Cautious Citizenship: The Deterring Effect of Immigration Issue Salience on Health Care Use and Bureaucratic Interactions among Latino US Citizens.

Science.gov (United States)

Pedraza, Franciso I; Nichols, Vanessa Cruz; LeBrón, Alana M W

2017-10-01

Research shows that health care use among Latino immigrants is adversely affected by restrictive immigration policy. A core concern is that immigrants shy away from sharing personal information in response to policies that expand bureaucratic monitoring of citizenship status across service-providing organizations. This investigation addresses the concern that immigration politics also negatively influences health care utilization among Latino US citizens. One implication is that health insurance expansions may not reduce health care inequities among Latinos due to concern about exposure to immigration law enforcement authorities. Using data from the 2015 Latino National Health and Immigration Survey, we examine the extent to which the politics of immigration deters individuals from going to health care providers and service-providing institutions. Results indicate that Latino US citizens are less likely to make an appointment to see a health care provider when the issue of immigration is mentioned. Additionally, Latino US citizens who know someone who has been deported are more inclined to perceive that information shared with health care providers is not secure. We discuss how cautious citizenship, or risk-avoidance behaviors toward public institutions in order to avoid scrutiny of citizenship status, informs debates about reducing health care inequities. Copyright © 2017 by Duke University Press.

Prohibition of artificial hypoxic environments in sports: health risks rather than ethics.

Science.gov (United States)

Lippi, Giuseppe; Franchini, Massimo; Guidi, Gian Cesare

2007-12-01

There is actual debate on a recent position of the World Anti-Doping Agency (WADA), which has cautiously refrained from banning hypoxic tents and intends to monitor their health risk. Regardless of teleological and deontological concepts, we highlight that the health risks inherent to the widespread use of these artificial performance-enhancing devices would make them as unsafe as other forms of blood doping.

International Monetary Fund sacrifices higher growth, employment, spending, and public investment in health systems in order to keep inflation unnecessarily low.

Science.gov (United States)

Rowden, Rick

2010-01-01

The International Monetary Fund's response to evidence on the impact of its programs on public health fails to address the fundamental criticisms about its policies. The IMF's demand for borrowers to achieve extremely low inflation targets is founded on very little empirical evidence in the peer-reviewed literature. The low-inflation policies privilege international creditors over domestic debtors and short-term priorities over long-term development goals, and contain high social costs, referred to by economists as a "sacrifice ratio." For example, governments' raising of interest rates to bring down inflation undermines the ability of domestic firms to expand production and employment and thus "sacrifices" higher economic growth and higher tax revenues and unnecessarily constrains domestic health spending. During financial crisis, most countries seek to lower interest rates to stimulate the economy, the opposite of the IMF's general advice. Perversely, compliance with IMF policies has become a prerequisite for receiving donor aid. Critiques of the IMF express significant concerns that IMF fiscal and monetary policies are unduly restrictive. Health advocates must weigh in on such matters and pressure their finance ministries, particularly in the G7, to take steps at the level of the IMF Executive Board to revisit and modify its policy framework on deficits and inflation. Such reforms are crucial to enable countries to generate more domestic resources while the global health community searches for ways to support strengthening health system capacity.

Handbook of methods for risk-based analyses of technical specifications

International Nuclear Information System (INIS)

Samanta, P.K.; Kim, I.S.; Mankamo, T.; Vesely, W.E.

1994-12-01

Technical Specifications (TS) requirements for nuclear power plants define the Limiting Conditions for Operation (LCOs) and Surveillance Requirements (SRs) to assure safety during operation. In general, these requirements are based on deterministic analysis and engineering judgments. Experiences with plant operation indicate that some elements of the requirements are unnecessarily restrictive, while a few may not be conducive to safety. The US Nuclear Regulatory Commission (USNRC) Office of Research has sponsored research to develop systematic risk-based methods to improve various aspects of TS requirements. This handbook summarizes these risk-based methods. The scope of the handbook includes reliability and risk-based methods for evaluating allowed outage times (AOTs), scheduled or preventive maintenance, action statements requiring shutdown where shutdown risk may be substantial, surveillance test intervals (STIs), and management of plant configurations resulting from outages of systems, or components. For each topic, the handbook summarizes analytic methods with data needs, outlines the insights to be gained, lists additional references, and gives examples of evaluations

Handbook of methods for risk-based analyses of technical specifications

Energy Technology Data Exchange (ETDEWEB)

Samanta, P.K.; Kim, I.S. [Brookhaven National Lab., Upton, NY (United States); Mankamo, T. [Avaplan Oy, Espoo (Finland); Vesely, W.E. [Science Applications International Corp., Dublin, OH (United States)

1994-12-01

Technical Specifications (TS) requirements for nuclear power plants define the Limiting Conditions for Operation (LCOs) and Surveillance Requirements (SRs) to assure safety during operation. In general, these requirements are based on deterministic analysis and engineering judgments. Experiences with plant operation indicate that some elements of the requirements are unnecessarily restrictive, while a few may not be conducive to safety. The US Nuclear Regulatory Commission (USNRC) Office of Research has sponsored research to develop systematic risk-based methods to improve various aspects of TS requirements. This handbook summarizes these risk-based methods. The scope of the handbook includes reliability and risk-based methods for evaluating allowed outage times (AOTs), scheduled or preventive maintenance, action statements requiring shutdown where shutdown risk may be substantial, surveillance test intervals (STIs), and management of plant configurations resulting from outages of systems, or components. For each topic, the handbook summarizes analytic methods with data needs, outlines the insights to be gained, lists additional references, and gives examples of evaluations.

Environmental risk assessments for transgenic crops producing output trait enzymes

Science.gov (United States)

Tuttle, Ann; Shore, Scott; Stone, Terry

2009-01-01

The environmental risks from cultivating crops producing output trait enzymes can be rigorously assessed by testing conservative risk hypotheses of no harm to endpoints such as the abundance of wildlife, crop yield and the rate of degradation of crop residues in soil. These hypotheses can be tested with data from many sources, including evaluations of the agronomic performance and nutritional quality of the crop made during product development, and information from the scientific literature on the mode-of-action, taxonomic distribution and environmental fate of the enzyme. Few, if any, specific ecotoxicology or environmental fate studies are needed. The effective use of existing data means that regulatory decision-making, to which an environmental risk assessment provides essential information, is not unnecessarily complicated by evaluation of large amounts of new data that provide negligible improvement in the characterization of risk, and that may delay environmental benefits offered by transgenic crops containing output trait enzymes. PMID:19924556

A cautious iodization programme bringing iodine intake to a low recommended level is associated with an increase in the prevalence of thyroid autoantibodies in the population

DEFF Research Database (Denmark)

Pedersen, Inge B.; Knudsen, Nils; Carlé, Allan

2011-01-01

·7 vs 19·9% (P women and especially observed at low...... concentrations of antibodies. Conclusion The prevalence of both TPO‐Ab and Tg‐Ab was higher 4–5 years after a cautious iodine fortification of salt was introduced in Denmark. The increase was most pronounced in young women and in the low concentrations of antibody. Further studies are needed to evaluate the long...

