPES) that combines key principles and practices of established quality systems. The Center has progressively integrated quality system frameworks including the Malcom Baldrige National Quality Award (MBNQA) Framework and Criteria for Performance Excellence, ISO 9001, and the Organizational Project Management Maturity Model (OPM3), as well as supplemental quality systems of ISO 15378 (packaging for medicinal products) and ISO 21500 (guide to project management) to systematically improve all areas of operations. These frameworks were selected for applicability to Center processes and systems, consistency and reinforcement of complimentary approaches, and international acceptance. External validations include the MBNQA, the highest quality award in the US, continued registration and conformance to ISO standards and guidelines, and multiple VA and state awards. With a focus on a holistic approach to quality involving processes, systems and personnel, this paper presents activities and lessons that were critical to building TIPES and establishing the quality environment for conducting clinical research in support of Veterans and national health care.

  2. Total integrated performance excellence system (TIPES: A true north direction for a clinical trial support center

    Directory of Open Access Journals (Sweden)

    Mike R. Sather

    2018-03-01

    Full Text Available This paper presents the quality journey taken by a Federal organization over more than 20 years. These efforts have resulted in the implementation of a Total Integrated Performance Excellence System (TIPES that combines key principles and practices of established quality systems. The Center has progressively integrated quality system frameworks including the Malcom Baldrige National Quality Award (MBNQA Framework and Criteria for Performance Excellence, ISO 9001, and the Organizational Project Management Maturity Model (OPM3, as well as supplemental quality systems of ISO 15378 (packaging for medicinal products and ISO 21500 (guide to project management to systematically improve all areas of operations. These frameworks were selected for applicability to Center processes and systems, consistency and reinforcement of complimentary approaches, and international acceptance. External validations include the MBNQA, the highest quality award in the US, continued registration and conformance to ISO standards and guidelines, and multiple VA and state awards. With a focus on a holistic approach to quality involving processes, systems and personnel, this paper presents activities and lessons that were critical to building TIPES and establishing the quality environment for conducting clinical research in support of Veterans and national health care.

  3. Integrating total quality management principles with the requirements of DOE Order 5700.6C

    Energy Technology Data Exchange (ETDEWEB)

    Hedges, D. [Scientific Ecology Group, Inc. (United States)

    1993-03-01

    The Department of Energy has recently required its field offices, contractors, and subcontractors to implement DOE Order 5700.6C, ``Quality Assurance,`` for all work on waste management contracts. The order restructures the 18 criteria of NQA-1 and focuses on the role of management in achieving and assuring quality, performance of activities to achieve and assure quality, and management`s assessment of its performance for the purpose of identifying improvements to be made. The DOE order also introduces elements of the total quality management (TQM) philosophy, which were not present in DOE Order 5700.6B. The research community within DOE has recently issued a document entitled DOE Order 5700.6C Implementation Guide, which is more explicit about the integration of TQM principles with the implementation of DOE Order 5700.6C in research facilities. The Environmental Protection Agency is sponsoring a quality assurance standard (ANSI/ASQC E-4) to replace EPA`s QAMS 005/80. The new standard is consistent with DOE Order 5700.6C, and it also stresses the integration of TQM principles within the quality assurance process. This paper discusses the intent and philosophy of the 10 criteria of the new DOE order, the status of ANSI/ASQC E-4, and how to effectively integrate TQM principles into the quality assurance process as the conversion is made from NQA-1 to DOE Order 5700.6C. The purpose and value of DOE Order 5700.6C Implementation Guide for research will also be discussed.

  4. Maximized liquid radwaste volume reduction through a total integrated process: A new technology success story

    International Nuclear Information System (INIS)

    Rae, G.A.

    1996-01-01

    A fundamental nuclear industry goal is the minimization of the generation of radioactive waste. This goal has been dramatically reinforced over the past few years due to the spiraling increased costs of both commercial and DOE disposal. To assist in meeting these goals and reducing the industry's costs, NUKEM initiated a new technology program to maximize the reduction of liquid radwaste through the use of a systematic approach or TIPS (Total Integrated Process System). This concept evaluates the total life cycle of various technologies in a combination that results in the final waste form being minimized to the pure solids content of the waste stream. Additionally, it allows for a final waste form that maximizes the utilization of the waste package and is conditioned to be readily acceptable to additional processing to meet new waste form requirements at future disposal sites, should interim storage of the waste be required. The TIPS, although first introduced at commercial facilities, has broad applications for DOE's liquid waste streams

  5. Integral elastic, electronic-state, ionization, and total cross sections for electron scattering with furfural

    Science.gov (United States)

    Jones, D. B.; da Costa, R. F.; Varella, M. T. do N.; Bettega, M. H. F.; Lima, M. A. P.; Blanco, F.; García, G.; Brunger, M. J.

    2016-04-01

    We report absolute experimental integral cross sections (ICSs) for electron impact excitation of bands of electronic-states in furfural, for incident electron energies in the range 20-250 eV. Wherever possible, those results are compared to corresponding excitation cross sections in the structurally similar species furan, as previously reported by da Costa et al. [Phys. Rev. A 85, 062706 (2012)] and Regeta and Allan [Phys. Rev. A 91, 012707 (2015)]. Generally, very good agreement is found. In addition, ICSs calculated with our independent atom model (IAM) with screening corrected additivity rule (SCAR) formalism, extended to account for interference (I) terms that arise due to the multi-centre nature of the scattering problem, are also reported. The sum of those ICSs gives the IAM-SCAR+I total cross section for electron-furfural scattering. Where possible, those calculated IAM-SCAR+I ICS results are compared against corresponding results from the present measurements with an acceptable level of accord being obtained. Similarly, but only for the band I and band II excited electronic states, we also present results from our Schwinger multichannel method with pseudopotentials calculations. Those results are found to be in good qualitative accord with the present experimental ICSs. Finally, with a view to assembling a complete cross section data base for furfural, some binary-encounter-Bethe-level total ionization cross sections for this collision system are presented.

  6. Integral elastic, electronic-state, ionization, and total cross sections for electron scattering with furfural

    Energy Technology Data Exchange (ETDEWEB)

    Jones, D. B. [School of Chemical and Physical Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 (Australia); Costa, R. F. da [Instituto de Física “Gleb Wataghin,” Universidade Estadual de Campinas, Campinas, 13083-859 São Paulo (Brazil); Departamento de Física, Universidade Federal do Espírito Santo, 29075-910, Vitória, Espírito Santo (Brazil); Varella, M. T. do N. [Instituto de Física, Universidade de São Paulo, CP 66318, 05315-970 São Paulo (Brazil); Bettega, M. H. F. [Departamento de Física, Universidade Federal do Paraná, CP 19044, 81531-990 Curitiba, Paraná (Brazil); Lima, M. A. P. [Instituto de Física “Gleb Wataghin,” Universidade Estadual de Campinas, Campinas, 13083-859 São Paulo (Brazil); Blanco, F. [Departamento de Física Atómica, Molecular y Nuclear, Universidad Complutense de Madrid, Madrid E-28040 (Spain); García, G. [Instituto de Física Fundamental, CSIC, Serrano 113-bis, 28006 Madrid (Spain); Brunger, M. J., E-mail: Michael.Brunger@flinders.edu.au [School of Chemical and Physical Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 (Australia); Institute of Mathematical Sciences, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2016-04-14

    We report absolute experimental integral cross sections (ICSs) for electron impact excitation of bands of electronic-states in furfural, for incident electron energies in the range 20–250 eV. Wherever possible, those results are compared to corresponding excitation cross sections in the structurally similar species furan, as previously reported by da Costa et al. [Phys. Rev. A 85, 062706 (2012)] and Regeta and Allan [Phys. Rev. A 91, 012707 (2015)]. Generally, very good agreement is found. In addition, ICSs calculated with our independent atom model (IAM) with screening corrected additivity rule (SCAR) formalism, extended to account for interference (I) terms that arise due to the multi-centre nature of the scattering problem, are also reported. The sum of those ICSs gives the IAM-SCAR+I total cross section for electron–furfural scattering. Where possible, those calculated IAM-SCAR+I ICS results are compared against corresponding results from the present measurements with an acceptable level of accord being obtained. Similarly, but only for the band I and band II excited electronic states, we also present results from our Schwinger multichannel method with pseudopotentials calculations. Those results are found to be in good qualitative accord with the present experimental ICSs. Finally, with a view to assembling a complete cross section data base for furfural, some binary-encounter-Bethe-level total ionization cross sections for this collision system are presented.

  7. Integral elastic, electronic-state, ionization, and total cross sections for electron scattering with furfural

    International Nuclear Information System (INIS)

    Jones, D. B.; Costa, R. F. da; Varella, M. T. do N.; Bettega, M. H. F.; Lima, M. A. P.; Blanco, F.; García, G.; Brunger, M. J.

    2016-01-01

    We report absolute experimental integral cross sections (ICSs) for electron impact excitation of bands of electronic-states in furfural, for incident electron energies in the range 20–250 eV. Wherever possible, those results are compared to corresponding excitation cross sections in the structurally similar species furan, as previously reported by da Costa et al. [Phys. Rev. A 85, 062706 (2012)] and Regeta and Allan [Phys. Rev. A 91, 012707 (2015)]. Generally, very good agreement is found. In addition, ICSs calculated with our independent atom model (IAM) with screening corrected additivity rule (SCAR) formalism, extended to account for interference (I) terms that arise due to the multi-centre nature of the scattering problem, are also reported. The sum of those ICSs gives the IAM-SCAR+I total cross section for electron–furfural scattering. Where possible, those calculated IAM-SCAR+I ICS results are compared against corresponding results from the present measurements with an acceptable level of accord being obtained. Similarly, but only for the band I and band II excited electronic states, we also present results from our Schwinger multichannel method with pseudopotentials calculations. Those results are found to be in good qualitative accord with the present experimental ICSs. Finally, with a view to assembling a complete cross section data base for furfural, some binary-encounter-Bethe-level total ionization cross sections for this collision system are presented.

  8. Lifetime total and beverage specific - alcohol intake and prostate cancer risk: a case-control study

    Directory of Open Access Journals (Sweden)

    Carruba Giuseppe

    2004-12-01

    Full Text Available Abstract Background We investigated lifetime alcohol consumption and prostate cancer risk in a case-control study conducted in Buffalo, NY (1998–2001. Methods The study included 88 men, aged 45 to 85 years with incident, histologically-confirmed prostate cancer and 272 controls. We conducted extensive in-person interviews regarding lifetime alcohol consumption and other epidemiologic data. Results Prostate cancer risk was not associated with lifetime intake of total and beverage specific ethanol. In addition we found no association with number of drinks per day (average drinks per day over the lifetime or drinks per drinking day (average drinks per day on drinking days only over the lifetime. However, we observed an inverse association with the total number of drinking years. Men in the lowest tertile of total drinking years had a two-fold prostate cancer risk than men in the highest tertile (OR 2.16, 95% CI 0.98–4.78, p for trend Conclusion Our results suggest that alcohol intake distribution across lifetime may play a more important role in prostate cancer etiology than total lifetime consumption.

  9. An integrated stochastic environmental risk assessment method and its application to a petroleum-contaminated site

    International Nuclear Information System (INIS)

    Liu, L.; Fuller, G.A.; Huang, G.H.

    1999-01-01

    Contamination of soil and water and the resulting threat to public health and the environment are the frequent results of oil spills, leaks and other releases of gasoline, diesel fuel, heating oil and other petroleum products. Integrating an analytical groundwater solute transport model within its general framework, this paper proposes an integrated stochastic risk assessment method and ways to apply it to petroleum-contaminated sites. Both the analytical solute transport model and the general risk assessment framework are solved by the Monte Carlo simulation technique for approaching the theoretical output distribution. Results of this study show that the total cancer risk has approximately log-normal distribution, irrespective of the fact that a variety of distributions were used to define the related parameters. It is claimed that the method can improve the effectiveness of the risk assessment for subsurface, and provide useful result for site remediation decisions. 23 refs., 3 tabs., 4 figs

  10. The background and theory of integrated risk management

    Science.gov (United States)

    Hunsucker, John L.

    1995-01-01

    While all good managers have always considered risk in their decision making, only recently have formal programs to do so been introduced. This report covers the logical structure behind the formulation of an integrated risk management plan (IRM). Included in the report are factors forcing the development of a formal plan to consider risk, the basic objective or purpose of an IRM, and desirable traits of such a plan. The report moves on to a discussion of background issues, seeks to formalize some definitions, and then discusses required information on threats. The report concludes with the steps for an IRM.

  11. A Look at the Practice of Risk Classification: Integrative Review

    Directory of Open Access Journals (Sweden)

    Luiz Alves Morais Filho

    2017-03-01

    Full Text Available Introduction: the increase in the number of patients in emergency services / emergency brought the need for screening / risk classification as a way to organize the urgency and emergency care in the health institutions. Objectives: know how to develop the risk classification practice in the Brazilian reality using the scientific production, the insertion of nurses in risk classification using the Brazilian scientific production. Methods: an integrative review was carried out, the data occurred during September 2015 in the following databases: Scientific Electronic Library Online (SciELO, Medical Literature Analysis and Retrieval System Online (Medline, and the Latin American and Caribbean System of Information on Health Sciences (LILACS "GOOGLE SCHOLAR." Results: it found 9,874 articles and selected 33 for analysis. The results were organized in 04 categories: Risk classification as assistance qualifier; risk classification’s organization; operation weaknesses of the risk classification and nurse's role in risk classification. Conclusion: We conclude that the risk classification qualifies the assistance in emergency services; there are many difficulties for the risk classification’s operation and the nurse has been established as a professional with technical and legal competence to perform the risk classification.

  12. Integrating Indigenous Knowledge in Climate Risk Management in ...

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

    27 mars 2008 ... Integrating Indigenous Knowledge in Climate Risk Management in support of Community Based Adaptation. Traditionally, African farmers have used indigenous knowledge to understand weather and climate patterns and make decisions about crop and irrigation cycles. However, increased variability ...

  13. Integration of transport concepts for risk assessment of pesticide erosion

    NARCIS (Netherlands)

    Yang, Xiaomei; Zee, van der Sjoerd E.A.T.M.; Gai, Lingtong; Wesseling, Jan G.; Ritsema, Coen J.; Geissen, Violette

    2016-01-01

    Environmental contamination by agrochemicals has been a large problem for decades. Pesticides are transported in runoff and remain attached to eroded soil particles, posing a risk to water and soil quality and human health. We have developed a parsimonious integrative model of pesticide

  14. Risk factors for revision of primary total hip arthroplasty: a systematic review

    Directory of Open Access Journals (Sweden)

    Prokopetz Julian JZ

    2012-12-01

    Full Text Available Abstract Background Numerous papers have been published examining risk factors for revision of primary total hip arthroplasty (THA, but there have been no comprehensive systematic literature reviews that summarize the most recent findings across a broad range of potential predictors. Methods We performed a PubMed search for papers published between January, 2000 and November, 2010 that provided data on risk factors for revision of primary THA. We collected data on revision for any reason, as well as on revision for aseptic loosening, infection, or dislocation. For each risk factor that was examined in at least three papers, we summarize the number and direction of statistically significant associations reported. Results Eighty-six papers were included in our review. Factors found to be associated with revision included younger age, greater comorbidity, a diagnosis of avascular necrosis (AVN as compared to osteoarthritis (OA, low surgeon volume, and larger femoral head size. Male sex was associated with revision due to aseptic loosening and infection. Longer operating time was associated with revision due to infection. Smaller femoral head size was associated with revision due to dislocation. Conclusions This systematic review of literature published between 2000 and 2010 identified a range of demographic, clinical, surgical, implant, and provider variables associated with the risk of revision following primary THA. These findings can inform discussions between surgeons and patients relating to the risks and benefits of undergoing total hip arthroplasty.

  15. RCT of an integrated CBT-HIV intervention on depressive symptoms and HIV risk.

    Science.gov (United States)

    Tobin, Karin; Davey-Rothwell, Melissa A; Nonyane, Bareng A S; Knowlton, Amy; Wissow, Lawrence; Latkin, Carl A

    2017-01-01

    Depression and depressive symptoms mediate the association between drug use and HIV risk. Yet, there are few interventions that target depressive symptoms and HIV risk for people who use drugs (PWUD). This study was a randomized controlled trial of an integrated cognitive behavioral therapy and HIV prevention intervention to reduce depressive symptoms, injection risk behaviors and increase condom use in a sample of urban people who used heroin or cocaine in the prior 6 months. A total of 315 individuals aged 18-55, who self-reported at least one HIV drug and sex risk behavior and scored ≥16 and symptoms, but weak impact on HIV risk. This trial is registered with ClinicalTrials.gov under the title "Neighborhoods, Networks, Depression, and HIV Risk" number NCT01380613.

  16. Prevalence and risk factors for postoperative delirium in total joint arthroplasty patients: A prospective study.

    Science.gov (United States)

    Chen, Wenliang; Ke, Xiurong; Wang, Xiaoqing; Sun, Xiaoliang; Wang, Juncheng; Yang, Guojing; Xia, Haijie; Zhang, Lei

    2017-05-01

    The aim of this prospective study was to investigate the incidence and clinical features of delirium after total joint arthroplasty, and to establish the potential risk factors for postoperative delirium. A total of 212 consecutive patients undergoing hip or knee arthroplasty, who met the inclusion and exclusive criteria were enrolled. The general characteristics, preoperative and postoperative hematological variables were documented respectively. According to the presence of delirium, all patients were divided into the delirium group and non-delirium group. Univariate and multivariate logistic regression were performed to identify the possible predictors for postoperative delirium. At a minimum of 6months of follow-up, 35 patients were observed with postoperative delirium at an estimated total incidence of 16.5%. The incidence of delirium was statistically higher in hip arthroplasty (22.8%) than that in knee arthroplasty (7.1%). The multivariate regression analysis identified older age (OR=1.590, P=0.023), a history of stroke (OR=190.23, P=0.036), preoperative PaO 2 (OR=1.277, P=0.018) and equivalent fentanyl dose (OR=1.010, P=0.012) as the predictive factors for postoperative delirium after total joint arthroplasty. The incidence of postoperative delirium after total joint arthroplasty is higher than expected. Based on our findings, we suggest that the surgeons should focus on those patients who have these risk factors and ensure the appropriate management to avoid postoperative delirium. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Managing Risks in Distributed Software Projects: An Integrative Framework

    DEFF Research Database (Denmark)

    Persson, John Stouby; Mathiassen, Lars; Boeg, Jesper

    2009-01-01

    techniques into an integrative framework for managing risks in distributed contexts. Subsequent implementation of a Web-based tool helped us refine the framework based on empirical evaluation of its practical usefulness.We conclude by discussing implications for both research and practice.......Software projects are increasingly geographically distributed with limited face-to-face interaction between participants. These projects face particular challenges that need carefulmanagerial attention. While risk management has been adopted with success to address other challenges within software...... development, there are currently no frameworks available for managing risks related to geographical distribution. On this background, we systematically review the literature on geographically distributed software projects. Based on the review, we synthesize what we know about risks and risk resolution...

  18. Integrated source-risk model for radon: A definition study

    International Nuclear Information System (INIS)

    Laheij, G.M.H.; Aldenkamp, F.J.; Stoop, P.

    1993-10-01

    The purpose of a source-risk model is to support policy making on radon mitigation by comparing effects of various policy options and to enable optimization of counter measures applied to different parts of the source-risk chain. There are several advantages developing and using a source-risk model: risk calculations are standardized; the effects of measures applied to different parts of the source-risk chain can be better compared because interactions are included; and sensitivity analyses can be used to determine the most important parameters within the total source-risk chain. After an inventory of processes and sources to be included in the source-risk chain, the models presently available in the Netherlands are investigated. The models were screened for completeness, validation and operational status. The investigation made clear that, by choosing for each part of the source-risk chain the most convenient model, a source-risk chain model for radon may be realized. However, the calculation of dose out of the radon concentrations and the status of the validation of most models should be improved. Calculations with the proposed source-risk model will give estimations with a large uncertainty at the moment. For further development of the source-risk model an interaction between the source-risk model and experimental research is recommended. Organisational forms of the source-risk model are discussed. A source-risk model in which only simple models are included is also recommended. The other models are operated and administrated by the model owners. The model owners execute their models for a combination of input parameters. The output of the models is stored in a database which will be used for calculations with the source-risk model. 5 figs., 15 tabs., 7 appendices, 14 refs

  19. A Proactive Approach to High Risk Delirium Patients Undergoing Total Joint Arthroplasty.

    Science.gov (United States)

    Duque, Andres F; Post, Zachary D; Orozco, Fabio R; Lutz, Rex W; Ong, Alvin C

    2018-04-01

    Delirium is a common complication among elderly patients undergoing total joint arthroplasty (TJA). Its incidence has been reported from 4% to 53%. The Centers for Medicare and Medicaid Services consider delirium following TJA a "never-event." The purpose of this study is to evaluate a simple perioperative protocol used to identify delirium risk patients and prevent its incidence following TJA. Our group developed a protocol to identify and prevent delirium in patients undergoing TJA. All patients were screened and scored in the preoperative assessment, on criteria such as age, history of forgetfulness, history of agitation or visual hallucinations, history of falls, history of postoperative confusion, and inability to perform higher brain functions. Patients were scored on performance in a simple mental examination. The patients were classified as low, medium, or high risk. Patients who were identified as high risk were enrolled in a delirium avoidance protocol that minimized narcotics and emphasized nursing involvement and fluids administration. Five of 7659 (0.065%) consecutive TJA patients from 2010 to 2015 developed delirium. A total of 422 patients were identified as high risk. All 5 patients who suffered delirium were within the high risk group. No low or medium risk patients suffered a delirium complication. Three (0.039%) patients suffered drug-induced delirium, 1 (0.013%) had delirium related to alcohol withdrawal, and 1 (0.013%) had delirium after a systemic infection. This protocol is effective in identifying patients at high delirium risk and diminishing the incidence of this complication by utilizing a simple screening tool and perioperative protocol. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Managing Climate Risk. Integrating Adaptation into World Bank Group Operations

    International Nuclear Information System (INIS)

    Van Aalst, M.

    2006-08-01

    Climate change is already taking place, and further changes are inevitable. Developing countries, and particularly the poorest people in these countries, are most at risk. The impacts result not only from gradual changes in temperature and sea level but also, in particular, from increased climate variability and extremes, including more intense floods, droughts, and storms. These changes are already having major impacts on the economic performance of developing countries and on the lives and livelihoods of millions of poor people around the world. Climate change thus directly affects the World Bank Group's mission of eradicating poverty. It also puts at risk many projects in a wide range of sectors, including infrastructure, agriculture, human health, water resources, and environment. The risks include physical threats to the investments, potential underperformance, and the possibility that projects will indirectly contribute to rising vulnerability by, for example, triggering investment and settlement in high-risk areas. The way to address these concerns is not to separate climate change adaptation from other priorities but to integrate comprehensive climate risk management into development planning, programs, and projects. While there is a great need to heighten awareness of climate risk in Bank work, a large body of experience on climate risk management is already available, in analytical work, in country dialogues, and in a growing number of investment projects. This operational experience highlights the general ingredients for successful integration of climate risk management into the mainstream development agenda: getting the right sectoral departments and senior policy makers involved; incorporating risk management into economic planning; engaging a wide range of nongovernmental actors (businesses, nongovernmental organizations, communities, and so on); giving attention to regulatory issues; and choosing strategies that will pay off immediately under current

  1. University Lawyers: A Study of Legal Risk, Risk Management and Role in Work Integrated Learning Programmes

    Science.gov (United States)

    Cameron, Craig; Klopper, Christopher

    2015-01-01

    Work integrated learning (WIL) is in growing demand by multiple stakeholders within the higher education sector in Australia. There are significant and distinct legal risks to universities associated with WIL programmes. University lawyers, along with WIL administrators and university management, are responsible for managing legal risk. This…

  2. Fibrosis-Related Biomarkers and Risk of Total and Cause-Specific Mortality

    Science.gov (United States)

    Agarwal, Isha; Glazer, Nicole L.; Barasch, Eddy; Biggs, Mary L.; Djoussé, Luc; Fitzpatrick, Annette L.; Gottdiener, John S.; Ix, Joachim H.; Kizer, Jorge R.; Rimm, Eric B.; Siscovick, David S.; Tracy, Russell P.; Zieman, Susan J.; Mukamal, Kenneth J.

    2014-01-01

    Fibrosis has been implicated in diverse diseases of the liver, kidney, lungs, and heart, but its importance as a risk factor for mortality remains unconfirmed. We determined the prospective associations of 2 complementary biomarkers of fibrosis, transforming growth factor-β (TGF-β) and procollagen type III N-terminal propeptide (PIIINP), with total and cause-specific mortality risks among community-living older adults in the Cardiovascular Health Study (1996–2010). We measured circulating TGF-β and PIIINP levels in plasma samples collected in 1996 and ascertained the number of deaths through 2010. Both TGF-β and PIIINP were associated with elevated risks of total and pulmonary mortality after adjustment for sociodemographic, clinical, and biochemical risk factors. For total mortality, the hazard ratios per doubling of TGF-β and PIIINP were 1.09 (95% confidence interval (CI): 1.01, 1.17; P = 0.02) and 1.14 (CI: 1.03, 1.27; P = 0.01), respectively. The corresponding hazard ratios for pulmonary mortality were 1.27 (CI: 1.01, 1.60; P = 0.04) for TGF-β and 1.52 (CI: 1.11, 2.10; P = 0.01) for PIIINP. Associations of TGF-β and PIIINP with total and pulmonary mortality were strongest among individuals with higher C-reactive protein concentrations (P for interaction < 0.05). Our findings provide some of the first large-scale prospective evidence that circulating biomarkers of fibrosis measured late in life are associated with death. PMID:24771724

  3. Integrated probabilistic risk assessment for nanoparticles: the case of nanosilica in food.

    Science.gov (United States)

    Jacobs, Rianne; van der Voet, Hilko; Ter Braak, Cajo J F

    Insight into risks of nanotechnology and the use of nanoparticles is an essential condition for the social acceptance and safe use of nanotechnology. One of the problems with which the risk assessment of nanoparticles is faced is the lack of data, resulting in uncertainty in the risk assessment. We attempt to quantify some of this uncertainty by expanding a previous deterministic study on nanosilica (5-200 nm) in food into a fully integrated probabilistic risk assessment. We use the integrated probabilistic risk assessment method in which statistical distributions and bootstrap methods are used to quantify uncertainty and variability in the risk assessment. Due to the large amount of uncertainty present, this probabilistic method, which separates variability from uncertainty, contributed to a better understandable risk assessment. We found that quantifying the uncertainties did not increase the perceived risk relative to the outcome of the deterministic study. We pinpointed particular aspects of the hazard characterization that contributed most to the total uncertainty in the risk assessment, suggesting that further research would benefit most from obtaining more reliable data on those aspects.

  4. Integrated probabilistic risk assessment for nanoparticles: the case of nanosilica in food

    International Nuclear Information System (INIS)

    Jacobs, Rianne; Voet, Hilko van der; Braak, Cajo J. F. ter

    2015-01-01

    Insight into risks of nanotechnology and the use of nanoparticles is an essential condition for the social acceptance and safe use of nanotechnology. One of the problems with which the risk assessment of nanoparticles is faced is the lack of data, resulting in uncertainty in the risk assessment. We attempt to quantify some of this uncertainty by expanding a previous deterministic study on nanosilica (5–200 nm) in food into a fully integrated probabilistic risk assessment. We use the integrated probabilistic risk assessment method in which statistical distributions and bootstrap methods are used to quantify uncertainty and variability in the risk assessment. Due to the large amount of uncertainty present, this probabilistic method, which separates variability from uncertainty, contributed to a better understandable risk assessment. We found that quantifying the uncertainties did not increase the perceived risk relative to the outcome of the deterministic study. We pinpointed particular aspects of the hazard characterization that contributed most to the total uncertainty in the risk assessment, suggesting that further research would benefit most from obtaining more reliable data on those aspects

  5. Integrated probabilistic risk assessment for nanoparticles: the case of nanosilica in food

    Energy Technology Data Exchange (ETDEWEB)

    Jacobs, Rianne, E-mail: rianne.jacobs@wur.nl; Voet, Hilko van der; Braak, Cajo J. F. ter [Wageningen University and Research Centre, Biometris (Netherlands)

    2015-06-15

    Insight into risks of nanotechnology and the use of nanoparticles is an essential condition for the social acceptance and safe use of nanotechnology. One of the problems with which the risk assessment of nanoparticles is faced is the lack of data, resulting in uncertainty in the risk assessment. We attempt to quantify some of this uncertainty by expanding a previous deterministic study on nanosilica (5–200 nm) in food into a fully integrated probabilistic risk assessment. We use the integrated probabilistic risk assessment method in which statistical distributions and bootstrap methods are used to quantify uncertainty and variability in the risk assessment. Due to the large amount of uncertainty present, this probabilistic method, which separates variability from uncertainty, contributed to a better understandable risk assessment. We found that quantifying the uncertainties did not increase the perceived risk relative to the outcome of the deterministic study. We pinpointed particular aspects of the hazard characterization that contributed most to the total uncertainty in the risk assessment, suggesting that further research would benefit most from obtaining more reliable data on those aspects.

  6. Integrating risk management and safety culture in a framework for risk informed decision making

    International Nuclear Information System (INIS)

    Nelson, W.R.

    2009-01-01

    Operators and regulators of nuclear power plants agree on the importance of maintaining safety and controlling accident risks. Effective safety and risk management requires treatment of both technical and organizational components. Probabilistic Risk Assessment (PRA) provides tools for technical risk management. However, organizational factors are not treated in PRA, but are addressed using different approaches. To bring both components together, a framework of Risk Informed Decision Making (RIDM) is needed. The objective tree structure of the International Atomic Energy Agency (IAEA) is a promising approach to combine both elements. Effective collaboration involving regulatory and industry groups is needed to accomplish the integration. (author)

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

    Directory of Open Access Journals (Sweden)

    Ali Musa Bozdogan

    2014-02-01

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

  8. Optimising an integrated crop-livestock farm using risk programming

    Directory of Open Access Journals (Sweden)

    SE Visagie

    2004-06-01

    Full Text Available Numerous studies have analysed farm planning decisions focusing on producer risk preferences. Few studies have focussed on the farm planning decisions in an integrated croplivestock farm context. Income variability and means of managing risk continues to receive much attention in farm planning research. Different risk programming models have attempted to focus on minimising the income variability of farm activities. This study attempts to identify the optimal mix of crops and the number of animals the farm needs to keep in the presence of crop production risk for a range of risk levels. A mixed integer linear programming model was developed to model the decision environment faced by an integrated crop-livestock farmer. The deviation of income from the expected value was used as a measure of risk. A case study is presented with representative data from a farm in the Swartland area. An investigation of the results of the model under different constraints shows that, in general, strategies that depend on crop rotation principles are preferred to strategies that follow mono-crop production practices.

  9. Dislocation of primary total hip arthroplasty and the risk of redislocation.

    LENUS (Irish Health Repository)

    Brennan, Stephen A

    2012-09-01

    6554 primary total hip arthroplasties were reviewed. Risk factors for dislocation were analysed to assess which were important in terms of predicting recurrent instability. The patients risk of having a second dislocation was independently associated with the surgical approach adopted (p = 0.03) and the time to first dislocation from the primary hip replacement (p = 0.002). Early dislocators whose surgery was performed through an anterolateral approach had less recurrence than late dislocators through a posterior or transtrochanteric approach. None of the other risk factors including head size (p = 0.59), modularity (p = 0.54), mechanism of dislocation (p = 0.23), leg length discrepancy (p = 0.69) and acetabular inclination (p = 0.31) were influential. The use of an abduction brace was not useful in preventing a further dislocation with 69.2% of those braced re-dislocating compared to 68.5% who were not braced (p = 0.96).

  10. Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation.

    Science.gov (United States)

    Guyen, Olivier; Pibarot, Vincent; Vaz, Gualter; Chevillotte, Christophe; Carret, Jean-Paul; Bejui-Hugues, Jacques

    2007-09-01

    We performed a retrospective study on 167 primary total hip arthroplasty (THA) procedures in 163 patients at high risk for instability to assess the reliability of unconstrained tripolar implants (press-fit outer metal shell articulating a bipolar polyethylene component) in preventing dislocations. Eighty-four percent of the patients had at least 2 risk factors for dislocation. The mean follow-up length was 40.2 months. No dislocation was observed. Harris hip scores improved significantly. Six hips were revised, and no aseptic loosening of the cup was observed. The tripolar implant was extremely successful in achieving stability. However, because of the current lack of data documenting polyethylene wear at additional bearing, the routine use of tripolar implants in primary THA is discouraged and should be considered at the present time only for selected patients at high risk for dislocation and with limited activities.

  11. Increased risk of revision for infection in rheumatoid arthritis patients with total hip replacements

    DEFF Research Database (Denmark)

    Schrama, Johannes Cornelis; Fenstad, Anne M; Dale, Håvard

    2015-01-01

    Background and purpose-Medical treatment of rheumatoid arthritis (RA) has changed dramatically over the last 15 years, including immune modulation. We investigated the risk of revision for infection after primary total hip replacement (THR) in patients with rheumatoid arthritis over a 16-year...... period, and compared it with that in THR patients with osteoarthritis (OA).Patients and methods-We identified 13,384 THRs in RA patients and 377,287 THRs in OA patients from 1995 through 2010 in a dataset from the Nordic Arthroplasty Register Association (NARA). Kaplan-Meier survival curves......, with revision for infection as the endpoint, were constructed. Cox regression analyses were performed to calculate the relative risk (RR) of revision for infection adjusted for age, sex, fixation technique, and year of primary surgery.Results-RA patients had a 1.3 times (95% CI 1.0-1.6) higher risk of revision...

  12. Total integrated energy system (TIES) feasibility analysis for the downtown redevelopment project, Pasadena, California

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-04-01

    The purpose of this study is to determine the most desirable method of serving the energy needs of a commercial development to be constructed in Pasadena, California. The factors that determine maximum desirability consist of the following: (1) maximum economic benefit to the energy user and to the surrounding community; (2) minimum usage of energy by both the energy user and the surrounding community; and (3) minimum introduction of pollutants into the community. The methods studied were the Total Integrated Energy System (TIES) concept in several configurations. The TIES concept differs from the ''total energy concept'' in the respect that the electric power output of the local power generation plant goes into the utility company distribution grid, rather than to the user. The user is served power from the grid, as with a conventional system, but also receives heating and cooling media produced from power generation by-product heat from the TIES plant. The effect of this concept is that a very large source-sink for electric energy is provided by the utility company grid. This, in turn, permits the plant to operate in response to instantaneous thermal demand, rather than instantaneous power demand. No auxiliary firing is ever required. No waste of unneeded by-product energy to atmosphere ever occurs. Balance is achieved by either delivering excess power into the grid or by withdrawing power production deficiency from the grid. Near-optimum efficiency is achieved during all operating conditions. There is no need whatsoever for the power-generating plant to be sized to meet the power demand, since it seldom, if ever, tracks the power demand. Sizing of the electric generation is solely a function of economics and the demand for waste heat.

  13. Aggregate Exposure and Cumulative Risk Assessment--Integrating Occupational and Non-occupational Risk Factors.

    Science.gov (United States)

    Lentz, T J; Dotson, G S; Williams, P R D; Maier, A; Gadagbui, B; Pandalai, S P; Lamba, A; Hearl, F; Mumtaz, M

    2015-01-01

    Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational.

  14. Redesigning the work system of rubber industries based on total ergonomics and ergo-micmac integration

    Science.gov (United States)

    Setiawan, H.

    2018-01-01

    The factory capacity achievement and the bottleneck reduction of production process at wet-blanket workstations are influenced by the balance of life quality rates and worker’s productivity, along with the worker’s ability and limitations, tasks, organization and work environment. The life quality of workers is indicated by: the reduction of workload, and fatigue. Meanwhile, work productivity is measured by increasing production results per work shift. The optimization of the quality of life and productivity of workers is achieved by redesigning the system and workstations based on ergonomics integrating Total Ergonomics with Ergo-MicMac (Micro Ergonomics and Macro Ergonomics), which includes redesigning wet-blanket folding worktable, regulating the system pattern of working in pairs, giving official break time, giving extra nutritious intakes such as sweet tea and snack Pempek, giving personal protective equipments, and redesigning physical working environments.This study was an experimental study, with treatment by subject design involving 30 workers sampled at a workstation condition before and after Ergonomics based redesign. The findings and conclusions of the study were derived from the reduction of the workload by 16.06%, fatigue by 18.84% and the increase of production results per work shift by 20.29%.

  15. European market integration for gas? Volume flexibility and political risk

    International Nuclear Information System (INIS)

    Asche, Frank; Tveteras, Ragnar; Osmundsen, Petter

    2002-01-01

    Long-term take-or-pay contracts regulating gas exports to the Continent are described and analyzed. We thereafter examine whether the German gas market is integrated. Time series of Norwegian, Dutch and Russian gas export prices to Germany in 1990-1998 are examined. Cointegration tests show that that the different border prices for gas to Germany move proportionally over time, indicating an integrated gas market. We find differences in mean prices, with Russian gas being sold at prices systematically lower than Dutch and Norwegian gas. Among the explanatory factors for price discrepancies are differences in volume flexibility (swing) and perceived political risk

  16. Fall Risk Score at the Time of Discharge Predicts Readmission Following Total Joint Arthroplasty.

    Science.gov (United States)

    Ravi, Bheeshma; Nan, Zhang; Schwartz, Adam J; Clarke, Henry D

    2017-07-01

    Readmission among Medicare recipients is a leading driver of healthcare expenditure. To date, most predictive tools are too coarse for direct clinical application. Our objective in this study is to determine if a pre-existing tool to identify patients at increased risk for inpatient falls, the Hendrich Fall Risk Score, could be used to accurately identify Medicare patients at increased risk for readmission following arthroplasty, regardless of whether the readmission was due to a fall. This study is a retrospective cohort study. We identified 2437 Medicare patients who underwent a primary elective total joint arthroplasty (TJA) of the hip or knee for osteoarthritis between 2011 and 2014. The Hendrich Fall Risk score was recorded for each patient preoperatively and postoperatively. Our main outcome measure was hospital readmission within 30 days of discharge. Of 2437 eligible TJA recipients, there were 226 (9.3%) patients who had a score ≥6. These patients were more likely to have an unplanned readmission (unadjusted odds ratio 2.84, 95% confidence interval 1.70-4.76, P 3 days (49.6% vs 36.6%, P = .0001), and were less likely to be sent home after discharge (20.8% vs 35.8%, P fall risk score after TJA is strongly associated with unplanned readmission. Application of this tool will allow hospitals to identify these patients and plan their discharge. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Totally implantable central venous access port infections in patients with digestive cancer: incidence and risk factors.

    Science.gov (United States)

    Touré, Abdoulaye; Vanhems, Philippe; Lombard-Bohas, Catherine; Cassier, Philippe; Péré-Vergé, Denis; Souquet, Jean-Christophe; Ecochard, René; Chambrier, Cécile

    2012-12-01

    Central venous access port-related bloodstream infection (CVAP-BSI) is associated with morbidity and mortality in patients with cancer. This study examined the incidence rates and risk factors for CVAP-BSI in adult patients with digestive cancer. This prospective observational cohort study was performed from 2007 to 2011 in 2 oncology units of a university hospital. Incidence rate was expressed as number of CVAP-BSI per 1,000 catheter-days. A Cox regression model was used to identify risk factors for CVAP-BSI. A total of 315 patients were included. CVAP-BSI occurred in 41 patients (13.0%). The overall incidence rate was 0.76/1,000 catheter-days. The rate was higher in patients with esophageal cancer (1.28. P = .05) and pancreatic cancer (1.24; P = .007). Risk factors independently associated with CVAP-BSI were World Health Organization performance status between 2 and 4, catheter utilization-days in the previous month, pancreatic cancer, and parenteral nutrition. Coagulase-negative Staphylococci and enterobacteria were the main microorganisms isolated. In adult patients with digestive cancer, pancreatic cancer, cumulative catheter utilization-days, World Health Organization performance status, and parenteral nutrition were identified as independent risk factors for CVAP-BSI. Patients with any of these risk factors could be candidates for preventive strategies. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  18. Total Probability of Collision as a Metric for Finite Conjunction Assessment and Collision Risk Management

    Science.gov (United States)

    Frigm, Ryan C.; Hejduk, Matthew D.; Johnson, Lauren C.; Plakalovic, Dragan

    2015-01-01

    On-orbit collision risk is becoming an increasing mission risk to all operational satellites in Earth orbit. Managing this risk can be disruptive to mission and operations, present challenges for decision-makers, and is time-consuming for all parties involved. With the planned capability improvements to detecting and tracking smaller orbital debris and capacity improvements to routinely predict on-orbit conjunctions, this mission risk will continue to grow in terms of likelihood and effort. It is very real possibility that the future space environment will not allow collision risk management and mission operations to be conducted in the same manner as it is today. This paper presents the concept of a finite conjunction assessment-one where each discrete conjunction is not treated separately but, rather, as a continuous event that must be managed concurrently. The paper also introduces the Total Probability of Collision as an analogous metric for finite conjunction assessment operations and provides several options for its usage in a Concept of Operations.

  19. Diabetes Mellitus and Hyperglycemia and the Risk of Aseptic Loosening in Total Joint Arthroplasty.

    Science.gov (United States)

    Maradit Kremers, Hilal; Schleck, Cathy D; Lewallen, Eric A; Larson, Dirk R; Van Wijnen, Andre J; Lewallen, David G

    2017-09-01

    It is unknown to what extent diabetes mellitus modifies the long-term risk of aseptic loosening in total hip arthroplasty (THA) and total knee arthroplasty (TKA). We examined the association between diabetes mellitus, perioperative hyperglycemia, and the likelihood of revisions for aseptic loosening. We studied 16,085 primary THA and TKA procedures performed at a large tertiary care hospital between 2002 and 2009. All blood glucose values around the time of surgery (within 1 week) were retrieved. Subsequent revision surgeries and the reasons for revision were ascertained through the institutional joint registry. Multivariate Cox models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for aseptic loosening associated with diabetes mellitus and hyperglycemia adjusting for age, gender, body mass index, and surgery type. A total of 2911 (18%) surgeries had a diagnosis of diabetes mellitus at the time of surgery. Glucose testing was performed at least once in 7055 (44%) procedures within ±1 week of surgery. Although diabetic patients did not experience a higher risk of revision for aseptic loosening (HR, 0.87; 95% CI, 0.55-1.38), higher preoperative glucose values on the day before surgery were significantly associated with both the overall risk of revisions (HR, 2.80; 95% CI, 1.00-7.85) and revisions for aseptic loosening (HR, 4.95; 95% CI, 1.26-19.54). High preoperative hyperglycemia is a potential risk factor for aseptic loosening in THA and TKA. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Plasma Total Antioxidant Capacity and Cardiometabolic Risk in Non-Obese and Clinically Healthy Young Adults.

    Science.gov (United States)

    Costa, Jamille Oliveira; Vásquez, Cecília M Passos; Santana, Gleiciane de Jesus; Silva, Natanael de Jesus; Braz, Juciene de Matos; Jesus, Amélia M Ribeiro de; Silva, Danielle Góes da; Cunha, Luana Celina Seraphim; Barbosa, Kiriaque Barra Ferreira

    2017-07-10

    The oxidative biomarkers play an important role in the genesis of cardiometabolic risk-related processes. To investigate the total antioxidant capacity of plasma and its association with cardiometabolic risk in non-obese and clinically healthy young adults. University students of the state of Sergipe, Brazil, aged between 18 and 25 years, were recruited for this study from May of 2013 and October of 2014. Anthropometric, clinical and biochemical parameters were measured and analyzed using protocols which were previously standardized and described in the literature. The measurement of plasma total antioxidant capacity was based on the ability that all the antioxidants present in the sample (plasma) have to inhibit the oxidation of the oxidizable substrate ABTS (2,2`- Azino-di-[3-ethylbenzthiazoline sulphonate]) to ABTS•+ by metmyoglobin. Approximately 25% of the sample presented more than one component of cardiometabolic risk. Low HDL-cholesterol was the most prevalent component. Compared to absence of components, the subjects with at least one component presented greater body weight and waist circumference, higher levels of diastolic blood pressure and fasting glucose, greater total cholesterol/HDL-c ratio, and lower levels of HDL-c (p literatura. A medida da capacidade antioxidante total do plasma baseou-se na capacidade de todos os antioxidantes presentes na amostra (plasma) em inibir a oxidação do substrato oxidável ABTS (2,2-Azino-bis-(3-etilbenzotiazolina-6-sulfonato) a ABTS•+ pela metamioglobina. Aproximadamente 25% da amostra apresentaram mais de um componente do risco cardiometabólico. Valores baixos de HDL foram o componente mais prevalente. Em comparação à ausência de componentes, os indivíduos com pelo menos um componente apresentou valores mais altos de peso corporal, circunferência da cintura, pressão sanguínea diastólica, glicemia de jejum e razão colesterol total/HDL-c, e valores mais baixos de HDL-c (p < 0,05). A glicemia de jejum

  1. Integrated presentation of ecological risk from multiple stressors

    Science.gov (United States)

    Goussen, Benoit; Price, Oliver R.; Rendal, Cecilie; Ashauer, Roman

    2016-10-01

    Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing and interpreting prevalence plots as a quantitative prediction of risk. Key components include environmental scenarios that integrate exposure and ecology, and ecological modelling of relevant endpoints to assess the effect of a combination of stressors. Our illustrative results demonstrate the importance of regional differences in environmental conditions and the confounding interactions of stressors. Using this framework and prevalence plots provides a risk-based approach that combines risk assessment and risk management in a meaningful way and presents a truly mechanistic alternative to the threshold approach. Even whilst research continues to improve the underlying models and data, regulators and decision makers can already use the framework and prevalence plots. The integration of multiple stressors, environmental conditions and variability makes ERA more relevant and realistic.

  2. Integrated presentation of ecological risk from multiple stressors.

    Science.gov (United States)

    Goussen, Benoit; Price, Oliver R; Rendal, Cecilie; Ashauer, Roman

    2016-10-26

    Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing and interpreting prevalence plots as a quantitative prediction of risk. Key components include environmental scenarios that integrate exposure and ecology, and ecological modelling of relevant endpoints to assess the effect of a combination of stressors. Our illustrative results demonstrate the importance of regional differences in environmental conditions and the confounding interactions of stressors. Using this framework and prevalence plots provides a risk-based approach that combines risk assessment and risk management in a meaningful way and presents a truly mechanistic alternative to the threshold approach. Even whilst research continues to improve the underlying models and data, regulators and decision makers can already use the framework and prevalence plots. The integration of multiple stressors, environmental conditions and variability makes ERA more relevant and realistic.

  3. Integrating Risk Analyses and Tools at the DOE Hanford Site

    International Nuclear Information System (INIS)

    LOBER, R.W.

    2002-01-01

    Risk assessment and environmental impact analysis at the U.S. Department of Energy (DOE) Hanford Site in Washington State has made significant progress in refining the strategy for using risk analysis to support closing of several hundred waste sites plus 149 single-shell tanks at the Hanford Site. A Single-Shell Tank System Closure Work Plan outlines the current basis for closing the single-shell tank systems. An analogous site approach has been developed to address closure of aggregated groups of similar waste sites. Because of the complexity, decision time frames, proximity of non-tank farm waste sites to tank farms, scale, and regulatory considerations, various projects are providing integrated assessments to support risk analyses and decision-making. Projects and the tools that are being developed and applied at Hanford to support retrieval and cleanup decisions include: (1) Life Cycle Model (LCM) and Risk Receptor Model (RRM)--A site-level set of tools to support strategic analyses through scoping level risk management to assess different alternatives and options for tank closure. (2) Systems Assessment Capability for Integrated Groundwater Nadose Zone (SAC) and the Site-Wide Groundwater Model (SWGM)--A site-wide groundwater modeling system coupled with a risk-based uncertainty analysis of inventory, vadose zone, groundwater, and river interactions for evaluating cumulative impacts from individual and aggregate waste sites. (3) Retrieval Performance Evaluation (RPE)--A site-specific, risk-based methodology developed to evaluate performance of waste retrieval, leak detection and closure on a tank-specific basis as a function of past tank Leaks, potential leakage during retrieval operations, and remaining residual waste inventories following completion of retrieval operations. (4) Field Investigation Report (FIR)--A corrective action program to investigate the nature and extent of past tank leaks through characterization activities and assess future impacts to

  4. Rate and Risk Factors for Periprosthetic Joint Infection Among 36,494 Primary Total Hip Arthroplasties.

    Science.gov (United States)

    Triantafyllopoulos, Georgios K; Soranoglou, Vasileios G; Memtsoudis, Stavros G; Sculco, Thomas P; Poultsides, Lazaros A

    2018-04-01

    As periprosthetic joint infections (PJIs) can have tremendous health and socioeconomic implications, recognizing patients at risk before surgery is of great importance. Therefore, we sought to determine the rate of and risk factors for deep PJI in patients undergoing primary total hip arthroplasty (THA). Clinical characteristics of patients treated with primary THA between January 1999 and December 2013 were retrospectively reviewed. These included patient demographics, comorbidities (including the Charlson/Deyo comorbidity index), length of stay, primary diagnosis, total/allogeneic transfusion rate, and in-hospital complications, which were grouped into local and systemic (minor and major). We determined the overall deep PJI rate, as well as the rates for early-onset (occurring within 2 years after index surgery) and late-onset PJI (occurring more than 2 years after surgery). A Cox proportional hazards regression model was constructed to identify risk factors for developing deep PJI. Significance level was set at 0.05. A deep PJI developed in 154 of 36,494 primary THAs (0.4%) during the study period. Early onset PJI was found in 122 patients (0.3%), whereas late PJI occurred in 32 patients (0.1%). Obesity, coronary artery disease, and pulmonary hypertension were identified as independent risk factors for deep PJI after primary THA. The rate of deep PJIs of the hip is relatively low, with the majority occurring within 2 years after THA. If the optimization of modifiable risk factors before THA can reduce the rate of this complication remains unknown, but should be attempted as part of good practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Incidence, Risk Factors, and Clinical Implications of Pneumonia Following Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Bohl, Daniel D; Saltzman, Bryan M; Sershon, Robert A; Darrith, Brian; Okroj, Kamil T; Della Valle, Craig J

    2017-06-01

    The purpose of this study is to determine the incidence, risk factors, and clinical implications of pneumonia following total joint arthroplasty (TJA). The American College of Surgeons National Surgical Quality Improvement Program was used to conduct a retrospective cohort study of patients undergoing TJA. Independent risk factors for the development of pneumonia within 30 days of TJA were identified using multivariate regression. Mortality and readmission rates were compared between patients who did and did not develop pneumonia. Multivariate regression was used to adjust for all demographic, comorbidity, and procedural characteristics. In total, 171,200 patients met inclusion criteria, of whom 66,493 (38.8%) underwent THA and 104,707 (61.2%) underwent TKA. Of the 171,200 patients, 590 developed pneumonia, yielding a rate of 0.34% (95% confidence interval = 0.32%-0.37%). Independent risk factors for pneumonia were chronic obstructive pulmonary disease, diabetes mellitus, greater age (most notably ≥80 years), dyspnea on exertion, dependent functional status, lower body mass index, hypertension, current smoker status, and male sex. The subset of patients who developed pneumonia following discharge had a higher readmission rate (82.1% vs 3.4%, adjusted relative risk [RR] = 16.6, P pneumonia. Pneumonia is a serious complication following TJA that occurs in approximately 1 in 300 patients. Approximately 4 in 5 patients who develop pneumonia are subsequently readmitted, and approximately 1 in 25 die. Given the serious implications of this complication, evidence-based pneumonia prevention programs including oral hygiene with chlorhexidine, sitting upright for meals, elevation of the head of the bed to at least 30°, aggressive incentive spirometry, and early ambulation should be considered for patients at greatest risk. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Cancer risk estimates from radiation therapy for heterotopic ossification prophylaxis after total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Mazonakis, Michalis; Berris, Theoharris; Damilakis, John [Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Iraklion, Crete (Greece); Lyraraki, Efrossyni [Department of Radiotherapy and Oncology, University Hospital of Iraklion, 71110 Iraklion, Crete (Greece)

    2013-10-15

    Purpose: Heterotopic ossification (HO) is a frequent complication following total hip arthroplasty. This study was conducted to calculate the radiation dose to organs-at-risk and estimate the probability of cancer induction from radiotherapy for HO prophylaxis.Methods: Hip irradiation for HO with a 6 MV photon beam was simulated with the aid of a Monte Carlo model. A realistic humanoid phantom representing an average adult patient was implemented in Monte Carlo environment for dosimetric calculations. The average out-of-field radiation dose to stomach, liver, lung, prostate, bladder, thyroid, breast, uterus, and ovary was calculated. The organ-equivalent-dose to colon, that was partly included within the treatment field, was also determined. Organ dose calculations were carried out using three different field sizes. The dependence of organ doses upon the block insertion into primary beam for shielding colon and prosthesis was investigated. The lifetime attributable risk for cancer development was estimated using organ, age, and gender-specific risk coefficients.Results: For a typical target dose of 7 Gy, organ doses varied from 1.0 to 741.1 mGy by the field dimensions and organ location relative to the field edge. Blocked field irradiations resulted in a dose range of 1.4–146.3 mGy. The most probable detriment from open field treatment of male patients was colon cancer with a high risk of 564.3 × 10{sup −5} to 837.4 × 10{sup −5} depending upon the organ dose magnitude and the patient's age. The corresponding colon cancer risk for female patients was (372.2–541.0) × 10{sup −5}. The probability of bladder cancer development was more than 113.7 × 10{sup −5} and 110.3 × 10{sup −5} for males and females, respectively. The cancer risk range to other individual organs was reduced to (0.003–68.5) × 10{sup −5}.Conclusions: The risk for cancer induction from radiation therapy for HO prophylaxis after total hip arthroplasty varies considerably by

  7. Cancer risk estimates from radiation therapy for heterotopic ossification prophylaxis after total hip arthroplasty

    International Nuclear Information System (INIS)

    Mazonakis, Michalis; Berris, Theoharris; Damilakis, John; Lyraraki, Efrossyni

    2013-01-01

    Purpose: Heterotopic ossification (HO) is a frequent complication following total hip arthroplasty. This study was conducted to calculate the radiation dose to organs-at-risk and estimate the probability of cancer induction from radiotherapy for HO prophylaxis.Methods: Hip irradiation for HO with a 6 MV photon beam was simulated with the aid of a Monte Carlo model. A realistic humanoid phantom representing an average adult patient was implemented in Monte Carlo environment for dosimetric calculations. The average out-of-field radiation dose to stomach, liver, lung, prostate, bladder, thyroid, breast, uterus, and ovary was calculated. The organ-equivalent-dose to colon, that was partly included within the treatment field, was also determined. Organ dose calculations were carried out using three different field sizes. The dependence of organ doses upon the block insertion into primary beam for shielding colon and prosthesis was investigated. The lifetime attributable risk for cancer development was estimated using organ, age, and gender-specific risk coefficients.Results: For a typical target dose of 7 Gy, organ doses varied from 1.0 to 741.1 mGy by the field dimensions and organ location relative to the field edge. Blocked field irradiations resulted in a dose range of 1.4–146.3 mGy. The most probable detriment from open field treatment of male patients was colon cancer with a high risk of 564.3 × 10 −5 to 837.4 × 10 −5 depending upon the organ dose magnitude and the patient's age. The corresponding colon cancer risk for female patients was (372.2–541.0) × 10 −5 . The probability of bladder cancer development was more than 113.7 × 10 −5 and 110.3 × 10 −5 for males and females, respectively. The cancer risk range to other individual organs was reduced to (0.003–68.5) × 10 −5 .Conclusions: The risk for cancer induction from radiation therapy for HO prophylaxis after total hip arthroplasty varies considerably by the treatment parameters, organ

  8. Risk and Cost of 90-Day Complications in Morbidly and Superobese Patients After Total Knee Arthroplasty.

    Science.gov (United States)

    Meller, Menachem M; Toossi, Nader; Johanson, Norman A; Gonzalez, Mark H; Son, Min-Sun; Lau, Edmund C

    2016-10-01

    This study investigated the risk and cost of postoperative complications associated with morbid and super obesity after total knee arthroplasty (TKA). A retrospective cohort study was conducted of patients who underwent TKA using Medicare hospital claims data. The International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code V85.4x was used to identify morbidly obese patients (body mass index [BMI] ≥40 kg/m(2)) and superobese patients (BMI ≥50 kg/m(2)) in 2011-2013. Patients without any BMI-related diagnosis codes were used as controls. Twelve complications occurred in the 90-day period after TKA were analyzed using multivariate Cox models, adjusting for patient demographic, morbidity, and institutional factors. In addition, hospital charges and payments were compared from primary surgery through subsequent 90 days. Morbidly obese patients showed a significantly elevated risk in most complications examined, with a 2-fold or higher risk in dislocation and wound dehiscence. In addition, death, periprosthetic joint infection, acute renal failure, and knee revision had significant hazard ratios between 1.5 and 2.0. However, risk of deep vein thrombosis and acute myocardial infarction did not increase for the morbidly obese patients. Superobese patients had significant increase in risk of infection, wound dehiscence, acute renal failures, revisions, death, and readmission compared with patients with BMI 40-49 kg/m(2). Significant dose-response trend was found between the level of BMI and risk for death, dislocation, implant failure, infection, readmission, revision, wound dehiscence, and acute renal failure. Controlling for patient and institutional factors, each TKA had an average total hospital charges of $75,884 among superobese patients, compared to $65,118 for the control group, a difference of $10,767. Medicare payment for the superobese patients was also higher, but only by $2703. Morbidly obese patients pose a significantly

  9. Integration of Public Finance Administration into ISO 9001 Total Quality Management

    Directory of Open Access Journals (Sweden)

    Hakan KİTAPÇI

    2012-06-01

    Full Text Available In Chronology; although they show different progress from each others, today Total Quality Management (TQM and Internal Auditing are two management concepts that are in mutual interaction and provide help for development of each other. TQM is a human based management concept that aims to increase customer satisfaction and enhance quality with decreasing cost in organizations. Internal Auditing is an independent, objective assurance and consultancy action on organization’s efficiency, productivity and accordance with laws and regulations. In this study; interrelation of public financial administration and TQM, how they interact each other and their size are displayed with searching lots of related scientific resources and a sample from public is given about application. In this study internal auditing is accepted as a management philosophy which has an important in TQM, and also which Exhausted risk, IT systems, internal Auditing Process, relationship with environment, performance and quality. At the end of study we can easily say that the new financial system realizes the ISO 9001 standards a high degree.

  10. An Integrative Review of Pediatric Fall Risk Assessment Tools.

    Science.gov (United States)

    DiGerolamo, Kimberly; Davis, Katherine Finn

    Patient fall prevention begins with accurate risk assessment. However, sustained improvements in prevention and quality of care include use of validated fall risk assessment tools (FRATs). The goal of FRATs is to identify patients at highest risk. Adult FRATs are often borrowed from to create tools for pediatric patients. Though factors associated with pediatric falls in the hospital setting are similar to those in adults, such as mobility, medication use, and cognitive impairment, adult FRATs and the factors associated with them do not adequately assess risk in children. Articles were limited to English language, ages 0-21years, and publish date 2006-2015. The search yielded 22 articles. Ten were excluded as the population was primarily adult or lacked discussion of a FRAT. Critical appraisal and findings were synthesized using the Johns Hopkins Nursing evidence appraisal system. Twelve articles relevant to fall prevention in the pediatric hospital setting that discussed fall risk assessment and use of a FRAT were reviewed. Comparison between and accuracy of FRATs is challenged when different classifications, definitions, risk stratification, and inclusion criteria are used. Though there are several pediatric FRATs published in the literature, none have been found to be reliable and valid across institutions and diverse populations. This integrative review highlights the importance of choosing a FRAT based on an institution's identified risk factors and validating the tool for one's own patient population as well as using the tool in conjunction with nursing clinical judgment to guide interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Progressive risk assessment of polychlorinated biphenyls through a Total Diet Study in the Korean population

    International Nuclear Information System (INIS)

    Shin, Eun-su; Nguyen, Khanh-Hoang; Kim, Jongchul; Kim, Cho-il; Chang, Yoon-Seok

    2015-01-01

    Human exposure to polychlorinated biphenyls (PCBs) from foods was investigated through a Total Diet Study (TDS) for the first time in Korea. A representative food list was developed from food intake data. Non-selected foods were also included in the TDS through the mapping process to anticipate practical risk assessment. For better representativeness, data (2008–2011) from the Korea National Health and Nutrition Examination Survey (KNHANES) were combined with the TDS data set. And also, we estimated the dietary exposure to PCBs from various food items using a ‘best-fit’ mapping process and assessed the differences in PCB exposures by sex and age. In this study, we examined total PCBs (62 congeners) including dioxin-like PCBs (DL-PCBs) and indicator PCBs, which are congeners that are mainly detected in various environmental matrices. The average dietary exposure (3.94 ng/kg body weight/day) that was estimated through food intake was 19.7% of the World Health Organization (WHO) recommendation. - Highlights: • A total of 282 samples, composed of the most consumed foodstuffs in Korea, were analysed and shown in detail. • The contamination status of total PCBs in food was assessed, through their various condition on cooking methods. • The dietary intakes of PCBs in various food groups were estimated in different region, gender and age groups. • The improved and systematic food selection process was applied such as ‘mapping process’. - This study is to ensure food safety through total analysis of PCBs with the improved risk assessment method.

  12. Clinical Characteristics and Risk Factors for the Development of Postoperative Hepatic Steatosis After Total Pancreatectomy.

    Science.gov (United States)

    Hata, Tatsuo; Ishida, Masaharu; Motoi, Fuyuhiko; Sakata, Naoaki; Yoshimatsu, Gumpei; Naitoh, Takeshi; Katayose, Yu; Egawa, Shinichi; Unno, Michiaki

    2016-03-01

    The occurrence of hepatic steatosis after pancreatectomy is known to be associated with the remnant pancreatic function. However, other risk factors for hepatic steatosis after pancreatectomy remain unknown. The aims of this study were to identify other risk factors in addition to the remnant pancreatic function and elucidate the relationship between postoperative hepatic steatosis and pancreatic exocrine insufficiency in totally pancreatomized patients. Forty-three patients who underwent total pancreatectomy were analyzed. Hepatic steatosis was defined as the attenuation of unenhanced computed tomography values. Clinical findings and laboratory data were compared between patients with and without hepatic steatosis. Sixteen (37.2%) patients developed hepatic steatosis after total pancreatectomy, with marked declines in the Controlling Nutritional Status score and body mass index. Multiple linear regression analysis revealed that the attenuation of computed tomography values was correlated with female sex (P = 0.002), early postoperative serum albumin levels (P = 0.003), and pancreatic enzyme replacement therapy with high-dose pancrelipase (P = 0.032). Postoperative hepatic steatosis after pancreatectomy is associated with sex, malnutrition, and pancreatic exocrine insufficiency. High-dose pancreatic enzyme replacement therapy may have preventive effects on hepatic steatosis occurring after pancreatectomy.

  13. Strategy for integrated CERCLA/NEPA risk assessments

    International Nuclear Information System (INIS)

    MacDonell, M.M.; Haroun, L.A.; Peterson, J.M.; Blunt, D.A.; Fingleton, D.J.; Picel, M.H.

    1991-01-01

    The US Department of Energy (DOE) has established a policy whereby, for remedial actions, the procedural and documentational requirements of the National Environmental Policy Act (NEPA) are integrated with those of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended. However, the objectives of risk assessment under NEPA and CERCLA differ somewhat. Until its recent application at contaminated sites, NEPA analysis has typically been applied to impacts from taking actions at clean sites (e.g., for construction activities), and a somewhat loosely structured process has historically been used to estimate relative risks for NEPA analyses. Decisions such as cleanup levels were not made on the basis of the risk estimates, and they therefore tended to be conservative and were not discussed in detail. In contrast, risks estimated for Superfund (CERCLA) sites are used to focus the decision-making process for those sites and support national prioritization for cleanup, and the US Environmental Protection Agency (EPA) has developed a detailed framework for preparing baseline health risk assessments for these sites. The purpose of this paper is to discuss issues related to intergrating the CERCLA and NEPA approaches into the risk assessments that have been prepared for a DOE remedial action project at the Weldon Spring site near St. Charles, Missouri. These issues are grouped into three basic categories: general assumptions for the impact evaluation, data management, and presentation of the methodology and results. This paper is not intended to represent DOE policy and guidance, nor does it represent the only approach that can be used for integrated risk assessments. It merely discusses the process that was used for the Weldon Spring project, articulating the issues that were encountered and how they were addressed

  14. NASA Space Radiation Program Integrative Risk Model Toolkit

    Science.gov (United States)

    Kim, Myung-Hee Y.; Hu, Shaowen; Plante, Ianik; Ponomarev, Artem L.; Sandridge, Chris

    2015-01-01

    NASA Space Radiation Program Element scientists have been actively involved in development of an integrative risk models toolkit that includes models for acute radiation risk and organ dose projection (ARRBOD), NASA space radiation cancer risk projection (NSCR), hemocyte dose estimation (HemoDose), GCR event-based risk model code (GERMcode), and relativistic ion tracks (RITRACKS), NASA radiation track image (NASARTI), and the On-Line Tool for the Assessment of Radiation in Space (OLTARIS). This session will introduce the components of the risk toolkit with opportunity for hands on demonstrations. The brief descriptions of each tools are: ARRBOD for Organ dose projection and acute radiation risk calculation from exposure to solar particle event; NSCR for Projection of cancer risk from exposure to space radiation; HemoDose for retrospective dose estimation by using multi-type blood cell counts; GERMcode for basic physical and biophysical properties for an ion beam, and biophysical and radiobiological properties for a beam transport to the target in the NASA Space Radiation Laboratory beam line; RITRACKS for simulation of heavy ion and delta-ray track structure, radiation chemistry, DNA structure and DNA damage at the molecular scale; NASARTI for modeling of the effects of space radiation on human cells and tissue by incorporating a physical model of tracks, cell nucleus, and DNA damage foci with image segmentation for the automated count; and OLTARIS, an integrated tool set utilizing HZETRN (High Charge and Energy Transport) intended to help scientists and engineers study the effects of space radiation on shielding materials, electronics, and biological systems.

  15. Industrial water resources management based on violation risk analysis of the total allowable target on wastewater discharge.

    Science.gov (United States)

    Yue, Wencong; Cai, Yanpeng; Xu, Linyu; Yang, Zhifeng; Yin, Xin'An; Su, Meirong

    2017-07-11

    To improve the capabilities of conventional methodologies in facilitating industrial water allocation under uncertain conditions, an integrated approach was developed through the combination of operational research, uncertainty analysis, and violation risk analysis methods. The developed approach can (a) address complexities of industrial water resources management (IWRM) systems, (b) facilitate reflections of multiple uncertainties and risks of the system and incorporate them into a general optimization framework, and (c) manage robust actions for industrial productions in consideration of water supply capacity and wastewater discharging control. The developed method was then demonstrated in a water-stressed city (i.e., the City of Dalian), northeastern China. Three scenarios were proposed according to the city's industrial plans. The results indicated that in the planning year of 2020 (a) the production of civilian-used steel ships and machine-made paper & paperboard would reduce significantly, (b) violation risk of chemical oxygen demand (COD) discharge under scenario 1 would be the most prominent, compared with those under scenarios 2 and 3, (c) the maximal total economic benefit under scenario 2 would be higher than the benefit under scenario 3, and (d) the production of rolling contact bearing, rail vehicles, and commercial vehicles would be promoted.

  16. Preoperative psychosocial risk factors for poor outcomes at 1 and 5 years after total knee replacement.

    Science.gov (United States)

    Wylde, Vikki; Trela-Larsen, Lea; Whitehouse, Michael R; Blom, Ashley W

    2017-10-01

    Background and purpose - Psychosocial factors are important risk factors for poor outcomes in the first year after total knee replacement (TKR), however their impact on long-term outcomes is unclear. We aimed to identify preoperative psychosocial risk factors for poor outcomes at 1 year and 5 years after TKR. Patients and methods - 266 patients were recruited prior to TKR surgery. Knee pain and function were assessed preoperatively and at 1 and 5 years postoperative using the WOMAC Pain score, WOMAC Function score and American Knee Society Score (AKSS) Knee score. Preoperative depression, anxiety, catastrophizing, pain self-efficacy and social support were assessed. Statistical analyses involved multiple linear regression and mixed effect linear regression. Results - Higher anxiety was a risk factor for worse pain at 1 year postoperative. No psychosocial factors were associated with any outcomes at 5 years postoperative. Analysis of change over time found that patients with higher pain self-efficacy had lower preoperative pain and experienced less improvement in pain up to 1 year postoperative. Higher pain self-efficacy was associated with less improvement in the AKSS up to 1 year postoperative but more improvement between 1 and 5 years postoperative. Interpretation - Preoperative anxiety was found to influence pain at 1 year after TKR. However, none of the psychosocial variables were risk factors for a poor outcome at 5 years post-operative, suggesting that the negative effects of anxiety on outcome do not persist in the longer-term.

  17. SYNERGISTIC EFFECTS OF TOTAL QUALITY MANAGEMENT AND OPERATIONAL RISK MANAGEMENT IN CENTRAL BANKS

    Directory of Open Access Journals (Sweden)

    Radoica Luburić

    2012-12-01

    Full Text Available This paper focuses on two very important and current approaches to management: Total Quality Management (TQM and Operational Risk Management (ORM. As a paradigm of business success, TQM provides the key assumptions for survival, development and success of an organisation, regardless of any limitations whatsoever. ORM, on the other hand, is predetermined to be an irreplaceable managerial tool that enables organisations to survive in any environment. In times of accelerated political, economic and technological changes, frequent natural disasters, acts of terrorism and other external events, a successful risk management has been gaining importance and becomes one of the key competitive advantages of an organisation. The ultimate objective is to make TQM and ORM, as two rather compatible and complementary approaches to risk management, harmonized, efficient and functional in order to get their synergistic effects in an organisation in full swing and practice. Various organisations, and thus central banks as conservative institutions, have an innovative opportunity to timely minimize their operational risk through preventive, comprehensive and synergistic operation of TQM and ORM and thus significantly contribute to improving their business performance.

  18. Less Than Total Excision of Infected Prosthetic PTFE Graft Does Not Increase the Risk of Reinfection.

    Science.gov (United States)

    Sgroi, Michael D; Kirkpatrick, Vincent E; Resnick, Karen A; Williams, Russell A; Wilson, Samuel E; Gordon, Ian L

    2015-01-01

    Traditional treatment of infected polytetrafluoroethylene (PTFE) grafts consist of removal of the entire prosthesis. Closure of the native vessels may compromise vascular patency. We examined the outcomes for patients in whom a PTFE remnant of an infected graft was retained on the vessel. We reviewed the operating room log from 2000 to 2011 and identified all patients who had partial removal of an infected PTFE graft used for hemodialysis or peripheral bypass. These patients were examined for subsequent complications. Twenty-seven patients underwent 30 partial graft excisions with mean follow-up of 27 months. A total of 17% (5 of 30) of the partial graft resection procedures resulted in complications. Of 48 total remnants left behind at the arterial or venous anastomoses, reinfection occurred in 15%. Leaving a well-incorporated small 1-to 5-mm PTFE remnant at the arterial or venous anastomoses can be performed safely with a low risk of complications. © The Author(s) 2015.

  19. Genetic Schizophrenia Risk Variants Jointly Modulate Total Brain and White Matter Volume

    DEFF Research Database (Denmark)

    Terwisscha van Scheltinga, Afke F; Bakker, Steven C; van Haren, Neeltje E M

    2013-01-01

    with total brain volume (R(2)=.048, p=1.6×10(-4)) and white matter volume (R(2)=.051, p=8.6×10(-5)) equally in patients and control subjects. The number of (independent) SNPs that substantially influenced both disease risk and white matter (n=2020) was much smaller than the entire set of SNPs that modulated...... modulating schizophrenia and brain volume. METHODS: Odds ratios for genome-wide SNP data were calculated in the sample collected by the Psychiatric Genome-wide Association Study Consortium (8690 schizophrenia patients and 11,831 control subjects, excluding subjects from the present study). These were used...

  20. Levels of plasma selenium and urinary total arsenic interact to affect the risk for prostate cancer.

    Science.gov (United States)

    Hsueh, Yu-Mei; Su, Chien-Tien; Shiue, Horng-Sheng; Chen, Wei-Jen; Pu, Yeong-Shiau; Lin, Ying-Chin; Tsai, Cheng-Shiuan; Huang, Chao-Yuan

    2017-09-01

    This study investigated whether plasma selenium levels modified the risk for prostate cancer (PC) related to arsenic exposure. We conducted a case-control study that included 318 PC patients and 318 age-matched, healthy control subjects. Urinary arsenic profiles were examined using HPLC-HG-AAS and plasma selenium levels were measured by ICP-MS. We found that plasma selenium levels displayed a significant dose-dependent inverse association with PC. The odds ratio (OR) and 95% confidence interval (CI) for PC was 0.07 (0.04-0.13) among participants with a plasma selenium level >28.06 μg/dL vs. ≤19.13 μg/dL. A multivariate analysis showed that participants with a urinary total arsenic concentration >29.28 μg/L had a significantly higher OR (1.75, 1.06-2.89) for PC than participants with ≤29.89 μg/L. The combined presence of a low plasma selenium level and a high urinary total arsenic concentration exponentially increased the OR for PC, and additively interacted with PSA at levels ≥20 ng/mL. This is the first epidemiological study to examine the combined effects of plasma selenium and urinary total arsenic levels on the OR for PC. Our data suggest a low plasma selenium level coupled with a high urinary total arsenic concentration creates a significant risk for aggressive PC. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Depression and suicide risk among nursing professionals: an integrative review

    Directory of Open Access Journals (Sweden)

    Darlan dos Santos Damásio Silva

    2015-12-01

    Full Text Available Abstract OBJECTIVE Discussing the factors associated with major depression and suicide risk among nursing professionals. METHOD An integrative review in PubMed/MEDLINE, LILACS, SciELO and BDENF databases, between 2003 and 2015. RESULTS 20 published articles were selected, mostly from between 2012 and 2014, with significant production in Brazil. Nursing professionals are vulnerable to depression when young, married, performing night work and having several jobs, and when they have a high level of education, low family income, work overload, high stress, insufficient autonomy and a sense of professional insecurity and conflict in the family and workrelationship. Suicide risk was correlated with the presence of symptoms of depression, high levels of emotional exhaustion, depersonalization and low personal accomplishment; characteristics of Burnout Syndrome. CONCLUSION Suicide risk among nursing professionals is associated with symptoms of depression and correlated with Burnout Syndrome, which can affect work performance.

  2. STEAM GENERATOR TUBE INTEGRITY ANALYSIS OF A TOTAL LOSS OF ALL HEAT SINKS ACCIDENT FOR WOLSONG NPP UNIT 1

    Directory of Open Access Journals (Sweden)

    HEOK-SOON LIM

    2014-02-01

    Full Text Available A total loss of all heat sinks is considered a severe accident with a low probability of occurrence. Following a total loss of all heat sinks, the degasser/condenser relief valves (DCRV become the sole means available for the depressurization of the primary heat transport system. If a nuclear power plant has a total loss of heat sinks accident, high-temperature steam and differential pressure between the primary heat transport system (PHTS and the steam generator (SG secondary side can cause a SG tube creep rupture. To protect the PHTS during a total loss of all heat sinks accident, a sufficient depressurization capability of the degasser/condenser relief valve and the SG tube integrity is very important. Therefore, an accurate estimation of the discharge through these valves is necessary to assess the impact of the PHTS overprotection and the SG tube integrity of the primary circuit. This paper describes the analysis of DCRV discharge capacity and the SG tube integrity under a total loss of all heat sink using the CATHENA code. It was found that the DCRV's discharge capacity is enough to protect the overpressure in the PHTS, and the SG tube integrity is maintained in a total loss of all heat accident.

  3. Steam Generator Tube Integrity Analysis of A Total Loss of all Heat Sinks Accident for Wolsong NPP Unit 1

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Heoksoon; Song, Taeyoung; Chi, Moongoo [Korea Htydro and Nuclear Power Co., Ltd., Daejeon (Korea, Republic of); Kim, Seoungrae [Nuclear Engineering Service and Solution, Daejeon (Korea, Republic of)

    2014-02-15

    A total loss of all heat sinks is considered a severe accident with a low probability of occurrence. Following a total loss of all heat sinks, the degasser/condenser relief valves (DCRV) become the sole means available for the depressurization of the primary heat transport system. If a nuclear power plant has a total loss of heat sinks accident, high-temperature steam and differential pressure between the primary heat transport system (PHTS) and the steam generator (SG) secondary side can cause a SG tube creep rupture. To protect the PHTS during a total loss of all heat sinks accident, a sufficient depressurization capability of the degasser/condenser relief valve and the SG tube integrity is very important. Therefore, an accurate estimation of the discharge through these valves is necessary to assess the impact of the PHTS overprotection and the SG tube integrity of the primary circuit. This paper describes the analysis of DCRV discharge capacity and the SG tube integrity under a total loss of all heat sink using the CATHENA code. It was found that the DCRV's discharge capacity is enough to protect the overpressure in the PHTS, and the SG tube integrity is maintained in a total loss of all heat accident.

  4. Steam Generator Tube Integrity Analysis of A Total Loss of all Heat Sinks Accident for Wolsong NPP Unit 1

    International Nuclear Information System (INIS)

    Lim, Heoksoon; Song, Taeyoung; Chi, Moongoo; Kim, Seoungrae

    2014-01-01

    A total loss of all heat sinks is considered a severe accident with a low probability of occurrence. Following a total loss of all heat sinks, the degasser/condenser relief valves (DCRV) become the sole means available for the depressurization of the primary heat transport system. If a nuclear power plant has a total loss of heat sinks accident, high-temperature steam and differential pressure between the primary heat transport system (PHTS) and the steam generator (SG) secondary side can cause a SG tube creep rupture. To protect the PHTS during a total loss of all heat sinks accident, a sufficient depressurization capability of the degasser/condenser relief valve and the SG tube integrity is very important. Therefore, an accurate estimation of the discharge through these valves is necessary to assess the impact of the PHTS overprotection and the SG tube integrity of the primary circuit. This paper describes the analysis of DCRV discharge capacity and the SG tube integrity under a total loss of all heat sink using the CATHENA code. It was found that the DCRV's discharge capacity is enough to protect the overpressure in the PHTS, and the SG tube integrity is maintained in a total loss of all heat accident

  5. Integrating physical and financial approaches to manage environmental financial risk

    Science.gov (United States)

    Characklis, Gregory; Meyer, Eliot; Foster, Benjamin

    2017-04-01

    Physical and/or engineered solutions have long been used to manage risks associated with adverse environmental events. Examples include reservoirs as a tool for mitigating drought-related supply risk, levees for managing flood risk and dredging of inland waterways to ensure navigability during low flow periods. These measures can reduce many types of risk (e.g., loss of life), but are often employed as a means of protecting against financial losses. When the focus is on managing environmental financial risk, physical solutions can be effective, but also costly. In many cases, non-physical tools can provide a less expensive means of managing financial risk, with these often taking the form of financial instruments such as hedging contracts, contingency funds or insurance. Some of these instruments, such as flood insurance, are widely available, but historically many environmental financial risks have been managed primarily (or solely) via physical solutions without much consideration of alternatives, thereby opening opportunities for innovation in developing financial solutions. Recent research has demonstrated that financial instruments can play a significant role in managing drought-related financial risk in sectors as diverse as water utilities, energy generation and inland navigation. Nonetheless, this work has largely considered the use of these instruments within systems in which physical solutions are already in place (but failing to achieve desired performance). The next step in the evolution of managing environmental financial risk involves developing methods for designing risk management strategies that do not assume an established physical system. Here the goal is to identify the relative role that physical solutions and financial instruments should play as they are integrated into a comprehensive risk management strategy. This is not a straightforward challenge as one approach reduces the risk of financial losses and the other redistributes those losses

  6. Optimization of total arc degree for stereotactic radiotherapy by using integral biologically effective dose and irradiated volume

    International Nuclear Information System (INIS)

    Lim, Do Hoon; Kim, Dae Yong; Lee, Myung Za; Chun, Ha Chung

    2001-01-01

    To find the optimal values of total arc degree to protect the normal brain tissue from high dose radiation in stereotactic radiotherapy planning. With Xknife-3 planning system and 4 MV linear accelerator, the authors planned under various values of parameters. One isocenter, 12, 20, 30, 40, 50, and 60 mm of collimator diameters, 100 deg, 200 deg, 300 deg, 400 deg, 500 deg, 600 deg, of total arc degrees, and 30 deg or 45 deg of arc intervals were used. After the completion of planning, the plans were compared each other using V 50 (the volume of normal brain that is delivered high dose radiation) and integral biologically effective dose. At 30 deg of arc interval, the values of V 50 had the decreased pattern with the increase of total arc degree in any collimator diameter. At 45 deg arc interval, up to 400 deg of total arc degree, the values of V 50 decreased with the increase of total arc degree, but at 500 deg and 600 deg of total arc degrees, the values increased. At 30 deg of arc interval, integral biologically effective dose showed the decreased pattern with the increase of total arc degree in any collimator diameter. At 45 deg arc interval with less than 40 mm collimator diameter, the integral biologically effective dose decreased with the increase of total arc degree, but with 50 and 60 mm of collimator diameters, up to 400 deg of total arc degree, integral biologically effective dose decreased with the increase of total arc degree, but at 500 deg and 600 deg of total arc degrees, the values increased. In the stereotactic radiotherapy planning for brain lesions, planning with 400 deg of total arc degree is optimal. Especially, when the larger collimator more than 50 mm diameter should be used, the uses of 500 deg and 600 deg of total arc degrees make the increase of V 50 and integral biologically effective dose, Therefore stereotactic radiotherapy planning using 400 deg of total arc degree can increase the therapeutic ratio and produce the effective outcome

  7. Integrated approach for coastal hazards and risks in Sri Lanka

    Science.gov (United States)

    Garcin, M.; Desprats, J. F.; Fontaine, M.; Pedreros, R.; Attanayake, N.; Fernando, S.; Siriwardana, C. H. E. R.; de Silva, U.; Poisson, B.

    2008-06-01

    The devastating impact of the tsunami of 26 December 2004 on the shores of the Indian Ocean recalled the importance of knowledge and the taking into account of coastal hazards. Sri Lanka was one of the countries most affected by this tsunami (e.g. 30 000 dead, 1 million people homeless and 70% of the fishing fleet destroyed). Following this tsunami, as part of the French post-tsunami aid, a project to establish a Geographical Information System (GIS) on coastal hazards and risks was funded. This project aims to define, at a pilot site, a methodology for multiple coastal hazards assessment that might be useful for the post-tsunami reconstruction and for development planning. This methodology could be applied to the whole coastline of Sri Lanka. The multi-hazard approach deals with very different coastal processes in terms of dynamics as well as in terms of return period. The first elements of this study are presented here. We used a set of tools integrating a GIS, numerical simulations and risk scenario modelling. While this action occurred in response to the crisis caused by the tsunami, it was decided to integrate other coastal hazards into the study. Although less dramatic than the tsunami these remain responsible for loss of life and damage. Furthermore, the establishment of such a system could not ignore the longer-term effects of climate change on coastal hazards in Sri Lanka. This GIS integrates the physical and demographic data available in Sri Lanka that is useful for assessing the coastal hazards and risks. In addition, these data have been used in numerical modelling of the waves generated during periods of monsoon as well as for the December 2004 tsunami. Risk scenarios have also been assessed for test areas and validated by field data acquired during the project. The results obtained from the models can be further integrated into the GIS and contribute to its enrichment and to help in better assessment and mitigation of these risks. The coastal-hazards-and-risks

  8. Integrated approach for coastal hazards and risks in Sri Lanka

    Directory of Open Access Journals (Sweden)

    M. Garcin

    2008-06-01

    Full Text Available The devastating impact of the tsunami of 26 December 2004 on the shores of the Indian Ocean recalled the importance of knowledge and the taking into account of coastal hazards. Sri Lanka was one of the countries most affected by this tsunami (e.g. 30 000 dead, 1 million people homeless and 70% of the fishing fleet destroyed. Following this tsunami, as part of the French post-tsunami aid, a project to establish a Geographical Information System (GIS on coastal hazards and risks was funded. This project aims to define, at a pilot site, a methodology for multiple coastal hazards assessment that might be useful for the post-tsunami reconstruction and for development planning. This methodology could be applied to the whole coastline of Sri Lanka.

    The multi-hazard approach deals with very different coastal processes in terms of dynamics as well as in terms of return period. The first elements of this study are presented here. We used a set of tools integrating a GIS, numerical simulations and risk scenario modelling. While this action occurred in response to the crisis caused by the tsunami, it was decided to integrate other coastal hazards into the study. Although less dramatic than the tsunami these remain responsible for loss of life and damage. Furthermore, the establishment of such a system could not ignore the longer-term effects of climate change on coastal hazards in Sri Lanka.

    This GIS integrates the physical and demographic data available in Sri Lanka that is useful for assessing the coastal hazards and risks. In addition, these data have been used in numerical modelling of the waves generated during periods of monsoon as well as for the December 2004 tsunami. Risk scenarios have also been assessed for test areas and validated by field data acquired during the project. The results obtained from the models can be further integrated into the GIS and contribute to its enrichment and to help in better assessment and mitigation

  9. Severe Pulmonary Toxicity After Myeloablative Conditioning Using Total Body Irradiation: An Assessment of Risk Factors

    International Nuclear Information System (INIS)

    Kelsey, Chris R.; Horwitz, Mitchell E.; Chino, Junzo P.; Craciunescu, Oana; Steffey, Beverly; Folz, Rodney J.; Chao, Nelson J.; Rizzieri, David A.; Marks, Lawrence B.

    2011-01-01

    Purpose: To assess factors associated with severe pulmonary toxicity after myeloablative conditioning using total body irradiation (TBI) followed by allogeneic stem cell transplantation. Methods and Materials: A total of 101 adult patients who underwent TBI-based myeloablative conditioning for hematologic malignancies at Duke University between 1998 and 2008 were reviewed. TBI was combined with high-dose cyclophosphamide, melphalan, fludarabine, or etoposide, depending on the underlying disease. Acute pulmonary toxicity, occurring within 90 days of transplantation, was scored using Common Terminology Criteria for Adverse Events version 3.0. Actuarial overall survival and the cumulative incidence of acute pulmonary toxicity were calculated via the Kaplan-Meier method and compared using a log-rank test. A binary logistic regression analysis was performed to assess factors independently associated with acute severe pulmonary toxicity. Results: The 90-day actuarial risk of developing severe (Grade 3-5) pulmonary toxicity was 33%. Actuarial survival at 90 days was 49% in patients with severe pulmonary toxicity vs. 94% in patients without (p < 0.001). On multivariate analysis, the number of prior chemotherapy regimens was the only factor independently associated with development of severe pulmonary toxicity (odds ratio, 2.7 per regimen). Conclusions: Severe acute pulmonary toxicity is prevalent after TBI-based myeloablative conditioning regimens, occurring in approximately 33% of patients. The number of prior chemotherapy regimens appears to be an important risk factor.

  10. Pain catastrophizing as a risk factor for chronic pain after total knee arthroplasty: a systematic review

    Directory of Open Access Journals (Sweden)

    Burns LC

    2015-01-01

    Full Text Available Lindsay C Burns,1–3 Sarah E Ritvo,1 Meaghan K Ferguson,1 Hance Clarke,3–5 Ze’ev Seltzer,3,5 Joel Katz1,3–5 1Department of Psychology, York University, Toronto, ON, Canada; 2Arthritis Research Centre of Canada, Vancouver, BC, Canada; 3Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada; 4Department of Anesthesia, University of Toronto, Toronto, ON, Canada; 5Centre for the Study of Pain, Faculties of Dentistry and Medicine, University of Toronto, Toronto, ON, Canada Background: Total knee arthroplasty (TKA is a common and costly surgical procedure. Despite high success rates, many TKA patients develop chronic pain in the months and years following surgery, constituting a public health burden. Pain catastrophizing is a construct that reflects anxious preoccupation with pain, inability to inhibit pain-related fears, amplification of the significance of pain vis-à-vis health implications, and a sense of helplessness regarding pain. Recent research suggests that it may be an important risk factor for untoward TKA outcomes. To clarify this impact, we systematically reviewed the literature to date on pain catastrophizing as a prospective predictor of chronic pain following TKA. Methods: We searched MEDLINE, EMBASE, and PsycINFO databases to identify articles related to pain catastrophizing, TKA, risk models, and chronic pain. We reviewed titles and abstracts to identify original research articles that met our specified inclusion criteria. Included articles were then rated for methodological quality. including methodological quality. Due to heterogeneity in follow-up, analyses, and outcomes reported across studies, a quantitative meta-analysis could not be performed. Results: We identified six prospective longitudinal studies with small-to-mid-sized samples that met the inclusion criteria. Despite considerable variability in reported pain outcomes, pain catastrophizing was identified as a significant

  11. Dynamic integration of residential building design and green energies : the Bireth approach : building integrated renewable energy total harvest approach

    Energy Technology Data Exchange (ETDEWEB)

    Cheung, K.P. [Hong Kong Univ., Hong Kong (China). Dept. of Architecture; Luk, C.L.P. [Chu Hai College of Higher Education, Hong Kong (China). Dept. of Architecture; Wong, S.T. [Hong Kong Univ., Hong Kong (China). Div. of Arts and Humanities, SPACE; Chung, S.L.; Fung, K.S.; Leung, M.F. [Hong Kong Inst. of Vocational Education, Hong Kong (China)

    2006-07-01

    Renewable energy sources that are commonly used in buildings include solar energy, wind energy and rainwater collection. High quality environmentally responsive residential buildings are designed to provide good insulation in winter and solar shading in summer. However, this study demonstrated that the green energy design in residential buildings is not usually well integrated. For example, windows with clear double or triple glazed glass, allow good penetration of sunlight during the day in winter, but are not further dynamically insulated for when the sun goes down to avoid heat loss from the building. Additionally, good solar static shading devices often block much needed daylight on cloudy winter days. These examples emphasize the lack of an integrated approach to gain the best advantage of green energies and to minimize energy costs in residential buildings. This study addressed issues facing the integrated approach with particular reference to the design of a small residential building in rural Beijing. The design included a new approach for interpreting a traditional Beijing court yard house in the modern Beijing rural context, while integrating multi-responding innovative green energy applications derived from first principles. This paper also presented a proposal for a village house in Hong Kong to harvest as much renewable energies as possible, primarily wind energy and solar energy, that come into contact with the building. The purpose was to work towards a renewable energy approach for buildings, namely the Bireth approach, which will benefit practically all houses by making them zero energy houses. The paper described the feasibility of integrating renewable energies in buildings to fulfill performance requirements such improving ventilation, providing warm interiors, drying clothes, or storing solar and wind energies into power batteries. The challenges facing the development of a proposed micro solar hot air turbine were also presented. 15 refs., 6

  12. Risk assessment to an integrated planning model for UST programs

    International Nuclear Information System (INIS)

    Ferguson, K.W.

    1993-01-01

    The US Postal Service maintains the largest civilian fleet in the United States totaling approximately 180,000 vehicles. To support the fleets daily energy requirements, the Postal Service also operates one of the largest networks of underground storage tanks nearly 7,500 nationwide. A program to apply risk assessment to planning, budget development and other management actions was implemented during September, 1989. Working closely with a consultant, the postal service developed regulatory and environmental risk criteria and weighting factors for a ranking model. The primary objective was to identify relative risks for each underground tank at individual facilities. Relative risks at each facility were determined central to prioritizing scheduled improvements to the tank network. The survey was conducted on 302 underground tanks in the Northeast Region of the US. An environmental and regulatory risk score was computed for each UST. By ranking the tanks according to their risk score, tanks were classified into management action categories including, but the limited to, underground tank testing, retrofit, repair, replacement and closure

  13. Can an arthroplasty risk score predict bundled care events after total joint arthroplasty?

    Directory of Open Access Journals (Sweden)

    Blair S. Ashley, MD

    2018-03-01

    Full Text Available Background: The validated Arthroplasty Risk Score (ARS predicts the need for postoperative triage to an intensive care setting. We hypothesized that the ARS may also predict hospital length of stay (LOS, discharge disposition, and episode-of-care cost (EOCC. Methods: We retrospectively reviewed a series of 704 patients undergoing primary total hip and knee arthroplasty over 17 months. Patient characteristics, 90-day EOCC, LOS, and readmission rates were compared before and after ARS implementation. Results: ARS implementation was associated with fewer patients going to a skilled nursing or rehabilitation facility after discharge (63% vs 74%, P = .002. There was no difference in LOS, EOCC, readmission rates, or complications. While the adoption of the ARS did not change the mean EOCC, ARS >3 was predictive of high EOCC outlier (odds ratio 2.65, 95% confidence interval 1.40-5.01, P = .003. Increased ARS correlated with increased EOCC (P = .003. Conclusions: Implementation of the ARS was associated with increased disposition to home. It was predictive of high EOCC and should be considered in risk adjustment variables in alternative payment models. Keywords: Bundled payments, Risk stratification, Arthroplasty

  14. Risk management: integration of social and technical risk variables into safety assessments of LWR'S

    International Nuclear Information System (INIS)

    Turnage, J.J.; Husseiny, A.A.

    1980-01-01

    A risk management methodology is developed here to formalize the acceptability levels of commercial LWR power plants via the estimation of risk levels acceptable to the public and the integration of such estimates into risk-benefit analysis. Utility theory is used for developing preference models based on value trade-offs among multiple objectives and uncertainties about the impact of alternatives. The method involves reducing the various variables affecting safety acceptability decisions to a single function that provides a metric for acceptability levels. The function accomondates for technical criteria related to design and licensing decisions, as well as public reactions to certain choices

  15. Total, Dietary, and Supplemental Vitamin C Intake and Risk of Incident Kidney Stones.

    Science.gov (United States)

    Ferraro, Pietro Manuel; Curhan, Gary C; Gambaro, Giovanni; Taylor, Eric N

    2016-03-01

    Previous studies of vitamin C and kidney stones were conducted mostly in men and either reported disparate results for supplemental and dietary vitamin C or did not examine dietary vitamin C. Prospective cohort analysis. 156,735 women in the Nurses' Health Study (NHS) I and II and 40,536 men in the Health Professionals Follow-up Study (HPFS). Total, dietary, and supplemental vitamin C intake, adjusted for age, body mass index, thiazide use, and dietary factors. Incident kidney stones. During a median follow-up of 11.3 to 11.7 years, 6,245 incident kidney stones were identified. After multivariable adjustment, total vitamin C intake (vitamin C intake for the 500- to 999-mg/d category was ∼700mg/d. Supplemental vitamin C intake (no use [reference], vitamin C intake was not associated with stones among men or women, although few participants had dietary intakes > 700mg/d. Nutrient intakes derived from food-frequency questionnaires, lack of data on stone composition for all cases. Total and supplemental vitamin C intake was significantly associated with higher risk for incident kidney stones in men, but not in women. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  16. Hanford Site's Integrated Risk Assessment Program: No-intervention risk assessment

    International Nuclear Information System (INIS)

    Mahaffey, J.A.; Dukelow, J.S. Jr.; Stenner, R.D.

    1994-08-01

    The long-term goal of the Integrated Risk Assessment program (IRAP) is to estimate risks to workers, the public, organizations, and groups with reserved rights to Site access, the ecosystem, and natural resources to aid in managing environmental restoration and waste management at the Hanford Site. For each of these, information is needed about current risks, risks during cleanup, and endstate risks. The objective is three-fold: to determine if and when to remediate, and to what extent; to identify information unavailable but needed to make better cleanup decisions; to establish technology performance criteria for achieving desired cleanup levels; to understand costs and benefits of activities from a Site-wide perspective. The no-intervention risk, assessment is the initial evaluation of public health risks conducted under IRAP. The objective is to identify types of activities that the US Department of Energy (DOE) must accomplish for closure of the Hanford Site, defined as no further DOE intervention. There are two primary conclusions from the no-intervention risk assessment. First, some maintenance and operations activities at Hanford must be continued to protect the public from grave risks. However, when large Hanford expenditures are compared to cleanup progress, funds expended for maintenance and operations must be put in proper perspective. Second, stakeholder's emphasis on public risks at Hanford, as indicated by remediation priorities, are not in line with those estimated. The focus currently is on compliance with regulations, and on dealing with issues which are visible to stakeholders

  17. Atypical audiovisual speech integration in infants at risk for autism.

    Directory of Open Access Journals (Sweden)

    Jeanne A Guiraud

    Full Text Available The language difficulties often seen in individuals with autism might stem from an inability to integrate audiovisual information, a skill important for language development. We investigated whether 9-month-old siblings of older children with autism, who are at an increased risk of developing autism, are able to integrate audiovisual speech cues. We used an eye-tracker to record where infants looked when shown a screen displaying two faces of the same model, where one face is articulating/ba/and the other/ga/, with one face congruent with the syllable sound being presented simultaneously, the other face incongruent. This method was successful in showing that infants at low risk can integrate audiovisual speech: they looked for the same amount of time at the mouths in both the fusible visual/ga/- audio/ba/and the congruent visual/ba/- audio/ba/displays, indicating that the auditory and visual streams fuse into a McGurk-type of syllabic percept in the incongruent condition. It also showed that low-risk infants could perceive a mismatch between auditory and visual cues: they looked longer at the mouth in the mismatched, non-fusible visual/ba/- audio/ga/display compared with the congruent visual/ga/- audio/ga/display, demonstrating that they perceive an uncommon, and therefore interesting, speech-like percept when looking at the incongruent mouth (repeated ANOVA: displays x fusion/mismatch conditions interaction: F(1,16 = 17.153, p = 0.001. The looking behaviour of high-risk infants did not differ according to the type of display, suggesting difficulties in matching auditory and visual information (repeated ANOVA, displays x conditions interaction: F(1,25 = 0.09, p = 0.767, in contrast to low-risk infants (repeated ANOVA: displays x conditions x low/high-risk groups interaction: F(1,41 = 4.466, p = 0.041. In some cases this reduced ability might lead to the poor communication skills characteristic of autism.