Technological risk: Perception and handling in the EEC

International Nuclear Information System (INIS)

Schuster, G.

1980-01-01

The Europeans tend to believe that in their own country science is put to use for the benefit of people in general. But this reductance is accompanied by a widespread feeling in all countries that politicians do not give serious enough consideration to the choices that have to be made in this field. The more technology interferes with the moral and physical sphere of man, the more cautious people are, considering such technology to be risky. The more public opinion is conscious of what is at stake with possible risks and hazards, the more people are inclined to run these risks and hazards. (DG)

Use of probabilistic risk assessments to define areas of possible exemption from regulatory requirements

International Nuclear Information System (INIS)

Thompson, C.A.; Carlson, D.; Kolaczkowski, A.; LaChance, J.

1988-01-01

The Risk-Based Licensing Program (RBLP) was sponsored by the Department of Energy for the purpose of establishing and demonstrating an approach for identifying potential areas for exemption from current regulatory requirements in the licensing of nuclear power plants. Such an approach could assist in the improvement of the regulatory process for both current and future nuclear plant designs. Use of the methodology could result in streamlining the regulatory process by eliminating unnecessarily detailed reviews of portions of a plant design not important to risk. The RBLP methodology utilizes probabilistic risk assessments, (PRAs), which are required of all future applicants for nuclear power plant licenses. PRA results are used as a screening tool to determine the risk significance of various plant features which are correlated to the risk importance of regulations to identify potential areas for regulatory exemption. Additional consideration is then given to non-risk factors in the final determination of exemption candidates. The RBLP methodology was demonstrated using an existing PRA. The results of the demonstration are highlighted. 10 refs

Risk communication related to animal products derived from biotechnology.

Science.gov (United States)

McCrea, D

2005-04-01

Previous chapters of this review have dealt with the key considerations related to the application of biotechnology in veterinary science and animal production. This article explores the theory and practice of risk communication and sets out the basic principles for good risk communication when dealing with new technologies, uncertainty, and cautious and sceptical consumers. After failure to communicate with consumers and stakeholders about the risk to human health from bovine spongiform encephalopathy (BSE) in the 1990s, Government Agencies in the United Kingdom have made significant improvements in risk communication. The official inquiry that followed the BSE crisis concluded that a policy of openness was the correct approach, and this article emphasises the importance of consultation, consistency and transparency. There are, however, many different factors that affect public perception of risk (religious, political, social, cultural, etc.) and developing effective risk communication strategies must take all of these complex issues into consideration.

Applying radiation approaches to the control of public risks from chemical agents

International Nuclear Information System (INIS)

Alexander, R.E.

1989-01-01

IF a hazardous agent has a threshold, prevention is the obvious measure of success. To the eyes of this author, success is also achieveable for a hazardous agent that may have no threshold and that causes its effects in a probabilistic manner. First, the technical people responsible for protection must be given a reasonable, well defined risk objective by governmental authorities. To the extent that they meet that objective (1) without unnecessarily increasing operational costs, (2) without interfering unnecessarily with operational activities, and (3) without diverting resources away from greater risks, they are successful. Considering these three qualifications, radiation protection for members of the public can hardly be presented as the panacea for other hazardous agents. It would be an error to dismiss the improvement opportunities discussed above as being of acdemic interest only. Decades of experience with radiation have demonstrated that these problems are both real adn significant. In the US the axioms discussed above are accepted as scientific fact for radiation by many policy makers, the news media and the public. For any operation the collective dose is calculated using zero dose as the lower limit of integration, the results are converted to cancer deaths using the risk coefficients, and decisions are made as though these deaths would actually occur without governmental intervention. As a result, billions of dollars and a very large number of highly skilled persons are being expended to protect against radiation doses far smaller than geographical variations in the natural radiation background. These expenditures are demanded by, and required for well-meaning, nontechnical people who have been misled. It is often stated by knowledgeable people that if the degree of protection required for radiation were also to be requested for the other hazards, human progress would come to a halt. If the radiation approaches are to be used in the control of public

The Impact of Smokeless Tobacco Risk Information on Smokers' Risk Perceptions and Use Intentions: A News Media Experiment.

Science.gov (United States)

Wackowski, Olivia A; Manderski, Michelle T Bover; Lewis, M Jane; Delnevo, Cristine D

2017-12-13

Little research exists on the impact of risk information comparing smokeless tobacco (SLT) use, particularly snus, to cigarette smoking. This study explored this topic using a communication channel where smokers may be exposed to such information-the news media. We randomly assigned 1008 current smokers to read one of three constructed news stories or to a control group (no article). The "favorable" story framed snus as a "safer" smoking alternative while the "cautious" story described snus risks. The "mixed" version described potential risks and harm-reduction benefits. Participants completed a post-article survey with snus risk and harm perception and use intention measures. Article condition was significantly associated with perceived harm of daily snus use relative to smoking (1 = a lot less harmful - 5 = a lot more harmful; p news messages about SLT and snus relative to cigarettes may impact smokers' SLT harm perceptions and use intentions. Tobacco control professionals and FDA officials should consider the potential impact of the news media when communicating about tobacco risks.

Malignant transformation of a potentially low risk lichenoid reaction

International Nuclear Information System (INIS)

Ashir, K.R.; Chatra, L.

2012-01-01

Lichenoid reaction represents a family of oral lesions identical, both clinically and histologically to oral lichen planus. The triggering factor for this lesion varies from medicines to dental materials, usually demonstrating a cause-effect relationship unlike lichen planus. We present a typical case of lichenoid reaction on the buccal mucosa that appeared in response to betel quid which progressed to carcinoma during a follow-up period of 6 months. Lichenoid reactions occurring in response to known carcinogens and that occurring in risk group population has to be observed more cautiously. (author)

Importance measures and genetic algorithms for designing a risk-informed optimally balanced system

International Nuclear Information System (INIS)

Zio, Enrico; Podofillini, Luca

2007-01-01

This paper deals with the use of importance measures for the risk-informed optimization of system design and management. An optimization approach is presented in which the information provided by the importance measures is incorporated in the formulation of a multi-objective optimization problem to drive the design towards a solution which, besides being optimal from the points of view of economics and safety, is also 'balanced' in the sense that all components have similar importance values. The approach allows identifying design systems without bottlenecks or unnecessarily high-performing components and with test/maintenance activities calibrated according to the components' importance ranking. The approach is tested at first against a multi-state system design optimization problem in which off-the-shelf components have to be properly allocated. Then, the more realistic problem of risk-informed optimization of the technical specifications of a safety system of a nuclear power plant is addressed

Handbook of methods for risk-based analysis of technical specification requirements

International Nuclear Information System (INIS)

Samanta, P.K.; Vesely, W.E.