  18. The Strategic and Legal Risks of Work-Integrated Learning: An Enterprise Risk Management Perspective

    Science.gov (United States)

    Cameron, Craig

    2017-01-01

    Work-integrated learning (WIL) is a risky business for universities. WIL is a strategic risk worthy of pursuing by universities in the prevailing higher education environment, which is characterized by competition, changes in funding arrangements and stakeholder demand for WIL. Nevertheless the strategic opportunities that WIL presents cannot be…

  19. Is Yang-Mills equation a totally integrable system. Lecture III

    International Nuclear Information System (INIS)

    Chau Wang, L.L.

    1981-01-01

    Topics covered include: loop-space formulation of gauge theory - loop-space chiral equation; two dimensional chiral equation - conservation laws, linear system and integrability; and parallel development for the loop-space chiral equation - subtlety

  20. Incidence and Risk Factors for Blood Transfusion in Total Joint Arthroplasty: Analysis of a Statewide Database.

    Science.gov (United States)

    Slover, James; Lavery, Jessica A; Schwarzkopf, Ran; Iorio, Richard; Bosco, Joseph; Gold, Heather T

    2017-09-01

    Significant attempts have been made to adopt practices to minimize blood transfusion after total joint arthroplasty (TJA) because of transfusion cost and potential negative clinical consequences including allergic reactions, transfusion-related lung injuries, and immunomodulatory effects. We aimed to evaluate risk factors for blood transfusion in a large cohort of TJA patients. We used the all-payer California Healthcare Cost and Utilization Project data from 2006 to 2011 to examine the trends in utilization of blood transfusion among arthroplasty patients (n = 320,746). We performed descriptive analyses and multivariate logistic regression clustered by hospital, controlling for Deyo-Charlson comorbidity index, age, insurance type (Medicaid vs others), gender, procedure year, and race/ethnicity. Eighteen percent (n = 59,038) of TJA patients underwent blood transfusion during their surgery, from 15% with single knee to 45% for bilateral hip arthroplasty. Multivariate analysis indicated that compared with the referent category of single knee arthroplasty, single hip had a significantly higher odds of blood transfusion (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.68-1.83), as did bilateral knee (OR, 3.57; 95% CI, 3.20-3.98) and bilateral hip arthroplasty (OR, 6.17; 95% CI, 4.85-7.85). Increasing age (eg, age ≥80 years; OR, 2.99; 95% CI, 2.82-3.17), Medicaid insurance (OR, 1.36; 95% CI, 1.27-1.45), higher comorbidity index (eg, score of ≥3; OR, 2.33; 95% CI, 2.22-2.45), and females (OR, 1.75; 95% CI, 1.70-1.80) all had significantly higher odds of blood transfusion after TJA. Primary hip arthroplasties have significantly greater risk of transfusion than knee arthroplasties, and bilateral procedures have even greater risk, especially for hips. These factors should be considered when evaluating the risk for blood transfusions. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Mediterranean Storms: An Integrated Approach of Risk Management

    Science.gov (United States)

    Karageorgou, H.; Riza, E.; Linos, A.; Papanikolaou, D.

    2010-09-01

    Disaster by UN definition is "a serious disruption of the functioning of a community or a society, involving widespread human, material, economic, or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using only its own resources". Mediterranean storms induce flash floods caused by excessive amounts of rainfall within a short lasting period of time. The intensity and duration of precipitation, region geomorphology, urbanization and different governmental emergency management structures trigger different consequences between Mediterranean countries. The integrated approach in management of storm risk represents a holistic perspective including interactions between government, science and technology institutions, developing agencies, private sector, NGOs and public. Local authorities and national government are responsible for the design, preparation and decision on storm risk management policies and strategies considering scientific risk identifying, assessing and understanding. Efficient governance management requires satisfied response to early warning systems, functionality of the affected systems upon which society depends and appropriate focus on variable interest, beliefs, values and ideologies between social groups. Also an appropriate balancing of benefits and costs in an efficient and equitable manner is important for the governance risk management. Natural sciences in corporation with the engineering science have developed effective early prediction, warning and monitoring systems on storm and flood risk. The health sciences use prediction systems for health related hazards and consequences and the social sciences research estimates the human resilience during disasters and the factors which affect and determine the human behavior. Also social sciences survey the response of public to early warning messages, the appropriate communicative methods to distributing messages and mechanisms to improve public

  2. Reducing acquisition risk through integrated systems of systems engineering

    Science.gov (United States)

    Gross, Andrew; Hobson, Brian; Bouwens, Christina

    2016-05-01

    In the fall of 2015, the Joint Staff J7 (JS J7) sponsored the Bold Quest (BQ) 15.2 event and conducted planning and coordination to combine this event into a joint event with the Army Warfighting Assessment (AWA) 16.1 sponsored by the U.S. Army. This multipurpose event combined a Joint/Coalition exercise (JS J7) with components of testing, training, and experimentation required by the Army. In support of Assistant Secretary of the Army for Acquisition, Logistics, and Technology (ASA(ALT)) System of Systems Engineering and Integration (SoSE&I), Always On-On Demand (AO-OD) used a system of systems (SoS) engineering approach to develop a live, virtual, constructive distributed environment (LVC-DE) to support risk mitigation utilizing this complex and challenging exercise environment for a system preparing to enter limited user test (LUT). AO-OD executed a requirements-based SoS engineering process starting with user needs and objectives from Army Integrated Air and Missile Defense (AIAMD), Patriot units, Coalition Intelligence, Surveillance and Reconnaissance (CISR), Focused End State 4 (FES4) Mission Command (MC) Interoperability with Unified Action Partners (UAP), and Mission Partner Environment (MPE) Integration and Training, Tactics and Procedures (TTP) assessment. The SoS engineering process decomposed the common operational, analytical, and technical requirements, while utilizing the Institute of Electrical and Electronics Engineers (IEEE) Distributed Simulation Engineering and Execution Process (DSEEP) to provide structured accountability for the integration and execution of the AO-OD LVC-DE. As a result of this process implementation, AO-OD successfully planned for, prepared, and executed a distributed simulation support environment that responsively satisfied user needs and objectives, demonstrating the viability of an LVC-DE environment to support multiple user objectives and support risk mitigation activities for systems in the acquisition process.

  3. Integration of risk analysis, land use planning, and cost analysis

    International Nuclear Information System (INIS)

    Rajen, G.; Sanchez, G.

    1994-01-01

    The Department of Energy (DOE) and the Pueblo of San Ildefonso (Pueblo), which is a sovereign Indian tribe, have often been involved in adversarial situations regarding the Los Alamos National Laboratory (LANL). The Pueblo shares a common boundary with the LANL. This paper describes an on-going project that could alter the DOE and the Pueblo's relationship to one of cooperation; and unite the DOE and the Pueblo in a Pollution Prevention/Waste Minimization, and Integrated Risk Analysis and Land Use Planning effort

  4. The carcinogenic risk of high dose total body irradiation in non-human primates

    International Nuclear Information System (INIS)

    Broerse, J.J.; Bartstra, R.W.; Bekkum, D.W. van; Hage, M.H. van der; Zurcher, C.; Zwieten, M.J. van; Hollander, C.F.

    2000-01-01

    High dose total body irradiation (TBI) in combination with chemotherapy, followed by rescue with bone marrow transplantation (BMT), is increasingly used for the treatment of haematological malignancies. With the increasing success of this treatment and its current introduction for treating refractory autoimmune diseases the risk of radiation carcinogenesis is of growing concern. Studies on turnout induction in non-human primates are of relevance in this context since the response of this species to radiation does not differ much from that in man. Since the early sixties, studies have been performed on acute effects in Rhesus monkeys and the protective action of bone marrow transplantation after irradiation with X-rays (average total body dose 6.8 Gy) and fission neutrons (average dose 3.4 Gy). Of those monkeys, which were irradiated and reconstituted with autologous bone marrow, 20 animals in the X-irradiated group and nine animals in the neutron group survived more than 3 years. A group of 21 non-irradiated Rhesus monkeys of a comparable age distribution served as controls. All animals were regularly screened for the occurrence of neoplasms. Complete necropsies were performed after natural death or euthanasia. At post-irradiation intervals of 4-21 years an appreciable number of tumours was observed. In the neutron irradiated group eight out of nine animals died with one or more malignant tumours. In the X-irradiated group this fraction was 10 out of 20. The tumours in the control group, in seven out of the 21 animals, appeared at much older a-e compared with those in the irradiated cohorts. The histogenesis of the tumours was diverse with a preponderance of renal carcinoma, sarcomas among which osteosarcormas, and malignant glomus tumours in the irradiated groups. When corrected for competing risks, the carcinogenic risk of TBI in the Rhesus monkeys is similar to that derived from the studies of the Japanese atomic bomb survivors. The increase of the risk by a

  5. Integrated Data Fusion and Mining Techniques for Monitoring Total Organic Carbon Concentrations in a Lake

    Science.gov (United States)

    Total organic carbon (TOC) in surface waters, markedly of seasonal variations, is a known precursor of disinfection byproducts such as Total Trihalomethanes (TTHM) in drinking water treatment. Real-time knowledge of TOC distribution in source water can help treatment operation to...

  6. Towards integrative risk management and more resilient societies

    Science.gov (United States)

    Al-Khudhairy, D.; Axhausen, K.; Bishop, S.; Herrmann, H.; Hu, B.; Kröger, W.; Lewis, T.; MacIntosh, J.; Nowak, A.; Pickl, S.; Stauffacher, D.; Tan, E.

    2012-11-01

    Society depends decisively on the availability of infrastructure systems such as energy, telecommunication, transportation, banking and finance, health care and governmental and public administration. Even selective damages of one of these infrastructures may result in disruptions of governmental, industrial or public functions. Vulnerability of infrastructures therefore provides spectacular leverage for natural disasters as well as criminal and terrorist actions. Threats and risks are part of the technological, economical, and societal development. This article focuses on the development and characterization of an integrative risk-management which, from the perspective of "resilient systems", can be seen as an innovative and pro-active crisis management approach dealing with the increasing amount of complexity in societies in a comprehensive, agile and adaptive way.

  7. Daily total physical activity level and total cancer risk in men and women: results from a large-scale population-based cohort study in Japan.

    Science.gov (United States)

    Inoue, Manami; Yamamoto, Seiichiro; Kurahashi, Norie; Iwasaki, Motoki; Sasazuki, Shizuka; Tsugane, Shoichiro

    2008-08-15

    The impact of total physical activity level on cancer risk has not been fully clarified, particularly in non-Western, relatively lean populations. The authors prospectively examined the association between daily total physical activity (using a metabolic equivalents/day score) and subsequent cancer risk in the Japan Public Health Center-based Prospective Study. A total of 79,771 general-population Japanese men and women aged 45-74 years who responded to a questionnaire in 1995-1999 were followed for total cancer incidence (4,334 cases) through 2004. Compared with subjects in the lowest quartile, increased daily physical activity was associated with a significantly decreased risk of cancer in both sexes. In men, hazard ratios for the second, third, and highest quartiles were 1.00 (95% confidence interval (CI): 0.90, 1.11), 0.96 (95% CI: 0.86, 1.07), and 0.87 (95% CI: 0.78, 0.96), respectively (p for trend = 0.005); in women, hazard ratios were 0.93 (95% CI: 0.82, 1.05), 0.84 (95% CI: 0.73, 0.96), and 0.84 (95% CI: 0.73, 0.97), respectively (p for trend = 0.007). The decreased risk was more clearly observed in women than in men, especially among the elderly and those who regularly engaged in leisure-time sports or physical exercise. By site, decreased risks were observed for cancers of the colon, liver, and pancreas in men and for cancer of the stomach in women. Increased daily physical activity may be beneficial in preventing cancer in a relatively lean population.

  8. Application of the integrated analysis of safety (ISA) to sequences of Total loss of feed water in a PWR Reactor

    International Nuclear Information System (INIS)

    Moreno Chamorro, P.; Gallego Diaz, C.

    2011-01-01

    The main objective of this work is to show the current status of the implementation of integrated analysis of safety (ISA) methodology and its SCAIS associated tool (system of simulation codes for ISA) to the sequence analysis of total loss of feedwater in a PWR reactor model Westinghouse of three loops with large, dry containment.

  9. Integrated Autopilot/Autothrottle Based on a Total Energy Control Concept: Design and Evaluation of Additional Autopilot Modes

    Science.gov (United States)

    Bruce, Kevin R.

    1988-01-01

    An integrated autopilot/autothrottle system was designed using a total energy control design philosophy. This design ensures that the system can differentiate between maneuvers requiring a change in thrust to accomplish a net energy change, and those maneuvers which only require elevator control to redistribute energy. The system design, the development of the system, and a summary of simulation results are defined.

  10. An Integrated and Interdisciplinary Model for Predicting the Risk of Injury and Death in Future Earthquakes.

    Science.gov (United States)

    Shapira, Stav; Novack, Lena; Bar-Dayan, Yaron; Aharonson-Daniel, Limor

    2016-01-01

    A comprehensive technique for earthquake-related casualty estimation remains an unmet challenge. This study aims to integrate risk factors related to characteristics of the exposed population and to the built environment in order to improve communities' preparedness and response capabilities and to mitigate future consequences. An innovative model was formulated based on a widely used loss estimation model (HAZUS) by integrating four human-related risk factors (age, gender, physical disability and socioeconomic status) that were identified through a systematic review and meta-analysis of epidemiological data. The common effect measures of these factors were calculated and entered to the existing model's algorithm using logistic regression equations. Sensitivity analysis was performed by conducting a casualty estimation simulation in a high-vulnerability risk area in Israel. the integrated model outcomes indicated an increase in the total number of casualties compared with the prediction of the traditional model; with regard to specific injury levels an increase was demonstrated in the number of expected fatalities and in the severely and moderately injured, and a decrease was noted in the lightly injured. Urban areas with higher populations at risk rates were found more vulnerable in this regard. The proposed model offers a novel approach that allows quantification of the combined impact of human-related and structural factors on the results of earthquake casualty modelling. Investing efforts in reducing human vulnerability and increasing resilience prior to an occurrence of an earthquake could lead to a possible decrease in the expected number of casualties.

  11. Approaches to cancer assessment in EPA's Integrated Risk Information System.

    Science.gov (United States)

    Gehlhaus, Martin W; Gift, Jeffrey S; Hogan, Karen A; Kopylev, Leonid; Schlosser, Paul M; Kadry, Abdel-Razak

    2011-07-15

    The U.S. Environmental Protection Agency's (EPA) Integrated Risk Information System (IRIS) Program develops assessments of health effects that may result from chronic exposure to chemicals in the environment. The IRIS database contains more than 540 assessments. When supported by available data, IRIS assessments provide quantitative analyses of carcinogenic effects. Since publication of EPA's 2005 Guidelines for Carcinogen Risk Assessment, IRIS cancer assessments have implemented new approaches recommended in these guidelines and expanded the use of complex scientific methods to perform quantitative dose-response assessments. Two case studies of the application of the mode of action framework from the 2005 Cancer Guidelines are presented in this paper. The first is a case study of 1,2,3-trichloropropane, as an example of a chemical with a mutagenic mode of carcinogenic action thus warranting the application of age-dependent adjustment factors for early-life exposure; the second is a case study of ethylene glycol monobutyl ether, as an example of a chemical with a carcinogenic action consistent with a nonlinear extrapolation approach. The use of physiologically based pharmacokinetic (PBPK) modeling to quantify interindividual variability and account for human parameter uncertainty as part of a quantitative cancer assessment is illustrated using a case study involving probabilistic PBPK modeling for dichloromethane. We also discuss statistical issues in assessing trends and model fit for tumor dose-response data, analysis of the combined risk from multiple types of tumors, and application of life-table methods for using human data to derive cancer risk estimates. These issues reflect the complexity and challenges faced in assessing the carcinogenic risks from exposure to environmental chemicals, and provide a view of the current trends in IRIS carcinogenicity risk assessment. Copyright © 2011. Published by Elsevier Inc.

  12. Approaches to cancer assessment in EPA's Integrated Risk Information System

    International Nuclear Information System (INIS)

    Gehlhaus, Martin W.; Gift, Jeffrey S.; Hogan, Karen A.; Kopylev, Leonid; Schlosser, Paul M.; Kadry, Abdel-Razak

    2011-01-01

    The U.S. Environmental Protection Agency's (EPA) Integrated Risk Information System (IRIS) Program develops assessments of health effects that may result from chronic exposure to chemicals in the environment. The IRIS database contains more than 540 assessments. When supported by available data, IRIS assessments provide quantitative analyses of carcinogenic effects. Since publication of EPA's 2005 Guidelines for Carcinogen Risk Assessment, IRIS cancer assessments have implemented new approaches recommended in these guidelines and expanded the use of complex scientific methods to perform quantitative dose-response assessments. Two case studies of the application of the mode of action framework from the 2005 Cancer Guidelines are presented in this paper. The first is a case study of 1,2,3-trichloropropane, as an example of a chemical with a mutagenic mode of carcinogenic action thus warranting the application of age-dependent adjustment factors for early-life exposure; the second is a case study of ethylene glycol monobutyl ether, as an example of a chemical with a carcinogenic action consistent with a nonlinear extrapolation approach. The use of physiologically based pharmacokinetic (PBPK) modeling to quantify interindividual variability and account for human parameter uncertainty as part of a quantitative cancer assessment is illustrated using a case study involving probabilistic PBPK modeling for dichloromethane. We also discuss statistical issues in assessing trends and model fit for tumor dose-response data, analysis of the combined risk from multiple types of tumors, and application of life-table methods for using human data to derive cancer risk estimates. These issues reflect the complexity and challenges faced in assessing the carcinogenic risks from exposure to environmental chemicals, and provide a view of the current trends in IRIS carcinogenicity risk assessment.

  13. Integrated risk assessment for spent fuel transportation using developed software

    International Nuclear Information System (INIS)

    Yun, Mi Rae; Christian, Robby; Kim, Bo Gyung; Almomani, Belal; Ham, Jae Hyun; Kang, Gook Hyun; Lee, Sang hoon

    2016-01-01

    As on-site spent fuel storage meets limitation of their capacity, spent fuel need to be transported to other place. In this research, risk of two ways of transportation method, maritime transportation and on-site transportation, and interim storage facility were analyzed. Easier and integrated risk assessment for spent fuel transportation will be possible by applying this software. Risk assessment for spent fuel transportation has not been researched and this work showed a case for analysis. By using this analysis method and developed software, regulators can get some insights for spent fuel transportation. For example, they can restrict specific region for preventing ocean accident and also they can arrange spend fuel in interim storage facility avoiding most risky region which have high risk from aircraft engine shaft. Finally, they can apply soft material on the floor for specific stage for on-site transportation. In this software, because we targeted Korea, we need to use Korean reference data. However, there were few Korean reference data. Especially, there was no food chain data for Korean ocean. In MARINRAD, they used steady state food chain model, but it is far from reality. Therefore, to get Korean realistic reference data, dynamic food chain model for Korean ocean need to be developed

  14. Integrated risk assessment for spent fuel transportation using developed software

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Mi Rae; Christian, Robby; Kim, Bo Gyung; Almomani, Belal; Ham, Jae Hyun; Kang, Gook Hyun [KAIST, Daejeon (Korea, Republic of); Lee, Sang hoon [Keimyung University, Daegu (Korea, Republic of)

    2016-05-15

    As on-site spent fuel storage meets limitation of their capacity, spent fuel need to be transported to other place. In this research, risk of two ways of transportation method, maritime transportation and on-site transportation, and interim storage facility were analyzed. Easier and integrated risk assessment for spent fuel transportation will be possible by applying this software. Risk assessment for spent fuel transportation has not been researched and this work showed a case for analysis. By using this analysis method and developed software, regulators can get some insights for spent fuel transportation. For example, they can restrict specific region for preventing ocean accident and also they can arrange spend fuel in interim storage facility avoiding most risky region which have high risk from aircraft engine shaft. Finally, they can apply soft material on the floor for specific stage for on-site transportation. In this software, because we targeted Korea, we need to use Korean reference data. However, there were few Korean reference data. Especially, there was no food chain data for Korean ocean. In MARINRAD, they used steady state food chain model, but it is far from reality. Therefore, to get Korean realistic reference data, dynamic food chain model for Korean ocean need to be developed.

  15. Acetabular cup position and risk of dislocation in primary total hip arthroplasty

    DEFF Research Database (Denmark)

    Seagrave, Kurt G; Troelsen, Anders; Malchau, Henrik

    2017-01-01

    Background and purpose - Hip dislocation is one of the most common complications following total hip arthroplasty (THA). Several factors that affect dislocation have been identified, including acetabular cup positioning. Optimal values for cup inclination and anteversion are debatable. We performed...... a systematic review to describe the different methods for measuring cup placement, target zones for cup positioning, and the association between cup positioning and dislocation following primary THA. Methods - A systematic search of literature in the PubMed database was performed (January and February 2016......) to identify articles that compared acetabular cup positioning and the risk of dislocation. Surgical approach and methods for measurement of cup angles were also considered. Results - 28 articles were determined to be relevant to our research question. Some articles demonstrated that cup positioning influenced...

  16. La auditoría integral o total informe final del proyecto

    OpenAIRE

    Casal, Armando Miguel

    1999-01-01

    Se propone dar una perspectiva de conjunto de la auditoría integral, considerando que dicha expresión no está todavía comprendida en forma adecuada. Dicha auditoría representa un concepto en evolución a lo largo del tiempo, que incluye sus diferentes enfoques y la necesidad de su aplicación en los distintos sectores de la economía, tanto públicos, como privados o mixtos.La auditoría integral fue desarrollada originalmente en el sector público, para que los auditores independientes, proporcion...

  17. [Risk factors for elevated serum total bile acid in preterm infants].

    Science.gov (United States)

    Song, Yan-Ting; Wang, Yong-Qin; Zhao, Yue-Hua; Zhu, Hai-Ling; Liu, Qian; Zhang, Xiao; Gao, Yi-Wen; Zhang, Wei-Ye; Sang, Yu-Tong

    2018-03-01

    To study the risk factors for elevated serum total bile acid (TBA) in preterm infants. A retrospective analysis was performed for the clinical data of 216 preterm infants who were admitted to the neonatal intensive care unit. According to the presence or absence of elevated TBA (TBA >24.8 μmol/L), the preterm infants were divided into elevated TBA group with 53 infants and non-elevated TBA group with 163 infants. A univariate analysis and an unconditional multivariate logistic regression analysis were used to investigate the risk factors for elevated TBA. The univariate analysis showed that there were significant differences between the elevated TBA group and the non-elevated TBA group in gestational age at birth, birth weight, proportion of small-for-gestational-age infants, proportion of infants undergoing ventilator-assisted ventilation, fasting time, parenteral nutrition time, and incidence of neonatal respiratory failure and sepsis (PTBA in preterm infants. Low birth weight and neonatal sepsis may lead to elevated TBA in preterm infants.

  18. Oil characterisation: assessment of composition, risks, degradation and remediation potential of total petroleum hydrocarbons in soil

    International Nuclear Information System (INIS)

    Lookman, R.; Vanermen, G.; Van De Weghe, H.; Gemoets, J.; Van der Sterren, G.; Alphenaar, A.

    2005-01-01

    Several methods are available for the characterization of petroleum hydrocarbons. The TPHCWG (Total Petroleum Hydrocarbon Criteria Working Group) developed a method based on a silica column separation of aromatics and aliphatics and a GC-FID subdivision into equivalent-carbon fractions (EC) ('TPH-method'). This method was mainly developed for assessing human risks of oil compounds. Within NOBIS (Dutch Research program Biological In-situ Remediation), another method was developed based upon an equilibrium-experiment of the oil-polluted soil with water (column recirculation), which was further developed by TTE ('TTE-method'). This method uses measured water solubilities of individual oil components and GC-retention times yielding a subdivision of the hydrocarbons into compound classes that are relevant for assessing the remediation potential of the specific oil pollution. In this paper we present results of a research project in which we developed a new method, the 'OK-method' that combines these two procedures and allows a complete characterisation of the oil in terms of composition, (human) risks, volatility, solubility, plume behaviour (migration velocities of the soluble components) and aerobic degradation potential. (authors)

  19. Oil characterisation: assessment of composition, risks, degradation and remediation potential of total petroleum hydrocarbons in soil

    Energy Technology Data Exchange (ETDEWEB)

    Lookman, R.; Vanermen, G.; Van De Weghe, H.; Gemoets, J. [Vito, Mol (Belgium); Van der Sterren, G.; Alphenaar, A. [TTE, Deventer (Netherlands)

    2005-07-01

    Several methods are available for the characterization of petroleum hydrocarbons. The TPHCWG (Total Petroleum Hydrocarbon Criteria Working Group) developed a method based on a silica column separation of aromatics and aliphatics and a GC-FID subdivision into equivalent-carbon fractions (EC) ('TPH-method'). This method was mainly developed for assessing human risks of oil compounds. Within NOBIS (Dutch Research program Biological In-situ Remediation), another method was developed based upon an equilibrium-experiment of the oil-polluted soil with water (column recirculation), which was further developed by TTE ('TTE-method'). This method uses measured water solubilities of individual oil components and GC-retention times yielding a subdivision of the hydrocarbons into compound classes that are relevant for assessing the remediation potential of the specific oil pollution. In this paper we present results of a research project in which we developed a new method, the 'OK-method' that combines these two procedures and allows a complete characterisation of the oil in terms of composition, (human) risks, volatility, solubility, plume behaviour (migration velocities of the soluble components) and aerobic degradation potential. (authors)

  20. Risk of contralateral avascular necrosis (AVN) after total hip arthroplasty (THA) for non-traumatic AVN.

    Science.gov (United States)

    Goker, Berna; Block, Joel A

    2006-01-01

    The risk of developing bilateral disease progressing to total hip arthroplasty (THA) among patients who undergo unilateral THA for non-traumatic avascular necrosis (AVN) remains poorly understood. An analysis of the time-course to contralateral THA, as well as the effects of underlying AVN risk factors, is presented. Forty-seven consecutive patients who underwent THA for AVN were evaluated. Peri-operative and annual post-operative antero-posterior pelvis radiographs were examined for evidence of contralateral involvement. Patient age, weight, height, underlying AVN risk factor(s), date of onset of contralateral hip pain if occurred, and date of contralateral THA if performed, were recorded. Bone scan, computerized tomography and magnetic resonance imaging data were utilized when available. Twenty-one patients (46.6%) underwent contralateral THA for AVN within a median of 9 months after the initial THA (range 0-93, interquartile range 28.5 months). The median follow-up for patients without contralateral THA was 75 months (range 3-109, interquartile range 69 months). Thirty-four patients had radiographic findings of contralateral AVN at study entry; 25 were symptomatic bilaterally at entry and 7 developed contralateral symptoms within a mean time of 12 months (median 10 months, interquartile range 12 months). None of the 13 patients who were free of radiographic evidence of contralateral AVN at study entry developed evidence of AVN during the follow-up. AVN associated with glucocorticoid use was more likely to manifest as bilateral disease than either idiopathic AVN or ethanol-associated AVN (P=0.02 and P=0.03 respectively). Radiographically-evident AVN in the contralateral hip at THA is unlikely to remain asymptomatic for a prolonged period of time. Conversely, asymptomatic contralateral hips without radiographic evidence of AVN are unlikely to develop clinically significant AVN.

  1. Quantifying Blood Loss and Transfusion Risk After Primary vs Conversion Total Hip Arthroplasty.

    Science.gov (United States)

    Newman, Jared M; Webb, Matthew R; Klika, Alison K; Murray, Trevor G; Barsoum, Wael K; Higuera, Carlos A

    2017-06-01

    Primary total hip arthroplasty (THA) and conversion THA may result in substantial blood loss, sometimes necessitating transfusion. Despite the complexities of the latter, both are grouped in the same category for quality assessment and reimbursement. This study's purpose was to compare both blood loss and transfusion risk in primary and conversion THA and identify their associated predictors. A total of 1616 patients who underwent primary and conversion THA at a single hospital from 2009-2013 were reviewed (primary THA = 1575; conversion THA = 41). Demographics, comorbidities, and perioperative data were collected from electronic records. Blood loss was calculated using a validated method. Transfusion triggers were based on standardized criteria. Separate multivariable regression models for blood loss and transfusion were performed. Conversion THA patients were younger (P = .002), had lower age-adjusted Charlson scores (P = .006), longer surgeries (P quantified in the present study and showed consistent results between the 2 metrics. The differences between these procedures should be addressed during quality assurance because conversion THA is associated with higher resource utilization, which is important in the allocation of resources and tiered reimbursement strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Integrated Risk Assessment to Natural Hazards in Motozintla, Chiapas, Mexico

    Science.gov (United States)

    Novelo-Casanova, D. A.

    2012-12-01

    An integrated risk assessment includes the analysis of all components of individual constituents of risk such as baseline study, hazard identification and categorization, hazard exposure, and vulnerability. Vulnerability refers to the inability of people, organizations, and societies to withstand adverse impacts from multiple stressors to which they are exposed. These impacts are due to characteristics inherent in social interactions, institutions, and systems of cultural values. Thus, social vulnerability is a pre-existing condition that affects a society's ability to prepare for and recover from a disruptive event. Risk is the probability of a loss, and this loss depends on three elements: hazard, exposure, and vulnerability. Thus, risk is the estimated impact that a hazard event would have on people, services, facilities, structures and assets in a community. In this work we assess the risk to natural hazards in the community of Motozintla located in southern Mexico in the state of Chiapas (15.37N, 92.25W) with a population of about 20 000 habitants. Due to its geographical and geological location, this community is continuously exposed to many different natural hazards (earthquakes, landslides, volcanic eruptions, and floods). To determine the level of exposure of the community to natural hazards, we developed integrated studies and analysis of seismic microzonation, landslide and flood susceptibility as well as volcanic impact using standard methodologies. Social vulnerability was quantified from data obtained from local families interviews. Five variables were considered: household structure quality and design, availability of basic public services, family economic conditions, existing family plans for disaster preparedness, and risk perception.The number of families surveyed was determined considering a sample statistically significant. The families that were interviewed were selected using the simple random sampling technique with replacement. With these

  3. On integrating modeling software for application to total-system performance assessment

    International Nuclear Information System (INIS)

    Lewis, L.C.; Wilson, M.L.

    1994-05-01

    We examine the processes and methods used to facilitate collaboration in software development between two organizations at separate locations -- Lawrence Livermore National Laboratory (LLNL) in California and Sandia National Laboratories (SNL) in New Mexico. Our software development process integrated the efforts of these two laboratories. Software developed at LLNL to model corrosion and failure of waste packages and subsequent releases of radionuclides was incorporated as a source term into SNLs computer models for fluid flow and radionuclide transport through the geosphere

  4. Integrative Understanding of Familial Impulsivity, Early Adversity and Suicide Risk

    Directory of Open Access Journals (Sweden)

    Isabela M. M. Lima

    2017-12-01

    Full Text Available Introduction: Impulsivity is a core characteristic of bipolar disorder and it was observed as elevated in individuals with the disorder and in their relatives. Both impulsivity and history of maltreatment are risk factors for suicide attempts, however, these two key variables may not be independent, given the fact that parental impulsivity and associated social context could increase the risk of child maltreatment. In this study it was examined the association between the impulsivity of relatives and child maltreatment taking into consideration the conjoint and unique effects of these two variables on the risk of suicide attempts among the patients.Materials and Methods: Participants of the study consisted of 117 patients diagnosed with bipolar disorder and 25 first-degree relatives. Linear regression model was conducted to describe associations between facets of impulsivity of relatives and levels of child maltreatment reported by patients. The independent associations of suicide attempt history with the dimensions of impulsivity of the patient and maltreatment were tested by multinomial logistic regression.Results: Impulsivity of relatives and, more specifically, inhibitory control can predict the maltreatment of the patient. Inhibitory control and emotional abuse were related, conjointly, to a greater likelihood of having a history of more than one suicide attempt.Discussion: Considering that the impulsivity of relatives predicts child maltreatment, it is possible that a genetically shared impulsivity is an underlying feature associated with the history of multiple suicide attempts. These findings highlight the importance of considering child maltreatment, impulsivity and suicide attempt history in integrative models.

  5. Integrative Understanding of Familial Impulsivity, Early Adversity and Suicide Risk.

    Science.gov (United States)

    Lima, Isabela M M; Malloy-Diniz, Leandro F; de Miranda, Débora M; Da Silva, Antônio G; Neves, Fernando S; Johnson, Sheri L

    2017-01-01

    Introduction: Impulsivity is a core characteristic of bipolar disorder and it was observed as elevated in individuals with the disorder and in their relatives. Both impulsivity and history of maltreatment are risk factors for suicide attempts, however, these two key variables may not be independent, given the fact that parental impulsivity and associated social context could increase the risk of child maltreatment. In this study it was examined the association between the impulsivity of relatives and child maltreatment taking into consideration the conjoint and unique effects of these two variables on the risk of suicide attempts among the patients. Materials and Methods: Participants of the study consisted of 117 patients diagnosed with bipolar disorder and 25 first-degree relatives. Linear regression model was conducted to describe associations between facets of impulsivity of relatives and levels of child maltreatment reported by patients. The independent associations of suicide attempt history with the dimensions of impulsivity of the patient and maltreatment were tested by multinomial logistic regression. Results: Impulsivity of relatives and, more specifically, inhibitory control can predict the maltreatment of the patient. Inhibitory control and emotional abuse were related, conjointly, to a greater likelihood of having a history of more than one suicide attempt. Discussion: Considering that the impulsivity of relatives predicts child maltreatment, it is possible that a genetically shared impulsivity is an underlying feature associated with the history of multiple suicide attempts. These findings highlight the importance of considering child maltreatment, impulsivity and suicide attempt history in integrative models.

  6. A comparison of integrated safety analysis and probabilistic risk assessment

    International Nuclear Information System (INIS)

    Damon, Dennis R.; Mattern, Kevin S.

    2013-01-01

    The U.S. Nuclear Regulatory Commission conducted a comparison of two standard tools for risk informing the regulatory process, namely, the Probabilistic Risk Assessment (PRA) and the Integrated Safety Analysis (ISA). PRA is a calculation of risk metrics, such as Large Early Release Frequency (LERF), and has been used to assess the safety of all commercial power reactors. ISA is an analysis required for fuel cycle facilities (FCFs) licensed to possess potentially critical quantities of special nuclear material. A PRA is usually more detailed and uses more refined models and data than an ISA, in order to obtain reasonable quantitative estimates of risk. PRA is considered fully quantitative, while most ISAs are typically only partially quantitative. The extension of PRA methodology to augment or supplant ISAs in FCFs has long been considered. However, fuel cycle facilities have a wide variety of possible accident consequences, rather than a few surrogates like LERF or core damage as used for reactors. It has been noted that a fuel cycle PRA could be used to better focus attention on the most risk-significant structures, systems, components, and operator actions. ISA and PRA both identify accident sequences; however, their treatment is quite different. ISA's identify accidents that lead to high or intermediate consequences, as defined in 10 Code of Federal Regulations (CFR) 70, and develop a set of Items Relied on For Safety (IROFS) to assure adherence to performance criteria. PRAs identify potential accident scenarios and estimate their frequency and consequences to obtain risk metrics. It is acceptable for ISAs to provide bounding evaluations of accident consequences and likelihoods in order to establish acceptable safety; but PRA applications usually require a reasonable quantitative estimate, and often obtain metrics of uncertainty. This paper provides the background, features, and methodology associated with the PRA and ISA. The differences between the

  7. Risk factors for early complications after laparoscopic total mesorectal excision for locally advanced rectal cancer: A single center experience

    Directory of Open Access Journals (Sweden)

    Liye Liu

    2016-01-01

    Conclusions: Aged patients, large tumor, lower tumor location and conversion were risk factors in performing laparoscopic TME for locally advanced rectal cancer. Patients with these characteristics should be carefully considered before undergoing laparoscopic total mesorectal excision.

  8. [Integrated Management Area of Vascular Risk: A new organisational model for global control of risk factors].

    Science.gov (United States)

    Armario, P; Jericó, C; Vila, L; Freixa, R; Martin-Castillejos, C; Rotllan, M

    Cardiovascular disease (CVD), is a major cause of morbidity and mortality that increases the cost of care. Currently there is a low degree of control of the main cardiovascular risk factors, although we have a good therapeutic arsenal. To achieve the improvement of this reality, a good coordination and multidisciplinary participation are essential. The development of new organizational models such as the Integrated Management Area of Vascular Risk can facilitate the therapeutic harmonization and unification of the health messages offered by different levels of care, based on clinical practice guidelines, in order to provide patient-centred integrated care. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Integrating a Social Behavior Intervention during Small Group Academic Instruction Using a Total Group Criterion Intervention

    Science.gov (United States)

    Rodriguez, Billie Jo; Anderson, Cynthia M.

    2014-01-01

    Total group contingencies, a variation of interdependent group contingencies, provide educators with an efficient and effective mechanism to improve social behavior and increase academic skills. Their utility has not been examined in small educational groups. This is unfortunate as supplemental instruction frequently is delivered in small group…

  10. 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...

  11. Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation

    International Nuclear Information System (INIS)

    Li, Richard; Polishchuk, Alexei; DuBois, Steven; Hawkins, Randall; Lee, Stephanie W.; Bagatell, Rochelle; Shusterman, Suzanne; Hill-Kayser, Christine; Al-Sayegh, Hasan; Diller, Lisa; Haas-Kogan, Daphne A.; Matthay, Katherine K.; London, Wendy B.

    2017-01-01

    Purpose: External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials: We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results: Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease (P=.03). Conclusions: Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy.

  12. Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Li, Richard [Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Polishchuk, Alexei [School of Medicine, University of California San Francisco, San Francisco, California (United States); DuBois, Steven [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Hawkins, Randall [School of Medicine, University of California San Francisco, San Francisco, California (United States); Lee, Stephanie W. [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Bagatell, Rochelle [Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania (United States); Shusterman, Suzanne [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Hill-Kayser, Christine [Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Al-Sayegh, Hasan [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Diller, Lisa [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Haas-Kogan, Daphne A. [Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Matthay, Katherine K. [School of Medicine, University of California San Francisco, San Francisco, California (United States); London, Wendy B. [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); and others

    2017-02-01

    Purpose: External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials: We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results: Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease (P=.03). Conclusions: Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy.

  13. Low-dose total skin electron beam therapy for cutaneous lymphoma : Minimal risk of acute toxicities.

    Science.gov (United States)

    Kroeger, Kai; Elsayad, Khaled; Moustakis, Christos; Haverkamp, Uwe; Eich, Hans Theodor

    2017-12-01

    Low-dose total skin electron beam therapy (TSEBT) is attracting increased interest for the effective palliative treatment of primary cutaneous T‑cell lymphoma (pCTCL). In this study, we compared toxicity profiles following various radiation doses. We reviewed the records of 60 patients who underwent TSEBT for pCTCL between 2000 and 2016 at the University Hospital of Munster. The treatment characteristics of the radiotherapy (RT) regimens and adverse events (AEs) were then analyzed and compared. In total, 67 courses of TSEBT were administered to 60 patients. Of these patients, 34 (51%) received a standard dose with a median surface dose of 30 Gy and 33 patients (49%) received a low dose with the median surface dose of 12 Gy (7 salvage low-dose TSEBT courses were administered to 5 patients). After a median follow-up of 15 months, the overall AE rate was 100%, including 38 patients (57%) with grade 2 and 7 (10%) with grade 3 AEs. Patients treated with low-dose TSEBT had significantly fewer grade 2 AEs than those with conventional dose regimens (33 vs. 79%, P dose regimen compared to those with the conventional dose regimens (6 vs. 15%, P = 0.78). Multiple/salvage low-dose TSEBT courses were not associated with an increased risk of acute AEs. Low-dose TSEBT regimens are associated with significantly fewer grade 2 acute toxicities compared with conventional doses of TSEBT. Repeated/Salvage low-dose TSEBT, however, appears to be tolerable and can even be applied safely in patients with cutaneous relapses.

  14. Psychological factors as risk factors for poor hip function after total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Benditz A

    2017-02-01

    Full Text Available Achim Benditz,1 Petra Jansen,2 Jan Schaible,1 Christina Roll,1 Joachim Grifka,1 Jürgen Götz1 1Department of Orthopedics, University Medical Center Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, 2Department of Sport Science, University of Regensburg, Regensburg, Germany Abstract: Recovery after total hip arthroplasty (THA is influenced by several psychological aspects, such as depression, anxiety, resilience, and personality traits. We hypothesized that preoperative depression impedes early functional outcome after THA (primary outcome measure. Additional objectives were perioperative changes in the psychological status and their influence on perioperative outcome. This observational study analyzed depression, anxiety, resilience, and personality traits in 50 patients after primary unilateral THA. Hip functionality was measured by means of the Harris Hip Score. Depression, state anxiety, and resilience were evaluated preoperatively as well as 1 and 5 weeks postoperatively. Trait anxiety and personality traits were measured once preoperatively. Patients with low depression and anxiety levels had significantly better outcomes with respect to early hip functionality. Resilience and personality traits did not relate to hip functionality. Depression and state anxiety levels significantly decreased within the 5-week stay in the acute and rehabilitation clinic, whereas resilience remained at the same level. Our study suggests that low depression and anxiety levels are positively related to early functionality after THA. Therefore, perioperative measurements of these factors seem to be useful to provide the best support for patients with risk factors. Keywords: total hip arthroplasty, psychological factors, depression, state anxiety, trait anxiety, resilience, personality traits

  15. Total elimination of sampling errors in polarization imagery obtained with integrated microgrid polarimeters.

    Science.gov (United States)

    Tyo, J Scott; LaCasse, Charles F; Ratliff, Bradley M

    2009-10-15

    Microgrid polarimeters operate by integrating a focal plane array with an array of micropolarizers. The Stokes parameters are estimated by comparing polarization measurements from pixels in a neighborhood around the point of interest. The main drawback is that the measurements used to estimate the Stokes vector are made at different locations, leading to a false polarization signature owing to instantaneous field-of-view (IFOV) errors. We demonstrate for the first time, to our knowledge, that spatially band limited polarization images can be ideally reconstructed with no IFOV error by using a linear system framework.

  16. Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk : Results from the EPIC cohort study

    NARCIS (Netherlands)

    Sanikini, Harinakshi; Dik, Vincent K.; Siersema, Peter D.; Bhoo-Pathy, Nirmala; Uiterwaal, Cuno S. P. M.; Peeters, Petra H. M.; Alez, Carlos A. Gonz; Zamora-Ros, Raul; Overvad, Kim; Nneland, Anne Tj; Roswall, Nina; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Racine, Antoine; Kuehn, Tilman; Katzke, Verena; Boeing, Heiner; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Lagiou, Pagona; Palli, Domenico; Grioni, Sara; Vineis, Paolo; Tumino, Rosario; Panico, Salvatore; Weiderpass, Elisabete; Skeie, Guri; Braaten, Tonje; Huerta, Jose Maria; Sanchez-Cantalejo, Emilio; Barricarte, Aurelio; Sonestedt, Emily; Wallstrom, Peter; Nilsson, Lena Maria; Johansson, Ingegerd; Bradbury, Kathryn E.; Khaw, Kay-Tee; Wareham, Nick; Huybrechts, Inge; Freisling, Heinz; Cross, Amanda J.; Riboli, Elio; Bueno-de-Mesquita, H. B(as)

    2015-01-01

    Prospective studies examining the association between coffee and tea consumption and gastric cancer risk have shown inconsistent results. We investigated the association between coffee (total, caffeinated and decaffeinated) and tea consumption and the risk of gastric cancer by anatomical site and

  17. Integrating a quantitative risk appraisal in a health impact assessment

    DEFF Research Database (Denmark)

    Adám, Balázs; Molnár, Agnes; Gulis, Gabriel

    2013-01-01

    BACKGROUND: Although the quantification of health outcomes in a health impact assessment (HIA) is scarce in practice, it is preferred by policymakers, as it assists various aspects of the decision-making process. This article provides an example of integrating a quantitative risk appraisal...... in an HIA performed for the recently adopted Hungarian anti-smoking policy which introduced a smoking ban in closed public places, workplaces and public transport vehicles, and is one of the most effective measures to decrease smoking-related ill health. METHODS: A comprehensive, prospective HIA...... to decrease the prevalence of active and passive smoking and result in a considerably positive effect on several diseases, among which lung cancer, chronic pulmonary diseases, coronary heart diseases and stroke have the greatest importance. The health gain calculated for the quantifiable health outcomes...

  18. Natriuretic peptides and integrated risk assessment for cardiovascular disease

    DEFF Research Database (Denmark)

    Willeit, Peter; Kaptoge, S; Welsh, P.

    2016-01-01

    samples and collection of data from studies identified through a systematic search of the literature (PubMed, Scientific Citation Index Expanded, and Embase) for articles published up to Sept 4, 2014, using search terms related to natriuretic peptide family members and the primary outcomes......BACKGROUND: Guidelines for primary prevention of cardiovascular diseases focus on prediction of coronary heart disease and stroke. We assessed whether or not measurement of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration could enable a more integrated approach than at present...... by predicting heart failure and enhancing coronary heart disease and stroke risk assessment. METHODS: In this individual-participant-data meta-analysis, we generated and harmonised individual-participant data from relevant prospective studies via both de-novo NT-proBNP concentration measurement of stored...

  19. Simulation analysis for integrated evaluation of technical and commercial risk

    International Nuclear Information System (INIS)

    Gutleber, D.S.; Heiberger, E.M.; Morris, T.D.

    1995-01-01

    Decisions to invest in oil- and gasfield acquisitions or participating interests often are based on the perceived ability to enhance the economic value of the underlying asset. A multidisciplinary approach integrating reservoir engineering, operations and drilling, and deal structuring with Monte Carlo simulation modeling can overcome weaknesses of deterministic analysis and significantly enhance investment decisions. This paper discusses the use of spreadsheets and Monte Carlo simulation to generate probabilistic outcomes for key technical and economic parameters for ultimate identification of the economic volatility and value of potential deal concepts for a significant opportunity. The approach differs from a simple risk analysis for an individual well by incorporating detailed, full-field simulations that vary the reservoir parameters, capital and operating cost assumptions, and schedules on timing in the framework of various deal structures

  20. Total petroleum hydrocarbons: Characterization of physico-chemical behaviour and risks

    Energy Technology Data Exchange (ETDEWEB)

    Gemoets, J.; Lookman, R.; Vanermen, G.; Houtven, D. van; Bertels, D.; Weltens, R.; Cornelis, C. [VITO, Mol (Belgium); Vries, P. de; Sterren, G. van der; Alphenaar, A. [TTE, Deventer (Netherlands)

    2003-07-01

    Several methods are available for the characterization of petroleum hydrocarbons. Recently, the TPHCWG (Total Petroleum Hydrocarbon Criteria Working Group) developed a method based upon a silica column separation of aromatics and aliphatics and a GC-FID subdivision into equivalent-carbon fractions (EC) ('TPH-method'). Within NOBIS (Dutch Research program Biological I-situ Remediation), another method was developed based upon an equilibrium-experiment of the oil-polluted soil with water (column recirculation), which was further developed by TTE ('TTE-method'). This method uses measured water solubilities of individual oil components and GC-retention times yielding a subdivision of the hydrocarbons into compound classes. The present study aims at a verification (reproducibility; accuracy) and optimization of both methods and a critical review on the relevance of the proposed fractions for the prediction of human health risks. Two 'umpire' methods were selected for reference: GS-MS in full scan mode and liquid state NMR. (orig.)

  1. Fractionated total lymphoid irradiation as preparative immunosuppression in high risk renal transplantation

    International Nuclear Information System (INIS)

    Najarian, J.S.; Ferguson, R.M.; Sutherland, D.E.; Slavin, S.; Kim, T.; Kersey, J.; Simmons, R.L.

    1982-01-01

    Twenty-two patients at high risk to reject renal allografts have been treated with fractionated total lymphoid irradiation (FTLI) prior to transplantation of primary (2), secondary (16) or tertiary (4) renal allografts. All patients undergoing retransplantation had rapidly rejected previous grafts. At 24 months following transplantation, 72% of grafts were functioning in the TLI group compared with a 38% graft function in an historical control group of recipients receiving secondary or tertiary grafts and treated with conventional immunosuppression. Important variables in determining success of transplantation following fractionated TLI include the dose of TLI, the interval from radiation to transplantation, and maintenance post-transplant immunosuppressive therapy. Optimal results were achieved with 2500 rads delivered in 100 rad fractions followed by transplantation within two weeks, and a tapering prednisone schedule and maintenance azathioprine post-transplantation. Seventeen patients had significant complications of the radiation treatment and there was one death, prior to transplantation, associated with pneumonitis. In vitro assessment of immune function demonstrated marked peripheral T cell depletion and loss of in vitro responsiveness to mitogen and allogeneic stimulation following FTLI. The administration of donor bone marrow at the time of transplantation did not produce chimerism. The results suggest that when properly utilized FTLI can produce effective adjunctive immunosuppression for clinical transplantation

  2. Total flying hours and risk of high systolic blood pressure in the civilian pilot in Indonesia

    Directory of Open Access Journals (Sweden)

    Ferdi Afian

    2016-07-01

    medical examinations in the Civil Aviation Medical Center  on 18 to 29 May 2015. Several data among other, others, were on demographic and job characteristics, clinical, exercise habits, eating habits, and history of the disease. High systolic blood pressure defined as systolic blood pressure  140 mmHg or more. Results: Of the 690 pilots who conduct periodic health examinations, 428 male pilots willing to participate this study. Age and history of hypertension is the dominant risk factor associated with high systolic blood pressure. When compared with the pilot age 19-39 years, 40-65 years old had 15.1-fold greater risk of high systolic blood pressure [odds ratio (adjusted ORa= 15.12; p= 0.001]. Pilot with a history of hypertension compared to those without a history of having high systolic blood pressure risk 93.2 times larger (ORa= 93.21; p= 0.001. Conclusion: Age of 40-65 years and had history of hypertension increased the riskj of systolic blood pressure among civilian pilot in Indonesia. Key words: systolic blood pressure, total flight hours, civilian pilot, Indonesia

  3. TotalReCaller: improved accuracy and performance via integrated alignment and base-calling.

    Science.gov (United States)

    Menges, Fabian; Narzisi, Giuseppe; Mishra, Bud

    2011-09-01

    Currently, re-sequencing approaches use multiple modules serially to interpret raw sequencing data from next-generation sequencing platforms, while remaining oblivious to the genomic information until the final alignment step. Such approaches fail to exploit the full information from both raw sequencing data and the reference genome that can yield better quality sequence reads, SNP-calls, variant detection, as well as an alignment at the best possible location in the reference genome. Thus, there is a need for novel reference-guided bioinformatics algorithms for interpreting analog signals representing sequences of the bases ({A, C, G, T}), while simultaneously aligning possible sequence reads to a source reference genome whenever available. Here, we propose a new base-calling algorithm, TotalReCaller, to achieve improved performance. A linear error model for the raw intensity data and Burrows-Wheeler transform (BWT) based alignment are combined utilizing a Bayesian score function, which is then globally optimized over all possible genomic locations using an efficient branch-and-bound approach. The algorithm has been implemented in soft- and hardware [field-programmable gate array (FPGA)] to achieve real-time performance. Empirical results on real high-throughput Illumina data were used to evaluate TotalReCaller's performance relative to its peers-Bustard, BayesCall, Ibis and Rolexa-based on several criteria, particularly those important in clinical and scientific applications. Namely, it was evaluated for (i) its base-calling speed and throughput, (ii) its read accuracy and (iii) its specificity and sensitivity in variant calling. A software implementation of TotalReCaller as well as additional information, is available at: http://bioinformatics.nyu.edu/wordpress/projects/totalrecaller/ fabian.menges@nyu.edu.

  4. Architecture for Integrated Medical Model Dynamic Probabilistic Risk Assessment

    Science.gov (United States)

    Jaworske, D. A.; Myers, J. G.; Goodenow, D.; Young, M.; Arellano, J. D.

    2016-01-01

    Probabilistic Risk Assessment (PRA) is a modeling tool used to predict potential outcomes of a complex system based on a statistical understanding of many initiating events. Utilizing a Monte Carlo method, thousands of instances of the model are considered and outcomes are collected. PRA is considered static, utilizing probabilities alone to calculate outcomes. Dynamic Probabilistic Risk Assessment (dPRA) is an advanced concept where modeling predicts the outcomes of a complex system based not only on the probabilities of many initiating events, but also on a progression of dependencies brought about by progressing down a time line. Events are placed in a single time line, adding each event to a queue, as managed by a planner. Progression down the time line is guided by rules, as managed by a scheduler. The recently developed Integrated Medical Model (IMM) summarizes astronaut health as governed by the probabilities of medical events and mitigation strategies. Managing the software architecture process provides a systematic means of creating, documenting, and communicating a software design early in the development process. The software architecture process begins with establishing requirements and the design is then derived from the requirements.

  5. Families at financial risk due to high ratio of out-of-pocket health care expenditures to total income.

    Science.gov (United States)

    Bennett, Kevin J; Dismuke, Clara E

    2010-05-01

    High out-of-pocket expenditures for health care can put individuals and families at financial risk. Several groups, including racial/ethnic minority groups, the uninsured, rural residents, and those in poorer health are at risk for this increased burden. The analysis utilized 2004-2005 MEPS data. The dependent variables were the out-of-pocket health care spending to total income ratios for total spending, office-based visits, and prescription drugs. Multivariate analyses with instrumental variables controlled for respondent characteristics. Gender, age, rurality, insurance coverage, health status, and health care utilization were all associated with higher out-of-pocket to income ratios. Certain groups, such as women, the elderly, those in poor health, and rural residents, are at a greater financial risk due to their higher out-of-pocket to total income spending ratios. Policymakers must be aware of these increased risks in order to provide adequate resources and targeted interventions to alleviate some of this burden.

  6. Dietary fats, cerebrovasculature integrity and Alzheimer's disease risk.

    Science.gov (United States)

    Takechi, R; Galloway, S; Pallebage-Gamarallage, M M S; Lam, V; Mamo, J C L

    2010-04-01

    An emerging body of evidence is consistent with the hypothesis that dietary fats influence Alzheimer's disease (AD) risk, but less clear is the mechanisms by which this occurs. Alzheimer's is an inflammatory disorder, many consider in response to fibrillar formation and extracellular deposition of amyloid-beta (Abeta). Alternatively, amyloidosis could notionally be a secondary phenomenon to inflammation, because some studies suggest that cerebrovascular disturbances precede amyloid plaque formation. Hence, dietary fats may influence AD risk by either modulating Abeta metabolism, or via Abeta independent pathways. This review explores these two possibilities taking into consideration; (i) the substantial affinity of Abeta for lipids and its ordinary metabolism as an apolipoprotein; (ii) evidence that Abeta has potent vasoactive properties and (iii) studies which show that dietary fats modulate Abeta biogenesis and secretion. We discuss accumulating evidence that dietary fats significantly influence cerebrovascular integrity and as a consequence altered Abeta kinetics across the blood-brain barrier (BBB). Specifically, chronic ingestion of saturated fats or cholesterol appears to results in BBB dysfunction and exaggerated delivery from blood-to-brain of peripheral Abeta associated with lipoproteins of intestinal and hepatic origin. Interestingly, the pattern of saturated fat/cholesterol induced cerebrovascular disturbances in otherwise normal wild-type animal strains is analogous to established models of AD genetically modified to overproduce Abeta, consistent with a causal association. Saturated fats and cholesterol may exacerbate Abeta induced cerebrovascular disturbances by enhancing exposure of vessels of circulating Abeta. However, presently there is no evidence to support this contention. Rather, SFA and cholesterol appear to more broadly compromise BBB integrity with the consequence of plasma protein leakage into brain, including lipoprotein associated Abeta

  7. The Role of Standardization in Improving the Effectiveness of Integrated Risk Management

    OpenAIRE

    Ciocoiu, Carmen Nadia; Dobrea, Razvan Catalin

    2010-01-01

    The need of standardization in risk management is justified by the efforts to develop and introduce, during the last few years, integrated risk management frameworks inside the organizations. The financial crisis has underscored the fact that significant improvements in risk management organizations and capabilities are required. The business community and also the experts recognize that the risk management standards have an important role in improving the effectiveness of integrated risk man...

  8. Integration of project management and systems engineering: Tools for a total-cycle environmental management system

    International Nuclear Information System (INIS)

    Blacker, P.B.; Winston, R.

    1997-01-01

    An expedited environmental management process has been developed at the Idaho National Engineering and Environmental Laboratory (INEEL). This process is one result of the Lockheed Martin commitment to the US Department of Energy to incorporate proven systems engineering practices with project management and program controls practices at the INEEL. Lockheed Martin uses a graded approach of its management, operations, and systems activities to tailor the level of control to the needs of the individual projects. The Lockheed Martin definition of systems engineering is: ''''Systems Engineering is a proven discipline that defines and manages program requirements, controls risk, ensures program efficiency, supports informed decision making, and verifies that products and services meet customer needs.'''' This paper discusses: the need for an expedited environmental management process; how the system was developed; what the system is; what the system does; and an overview of key components of the process

  9. Governance in support of integrated flood risk management? The case of Romania

    NARCIS (Netherlands)

    Vinke-de Kruijf, Joanne; Kuks, Stefanus M.M.; Augustijn, Dionysius C.M.

    2015-01-01

    Building on an existing model of governance, this paper aims to assess the supportiveness of Romania׳s structural flood risk governance context towards integrated flood risk management. We assert that a governance structure supports the development and implementation of integrated flood risk

  10. QUALITY MANAGEMENT AND INTEGRATED TOTAL QUALITY IN SPANISH MINING: RESULTS OF AN EMPIRICAL STUDY

    OpenAIRE

    CARMEN ESCANCIANO; FRANCISCO-JAVIER IGLESIAS-RODRÍGUEZ

    2012-01-01

    En este artículo se presentan y analizan los resultados de un estudio empírico realizado en España entre empresas mineras certificadas ISO 9001. El objetivo perseguido es doble: en primer lugar, reflexionar sobre la situación de la gestión de calidad en la minería española; en segundo término, valorar en qué medida la posesión de un sistema de gestión de calidad constituye un pilar a partir del cual iniciar la andadura hacia la calidad total integrada con otros sistemas de gestión tan importa...

  11. QUALITY MANAGEMENT AND INTEGRATED TOTAL QUALITY IN SPANISH MINING: RESULTS OF AN EMPIRICAL STUDY

    Directory of Open Access Journals (Sweden)

    CARMEN ESCANCIANO

    2012-01-01

    Full Text Available En este artículo se presentan y analizan los resultados de un estudio empírico realizado en España entre empresas mineras certificadas ISO 9001. El objetivo perseguido es doble: en primer lugar, reflexionar sobre la situación de la gestión de calidad en la minería española; en segundo término, valorar en qué medida la posesión de un sistema de gestión de calidad constituye un pilar a partir del cual iniciar la andadura hacia la calidad total integrada con otros sistemas de gestión tan importantes en este sector industrial como el de la gestión ambiental o la gestión de la seguridad y salud laboral.

  12. Simulation of worst-case operating conditions for integrated circuits operating in a total dose environment

    International Nuclear Information System (INIS)

    Bhuva, B.L.

    1987-01-01

    Degradations in the circuit performance created by the radiation exposure of integrated circuits are so unique and abnormal that thorough simulation and testing of VLSI circuits is almost impossible, and new ways to estimate the operating performance in a radiation environment must be developed. The principal goal of this work was the development of simulation techniques for radiation effects on semiconductor devices. The mixed-mode simulation approach proved to be the most promising. The switch-level approach is used to identify the failure mechanisms and critical subcircuits responsible for operational failure along with worst-case operating conditions during and after irradiation. For precise simulations of critical subcircuits, SPICE is used. The identification of failure mechanisms enables the circuit designer to improve the circuit's performance and failure-exposure level. Identification of worst-case operating conditions during and after irradiation reduces the complexity of testing VLSI circuits for radiation environments. The results of test circuits for failure simulations using a conventional simulator and the new simulator showed significant time savings using the new simulator. The savings in simulation time proved to be circuit topology-dependent. However, for large circuits, the simulation time proved to be orders of magnitude smaller than simulation time for conventional simulators

  13. Risk factors for deep infection after total knee arthroplasty: a meta-analysis.

    Science.gov (United States)

    Chen, Jie; Cui, Yunying; Li, Xin; Miao, Xiangwan; Wen, Zhanpeng; Xue, Yan; Tian, Jing

    2013-05-01

    Estimated the risk factors for postoperative infection after total knee arthroplasty (TKA) to prevent its occurrence. The meta-analysis collected twelve cohorts or case-control studies which included 548 infected persons in 57,223 general cases. Review Manager 5.0 was operated to assess the heterogeneity and to give an overall estimate of the association of factors with postoperative infection after TKA. The main factors distinctly associated with infection after TKA were BMI (BMI >30: OR = 2.53, 95 % CI 1.25, 5.13; BMI >40: OR = 4.00, 95 % CI 1.23, 12.98), diabetes mellitus (OR = 3.72, 95 % CI 2.30, 6.01), hypertension (OR = 2.53, 95 % CI 1.07, 5.99), steroid therapy (OR = 2.04, 95 % CI 1.11, 3.74), and rheumatoid arthritis (OR = 1.83; 95 % CI 1.42, 2.36). It had no sufficient evidences to reveal that gender could lead to infection after TKA. Osteoarthritis appeared to have a moderately protective effect. Statistical analysis revealed no correlation between urinary tract infection, fixation method, ASA, bilateral operation, age, transfusion, antibiotics, bone graft, and infection. There were positive evidences for some certain factors which could be targeted for prevention of the onset of infection, but more studies are needed to define the association of some other controversial factors in infection, like osteoarthritis, gender and so on. The quality of studies also needs to be improved.

  14. Estimation of Total Glomerular Number Using an Integrated Disector Method in Embryonic and Postnatal Kidneys

    Directory of Open Access Journals (Sweden)

    Michel G Arsenault

    2014-06-01

    Full Text Available Congenital Anomalies of the Kidney and Urinary Tract (CAKUT are a polymorphic group of clinical disorders comprising the major cause of renal failure in children. Included within CAKUT is a wide spectrum of developmental malformations ranging from renal agenesis, renal hypoplasia and renal dysplasia (maldifferentiation of renal tissue, each characterized by varying deficits in nephron number. First presented in the Brenner Hypothesis, low congenital nephron endowment is becoming recognized as an antecedent cause of adult-onset hypertension, a leading cause of coronary heart disease, stroke, and renal failure in North America. Genetic mouse models of impaired nephrogenesis and nephron endowment provide a critical framework for understanding the origins of human kidney disease. Current methods to quantitate nephron number include (i acid maceration (ii estimation of nephron number from a small number of tissue sections (iii imaging modalities such as MRI and (iv the gold standard physical disector/fractionator method. Despite its accuracy, the physical disector/fractionator method is rarely employed because it is labour-intensive, time-consuming and costly to perform. Consequently, less rigourous methods of nephron estimation are routinely employed by many laboratories. Here we present an updated, digitized version of the physical disector/fractionator method using free open source Fiji software, which we have termed the integrated disector method. This updated version of the gold standard modality accurately, rapidly and cost-effectively quantitates nephron number in embryonic and post-natal mouse kidneys, and can be easily adapted for stereological measurements in other organ systems.

  15. Integration into plant biology and soil science has provided insights into the total environment.

    Science.gov (United States)

    Shao, Hongbo; Lu, Haiying; Xu, Gang; Marian, Brestic

    2017-02-01

    The total environment includes 5 closely-linking circles, in which biosphere and lithosphere are the active core. As global population increases and urbanization process accelerates, arable land is gradually decreasing under global climate change and the pressure of various types of environmental pollution. This case is especially for China. Land is the most important resources for human beings' survival. How to increase and manage arable land is the key for sustainable agriculture development. China has extensive marshy land that can be reclamated for the better potential land resources under the pre- condition of protecting the environment, which will be a good way for enlarging globally and managing arable land. Related studies have been conducted in China for the past 30years and now many results with obvious practical efficiency have been obtained. For summarizing these results, salt-soil will be the main target and related contents such as nutrient transport, use types, biodiversity and interactions with plants from molecular biology to ecology will be covered, in which the interactions among biosphere, lithosphere, atmosphere and anthroposphere will be focused on. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Using integrated environmental modeling to automate a process-based Quantitative Microbial Risk Assessment

    Science.gov (United States)

    Integrated Environmental Modeling (IEM) organizes multidisciplinary knowledge that explains and predicts environmental-system response to stressors. A Quantitative Microbial Risk Assessment (QMRA) is an approach integrating a range of disparate data (fate/transport, exposure, an...

  17. Using Integrated Environmental Modeling to Automate a Process-Based Quantitative Microbial Risk Assessment (presentation)

    Science.gov (United States)

    Integrated Environmental Modeling (IEM) organizes multidisciplinary knowledge that explains and predicts environmental-system response to stressors. A Quantitative Microbial Risk Assessment (QMRA) is an approach integrating a range of disparate data (fate/transport, exposure, and...

  18. Risk Assessment of Total Coliform in X WTP’s Water Production Using Failure Mode And Effect Analysis Method

    Directory of Open Access Journals (Sweden)

    Bella Apriliani Amanda

    2017-07-01

    Full Text Available The greatest risk of drinking water supply is a failure to provide safe drinking water for communities. Based on IPA Kedunguling testing report on March 2016 noted that sample exceeding the quality standart of Peraturan Menteri Kesehatan RI No 492/2010 for the total coliform quality standart. The presence of total coliforms indicating water contamination by pathogen means the water is not safe to consume. The disinfection process has an importance rule in pathogen inactivation. Disinfectant performance is influenced by temperature, pH, turbidity, and the presence of organic materials. One way to control the quality of water produced by using a risk management approach Failure Modes and Effect Analysis (FMEA methods. The potential risks should be measured to determine causes of the problems and find the appropriate risk reduction. The risk assessment is using Risk Priority Number (RPN scale as a basis prioritization of remedial action on issues. Based on identification and risk analysis using FMEA known that the greatest risk of failure is the stipulation of chlorine dose and organic substances (category of high risk level; residual chlorine (category of moderate risk level; turbidity and pH (very low risk level category. Improvement proposal that can be done to reduce total coliforms presence in IPA Kedunguling is by increasing residual chlorine to 0.6 mg/l, set a daily chlorine level, controlling DBPs forming by lowering the concentration of organic precursor using granular activated carbon (GAC or aeration, by lowering the dose of disinfectant, set aside DBPs after the compound is formed using granular activated carbon (GAC, turbidity and pH monitoring, and regularly washing the filters

  19. Integrated risk management of safety and development on transportation corridors

    International Nuclear Information System (INIS)

    Thekdi, Shital A.; Lambert, James H.

    2015-01-01

    Prioritization of investments to protect safety and performance of multi-regional transportation networks from adjacent land development is a key concern for infrastructure agencies, land developers, and other stakeholders. Despite ample literature describing relationships between transportation and land use, no evidence-based methods exist for monitoring corridor needs on a large scale. Risk analysis is essential to the preservation of system safety and capacity, including avoidance of costly retrofits, regret, and belated action. This paper introduces the Corridor Trace Analysis (CTA) for prioritizing corridor segments that are vulnerable to adjacent land development. The method integrates several components: (i) estimation of likelihood of adjacent land development, using influence diagram and rule-based modeling, (ii) characterization of access point density using geospatial methods, and (iii) plural-model evaluation of corridors, monitoring indices of land development likelihood, access point densities, and traffic volumes. The results inform deployment of options that include closing access points, restricting development, and negotiation of agencies and developers. The CTA method is demonstrated on a region encompassing 6000 centerline miles (about 10,000 km) of transportation corridors. The method will be of interest to managers investing in safety and performance of infrastructure systems, balancing safety, financial, and other criteria of concern for diverse stakeholders. - Highlights: • The Corridor Trace Analysis (CTA) method for prioritizing transportation corridors. • The CTA method studies corridors vulnerable to adjacent land development. • The CTA method quantifies the influence of risk scenarios on agency priorities. • The CTA method is demonstrated on 6000 miles of critical transportation corridor

  20. Integration of Evidence Base into a Probabilistic Risk Assessment

    Science.gov (United States)

    Saile, Lyn; Lopez, Vilma; Bickham, Grandin; Kerstman, Eric; FreiredeCarvalho, Mary; Byrne, Vicky; Butler, Douglas; Myers, Jerry; Walton, Marlei

    2011-01-01

    INTRODUCTION: A probabilistic decision support model such as the Integrated Medical Model (IMM) utilizes an immense amount of input data that necessitates a systematic, integrated approach for data collection, and management. As a result of this approach, IMM is able to forecasts medical events, resource utilization and crew health during space flight. METHODS: Inflight data is the most desirable input for the Integrated Medical Model. Non-attributable inflight data is collected from the Lifetime Surveillance for Astronaut Health study as well as the engineers, flight surgeons, and astronauts themselves. When inflight data is unavailable cohort studies, other models and Bayesian analyses are used, in addition to subject matters experts input on occasion. To determine the quality of evidence of a medical condition, the data source is categorized and assigned a level of evidence from 1-5; the highest level is one. The collected data reside and are managed in a relational SQL database with a web-based interface for data entry and review. The database is also capable of interfacing with outside applications which expands capabilities within the database itself. Via the public interface, customers can access a formatted Clinical Findings Form (CLiFF) that outlines the model input and evidence base for each medical condition. Changes to the database are tracked using a documented Configuration Management process. DISSCUSSION: This strategic approach provides a comprehensive data management plan for IMM. The IMM Database s structure and architecture has proven to support additional usages. As seen by the resources utilization across medical conditions analysis. In addition, the IMM Database s web-based interface provides a user-friendly format for customers to browse and download the clinical information for medical conditions. It is this type of functionality that will provide Exploratory Medicine Capabilities the evidence base for their medical condition list

  1. A totally heat-integrated distillation column (THIDiC) - the effect of feed pre-heating by distillate

    Energy Technology Data Exchange (ETDEWEB)

    Huang Kejin [School of Information Science and Technology, Beijing University of Chemical Technology, Beijing 100029 (China)], E-mail: huangkj@mail.buct.edu.cn; Shan Lan; Zhu Qunxiong [School of Information Science and Technology, Beijing University of Chemical Technology, Beijing 100029 (China); Qian Jixin [School of Information Science and Technology, Zhejiang University, Zhejiang 300027 (China)

    2008-06-15

    An ideal heat-integrated distillation column (ideal HIDiC) is characterized by external zero-reflux and zero-reboil ratio operation. Since the distillate is a high-pressure vapor phase flow, it can be used to pre-heat the feed to be separated, thereby giving rise to a totally heat-integrated distillation column (THIDiC). Although the THIDiC is more thermodynamically efficient than the ideal HIDiC, it is found that the heat integration between the distillate and feed turns it into an open-loop integrating process and poses additional difficulties to process operation. Therefore, a careful decision must be made on the selection between the ideal HIDiC and the THIDiC during process development. In this paper, separation of a binary equimolar mixture of benzene and toluene is selected as an illustrative example. Both process design and operability analysis are conducted, with special emphasis focused on the characteristics of feed pre-heating with distillate. The results obtained show deep insight into the design and operation of the THIDiC.

  2. A totally heat-integrated distillation column (THIDiC) - the effect of feed pre-heating by distillate

    International Nuclear Information System (INIS)

    Huang Kejin; Shan Lan; Zhu Qunxiong; Qian Jixin

    2008-01-01

    An ideal heat-integrated distillation column (ideal HIDiC) is characterized by external zero-reflux and zero-reboil ratio operation. Since the distillate is a high-pressure vapor phase flow, it can be used to pre-heat the feed to be separated, thereby giving rise to a totally heat-integrated distillation column (THIDiC). Although the THIDiC is more thermodynamically efficient than the ideal HIDiC, it is found that the heat integration between the distillate and feed turns it into an open-loop integrating process and poses additional difficulties to process operation. Therefore, a careful decision must be made on the selection between the ideal HIDiC and the THIDiC during process development. In this paper, separation of a binary equimolar mixture of benzene and toluene is selected as an illustrative example. Both process design and operability analysis are conducted, with special emphasis focused on the characteristics of feed pre-heating with distillate. The results obtained show deep insight into the design and operation of the THIDiC

  3. Low-dose total skin electron beam therapy for cutaneous lymphoma. Minimal risk of acute toxicities

    Energy Technology Data Exchange (ETDEWEB)

    Kroeger, Kai; Elsayad, Khaled; Moustakis, Christos; Haverkamp, Uwe; Eich, Hans Theodor [University Hospital of Muenster, Department of Radiation Oncology, Muenster (Germany)

    2017-12-15

    Low-dose total skin electron beam therapy (TSEBT) is attracting increased interest for the effective palliative treatment of primary cutaneous T-cell lymphoma (pCTCL). In this study, we compared toxicity profiles following various radiation doses. We reviewed the records of 60 patients who underwent TSEBT for pCTCL between 2000 and 2016 at the University Hospital of Munster. The treatment characteristics of the radiotherapy (RT) regimens and adverse events (AEs) were then analyzed and compared. In total, 67 courses of TSEBT were administered to 60 patients. Of these patients, 34 (51%) received a standard dose with a median surface dose of 30 Gy and 33 patients (49%) received a low dose with the median surface dose of 12 Gy (7 salvage low-dose TSEBT courses were administered to 5 patients). After a median follow-up of 15 months, the overall AE rate was 100%, including 38 patients (57%) with grade 2 and 7 (10%) with grade 3 AEs. Patients treated with low-dose TSEBT had significantly fewer grade 2 AEs than those with conventional dose regimens (33 vs. 79%, P < 0.001). A lower grade 3 AE rate was also observed in patients who had received the low-dose regimen compared to those with the conventional dose regimens (6 vs. 15%, P = 0.78). Multiple/salvage low-dose TSEBT courses were not associated with an increased risk of acute AEs. Low-dose TSEBT regimens are associated with significantly fewer grade 2 acute toxicities compared with conventional doses of TSEBT. Repeated/Salvage low-dose TSEBT, however, appears to be tolerable and can even be applied safely in patients with cutaneous relapses. (orig.) [German] Eine niedrigdosierte Ganzhautelektronenbestrahlung (TSEBT) wird vermehrt zur effektiven palliativen Behandlung von Patienten mit primaer kutanen T-Zell-Lymphomen (pCTCL) eingesetzt. In dieser Studie vergleichen wir die Toxizitaetsprofile verschiedener Dosiskonzepte. Untersucht wurden 60 zwischen 2000 und 2016 am Universitaetsklinikum Muenster mittels TSEBT

  4. Risk Management: An Integral Part of Operational Planning

    National Research Council Canada - National Science Library

    Latrash, Frederick

    1999-01-01

    ...) and Joint Task Force (JTF) Commander to achieve military objectives. Risk Management (RM) is a five step process that identifies hazards, assesses risks and implements controls to reduce risks to an acceptable level...

  5. Smoking, body weight, physical exercise, and risk of lower limb total joint replacement in a population-based cohort of men.

    Science.gov (United States)

    Mnatzaganian, George; Ryan, Philip; Norman, Paul E; Davidson, David C; Hiller, Janet E

    2011-08-01

    To assess the associations of smoking, body weight, and physical activity with risk of undergoing total joint replacement (TJR) in a population-based cohort of men. A cohort study of 11,388 men that integrated clinical data with hospital morbidity data and mortality records was undertaken. The risk of undergoing TJR was modeled on baseline weight, height, comorbidity, socioeconomic status, years of smoking, and exercise in 3 separate age groups, using Cox proportional hazards regressions and competing risk regressions (CRRs). Dose-response relationships between weight and risk of TJR and between smoking and risk of TJR were observed. Being overweight independently increased the risk of TJR, while smoking lowered the risk. The decreased risk among smokers was demonstrated in both Cox and CRR models and became apparent after 23 years of exposure. Men who were in the highest quartile (≥48 years of smoking) were 42-51% less likely to undergo TJR than men who had never smoked. Tests for trend in the log hazard ratios (HRs) across both smoking and weight quantiles yielded significant P values. Vigorous exercise increased the hazard of TJR; however, the association reached statistical significance only in the 70-74-year-old age group (adjusted HR 1.64 [95% confidence interval 1.19-2.24]). Adjusting for Deyo-Charlson Index or Elixhauser's comorbidity measures did not eliminate these associations. Our findings indicate that being overweight and reporting vigorous physical activity increase the risk of TJR. This study is the first to demonstrate a strong inverse dose-response relationship between duration of smoking and risk of TJR. More research is needed to better understand the role of smoking in the pathogenesis of osteoarthritis. Copyright © 2011 by the American College of Rheumatology.

  6. Do we see how they perceive risk? An integrated analysis of risk perception and its effect on workplace safety behavior.

    Science.gov (United States)

    Xia, Nini; Wang, Xueqing; Griffin, Mark A; Wu, Chunlin; Liu, Bingsheng

    2017-09-01

    While risk perception is a key factor influencing safety behavior, the academia lacks specific attention to the ways that workers perceive risk, and thus little is known about the mechanisms through which different risk perceptions influence safety behavior. Most previous research in the workplace safety domain argues that people tend to perceive risk based on rational formulations of risk criticality. However, individuals' emotions can be also useful in understanding their perceptions. Therefore, this research employs an integrated analysis concerning the rational and emotional perspectives. Specifically, it was expected that the identified three rational ways of perceiving risk, i.e., perceived probability, severity, and negative utility, would influence the direct emotional risk perception. Furthermore, these four risk perceptions were all expected to positively but differently influence safety behavior. The hypotheses were tested using a sample of 120 construction workers. It was found that all the three rational risk perceptions significantly influenced workers' direct perception of risk that is mainly based on emotions. Furthermore, safety behavior among workers relied mainly on emotional perception but not rational calculations of risk. This research contributes to workplace safety research by highlighting the importance of integrating the emotional assessment of risk, especially when workers' risk perception and behavior are concerned. Suggested avenues for improving safety behavior through improvement in risk perception include being aware of the possibility of different ways of perceiving risk, promoting experience sharing and accident simulation, and uncovering risk information. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Integrated probabilistic risk assessment for nanoparticles: the case of nanosilica in food

    OpenAIRE

    Jacobs, R.; Voet, van der, H.; Braak, ter, C.J.F.

    2015-01-01

    Insight into risks of nanotechnology and the use of nanoparticles is an essential condition for the social acceptance and safe use of nanotechnology. One of the problems with which the risk assessment of nanoparticles is faced is the lack of data, resulting in uncertainty in the risk assessment. We attempt to quantify some of this uncertainty by expanding a previous deterministic study on nanosilica (5?200?nm) in food into a fully integrated probabilistic risk assessment. We use the integrate...

  8. Real-world effectiveness of valsartan on hypertension and total cardiovascular risk: review and implications of a translational research program

    Science.gov (United States)

    Abraham, Ivo; MacDonald, Karen; Hermans, Christine; Aerts, Ann; Lee, Christopher; Brié, Heidi; Vancayzeele, Stefaan

    2011-01-01

    The pharmacological efficacy of various monotherapy, single pill, and combination therapies of the angiotensin II receptor blocker valsartan have been established, mainly through randomized controlled trials that used similar methodological and statistical platforms and thus enabled synthesis of evidence. The real world effectiveness of valsartan has been studied extensively, but the relative lack of scientific and technical congruence of these studies render synthesis virtually impossible. To date, all have focused on blood pressure outcomes, despite evidence-based calls to grade antihypertensive treatment to patients’ total cardiovascular risk. We review a T3 translational research program of seven studies involving valsartan monotherapy as well as single and separate pill combinations, and the determinants and effect on blood pressure and total cardiovascular risk outcomes. All seven studies examined not only the impact of valsartan-based regimens on blood pressure values and control, but also, within a statistical hierarchical approach, the physician- and patient-related determinants of these blood pressure outcomes. Two studies also investigated the determinants and outcomes of valsartan-based treatment on total cardiovascular risk – among the first studies to use this risk coefficient as an outcome rather than only a determinant. These seven studies included a total of 19,533 patients, contributed by 3434 physician-investigators in Belgium – a country particularly well-suited for observational effectiveness studies because of demographics and epidemiology. Each study used the same methodological and statistical platform. We summarize the impact of various valsartan regimens on such outcomes as blood pressure values and control, change in total cardiovascular risk, and reduction in risk by at least one category. We also review the results of statistical multilevel and logistic modeling of physician- and patient-related determinants on these outcomes

  9. 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...

  10. Integrated risk management in a commercial market-maker bank using the 'cash flow at risk' approach

    OpenAIRE

    Voloshyn, Ihor; Voloshyn, Mykyta

    2013-01-01

    In this article, on the basis of the "cash flow at risk" approach, the system of the integrated (credit, market, operational and liquidity risks) risk management in a market-maker commercial bank is developed. This system guarantees reaching profitability, liquidity and coverage of banking risks and thus allows the fullest protection of the interests of depositors, creditors and shareholders of the bank providing its sustainable development.

  11. An Integrated Risk Index Model Based on Hierarchical Fuzzy Logic for Underground Risk Assessment

    Directory of Open Access Journals (Sweden)

    Muhammad Fayaz

    2017-10-01

    Full Text Available Available space in congested cities is getting scarce due to growing urbanization in the recent past. The utilization of underground space is considered as a solution to the limited space in smart cities. The numbers of underground facilities are growing day by day in the developing world. Typical underground facilities include the transit subway, parking lots, electric lines, water supply and sewer lines. The likelihood of the occurrence of accidents due to underground facilities is a random phenomenon. To avoid any accidental loss, a risk assessment method is required to conduct the continuous risk assessment and report any abnormality before it happens. In this paper, we have proposed a hierarchical fuzzy inference based model for under-ground risk assessment. The proposed hierarchical fuzzy inference architecture reduces the total number of rules from the rule base. Rule reduction is important because the curse of dimensionality damages the transparency and interpretation as it is very tough to understand and justify hundreds or thousands of fuzzy rules. The computation time also increases as rules increase. The proposed model takes 175 rules having eight input parameters to compute the risk index, and the conventional fuzzy logic requires 390,625 rules, having the same number of input parameters to compute risk index. Hence, the proposed model significantly reduces the curse of dimensionality. Rule design for fuzzy logic is also a tedious task. In this paper, we have also introduced new rule schemes, namely maximum rule-based and average rule-based; both schemes can be used interchangeably according to the logic needed for rule design. The experimental results show that the proposed method is a virtuous choice for risk index calculation where the numbers of variables are greater.

  12. Method for Assessing the Integrated Risk of Soil Pollution in Industrial and Mining Gathering Areas

    Science.gov (United States)

    Guan, Yang; Shao, Chaofeng; Gu, Qingbao; Ju, Meiting; Zhang, Qian

    2015-01-01

    Industrial and mining activities are recognized as major sources of soil pollution. This study proposes an index system for evaluating the inherent risk level of polluting factories and introduces an integrated risk assessment method based on human health risk. As a case study, the health risk, polluting factories and integrated risks were analyzed in a typical industrial and mining gathering area in China, namely, Binhai New Area. The spatial distribution of the risk level was determined using a Geographic Information System. The results confirmed the following: (1) Human health risk in the study area is moderate to extreme, with heavy metals posing the greatest threat; (2) Polluting factories pose a moderate to extreme inherent risk in the study area. Such factories are concentrated in industrial and urban areas, but are irregularly distributed and also occupy agricultural land, showing a lack of proper planning and management; (3) The integrated risks of soil are moderate to high in the study area. PMID:26580644

  13. Method for Assessing the Integrated Risk of Soil Pollution in Industrial and Mining Gathering Areas.

    Science.gov (United States)

    Guan, Yang; Shao, Chaofeng; Gu, Qingbao; Ju, Meiting; Zhang, Qian

    2015-11-13

    Industrial and mining activities are recognized as major sources of soil pollution. This study proposes an index system for evaluating the inherent risk level of polluting factories and introduces an integrated risk assessment method based on human health risk. As a case study, the health risk, polluting factories and integrated risks were analyzed in a typical industrial and mining gathering area in China, namely, Binhai New Area. The spatial distribution of the risk level was determined using a Geographic Information System. The results confirmed the following: (1) Human health risk in the study area is moderate to extreme, with heavy metals posing the greatest threat; (2) Polluting factories pose a moderate to extreme inherent risk in the study area. Such factories are concentrated in industrial and urban areas, but are irregularly distributed and also occupy agricultural land, showing a lack of proper planning and management; (3) The integrated risks of soil are moderate to high in the study area.

  14. 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

  15. Probabilistic integrated risk assessment of human exposure risk to environmental bisphenol A pollution sources.

    Science.gov (United States)

    Fu, Keng-Yen; Cheng, Yi-Hsien; Chio, Chia-Pin; Liao, Chung-Min

    2016-10-01

    Environmental bisphenol A (BPA) exposure has been linked to a variety of adverse health effects such as developmental and reproductive issues. However, establishing a clear association between BPA and the likelihood of human health is complex yet fundamentally uncertain. The purpose of this study was to assess the potential exposure risks from environmental BPA among Chinese population based on five human health outcomes, namely immune response, uterotrophic assay, cardiovascular disease (CVD), diabetes, and behavior change. We addressed these health concerns by using a stochastic integrated risk assessment approach. The BPA dose-dependent likelihood of effects was reconstructed by a series of Hill models based on animal models or epidemiological data. We developed a physiologically based pharmacokinetic (PBPK) model that allows estimation of urinary BPA concentration from external exposures. Here we showed that the daily average exposure concentrations of BPA and urinary BPA estimates were consistent with the published data. We found that BPA exposures were less likely to pose significant risks for infants (0-1 year) and adults (male and female >20 years) with human long-term BPA susceptibility in relation to multiple exposure pathways, and for informing the public of the negligible magnitude of environmental BPA pollution impacts on human health.

  16. Transferrin saturation ratio and risk of total and cardiovascular mortality in the general population.

    LENUS (Irish Health Repository)

    Stack, A G

    2014-08-01

    The transferrin saturation (TSAT) ratio is a commonly used indicator of iron deficiency and iron overload in clinical practice but precise relationships with total and cardiovascular mortality are unclear.

  17. Total Integrative Evolutionary Communication

    DEFF Research Database (Denmark)

    Nedergaard Thomsen, Ole; Brier, Søren

    2014-01-01

    ) instinctual-motivational-emotional sign plays (a level which is shared with other animals and is the domain of ethology), and (3) premeditated, intentional symbol-based language games (specifically human unitary thinking-speaking-gesturing, the domain of pragmatics-based functional linguistics...

  18. IRRAS, Integrated Reliability and Risk Analysis System for PC

    International Nuclear Information System (INIS)

    Russell, K.D.

    1995-01-01

    1 - Description of program or function: IRRAS4.16 is a program developed for the purpose of performing those functions necessary to create and analyze a complete Probabilistic Risk Assessment (PRA). This program includes functions to allow the user to create event trees and fault trees, to define accident sequences and basic event failure data, to solve system and accident sequence fault trees, to quantify cut sets, and to perform uncertainty analysis on the results. Also included in this program are features to allow the analyst to generate reports and displays that can be used to document the results of an analysis. Since this software is a very detailed technical tool, the user of this program should be familiar with PRA concepts and the methods used to perform these analyses. 2 - Method of solution: IRRAS4.16 is written entirely in MODULA-2 and uses an integrated commercial graphics package to interactively construct and edit fault trees. The fault tree solving methods used are industry recognized top down algorithms. For quantification, the program uses standard methods to propagate the failure information through the generated cut sets. 3 - Restrictions on the complexity of the problem: Due to the complexity of and the variety of ways a fault tree can be defined it is difficult to define limits on the complexity of the problem solved by this software. It is, however, capable of solving a substantial fault tree due to efficient methods. At this time, the software can efficiently solve problems as large as other software currently used on mainframe computers. Does not include source code

  19. Fatores de Risco para Infecção Pós-histerectomia Total Abdominal Risk Factors for Infection after Total Abdominal Hysterectomy

    Directory of Open Access Journals (Sweden)

    Melania Maria Ramos de Amorim

    2000-08-01

    with the occurrence of surgical site infection in patients submitted to total abdominal hysterectomy at the Instituto Materno ¾ Infantil de Pernambuco (iMIP. Methods: a cross-sectional study was conducted, enrolling patients submitted to total abdominal hysterectomy at IMIP who returned to postsurgical consultation for infection control, between January, 1995 and December, 1998 (n = 414. The frequency of surgical site infection (defined according to the CDC criteria, 1998 was 10% (42 cases. Prevalence risk (PR of infection (dependent variable and its 95% confidence interval (CI were calculated for independent variables: age, obesity, hypertension, diabetes, malignant pathology, type of incision, duration of surgery and antibiotic prophylaxis. Multiple logistic regression analysis was used to determine adjusted risk of infection. Results: a significantly increased risk of infection was found for the following variables: age >60 years (PR = 2.39, 95% CI = 1.15-4.94, obesity (PR = 3.2, 95% CI = 1.83-5.59, duration of surgery >2 hours (PR = 2.35, 95% CI = 1.32-4.21 and diabetes (PR = 6.0, 95% CI = 3.41-10.57. On the other hand, risk of infection was significantly reduced when antibiotic prophylaxis was administered (PR = 0.38, 95% CI = 0.21-0.68. Type of incision, malignant disease and hypertension were not associated with infection. Conclusions: the factors associated with increased risk of surgical site infection after total abdominal hysterectomy at IMIP were: age >60 years, obesity, diabetes and surgical duration >2 hours. Antibiotic prophylaxis showed a protective effect with reduction of risk of infection.

  20. Total and HDL cholesterol and risk of stroke. EUROSTROKE: a collaborative study among research centres in Europe

    NARCIS (Netherlands)

    M.L. Bots (Michiel); D.E. Grobbee (Diederick); P.C. Elwood; Y. Nikitin; J.T. Salonen; A. Freire de Concalves; D. Inzitari; J. Sivenius; V. Benetou (Vassiliki); J. Tuomilehto; P.J. Koudstaal (Peter Jan)

    2002-01-01

    textabstractBACKGROUND: Controversy remains on the relation between serum lipids levels and stroke risk. This paper investigated the association of total and HDL cholesterol level to fatal and non-fatal, and haemorrhagic and ischaemic stroke in four European cohorts participating

  1. Methodological Bases for Describing Risks of the Enterprise Business Model in Integrated Reporting

    Directory of Open Access Journals (Sweden)

    Nesterenko Oksana O.

    2017-12-01

    Full Text Available The aim of the article is to substantiate the methodological bases for describing the business and accounting risks of an enterprise business model in integrated reporting for their timely detection and assessment, and develop methods for their leveling or minimizing and possible prevention. It is proposed to consider risks in the process of forming integrated reporting from two sides: first, risks that arise in the business model of an organization and should be disclosed in its integrated report; second, accounting risks of integrated reporting, which should be taken into account by members of the cross-sectoral working group and management personnel in the process of forming and promulgating integrated reporting. To develop an adequate accounting and analytical tool for disclosure of information about the risks of the business model and integrated reporting, their leveling or minimization, in the article a terminological analysis of the essence of entrepreneurial and accounting risks is carried out. The entrepreneurial risk is defined as an objective-subjective economic category that characterizes the probability of negative or positive consequences of economic-social-ecological activity within the framework of the business model of an enterprise under uncertainty. The accounting risk is suggested to be understood as the probability of unfavorable consequences as a result of organizational, methodological errors in the integrated accounting system, which present threat to the quality, accuracy and reliability of the reporting information on economic, social and environmental activities in integrated reporting as well as threat of inappropriate decision-making by stakeholders based on the integrated report. For the timely identification of business risks and maximum leveling of the influence of accounting risks on the process of formation and publication of integrated reporting, in the study the place of entrepreneurial and accounting risks in

  2. Having a Go: Looking at Teachers' Experience of Risk-Taking in Technology Integration

    Science.gov (United States)

    Howard, Sarah K.; Gigliotti, Amanda

    2016-01-01

    Risk is an integral part of change. Technology-related change in teachers' practice is guided by confidence engaging in and beliefs about integration. However, it is also affected by how teachers feel about taking risks, experimenting and change. This paper presents a theoretical framework of affect and emotion to understand how teachers…

  3. Evaluation of total effort and risk of membraneless tubular fuel cell concept

    Energy Technology Data Exchange (ETDEWEB)

    Bambace, Luis Antonio Waack [Instituto Nacional de Pesquisas Espaciais - INPE, Sao Jose dos Campos, SP (Brazil)], e-mail: bambace@dem.inpe.br

    2010-07-01

    Traditionally people estimate project risks and duration by comparing predicted actions with similar ones. This methodology is rather difficult to apply in very innovative projects, as several of their Work Breakdown Structure (WBS) actions are quite new to a particular developer, even if this action is a standard procedure in another field or company. This paper proposes the use of an alternative methodology with fuel cell design example, which is inspired in Suh third axiom, Jelinsky-Moranda Model of software reliability (JMSRM). This model considers human error with JMRSR, relates the number of trials with entropy and search residual risk, feasibility with model uncertainty and acceptable and target risks, and the matching of search field and real solution field with statistical tools. (author)

  4. Risk assessment of welders` exposure to total fume in an automobile industry

    Directory of Open Access Journals (Sweden)

    2012-01-01

    Full Text Available Introduction: Risk assessment of Toxic or hazardous chemicals enables the Industrial Hygienists to make the appropriate decision in providing healthy work place. This project was conducted in an assembling plant,(4workshop of an Automobile Industry in IRAN with 2 types of welding operations, including GMAW (CO2 welding and Spot resistance welding operations. . Method and Materials: Welders` exposures were assessed via collecting 143 breathing zone air samples based on NIOSH 0500 method. Risk assessment was carried out using Singapore recommended method. .Results: Finding showed that the mean of welders exposure in GMAW and Spot resistance welding operations 5.61 ± 5.78and 2.38± 2.15 mg/m3, respectively(p<0.05. The results showed that in GMAW welders had the highe exposure in comparison with Spot resistance welders (p<0.05. The findings also demonstrated that the risk rate of GMAW welders were high, while this rate for Spot resistance was low. .Conclusion: more hygienic attention is needed for GTAW welders. Control approaches are required including effective engineering control, conduct air monitoring, biological monitoring training, adopt respiratory protection program, develop and implement safe and correct work procedures and finally reassess the risk after all the controls have been done.

  5. Risk of Myocardial Infarction Attributable to Elevated Levels of Total Cholesterol Among Hypertensives

    NARCIS (Netherlands)

    Glazer, Nicole L.; Smith, Nicholas L.; Heckbert, Susan R.; Doggen, Catharina Jacoba Maria; Lemaitre, Rozenn N.; Psaty, Bruce M.

    2005-01-01

    Background Although cholesterol is an important risk factor for coronary heart disease (CHD) among hypertensives, the burden of CHD among hypertensives that may be due to elevated cholesterol has not been well documented. This study aimed to estimate the proportion of incident myocardial infarction

  6. Social network diversity and risks of ischemic heart disease and total mortality

    DEFF Research Database (Denmark)

    Barefoot, John C; Grønbaek, Morten; Jensen, Gorm

    2005-01-01

    Measures of various types of social contacts were used as predictors of ischemic heart disease events and total mortality in an age-stratified random sample of 9,573 adults enrolled in the Copenhagen City Heart Study (Copenhagen, Denmark). Baseline examinations were conducted in 1991-1994, and pa......Measures of various types of social contacts were used as predictors of ischemic heart disease events and total mortality in an age-stratified random sample of 9,573 adults enrolled in the Copenhagen City Heart Study (Copenhagen, Denmark). Baseline examinations were conducted in 1991...

  7. [Case-control study on effect of rivaroxaban on the risk of hidden bleeding after total hip arthroplasty].

    Science.gov (United States)

    Li, Jun; Jing, Jue-Hua; Shi, Zhan-Jun; Zhou, Yun

    2014-01-01

    To investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty. From October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group(44 cases)and control group(44 cases). There were 25 males and 19 females in the Rivaroxaban group, with an average age of (58.48 +/- 15.19) years old; in the control group,24 patients were male and 20 patients were female, with an average age of (61.11 +/- 13.54) years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day, and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded, blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula. The mean total blood loss was (1509.56 +/- 325.23) ml and the hidden blood loss was(581.47 +/- 215.01) ml, accounting for (37.88 +/- 10.42)% in the Rivaroxaban group. The mean total blood loss was (1262.30 +/- 397.95) ml and the hidden blood loss was (395.59 +/- 97.33) ml, accounting for (30.62 +/- 0.20)% in the control group. The total blood loss, hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,b ut there was no significant difference on dominant blood loss between two groups. Rivaroxaban increased the overall bleeding risk of total hip arthroplasty, especially hidden bleeding risk, which should be careful used.