1994-01-01

Technical Specifications (TS) requirements for nuclear power plants define the Limiting Conditions for Operation (LCOs) and Surveillance Requirements (SRs) to assure safety during operation. In general, these requirements were based on deterministic analysis and engineering judgments. Experiences with plant operation indicate that some elements of the requirements are unnecessarily restrictive, while others may not be conducive to safety. Improvements in these requirements are facilitated by the availability of plant specific Probabilistic Safety Assessments (PSAs). The use of risk and reliability-based methods to improve TS requirements has gained wide interest because these methods can: Quantitatively evaluate the risk and justify changes based on objective risk arguments; Provide a defensible basis for these requirements for regulatory applications. The US NRC Office of Research is sponsoring research to develop systematic risk-based methods to improve various aspects of TS requirements. The handbook of methods, which is being prepared, summarizes such risk-based methods. The scope of the handbook includes reliability and risk-based methods for evaluating allowed outage times (AOTs), action statements requiring shutdown where shutdown risk may be substantial, surveillance test intervals (STIs), defenses against common-cause failures, managing plant configurations, and scheduling maintenances. For each topic, the handbook summarizes methods of analysis and data needs, outlines the insights to be gained, lists additional references, and presents examples of evaluations

Handbook of methods for risk-based analysis of Technical Specification requirements

International Nuclear Information System (INIS)

Samanta, P.K.; Vesely, W.E.

1993-01-01

Technical Specifications (TS) requirements for nuclear power plants define the Limiting Conditions for Operation (LCOs) and Surveillance Requirements (SRs) to assure safety during operation. In general, these requirements were based on deterministic analysis and engineering judgments. Experiences with plant operation indicate that some elements of the requirements are unnecessarily restrictive, while others may not be conducive to safety. Improvements in these requirements are facilitated by the availability of plant specific Probabilistic Safety Assessments (PSAs). The use of risk and reliability-based methods to improve TS requirements has gained wide interest because these methods can: quantitatively evaluate the risk impact and justify changes based on objective risk arguments. Provide a defensible basis for these requirements for regulatory applications. The United States Nuclear Regulatory Commission (USNRC) Office of Research is sponsoring research to develop systematic risk-based methods to improve various aspects of TS requirements. The handbook of methods, which is being prepared, summarizes such risk-based methods. The scope of the handbook includes reliability and risk-based methods for evaluating allowed outage times (AOTs), action statements requiring shutdown where shutdown risk may be substantial, surveillance test intervals (STIs), defenses against common-cause failures, managing plant configurations, and scheduling maintenances. For each topic, the handbook summarizes methods of analysis and data needs, outlines the insights to be gained, lists additional references, and presents examples of evaluations

How does economic risk aversion affect biodiversity?

Science.gov (United States)

Mouysset, L; Doyen, L; Jiguet, F

2013-01-01

Significant decline of biodiversity in farmlands has been reported for several decades. To limit the negative impact of agriculture, many agro-environmental schemes have been implemented, but their effectiveness remains controversial. In this context, the study of economic drivers is helpful to understand the role played by farming on biodiversity. The present paper analyzes the impact of risk aversion on farmland biodiversity. Here "risk aversion" means a cautious behavior of farmers facing uncertainty. We develop a bio-economic model that articulates bird community dynamics and representative farmers selecting land uses within an uncertain macro-economic context. It is specialized and calibrated at a regional scale for France through national databases. The influence of risk aversion is assessed on ecological, agricultural, and economic outputs through projections at the 2050 horizon. A high enough risk aversion appears sufficient to both manage economic risk and promote ecological performance. This occurs through a diversification mechanism on regional land uses. However, economic calibration leads to a weak risk-aversion parameter, which is consistent with the current decline of farmland birds. Spatial disparities however suggest that public incentives could be necessary to reinforce the diversification and bio-economic effectiveness.

Notification of occupational disease and the risk of work disability

DEFF Research Database (Denmark)

Kolstad, Henrik A; Christensen, Michael V; Jensen, Lone Donbæk

2012-01-01

for patients who were not working. CONCLUSIONS: Notification of an occupational disease may, as an unintended side effect, increase the risk of work disability. A cautious interpretation is warranted because data analyses may not fully have accounted for the poorer vocational prognosis already present......OBJECTIVES: The aim of this study was to analyze if notification of an occupational disease increases the risk of work disability. METHODS: We included 2304 patients examined at the Department of Occupational Medicine, Aarhus University Hospital, 1998-2005 and followed them for two years. A total......, occupational, and social characteristics that predict poorer vocational prognosis. Analyses that adjusted for these differences showed an increased risk of work disability following notification for patients who were working when notified at baseline (HR (adj)1.46, 95% CI 1.17-1.82). No effect was seen...

Red Color and Risk-Taking Behavior in Online Environments

Science.gov (United States)

Gnambs, Timo; Appel, Markus; Oeberst, Aileen

2015-01-01

In many situations red is associated with hazard and danger. As a consequence, it was expected that task-irrelevant color cues in online environments would affect risk-taking behaviors. This assumption was tested in two web-based experiments. The first study (N = 383) demonstrated that in risky choice dilemmas respondents preferred the less risky option when the displayed university logo was in red (versus gray); but only when both choice alternatives were at least moderately risky. The second study (N = 144) replicated these results with a behavioral outcome: Respondents showed more cautious behavior in a web-based game when the focal stimuli were colored red (versus blue). Together, these findings demonstrate that variations in the color design of a computerized environment affect risk taking: Red color leads to more conservative choices and behaviors. PMID:26207983

Technical risk - individual responsibility

International Nuclear Information System (INIS)

Herzog, R.