  8. Integration of second cancer risk calculations in a radiotherapy treatment planning system

    International Nuclear Information System (INIS)

    Hartmann, M; Schneider, U

    2014-01-01

    Second cancer risk in patients, in particular in children, who were treated with radiotherapy is an important side effect. It should be minimized by selecting an appropriate treatment plan for the patient. The objectives of this study were to integrate a risk model for radiation induced cancer into a treatment planning system which allows to judge different treatment plans with regard to second cancer induction and to quantify the potential reduction in predicted risk. A model for radiation induced cancer including fractionation effects which is valid for doses in the radiotherapy range was integrated into a treatment planning system. From the three-dimensional (3D) dose distribution the 3D-risk equivalent dose (RED) was calculated on an organ specific basis. In addition to RED further risk coefficients like OED (organ equivalent dose), EAR (excess absolute risk) and LAR (lifetime attributable risk) are computed. A risk model for radiation induced cancer was successfully integrated in a treatment planning system. Several risk coefficients can be viewed and used to obtain critical situations were a plan can be optimised. Risk-volume-histograms and organ specific risks were calculated for different treatment plans and were used in combination with NTCP estimates for plan evaluation. It is concluded that the integration of second cancer risk estimates in a commercial treatment planning system is feasible. It can be used in addition to NTCP modelling for optimising treatment plans which result in the lowest possible second cancer risk for a patient.

  9. Living PRAs [probabilistic risk analysis] made easier with IRRAS [Integrated Reliability and Risk Analysis System

    International Nuclear Information System (INIS)

    Russell, K.D.; Sattison, M.B.; Rasmuson, D.M.

    1989-01-01

    The Integrated Reliability and Risk Analysis System (IRRAS) is an integrated PRA software tool that gives the user the ability to create and analyze fault trees and accident sequences using an IBM-compatible microcomputer. This program provides functions that range from graphical fault tree and event tree construction to cut set generation and quantification. IRRAS contains all the capabilities and functions required to create, modify, reduce, and analyze event tree and fault tree models used in the analysis of complex systems and processes. IRRAS uses advanced graphic and analytical techniques to achieve the greatest possible realization of the potential of the microcomputer. When the needs of the user exceed this potential, IRRAS can call upon the power of the mainframe computer. The role of the Idaho National Engineering Laboratory if the IRRAS program is that of software developer and interface to the user community. Version 1.0 of the IRRAS program was released in February 1987 to prove the concept of performing this kind of analysis on microcomputers. This version contained many of the basic features needed for fault tree analysis and was received very well by the PRA community. Since the release of Version 1.0, many user comments and enhancements have been incorporated into the program providing a much more powerful and user-friendly system. This version is designated ''IRRAS 2.0''. Version 3.0 will contain all of the features required for efficient event tree and fault tree construction and analysis. 5 refs., 26 figs

  10. Risk-Aversion: Understanding Teachers' Resistance to Technology Integration

    Science.gov (United States)

    Howard, Sarah K.

    2013-01-01

    Teachers who do not integrate technology are often labelled as "resistant" to change. Yet, considerable uncertainties remain about appropriate uses and actual value of technology in teaching and learning, which can make integration and change seem risky. The purpose of this article is to explore the nature of teachers' analytical and…

  11. Real-world effectiveness of valsartan on hypertension and total cardiovascular risk: review and implications of a translational research program

    Directory of Open Access Journals (Sweden)

    Abraham I

    2011-03-01

    Full Text Available Ivo Abraham1,2, Karen MacDonald2, Christine Hermans3, Ann Aerts3, Christopher Lee2,4, Heidi Brié3, Stefaan Vancayzeele31Center for Health Outcomes and Pharmacoeconomic Research, and Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA; 2Matrix45, Earlysville, VA, USA; 3Novartis Pharma, Vilvoorde, Belgium; 4School of Nursing, Oregon Health and Science University, Portland, OR, USAAbstract: The pharmacological efficacy of various monotherapy, single pill, and combination therapies of the angiotensin II receptor blocker valsartan have been established, mainly through randomized controlled trials that used similar methodological and statistical platforms and thus enabled synthesis of evidence. The real world effectiveness of valsartan has been studied extensively, but the relative lack of scientific and technical congruence of these studies render synthesis virtually impossible. To date, all have focused on blood pressure outcomes, despite evidence-based calls to grade antihypertensive treatment to patients' total cardiovascular risk. We review a T3 translational research program of seven studies involving valsartan monotherapy as well as single and separate pill combinations, and the determinants and effect on blood pressure and total cardiovascular risk outcomes. All seven studies examined not only the impact of valsartan-based regimens on blood pressure values and control, but also, within a statistical hierarchical approach, the physician- and patient-related determinants of these blood pressure outcomes. Two studies also investigated the determinants and outcomes of valsartan-based treatment on total cardiovascular risk – among the first studies to use this risk coefficient as an outcome rather than only a determinant. These seven studies included a total of 19,533 patients, contributed by 3434 physician-investigators in Belgium – a country particularly well-suited for observational

  12. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

    Full Text Available OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI and glycemic load (GL are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ. We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths. As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04; P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  13. Prismatic TIR (total internal reflection) low-concentration PV (photovoltaics)-integrated façade for low latitudes

    International Nuclear Information System (INIS)

    Sabry, Mohamed

    2016-01-01

    Low-concentration Façade-integrated Photovoltaic system in the form of TIR (total internal reflection) prismatic segmented façade could play an effective role in reducing the direct component of solar radiation transmitting through buildings, hence reducing both cooling and artificial lighting load on such buildings. A prismatic segmented façade is capable of allowing diffused skylight to transmit through it to the building interior, while preventing most of the direct solar radiation and converting it into clean energy by means of the integrated PV (​photovoltaics) cells. A range of prismatic TIR segmented façades with different head angles has been designed based on the geographical latitude of the chosen location. Each façade configuration is simulated by ray-tracing technique and its performance is investigated against realistic direct solar radiation data in two clear sky days representing summer and winter of the targeted location. Ray tracing simulations revealed that all of the selected configurations could collect most of the direct solar radiation in summer. In contrary, larger head angle of the segmented façade could collect wider intervals around the noon time till reaching a head angle of 23° at which most of the incident direct solar radiation could be collected. - Highlights: • 5 different head angles of prismatic segmented PV-integrated Façade are ray-traced. • Transmitted and PV-collected solar radiation percentages are determined. • DNI daily profiles with associated solar altitudes and azimuth data are simulated. • Expected transmitted and PV collected solar radiation are calculated for the proposed segments.

  14. Selecting a Risk-Based SQC Procedure for a HbA1c Total QC Plan.

    Science.gov (United States)

    Westgard, Sten A; Bayat, Hassan; Westgard, James O

    2017-09-01

    Recent US practice guidelines and laboratory regulations for quality control (QC) emphasize the development of QC plans and the application of risk management principles. The US Clinical Laboratory Improvement Amendments (CLIA) now includes an option to comply with QC regulations by developing an individualized QC plan (IQCP) based on a risk assessment of the total testing process. The Clinical and Laboratory Standards Institute (CLSI) has provided new practice guidelines for application of risk management to QC plans and statistical QC (SQC). We describe an alternative approach for developing a total QC plan (TQCP) that includes a risk-based SQC procedure. CLIA compliance is maintained by analyzing at least 2 levels of controls per day. A Sigma-Metric SQC Run Size nomogram provides a graphical tool to simplify the selection of risk-based SQC procedures. Current HbA1c method performance, as demonstrated by published method validation studies, is estimated to be 4-Sigma quality at best. Optimal SQC strategies require more QC than the CLIA minimum requirement of 2 levels per day. More complex control algorithms, more control measurements, and a bracketed mode of operation are needed to assure the intended quality of results. A total QC plan with a risk-based SQC procedure provides a simpler alternative to an individualized QC plan. A Sigma-Metric SQC Run Size nomogram provides a practical tool for selecting appropriate control rules, numbers of control measurements, and run size (or frequency of SQC). Applications demonstrate the need for continued improvement of analytical performance of HbA1c laboratory methods.

  15. An ignored risk factor in toxicology: The total imprecision of exposure assessment

    DEFF Research Database (Denmark)

    Grandjean, Philippe; Budtz-Jørgensen, Esben

    2010-01-01

    twice as much for maternal hair. The total imprecision of these biomarkers much exceeded the normal laboratory variability of less than 5%. Such imprecision can cause underestimation of dose-related toxicity, and data analysis should therefore include sensitivity analyses that take this factor...... were determined in cord blood, cord tissue, and maternal hair. We determined their mutual correlations and their associations with the child's neurobehavioral effect variables at age 7 years. The exposure biomarkers correlated well with one another, but the cord blood mercury concentration showed......Quality assurance of exposure biomarkers usually focuses on laboratory performance only. Using data from a prospective birth cohort study in the Faroe Islands, we have assessed the total imprecision of exposure biomarkers. As biomarkers of prenatal methylmercury exposure, mercury concentrations...

  16. HVAC fault tree analysis for WIPP integrated risk assessment

    International Nuclear Information System (INIS)

    Kirby, P.; Iacovino, J.

    1990-01-01

    In order to evaluate the public health risk from operation of the Waste Isolation Pilot Plant (WIPP) due to potential radioactive releases, a probabilistic risk assessment of waste handling operations was conducted. One major aspect of this risk assessment involved fault tree analysis of the plant heating, ventilation, and air conditioning (HVAC) systems, which comprise the final barrier between waste handling operations and the environment. 1 refs., 1 tab

  17. International Asset Pricing, Currency Risk and Integration of Markets

    Directory of Open Access Journals (Sweden)

    Sema BAYRAKTAR

    2014-11-01

    Full Text Available This study attempts to test the conditional version of the international asset-pricing model proposed in Bayraktar (2000, 2009 by using a parsimonious multivariate GARCH process. The theoretical model, contrary to previous empirical studies that have used random selection of currency risks, determines which currencies should be included in an empirical test, thus avoids this kind of random selection bias. The results from both full and sub-samples regressions provide some weak evidence for the existence of exchange rate risks, thus partially support the theory. However, exchange rate risks' premia are found considerably smaller than that of market risk.

  18. A Risk Management Architecture for Emergency Integrated Aircraft Control

    Science.gov (United States)

    McGlynn, Gregory E.; Litt, Jonathan S.; Lemon, Kimberly A.; Csank, Jeffrey T.

    2011-01-01

    Enhanced engine operation--operation that is beyond normal limits--has the potential to improve the adaptability and safety of aircraft in emergency situations. Intelligent use of enhanced engine operation to improve the handling qualities of the aircraft requires sophisticated risk estimation techniques and a risk management system that spans the flight and propulsion controllers. In this paper, an architecture that weighs the risks of the emergency and of possible engine performance enhancements to reduce overall risk to the aircraft is described. Two examples of emergency situations are presented to demonstrate the interaction between the flight and propulsion controllers to facilitate the enhanced operation.

  19. Prioritization Risk Integration Simulation Model (PRISM) For Environmental Remediation and Waste Management - 12097

    Energy Technology Data Exchange (ETDEWEB)

    Pentz, David L.; Stoll, Ralph H.; Greeves, John T. [Predicus LLC, Issaquah, WA 98027 (United States); Miller, R. Ian [GoldSim Technology Group, LLC, Issaquah, WA 98027 (United States); Nutt, W. Mark [Argonne National Laboratory, Argonne, IL 60439 (United States)

    2012-07-01

    The PRISM (Prioritization Risk Integration Simulation Model), a computer model was developed to support the Department of Energy's Office of Environmental Management (DOE-EM) in its mission to clean up the environmental legacy from the Nation's nuclear weapons materials production complex. PRISM provides a comprehensive, fully integrated planning tool that can tie together DOE-EM's projects. It is designed to help DOE managers develop sound, risk-informed business practices and defend program decisions. It provides a better ability to understand and manage programmatic risks. The underlying concept for PRISM is that DOE-EM 'owns' a portfolio of environmental legacy obligations (ELOs), and that its mission is to transform the ELOs from their current conditions to acceptable conditions, in the most effective way possible. There are many types of ELOs - - contaminated soils and groundwater plumes, disused facilities awaiting D and D, and various types of wastes waiting for processing or disposal. For a given suite of planned activities, PRISM simulates the outcomes as they play out over time, allowing for all key identified uncertainties and risk factors. Each contaminated building, land area and waste stream is tracked from cradle to grave, and all of the linkages affecting different waste streams are captured. The progression of the activities is fully dynamic, reflecting DOE-EM's prioritization approaches, precedence requirements, available funding, and the consequences of risks and uncertainties. The top level of PRISM is the end-user interface that allows rapid evaluation of alternative scenarios and viewing the results in a variety of useful ways. PRISM is a fully probabilistic model, allowing the user to specify uncertainties in input data (such as the magnitude of an existing groundwater plume, or the total cost to complete a planned activity) as well as specific risk events that might occur. PRISM is based on the GoldSim software

  20. Integration of social perception in flash flood risk management for resilience improvement

    Science.gov (United States)

    Diez-Herrero, Andres; Amerigo, Maria; Bodoque, Jose Maria; Garcia, Juan Antonio; Olcina-Cantos, Jorge

    2015-04-01

    Spain is, behind Switzerland, the second most mountainous country in Europe, which determines that after the occurrence of heavy or intense rainfall events, a fast hydrological response takes place due to steep slopes and strong hydrological connectivity. As a result, flash floods are, among natural hazards, the main social risk in Spain. In fact, they have provoked some of the greatest natural disasters in recent history of the country (e.g. Yebra and Almoguera in 1995, Biescas in 1996 or Badajoz in 1997, which totalized more than 200 deceased in the last decades). This work is focused on the village of Navaluenga (Central Spain), in which we have been studying flash floods, under the consideration of different perspectives and using different approaches, for the past 20 years; and in which the regional government has recently approved the Civil Protection Plan.In this research, we examine social perception of flash floodsthrough surveys and interviews; one turn previous to the communication plan and other one after this dissemination activities to population. To this end, the individual and groupal differences were explored, by taking into account socio-demographic variables. In addition, we have considered psychological and material dimensions of vulnerability associated to flood risk, as well as to the emotional dimension through the consideration of psyco-environmental variables.Thus, this research aims to identify what aspects of the social perception differs from scientific/technical knowledge acquired which, in turn, may decrease the efficiency of a risk mitigation plan or even determine its failure. To minimize this lack of harmony, and at the same time to increase awareness of population, we propose a risk communication plan to improve preparedness of the community. To this end, we propose an approach in which messages reach the population quickly and in an understandable way. In this regard, risk communication is based on the integration of suitable

  1. Integrating Fine Arts Instruction with At Risk Students.

    Science.gov (United States)

    Brieger, Charles; Kendall-Dudley, Lori; Sarmiento, Patty

    This report details a program design for improving fine arts instruction among at-risk students. The participants were in a second and third grade bilingual class and a first-through third-grade learning disabled and behavior disordered class in an at-risk elementary school along with a heterogeneous fourth-grade class in a neighboring Midwest…

  2. Total mercury in muscles and liver of Mugil spp. from three coastal lagoons of NW Mexico: concentrations and risk assessment.

    Science.gov (United States)

    Delgado-Alvarez, C G; Frías-Espericueta, M G; Ruelas-Inzunza, J; Becerra-Álvarez, M J; Osuna-Martínez, C C; Aguilar-Juárez, M; Osuna-López, J I; Escobar-Sánchez, O; Voltolina, D

    2017-07-01

    Total mercury (Hg) concentrations were determined by atomic absorption spectrophotometry in muscles and liver of composite samples of Mugil cephalus and M. curema collected during November 2013 and in January, April, and July 2014 from the coastal lagoons Altata-Ensenada del Pabellón (AEP), Ceuta (CEU), and Teacapán-Agua Brava (TAG) of Sinaloa State. The mean Hg contents and information on local consumption were used to assess the possible risk caused by fish ingestion. Mean total mercury levels in the muscles ranged from 0.11 to 0.39 μg/g, while the range for liver was 0.12-3.91 μg/g. The mean Hg content of the liver was significantly (p mercury calculated for the younger age classes of one fishing community were >1, indicating a possible risk for some fishing communities of the Mexican Pacific coast.

  3. Development of Integrated Assessment Technology of Risk and Performance

    International Nuclear Information System (INIS)

    Yang, Jun Eon; Kang, Dae Il; Kang, Hyun Gook

    2010-04-01

    The main idea and contents are summarized as below 1) Development of new risk/performance assessment system innovating old labor-intensive risk assessment structure - New consolidated risk assessment technology from various hazard(flood, fire, seismic in NPP) - BOP model development for performance monitoring - Consolidated risk/performance management system for consistency and efficiency of NPP 2) Resolution technology for pending issues in PSA - Base technology for PSA of digital I and C system - Base technology for seismic PSA reflecting domestic seismic characteristics and aging effect - Uncertainty reduction technology for level 2 PSA and best estimation of containment failure frequency 3) Next generation risk/performance assessment technology - Human-induced error reduction technology for efficient operation of a NPP

  4. An integrated risk sensing system for geo-structural safety

    Institute of Scientific and Technical Information of China (English)

    H.W. Huang; D.M. Zhang; B.M. Ayyub

    2017-01-01

    Over the last decades, geo-structures are experiencing a rapid development in China. The potential risks inherent in the huge amount of construction and asset operation projects in China were well managed in the major project, i.e. the project of Shanghai Yangtze tunnel in 2002. Since then, risk assessment of geo-structures has been gradually developed from a qualitative manner to a quantitative manner. However, the current practices of risk management have been paid considerable attention to the assessment, but little on risk control. As a result, the responses to risks occurrences after a comprehensive assessment are basically too late. In this paper, a smart system for risk sensing incorporating the wireless sensor network (WSN) on-site visualization techniques and the resilience-based repair strategy was proposed. The merit of this system is the real-time monitoring for geo-structural performance and dynamic pre-warning for safety of on-site workers. The sectional convergence, joint opening, and seepage of segmental lining of shield tunnel were monitored by the micro-electro-mechanical systems (MEMS) based sensors. The light emitting diode (LED) coupling with the above WSN system was used to indicate different risk levels on site. By sensing the risks and telling the risks in real time, the geo-risks could be controlled and the safety of geo-structures could be assured to a certain degree. Finally, a resilience-based analysis model was proposed for designing the repair strategy by using the measured data from the WSN system. The application and efficiency of this system have been validated by two cases including Shanghai metro tunnel and underwater road tunnel.

  5. For which option is credit risk more representative on China banks' total factor productivity Efficiency change or technological progress?

    Institute of Scientific and Technical Information of China (English)

    Fadzlan Sufian

    2012-01-01

    Purpose-The purpose of this paper is to provide new empirical evidence on the impact of credit risk on China banks' total factor productivity.Design/methodology/approach-The paper employs the Malmquist Productivity Index (MP1) which allows for the examination of five different indices:total factor productivity change (TFPCH);technological change (TECHCH);efficiency change (EFFCH);pure technical efficiency change (PEFFCH);and scale efficiency change (SECH) indices.Findings-The empirical findings indicate that the State Owned Commercial Banks (SOCB),Joint Stock Commercial Banks (JSCB),and City Commercial Banks (CCB) have exhibited lower TFPCH levels with the inclusion of risk factor.It was found that the JSCB and CCB have exhibited lower TFPCH due to TECHCH,while the SOCB have exhibited lower TFPCH due to EFFCH.The empirical findings suggest that the inclusion of credit risk factor has resulted in a higher JSCB EFFCH levels.On the other hand,the SOCB and CCB have exhibited a lower EFFCH levels due to SECH and PEFFCH,respectively.Research limitations/implications-The results clearly highlight the importance of credit risk and lending quality in determining the total factor productivity change of banks operating in the China banking sector.The author demonstrates that the inclusion of credit risk factor has resulted in a lower TFPCH level of all banks operating in the China banking sector.Thus,excluding the credit risk factor from the analysis on the China banking sector may potentially bias the result upwards.Practical impIications-In an environment of heavy government influence over the lending process,a large proportion of loans extended by Chinese banks over the years have gone bad.Policymakers should prevent the flow of new non-performing loans by separating bad clients from banks that are being restructured and recapitalized in the reform of the banking sector.Originality/value-By employing the Malmquist Productivity Index (MPI),the present paper contributes to

  6. Risk factors and clinical course of hungry bone syndrome after total parathyroidectomy in dialysis patients with secondary hyperparathyroidism.

    Science.gov (United States)

    Ho, Lo-Yi; Wong, Ping-Nam; Sin, Ho-Kwan; Wong, Yuk-Yi; Lo, Kwok-Chi; Chan, Shuk-Fan; Lo, Man-Wai; Lo, Kin-Yee; Mak, Siu-Ka; Wong, Andrew Kui-Man

    2017-01-10

    Hungry bone syndrome (HBS) is an important postoperative complication after parathyroidectomy for severe secondary hyperparathyroidism (SHPT). There is, however, little data in the literature on its detailed clinical course, and the associated risk factors remain controversial. We did a single-center retrospective study on 62 consecutive dialysis patients who underwent total parathyroidectomy for SHPT to examine the risk factors, clinical course and outcome. Data on demographic characteristics, perioperative laboratory parameters including serum calcium, phosphate, alkaline phosphatase (ALP) and parathyroid hormone (PTH), drug treatment for SHPT and operative details of parathyroidectomy were collected. Seventeen (27.4%) patients developed severe postoperative hypocalcemia with HBS. The serum calcium dropped progressively while serum ALP rose after operation until 2 weeks later when serum calcium reached the trough and serum ALP peaked. Serum phosphate also fell but stabilized between 4 and 14 days. The total postoperative calcium and vitamin D supplementation was significantly larger, and hospital stay was significantly longer in the group with HBS as compared with those without HBS. Young age, high body weight, high preoperative ALP level, and low preoperative calcium level independently predicted the development of HBS while preoperative PTH and use of cinacalcet or paricalcitol did not. HBS was common after total parathyroidectomy in patients with SHPT, and it is important to closely monitor the postoperative serum calcium, phosphate and ALP levels in the following 2 weeks, especially for those at risk. The implications of our findings on perioperative management are discussed.

  7. Total management of chronic obstructive pulmonary disease (COPD) as an independent risk factor for cardiovascular disease.

    Science.gov (United States)

    Onishi, Katsuya

    2017-08-01

    Patients with cardiovascular disease (CVD) often have multiple comorbid conditions that may interact with each other, confound the choice of treatments, and reduce mortality. Chronic obstructive pulmonary disease (COPD) is one of the most important comorbidities of CVD, which causes serious consequences in patients with ischemic heart disease, stroke, arrhythmia, and heart failure. COPD shares common risk factors such as tobacco smoking and aging with CVD, is associated with less physical activity, and produces systemic inflammation and oxidative stress. Overall, patients with COPD have a 2-3-fold increased risk of CVD as compared to age-matched controls when adjusted for tobacco smoking. Chronic heart failure (HF) is a frequent and important comorbidity which has a significant impact on prognosis in COPD, and vice versa. HF overlaps in symptoms and signs and has a common comorbidity with COPD, so that diagnosis of COPD is difficult in patients with HF. The combination of HF and COPD presents many therapeutic challenges including beta-blockers (BBs) and beta-agonists. Inhaled long-acting bronchodilators including beta2-agonists and anticholinergics for COPD would not worsen HF. Diuretics are relatively safe, and angiotensin-converting enzyme inhibitors are preferred to treat HF accompanied with COPD. BBs are only relatively contraindicated in asthma, but not in COPD. Low doses of cardioselective BBs should be aggressively initiated in clinically stable patients with HF accompanied with COPD combined with close monitoring for signs of airway obstruction and gradually up-titrated to the maximum tolerated dose. Encouraging appropriate and aggressive treatment for both HF and COPD should be recommended to improve quality of life and mortality in HF patients with COPD. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  8. Risk assessment concept in the new approach directives and its integration in the Enterprise Risk Management (ERM

    Directory of Open Access Journals (Sweden)

    Đapić Mirko

    2012-03-01

    Full Text Available In the nineties years of the previous century, the European Union achieved, through introducing the New and Global Approach to technical harmonization and standardization, a significant improvement in the approach to conformity assessment of products, by integrating the requirements for technical products safety into the process of its designing. This was achieved by preventive analyzing and quantifying of risk levels in the design process with the objective of determining the scope of the needed safety systems. On the other hand, we have witnessed a rapid development and implementation of holistic approaches to risks management in enterprises, unified in the modern business practice by the name of Enterprise Risk Management (ERM. Going along that line, the paper presents, through the basis of the EU New and Global Approach, the concept of risk assessment in the New Approach directives (Machinery, Lifts, ATEX, etc and provides the concept of its integration into the holistic approach of risks management in enterprises, such as ERM.

  9. Risk of pneumonia and urinary tract infection within the first week after total hip arthroplasty and the impact on survival

    Directory of Open Access Journals (Sweden)

    Glassou EN

    2017-01-01

    Full Text Available Eva N Glassou,1,2 Torben B Hansen,1,3 Alma B Pedersen2 1University Clinic of Hand, Hip and Knee Surgery, Department of Orthopedic Surgery, Regional Hospital West Jutland, Aarhus University, 2Department of Clinical Epidemiology, Aarhus University Hospital, 3The Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement, Aarhus University, Aarhus, Denmark Background: Pneumonia and urinary tract infections (UTIs increase morbidity and mortality. There is little epidemiological evidence from large population-based studies on risk factors for these infections and subsequent mortality in total hip arthroplasty (THA patients.Aim: To examine the risk factors of postoperative pneumonia and UTI after THA and their impact on survival.Patients and methods: We used the Danish Hip Arthroplasty Register to identify THAs due to osteoarthritis registered from 2000 to 2013. We collected data about comorbidities, mortality and infections in relation to primary hospitalization and potential predictive variables from administrative databases. Regression models were used to estimate associations between potential risk factors and infection, and subsequently, between infection and mortality.Results: In total 84,812 THAs were included. The cumulative incidence of pneumonia and UTI within 7 days of the primary procedure were 0.21 (95% confidence interval [CI]: 0.18–0.25 and 0.29 (95% CI: 0.26–0.33, respectively. Patient-related risk factors for infection were being 80 years or older, gender and a comorbidity burden at time of surgery. The hazard ratio (HR of dying within 90 days of the primary THA was 10.67 (95% CI: 5.79–19.57 compared to patients without pneumonia. For patients with UTIs, the HR was 1.64 (95% CI: 0.41–6.59 compared to those without a UTI.Conclusion: Pneumonia was associated with an increased short-term risk of dying, despite adjustment for coexisting comorbidity and other potential confounders. Age, gender and comorbidity were the most

  10. Higher complication risk of totally implantable venous access port systems in patients with advanced cancer - a single institution retrospective analysis.

    Science.gov (United States)

    Chang, Yi-Fang; Lo, An-Chi; Tsai, Chung-Hsin; Lee, Pei-Yi; Sun, Shen; Chang, Te-Hsin; Chen, Chien-Chuan; Chang, Yuan-Shin; Chen, Jen-Ruei

    2013-02-01

    Totally implantable port systems are generally recommended for prolonged central venous access in diverse settings, but their risk of complications remains unclear for patients with advanced cancer. The aim of this study was to assess the risk of port system failure in patients with advanced cancer. We conducted a retrospective cohort study in a comprehensive cancer centre. A detailed chart review was conducted among 566 patients with 573 ports inserted during January-June, 2009 (average 345.3 catheter-days). Cox regression analysis was applied to evaluate factors during insertion and early maintenance that could lead to premature removal of the port systems due to infection or occlusion. Port system-related infection was significantly associated with receiving palliative care immediately after implantation (hazard ratio, HR = 7.3, 95% confidence interval, 95% CI = 1.2-46.0), after adjusting for probable confounders. Primary cancer site also impacted the occurrence of device-related infection. Receiving oncologic/palliative care (HR = 3.0, P = 0.064), advanced cancer stage (HR = 6.5, P = 0.077) and body surface area above 1.71 m(2) (HR = 3.4, P = 0.029) increased the risk of port system occlusion. Our study indicates that totally implantable port systems yield a higher risk of complications in terminally ill patients. Further investigation should be carefully conducted to compare outcomes of various central venous access devices in patients with advanced cancer and to develop preventive strategies against catheter failure.

  11. Total Mercury in Squalid Callista Megapitaria squalida from the SW Gulf of California, Mexico: Tissue Distribution and Human Health Risk.

    Science.gov (United States)

    Romo-Piñera, Abril K; Escobar-Sánchez, Ofelia; Ruelas-Inzunza, Jorge; Frías-Espericueta, Martín G

    2018-03-01

    We evaluated the total Hg concentration in different tissues of squalid callista Megapitaria squalida in order to measure Hg distribution in tissue and to estimate human health risk. Samples were obtained by free diving in the SW Gulf of California, Mexico. Concentrations are given on a wet weight basis. A total of 89 squalid callista specimens were obtained, presenting an average Hg concentration of 0.07 ± 0.04 µg g -1 . There were no significant differences (p > 0.05) in Hg concentration between tissues (visceral mass = 0.09 ± 0.08 µg g -1 ; mantle = 0.06 ± 0.07 µg g -1 ; muscle = 0.06 ± 0.04 µg g -1 ). The low Hg values found in squalid callista and its low risk quotient (HQ = 0.03) suggest that the consumption of squalid callista does not represent a human health risk. However, HQ calculated using MeHg was > 1, it which could indicate a potential risk related to consumption of clams.

  12. An In Silico Approach for Evaluating a Fraction-Based, Risk Assessment Method for Total Petroleum Hydrocarbon Mixtures

    Directory of Open Access Journals (Sweden)

    Nina Ching Y. Wang

    2012-01-01

    Full Text Available Both the Massachusetts Department of Environmental Protection (MADEP and the Total Petroleum Hydrocarbon Criteria Working Group (TPHCWG developed fraction-based approaches for assessing human health risks posed by total petroleum hydrocarbon (TPH mixtures in the environment. Both organizations defined TPH fractions based on their expected environmental fate and by analytical chemical methods. They derived toxicity values for selected compounds within each fraction and used these as surrogates to assess hazard or risk of exposure to the whole fractions. Membership in a TPH fraction is generally defined by the number of carbon atoms in a compound and by a compound's equivalent carbon (EC number index, which can predict its environmental fate. Here, we systematically and objectively re-evaluate the assignment of TPH to specific fractions using comparative molecular field analysis and hierarchical clustering. The approach is transparent and reproducible, reducing inherent reliance on judgment when toxicity information is limited. Our evaluation of membership in these fractions is highly consistent (̃80% on average across various fractions with the empirical approach of MADEP and TPHCWG. Furthermore, the results support the general methodology of mixture risk assessment to assess both cancer and noncancer risk values after the application of fractionation.

  13. Tourniquets do not increase the total blood loss or re-amputation risk in transtibial amputations

    DEFF Research Database (Denmark)

    Wied, Christian; Tengberg, Peter T; Holm, Gitte

    2017-01-01

    AIM: To investigate the total blood loss (TBL) and the safety with respect to the re-amputation rate after transtibial amputation (TTA) conducted with and without a tourniquet. METHODS: The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January...... 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications. All patients underwent a standardized TTA procedure that was performed approximately 10 cm below the knee joint and performed...... portion, which equals 55 g/L of haemoglobin. The TBL during the first four postoperative days was calculated based on the haemoglobin level and the estimated blood volume. The re-amputation rate was evaluated within 30 d. RESULTS: Seventy-four out of 86 consecutive patients who underwent TTA within...

  14. Ileus following total hip or knee arthroplasty is associated with increased risk of deep venous thrombosis and pulmonary embolism.

    Science.gov (United States)

    Berend, Keith R; Lombardi, Adolph V; Mallory, Thomas H; Dodds, Kathleen L; Adams, Joanne B

    2004-10-01

    Venous thromboembolic disease (VTD), deep venous thrombosis and pulmonary embolism, causes morbidity and mortality following total hip and total knee arthroplasties, while ileus complicates up to 4.0%. The clinical courses of 2,949 patients undergoing 3,364 consecutive primary and revision total hip and total knee arthroplasties, radical debridements, and reimplantations at one institution over a 2-year period were reviewed to examine the relationship between ileus and VTD. VTD prophylaxis consisted of aspirin and intermittent plantar pulse boots for all patients except those at high risk, who received parenteral chemical prophylaxis and boots. Ileus occurred in 62 patients (2.1%) and symptomatic DVT in 51 (1.7%). With ileus, the incidence of DVT was 8.1%: odds ratio 5.5 (P =.0036). Symptomatic pulmonary embolism occurred in 7 patients (0.24%); with ileus the incidence was 3.2%: odds ratio 19.6 (P =.0082). A significant increase was observed in rates of VTD with ileus. We recommend using parenteral chemical and mechanical prophylaxis in patients with ileus following total hip and total knee arthroplasties.

  15. First trimester serum levels of the soluble transcobalamin receptor, holo-transcobalamin, and total transcobalamin in relation to preeclampsia risk

    DEFF Research Database (Denmark)

    Abuyaman, Omar; Torring, Niels; Obeid, Rima

    2016-01-01

    transcobalamin (TC) with the risk of subsequent preeclampsia using serum samples from asymptomatic first trimester pregnant women. Moreover, we aimed to establish reference intervals of the aforementioned biomarkers for first trimester pregnant women who remained healthy throughout pregnancy. STUDY DESIGN...... preeclampsia while the controls remained normotensive throughout pregnancy. We measured the serum concentration of sCD320, holoTC, and total TC by using in-house ELISA methods. RESULTS: First trimester median concentrations of sCD320, holoTC and total TC were not significantly different between cases...... and controls. The odd ratio for developing preeclampsia based on exposure to low or high levels of sCD320, holoTC or total TC at first trimester was not significant. The reference intervals (2.5-97.5% percentiles (median)) derived from the controls were 50-170 (90) pmol\\L for sCD320, 20-140 (70) pmol...

  16. Climate Leadership webinar on Integrating Energy and Climate Risk Management

    Science.gov (United States)

    Allergan, a multi-specialty healthcare company and pharmaceutical manufacturer, discusses how it manages climate and energy risks, how these areas are linked, and how energy and climate management strategies pervade critical business decisions.

  17. Integrated Intervention for Diabetes Risk After Gestational Diabetes ...

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

    Reducing the risk, improving women's health Research has shown that ... diabetes from developing type 2 diabetes in the years after pregnancy. ... maternal and child health and nutrition together, rather than separately, as is currently done.

  18. Integrated Risk and Knowledge Management Program -- IRKM-P

    Science.gov (United States)

    Lengyel, David M.

    2009-01-01

    The NASA Exploration Systems Mission Directorate (ESMD) IRKM-P tightly couples risk management and knowledge management processes and tools to produce an effective "modern" work environment. IRKM-P objectives include: (1) to learn lessons from past and current programs (Apollo, Space Shuttle, and the International Space Station); (2) to generate and share new engineering design, operations, and management best practices through preexisting Continuous Risk Management (CRM) procedures and knowledge-management practices; and (3) to infuse those lessons and best practices into current activities. The conceptual framework of the IRKM-P is based on the assumption that risks highlight potential knowledge gaps that might be mitigated through one or more knowledge management practices or artifacts. These same risks also serve as cues for collection of knowledge particularly, knowledge of technical or programmatic challenges that might recur.

  19. Social Integration and Reduced Risk of Coronary Heart Disease in Women: The Role of Lifestyle Behaviors.

    Science.gov (United States)

    Chang, Shun-Chiao; Glymour, Maria; Cornelis, Marilyn; Walter, Stefan; Rimm, Eric B; Tchetgen Tchetgen, Eric; Kawachi, Ichiro; Kubzansky, Laura D

    2017-06-09

    Higher social integration is associated with lower cardiovascular mortality; however, whether it is associated with incident coronary heart disease (CHD), especially in women, and whether associations differ by case fatality are unclear. This study sought to examine the associations between social integration and risk of incident CHD in a large female prospective cohort. Seventy-six thousand three hundred and sixty-two women in the Nurses' Health Study, free of CHD and stroke at baseline (1992), were followed until 2014. Social integration was assessed by a simplified Berkman-Syme Social Network Index every 4 years. End points included nonfatal myocardial infarction and fatal CHD. Two thousand three hundred and seventy-two incident CHD events occurred throughout follow-up. Adjusting for demographic, health/medical risk factors, and depressive symptoms, being socially integrated was significantly associated with lower CHD risk, particularly fatal CHD. The most socially integrated women had a hazard ratio of 0.55 (95% confidence interval, 0.41-0.73) of developing fatal CHD compared with those least socially integrated ( P for trend social integration and nonfatal myocardial infarction risk were largely explained by health-promoting behaviors, particularly through differences in cigarette smoking; however, the association with fatal CHD risk remained after accounting for these behaviors and, thus, may involve more direct biological mechanisms. Social integration is inversely associated with CHD incidence in women, but is largely explained by lifestyle/behavioral pathways. © 2017 American Heart Association, Inc.

  20. Comparative, collaborative, and integrative risk governance for emerging technologies

    OpenAIRE

    LINKOV IGOR; TRUMP BENJAMIN D.; ANKLAM ELKE; BERBUBE DAVID; BOISSEAU PATRICK; CUMMINGS CHRISTOPHER; FERSON SCOTT; FLORIN MARIE-VALENTINE; GOLDSTEIN BERNARD; HRISTOZOV DANAIL; JENSEN KELD ASTRUP; KATALAGARIANAKIS GEORGIOS; KUZMA JENNIFER; LAMBERT JAMES H.; MALLOY TIMOTHY

    2018-01-01

    Various emerging technologies challenge existing governance processes to identify, assess, and manage risk. Though the existing risk-based paradigm has been essential for assessment of many chemical, biological, radiological, and nuclear technologies, a complementary approach may be warranted for the early-stage assessment and management challenges of high uncertainty technologies ranging from nanotechnology to synthetic biology to artificial intelligence, among many others. This ...

  1. Integrative Understanding of Familial Impulsivity, Early Adversity and Suicide Risk

    OpenAIRE

    Lima, Isabela M. M.; Malloy-Diniz, Leandro F.; de Miranda, Débora M.; Da Silva, Antônio G.; Neves, Fernando S.; Johnson, Sheri L.

    2017-01-01

    Introduction: Impulsivity is a core characteristic of bipolar disorder and it was observed as elevated in individuals with the disorder and in their relatives. Both impulsivity and history of maltreatment are risk factors for suicide attempts, however, these two key variables may not be independent, given the fact that parental impulsivity and associated social context could increase the risk of child maltreatment. In this study it was examined the association between the impulsivity of relat...

  2. Chronic wasting disease risk analysis workshop: An integrative approach

    Science.gov (United States)

    Gillette, Shana; Dein, Joshua; Salman, Mo; Richards, Bryan; Duarte, Paulo

    2004-01-01

    Risk analysis tools have been successfully used to determine the potential hazard associated with disease introductions and have facilitated management decisions designed to limit the potential for disease introduction. Chronic Wasting Disease (CWD) poses significant challenges for resource managers due to an incomplete understanding of disease etiology and epidemiology and the complexity of management and political jurisdictions. Tools designed specifically to assess the risk of CWD introduction would be of great value to policy makers in areas where CWD has not been detected.

  3. Integrating LCA and Risk Assessment for Decision Support

    DEFF Research Database (Denmark)

    Dong, Yan; Miraglia, Simona; Manzo, Stefano

    The study aims at developing a methodology using decision analysis theory and tools to find the optimal policy (or design) of the studied system, to ensure both sustainability and meanwhile manage risks.......The study aims at developing a methodology using decision analysis theory and tools to find the optimal policy (or design) of the studied system, to ensure both sustainability and meanwhile manage risks....

  4. Integration of expert knowledge and uncertainty in natural risk assessment

    Science.gov (United States)

    Baruffini, Mirko; Jaboyedoff, Michel

    2010-05-01

    Natural hazards occurring in alpine regions during the last decades have clearly shown that interruptions of the Swiss railway power supply and closures of the Gotthard highway due to those events have increased the awareness of infrastructure vulnerability also in Switzerland and illustrate the potential impacts of failures on the performance of infrastructure systems. This asks for a high level of surveillance and preservation along the transalpine lines. Traditional simulation models are only partially capable to predict complex systems behaviours and the subsequently designed and implemented protection strategies are not able to mitigate the full spectrum of risk consequences. They are costly, and maximal protection is most probably not economically feasible. In addition, the quantitative risk assessment approaches such as fault tree analysis, event tree analysis and equivalent annual fatality analysis rely heavily on statistical information. Collecting sufficient data to base a statistical probability of risk is costly and, in many situations, such data does not exist; thus, expert knowledge and experience or engineering judgment can be exploited to estimate risk qualitatively. In order to overcome the statistics lack we used models based on expert's knowledge in order to qualitatively predict based on linguistic appreciation that are more expressive and natural in risk assessment. Fuzzy reasoning (FR) can be used providing a mechanism of computing with words (Zadeh, 1965) for modelling qualitative human thought processes in analyzing complex systems and decisions. Uncertainty in predicting the risk levels arises from such situations because no fully-formalized knowledge are available. Another possibility is to use probability based on triangular probability density function (T-PDF) that can be used to follow the same flow-chart as FR. We implemented the Swiss natural hazard recommendations FR and probability using T-PDF in order to obtain hazard zoning and

  5. From Physical Process to Economic Cost - Integrated Approaches of Landslide Risk Assessment

    Science.gov (United States)

    Klose, M.; Damm, B.

    2014-12-01

    The nature of landslides is complex in many respects, with landslide hazard and impact being dependent on a variety of factors. This obviously requires an integrated assessment for fundamental understanding of landslide risk. Integrated risk assessment, according to the approach presented in this contribution, implies combining prediction of future landslide occurrence with analysis of landslide impact in the past. A critical step for assessing landslide risk in integrated perspective is to analyze what types of landslide damage affected people and property in which way and how people contributed and responded to these damage types. In integrated risk assessment, the focus is on systematic identification and monetization of landslide damage, and analytical tools that allow deriving economic costs from physical landslide processes are at the heart of this approach. The broad spectrum of landslide types and process mechanisms as well as nonlinearity between landslide magnitude, damage intensity, and direct costs are some main factors explaining recent challenges in risk assessment. The two prevailing approaches for assessing the impact of landslides in economic terms are cost survey (ex-post) and risk analysis (ex-ante). Both approaches are able to complement each other, but yet a combination of them has not been realized so far. It is common practice today to derive landslide risk without considering landslide process-based cause-effect relationships, since integrated concepts or new modeling tools expanding conventional methods are still widely missing. The approach introduced in this contribution is based on a systematic framework that combines cost survey and GIS-based tools for hazard or cost modeling with methods to assess interactions between land use practices and landslides in historical perspective. Fundamental understanding of landslide risk also requires knowledge about the economic and fiscal relevance of landslide losses, wherefore analysis of their

  6. Dietary exposure and human risk assessment of phthalate esters based on total diet study in Cambodia

    International Nuclear Information System (INIS)

    Cheng, Zhang; Li, Han-Han; Wang, Hong-sheng; Zhu, Xue-Mei; Sthiannopkao, Suthipong; Kim, Kyoung-Woong; Yasin, Mohamed Salleh Mohamed; Hashim, Jamal Hisham; Wong, Ming-Hung

    2016-01-01

    Phthalate esters are used in a wide variety of consumer products, and human exposure to this class of compounds is widespread. Nevertheless, studies on dietary exposure of human to phthalates are limited. In this study, to assess the daily intakes of phthalate esters and the possible adverse health impacts, different food samples were collected from three areas of Cambodia, one of the poorest countries in the world. The ∑phthalate ester concentrations in Kampong Cham, Kratie and Kandal provinces ranged from 0.05 to 2.34 (median 0.88) μg g −1 , 0.19–1.65 (median 0.86) μg g −1 and 0.24–3.05 (median 0.59) μg g −1 wet weight (ww), respectively. Di-2-Ethylhexyl phthalate (DEHP) and diisobutyl phthalate (DiBP) were the predominant compounds among all foodstuffs. The estimated daily intake (EDI) of phthalate esters for the general population in Kampong Cham, Kratie and Kandal was 34.3, 35.6 and 35.8 μg kg −1 bw d −1 , respectively. The dietary daily intake of DEHP, benzylbutyl phthalate (BBP) and di-n-butyl phthalate (DBP) in Kampong Cham, Kratie and Kandal were below the tolerable daily intakes (TDI) imposed by the European Food Safety Authority (EFSA) and reference doses (RfD) imposed by The United States Environmental Protection Agency (USEPA). Rice contributed the greatest quantity of DEHP to the daily intake in Cambodia so may deserve further exploration. To our knowledge, this is the first study to investigate the occurrence and the daily intakes of phthalate esters in Cambodia. - Highlights: • Phthalate esters concentration in daily foodstuffs collected from Cambodia. • Investigate the bioaccessbility of phthalate esters via the foodstuffs consumption. • Health risk evaluation of dietary exposure to phthalate esters.

  7. Dietary exposure and human risk assessment of phthalate esters based on total diet study in Cambodia

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Zhang; Li, Han-Han [College of Environment, Sichuan Agricultural University, Chengdu 611130 (China); Wang, Hong-sheng [Department of Microbial and Biochemical Pharmacy, School of Pharmaceutical Sciences, Sun Yat-sen University, No.132 Waihuandong Road, University Town, Guangzhou 510006 (China); Zhu, Xue-Mei [College of Environment, Sichuan Agricultural University, Chengdu 611130 (China); Sthiannopkao, Suthipong [Department of Environmental and Occupational Health, National Cheng Kung University, Tainan City, Taiwan (China); Kim, Kyoung-Woong [School of Environmental Science and Engineering, Gwangju Institute of Science and Technology, Gwangju (Korea, Republic of); Yasin, Mohamed Salleh Mohamed; Hashim, Jamal Hisham [United Nations University-International Institute for Global Health, Kuala Lumpur (Malaysia); Wong, Ming-Hung, E-mail: minghwong@ied.edu.hk [Consortium on Health, Environment, Education and Research (CHEER), and Department of Science and Environmental Studies, Hong Kong Institute of Education, Tai Po, Hong Kong (China); School of Environment, Jinan University, Guangzhou (China)

    2016-10-15

    Phthalate esters are used in a wide variety of consumer products, and human exposure to this class of compounds is widespread. Nevertheless, studies on dietary exposure of human to phthalates are limited. In this study, to assess the daily intakes of phthalate esters and the possible adverse health impacts, different food samples were collected from three areas of Cambodia, one of the poorest countries in the world. The ∑phthalate ester concentrations in Kampong Cham, Kratie and Kandal provinces ranged from 0.05 to 2.34 (median 0.88) μg g{sup −1}, 0.19–1.65 (median 0.86) μg g{sup −1} and 0.24–3.05 (median 0.59) μg g{sup −1} wet weight (ww), respectively. Di-2-Ethylhexyl phthalate (DEHP) and diisobutyl phthalate (DiBP) were the predominant compounds among all foodstuffs. The estimated daily intake (EDI) of phthalate esters for the general population in Kampong Cham, Kratie and Kandal was 34.3, 35.6 and 35.8 μg kg{sup −1} bw d{sup −1}, respectively. The dietary daily intake of DEHP, benzylbutyl phthalate (BBP) and di-n-butyl phthalate (DBP) in Kampong Cham, Kratie and Kandal were below the tolerable daily intakes (TDI) imposed by the European Food Safety Authority (EFSA) and reference doses (RfD) imposed by The United States Environmental Protection Agency (USEPA). Rice contributed the greatest quantity of DEHP to the daily intake in Cambodia so may deserve further exploration. To our knowledge, this is the first study to investigate the occurrence and the daily intakes of phthalate esters in Cambodia. - Highlights: • Phthalate esters concentration in daily foodstuffs collected from Cambodia. • Investigate the bioaccessbility of phthalate esters via the foodstuffs consumption. • Health risk evaluation of dietary exposure to phthalate esters.

  8. EPICO 4.0. 'Total quality' in the management of invasive candidiasis in critically ill patients by analysing the integrated process.

    Science.gov (United States)

    Zaragoza, Rafael; Ferrer, Ricard; Llinares, Pedro; Maseda, Emilio; Rodríguez, Alejandro; Grau, Santiago; Quindós, Guillermo

    A high quality integrated process in the clinical setting of non-neutropenic critically ill patients at risk for invasive candidiasis is a necessary tool to improve the management of these patients. To identify the key points on invasive candidiasis in order to develop a set of recommendations with a high level of consensus required for the creation of a total quality integrated process for the management of non-neutropenic critically ill patients at risk of invasive candidiasis. After a thorough review of the literature of the previous five years, a Spanish prospective questionnaire, which measured consensus by the Delphi technique, was anonymously conducted by e-mail, including 31 national multidisciplinary experts with extensive experience in invasive fungal infections, from six national scientific societies. The experts included a specialist in intensive care medicine, anesthetists, microbiologists, pharmacologists, and specialists in infectious diseases that responded 27 questions prepared by the coordination group. The educational objectives considered six processes that included knowledge of the local epidemiology, the creation and development of multidisciplinary teams, the definitions of the process, protocols, and indicators (KPI), an educational phase, hospital implementation, and the measurement of outcomes. The level of agreement among experts in each category to be selected should exceed 70%. In a second phase, after drawing up the recommendations of the selected processes, a face to face meeting with more than 60 specialists was held. The specialists were asked to validate the pre-selected recommendations. Firstly, 20 recommendations from all the sections were pre-selected: Knowledge of local epidemiology (3 recommendations), creation and development of multidisciplinary teams (3), definition of the process, protocols and indicators (1), educational phase (3), hospital implementation (3), and measurement of outcomes (7). After the second phase, 18

  9. Integration of risk aversion in the evaluation of the external cost of a nuclear accident

    International Nuclear Information System (INIS)

    Eeckhoudt, L.; Schieber, C.; Schneider, Th.