1984-01-01

The author, vice-president of the Federal Constitutional Court, delivered this opening address at the international symposium on nuclear liability held in Munich in September 1984 by OECD/NEA and IAEA. He starts by asking: Where does danger begin, where does risk end. It is the true and original task of the state to keep damage away from its citizens: this entails the obligation for additional garantees - not withstanding an almost greatest possible degree of safety - to at least helpfully compensate damage incurred, should such damage arise. In case of really severe accidents the essential thing is not the operator's liability but the entry of the state into that obligation, and this fact remains unchanged even if the maximum limits of liability were raised or in case of their removal. Therefore it is not necessary to be cautious about the question of unlimited liability, i.e. the unlimited entry of the state into such obligations, especially as all those responsible are convinced that there is practically no risk of that contingency occurring. (HSCH) [de

Cardiovascular risk during hormonal treatment in patients with prostate cancer

International Nuclear Information System (INIS)

Van Poppel, Hein; Tombal, Bertrand

2011-01-01

The objective of this review is to provide information on cardiovascular risk following androgen-deprivation therapy (ADT) in prostate cancer patients and to suggest potential prevention and management strategies. Androgen deprivation therapy can cause peripheral insulin resistance, increase fat mass and low-density lipoprotein cholesterol, and induce type 2 diabetes. While recent studies have reported an association in patients with prostate cancer between ADT and increased risk of cardiovascular events, other studies have not detected the association. However, at this time, it is plausible that ADT could increase cardiovascular risk because of the adverse effect of ADT on risk factors for cardiovascular disease. It is advisable that prostate cancer patients in whom ADT is initiated be referred to their physician, who will carefully monitor them for potential metabolic effects. Therefore, physicians should be informed about these potential side effects. This especially applies to men aged >65 years and those with pre-existing cardiovascular comorbidities. Adopting a healthy lifestyle including a balanced diet and regular physical activity is recommended. Patients with cardiovascular disease should receive appropriate preventive therapies, including lipid-lowering, antihypertensive, glucose-lowering, and antiplatelet therapy. ADT should preferably not be unnecessarily administered to prostate cancer patients with pre-existing cardiovascular disease, certainly not to those in whom the risk of prostate cancer-specific mortality is low. The physician should carefully weigh the potential benefits of ADT against the possible risks in individual patients with prostate cancer

Tuberculosis: A Problem for Lifeguards?

Science.gov (United States)

Skaros, Susan

1996-01-01

Lifeguards run the risk of workplace infection by tuberculosis-carrying swimmers. Even if they work in ventilated, sunlit areas (which reduces risk), they can contract tuberculosis when performing respiratory resuscitation. Without appropriate precautions, lifeguards may be unnecessarily exposed. A tuberculosis infection control plan is needed in…

Tattoos and transfusion-transmitted disease risk: implications for the screening of blood donors in Brazil

Directory of Open Access Journals (Sweden)

Sérgio de A. Nishioka

Full Text Available Having a tattoo has been associated with serological evidence of hepatitis B and C viruses, as well as human immunodeficiency virus infections and syphilis; all of these are known to be transmissible by blood transfusion. These associations are of higher magnitude for individuals with nonprofessionally-applied tattoos and with two or more tattoos. Tattoos are common among drug addicts and prisoners, conditions that are also associated with transfusion-transmitted diseases. We examined the implications of these associations for the screening of blood donors in Brazil. Numbers of individuals who would be correctly or unnecessarily deferred from blood donation on the basis of the presence of tattoos, and on their number and type, were calculated for different prevalence situations based on published odds ratios. If having a tattoo was made a deferral criterion, cost savings (due to a reduced need for laboratory testing and subsequent follow-up would accrue at the expense of the deferral of appropriate donors. Restricting deferral to more `at-risk' sub-groups of tattooed individuals would correctly defer less individuals and would also reduce the numbers of potential donors unnecessarily deferred. Key factors in balancing cost savings and unnecessary deferrals include the magnitude of the pool of blood donors in the population, the prevalence of individuals with tattoos and the `culture' of tattoos in the population. Tattoos can therefore be an efficient criterion for the screening of blood donors in certain settings, a finding that requires corroboration from larger population-based studies.

Virtual driving and risk taking: do racing games increase risk-taking cognitions, affect, and behaviors?

Science.gov (United States)

Fischer, Peter; Kubitzki, Jörg; Guter, Stephanie; Frey, Dieter

2007-03-01

Research has consistently shown that aggressive video console and PC games elicit aggressive cognitions, affect, and behaviors. Despite the increasing popularity of racing (driving) games, nothing is known about the psychological impact of this genre. This study investigated whether playing racing games affects cognitions, affect, and behaviors that can promote risk taking in actual road traffic situations. In Study 1, the authors found that the frequency of playing racing games was positively associated with competitive driving, obtrusive driving, and car accidents; a negative association with cautious driving was observed. To determine cause and effect, in Study 2, the authors manipulated whether participants played 1 of 3 racing games or 1 of 3 neutral games. Participants who played a racing game subsequently reported a higher accessibility of cognitions and affect positively associated with risk taking than did participants who played a neutral game. Finally, on a more behavioral level, in Study 3, the authors found that men who played a racing game subsequently took higher risks in computer-simulated critical road traffic situations than did men who played a neutral game. Theoretical and practical implications are discussed. ((c) 2007 APA, all rights reserved).

Assess for Success: The Role of Doctrine in Effective Combat Assessment

National Research Council Canada - National Science Library

Bailey, Thomas

2001-01-01

... and equipment unnecessarily at risk, Operations since then have not fared much better, This paper examines the "BDA problem" in some detail, focusing on the current military doctrine that has evolved in recent...

Red Color and Risk-Taking Behavior in Online Environments.

Directory of Open Access Journals (Sweden)

Timo Gnambs

Full Text Available In many situations red is associated with hazard and danger. As a consequence, it was expected that task-irrelevant color cues in online environments would affect risk-taking behaviors. This assumption was tested in two web-based experiments. The first study (N = 383 demonstrated that in risky choice dilemmas respondents preferred the less risky option when the displayed university logo was in red (versus gray; but only when both choice alternatives were at least moderately risky. The second study (N = 144 replicated these results with a behavioral outcome: Respondents showed more cautious behavior in a web-based game when the focal stimuli were colored red (versus blue. Together, these findings demonstrate that variations in the color design of a computerized environment affect risk taking: Red color leads to more conservative choices and behaviors.

The Sicomines agreement revisited: prudent Chinese banks and risk-taking Chinese companies

DEFF Research Database (Denmark)

Jansson, Johanna

2013-01-01

The Sicomines ‘minerals-for-infrastructure' agreement struck between the Congolese government and a consortium of Chinese companies in 2007 is one of the most well-known embodiments of the Chinese presence in Africa. This briefing analyses recent developments in the implementation of the agreement....... With important expenses incurred in the DRC, the Chinese parties to the agreement are still negotiating for a financing arrangement in China. This illustrates that China is no monolith in its overseas activities. While China’s banks are cautious, the real risk-takers in the context of the Sicomines agreement...... are the Chinese companies....

On the Concept and Definition of Terrorism Risk.

Science.gov (United States)

Aven, Terje; Guikema, Seth

2015-12-01

In this article, we provide some reflections on how to define and understand the concept of terrorism risk in a professional risk assessment context. As a basis for this discussion we introduce a set of criteria that we believe should apply to any conceptualization of terrorism risk. These criteria are based on both criteria used in other areas of risk analysis and our experience with terrorism risk analysis. That is, these criteria offer our perspective. We show that several of the suggested perspectives and definitions have weaknesses in relation to these criteria. A main problem identified is the idea that terrorism risk can be conceptualized as a function of probability and consequence, not as a function of the interactions between adaptive individuals and organizations. We argue that perspectives based solely on probability and consequence should be used cautiously or not at all because they fail to reflect the essential features of the concept of terrorism risk, the threats and attacks, their consequences, and the uncertainties, all in the context of adaptation by the adversaries. These three elements should in our view constitute the main pillars of the terrorism risk concept. From this concept we can develop methods for assessing the risk by identifying a set of threats, attacks, and consequence measures associated with the possible outcome scenarios together with a description of the uncertainties and interactions between the adversaries. © 2015 Society for Risk Analysis.

Benefits and Harms of Treatment of Asymptomatic Bacteriuria: A Systematic Review and Meta-analysis by the European Association of Urology Urological Infection Guidelines Panel

NARCIS (Netherlands)

Köves, Bela; Cai, Tommaso; Veeratterapillay, Rajan; Pickard, Robert; Seisen, Thomas; Lam, Thomas B.; Yuan, Cathy Yuhong; Bruyere, Franck; Wagenlehner, Florian; Bartoletti, Riccardo; Geerlings, Suzanne E.; Pilatz, Adrian; Pradere, Benjamin; Hofmann, Fabian; Bonkat, Gernot; Wullt, Björn

2017-01-01

People with asymptomatic bacteriuria (ABU) are often unnecessarily treated with antibiotics risking adverse effects and antimicrobial resistance. We performed a systematic review to determine any benefits and harms of treating ABU in particular patient groups. Relevant databases were searched and

'Everyone has an agenda': Professionals' understanding and negotiation of risk within the Guardianship system of Victoria, Australia.

Science.gov (United States)

Wyllie, Aaron; Saunders, Bernadette J

2018-02-19

It is frequently asserted that pressures to assess and manage risk have eroded the therapeutic, rights-based foundation of the human services profession. Some argue that human service workers operate in a culture of fear in which self-protection and blame avoidance, rather than clients' needs, primarily drive decision-making. In the field of Adult Guardianship, it has been suggested that organisational risk avoidance may be motivating applications for substitute decision-makers, unnecessarily curtailing clients' rights and freedoms. However, the absence of research examining the operation of risk within Guardianship decision-making inhibits verifying and responding to this very serious suggestion. This article draws on semi-structured interviews conducted with 10 professionals involved in the Victorian Guardianship system, which explored how issues of risk are perceived and negotiated in everyday practice. Risk was found to be a complex and subjective construct which can present both dangers and opportunities for Guardianship practitioners and their clients. While a number of participants reported that Guardianship might sometimes operate as an avenue for mitigating the fear and uncertainty of risk, most participants also valued positive risk-taking and were willing, in their clients' interests, to challenge conservative logics of risk. These findings highlight the need for further research which examines how service providers and policy makers can create spaces that support open discussions around issues of risk and address practitioners' sense of fear and vulnerability. © 2018 John Wiley & Sons Ltd.

CONTRACTUAL RISKS IN THE NEW ZEALAND CONSTRUCTION INDUSTRY: ANALYSIS AND MITIGATION MEASURES

Directory of Open Access Journals (Sweden)

Jasper Mbachu

2014-12-01

Full Text Available While tendering for jobs, a contractor is expected to analyse the various risks in each prospective project and price them appropriately. Contingencies are included in the tender price to cater for the various risks based on their impacts on the project targets and profit margin. Currently in New Zealand (NZ, there is little or no information on the various contractual risks and their mitigation measures. This has led to contractors over compensating or under compensating for risks with costly consequences. This study aimed to establish priority contractual risks in the NZ construction industry, and their mitigation measures. The research was based on a questionnaire survey of consultants and contractors. Descriptive statistics and multi-attribute techniques were used in the data analysis. Results showed 21 risk factors which were segregated into 6 broad categories in diminishing levels of significance as follows: Site conditions, main contractor, pricing, subcontractor, external and client- related risks. Putting tags and conditions to risky price items in the tender bids, and transferring the risks onto other parties were analysed as the 2 most effective out of the 5 key risk mitigation measures identified. Being cautious of the priority risks and application of the identified effective risk mitigation measures could guide contractors and the project team to more appropriately budget for and respond to risks, thereby ensuring more satisfactory project outcomes.

Clinical radiation doses for spinal cord: the 1988 international questionnaire

International Nuclear Information System (INIS)

Fowler, J.F.; Bogaert, W. vanden; Scheuren, E. van der; Bentzen, S.M.; Bond, S.J.; Ang, K.K.; Kogel, A.J. van der

2000-01-01

Emmanuel van der Schueren gave a keynote lecture at the 1988 ASTRO annual conference pointing out that the spinal cord 'tolerance doses' then prescribed were probably unnecessarily cautious, resulting in probable underdosing of some tumours. This lecture was supported both by an international questionnaire which he and two of the present authors had conducted, and by animal experimental data. In 1997 he initiated a 10-year follow-up questionnaire, the results of which are summarised here. The present report analyses the chance in prescriptions from 1988 to 1998 and the variation in prescriptions among various regions of the World. The main conclusion is that prescribed dose levels have increased significantly in this period. Large geographical variations still exist. Among responders who use a formula to correct for changed dose per fraction, 90% are now using the linear-quadratic model vs. 33% in 1988. The current status of clinically acceptable doses to spinal cord in 2-Gy fractions is discussed briefly. Further details from the responses to the 1998 questionnaire will be presented in another publication. (author)

The social perception of risk

International Nuclear Information System (INIS)

Eiser, J.R.

1989-01-01

Much research on acceptance of risks implies a distinction between objective and subjective definitions of risk. This paper disputes this distinction, arguing instead that discrepancies between public and 'expert' views are to be better understood in terms of differences in how decisions are seen to be made. Risk is a product of decisions taken in response to environmental events, and depends not simply on the threat posed by such events but on the quality of the decisions. A model of decision quality is presented, derived from signal detection theory, which distinguishes between the ability to discriminate between different kinds of events, and the criterion, or level of certainty that is required before a particular response is chosen. Whereas discrimination ability depends on the expertise of decision-makers and the predictability of the events in question, the response criterion reflects considerations of costs, benefits and equity. Where the cost of overlooking a real threat ('false-negative' response) is high, a cautious criterion may be demanded. Where discrimination ability is also seen to be low, the chance of 'false-negatives' may only be adequately reduced at the price of a large number of 'false-positives', or 'unnecessary' protective responses against imagined threats. In extreme cases, this may amount to total opposition to the operation of a system. (author)

Emerging technologies in healthcare: navigating risks, evaluating rewards.