    1998-01-01

    Full text of publication follows: the external costs of fuel cycles used in the production of electricity are those imposed on society and environment that are not accounted for by the producers and consumers of energy. Within the evaluation of the external cost of the nuclear fuel cycle, the evaluation of a nuclear accident has to be addressed. For this purpose, the basic approach consists in calculating the expected value of various occident scenarios. the main criticism of this approach is that there is a discrepancy between the social acceptability of the risk and the average monetary value which corresponds in principle to the compensation of the consequences for each individual of the population affected by the accident. The aim of this paper is to propose a methodology for the integration of risk aversion, relying on the expected utility approach, as well as a numerical application based on the French data for the external cost of a nuclear accident. Although a huge range of values has been published for the relative risk aversion coefficient, it seems reasonable to adopt a value of 2 for the specific case of nuclear accident. This leads to an estimated multiplying coefficient approximately equal to 20 to be applied to the expected external cost of a nuclear accident corresponding to a release of about 1% of the core. In this case, the external cost of the nuclear accident is estimated to 0.046 mECU/kWh (i.e. about 50% of the total external costs of the nuclear fuel cycle estimated at 0.1 mECU/kWh with a 3% discount rate), instead of 0.0023 mECU/kWh without taking into account risk aversion. (authors)

  10. Early amplitude‐integrated electroencephalography for monitoring neonates at high risk for brain injury

    Directory of Open Access Journals (Sweden)

    Gabriel Fernando Todeschi Variane

    2017-09-01

    Conclusion: This study supports previous results and demonstrates the utility of amplitude‐integrated electroencephalography for monitoring brain function and predicting early outcome in the studied groups of infants at high risk for brain injury.

  11. Stakeholder consultations and opportunities for integrating socio-behavioural factors into the pesticide risk analysis process.

    Science.gov (United States)

    Calliera, Maura; Marchis, Alex; Sacchettini, Gabriele; Capri, Ettore

    2016-02-01

    The pesticide risk analysis process is well regulated in the EU, especially in relation to placing on the market authorisation procedures, but in order to avoid risks for human health and environment in the use phase, information on how these substances are employed and on socio-behavioural factors that can influence the exposure have to be taken into account. To better explore reasons about the gap between risk assessment and risk management, within the EU FP7 Health and Environmental Risks: Organisation, Integration and Cross-fertilisation of Scientific Knowledge (HEROIC) project, a stepwise stakeholder's consultation process was developed using a mixed approach in two different phases (survey and roundtable). We elicited stakeholder views regarding factors that could limit the pesticide risk assessment phase linked on how the knowledge is produced and the way the data are used in risk management and in risk communication, also taking into account qualitative factors such as responsibility, trust and behaviours, which could have impact on risk assessment policies. Activities deployed indicate that some changes and interaction are needed to better define the problems at the formulation stage, and the type of information risk assessor has to provide, to better inform risk manager in addressing different societal needs, to strengthen the credibility of the process of risk assessment and improve the effectiveness of policies. Integrations between disciplines may initially increase the complexity but in turn will provide a better and more useful estimation of the risk, reinforce transparency and drive a more efficient use of risk management resources.

  12. Analyzing Integrated Cost-Schedule Risk for Complex Product Systems R&D Projects

    Directory of Open Access Journals (Sweden)

    Zhe Xu

    2014-01-01

    Full Text Available The vast majority of the research efforts in project risk management tend to assess cost risk and schedule risk independently. However, project cost and time are related in reality and the relationship between them should be analyzed directly. We propose an integrated cost and schedule risk assessment model for complex product systems R&D projects. Graphical evaluation review technique (GERT, Monte Carlo simulation, and probability distribution theory are utilized to establish the model. In addition, statistical analysis and regression analysis techniques are employed to analyze simulation outputs. Finally, a complex product systems R&D project as an example is modeled by the proposed approach and the simulation outputs are analyzed to illustrate the effectiveness of the risk assessment model. It seems that integrating cost and schedule risk assessment can provide more reliable risk estimation results.

  13. Corporate foreign exchange speculation and integrated risk management

    DEFF Research Database (Denmark)

    Aabo, Tom; Hansen, Marianna Andryeyeva; Pantzalis, Christos

    2012-01-01

    Purpose – The purpose of this paper is to investigate how non-finance departmental involvement in the management of exchange rate risks impacts the extent of foreign exchange speculation in non-financial firms. Design/methodology/approach – We survey non-financial firms in a small open economy...... (Denmark) to investigate the extent of foreign exchange speculation and how it is related to the degree of non-finance departmental involvement in the management of exchange rate risks. We employ binary and ordered probit regression analysis. Findings – We find a positive link between 1) the extent...... to which other departments than the finance department is involved in the management of exchange rate risks and 2) the extent to which the firm is likely to speculate – whether in the form of selective hedging or active speculation – on the foreign exchange market. Practical implications – Our findings...

  14. Risk of a second malignant neoplasm after cancer in childhood treated with radiotherapy: correlation with the integral dose

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, F.; Rubino, C.; Guerin, S.; de Vathaire, F. [National Institute of Public Health and Medical Research (INSERM) Unit 605, Institut Gustave-Roussy, Villejuif (France); Diallo, I.; Samand, A. [National Institute of Public Health and Medical Research (INSERM) Unit 605, Institut Gustave-Roussy, Villejuif, (France); Medical Physics and Radiotherapy Departments, Institut Gustave-Roussy, Villejuif (France); Hawkins, M. [Centre for Childhood Cancer Survivor Studies, University of Birmingham, Birmingham (United Kingdom); Oberlin, O. [Paediatrics Department, Institut Gustave-Roussy, Villejuif (France); Lefkopoulos, D. [Medical Physics and Radiotherapy Departments, Institut Gustave-Roussy, Villejuif (France)

    2006-07-01

    In the cohort, among patients who had received radiotherapy, only those who had received the highest integral dose had a higher risk. Among the other patients, including 80% of the variability of the integral dose, no increased risk was evidenced. Thus, the integral dose in the study cannot be considered as a good predictor of later risk. (N.C.)

  15. Risk of a second malignant neoplasm after cancer in childhood treated with radiotherapy: correlation with the integral dose

    International Nuclear Information System (INIS)

    Nguyen, F.; Rubino, C.; Guerin, S.; de Vathaire, F.; Diallo, I.; Samand, A.; Hawkins, M.; Oberlin, O.; Lefkopoulos, D.

    2006-01-01

    In the cohort, among patients who had received radiotherapy, only those who had received the highest integral dose had a higher risk. Among the other patients, including 80% of the variability of the integral dose, no increased risk was evidenced. Thus, the integral dose in the study cannot be considered as a good predictor of later risk. (N.C.)

  16. Integrated methodology for production related risk management of vehicle electronics (IMPROVE)

    OpenAIRE

    Geis, Stefan Rafael

    2006-01-01

    This scientific work is designated to provide an innovative and integrated conceptional approach to improve the assembly quality of automotive electronics. This is achieved by the reduction and elimination of production related risks of automotive electronics and the implementation of a sustainable solution process. The focus is the development and implementation of an integrated technical risk management approach for automotive electronics throughout the vehicle life cycle and the vehicle pr...

  17. Total flight hours, irritated and burning eye and risk of mild myopia in civilian pilots in Indonesia

    Directory of Open Access Journals (Sweden)

    Pritha Maya Savitri

    2016-07-01

      in civilian aviator and other populatian. This study aims to identify risk factors that affect the incidence of mild myopia in  civilian pilot in Indonesia. Methods: This study using cross-sectional method with purposive sampling. Subjects answered the questionaire.  Subject of this study are 21-45 years old male civilian aviators which performs scheduled medical check up at Civil Aviatian Medical Centre at May 5 – 21, 2014. The researcher using the medical record to get data about visual acuity. Cox regression analyses using Stata 9. Mild myopia in this study is defect distant visual acuity with corrected lens power -0.25 s/d -0.30. Results: The percentage of mild myopia in this study was 36%. Subjects with a total of 1000 hours of flying hours or more had a 28% higher risk of experiencing mild myopia [relative risk (RRa = 1.28; 95% confidence interval (CI = 1.00 to 1.64; P = 0.047]. A history of parental myopia will increase the risk of mild myopia 5 times (RRa = 5.32, P = 0.000. Subjects with symptoms of difficulty focus has 48% higher risk of experiencing mild myopia (RRa = 1.48, 95% CI = 1.19 to 1.85, P = 0.001. Subjects with symptoms such as eye irritation, gritty, burning has a 54% lower risk of experiencing mild myopia (RRa = 0.46, 95% CI = 0.26-0.83, P = 0.009. Conclusions: Total flight time, parental myopia, visual fatigue; difficulty in focusing and foggy letters are influenced risk factors for mild myopia in civilian aviator in Indonesia. Key words: mild myopia, civilian aviator, total flight time, Indonesia.

  18. Crisis and emergency risk communication as an integrative model.

    Science.gov (United States)

    Reynolds, Barbara; W Seeger, Matthew

    2005-01-01

    This article describes a model of communication known as crisis and emergency risk communication (CERC). The model is outlined as a merger of many traditional notions of health and risk communication with work in crisis and disaster communication. The specific kinds of communication activities that should be called for at various stages of disaster or crisis development are outlined. Although crises are by definition uncertain, equivocal, and often chaotic situations, the CERC model is presented as a tool health communicators can use to help manage these complex events.

  19. Total Dietary Fiber, and Selected Vegetable, Fruit, Legume and Cereal Fiber Intake and Risk of Heart Attack in Periodontitis Subjects

    Directory of Open Access Journals (Sweden)

    Nelson Wood

    2011-10-01

    Full Text Available Background: Epidemiological studies have found an association between periodontal disease and coronary artery disease(Arbes, Slade et al. 1999; Beck, Elter et al. 2001; Genco, Offenbacher et al. 2002, and have even implicated periodontal disease as a risk factor(Arbes, Slade et al. 1999; Beck, Elter et al. 2001, however have not proven causality(Hujoel, Drangholt et al. 2000. Although dietary amounts, sources, and types (soluble versus insoluble of fiber have been shown to reduce the risk of heart attack (Liu, Buring et al. 2002; Negri, Vecchia et al. 2003, this author is unaware of studies that have examined the association between food sources of dietary fiber and heart attack risk in subjects with periodontitis.This study was designed to determine whether total dietary fiber and fiber from different plant sources (vegetables, fruits, legumes, or cereals modified self-reported HA risk, as well as acute-phase inflammatory responses in subjects with periodontitis using NHANES III data.Objectives: The objective of this study was to investigate the association between total dietary fiber intake levels, and selected vegetables, fruits, legumes, and cereal fiber intake and the risk of self-reported history of heart attack (HA in periodontitis subjects using data available in the Third National Health and Nutrition Examination Survey (NHANES III.Materials and Methods: Adult participants in NHANES III were used in this study. Zero to thirty three (0-33 percent of sites with periodontal attachment loss > 3 mm was considered a healthy periodontium, while greater than thirty three percent (>33 of sites with periodontal attachment loss of > 3 mm as periodontitis. The outcome variable was the self-reported history of HA. Total dietary fiber, and monthly selected vegetable, fruit, legume and cereal consumption were divided into low and adequate levels. Data was analyzed by Kruskal-Wallis, ANOVA and multivariate analyses using SPSS ®. P<0.05 was used to

  20. Alternative Payment Models Should Risk-Adjust for Conversion Total Hip Arthroplasty: A Propensity Score-Matched Study.

    Science.gov (United States)

    McLawhorn, Alexander S; Schairer, William W; Schwarzkopf, Ran; Halsey, David A; Iorio, Richard; Padgett, Douglas E

    2017-12-06

    For Medicare beneficiaries, hospital reimbursement for nonrevision hip arthroplasty is anchored to either diagnosis-related group code 469 or 470. Under alternative payment models, reimbursement for care episodes is not further risk-adjusted. This study's purpose was to compare outcomes of primary total hip arthroplasty (THA) vs conversion THA to explore the rationale for risk adjustment for conversion procedures. All primary and conversion THAs from 2007 to 2014, excluding acute hip fractures and cancer patients, were identified in the National Surgical Quality Improvement Program database. Conversion and primary THA patients were matched 1:1 using propensity scores, based on preoperative covariates. Multivariable logistic regressions evaluated associations between conversion THA and 30-day outcomes. A total of 2018 conversions were matched to 2018 primaries. There were no differences in preoperative covariates. Conversions had longer operative times (148 vs 95 minutes, P reimbursement models shift toward bundled payment paradigms, conversion THA appears to be a procedure for which risk adjustment is appropriate. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Comparative risk analysis for the Rocky Flats Plant integrated project planning

    International Nuclear Information System (INIS)

    Jones, M.E.; Shain, D.I.

    1994-01-01

    The Rocky Flats Plant is developing, with active stakeholder participation, a comprehensive planning strategy that will support transition of the Rocky Flats Plant from a nuclear weapons production facility to site cleanup and final disposition. Consideration of the interrelated nature of sitewide problems, such as material movement and disposition, facility and land use endstates, costs, relative risks to workers and the public, and waste disposition are all needed. Comparative Risk Analysis employs both incremental risk and cumulative risk evaluations to compare risks from postulated options or endstates and is an analytical tool for the Rocky Flats Plant Integrated Project Planning which can assist a decision-maker in evaluating relative risks among proposed remediation activity. However, risks from all of the remediation activities, decontamination and decommissioning activities, and normal ongoing operations are imposed upon the Rocky Flats workers, the surrounding public, and the environment. Comparative Risk Analysis will provide risk information, both human health and ecological, to aid in reducing unnecessary resource and monetary expenditures by focusing these resources on the largest risks first. Comparative Risk Analysis has been developed to aggregate various incremental risk estimates to develop a site cumulative risk estimate. The Comparative Risk Analysis methodology Group, consisting of community stakeholders, was established. Early stakeholder involvement in the risk analysis methodology development provides an opportunity for stakeholders to influence the risk information delivered to a decision-maker. This paper discusses development of the Comparative Risk Analysis methodology, stakeholder participation and lessons learned from these challenges

  2. Application of the integrated analysis of safety (IAS) to sequences of Total loss of feed water in a PWR Reactor; Aplicacion del Analisis Integrado de Seguridad (ISA) a Secuencias de Perdidas Total de Agua de Alimentacion en un Reactor PWR

    Energy Technology Data Exchange (ETDEWEB)

    Moreno Chamorro, P.; Gallego Diaz, C.

    2011-07-01

    The main objective of this work is to show the current status of the implementation of integrated analysis of safety (IAS) methodology and its SCAIS associated tool (system of simulation codes for IAS) to the sequence analysis of total loss of feedwater in a PWR reactor model Westinghouse of three loops with large, dry containment.

  3. An integrated dynamic model for probabilistic risk assessments

    International Nuclear Information System (INIS)

    Hsueh, K.-S.; Wang Kong

    2004-01-01

    The purpose of this dissertation is to develop a simulation based accident sequence analysis program (ADS) for large scale dynamic accident sequence simulation. Human operators, front-line and support systems as well as plant thermal-hydraulic behavior are explicitly modeled as integrated active parts in the development of accident scenarios. To overcome the model size, the proposed methodology employs several techniques including use of 'initial state vector' which decouples time-dependent and time-independent factors, and a depth first integration method in which the computation memory demand increases in a linear order. The computer implementation of the method is capable of simulating up to 500 branch points in sequence development, models system failure during operation, allows for recovery from operator errors and hardware failures, and implements a simple model for operator system interactions. (author)

  4. Integrated Intervention for Diabetes Risk After Gestational Diabetes ...

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

    They will work with at-risk women from poor communities who use the public health system in the cities of Cape Town and Johannesburg. The proposed intervention involves offering women a special test to see whether they have diabetes six weeks after delivery, along with counselling about healthy lifestyles from a ...

  5. Integrating Technology into the Curriculum for "At-Risk" Youth

    Science.gov (United States)

    McCall, Denise

    2009-01-01

    This Independent Learning Project (ILP) discusses the best practices in educational technology to improve the behavior, instruction, and learning of at-risk youth, for whom technology offers unique opportunities. Research is compiled from numerous scholarly print and online sources. A guide for teachers provides detailed strategies, software…

  6. CIA increases cybersecurity Integrated approach to digital risks

    International Nuclear Information System (INIS)

    2015-01-01

    The article gives an overview of activities of the cybersecurity group, which was set up in order to go a step further. They have launched a project to manage cybersecurity. The underlying principle is a general pattern that determines policies and the responsibilities for risk management.

  7. Total flight hours, irritated and burning eye and risk of mild myopia in civilian pilots in Indonesia

    Directory of Open Access Journals (Sweden)

    Pritha Maya Savitri

    2016-07-01

    Full Text Available Latar belakang: Miopia merupakan kelainan refraksi yang sering terjadi di antara penerbang. Penelitianini bertujuan mengidentifikasi beberapa faktor risiko dominan terhadap miopia ringan pada penerbang sipildi Indonesia.Metode: Subyek adalah penerbang sipil pria berusia 21-45 tahun yang dipilih secara purposif di antara yangsedang melaksanakan pemeriksaan kesehatan berkala di Balai Kesehatan Penerbangan Jakarta. Data tajampenglihatan dan gula darah didapatkan dari rekam medik. Miopia ringan adalah subyek dengan penurunantajam penglihatan dengan koreksi lensa -0,25 sampai dengan -0,30. Analisis data dengan regresi Coxmenggunakan Stata 10.Hasil: Persentase miopia ringan dalam penelitian ini sebesar 36%. Faktor risiko dominan terhadap myopiaringan adalah jam terbang total, riwayat orang tua myopia, dan gejala iritasi dan gatal mata. Subyekdengan dibandingkan dengan yang kurang dari 1000 jam terbang 28% lebih tinggi berisiko myopia ringan[risiko relatif suaian (RRa = 1,28; 95% interval kepercayaan (CI =1,00-1,64; P = 0,047]. Subyek dengandibandingkan ttanpa riwayat orang tua myopia 32% lebih tinggi berisiko myopia ringan (RRa = 5,32; 95%CI = 3,75-7,55; P = 0,000. Sedangkan subyek dengan dibandingkan tanpa gejala iritasi mata 48% lebihbesar berisiko miopia ringan RRa = 1,48; 95% CI = 1,19-1,85; P = 0,001. Subyek dengan dibandingkantanpa gejala iritasi mata 46% lebih berisiko miopia ringan (RRa = 0,46; 95% CI = 0,26-0,83; P = 0,009.Kesimpulan: Jam terbang total lebih dari 1000 jam, riwayat orang tua miopia, iritasi mata merupakanfaktor risiko dominan terhadap miopia ringan pada penerbang sipil di Indonesia. (Health Science Journalof Indonesia 2016;7:49-53Kata kunci: miopia ringan, penerbang sipil, jam terbang, Indonesia Background: Spatial orientation is the main problem to pilots that determined by visual, vestibuler andpropioseptif. This study aims to identify several dominant risk factors related to mild myopia in civilianpilots in Indonesia

  8. A case-control study to identify risk factors for totally implantable central venous port-related bloodstream infection.

    Science.gov (United States)

    Lee, Guk Jin; Hong, Sook Hee; Roh, Sang Young; Park, Sa Rah; Lee, Myung Ah; Chun, Hoo Geun; Hong, Young Seon; Kang, Jin Hyoung; Kim, Sang Il; Kim, Youn Jeong; Chun, Ho Jong; Oh, Jung Suk

    2014-07-01

    To date, the risk factors for central venous port-related bloodstream infection (CVPBSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.

  9. Acyl/free carnitine ratio is a risk factor for hepatic steatosis after pancreatoduodenectomy and total pancreatectomy.

    Science.gov (United States)

    Nakamura, Masafumi; Nakata, Kohei; Matsumoto, Hideo; Ohtsuka, Takao; Yoshida, Koji; Tokunaga, Shoji; Hino, Keisuke

    Hepatic steatosis, one of the most frequent long-term complications of pancreatectomy, influences not only hepatic function but also survival rate. However, its risk factors and pathogenesis have not been established. The purpose of this study was to clarify the risk factors for hepatic steatosis after pancreatectomy. In this retrospective study of 21 patients who had undergone pancreatectomy (19 cases of pancreatoduodenectomy and 2 cases of total pancreatectomy), serum carnitine concentrations, fractions of carnitine, and hepatic attenuation on computed tomography images were analyzed with the aim of identifying risk factors for hepatic steatosis. Thirteen (61.9%) of the 21 patients were diagnosed as having hypocarnitinemia after pancreatectomy. Average hepatic attenuation was as low as 42.2HU (±21.3 SD). A high ratio of acyl/free carnitine was associated with less pronounced hepatic attenuation according to both univariate (P pancreatectomy in some patients. The statistical analyses suggest that a high ratio of acyl/free carnitine is an independent risk factor for hepatic steatosis after pancreatectomy. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  10. Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis.

    Science.gov (United States)

    Kong, Lingde; Cao, Junming; Zhang, Yingze; Ding, Wenyuan; Shen, Yong

    2017-06-01

    To identify risk factors for periprosthetic joint infection following primary total joint arthroplasty, a systematic search was performed in Pubmed, Embase and Cochrane library databases. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Patient characteristics, surgical-related factors and comorbidities, as potential risk factors, were investigated. The main factors associated with infection after total joint arthroplasty (TJA) were male gender (OR, 1·48; 95% CI, 1.19-1.85), age (SMD, -0·10; 95% CI, -0.17--0.03), obesity (OR, 1·54; 95% CI, 1·25-1·90), alcohol abuse (OR, 1·88; 95% CI, 1·32-2·68), American Society of Anesthesiologists (ASA) scale > 2 (OR, 2·06; 95% CI, 1·77-2·39), operative time (SMD, 0·49; 95% CI, 0·19-0·78), drain usage (OR, 0·36; 95% CI, 0·18-0·74), diabetes mellitus (OR, 1·58; 95% CI, 1·37-1·81), urinary tract infection (OR, 1·53; 95% CI, 1.09-2.16) and rheumatoid arthritis (OR, 1·57; 95% CI, 1·30-1·88). Among these risk factors, ASA score > 2 was a high risk factor, and drain usage was a protective factor. There was positive evidence for some factors that could be used to prevent the onset of infection after TJA. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  11. The effectiveness and cost-effectiveness of an integrated cardiometabolic risk assessment and treatment program in primary care (the INTEGRATE study).

    NARCIS (Netherlands)

    Stol, D.; Badenbroek, I.; Hollander, M.; Nielen, M.; Schellevis, F.; Wit, N. de

    2014-01-01

    The effectiveness and cost-effectiveness of an integrated cardiometabolic risk assessment and treatment program in primary care (the INTEGRATE study): a stepped-wedge randomized controlled trial protocol. Rationale: The increasing prevalence of cardiometabolic disease (CMD), including cardiovascular

  12. Towards an integrated approach to modelling the risks and impacts of invasive forest species

    Science.gov (United States)

    Denys Yemshanov; Daniel McKenney; John Pedlar; Frank Koch; David Cook

    2009-01-01

    In this paper we provide an overview of an integrated approach to modelling the risks and impacts associated with non-indigenous forest pest species. This is a broad and important topic given the scale of ecological and economic consequences associated with non-indigenous species in north america and elsewhere. Assessments of risk and impacts remain difficult due to...

  13. Integrated Risk-Capability Analysis under Deep Uncertainty : An ESDMA Approach

    NARCIS (Netherlands)

    Pruyt, E.; Kwakkel, J.H.

    2012-01-01

    Integrated risk-capability analysis methodologies for dealing with increasing degrees of complexity and deep uncertainty are urgently needed in an ever more complex and uncertain world. Although scenario approaches, risk assessment methods, and capability analysis methods are used, few organizations

  14. The contribution of disaster management to integrated flood risk management strategies: lessons learned from the Netherlands

    NARCIS (Netherlands)

    Kolen, B.; van Alphen, J

    2017-01-01

    An integrated flood risk management (IFRM) strategy consist of a comprehensive set of measures to reduce the risk: protective measures (to reduce the probability of a flood), and land use planning and disaster management (to reduce the consequences of a flood. In the Netherlands this is called a

  15. Integration of risk and benefit analysis - The window of benefit as a new tool?

    NARCIS (Netherlands)

    Palou, A.; Pico, C.; Keijer, J.

    2009-01-01

    Foods and food components can have positive and/or negative effects on our health, resulting in benefits and risks. At present these are evaluated in largely separated trajectories. In view of assessment, management, and communication, we here propose and argue for an integrated evaluation of risk

  16. Proposals for enhanced health risk assessment and stratification in an integrated care scenario

    NARCIS (Netherlands)

    Duenas-Espin, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Carles Contel, Joan; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M. H.; Lluch-Ariet, Magi; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastia; Schonenberg, Helen; Stoerk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-01-01

    Objectives: Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies

  17. Proposals for enhanced health risk assessment and stratification in an integrated care scenario

    NARCIS (Netherlands)

    Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-01-01

    OBJECTIVES: Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies

  18. The Program Risks of Work-Integrated Learning: A Study of Australian University Lawyers

    Science.gov (United States)

    Cameron, Craig; Freudenberg, Brett; Giddings, Jeff; Klopper, Christopher

    2018-01-01

    Work-integrated learning (WIL) is a risky business in higher education. The strategic opportunities that WIL presents for universities cannot be achieved without taking on unavoidable legal risks. University lawyers are involved with managing the legal risks as part of their internal delivery of legal services to universities. It is important to…

  19. INTEGRATED APPROACHES TO GEOPOLITICS AND RISKS IN INTERNATIONAL POLITICS

    OpenAIRE

    Dr. Sheriff Ghali Ibrahim; Dr. Iro Uke

    2016-01-01

    The paper examines the nature and impact of geopolitics on the global oil and gas business. It shows the relationship between politics and what nature provides such as oil and gas and the interplay between and among nations, people and institutions within the framework of geopolitics. The paper adopts the secondary methodology in order to investigate the risks (impact) attached to geopolitics. Findings show that, the concept of geopolitics is so versatile and multidimensional, enveloped by a ...

  20. Integrated presentation of ecological risk from multiple stressors

    OpenAIRE

    Goussen, Benoit Regis Marc; Price, Oliver R.; Rendal, Cecilie; Ashauer, Roman

    2016-01-01

    Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing ...

  1. A Roadmap of Risk Diagnostic Methods: Developing an Integrated View of Risk Identification and Analysis Techniques

    National Research Council Canada - National Science Library

    Williams, Ray; Ambrose, Kate; Bentrem, Laura

    2004-01-01

    ...), which is envisioned to be a comprehensive reference tool for risk identification and analysis (RI AND A) techniques. Program Managers (PMs) responsible for developing or acquiring software-intensive systems typically identify risks in different ways...

  2. Identifying and assessing the risk of opioid abuse in patients with cancer: an integrative review

    Directory of Open Access Journals (Sweden)

    Carmichael AN

    2016-06-01

    Full Text Available Ashley-Nicole Carmichael,1 Laura Morgan,1 Egidio Del Fabbro2 1School of Pharmacy, 2Division of Hematology, Oncology, and Palliative Care, Virginia Commonwealth University, Richmond, VA, USA Background: The misuse and abuse of opioid medications in many developed nations is a health crisis, leading to increased health-system utilization, emergency department visits, and overdose deaths. There are also increasing concerns about opioid abuse and diversion in patients with cancer, even at the end of life. Aims: To evaluate the current literature on opioid misuse and abuse, and more specifically the identification and assessment of opioid-abuse risk in patients with cancer. Our secondary aim is to offer the most current evidence of best clinical practice and suggest future directions for research. Materials and methods: Our integrative review included a literature search using the key terms “identification and assessment of opioid abuse in cancer”, “advanced cancer and opioid abuse”, “hospice and opioid abuse”, and “palliative care and opioid abuse”. PubMed, PsycInfo, and Embase were supplemented by a manual search. Results: We found 691 articles and eliminated 657, because they were predominantly noncancer populations or specifically excluded cancer patients. A total of 34 articles met our criteria, including case studies, case series, retrospective observational studies, and narrative reviews. The studies were categorized into screening questionnaires for opioid abuse or alcohol, urine drug screens to identify opioid misuse or abuse, prescription drug-monitoring programs, and the use of universal precautions. Conclusion: Screening questionnaires and urine drug screens indicated at least one in five patients with cancer may be at risk of opioid-use disorder. Several studies demonstrated associations between high-risk patients and clinical outcomes, such as aberrant behavior, prolonged opioid use, higher morphine-equivalent daily dose

  3. Integrating a gender dimension into osteoporosis and fracture risk research.

    Science.gov (United States)

    Geusens, Piet; Dinant, Geertjan

    2007-01-01

    Sex (referring to the strict biological sense) and gender (referring to the sociocultural dimension) are major determinants of health and disease. This review examines similarities and differences between the sexes in the prevalence of osteoporosis and fractures, bone- and fall-related risk factors for incident fractures, and the possibilities of fracture prevention, as well as gender differences in the perception of osteoporosis. We reviewed recent English-language publications on sex and gender differences in the context of osteoporosis and fracture risk. We refer to several reviews that provide extensive reference lists on the topics discussed. The incidence of fractures is higher in boys than in girls. The burden of fractures in adults increases with age, and it starts earlier and is higher in adult women than in adult men. With life expectancy increasing, the annual number of fractures is likely to increase substantially. Fractures in adults contribute to increased mortality (more in men than in women), increased morbidity (equal in men and women), and high costs (greater for women than for men). Adult men experience fewer fractures than women do. Men build larger bones with better microarchitecture while they are growing and thereafter have less increase in bone remodeling. Furthermore, they develop bone loss at a later age. Compared with their female counterparts, fewer older men are hypogonadic, and life expectancy is shorter for men than for women. There are multiple reasons for the differences in the incidences of fractures between men and women, related to the many factors associated with both bone and falls that influence fracture risk from the molecular and cellular level to the organ level. Sex hormones play a central and essential role in the physiology of bone by direct and indirect mechanisms (eg, by interfering with the growth hormone and insulin-like growth factor-1 axis). Case-finding strategies to identify patients at highest risk for fractures

  4. Credit Risk Management. A study on risk integration in the bank lending process.

    NARCIS (Netherlands)

    Sleddens, Linda Elsa Wilhelmina

    2011-01-01

    Credit risk management has been a topic much written about in the last decade. Substantial credit risk losses can undermine the stability of the bank. Both banks and national bank supervisors have realized the need to invest in credit risk management. Partly driven by regulations such as the Basel

  5. Stratifying risk in chronic kidney disease: an observational study of UK guidelines for measuring total proteinuria and albuminuria.

    Science.gov (United States)

    Methven, S; Traynor, J P; Hair, M D; St J O'Reilly, D; Deighan, C J; MacGregor, M S

    2011-08-01

    Proteinuria predicts poor renal and cardiovascular outcomes. Some guidelines recommend measuring proteinuria using albumin:creatinine ratio (ACR), while others recommend total protein:creatinine ratio (TPCR). To compare renal outcomes and mortality in the populations identified by these different recommendations. Retrospective longitudinal cohort study. Baseline ACR and TPCR measurements were obtained from 5586 patients with chronic kidney disease (CKD) attending a Scottish hospital nephrology clinic. The cohort was divided into three groups with concordant results by ACR and TPCR (no proteinuria; low proteinuria; significant proteinuria) and one group with discordant results (significant proteinuria with TPCR, but not ACR). Outcomes were assessed using Kaplan-Meier plots and Cox proportional hazards models. Median follow-up was 3.5 years [interquartile range (IQR) 2.1-6.0]; 844 (15%) died at 3.0 years (IQR 1.8-4.7) and 468 (8%) started renal replacement therapy (RRT) at 1.7 years (IQR 0.6-3.4). Proteinuria was associated with a substantially increased risk of RRT and death. Patients with significant proteinuria by TPCR, but not ACR (n = 231) had high renal risk, and the highest all-cause mortality (log-rank P < 0.001). With multivariate analysis the risk fell below those with significant proteinuria with concordant results by ACR and TPCR but remained considerably higher than those without significant proteinuria. Proteinuria screening with TPCR identifies an additional 16% of patients with significant proteinuria, not identified using ACR. This subgroup has high renal risk, and high risk of all-cause mortality and therefore warrant identification. Guideline recommendations on proteinuria screening in CKD should be reconsidered.

  6. Does IQ predict total and cardiovascular disease mortality as strongly as other risk factors? Comparison of effect estimates using the Vietnam Experience Study

    DEFF Research Database (Denmark)

    Batty, G D; Shipley, M J; Gale, C R

    2008-01-01

    To compare the strength of the relation of two measurements of IQ and 11 established risk factors with total and cardiovascular disease (CVD) mortality.......To compare the strength of the relation of two measurements of IQ and 11 established risk factors with total and cardiovascular disease (CVD) mortality....

  7. Blood transfusion in primary total shoulder arthroplasty: incidence, trends, and risk factors in the United States from 2000 to 2009.

    Science.gov (United States)

    Ryan, Devon J; Yoshihara, Hiroyuki; Yoneoka, Daisuke; Zuckerman, Joseph D

    2015-05-01

    Total shoulder arthroplasty (TSA) may be associated with substantial blood loss, and some patients require perioperative blood transfusion. Possible blood transfusion methods include predonated autologous blood transfusion, perioperative autologous blood transfusion, and allogeneic blood transfusion (ALBT). The purposes of the present study were to assess the incidence and recent trends over time of blood transfusion in TSA and analyze patient and hospital characteristics that affect the risk of ALBT. This study used national hospital discharge data from the National Inpatient Sample between 2000 and 2009. The data were used to generate the overall blood transfusion rate, and linear regression was used to assess trends in transfusion patterns over time. Logistic regression analysis was performed to analyze which patient and hospital characteristics independently influence the likelihood that a given patient undergoes ALBT. The overall blood transfusion rate (ie, the proportion of patients who received at least 1 transfusion of any kind) was 6.7%. This rate increased over time, from 4.9% in 2000 to 7.1% in 2009 (P blood transfusion rate in TSA found in the present study may be related to factors specific to TSA, such as the introduction of reverse total shoulder arthroplasty during the study period. A variety of patient and hospital characteristics contribute to the risk of undergoing ALBT. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  8. Coronary collateral circulation in patients with chronic coronary total occlusion; its relationship with cardiac risk markers and SYNTAX score.

    Science.gov (United States)

    Börekçi, A; Gür, M; Şeker, T; Baykan, A O; Özaltun, B; Karakoyun, S; Karakurt, A; Türkoğlu, C; Makça, I; Çaylı, M

    2015-09-01

    Compared to patients without a collateral supply, long-term cardiac mortality is reduced in patients with well-developed coronary collateral circulation (CCC). Cardiovascular risk markers, such as N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive C-reactive protein (hs-CRP) and high-sensitive cardiac troponin T (hs-cTnT) are independent predictors for cardiovascular mortality. The main goal of this study was to examine the relationship between CCC and cardiovascular risk markers. We prospectively enrolled 427 stable coronary artery disease patients with chronic total occlusion (mean age: 57.5±11.1 years). The patients were divided into two groups, according to their Rentrop scores: (a) poorly developed CCC group (Rentrop 0 and 1) and (b) well-developed CCC group (Rentrop 2 and 3). NT-proBNP, hs-CRP, hs-cTnT, uric acid and other biochemical markers were also measured. The SYNTAX score was calculated for all patients. The patients in the poorly developed CCC group had higher frequencies of diabetes and hypertension (prisk markers, such as NT-proBNP, hs-cTnT and hs-CRP are independently associated with CCC in stable coronary artery disease with chronic total occlusion. © The Author(s) 2014.

  9. INTEGRATED FRAMEWORK FOR ENHANCING EARTHQUAKE RISK MITIGATION DECISIONS

    Directory of Open Access Journals (Sweden)

    Temitope Egbelakin

    2015-12-01

    Full Text Available The increasing scale of losses from earthquake disasters has reinforced the need for property owners to become proactive in seismic risk reduction programs. However, despite advancement in seismic design methods and legislative frameworks, building owners are found unwilling or lack motivation to adopt adequate mitigation measures that will reduce their vulnerability to earthquake disasters. Various theories and empirical findings have been used to explain the adoption of protective behaviours including seismic mitigation decisions, but their application has been inadequate to enhance building owners’ protective decisions. A holistic framework that incorporates the motivational orientations of decision-making, coupled with the social, cultural, economic, regulatory, institutional and political realms of earthquake risk mitigation to enhance building owners’ decisions to voluntarily implement adequate mitigation measures, is proposed. This framework attempts to address any multi-disciplinary barriers that exist in earthquake disaster management, by ensuring that stakeholders involved in seismic mitigation decisions work together to foster seismic rehabilitation of EPBs, as well as illuminate strategies that will initiate, promote and sustain the adoption of long-term earthquake mitigation. .

  10. An integrative model of risk for high school disordered eating.

    Science.gov (United States)

    Davis, Heather A; Smith, Gregory T

    2018-06-21

    Binge eating and purging behaviors are associated with significant harm and distress among adolescents. The process by which these behaviors develop (often in the high school years) is not fully understood. We tested the Acquired Preparedness (AP) model of risk involving transactions among biological, personality, and psychosocial factors to predict binge eating and purging behavior in a sample of 1,906 children assessed in the spring of 5th grade (the last year of elementary school), the fall of 6th grade (the first year of middle school), spring of 6th grade, and spring of 10th grade (second year of high school). Pubertal onset in spring of 5th grade predicted increases in negative urgency, but not negative affect, in the fall of 6th grade. Negative urgency in the fall of 6th grade predicted increases in expectancies for reinforcement from eating in the spring of 6th grade, which in turn predicted increases in binge eating behavior in the spring of 10th grade. Negative affect in the fall of 6th grade predicted increases in thinness expectancies in the spring of 6th grade, which in turn predicted increases in purging in the spring of 10th grade. Results demonstrate similarities and differences in the development of these two different bulimic behaviors. Intervention efforts targeting the risk factors evident in this model may prove fruitful in the treatment of eating disorders characterized by binge eating and purging. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  11. Benefit–risk assessment of rivaroxaban versus enoxaparin for the prevention of venous thromboembolism after total hip or knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Levitan B

    2014-03-01

    Full Text Available Bennett Levitan,1 Zhong Yuan,1 Alexander GG Turpie,2 Richard J Friedman,3 Martin Homering,4 Jesse A Berlin,1 Scott D Berkowitz,5 Rachel B Weinstein,1 Peter M DiBattiste61Janssen Research & Development, LLC, Titusville, NJ, USA; 2Hamilton Health Sciences McMaster Clinic, McMaster University, Hamilton, ON, Canada; 3Charleston Orthopaedic Associates, Charleston, SC, USA; 4Bayer HealthCare, Berlin, Germany; 5Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA; 6Janssen Research & Development, Raritan, NJ, USAPurpose: Venous thromboembolism is a common complication after major orthopedic surgery. When prescribing anticoagulant prophylaxis, clinicians weigh the benefits of thromboprophylaxis against bleeding risk and other adverse events. Previous benefit–risk analyses of the REgulation of Coagulation in ORthopaedic surgery to prevent Deep vein thrombosis and pulmonary embolism (RECORD randomized clinical studies of rivaroxaban versus enoxaparin after total hip (THA or knee (TKA arthroplasty generally used pooled THA and TKA results, counted fatal bleeding as both an efficacy and a safety event, and included the active and placebo-controlled portions of RECORD2, which might confound benefit–risk assessments. We conducted a post hoc analysis without these constraints to assess benefit–risk for rivaroxaban versus enoxaparin in the RECORD studies.Patients and methods: Data from the safety population of the two THA and two TKA studies were pooled separately. The primary analysis compared the temporal course of event rates and rate differences between rivaroxaban and enoxaparin prophylaxis for symptomatic venous thromboembolism plus all-cause mortality (efficacy events versus nonfatal major bleeding (safety events. Additionally, these rates were used to derive measures of net clinical benefit, number needed to treat (NNT, and number needed to harm (NNH for these two end points.Results: After THA or TKA, and compared with enoxaparin, rivaroxaban

  12. A dynamic multimedia fuzzy-stochastic integrated environmental risk assessment approach for contaminated sites management

    International Nuclear Information System (INIS)

    Hu, Yan; Wen, Jing-ya; Li, Xiao-li; Wang, Da-zhou; Li, Yu

    2013-01-01

    Highlights: • Using interval mathematics to describe spatial and temporal variability and parameter uncertainty. • Using fuzzy theory to quantify variability of environmental guideline values. • Using probabilistic approach to integrate interval concentrations and fuzzy environmental guideline. • Establishment of dynamic multimedia environmental integrated risk assessment framework. -- Abstract: A dynamic multimedia fuzzy-stochastic integrated environmental risk assessment approach was developed for contaminated sites management. The contaminant concentrations were simulated by a validated interval dynamic multimedia fugacity model, and different guideline values for the same contaminant were represented as a fuzzy environmental guideline. Then, the probability of violating environmental guideline (Pv) can be determined by comparison between the modeled concentrations and the fuzzy environmental guideline, and the constructed relationship between the Pvs and environmental risk levels was used to assess the environmental risk level. The developed approach was applied to assess the integrated environmental risk at a case study site in China, simulated from 1985 to 2020. Four scenarios were analyzed, including “residential land” and “industrial land” environmental guidelines under “strict” and “loose” strictness. It was found that PAH concentrations will increase steadily over time, with soil found to be the dominant sink. Source emission in soil was the leading input and atmospheric sedimentation was the dominant transfer process. The integrated environmental risks primarily resulted from petroleum spills and coke ovens, while the soil environmental risks came from coal combustion. The developed approach offers an effective tool for quantifying variability and uncertainty in the dynamic multimedia integrated environmental risk assessment and the contaminated site management

  13. A dynamic multimedia fuzzy-stochastic integrated environmental risk assessment approach for contaminated sites management

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Yan; Wen, Jing-ya; Li, Xiao-li; Wang, Da-zhou; Li, Yu, E-mail: liyuxx8@hotmail.com

    2013-10-15

    Highlights: • Using interval mathematics to describe spatial and temporal variability and parameter uncertainty. • Using fuzzy theory to quantify variability of environmental guideline values. • Using probabilistic approach to integrate interval concentrations and fuzzy environmental guideline. • Establishment of dynamic multimedia environmental integrated risk assessment framework. -- Abstract: A dynamic multimedia fuzzy-stochastic integrated environmental risk assessment approach was developed for contaminated sites management. The contaminant concentrations were simulated by a validated interval dynamic multimedia fugacity model, and different guideline values for the same contaminant were represented as a fuzzy environmental guideline. Then, the probability of violating environmental guideline (Pv) can be determined by comparison between the modeled concentrations and the fuzzy environmental guideline, and the constructed relationship between the Pvs and environmental risk levels was used to assess the environmental risk level. The developed approach was applied to assess the integrated environmental risk at a case study site in China, simulated from 1985 to 2020. Four scenarios were analyzed, including “residential land” and “industrial land” environmental guidelines under “strict” and “loose” strictness. It was found that PAH concentrations will increase steadily over time, with soil found to be the dominant sink. Source emission in soil was the leading input and atmospheric sedimentation was the dominant transfer process. The integrated environmental risks primarily resulted from petroleum spills and coke ovens, while the soil environmental risks came from coal combustion. The developed approach offers an effective tool for quantifying variability and uncertainty in the dynamic multimedia integrated environmental risk assessment and the contaminated site management.

  14. Exploring the uncertainties in cancer risk assessment using the integrated probabilistic risk assessment (IPRA) approach.

    Science.gov (United States)

    Slob, Wout; Bakker, Martine I; Biesebeek, Jan Dirk Te; Bokkers, Bas G H

    2014-08-01

    Current methods for cancer risk assessment result in single values, without any quantitative information on the uncertainties in these values. Therefore, single risk values could easily be overinterpreted. In this study, we discuss a full probabilistic cancer risk assessment approach in which all the generally recognized uncertainties in both exposure and hazard assessment are quantitatively characterized and probabilistically evaluated, resulting in a confidence interval for the final risk estimate. The methodology is applied to three example chemicals (aflatoxin, N-nitrosodimethylamine, and methyleugenol). These examples illustrate that the uncertainty in a cancer risk estimate may be huge, making single value estimates of cancer risk meaningless. Further, a risk based on linear extrapolation tends to be lower than the upper 95% confidence limit of a probabilistic risk estimate, and in that sense it is not conservative. Our conceptual analysis showed that there are two possible basic approaches for cancer risk assessment, depending on the interpretation of the dose-incidence data measured in animals. However, it remains unclear which of the two interpretations is the more adequate one, adding an additional uncertainty to the already huge confidence intervals for cancer risk estimates. © 2014 Society for Risk Analysis.

  15. Integrating Household Risk Mitigation Behavior in Flood Risk Analysis: An Agent-Based Model Approach.

    Science.gov (United States)

    Haer, Toon; Botzen, W J Wouter; de Moel, Hans; Aerts, Jeroen C J H

    2017-10-01

    Recent studies showed that climate change and socioeconomic trends are expected to increase flood risks in many regions. However, in these studies, human behavior is commonly assumed to be constant, which neglects interaction and feedback loops between human and environmental systems. This neglect of human adaptation leads to a misrepresentation of flood risk. This article presents an agent-based model that incorporates human decision making in flood risk analysis. In particular, household investments in loss-reducing measures are examined under three economic decision models: (1) expected utility theory, which is the traditional economic model of rational agents; (2) prospect theory, which takes account of bounded rationality; and (3) a prospect theory model, which accounts for changing risk perceptions and social interactions through a process of Bayesian updating. We show that neglecting human behavior in flood risk assessment studies can result in a considerable misestimation of future flood risk, which is in our case study an overestimation of a factor two. Furthermore, we show how behavior models can support flood risk analysis under different behavioral assumptions, illustrating the need to include the dynamic adaptive human behavior of, for instance, households, insurers, and governments. The method presented here provides a solid basis for exploring human behavior and the resulting flood risk with respect to low-probability/high-impact risks. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  16. Integrated Project Management: A Case Study in Integrating Cost, Schedule, Technical, and Risk Areas

    Science.gov (United States)

    Smith, Greg

    2004-01-01

    This viewgraph presentation describes a case study as a model for integrated project management. The ISS Program Office (ISSPO) developed replacement fluid filtration cartridges in house for the International Space Station (ISS). The presentation includes a step-by-step procedure and organizational charts for how the fluid filtration problem was approached.

  17. Proposal of a risk-factor-based analytical approach for integrating occupational health and safety into project risk evaluation.

    Science.gov (United States)

    Badri, Adel; Nadeau, Sylvie; Gbodossou, André

    2012-09-01

    Excluding occupational health and safety (OHS) from project management is no longer acceptable. Numerous industrial accidents have exposed the ineffectiveness of conventional risk evaluation methods as well as negligence of risk factors having major impact on the health and safety of workers and nearby residents. Lack of reliable and complete evaluations from the beginning of a project generates bad decisions that could end up threatening the very existence of an organization. This article supports a systematic approach to the evaluation of OHS risks and proposes a new procedure based on the number of risk factors identified and their relative significance. A new concept called risk factor concentration along with weighting of risk factor categories as contributors to undesirable events are used in the analytical hierarchy process multi-criteria comparison model with Expert Choice(©) software. A case study is used to illustrate the various steps of the risk evaluation approach and the quick and simple integration of OHS at an early stage of a project. The approach allows continual reassessment of criteria over the course of the project or when new data are acquired. It was thus possible to differentiate the OHS risks from the risk of drop in quality in the case of the factory expansion project. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Validation of the total dysphagia risk score (TDRS) in head and neck cancer patients in a conventional and a partially accelerated radiotherapy scheme

    NARCIS (Netherlands)

    Nevens, Daan; Deschuymer, Sarah; Langendijk, Johannes A.; Daisne, Jean -Francois; Duprez, Frederic; De Neve, Wilfried; Nuyts, Sandra

    Background and purpose: A risk model, the total dysphagia risk score (TDRS), was developed to predict which patients are most at risk to develop grade >= 2 dysphagia at 6 months following radiotherapy (RT) for head and neck cancer. The purpose of this study was to validate this model at 6 months and

  19. Integrated testing strategies can be optimal for chemical risk classification.

    Science.gov (United States)

    Raseta, Marko; Pitchford, Jon; Cussens, James; Doe, John

    2017-08-01

    There is an urgent need to refine strategies for testing the safety of chemical compounds. This need arises both from the financial and ethical costs of animal tests, but also from the opportunities presented by new in-vitro and in-silico alternatives. Here we explore the mathematical theory underpinning the formulation of optimal testing strategies in toxicology. We show how the costs and imprecisions of the various tests, and the variability in exposures and responses of individuals, can be assembled rationally to form a Markov Decision Problem. We compute the corresponding optimal policies using well developed theory based on Dynamic Programming, thereby identifying and overcoming some methodological and logical inconsistencies which may exist in the current toxicological testing. By illustrating our methods for two simple but readily generalisable examples we show how so-called integrated testing strategies, where information of different precisions from different sources is combined and where different initial test outcomes lead to different sets of future tests, can arise naturally as optimal policies. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. A Review on Methods of Risk Adjustment and their Use in Integrated Healthcare Systems

    Science.gov (United States)

    Juhnke, Christin; Bethge, Susanne

    2016-01-01

    Introduction: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The objective of this review was to obtain an overview of existing models of risk adjustment as well as on crucial weights in risk adjustment. Moreover, the predictive performance of selected methods in international healthcare systems should be analysed. Theory and methods: A comprehensive, systematic literature review on methods of risk adjustment was conducted in terms of an encompassing, interdisciplinary examination of the related disciplines. Results: In general, several distinctions can be made: in terms of risk horizons, in terms of risk factors or in terms of the combination of indicators included. Within these, another differentiation by three levels seems reasonable: methods based on mortality risks, methods based on morbidity risks as well as those based on information on (self-reported) health status. Conclusions and discussion: After the final examination of different methods of risk adjustment it was shown that the methodology used to adjust risks varies. The models differ greatly in terms of their included morbidity indicators. The findings of this review can be used in the evaluation of integrated healthcare delivery systems and can be integrated into quality- and patient-oriented reimbursement of care providers in the design of healthcare contracts. PMID:28316544

  1. Risk of cardiovascular disease and total mortality in adults with type 1 diabetes: Scottish registry linkage study.

    Directory of Open Access Journals (Sweden)

    Shona J Livingstone

    previously reported in other developed countries, CVD and mortality rates may not be generalizable to other countries. Limitations included lack of information on the specific insulin therapy used.Although the relative risks for CVD and total mortality associated with T1DM in this population have declined relative to earlier studies, T1DM continues to be associated with higher CVD and death rates than the non-diabetic population. Risk factor management should be improved to further reduce risk but better treatment approaches for achieving good glycaemic control are badly needed. Please see later in the article for the Editors' Summary.

  2. Effects of total integrated solar radiation on radial fruit cracking in tomato [Lycopersicon esculentum] cultivation under rain shelter in cool uplands

    International Nuclear Information System (INIS)

    Suzuki, T.; Yanase, S.; Enya, T.; Shimazu, T.; Tanaka, I.

    2007-01-01

    This study investigated the cause of radial fruit cracking in tomato cultivation under rain shelter in the cool uplands in Gifu Prefecture. The effect of total integrated radiation using two types of training methods was determined over a three-year period. The percentage of refused radial fruit cracking associated with increased total integrated solar radiation from the young fruit stage to the mature green stage. Fruit cracking occurred in the training method which foliage and fruits received a large amount of light-interception. Also, as for fruits that undergo vigorous enlargement, the frequency of the radial fruit cracking increased

  3. An Integrated Soft Computing Approach to Hughes Syndrome Risk Assessment.

    Science.gov (United States)

    Vilhena, João; Rosário Martins, M; Vicente, Henrique; Grañeda, José M; Caldeira, Filomena; Gusmão, Rodrigo; Neves, João; Neves, José

    2017-03-01

    The AntiPhospholipid Syndrome (APS) is an acquired autoimmune disorder induced by high levels of antiphospholipid antibodies that cause arterial and veins thrombosis, as well as pregnancy-related complications and morbidity, as clinical manifestations. This autoimmune hypercoagulable state, usually known as Hughes syndrome, has severe consequences for the patients, being one of the main causes of thrombotic disorders and death. Therefore, it is required to be preventive; being aware of how probable is to have that kind of syndrome. Despite the updated of antiphospholipid syndrome classification, the diagnosis remains difficult to establish. Additional research on clinically relevant antibodies and standardization of their quantification are required in order to improve the antiphospholipid syndrome risk assessment. Thus, this work will focus on the development of a diagnosis decision support system in terms of a formal agenda built on a Logic Programming approach to knowledge representation and reasoning, complemented with a computational framework based on Artificial Neural Networks. The proposed model allows for improving the diagnosis, classifying properly the patients that really presented this pathology (sensitivity higher than 85%), as well as classifying the absence of APS (specificity close to 95%).

  4. Pipeline integrity management: integration of geotechnical and mechanical assessment to control potential risks due to external forces

    Energy Technology Data Exchange (ETDEWEB)

    Malpartida Moya, John E.; Sota, Giancarlo Massucco de la; Seri, Walter [Compania Operadora de Gas del Amazonas, Lima (Peru)

    2009-07-01

    Every pipeline integrity management system evaluates and controls various threats. On pipelines which have particular characteristics as it is the case of the Andean pipelines and pipelines crossing jungles, one of the main threats are the external forces. Even, this threat causes a greater number of failures than other threats like corrosion or the third part damage. Facing this situation, the pipeline integrity management system of TgP has achieved an important development in the use and suitable handling of the information provided by diverse techniques of pipeline mechanical inspection and geotechnical inspection of the right-of-way (ROW). This document presents our methodology, which interrelate information of the in-line inspection, information of geotechnical inspections of the ROW, instrumentation (Strain Gages), topographic monitoring, among others. All this information is supported in a Geographic Information System (GIS) which allows us to integrate the information. By means of the pipeline integrity management system we control potential risks due to external forces, we have been able to act before events become critical, with no occurrence of failures. This system allows us simultaneously to optimize efforts and preserve the mechanical integrity of our pipelines, not producing neither personal nor environmental nor economical affectation. (author)

  5. Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis

    Directory of Open Access Journals (Sweden)

    Andressa Magalhães Teixeira

    Full Text Available ABSTRACT Objective: to identify evidence in the literature on the possible risk factors for the risk of unstable blood glucose diagnosis in individuals with type 2 diabetes mellitus, and to compare them with the risk factors described by NANDA International. Method: an integrative literature review guided by the question: what are the risk factors for unstable blood glucose level in people with type 2 diabetes mellitus? Primary studies were included whose outcomes were variations in glycemic levels, published in English, Portuguese or Spanish, in PubMed or CINAHL between 2010 and 2015. Results: altered levels of glycated hemoglobin, body mass index>31 kg/m2, previous history of hypoglycemia, cognitive deficit/dementia, autonomic cardiovascular neuropathy, comorbidities and weight loss corresponded to risk factors described in NANDA International. Other risk factors identified were: advanced age, black skin color, longer length of diabetes diagnosis, daytime sleepiness, macroalbuminuria, genetic polymorphisms, insulin therapy, use of oral antidiabetics, and use of metoclopramide, inadequate physical activity and low fasting glycemia. Conclusions: risk factors for the diagnosis, risk for unstable blood glucose level, for persons with type 2 diabetes mellitus were identified, and 42% of them corresponded to those of NANDA International. These findings may contribute to the practice of clinical nurses in preventing the deleterious effects of glycemic variation.

  6. Prospective associations of C-reactive protein (CRP) levels and CRP genetic risk scores with risk of total knee and hip replacement for osteoarthritis in a diverse cohort.

    Science.gov (United States)

    Shadyab, A H; Terkeltaub, R; Kooperberg, C; Reiner, A; Eaton, C B; Jackson, R D; Krok-Schoen, J L; Salem, R M; LaCroix, A Z

    2018-05-22

    To examine associations of high-sensitivity C-reactive protein (CRP) levels and polygenic CRP genetic risk scores (GRS) with risk of end-stage hip or knee osteoarthritis (OA), defined as incident total hip (THR) or knee replacement (TKR) for OA. This study included a cohort of postmenopausal white, African American, and Hispanic women from the Women's Health Initiative. Women were followed from baseline to date of THR or TKR, death, or December 31, 2014. Medicare claims data identified THR and TKR. Hs-CRP and genotyping data were collected at baseline. Three CRP GRS were constructed: 1) a 4-SNP GRS comprised of genetic variants representing variation in the CRP gene among European populations; 2) a multilocus 18-SNP GRS of genetic variants significantly associated with CRP levels in a meta-analysis of genome-wide association studies; and 3) a 5-SNP GRS of genetic variants significantly associated with CRP levels among African American women. In analyses conducted separately among each race and ethnic group, there were no significant associations of ln hs-CRP with risk of THR or TKR, after adjusting for age, body mass index, lifestyle characteristics, chronic diseases, hormone therapy use, and non-steroidal anti-inflammatory drug use. CRP GRS were not associated with risk of THR or TKR in any ethnic group. Serum levels of ln hs-CRP and genetically-predicted CRP levels were not associated with risk of THR or TKR for OA among a diverse cohort of women. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  7. Incidence, risk factors and the healthcare cost of falls postdischarge after elective total hip and total knee replacement surgery: protocol for a prospective observational cohort study

    Science.gov (United States)

    Hill, Anne-Marie; Ross-Adjie, Gail; McPhail, Steven M; Monterosso, Leanne; Bulsara, Max; Etherton-Beer, Christopher; Powell, Sarah-Jayne; Hardisty, Gerard

    2016-01-01

    Introduction The number of major joint replacement procedures continues to increase in Australia. The primary aim of this study is to determine the incidence of falls in the first 12 months after discharge from hospital in a cohort of older patients who undergo elective total hip or total knee replacement. Methods and analyses A prospective longitudinal observational cohort study starting in July 2015, enrolling patients aged ≥60 years who are admitted for elective major joint replacement (n=267 total hip replacement, n=267 total knee replacement) and are to be discharged to the community. Participants are followed up for 12 months after hospital discharge. The primary outcome measure is the rate of falls per thousand patient-days. Falls data will be collected by 2 methods: issuing a falls diary to each participant and telephoning participants monthly after discharge. Secondary outcomes include the rate of injurious falls and health-related quality of life. Patient-rated outcomes will be measured using the Oxford Hip or Oxford Knee score. Generalised linear mixed modelling will be used to examine the falls outcomes in the 12 months after discharge and to examine patient and clinical characteristics predictive of falls. An economic evaluation will be conducted to describe the nature of healthcare costs in the first 12 months after elective joint replacement and estimate costs directly attributable to fall events. Ethics and dissemination The results will be disseminated through local site networks and will inform future services to support older people undergoing hip or knee joint replacement and also through peer-reviewed publications and medical conferences. This study has been approved by The University of Notre Dame Australia and local hospital human research ethics committees. Trial registration number ACTRN12615000653561; Pre-results. PMID:27412102

  8. Dependent failure analysis research for the US NRC Risk Methods Integration and Evaluation Program

    International Nuclear Information System (INIS)

    Bohn, M.P.; Stack, D.W.; Campbell, D.J.; Rooney, J.J.; Rasmuson, D.M.

    1985-01-01

    The Risk Methods Integration and Evaluation Program (RMIEP), which is being performed for the Nuclear Regulatory Commission by Sandia National Laboratories, has the goals of developing new risk assessment methods and integrating the new and existing methods in a uniform procedure for performing an in-depth probabilistic risk assessment (PRA) with consistent levels of analysis for internal, external, and dependent failure scenarios. An important part of RMIEP is the recognition of the crucial importance of dependent common cause failures (CCFs) and the pressing need to develop effective methods for analyzing CCFs as part of a PRA. The NRC-sponsored Integrated Dependent Failure Methodology Program at Sandia is addressing this need. This paper presents a preliminary approach for analyzing CCFs as part of a PRA. A nine-step procedure for efficiently screening and analyzing dependent failure scenarios is presented, and each step is discussed

  9. Incidence of and risk factors for postoperative urinary retention in fast-track total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars; Bogø, Stina; Raaschou, Sofie

    2015-01-01

    BACKGROUND AND PURPOSE: Postoperative urinary retention (POUR) is a clinical challenge, but there is no scientific evidence for treatment principles. We describe the incidence of and predictive factors for POUR in fast-track total hip (THA) and knee arthroplasty (TKA). PATIENTS AND METHODS......, and preoperative international prostate symptom score (IPSS) were compared between catheterized and non-catheterized patients. RESULTS: The incidence of POUR was 40% (range between departments: 30-55%). Median bladder volume evacuated by catheterization was 0.6 (0.1-1.9) L. Spinal anesthesia increased the risk...... was 40%, with spinal anesthesia and increased IPSS in males as predictive factors. The large variation in perioperative bladder management and in bladder volumes evacuated by catheterization calls for randomized studies to define evidence-based principles for treatment of POUR in the future....

  10. Compound risk judgment in tasks with both idiosyncratic and systematic risk: The "Robust Beauty" of additive probability integration.

    Science.gov (United States)

    Sundh, Joakim; Juslin, Peter

    2018-02-01

    In this study, we explore how people integrate risks of assets in a simulated financial market into a judgment of the conjunctive risk that all assets decrease in value, both when assets are independent and when there is a systematic risk present affecting all assets. Simulations indicate that while mental calculation according to naïve application of probability theory is best when the assets are independent, additive or exemplar-based algorithms perform better when systematic risk is high. Considering that people tend to intuitively approach compound probability tasks using additive heuristics, we expected the participants to find it easiest to master tasks with high systematic risk - the most complex tasks from the standpoint of probability theory - while they should shift to probability theory or exemplar memory with independence between the assets. The results from 3 experiments confirm that participants shift between strategies depending on the task, starting off with the default of additive integration. In contrast to results in similar multiple cue judgment tasks, there is little evidence for use of exemplar memory. The additive heuristics also appear to be surprisingly context-sensitive, with limited generalization across formally very similar tasks. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Risk and integrity management system for PETRONAS Gas Berhad's gas and liquid hydrocarbon pipelines

    Energy Technology Data Exchange (ETDEWEB)

    Khalid, Tuan Hj. Ahmad Nadzri bin; Nasir, Osman; Napiah, Mohd Nazmi Mohd Ali [PETRONAS Gas Berhad, Johor (Malaysia); Choong, Evelyn

    2005-07-01

    PETRONAS Gas Berhad (PGB), Malaysia currently operates one of Southeast Asia's largest onshore pipeline systems comprising more than 2,500 km of large diameter high pressure gas and liquid transmission, supply and lateral pipelines. Recognizing the value of a risk based approach to pipeline integrity management program, in 2002 PGB implemented a customized and fully integrated Risk and Integrity Management System (RIMS) which included software modules for: data management; semi-quantitative risk assessment; risk control cost benefit analyses; defect assessment; corrosion growth modeling; and reporting. As part of this project, a benchmarking study performed jointly with the contractor, PGB's pipeline integrity programs were also compared with a broad group of international pipeline operators. This study compared the relative ranking position of PGB pre- and post implementation of RIMS. It demonstrated that implementation of RIMS places PGB in a select group of first quartile international pipeline operators, with respect to the implementation of pipeline integrity management best practice. This paper describes the functionalities of RIMS system and how it has benefited PGB, which have been realized to date from its implementation. (author)

  12. SU-F-T-248: FMEA Risk Analysis Implementation (AAPM TG-100) in Total Skin Electron Irradiation Technique

    Energy Technology Data Exchange (ETDEWEB)

    Ibanez-Rosello, B; Bautista-Ballesteros, J; Bonaque, J [Hospital La Fe, Valencia, Valencia (Spain); Perez-Calatayud, J [Hospital La Fe, Valencia, Valencia (Spain); Clinica Benidorm, Benidorm, Alicante (Spain); Gonzalez-Sanchis, A; Lopez-Torrecilla, J; Brualla-Gonzalez, L; Garcia-Hernandez, T; Vicedo-Gonzalez, A; Granero, D; Serrano, A; Borderia, B; Solera, C [Hospital General ERESA, Valencia, Valencia (Spain); Rosello, J [Hospital General ERESA, Valencia, Valencia (Spain); Universidad de Valencia, Valencia, Valencia (Spain)

    2016-06-15

    Purpose: Total Skin Electron Irradiation (TSEI) is a radiotherapy treatment which involves irradiating the entire body surface as homogeneously as possible. It is composed of an extensive multi-step technique in which quality management requires high consumption of resources and a fluid communication between the involved staff, necessary to improve the safety of treatment. The TG-100 proposes a new perspective of quality management in radiotherapy, presenting a systematic method of risk analysis throughout the global flow of the stages through the patient. The purpose of this work has been to apply TG-100 approach to the TSEI procedure in our institution. Methods: A multidisciplinary team specifically targeting TSEI procedure was formed, that met regularly and jointly developed the process map (PM), following TG-100 guidelines of the AAPM. This PM is a visual representation of the temporal flow of steps through the patient since start until the end of his stay in the radiotherapy service. Results: This is the first stage of the full risk analysis, which is being carried out in the center. The PM provides an overview of the process and facilitates the understanding of the team members who will participate in the subsequent analysis. Currently, the team is implementing the analysis of failure modes and effects (FMEA). The failure modes of each of the steps have been identified and assessors are assigning a value of severity (S), frequency of occurrence (O) and lack of detection (D) individually. To our knowledge, this is the first PM made for the TSEI. The developed PM can be useful for those centers that intend to implement the TSEI technique. Conclusion: The PM of TSEI technique has been established, as the first stage of full risk analysis, performed in a reference center in this treatment.

  13. Total joint replacement: A multiple risk factor analysis of physical activity level 1-2 years postoperatively.

    Science.gov (United States)

    Paxton, Elizabeth W; Torres, Andy; Love, Rebecca M; Barber, Thomas C; Sheth, Dhiren S; Inacio, Maria C S

    2016-07-01

    Background and purpose - The effect of total joint arthroplasty (TJA) on physical activity is not fully understood. We investigated the change in physical activity after TJA and patient factors associated with change. Patients and methods - Using a total joint replacement registry, primary total hip arthroplasty (THA) patients (n = 5,678) and knee arthroplasty (TKA) patients (n = 11,084) between January 1, 2010 and December 31, 2012 were identified. Median age at THA was 68 and median age at TKA was 67. Change in self-reported physical activity (minutes per week) from before TJA (within 1 year of surgery) to after TJA (1-2 years) was the outcome of interest. Patient demographics and comorbidities were evaluated as risk factors. Multiple linear regression was used. Results - Median physical activity before surgery was 50 min/week (IQR: 0-140) for THA patients and 58 (IQR: 3-143) for TKA patients. Median physical activity after surgery was 150 min/week (IQR: 60-280) for both THA patients and TKA patients. Following TJA, 50% of patients met CDC/WHO physical activity guideline criteria. Higher body mass index was associated with lower change in physical activity (THA: -7.1 min/week; TKA: -5.9 min/week). Females had lower change than males (THA: -11 min/week; TKA: -9.1 min/week). In TKA patients, renal failure was associated with lower change (-17 min/week), as were neurological disorders (-30 min/week). Interpretation - Self-reported minutes of physical activity increased from before to after TJA, but 50% of TJA patients did not meet recommended physical activity guideline criteria. Higher body mass index, female sex, and specific comorbidities were found to be associated with low change in physical activity. Patient education on the benefits of physical activity should concentrate on these subgroups of patients.

  14. Conscious worst case definition for risk assessment, part I: a knowledge mapping approach for defining most critical risk factors in integrative risk management of chemicals and nanomaterials.

    Science.gov (United States)

    Sørensen, Peter B; Thomsen, Marianne; Assmuth, Timo; Grieger, Khara D; Baun, Anders

    2010-08-15

    This paper helps bridge the gap between scientists and other stakeholders in the areas of human and environmental risk management of chemicals and engineered nanomaterials. This connection is needed due to the evolution of stakeholder awareness and scientific progress related to human and environmental health which involves complex methodological demands on risk management. At the same time, the available scientific knowledge is also becoming more scattered across multiple scientific disciplines. Hence, the understanding of potentially risky situations is increasingly multifaceted, which again challenges risk assessors in terms of giving the 'right' relative priority to the multitude of contributing risk factors. A critical issue is therefore to develop procedures that can identify and evaluate worst case risk conditions which may be input to risk level predictions. Therefore, this paper suggests a conceptual modelling procedure that is able to define appropriate worst case conditions in complex risk management. The result of the analysis is an assembly of system models, denoted the Worst Case Definition (WCD) model, to set up and evaluate the conditions of multi-dimensional risk identification and risk quantification. The model can help optimize risk assessment planning by initial screening level analyses and guiding quantitative assessment in relation to knowledge needs for better decision support concerning environmental and human health protection or risk reduction. The WCD model facilitates the evaluation of fundamental uncertainty using knowledge mapping principles and techniques in a way that can improve a complete uncertainty analysis. Ultimately, the WCD is applicable for describing risk contributing factors in relation to many different types of risk management problems since it transparently and effectively handles assumptions and definitions and allows the integration of different forms of knowledge, thereby supporting the inclusion of multifaceted risk

  15. From heat integration targets toward implementation – A TSA (total site analysis)-based design approach for heat recovery systems in industrial clusters

    International Nuclear Information System (INIS)

    Hackl, Roman; Harvey, Simon

    2015-01-01

    The European process industry is facing major challenges to decrease production costs. One strategy to achieve this is by increasing energy efficiency. Single chemical processes are often well-integrated and the tools to target and design such measures are well developed. Site-wide heat integration based on total site analysis tools can be used to identify opportunities to further increase energy efficiency. However, the methodology has to be developed further in order to enable identification of practical heat integration measures in a systematic way. Designing site-wide heat recovery systems across an industrial cluster is complex and involves aspects apart from thermal process and utility flows. This work presents a method for designing a roadmap of heat integration investments based on total site analysis. The method is applied to a chemical cluster in Sweden. The results of the case study show that application of the proposed method can achieve up to 42% of the previously targeted hot utility savings of 129 MW. A roadmap of heat integration systems is suggested, ranging from less complex systems that achieve a minor share of the heat recovery potential to sophisticated, strongly interdependent systems demanding large investments and a high level of collaboration. - Highlights: • Methodology focused on the practical implementation of site-wide heat recovery. • Algorithm to determine a roadmap of heat integration investments. • Case study: 42% hot utility savings potential at a pay-back period of 3.9y.

  16. Integrated Safety and Security Risk Assessment Methods: A Survey of Key Characteristics and Applications

    OpenAIRE

    Chockalingam, Sabarathinam; Hadziosmanovic, Dina; Pieters, Wolter; Teixeira, Andre; van Gelder, Pieter

    2017-01-01

    Over the last years, we have seen several security incidents that compromised system safety, of which some caused physical harm to people. Meanwhile, various risk assessment methods have been developed that integrate safety and security, and these could help to address the corresponding threats by implementing suitable risk treatment plans. However, an overarching overview of these methods, systematizing the characteristics of such methods, is missing. In this paper, we conduct a systematic l...

  17. An integrated PRA module for fast determination of risk significance and improvement effectiveness

    International Nuclear Information System (INIS)

    Chao, Chun-Chang; Lin, Jyh-Der

    2004-01-01

    With the widely use of PRA technology in risk-informed applications, to predict the changes of CDF and LERF becomes a standard process for risk-informed applications. This paper describes an integrated PRA module prepared for risk-informed applications. The module contains a super risk engine, a super fault tree engine, an advanced PRA model and a tool for data base maintenance. The individual element of the module also works well for purpose other than risk-informed applications. The module has been verified and validated through a series of scrupulous benchmark tests with similar software. The results of the benchmark tests showed that the module has remarkable accuracy and speed even for an extremely large-size top-logic fault tree as well as for the case in which large amount of MCSs may be generated. The risk monitor for nuclear power plants in Taiwan is the first application to adopt the module. The results predicted by the risk monitor are now accepted by the regulatory agency. A tool to determine the risk significance according to the inspection findings will be the next application to adopt the module in the near future. This tool classified the risk significance into four different color codes according to the level of increase on CDF. Experience of application showed that the flexibility, the accuracy and speed of the module make it useful in any risk-informed applications when risk indexes must be determined by resolving a PRA model. (author)

  18. A quantitative flood risk analysis methodology for urban areas with integration of social research data

    Directory of Open Access Journals (Sweden)

    I. Escuder-Bueno

    2012-09-01

    Full Text Available Risk analysis has become a top priority for authorities and stakeholders in many European countries, with the aim of reducing flooding risk, considering the population's needs and improving risk awareness. Within this context, two methodological pieces have been developed in the period 2009–2011 within the SUFRI project (Sustainable Strategies of Urban Flood Risk Management with non-structural measures to cope with the residual risk, 2nd ERA-Net CRUE Funding Initiative. First, the "SUFRI Methodology for pluvial and river flooding risk assessment in urban areas to inform decision-making" provides a comprehensive and quantitative tool for flood risk analysis. Second, the "Methodology for investigation of risk awareness of the population concerned" presents the basis to estimate current risk from a social perspective and identify tendencies in the way floods are understood by citizens. Outcomes of both methods are integrated in this paper with the aim of informing decision making on non-structural protection measures. The results of two case studies are shown to illustrate practical applications of this developed approach. The main advantage of applying the methodology herein presented consists in providing a quantitative estimation of flooding risk before and after investing in non-structural risk mitigation measures. It can be of great interest for decision makers as it provides rational and solid information.

  19. A quantitative flood risk analysis methodology for urban areas with integration of social research data

    Science.gov (United States)

    Escuder-Bueno, I.; Castillo-Rodríguez, J. T.; Zechner, S.; Jöbstl, C.; Perales-Momparler, S.; Petaccia, G.

    2012-09-01

    Risk analysis has become a top priority for authorities and stakeholders in many European countries, with the aim of reducing flooding risk, considering the population's needs and improving risk awareness. Within this context, two methodological pieces have been developed in the period 2009-2011 within the SUFRI project (Sustainable Strategies of Urban Flood Risk Management with non-structural measures to cope with the residual risk, 2nd ERA-Net CRUE Funding Initiative). First, the "SUFRI Methodology for pluvial and river flooding risk assessment in urban areas to inform decision-making" provides a comprehensive and quantitative tool for flood risk analysis. Second, the "Methodology for investigation of risk awareness of the population concerned" presents the basis to estimate current risk from a social perspective and identify tendencies in the way floods are understood by citizens. Outcomes of both methods are integrated in this paper with the aim of informing decision making on non-structural protection measures. The results of two case studies are shown to illustrate practical applications of this developed approach. The main advantage of applying the methodology herein presented consists in providing a quantitative estimation of flooding risk before and after investing in non-structural risk mitigation measures. It can be of great interest for decision makers as it provides rational and solid information.

  20. Integrated systems approach identifies risk regulatory pathways and key regulators in coronary artery disease.

    Science.gov (United States)

    Zhang, Yan; Liu, Dianming; Wang, Lihong; Wang, Shuyuan; Yu, Xuexin; Dai, Enyu; Liu, Xinyi; Luo, Shanshun; Jiang, Wei

    2015-12-01

    Coronary artery disease (CAD) is the most common type of heart disease. However, the molecular mechanisms of CAD remain elusive. Regulatory pathways are known to play crucial roles in many pathogenic processes. Thus, inferring risk regulatory pathways is an important step toward elucidating the mechanisms underlying CAD. With advances in high-throughput data, we developed an integrated systems approach to identify CAD risk regulatory pathways and key regulators. Firstly, a CAD-related core subnetwork was identified from a curated transcription factor (TF) and microRNA (miRNA) regulatory network based on a random walk algorithm. Secondly, candidate risk regulatory pathways were extracted from the subnetwork by applying a breadth-first search (BFS) algorithm. Then, risk regulatory pathways were prioritized based on multiple CAD-associated data sources. Finally, we also proposed a new measure to prioritize upstream regulators. We inferred that phosphatase and tensin homolog (PTEN) may be a key regulator in the dysregulation of risk regulatory pathways. This study takes a closer step than the identification of disease subnetworks or modules. From the risk regulatory pathways, we could understand the flow of regulatory information in the initiation and progression of the disease. Our approach helps to uncover its potential etiology. We developed an integrated systems approach to identify risk regulatory pathways. We proposed a new measure to prioritize the key regulators in CAD. PTEN may be a key regulator in dysregulation of the risk regulatory pathways.

  1. Meeting CCS communication challenges head-on: Integrating communications, planning, risk assessment, and project management

    Science.gov (United States)

    Greenberg, S.; Gauvreau, L.; Hnottavange-Telleen, K.; Finley, R.; Marsteller, S.

    2011-01-01

    The Midwest Geological Sequestration Consortium, Schlumberger Carbon Services, and Archer Daniels Midland has implemented a comprehensive communications plan at the Illinois Basin - Decatur Project (IBDP), a one million metric tonne Carbon Capture and Storage project in Decatur, IL, USA funded by the U.S. Department of Energy's National Energy Technology Laboratory. The IBDP Communication Plan includes consortium information, funding and disclaimer citations, description of target audiences, media communications guidelines, paper and presentations guidelines, site visit information, crisis communication, on-site photography regulations, and other components. The creation, development, and implementation processes for the IBDP Communication Plan (the Plan) are shared in this paper. New communications challenges, such as how to address add-on research requests, data sharing and management, scope increase, and contract agreements have arisen since the Plan was completed in January 2009, resulting in development of new policies and procedures by project management. Integrating communications planning, risk assessment, and project management ensured that consistent, factual information was developed and incorporated into project planning, and constitutes the basis of public communications. Successful integration has allowed the IBDP to benefit from early identification and mitigation of the potential project risks, which allows more time to effectively deal with unknown and unidentified risks that may arise. Project risks and risks associated with public perception can be managed through careful planning and integration of communication strategies into project management and risk mitigation. ?? 2011 Published by Elsevier Ltd.

  2. The joint contribution of neighborhood poverty and social integration to mortality risk in the United States.

    Science.gov (United States)

    Marcus, Andrea Fleisch; Echeverria, Sandra E; Holland, Bart K; Abraido-Lanza, Ana F; Passannante, Marian R

    2016-04-01

    A well-established literature has shown that social integration strongly patterns health, including mortality risk. However, the extent to which living in high-poverty neighborhoods and having few social ties jointly pattern survival in the United States has not been examined. We analyzed data from the Third National Health and Nutrition Examination Survey (1988-1994) linked to mortality follow-up through 2006 and census-based neighborhood poverty. We fit Cox proportional hazards models to estimate associations between social integration and neighborhood poverty on all-cause mortality as independent predictors and in joint-effects models using the relative excess risk due to interaction to test for interaction on an additive scale. In the joint-effects model adjusting for age, gender, race/ ethnicity, and individual-level socioeconomic status, exposure to low social integration alone was associated with increased mortality risk (hazard ratio [HR]: 1.42, 95% confidence interval [CI]: 1.28-1.59) while living in an area of high poverty alone did not have a significant effect (HR: 1.10; 95% CI: 0.95-1.28) when compared with being jointly unexposed. Individuals simultaneously living in neighborhoods characterized by high poverty and having low levels of social integration had an increased risk of mortality (HR: 1.63; 95% CI: 1.35-1.96). However, relative excess risk due to interaction results were not statistically significant. Social integration remains an important determinant of mortality risk in the United States independent of neighborhood poverty. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Risk analysis for U.S. offshore wind farms: the need for an integrated approach.

    Science.gov (United States)

    Staid, Andrea; Guikema, Seth D

    2015-04-01

    Wind power is becoming an increasingly important part of the global energy portfolio, and there is growing interest in developing offshore wind farms in the United States to better utilize this resource. Wind farms have certain environmental benefits, notably near-zero emissions of greenhouse gases, particulates, and other contaminants of concern. However, there are significant challenges ahead in achieving large-scale integration of wind power in the United States, particularly offshore wind. Environmental impacts from wind farms are a concern, and these are subject to a number of on-going studies focused on risks to the environment. However, once a wind farm is built, the farm itself will face a number of risks from a variety of hazards, and managing these risks is critical to the ultimate achievement of long-term reductions in pollutant emissions from clean energy sources such as wind. No integrated framework currently exists for assessing risks to offshore wind farms in the United States, which poses a challenge for wind farm risk management. In this "Perspective", we provide an overview of the risks faced by an offshore wind farm, argue that an integrated framework is needed, and give a preliminary starting point for such a framework to illustrate what it might look like. This is not a final framework; substantial work remains. Our intention here is to highlight the research need in this area in the hope of spurring additional research about the risks to wind farms to complement the substantial amount of on-going research on the risks from wind farms. © 2015 Society for Risk Analysis.

  4. The Tous Dam Disaster of 1982: Risk communication and the origins of integrated flood risk management in Spain

    Science.gov (United States)

    Serra-Llobet, A.; Tàbara, J.; Sauri, D.

    2012-12-01

    The failure of Tous dam on the Júcar River near Valencia in 1982 was one of the most important socio-natural disasters in 20th century Spain. The death toll of 25 would have been much greater had not a local dam manager anticipated the failure and alerted mayors of a failure, before it actually occurred. The Tous Dam failure occurred a week before the first democratic elections in Spain after the Franco dictatorship, it received extensive coverage in the media. As a result, this disaster triggered a paradigm change in the way disaster risks were perceived and managed at multiple levels of government in Spain. Many factors, often of a qualitative and organisational nature, affect (vertical and horizontal) communication in disaster risk reduction learning and planning at the community level. Through interviews with key actors and stakeholders, content analysis of scientific literature, review of historical and media accounts, and analysis of legislation and regulation, we documented changes that resulted from the Tous Dam failure: (1) A process of institutional development, which led to the growth, and increase in complexity of the organisations involved both in vertical and horizontal communication of disaster risk reduction. (2) Actions taken and experiences gained in dealing with disaster risk reduction in the Tous area were used as a benchmark to develop new strategies, as well as new mechanisms for communication and planning in other territories and other risk domains in Spain.We identify three main stages from 1980s to present in the evolution of disaster risk reduction planning in the area, which show a progressive shift towards a more integrated and preventative approach: (1) After the collapse of the Tous Dam, disaster risk reduction strategies in Spain focused on improving preparedness in order to reduce short-term risks. (2) Disaster management in the 1990s was strongly influenced by international initiatives (e.g. the UN International Decade for Natural

  5. Conscious worst case definition for risk assessment, part I. A knowledge mapping approach for defining most critical risk factors in integrative risk management of chemicals and nanomaterials

    DEFF Research Database (Denmark)

    Sørensen, P.S.; Thomsen, M.; Assmuth, T.

    2010-01-01

    This paper helps bridge the gap between scientists and other stakeholders in the areas of human and environmental risk management of chemicals and engineered nanomaterials. This connection is needed due to the evolution of stakeholder awareness and scientific progress related to human and environ...... and effectively handles assumptions and definitions and allows the integration of different forms of knowledge, thereby supporting the inclusion of multifaceted risk components in cumulative risk management.......This paper helps bridge the gap between scientists and other stakeholders in the areas of human and environmental risk management of chemicals and engineered nanomaterials. This connection is needed due to the evolution of stakeholder awareness and scientific progress related to human...... and environmental health which involves complex methodological demands on risk management. At the same time, the available scientific knowledge is also becoming more scattered across multiple scientific disciplines. Hence, the understanding of potentially risky situations is increasingly multifaceted, which again...

  6. Integrated risk reduction framework to improve railway hazardous materials transportation safety

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Xiang, E-mail: liu94@illinois.edu; Saat, M. Rapik, E-mail: mohdsaat@illinois.edu; Barkan, Christopher P.L., E-mail: cbarkan@illinois.edu

    2013-09-15

    Highlights: • An integrated framework is developed to optimize risk reduction. • A negative binomial regression model is developed to analyze accident-cause-specific railcar derailment probability. • A Pareto-optimality technique is applied to determine the lowest risk given any level of resource. • A multi-attribute decision model is developed to determine the optimal amount of investment for risk reduction. • The models could aid the government and rail industry in developing cost-efficient risk reduction policy and practice. -- Abstract: Rail transportation plays a critical role to safely and efficiently transport hazardous materials. A number of strategies have been implemented or are being developed to reduce the risk of hazardous materials release from train accidents. Each of these risk reduction strategies has its safety benefit and corresponding implementation cost. However, the cost effectiveness of the integration of different risk reduction strategies is not well understood. Meanwhile, there has been growing interest in the U.S. rail industry and government to best allocate resources for improving hazardous materials transportation safety. This paper presents an optimization model that considers the combination of two types of risk reduction strategies, broken rail prevention and tank car safety design enhancement. A Pareto-optimality technique is used to maximize risk reduction at a given level of investment. The framework presented in this paper can be adapted to address a broader set of risk reduction strategies and is intended to assist decision makers for local, regional and system-wide risk management of rail hazardous materials transportation.

  7. Risk assessment by integrating interpretive structural modeling and Bayesian network, case of offshore pipeline project

    International Nuclear Information System (INIS)

    Wu, Wei-Shing; Yang, Chen-Feng; Chang, Jung-Chuan; Château, Pierre-Alexandre; Chang, Yang-Chi

    2015-01-01

    The sound development of marine resource usage relies on a strong maritime engineering industry. The perilous marine environment poses the highest risk to all maritime work. It is therefore imperative to reduce the risk associated with maritime work by using some analytical methods other than engineering techniques. This study addresses this issue by using an integrated interpretive structure modeling (ISM) and Bayesian network (BN) approach in a risk assessment context. Mitigating or managing maritime risk relies primarily on domain expert experience and knowledge. ISM can be used to incorporate expert knowledge in a systematic manner and helps to impose order and direction on complex relationships that exist among system elements. Working with experts, this research used ISM to clearly specify an engineering risk factor relationship represented by a cause–effect diagram, which forms the structure of the BN. The expert subjective judgments were further transformed into a prior and conditional probability set to be embedded in the BN. We used the BN to evaluate the risks of two offshore pipeline projects in Taiwan. The results indicated that the BN can provide explicit risk information to support better project management. - Highlights: • We adopt an integrated method for risk assessment of offshore pipeline projects. • We conduct semi-structural interview with the experts for risk factor identification. • Interpretive structural modeling helps to form the digraph of Bayesian network (BN) • We perform the risk analysis with the experts by building a BN. • Risk evaluations of two case studies using the BN show effectiveness of the methods

  8. Riesgo familiar total en familias con escolares según rendimiento académico Risco familiar total em famílias com escolares conforme aproveitamento acadêmico Total family risk in families with schoolchildren according to academic performance

    Directory of Open Access Journals (Sweden)

    CAROLINA LUCERO ENRÍQUEZ GUERRERO

    comparativo transversal com um componente analítico e abordagem quantitativa; a amostra foi de 186 famílias, durante abril -julho de 2007. Os resultados apresentam predomínio de famílias nucleares em ambos os grupos (65%, relação inversa entre o risco familiar total avaliado pelo instrumento RFT 7-70 e o aproveitamento acadêmico do escolar da família, isto é, que as famílias que registraram alto risco (9% e meio (31% em maior proporção são famílias de escolares com baixo aproveitamento acadêmico, comparado com o predomínio de risco familiar baixo (78% nas famílias de crianças de alto aproveitamento. Aplicou-se a t de student para diferença de médias e verificou-se uma associação (P = 0,02 entre o risco familiar total alto e o baixo aproveitamento acadêmico do escolar. Em conclusão, estes resultados sugerem principalmente que é preciso priorizar os fatores de risco que determinam maior risco familiar em famílias com escolares de aproveitamento acadêmico alto e cuidar a saúde integral com uma abordagem familiar e intersectorial, além de participar ativamente nas comunidades, continuar pesquisando sobre as possíveis associações entre a saúde individual, práticas de saúde, educação, ambiente socioeconômico e psicoafetivo da família, e o sucesso educativo de escolares em famílias com idade escolar.This article presents the results of a study whose objective was to establish the family risk differences among two groups of families: one with schoolchildren that show high academic performance and children that show low academic performance in an educational center in Bogotá. Methodology: cross-sectional comparative study with and analytic component and a quantitative approach; the sample was 186 families during the period April-July 2007. The results show a predominance of nuclear families in both groups (65%, reverse relation between the family risk evaluated by the RFT 7-70 instrument and the academic performance of the family´s schoolchild

  9. Riesgo familiar total en familias con escolares según rendimiento académico Total family risk in families with schoolchildren according to academic performance Risco familiar total em famílias com escolares conforme aproveitamento acadêmico

    Directory of Open Access Journals (Sweden)

    CATAÑO ORDÓÑEZ NHORA

    2009-12-01

    Full Text Available Este artículo presenta los resultados del estudio cuyo objetivo fue establecer las diferencias en el riesgo familiar entre dos grupos de familias: con niños escolares de alto rendimiento y niños de bajo rendimiento académico en un centro educativo distrital de Bogotá. Metodología: estudio descriptivo comparativo transversal con un componente analítico y abordaje cuantitativo; la muestra fue de 186 familias, durante abril a julio de 2007. Los resultados muestran predominio de familias nucleares en ambos grupos (65%, relación inversa entre el riesgo familiar total evaluado por el instrumento RFT 7-70 y el rendimiento académico del escolar de la familia, es decir que las familias que registraron riesgo alto (9% y medio (31% en mayor proporción son familias con escolares de bajo rendimiento académico, frente al predominio del riesgo familiar bajo (78% en las familias con niños de alto rendimiento. Se aplicó t de student para diferencia de medias y se encontró asociación (P = 0,02 entre el riesgo familiar total alto y el bajo rendimiento académico del escolar. En conclusión, estos resultados sugieren principalmente que se deben priorizar los factores de riesgo que determinan mayor riesgo familiar en familias con escolares de bajo rendimiento académico y dar atención de salud integral con enfoque familiar e intersectorial, y participación activa de la comunidad. Continuar investigando en posibles asociaciones entre salud individual, prácticas de salud, educación, ambiente socioeconómico y psicoafectivo de la familia y el logro educativo de escolares en familias con niños en edad escolar.This article presents the results of a study whose objective was to establish the family risk differences among two groups of families: one with schoolchildren that show high academic performance and children that show low academic performance in an educational center in Bogotá. Methodology: cross-sectional comparative study with and

  10. Canadian Wildland Fire Strategy: A vision for an innovative and integrated approach to managing the risks

    Science.gov (United States)

    Canadian Wildland Fire Strategy Project Management Team

    2006-01-01

    The Canadian Wildland Fire Strategy (CWFS) provides a vision for a new, innovative, and integrated approach to wildland fire management in Canada. It was developed under the auspices of the Canadian Council of Forest Ministers and seeks to balance the social, ecological, and economic aspects of wildland fire through a risk management framework that emphasizes hazard...

  11. Integrated Foreign Exchange Risk Management: The Role of Import in Medium-Sized, Manufacturing Firms

    DEFF Research Database (Denmark)

    Aabo, Tom; Høg, Esben; Kuhn, Jochen

    2010-01-01

    Empirical research has focused on export as a proxy for exchange rate exposure and the use of foreign exchange derivatives as an instrument to deal with this exposure. This empirical study applies an integrated foreign exchange risk management approach with a particular focus on the role of impor...

  12. Integrated Safety and Security Risk Assessment Methods: A Survey of Key Characteristics and Applications

    NARCIS (Netherlands)

    Chockalingam, Sabarathinam; Hadziosmanovic, D.; Pieters, Wolter; Texeira, Andre; van Gelder, Pieter

    2016-01-01

    Over the last years, we have seen several security incidents that compromised system safety, of which some caused physical harm to people. Meanwhile, various risk assessment methods have been developed that integrate safety and security, and these could help to address the corresponding threats by

  13. Integral Risk Management for DBFM Tenders and Contracts in the Netherlands

    NARCIS (Netherlands)

    Wong, J.; Berkelaar, R.; Pekelharing, H.

    2015-01-01

    This paper presents an overview of an integral risk management approach with emphasis on the relationships with the costing and scheduling processes. Forms of uncertainty related to project planning are classified and implemented in the probabilistic costing and scheduling processes. Furthermore,

  14. Online communication among adolescents: An integrated model on its attraction, opportunities, and risks.

    NARCIS (Netherlands)

    Valkenburg, P.M.; Peter, J.

    2011-01-01

    Adolescents far outnumber adults in their use of e-communication technologies, such as instant messaging and social network sites. In this article, we present an integrative model that helps us to understand both the appeal of these technologies and their risks and opportunities for the psychosocial

  15. Crop modelling for integrated assessment of risk to food production from climate change

    Czech Academy of Sciences Publication Activity Database

    Ewert, F.; Rötter, R. P.; Bindi, M.; Weber, H.; Trnka, Miroslav; Kersebaum, K. C.; Olesen, J. E.; van Ittersum, M. K.; Janssen, S.; Rivingtom, M.; Semenov, M. A.; Wallach, D.; Porter, J. R.; Stewart, D.; Vegahen, J.; Gaiser, T.; Palouso, T.; Tao, F.; Nendel, C.; Roggero, P. P.; Bartošová, Lenka; Asseng, S.

    2015-01-01

    Roč. 72, oct (2015), s. 287-303 ISSN 1364-8152 R&D Projects: GA MZe QJ1310123; GA MŠk(CZ) EE2.3.20.0248 Institutional support: RVO:67179843 Keywords : uncertainty * scaling * integrated assessment * risk assessment * adaptation * crop models Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 4.207, year: 2015

  16. Improvement of risk assessment by integrating toxicological and epidemiological approaches: the case of isoflavones

    NARCIS (Netherlands)

    Islam, M.A.

    2015-01-01

    Improvement of risk assessment by integrating toxicological and epidemiological approaches: the case of isoflavones

    PhD-thesis Mohammed Ariful Islam

    This thesis describes the results of a research project that aimed at the improvement of

  17. An Approach for Integrating Toxicogenomic Data in Risk Assessment: The Dibutyl Phthalate Case Study

    Science.gov (United States)

    An approach for evaluating and integrating genomic data in chemical risk assessment was developed based on the lessons learned from performing a case study for the chemical dibutyl phthalate. A case study prototype approach was first developed in accordance with EPA guidance and ...

  18. Crop modelling for integrated assessment of risk to food production from climate change

    NARCIS (Netherlands)

    Ewert, F.; Rötter, R.P.; Bindi, M.; Webber, Heidi; Trnka, M.; Kersebaum, K.C.; Olesen, J.E.; Ittersum, van M.K.; Janssen, S.J.C.; Rivington, M.; Semenov, M.A.; Wallach, D.; Porter, J.R.; Stewart, D.; Verhagen, J.; Gaiser, T.; Palosuo, T.; Tao, F.; Nendel, C.; Roggero, P.P.; Bartosová, L.; Asseng, S.

    2015-01-01

    The complexity of risks posed by climate change and possible adaptations for crop production has called for integrated assessment and modelling (IAM) approaches linking biophysical and economic models. This paper attempts to provide an overview of the present state of crop modelling to assess

  19. Integrating household risk mitigation behaviour in flood risk analysis : An agent-based model approach

    NARCIS (Netherlands)

    Haer, Toon; Botzen, W.J.W.|info:eu-repo/dai/nl/297620584; Aerts, Jeroen

    2017-01-01

    Recent studies showed that climate change and socioeconomic trends are expected to increase flood risks in many regions. However, in these studies, human behavior is commonly assumed to be constant, which neglects interaction and feedback loops between human and environmental systems. This neglect

  20. Evaluation of sustainable supply chain risk management using an integrated fuzzy TOPSIS- CRITIC approach

    DEFF Research Database (Denmark)

    Rostamzadeh, Reza; Ghorabaee, Mehdi Keshavarz; Govindan, Kannan

    2018-01-01

    Supply chain risk management research has mainly mistreated the important of sustainability issues. Moreover, there is little knowledge about sustainable management of risk and supply chain and the way they impose losses for firms. Risk management's duty in the supply chain is to identify, analyze......, and provide solutions for accountability, control and monitor the risks in the economic and production cycle. This study aims to develop a framework for the sustainable supply chain risk management (SSCRM) evaluation. To this end, an integrated fuzzy multi-criteria decision-making (MCDM) approach is proposed...... based on the technique in order of preference by similarity to ideal solution (TOPSIS) and criteria importance through inter-criteria correlation (CRITIC) methods. The literature was reviewed and the potential criteria were identified. Through an expert panel the criteria were filtered. Seven main...

  1. Integration of renewable generation uncertainties into stochastic unit commitment considering reserve and risk: A comparative study

    International Nuclear Information System (INIS)

    Quan, Hao; Srinivasan, Dipti; Khosravi, Abbas

    2016-01-01

    The uncertainties of renewable energy have brought great challenges to power system commitment, dispatches and reserve requirement. This paper presents a comparative study on integration of renewable generation uncertainties into SCUC (stochastic security-constrained unit commitment) considering reserve and risk. Renewable forecast uncertainties are captured by a list of PIs (prediction intervals). A new scenario generation method is proposed to generate scenarios from these PIs. Different system uncertainties are considered as scenarios in the stochastic SCUC problem formulation. Two comparative simulations with single (E1: wind only) and multiple sources of uncertainty (E2: load, wind, solar and generation outages) are investigated. Five deterministic and four stochastic case studies are performed. Different generation costs, reserve strategies and associated risks are compared under various scenarios. Demonstrated results indicate the overall costs of E2 is lower than E1 due to penetration of solar power and the associated risk in deterministic cases of E2 is higher than E1. It implies the superimposed effect of uncertainties during uncertainty integration. The results also demonstrate that power systems run a higher level of risk during peak load hours, and that stochastic models are more robust than deterministic ones. - Highlights: • An extensive comparative study for renewable integration is presented. • A novel scenario generation method is proposed. • Wind and solar uncertainties are represented by a list of prediction intervals. • Unit commitment and dispatch costs are discussed considering reserve and risk.