Science.gov (United States)

McGrady, Elizabeth; Conger, Sue; Blanke, Sandra; Landry, Brett J L

2010-01-01

The purpose of this prescriptive research is to help decision makers become better informed about three technologies emerging in the healthcare arena by providing a basic description of the technology and describing their current applications, future healthcare deployment, potential risks, and related managerial issues. Two of the technologies, radio frequency identification (RFID) and global positioning systems (GPS), are currently available to healthcare organizations and appear capable of decreasing cost but may require significant initial investment and have disruptive potential. The third technology, nanotechnology, has limited current use but may revolutionize both the delivery of medicine and hospital infrastructure management. With cautious attention to managerial issues and meticulous attention to implementation details, healthcare organizations that can successfully navigate the coming technologically driven paradigm shifts will emerge more resilient organizations.

Is there an added value of faecal calprotectin and haemoglobin in the diagnostic work-up for primary care patients suspected of significant colorectal disease? A cross-sectional diagnostic study

NARCIS (Netherlands)

Elias, Sjoerd G.; Kok, Liselotte; de Wit, NJ; Witteman, Ben J. M.; Goedhard, Jelle G.; Romberg-Camps, Marielle J. L.; Muris, Jean W. M.; Moons, Karel G. M.

2016-01-01

Background The majority of primary care patients referred for bowel endoscopy do not have significant colorectal disease (SCD), and are – in hindsight – unnecessarily exposed to a small but realistic risk of severe endoscopy-associated complications. We developed a diagnostic strategy to better

TropJrnal Vol 28 No1&2 4Intnet publicatn

African Journals Online (AJOL)

Administrator

(6.7%), infertility (5.2%) and pelvic inflammatory disease (3.5%). All the deaths occurred in the emergency group (2.4%). ... unsafe abortion, unnecessarily risking their lives and health. The WHO defines unsafe abortion as a ... sex education, effective management of postabortal complications and review of abortion.

Radiation protection philosophy and risk estimates. NCRP Report 43 (1975), NAS-Beir Committee Report (1972, UNSCEAR Report (1972)

International Nuclear Information System (INIS)

Casarett, G.W.

1975-01-01

The purpose of the NCRP report no. 43 was to determine what influence the epidemiological and experimental radiobiological reports of the past several years should have on current NCRP radiation exposure standards. The position of the NCRP is that the lowest practicable radiation level below the recommended dose limits is the fundamental basis for establishing radiation protection standards, and on the assumption that the most important health hazards do not have a dose threshold. The BEIR report states that societal needs can be met with far lower average exposures and risks than permitted by the current Radiation Protection Guide of 170 millirems per yr, and that the current Guide is unnecessarily high. A review is given of the recent history of radiation protection standards and a discussion is given of similarities and differences between the BEIR and UNSCEAR reports

Risk-weighted optimization for cyclic steam stimulation of water-underlain reservoirs

International Nuclear Information System (INIS)

Mehra, R.K.; Ding, L.Y.; Donnelly, J.K.

1991-01-01

The paper describes the procedure that was adopted to develop operating guidelines for the cyclic steam stimulation process in a water underlain oil sands reservoir. The study consisted of three parts: i) The risks associated with fracturing into water sands were quantified by conducting a stochastic simulation; ii) Numerical simulations were conducted to obtain correlations among the cumulative production volumes and six selected operating variables; iii) These correlations were subsequently embodied in the economic model to maximize the profits under different constraints. The study concluded that rather than a unique value, a wide range of operating conditions maximized the project profitability. It recommended that a cautious approach in exploitation of these resources was warranted since the penalty for selecting non-optimal conditions was not high

Chronic Infections of the Urinary Tract and Bladder Cancer Risk: a Systematic Review.

Science.gov (United States)

Anderson-Otunu, Oghenetejiri; Akhtar, Saeed

2016-01-01

Literature on the relationship between recurrent urinary tract infections and urinary bladder carcinoma risk has been inconsistent. Therefore, we carried out this systematic review of observational studies to ascertain if there is any association between chronic urinary tract infection and urinary bladder carcinoma. A total of 10 databases were searched using Boolean: CINAHL, PUBMED, Google Scholar, Medline, Science Direct, SCIRUS, Cochrane, UK PubMed central, NHS evidence and WHO-website. The search yielded an initial hit of 3,518 articles and after screening and critical appraisal, seven studies were included for this review. Four articles reported an association between chronic urinary tract infections and bladder cancer while three concluded a weak or no association at least in one gender. Main findings in this review were that most of the studies reported an association between chronic urinary tract infections and bladder cancer risk. However, inferences about the causal association between chronic urinary tract infections and bladder cancer risk should be drawn cautiously considering the methodological limitations of case-control studies included in this review. Therefore, more empirical evidence is needed to determine the causal nature of relationships between chronic urinary tract infections and bladder cancer risk.

Risk factors affecting chronic rupture of the plantar fascia.

Science.gov (United States)

Lee, Ho Seong; Choi, Young Rak; Kim, Sang Woo; Lee, Jin Yong; Seo, Jeong Ho; Jeong, Jae Jung

2014-03-01

Prior to 1994, plantar fascia ruptures were considered as an acute injury that occurred primarily in athletes. However, plantar fascia ruptures have recently been reported in the setting of preexisting plantar fasciitis. We analyzed risk factors causing plantar fascia rupture in the presence of preexisting plantar fasciitis. We retrospectively reviewed 286 patients with plantar fasciitis who were referred from private clinics between March 2004 and February 2008. Patients were divided into those with or without a plantar fascia rupture. There were 35 patients in the rupture group and 251 in the nonrupture group. The clinical characteristics and risk factors for plantar fascia rupture were compared between the 2 groups. We compared age, gender, the affected site, visual analog scale pain score, previous treatment regimen, body mass index, degree of ankle dorsiflexion, the use of steroid injections, the extent of activity, calcaneal pitch angle, the presence of a calcaneal spur, and heel alignment between the 2 groups. Of the assessed risk factors, only steroid injection was associated with the occurrence of a plantar fascia rupture. Among the 35 patients with a rupture, 33 had received steroid injections. The odds ratio of steroid injection was 33. Steroid injections for plantar fasciitis should be cautiously administered because of the higher risk for plantar fascia rupture. Level III, retrospective comparative study.

Inhibition of Pre-Supplementary Motor Area by Continuous Theta Burst Stimulation Leads to More Cautious Decision-making and More Efficient Sensory Evidence Integration.

Science.gov (United States)

Tosun, Tuğçe; Berkay, Dilara; Sack, Alexander T; Çakmak, Yusuf Ö; Balcı, Fuat

2017-08-01

Decisions are made based on the integration of available evidence. The noise in evidence accumulation leads to a particular speed-accuracy tradeoff in decision-making, which can be modulated and optimized by adaptive decision threshold setting. Given the effect of pre-SMA activity on striatal excitability, we hypothesized that the inhibition of pre-SMA would lead to higher decision thresholds and an increased accuracy bias. We used offline continuous theta burst stimulation to assess the effect of transient inhibition of the right pre-SMA on the decision processes in a free-response two-alternative forced-choice task within the drift diffusion model framework. Participants became more cautious and set higher decision thresholds following right pre-SMA inhibition compared with inhibition of the control site (vertex). Increased decision thresholds were accompanied by an accuracy bias with no effects on post-error choice behavior. Participants also exhibited higher drift rates as a result of pre-SMA inhibition compared with the vertex inhibition. These results, in line with the striatal theory of speed-accuracy tradeoff, provide evidence for the functional role of pre-SMA activity in decision threshold modulation. Our results also suggest that pre-SMA might be a part of the brain network associated with the sensory evidence integration.

Do Procrastination-Friendly Environments Make Students Delay Unnecessarily?

Science.gov (United States)

Nordby, Kent; Klingsieck, Katrin; Svartdal, Frode

2017-01-01

Research on procrastination emphasizes trait explanations for unwanted delay, yet environmental factors are most probably significant contributors to the problem. In this paper, we review literature related to the influence of environmental factors on academic procrastination and investigate how such factors may be assessed in facilitating…

Threat affects risk preferences in movement decision making

Science.gov (United States)

O'Brien, Megan K.; Ahmed, Alaa A.

2015-01-01

Emotional states such as sadness, anger, and threat have been shown to play a critical role in decision-making processes. Here we addressed the question of whether risk preferences are influenced by postural threat and whether this influence generalizes across motor tasks. We examined risk attitudes in the context of arm-reaching (ARM) and whole-body (WB) leaning movements, expecting that increased postural threat would lead to proportionally similar changes in risk-sensitivity for each motor task. Healthy young adults were shown a series of two-alternative forced-choice lotteries, where they were asked to choose between a riskier lottery and a safer lottery on each trial. Our lotteries consisted of different monetary rewards and target sizes. Subjects performed each choice task at ground level and atop an elevated platform. In the presence of this postural threat, increased physiological arousal was correlated with decreased movement variability. To determine risk-sensitivity, we quantified the frequency with which a subject chose the riskier lottery and fit lottery responses to a choice model based on cumulative prospect theory (CPT). Subjects exhibited idiosyncratic changes in risk-sensitivity between motor tasks and between elevations. However, we found that overweighting of small probabilities increased with postural threat in the WB task, indicating a more cautious, risk-averse strategy is ascribed to the possibility of a fall. Subjects were also more risk-seeking in the WB movements than in ARM at low elevation; this behavior does not seem to derive from consistent distortions in utility or probability representations but may be explained by subjects' inaccurate estimation of their own motor variability. Overall, our findings suggest that implicit threat can modify risk attitudes in the motor domain, and the threat may induce risk-aversion in salient movement tasks. PMID:26106311

Threat affects risk preferences in movement decision making

Directory of Open Access Journals (Sweden)

Megan K. O'Brien

2015-06-01

Full Text Available Emotional states such as sadness, anger, and threat have been shown to play a critical role in decision-making processes. Here we addressed the question of whether risk preferences are influenced by postural threat and whether this influence generalizes across motor tasks. We examined risk attitudes in the context of arm-reaching and whole-body leaning movements, expecting that increased postural threat would lead to proportionally similar changes in risk-sensitivity for each motor task. Healthy young adults were shown a series of two-alternative forced-choice lotteries, where they were asked to choose between a riskier lottery and a safer lottery on each trial. Our lotteries consisted of different monetary rewards and target sizes. Subjects performed each choice task at ground level and atop an elevated platform. In the presence of this postural threat, increased physiological arousal was correlated with decreased movement variability. To determine risk-sensitivity, we quantified the frequency with which a subject chose the riskier lottery and fit lottery responses to a choice model based on cumulative prospect theory. Subjects exhibited idiosyncratic changes in risk-sensitivity between motor tasks and between elevations. However, we found that overweighting of small probabilities increased with postural threat in the whole-body task, indicating a more cautious, risk-averse strategy is ascribed to the possibility of a fall. Subjects were also more risk-seeking in the whole-body movements than in arm-reaching at low elevation; this behavior does not seem to derive from consistent distortions in utility or probability representations but may be explained by subjects’ inaccurate estimation of their own motor variability. Overall, our findings suggest that implicit threat can modify risk attitudes in the motor domain, and the threat may induce risk-aversion in salient movement tasks.

Threat affects risk preferences in movement decision making.

Science.gov (United States)

O'Brien, Megan K; Ahmed, Alaa A

2015-01-01

Emotional states such as sadness, anger, and threat have been shown to play a critical role in decision-making processes. Here we addressed the question of whether risk preferences are influenced by postural threat and whether this influence generalizes across motor tasks. We examined risk attitudes in the context of arm-reaching (ARM) and whole-body (WB) leaning movements, expecting that increased postural threat would lead to proportionally similar changes in risk-sensitivity for each motor task. Healthy young adults were shown a series of two-alternative forced-choice lotteries, where they were asked to choose between a riskier lottery and a safer lottery on each trial. Our lotteries consisted of different monetary rewards and target sizes. Subjects performed each choice task at ground level and atop an elevated platform. In the presence of this postural threat, increased physiological arousal was correlated with decreased movement variability. To determine risk-sensitivity, we quantified the frequency with which a subject chose the riskier lottery and fit lottery responses to a choice model based on cumulative prospect theory (CPT). Subjects exhibited idiosyncratic changes in risk-sensitivity between motor tasks and between elevations. However, we found that overweighting of small probabilities increased with postural threat in the WB task, indicating a more cautious, risk-averse strategy is ascribed to the possibility of a fall. Subjects were also more risk-seeking in the WB movements than in ARM at low elevation; this behavior does not seem to derive from consistent distortions in utility or probability representations but may be explained by subjects' inaccurate estimation of their own motor variability. Overall, our findings suggest that implicit threat can modify risk attitudes in the motor domain, and the threat may induce risk-aversion in salient movement tasks.

Risk factors for osteoporosis in female patients with systemic lupus erythematosus.