  2. Integrated Level 3 risk assessment for the LaSalle Unit 2 nuclear power plant

    International Nuclear Information System (INIS)

    Payne, A.C. Jr.; Brown, T.D.; Miller, L.A.

    1991-01-01

    An integrated Level 3 probabilistic risk assessment (PRA) was performed on the LaSalle County Station nuclear power plant using state-of-the-art PRA analysis techniques. The objective of this study was to provide an estimate of the risk to the offsite population during full power operation of the plant and to include a characterization of the uncertainties in the calculated risk values. Uncertainties were included in the accident frequency analysis, accident progression analysis, and the source term analysis. Only weather uncertainties were included in the consequence analysis. In this paper selected results from the accident frequency, accident progression, source term, consequence, and integrated risk analyses are discussed and the methods used to perform a fully integrated Level 3 PRA are examined. LaSalle County Station is a two-unit nuclear power plant located 55 miles southwest of Chicago, Illinois. Each unit utilizes a Mark 2 containment to house a General Electric 3323 MWt BWR-5 reactor. This PRA, which was performed on Unit 2, included internal as well as external events. External events that were propagated through the risk analysis included earthquakes, fires, and floods. The internal event accident scenarios included transients, transient-induced LOCAs (inadvertently stuck open relief valves), anticipated transients without scram, and loss of coolant accidents

  3. Risk and Work Configuration Management as a Function of Integrated Safety Management

    International Nuclear Information System (INIS)

    Lana Buehrer; Michele Kelly; Fran Lemieux; Fred Williams

    2007-01-01

    National Security Technologies, LLC (NSTec), has established a work management program and corresponding electronic Facilities and Operations Management Information System (e-FOM) to implement Integrated Safety Management (ISM). The management of work scopes, the identification of hazards, and the establishment of implementing controls are reviewed and approved through electronic signatures. Through the execution of the program and the implementation of the electronic system, NSTec staff work within controls and utilize feedback and improvement process. The Integrated Work Control Manual further implements the five functions of ISM at the Activity level. By adding the Risk and Work Configuration Management program, NSTec establishes risk acceptance (business and physical) for liabilities within the performance direction and work management processes. Requirements, roles, and responsibilities are specifically identified in the program while e-FOM provides the interface and establishes the flowdown from the Safety Chain to work and facilities management processes to company work-related directives, and finally to Subject Matter Expert concurrence. The Program establishes, within the defined management structure, management levels for risk identification, risk mitigation (controls), and risk acceptance (business and physical) within the Safety Chain of Responsibility. The Program also implements Integrated Safeguards and Security Management within the NSTec Safety Chain of Responsibility. Once all information has been entered into e-FOM, approved, and captured as data, the information becomes searchable and sortable by hazard, location, organization, mitigating controls, etc

  4. A framework to integrate software behavior into dynamic probabilistic risk assessment

    International Nuclear Information System (INIS)

    Zhu Dongfeng; Mosleh, Ali; Smidts, Carol

    2007-01-01

    Software plays an increasingly important role in modern safety-critical systems. Although, research has been done to integrate software into the classical probabilistic risk assessment (PRA) framework, current PRA practice overwhelmingly neglects the contribution of software to system risk. Dynamic probabilistic risk assessment (DPRA) is considered to be the next generation of PRA techniques. DPRA is a set of methods and techniques in which simulation models that represent the behavior of the elements of a system are exercised in order to identify risks and vulnerabilities of the system. The fact remains, however, that modeling software for use in the DPRA framework is also quite complex and very little has been done to address the question directly and comprehensively. This paper develops a methodology to integrate software contributions in the DPRA environment. The framework includes a software representation, and an approach to incorporate the software representation into the DPRA environment SimPRA. The software representation is based on multi-level objects and the paper also proposes a framework to simulate the multi-level objects in the simulation-based DPRA environment. This is a new methodology to address the state explosion problem in the DPRA environment. This study is the first systematic effort to integrate software risk contributions into DPRA environments

  5. Risk perception and control, an integration of the psychometric research paradigm and social psychology

    International Nuclear Information System (INIS)

    Haugen, K.

    1998-01-01

    Full text of publication follows: this paper argues that perceptual control is an essential component in human risk evaluation. Control is seen as an integrative concept between the psychometric research paradigm and various psychological theories. The psychometric approach to the study of risk has mainly dealt with the intuitive judgements people do when they are asked to evaluate risky activities and technologies. It shows that people judge risk in relation to the possible consequences and probabilities related to an outcome; the former more typical for the public and the latter more often used by experts. The psychometric research tradition has concentrated on doing human risk evaluations quantifiable and the reactions predictable. This paper also relates to possible practical implications of this strategy, namely that humans react heterogeneously to different kinds of threats due to perceived control. Theoretical ability to explain and elaborate perceptions of risk, as well as individual reactions, were the main criteria for the literature selection, which includes work on e.g. attribution theory, locus of control, and learned helplessness. Thus, the paper addresses available psychological views for a contribution to a developed theoretical framework for human risk evaluation. It seeks to compare and integrate the psychometric research tradition within social psychological theories. The way in which people find their informational basis for their risk judgements, either from others or from their own perceptions is also discussed. Furthermore, the theories are related to the social and psychological reactions of the Chernobyl accident. The paper concludes that psychological theories can contribute to a more comprehensive framework for the understanding of human risk evaluation, leading to a more coherent and integrative knowledge. (author)

  6. An approach for integrating toxicogenomic data in risk assessment: The dibutyl phthalate case study

    Energy Technology Data Exchange (ETDEWEB)

    Euling, Susan Y., E-mail: euling.susan@epa.gov [National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC (United States); Thompson, Chad M. [ToxStrategies, Inc., 23501 Cinco Ranch Blvd., Suite G265, Katy, TX 77494 (United States); Chiu, Weihsueh A. [National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC (United States); Benson, Robert [U.S. Environmental Protection Agency, Region 8, Mail code 8P-W, 1595 Wynkoop Street, Denver, CO 80202 (United States)

    2013-09-15

    An approach for evaluating and integrating genomic data in chemical risk assessment was developed based on the lessons learned from performing a case study for the chemical dibutyl phthalate. A case study prototype approach was first developed in accordance with EPA guidance and recommendations of the scientific community. Dibutyl phthalate (DBP) was selected for the case study exercise. The scoping phase of the dibutyl phthalate case study was conducted by considering the available DBP genomic data, taken together with the entire data set, for whether they could inform various risk assessment aspects, such as toxicodynamics, toxicokinetics, and dose–response. A description of weighing the available dibutyl phthalate data set for utility in risk assessment provides an example for considering genomic data for future chemical assessments. As a result of conducting the scoping process, two questions—Do the DBP toxicogenomic data inform 1) the mechanisms or modes of action?, and 2) the interspecies differences in toxicodynamics?—were selected to focus the case study exercise. Principles of the general approach include considering the genomics data in conjunction with all other data to determine their ability to inform the various qualitative and/or quantitative aspects of risk assessment, and evaluating the relationship between the available genomic and toxicity outcome data with respect to study comparability and phenotypic anchoring. Based on experience from the DBP case study, recommendations and a general approach for integrating genomic data in chemical assessment were developed to advance the broader effort to utilize 21st century data in risk assessment. - Highlights: • Performed DBP case study for integrating genomic data in risk assessment • Present approach for considering genomic data in chemical risk assessment • Present recommendations for use of genomic data in chemical risk assessment.

  7. Total working period and other risk factors related to eating protein foods habits among civil pilots in Indonesia

    Directory of Open Access Journals (Sweden)

    Indah Imelda Hutabarat

    2017-07-01

    pilots in Indonesia. Methods: A cross-sectional study using secondary data from the survey of eating, drinking and physical exercise habits among civilian pilots in Indonesia 2016. Data collected were demographic characteristics, physical exercise habits, smoking habits, knowledge, body mass index and flight characteristics. Cox regression analysis was used to analyze the dominant factors associated with protein eating habits. Results: Among 528 pilots aged 19-64 years, 194 (36.74% pilots had excessive protein eating habits . Long working period and body mass index were the dominant risk factors associated with protein eating habit in pilots. Compared to pilots with 1-9 years working period, pilots with 10-40 years working period had 35% lower risk of excessive protein eating habits (RRA = 0.65; 95% CI 0:49 - 0.87. Compared to pilots with normal body mass index, overweight pilots had 34% lower risk of excessive protein eating habits (RRA = 0.66; 95% CI 0:47 - 0.93. Conclusion: Long working period and overweight were protective factors from the risk of excessive protein eating habits Keywords: protein eating habits, total working periode, body mass index, civilian pilots Indonesia

  8. Integration of laboratory bioassays into the risk-based corrective action process

    International Nuclear Information System (INIS)

    Edwards, D.; Messina, F.; Clark, J.

    1995-01-01

    Recent data generated by the Gas Research Institute (GRI) and others indicate that residual hydrocarbon may be bound/sequestered in soil such that it is unavailable for microbial degradation, and thus possibly not bioavailable to human/ecological receptors. A reduction in bioavailability would directly equate to reduced exposure and, therefore, potentially less-conservative risk-based cleanup soil goals. Laboratory bioassays which measure bioavailability/toxicity can be cost-effectively integrated into the risk-based corrective action process. However, in order to maximize the cost-effective application of bioassays several site-specific parameters should be addressed up front. This paper discusses (1) the evaluation of parameters impacting the application of bioassays to soils contaminated with metals and/or petroleum hydrocarbons and (2) the cost-effective integration of bioassays into a tiered ASTM type framework for risk-based corrective action

  9. An Integrated Cyber Security Risk Management Approach for a Cyber-Physical System

    Directory of Open Access Journals (Sweden)

    Halima Ibrahim Kure

    2018-05-01

    Full Text Available A cyber-physical system (CPS is a combination of physical system components with cyber capabilities that have a very tight interconnectivity. CPS is a widely used technology in many applications, including electric power systems, communications, and transportation, and healthcare systems. These are critical national infrastructures. Cybersecurity attack is one of the major threats for a CPS because of many reasons, including complexity and interdependencies among various system components, integration of communication, computing, and control technology. Cybersecurity attacks may lead to various risks affecting the critical infrastructure business continuity, including degradation of production and performance, unavailability of critical services, and violation of the regulation. Managing cybersecurity risks is very important to protect CPS. However, risk management is challenging due to the inherent complex and evolving nature of the CPS system and recent attack trends. This paper presents an integrated cybersecurity risk management framework to assess and manage the risks in a proactive manner. Our work follows the existing risk management practice and standard and considers risks from the stakeholder model, cyber, and physical system components along with their dependencies. The approach enables identification of critical CPS assets and assesses the impact of vulnerabilities that affect the assets. It also presents a cybersecurity attack scenario that incorporates a cascading effect of threats and vulnerabilities to the assets. The attack model helps to determine the appropriate risk levels and their corresponding mitigation process. We present a power grid system to illustrate the applicability of our work. The result suggests that risk in a CPS of a critical infrastructure depends mainly on cyber-physical attack scenarios and the context of the organization. The involved risks in the studied context are both from the technical and

  10. Development of Integrated Code for Risk Assessment (INCORIA) for Physical Protection System

    International Nuclear Information System (INIS)

    Jang, Sung Soon; Seo, Hyung Min; Yoo, Ho Sik

    2010-01-01

    A physical protection system (PPS) integrates people, procedures and equipment for the protection of assets or facilities against theft, sabotage or other malevolent human attacks. Among critical facilities, nuclear facilities and nuclear weapon sites require the highest level of PPS. After the September 11, 2001 terrorist attacks, international communities, including the IAEA, have made substantial efforts to protect nuclear material and nuclear facilities. The international flow on nuclear security is using the concept or risk assessment. The concept of risk assessment is firstly devised by nuclear safety people. They considered nuclear safety including its possible risk, which is the frequency of failure and possible consequence. Nuclear security people also considers security risk, which is the frequency of threat action, vulnerability, and consequences. The concept means that we should protect more when the credible threat exists and the possible radiological consequence is high. Even if there are several risk assessment methods of nuclear security, the application needs the help of tools because of a lot of calculation. It's also hard to find tools for whole phase of risk assessment. Several codes exist for the part of risk assessment. SAVI are used for vulnerability of PPS. Vital area identification code is used for consequence analysis. We are developing Integrated Code for Risk Assessment (INCORIA) to apply risk assessment methods for nuclear facilities. INCORIA evaluates PP-KINAC measures and generation tools for threat scenario. PP-KINAC is risk assessment measures for physical protection system developed by Hosik Yoo and is easy to apply. A threat scenario tool is used to generate threat scenario, which is used as one of input value to PP-KINAC measures

  11. Proposals for enhanced health risk assessment and stratification in an integrated care scenario

    Science.gov (United States)

    Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-01-01

    Objectives Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. Settings The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). Participants Responsible teams for regional data management in the five ACT regions. Primary and secondary outcome measures We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. Results There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. Conclusions The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches

  12. Proposals for enhanced health risk assessment and stratification in an integrated care scenario.

    Science.gov (United States)

    Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-04-15

    Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). Responsible teams for regional data management in the five ACT regions. We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches. Applicability and impact of the proposals for enhanced clinical risk assessment require

  13. Cross-sectional associations of total sitting and leisure screen time with cardiometabolic risk in adults. Results from the HUNT Study, Norway

    NARCIS (Netherlands)

    Chau, J.Y.; Grunseit, A.; Midthjell, K.; Holmen, J.; Holmen, T.L.; Bauman, A.E.; van der Ploeg, H.P.

    2014-01-01

    Objectives: To examine associations of total sitting time, TV-viewing and leisure-time computer use with cardiometabolic risk biomarkers in adults. Design: Population based cross-sectional study. Methods: Waist circumference, BMI, total cholesterol, HDL cholesterol, blood pressure, non-fasting

  14. Perceptions of risk, risk aversion, and barriers to adoption of decision support systems and integrated pest management: an introduction.

    Science.gov (United States)

    Gent, David H; De Wolf, Erick; Pethybridge, Sarah J

    2011-06-01

    Rational management of plant diseases, both economically and environmentally, involves assessing risks and the costs associated with both correct and incorrect tactical management decisions to determine when control measures are warranted. Decision support systems can help to inform users of plant disease risk and thus assist in accurately targeting events critical for management. However, in many instances adoption of these systems for use in routine disease management has been perceived as slow. The under-utilization of some decision support systems is likely due to both technical and perception constraints that have not been addressed adequately during development and implementation phases. Growers' perceptions of risk and their aversion to these perceived risks can be reasons for the "slow" uptake of decision support systems and, more broadly, integrated pest management (IPM). Decision theory provides some tools that may assist in quantifying and incorporating subjective and/or measured probabilities of disease occurrence or crop loss into decision support systems. Incorporation of subjective probabilities into IPM recommendations may be one means to reduce grower uncertainty and improve trust of these systems because management recommendations could be explicitly informed by growers' perceptions of risk and economic utility. Ultimately though, we suggest that an appropriate measure of the value and impact of decision support systems is grower education that enables more skillful and informed management decisions independent of consultation of the support tool outputs.

  15. Patient risk taking and spending habits correlate with willingness to pay for novel total joint arthroplasty implants

    Directory of Open Access Journals (Sweden)

    Ran Schwarzkopf, MD, MSc

    2015-03-01

    Full Text Available In this study, we compare patients' risk-taking and spending behaviors to their willingness to pay (WTP for novel implants in a joint arthroplasty. 210 patients were surveyed regarding risk-taking and spending behavior, and WTP for novel implants with either increased-longevity, increased-longevity with higher risk of complications, or decreased risk of complications compared to a standard implant. Patients with increased recreational risk-taking behavior were more WTP for increased-longevity. Patients who “rarely“ take health-risks were more WTP for decreased risk of complications. Patients with higher combined risk scores were more WTP for all novel implants. Patients who paid more than $50,000 for their current car were more WTP for decreased complications. This study shows that patients' risk taking and spending behavior influences their WTP for novel implants.

  16. Integrated societal risk assessment framework for nuclear power and renewable energy sources

    International Nuclear Information System (INIS)

    Lee, Sang Hun; Kang, Hyun Gook

    2015-01-01

    Recently, the estimation of the social cost of energy sources has been emphasized as various novel energy options become feasible in addition to conventional ones. In particular, the social cost of introducing measures to protect power-distribution systems from power-source instability and the cost of accident-risk response for various power sources must be investigated. To account for these risk factors, an integrated societal risk assessment framework, based on power-uncertainty analysis and accident-consequence analysis, is proposed. In this study, we applied the proposed framework to nuclear power plants, solar photovoltaic systems, and wind-turbine generators. The required capacity of gas-turbine power plants to be used as backup power facilities to compensate for fluctuations in the power output from the main power source was estimated based on the performance indicators of each power source. The average individual health risk per terawatt-hours (TWh) of electricity produced by each power source was quantitatively estimated by assessing accident frequency and the consequences of specific accident scenarios based on the probabilistic risk assessment methodology. This study is expected to provide insight into integrated societal risk analysis, and can be used to estimate the social cost of various power sources

  17. Integrated societal risk assessment framework for nuclear power and renewable energy sources

    Directory of Open Access Journals (Sweden)

    Sang Hun Lee

    2015-06-01

    Full Text Available Recently, the estimation of the social cost of energy sources has been emphasized as various novel energy options become feasible in addition to conventional ones. In particular, the social cost of introducing measures to protect power-distribution systems from power-source instability and the cost of accident-risk response for various power sources must be investigated. To account for these risk factors, an integrated societal risk assessment framework, based on power-uncertainty analysis and accident-consequence analysis, is proposed. In this study, we applied the proposed framework to nuclear power plants, solar photovoltaic systems, and wind-turbine generators. The required capacity of gas-turbine power plants to be used as backup power facilities to compensate for fluctuations in the power output from the main power source was estimated based on the performance indicators of each power source. The average individual health risk per terawatt-hours (TWh of electricity produced by each power source was quantitatively estimated by assessing accident frequency and the consequences of specific accident scenarios based on the probabilistic risk assessment methodology. This study is expected to provide insight into integrated societal risk analysis, and can be used to estimate the social cost of various power sources.

  18. Framework for integrating human and animal data in chemical risk assessment.

    Science.gov (United States)

    Lavelle, Karlene S; Robert Schnatter, A; Travis, Kim Z; Swaen, Gerard M H; Pallapies, Dirk; Money, Chris; Priem, Peter; Vrijhof, Henk

    2012-03-01

    Although regulatory agencies formally encourage the integration of all available data in chemical risk assessment, consistent implementation of this practice has been constrained by the lack of a clear, systematic method for doing so. In this paper, we describe a methodology for evaluating, classifying and integrating human and animal data into the risk assessment process that incorporates: (1) a balanced appraisal of human and animal data, (2) relevance to different stages of the risk assessment process, and (3) accommodation for different data quality requirements. The proposed framework offers a flexible, step-wise approach for determining which set of available data best support the chemical risk assessment that involves the rating and relative ranking of human and animal data quality. The evaluation of human data incorporates seven data quality elements, nature and specificity of the lead effect; evaluation of animal data incorporates data quality and relevance to humans. Results of simulations with selected chemicals previously evaluated in a formal risk assessment generally agreed with existing regulatory guidance. Application of the proposed framework across a wider range of chemical agents will improve transparency of the risk assessment process and validity of results, while informing continuous refinements to this evolving methodology. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. An integrated probabilistic risk analysis decision support methodology for systems with multiple state variables

    International Nuclear Information System (INIS)

    Sen, P.; Tan, John K.G.; Spencer, David

    1999-01-01

    Probabilistic risk analysis (PRA) methods have been proven to be valuable in risk and reliability analysis. However, a weak link seems to exist between methods for analysing risks and those for making rational decisions. The integrated decision support system (IDSS) methodology presented in this paper attempts to address this issue in a practical manner. In consists of three phases: a PRA phase, a risk sensitivity analysis (SA) phase and an optimisation phase, which are implemented through an integrated computer software system. In the risk analysis phase the problem is analysed by the Boolean representation method (BRM), a PRA method that can deal with systems with multiple state variables and feedback loops. In the second phase the results obtained from the BRM are utilised directly to perform importance and risk SA. In the third phase, the problem is formulated as a multiple objective decision making problem in the form of multiple objective reliability optimisation. An industrial example is included. The resultant solutions of a five objective reliability optimisation are presented, on the basis of which rational decision making can be explored

  20. Integrated societal risk assessment framework for nuclear power and renewable energy sources

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Hun; Kang, Hyun Gook [Dept. of Nuclear and Quantum Engineering, KAIST, Daejeon (Korea, Republic of)

    2015-06-15

    Recently, the estimation of the social cost of energy sources has been emphasized as various novel energy options become feasible in addition to conventional ones. In particular, the social cost of introducing measures to protect power-distribution systems from power-source instability and the cost of accident-risk response for various power sources must be investigated. To account for these risk factors, an integrated societal risk assessment framework, based on power-uncertainty analysis and accident-consequence analysis, is proposed. In this study, we applied the proposed framework to nuclear power plants, solar photovoltaic systems, and wind-turbine generators. The required capacity of gas-turbine power plants to be used as backup power facilities to compensate for fluctuations in the power output from the main power source was estimated based on the performance indicators of each power source. The average individual health risk per terawatt-hours (TWh) of electricity produced by each power source was quantitatively estimated by assessing accident frequency and the consequences of specific accident scenarios based on the probabilistic risk assessment methodology. This study is expected to provide insight into integrated societal risk analysis, and can be used to estimate the social cost of various power sources.

  1. Highlight report: Launch of a large integrated European in vitro toxicology project: EU-ToxRisk.

    Science.gov (United States)

    Daneshian, Mardas; Kamp, Hennicke; Hengstler, Jan; Leist, Marcel; van de Water, Bob

    2016-05-01

    The integrated European project, EU-ToxRisk, proudly sees itself as "flagship" exploring new alternative-to-animal approaches to chemical safety evaluation. It promotes mechanism-based toxicity testing and risk assessment according to the principles laid down for toxicology for the twenty-first century. The project was officially launched in January 2016 with a kickoff meeting in Egmond aan Zee, the Netherlands. Over 100 scientists representing academia and industry as well as regulatory authorities attended the inaugural meeting. The project will integrate advances in in vitro and in silico toxicology, read-across methods, and adverse outcome pathways. EU-ToxRisk will continue to make use of the case study strategy deployed in SEURAT-1, a FP7 initiative ended in December 2015. Even though the development of new non-animal methods is one target of EU-ToxRisk, the project puts special emphasis on their acceptance and implementation in regulatory contexts. This €30 million Horizon 2020 project involves 38 European partners and one from the USA. EU-ToxRisk aims at the "development of a new way of risk assessment."

  2. A time-motion study of cardiovascular disease risk factor screening integrated into HIV clinic visits in Swaziland.

    Science.gov (United States)

    Palma, Anton M; Rabkin, Miriam; Simelane, Samkelo; Gachuhi, Averie B; McNairy, Margaret L; Nuwagaba-Biribonwoha, Harriet; Bongomin, Pido; Okello, Velephi N; Bitchong, Raymond A; El-Sadr, Wafaa M

    2018-03-01

    Screening of modifiable cardiovascular disease (CVD) risk factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without screening and measured time spent on HIV and CVD risk factor screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with screening. We observed 172 patient visits (122 with CVD risk factor screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p < 0.01). Time spent on HIV care was not affected: 4 (2 to 10) versus 4 (2 to 11) (p = 0.57). We recruited 126 patients for exit interviews, all of whom indicated that they would recommend screening to others. Provision of CVD risk factor screening more than tripled the length of routine HIV clinic visits but did not reduce the time spent on HIV services. Programme managers need to take longer visit duration into account in order to effectively integrate CVD risk factor screening and counselling into HIV programmes. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

  3. Total water, phosphorus relaxation and inter-atomic organic to inorganic interface are new determinants of trabecular bone integrity.

    Directory of Open Access Journals (Sweden)

    Ratan Kumar Rai

    Full Text Available Bone is the living composite biomaterial having unique structural property. Presently, there is a considerable gap in our understanding of bone structure and composition in the native state, particularly with respect to the trabecular bone, which is metabolically more active than cortical bones, and is readily lost in post-menopausal osteoporosis. We used solid-state nuclear magnetic resonance (NMR to compare trabecular bone structure and composition in the native state between normal, bone loss and bone restoration conditions in rat. Trabecular osteopenia was induced by lactation as well as prolonged estrogen deficiency (bilateral ovariectomy, Ovx. Ovx rats with established osteopenia were administered with PTH (parathyroid hormone, trabecular restoration group, and restoration was allowed to become comparable to sham Ovx (control group using bone mineral density (BMD and µCT determinants. We used a technique combining (1H NMR spectroscopy with (31P and (13C to measure various NMR parameters described below. Our results revealed that trabecular bones had diminished total water content, inorganic phosphorus NMR relaxation time (T1 and space between the collagen and inorganic phosphorus in the osteopenic groups compared to control, and these changes were significantly reversed in the bone restoration group. Remarkably, bound water was decreased in both osteopenic and bone restoration groups compared to control. Total water and T1 correlated strongly with trabecular bone density, volume, thickness, connectivity, spacing and resistance to compression. Bound water did not correlate with any of the microarchitectural and compression parameters. We conclude that total water, T1 and atomic space between the crystal and organic surface are altered in the trabecular bones of osteopenic rats, and PTH reverses these parameters. Furthermore, from these data, it appears that total water and T1 could serve as trabecular surrogates of micro-architecture and

  4. Technical Report on Preliminary Methodology for Enhancing Risk Monitors with Integrated Equipment Condition Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Ramuhalli, Pradeep; Coles, Garill A.; Coble, Jamie B.; Hirt, Evelyn H.

    2013-09-17

    Small modular reactors (SMRs) generally include reactors with electric output of ~350 MWe or less (this cutoff varies somewhat but is substantially less than full-size plant output of 700 MWe or more). Advanced SMRs (AdvSMRs) refer to a specific class of SMRs and are based on modularization of advanced reactor concepts. AdvSMRs may provide a longer-term alternative to traditional light-water reactors (LWRs) and SMRs based on integral pressurized water reactor concepts currently being considered. Enhancing affordability of AdvSMRs will be critical to ensuring wider deployment. AdvSMRs suffer from loss of economies of scale inherent in small reactors when compared to large (~greater than 600 MWe output) reactors. Some of this loss can be recovered through reduced capital costs through smaller size, fewer components, modular fabrication processes, and the opportunity for modular construction. However, the controllable day-to-day costs of AdvSMRs will be dominated by operation and maintenance (O&M) costs. Technologies that help characterize real-time risk are important for controlling O&M costs. Risk monitors are used in current nuclear power plants to provide a point-in-time estimate of the system risk given the current plant configuration (e.g., equipment availability, operational regime, and environmental conditions). However, current risk monitors are unable to support the capability requirements listed above as they do not take into account plant-specific normal, abnormal, and deteriorating states of active components and systems. This report documents technology developments that are a step towards enhancing risk monitors that, if integrated with supervisory plant control systems, can provide the capability requirements listed and meet the goals of controlling O&M costs. The report describes research results from an initial methodology for enhanced risk monitors by integrating real-time information about equipment condition and POF into risk monitors.

  5. An Updated Methodology for Enhancing Risk Monitors with Integrated Equipment Condition Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Ramuhalli, Pradeep [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hirt, Evelyn H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Coles, Garill A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bonebrake, Christopher A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Ivans, William J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wootan, David W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Mitchell, Mark R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2014-07-18

    Small modular reactors (SMRs) generally include reactors with electric output of ~350 MWe or less (this cutoff varies somewhat but is substantially less than full-size plant output of 700 MWe or more). Advanced SMRs (AdvSMRs) refer to a specific class of SMRs and are based on modularization of advanced reactor concepts. Enhancing affordability of AdvSMRs will be critical to ensuring wider deployment, as AdvSMRs suffer from loss of economies of scale inherent in small reactors when compared to large (~greater than 600 MWe output) reactors and the controllable day-to-day costs of AdvSMRs will be dominated by operation and maintenance (O&M) costs. Technologies that help characterize real-time risk are important for controlling O&M costs. Risk monitors are used in current nuclear power plants to provide a point-in-time estimate of the system risk given the current plant configuration (e.g., equipment availability, operational regime, and environmental conditions). However, current risk monitors are unable to support the capability requirements listed above as they do not take into account plant-specific normal, abnormal, and deteriorating states of active components and systems. This report documents technology developments towards enhancing risk monitors that, if integrated with supervisory plant control systems, can provide the capability requirements listed and meet the goals of controlling O&M costs. The report describes research results on augmenting an initial methodology for enhanced risk monitors that integrate real-time information about equipment condition and POF into risk monitors. Methods to propagate uncertainty through the enhanced risk monitor are evaluated. Available data to quantify the level of uncertainty and the POF of key components are examined for their relevance, and a status update of this data evaluation is described. Finally, we describe potential targets for developing new risk metrics that may be useful for studying trade-offs for economic

  6. An Integrated Web-based Decision Support System in Disaster Risk Management

    Science.gov (United States)

    Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.

    2012-04-01

    Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact

  7. The Symbiose project: an integrated framework for performing environmental radiological risk assessment

    International Nuclear Information System (INIS)

    Gonze, M.A.; Mourlon, C.; Garcia-Sanchez, L.; Beaugelin, K.; Chen, T.; Le Dizes, S.

    2004-01-01

    Human health and ecological risk assessments usually require the integration of a wide range of environmental data and modelling approaches, with a varying level of detail dependent on the management objectives, the complexity of the site and the level of ignorance about the pollutant behaviour/toxicity. Like most scientists and assessors did it recently, we recognized the need for developing comprehensive, integrated and flexible approaches to risk assessment. To meet these needs, IRSN launched the Symbiose project (2002-2006) which aims first, at designing a framework for integrating and managing data, methods and knowledge of some relevance in radiological risk to humans/biota assessment studies, and second, at implementing this framework in an information management, modelling and calculation platform. Feasibility developments (currently completed) led to the specification of a fully integrated, object-oriented and hierarchical approach for describing the fate, transport and effect of radionuclides in spatially-distributed environmental systems. This innovative approach has then been implemented in a platform prototype, main components of which are a user-friendly and modular simulation environment (e.g. using GoldSim toolbox), and a hierarchical object-oriented biosphere database. Both conceptual and technical developments will be presented here. (author)

  8. Geo-risk in Central Africa: integrating multi-hazards and vulnerability to support risk management

    Science.gov (United States)

    Kervyn, Francois; Nicolas, d'Oreye; Haventith, Hans-Balder; Kervyn, Matthieu; Caroline, Michellier; Trefon, Theodore; Wolff, Eleonore

    2013-04-01

    In some places, geo-hazards are a major concern for population, the assets, and the economy. This is especially the case in the East African Rift (EAR), where high volcanic and tectonic activities are sometimes coupled with geopolitical issues and dense population as in the Kivu rift area. That area is one of the most densely populated regions of Central Africa and is affected by decades of political instability and subsequent humanitarian crisis. In that region, geo-hazards are poorly assessed despite the numerous recent and historical events. Moreover, the relief of the rift also corresponds in this area to the main political boundaries, which complicates the coordination and the management of geo-hazards monitoring networks and related mitigation measures. Based on the experience acquired through several projects focused on hazard assessment and reinforcement of local monitoring capacity, the GeoRisCA project is addressing the assessment of the global risk related to the major geohazards that affect the region. Taking into account the identified factors, GeoRisCA's objective is to assess the risk from multi geohazards in a region which is subject to many (possibly combined) disasters every year and which could undergo a large impact disaster in the coming years. At regional scale, the high seismicity and the volcanic activity are the most important concerns. Possible eruptions of lethal gas in certain area around Goma, and the large number of reported and likely future mass movements as well as site-specific seismic amplification effects increase the danger at local scale. As both human lives and specific ecosystems are under threat, comprehensive methodologies are required to reliably assess multi geohazards over both short and long terms and to clearly outline and map related risk. These tools are needed by local and regional authorities as well as local and international stakeholders in management and mitigation processes. Developed methodologies in Geo

  9. Total integrated dose testing of solid-state scientific CD4011, CD4013, and CD4060 devices by irradiation with CO-60 gamma rays

    Science.gov (United States)

    Dantas, A. R. V.; Gauthier, M. K.; Coss, J. R.

    1985-01-01

    The total integrated dose response of three CMOS devices manufactured by Solid State Scientific has been measured using CO-60 gamma rays. Key parameter measurements were made and compared for each device type. The data show that the CD4011, CD4013, and CD4060 produced by this manufacturers should not be used in any environments where radiation levels might exceed 1,000 rad(Si).

  10. Social Learning through Participatory Integrated Catchment Risk Assessment in the Solomon Islands

    Directory of Open Access Journals (Sweden)

    Suzanne Hoverman

    2011-06-01

    Full Text Available In developed countries a social learning approach has been shown to support Integrated Water Resources Management (IWRM by fostering stakeholders' understanding of system complexity, recognition of mutual dependence, appreciation of others' perspectives, and development of the capacity to work together and to create mutual trust. Much less is known about social learning's potential in less developed small island states, particularly postconflict island states, where integration must navigate prescriptive management, limited resources, widely differing world views, a history of adversarial relationships, and unsuccessful attempts at government-community collaboration. This paper analyzes the transformative aspects of a social learning experience that occurred during research facilitating participatory integrated catchment management in the Pacific. The study elicited community and expert knowledge to create systems understanding to generate and analyze complex scenarios for integrated catchment risk assessment in the Kongulai catchment, Solomon Islands. Separate sequenced and then combined discussions led to facilitated exploration of others' subjective assessment of catchment risks and management options. Issues of transparency, trust, accountability, and mutual responsibility were explored in carefully created discursive spaces, assisted by the immediacy of personal contact and the absence of complex bureaucratic structures. Despite historical difficulties, through the use of bridging individuals, participants were generally able to transcend the constraints of their individual knowledge cultures, expand awareness and appreciation of the complexity of human-environment systems for IWRM, and envisage new opportunities for productively working together in integrated catchment management.

  11. An integrated method for assessing climate-related risks and adaptation alternatives in urban areas

    Directory of Open Access Journals (Sweden)

    Yvonne Andersson-Sköld

    2015-01-01

    Full Text Available The urban environment is a complex structure with interlinked social, ecological and technical structures. Global warming is expected to have a broad variety of impacts, which will add to the complexity. Climate changes will force adaptation, to reduce climate-related risks. Adaptation measures can address one aspect at the time, or aim for a holistic approach to avoid maladaptation. This paper presents a systematic, integrated approach for assessing alternatives for reducing the risks of heat waves, flooding and air pollution in urban settings, with the aim of reducing the risk of maladaptation. The study includes strategies covering different spatial scales, and both the current climate situation and the climate predicted under climate change scenarios. The adaptation strategies investigated included increasing vegetation; selecting density, height and colour of buildings; and retreat or resist (defend against sea-level rise. Their effectiveness was assessed with regard to not only flooding, heat stress and air quality but also with regard to resource use, emissions to air (incl. GHG, soil and water, and people’s perceptions and vulnerability. The effectiveness of the strategies were ranked on a common scale (from −3 to 3 in an integrated assessment. Integrated assessments are recommended, as they help identify the most sustainable solutions, but to reduce the risk of maladaptation they require experts from a variety of disciplines. The most generally applicable recommendation, derived from the integrated assessment here, taking into account both expertise from different municipal departments, literature surveys, life cycle assessments and publics perceptions, is to increase the urban greenery, as it contributes to several positive aspects such as heat stress mitigation, air quality improvement, effective storm-water and flood-risk management, and it has several positive social impacts. The most favourable alternative was compact, mid

  12. Role of integrated approach of yoga therapy in a failed post-total knee replacement of bilateral knees

    Directory of Open Access Journals (Sweden)

    John Ebnezar

    2014-01-01

    Full Text Available OA Knee is the most common arthritis. Knee replacement Surgeries are being done increasingly in the present times. This has led to the violation of the standard indications and when knees are replaced ignoring other co - musculoskeletal conditions it results in the surgery failing early. This is about a patient who encountered a failed TKR due to improper selection as patient had bilateral OA Hip that was ignored in the initial stages. To overcome the problem she was advised bilateral hip replacement which would leave her with four replacements in the lower limb. She refused surgery and was told there are no alternative treatment options. This patient underwent a 3 week integrated course of IAYT at our center and she made a remarkable recovery. IAYT is a good non-surgical treatment that can be affective both before and after knee replacement and it should be considered as the first choice of treatment before surgery.

  13. Influence of risk factors on stomal recurrence after total laryngectomy for laryngeal carcinomas: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhi-Yi Wang

    2017-01-01

    Conclusions: In this study, we proved that subglottic location, advanced tumor stage, especially T4 stage, and preoperative tracheostomy were risk factors for SRAL for larynx cancer. However, many other potential risk factors, such as surgical margins, could not be determined for inadequate records. Hence, more prospective trials should be designed to determine the risk factors for SRAL for larynx cancer.

  14. On set-valued functionals: Multivariate risk measures and Aumann integrals

    Science.gov (United States)

    Ararat, Cagin

    In this dissertation, multivariate risk measures for random vectors and Aumann integrals of set-valued functions are studied. Both are set-valued functionals with values in a complete lattice of subsets of Rm. Multivariate risk measures are considered in a general d-asset financial market with trading opportunities in discrete time. Specifically, the following features of the market are incorporated in the evaluation of multivariate risk: convex transaction costs modeled by solvency regions, intermediate trading constraints modeled by convex random sets, and the requirement of liquidation into the first m ≤ d of the assets. It is assumed that the investor has a "pure" multivariate risk measure R on the space of m-dimensional random vectors which represents her risk attitude towards the assets but does not take into account the frictions of the market. Then, the investor with a d-dimensional position minimizes the set-valued functional R over all m-dimensional positions that she can reach by trading in the market subject to the frictions described above. The resulting functional Rmar on the space of d-dimensional random vectors is another multivariate risk measure, called the market-extension of R. A dual representation for R mar that decomposes the effects of R and the frictions of the market is proved. Next, multivariate risk measures are studied in a utility-based framework. It is assumed that the investor has a complete risk preference towards each individual asset, which can be represented by a von Neumann-Morgenstern utility function. Then, an incomplete preference is considered for multivariate positions which is represented by the vector of the individual utility functions. Under this structure, multivariate shortfall and divergence risk measures are defined as the optimal values of set minimization problems. The dual relationship between the two classes of multivariate risk measures is constructed via a recent Lagrange duality for set optimization. In

  15. Individual Breast Cancer risk assessment in Underserved Populations: Integrating empirical Bioethics and Health Disparities Research

    Science.gov (United States)

    Anderson, Emily E.; Hoskins, Kent

    2013-01-01

    Research suggests that individual breast cancer risk assessment may improve adherence to recommended screening and prevention guidelines, thereby decreasing morbidity and mortality. Further research on the use of risk assessment models in underserved minority populations is critical to informing national public health efforts to eliminate breast cancer disparities. However, implementing individual breast cancer risk assessment in underserved patient populations raises particular ethical issues that require further examination. After reviewing these issues, we will discuss how empirical bioethics research can be integrated with health disparities research to inform the translation of research findings. Our in-progress National Cancer Institute (NCI) funded study, How Do Underserved Minority Women Think About Breast Cancer?, conducted in the context of a larger study on individual breast cancer risk assessment, is presented as a model. PMID:23124498

  16. Use of Hip Arthroscopy and Risk of Conversion to Total Hip Arthroplasty: A Population-Based Analysis.

    Science.gov (United States)

    Schairer, William W; Nwachukwu, Benedict U; McCormick, Frank; Lyman, Stephen; Mayman, David

    2016-04-01

    To use population-level data to (1) evaluate the conversion rate of total hip arthroplasty (THA) within 2 years of hip arthroscopy and (2) assess the influence of age, arthritis, and obesity on the rate of conversion to THA. We used the State Ambulatory Surgery Databases and State Inpatient Databases for California and Florida from 2005 through 2012, which contain 100% of patient visits. Hip arthroscopy patients were tracked for subsequent primary THA within 2 years. Out-of-state patients and patients with less than 2 years follow-up were excluded. Multivariate analysis identified risks for subsequent hip arthroplasty after arthroscopy. We identified 7,351 patients who underwent hip arthroscopy with 2 years follow-up. The mean age was 43.9 ± 13.7 years, and 58.8% were female patients. Overall, 11.7% of patients underwent THA conversion within 2 years. The conversion rate was lowest in patients aged younger than 40 years (3.0%) and highest in the 60- to 69-year-old group (35.0%) (P arthroscopy. Patients treated at high-volume hip arthroscopy centers had a lower THA conversion rate than those treated at low-volume centers (15.1% v 9.7%, P arthroscopy is performed in patients of various ages, including middle-aged and elderly patients. Older patients have a higher rate of conversion to THA, as do patients with osteoarthritis or obesity. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  17. Preoperative preparation of high-risk, specifically hyperimmunized canine renal allograft recipients with total-lymphoid irradiation and cyclosporine

    International Nuclear Information System (INIS)

    Rapaport, F.T.; Meek, A.G.; Arnold, A.N.; Miura, S.; Hayashi, R.; Strober, S.

    1987-01-01

    Hyperimmunized subjects are a particularly high-risk and rapidly growing group in the patient population awaiting renal transplantation. In a search for methods designed to ameliorate the prognosis in such cases, dogs of defined DLA genotype were sensitized with DLA incompatible skin allografts and injections of buffy coat. Each recipient was challenged with a renal allograft bearing the same DLA incompatibilities. Five dogs received kidney transplants, without any other treatment, and rejected their transplants at 2.5, 4, 5, 6, and 6.5 days, respectively. Another four dogs were given a 9-11-week course (1760 +/- 35 cGy) of total-lymphoid irradiation (TLI), followed by rabbit antithymocyte globulin (ATG); these animals rejected their renal allografts at 7, 8, 14, and 17 days, respectively. Five other dogs were treated with TLI and received cyclosporine (CsA) and methylprednisolone (MPd) daily until graft rejection. Their renal allografts survived for 7.5, 8.5, 20, 62, and 227 days, respectively. Renal allografts placed in normal recipients under the same conditions of donor-recipient DLA incompatibility had a mean survival time of 12.4 days (range: 10-18 days). At the time of transplantation, the specific anti-DLA antibody titers in the recipients were 81 to 243 in the untreated dogs; 27 to 81 in the TLI-ATG-treated group, and 3 to 243 in the TLI-CsA/MPd-treated group. The titers fell within 24-48 hr after renal transplantation, to 3 to 81 in the untreated sensitized dogs; they were 3 to 9 in the TLI-ATG-treated group, and were 9 to 243 in the TLI-CsA/MPd treated group. The cytotoxic antibody titers reached postoperative peaks of 6500 to 200,000 in the untreated dogs; 729 to 6500 in the TLI-ATG-treated dogs, and 243 to 6500 in the TLI-CsA/MPd-treated recipients

  18. Likelihood ratio-based integrated personal risk assessment of type 2 diabetes.

    Science.gov (United States)

    Sato, Noriko; Htun, Nay Chi; Daimon, Makoto; Tamiya, Gen; Kato, Takeo; Kubota, Isao; Ueno, Yoshiyuki; Yamashita, Hidetoshi; Fukao, Akira; Kayama, Takamasa; Muramatsu, Masaaki

    2014-01-01

    To facilitate personalized health care for multifactorial diseases, risks of genetic and clinical/environmental factors should be assessed together for each individual in an integrated fashion. This approach is possible with the likelihood ratio (LR)-based risk assessment system, as this system can incorporate manifold tests. We examined the usefulness of this system for assessing type 2 diabetes (T2D). Our system employed 29 genetic susceptibility variants, body mass index (BMI), and hypertension as risk factors whose LRs can be estimated from openly available T2D association data for the Japanese population. The pretest probability was set at a sex- and age-appropriate population average of diabetes prevalence. The classification performance of our LR-based risk assessment was compared to that of a non-invasive screening test for diabetes called TOPICS (with score based on age, sex, family history, smoking, BMI, and hypertension) using receiver operating characteristic analysis with a community cohort (n = 1263). The area under the receiver operating characteristic curve (AUC) for the LR-based assessment and TOPICS was 0.707 (95% CI 0.665-0.750) and 0.719 (0.675-0.762), respectively. These AUCs were much higher than that of a genetic risk score constructed using the same genetic susceptibility variants, 0.624 (0.574-0.674). The use of ethnically matched LRs is necessary for proper personal risk assessment. In conclusion, although LR-based integrated risk assessment for T2D still requires additional tests that evaluate other factors, such as risks involved in missing heritability, our results indicate the potential usability of LR-based assessment system and stress the importance of stratified epidemiological investigations in personalized medicine.

  19. Integrated Approach Model of Risk, Control and Auditing of Accounting Information Systems

    Directory of Open Access Journals (Sweden)

    Claudiu BRANDAS

    2013-01-01

    Full Text Available The use of IT in the financial and accounting processes is growing fast and this leads to an increase in the research and professional concerns about the risks, control and audit of Ac-counting Information Systems (AIS. In this context, the risk and control of AIS approach is a central component of processes for IT audit, financial audit and IT Governance. Recent studies in the literature on the concepts of risk, control and auditing of AIS outline two approaches: (1 a professional approach in which we can fit ISA, COBIT, IT Risk, COSO and SOX, and (2 a research oriented approach in which we emphasize research on continuous auditing and fraud using information technology. Starting from the limits of existing approaches, our study is aimed to developing and testing an Integrated Approach Model of Risk, Control and Auditing of AIS on three cycles of business processes: purchases cycle, sales cycle and cash cycle in order to improve the efficiency of IT Governance, as well as ensuring integrity, reality, accuracy and availability of financial statements.

  20. Decision-Making Under Risk: Integrating Perspectives From Biology, Economics, and Psychology.

    Science.gov (United States)

    Mishra, Sandeep

    2014-08-01

    Decision-making under risk has been variably characterized and examined in many different disciplines. However, interdisciplinary integration has not been forthcoming. Classic theories of decision-making have not been amply revised in light of greater empirical data on actual patterns of decision-making behavior. Furthermore, the meta-theoretical framework of evolution by natural selection has been largely ignored in theories of decision-making under risk in the human behavioral sciences. In this review, I critically examine four of the most influential theories of decision-making from economics, psychology, and biology: expected utility theory, prospect theory, risk-sensitivity theory, and heuristic approaches. I focus especially on risk-sensitivity theory, which offers a framework for understanding decision-making under risk that explicitly involves evolutionary considerations. I also review robust empirical evidence for individual differences and environmental/situational factors that predict actual risky decision-making that any general theory must account for. Finally, I offer steps toward integrating various theoretical perspectives and empirical findings on risky decision-making. © 2014 by the Society for Personality and Social Psychology, Inc.

  1. Economic Impacts of Total Water Use Control in the Heihe River Basin in Northwestern China—An Integrated CGE-BEM Modeling Approach

    Directory of Open Access Journals (Sweden)

    Na Li

    2015-03-01

    Full Text Available This paper develops an integrated modeling approach combined with a top-down dynamic computable general equilibrium (CGE model and a bottom-up bio-economic model (BEM to study the economic impact of a total water use control policy in the Heihe river basin, northwestern China. The integrated CGE-BEM model is regionally disaggregated with a variety of crops and livestock, and includes the responses of farmers and consequent feedback effects in the regional economic system. The results show that under the total water use control scenario, the water use structure is changed and water use efficiency is improved. The total water use control policy has limited negative impact on the regional economic growth with only a slightly lower growth rate of 13.38% compared with a growth rate of 14% by 2020 under a business as usual water use scenario. However, the total water use control policy has significant negative impacts on several sectors, especially agriculture and food processing. It is expected cropping systems will change through a replacement of water-intensive crops with water-efficient crops. Farmers’ incomes will decrease by 3.14%. In order to alleviate farmers’ income loss and deal with water use conflicts across different sectors and regions, the promotion of migration of surplus labor from agriculture to non-agricultural sectors and the improvement of water use efficiency in agriculture are needed.

  2. Integrated batch production and maintenance scheduling for multiple items processed on a deteriorating machine to minimize total production and maintenance costs with due date constraint

    Directory of Open Access Journals (Sweden)

    Zahedi Zahedi

    2016-04-01

    Full Text Available This paper discusses an integrated model of batch production and maintenance scheduling on a deteriorating machine producing multiple items to be delivered at a common due date. The model describes the trade-off between total inventory cost and maintenance cost as the increase of production run length. The production run length is a time bucket between two consecutive preventive maintenance activities. The objective function of the model is to minimize total cost consisting of in process and completed part inventory costs, setup cost, preventive and corrective maintenance costs and rework cost. The problem is to determine the optimal production run length and to schedule the batches obtained from determining the production run length in order to minimize total cost.

  3. Dietary total flavonoids intake and risk of mortality from all causes and cardiovascular disease in the general population: A systematic review and meta-analysis of cohort studies.

    Science.gov (United States)

    Liu, Xue-Ming; Liu, Yu-Jian; Huang, Yao; Yu, Hong-Jie; Yuan, Shuai; Tang, Bo-Wen; Wang, Pei-Gang; He, Qi-Qiang

    2017-06-01

    Epidemiologic studies assessing the association between dietary total flavonoids intake and the risk of morta