Science.gov (United States)

Di Munno, O; Mazzantini, M; Delle Sedie, A; Mosca, M; Bombardieri, S

2004-01-01

In the last years it has been recognized that patients with systemic lupus erythematosus (SLE) are at high risk of osteoporosis (OP) and fractures, both occurring through disease-specific (chronic arthritis, reduced physical activity, induction of cytokines promoting bone resorption, renal impairment, endocrine factors) and nondisease-specific mechanisms (sunshine avoidance with consequent vitamin D deficiency, glucocorticoids, immunosuppressants and chronic anticoagulants). Regarding anticoagulants, subcutaneous heparin is crucial against the risk of recurrent thromboembolism or pregnancy loss, specifically in patients with SLE and anti-phospholipid syndrome (APS). Thus heparin-induced OP represents one of the hazards of this treatment, first because heparin must be used long-term and secondly because pregnancy and lactation themselves may predispose to OP and fractures. Current data suggest the use of prophylaxis with calcium and vitamin D in all patients treated with heparin during pregnancy. Nevertheless glucocorticoid-induced OP (GIOP) is considered the most serious risk factor for OP and fractures in SLE patients. All guidelines recommend general measures and supplementation with calcium and vitamin D in all patients. However when considering premenopausal patients, there is no generally recommended treatment. Bisphosphonates, which are considered the first choice therapy for the prevention and treatment of GIOP, should be used 'cautiously' in these patients. Therefore the potential risks and lack of efficacy data on fracture risk reduction in premenopausal patients must be weighed against their proven efficacy in postmenopausal patients.

Impact of high-risk conjunctions on Active Debris Removal target selection

OpenAIRE

Lidtke, Aleksander A.; Lewis, Hugh G.; Armellin, Roberto

2015-01-01

All rights reserved.Space debris simulations show that if current space launches continue unchanged, spacecraft operations might become difficult in the congested space environment. It has been suggested that Active Debris Removal (ADR) might be necessary in order to prevent such a situation. Selection of objects to be targeted by ADR is considered important because removal of non-relevant objects will unnecessarily increase the cost of ADR. One of the factors to be used in this ADR target se...

Ultraviolet radiation: effects on risks of prostate cancer and other internal cancers

International Nuclear Information System (INIS)

Moon, Samuel J.; Fryer, Anthony A.; Strange, Richard C.

2005-01-01

Governmental and research agencies worldwide have strongly advocated sun avoidance strategies in an attempt to counter marked increases in skin cancer incidence. Concurrently, there are reports describing widespread Vitamin D 3 deficiency. Because 1,25-dihydroxyvitamin D 3 , through interaction with the Vitamin D receptor, exerts pleiotrophic effects, such deficiency might be expected to have clinical consequences. Indeed, various reports indicate that exposure to ultraviolet radiation (UVR) exerts a protective effect on development of some common diseases including internal cancers and multiple sclerosis. We describe studies indicating that modest exposure reduces risk of prostate cancer. The effect of UVR is mediated by skin type; at lower levels of exposure a relative inability to effect skin pigmentation is protective presumably because it allows more efficient Vitamin D 3 synthesis. Polymorphic variants in genes associated with pigmentation including melanocyte stimulating hormone receptor and tyrosinase are also associated with prostate cancer risk. Overall, though preliminary and requiring cautious interpretation, these data indicate that moderate UVR exposure together with characteristics linked with less effective tanning confer reduced prostate cancer risk. Clearly, it is important to define safe levels of UVR that do not result in increased risk of skin cancers such as malignant melanoma

Ultraviolet radiation: effects on risks of prostate cancer and other internal cancers

Energy Technology Data Exchange (ETDEWEB)

Moon, Samuel J. [Human Genomics Research Group, Institute of Science and Technology in Medicine and Department of Urology, Keele University School of Medicine, University Hospital of North Staffordshire, Hartshill Campus, Stoke-on-Trent, ST4 7PA Staffordshire (United Kingdom); Fryer, Anthony A. [Human Genomics Research Group, Institute of Science and Technology in Medicine and Department of Urology, Keele University School of Medicine, University Hospital of North Staffordshire, Hartshill Campus, Stoke-on-Trent, ST4 7PA Staffordshire (United Kingdom); Strange, Richard C. [Human Genomics Research Group, Institute of Science and Technology in Medicine and Department of Urology, Keele University School of Medicine, University Hospital of North Staffordshire, Hartshill Campus, Stoke-on-Trent, ST4 7PA Staffordshire (United Kingdom)]. E-mail: paa00@keele.ac.uk

2005-04-01

Governmental and research agencies worldwide have strongly advocated sun avoidance strategies in an attempt to counter marked increases in skin cancer incidence. Concurrently, there are reports describing widespread Vitamin D{sub 3} deficiency. Because 1,25-dihydroxyvitamin D{sub 3}, through interaction with the Vitamin D receptor, exerts pleiotrophic effects, such deficiency might be expected to have clinical consequences. Indeed, various reports indicate that exposure to ultraviolet radiation (UVR) exerts a protective effect on development of some common diseases including internal cancers and multiple sclerosis. We describe studies indicating that modest exposure reduces risk of prostate cancer. The effect of UVR is mediated by skin type; at lower levels of exposure a relative inability to effect skin pigmentation is protective presumably because it allows more efficient Vitamin D{sub 3} synthesis. Polymorphic variants in genes associated with pigmentation including melanocyte stimulating hormone receptor and tyrosinase are also associated with prostate cancer risk. Overall, though preliminary and requiring cautious interpretation, these data indicate that moderate UVR exposure together with characteristics linked with less effective tanning confer reduced prostate cancer risk. Clearly, it is important to define safe levels of UVR that do not result in increased risk of skin cancers such as malignant melanoma.

The effects of peer influence on adolescent pedestrian road-crossing decisions.

Science.gov (United States)

Pfeffer, K; Hunter, E

2013-01-01

Adolescence is a high-risk period for pedestrian injury. It is also a time of heightened susceptibility to peer influence. The aim of this research was to examine the effects of peer influence on the pedestrian road-crossing decisions of adolescents. Using 10 videos of road-crossing sites, 80 16- to 18-year-olds were asked to make pedestrian road-crossing decisions. Participants were assigned to one of 4 experimental conditions: negative peer (influencing unsafe decisions), positive peer (influencing cautious decisions), silent peer (who observed but did not comment), and no peer (the participant completed the task alone). Peers from the adolescent's own friendship group were recruited to influence either an unsafe or a cautious decision. Statistically significant differences were found between peer conditions. Participants least often identified safe road-crossing sites when accompanied by a negative peer and more frequently identified dangerous road-crossing sites when accompanied by a positive peer. Both cautious and unsafe comments from a peer influenced adolescent pedestrians' decisions. These findings showed that road-crossing decisions of adolescents were influenced by both unsafe and cautious comments from their peers. The discussion highlighted the role that peers can play in both increasing and reducing adolescent risk-taking.

Perceived risks and benefits of hippotherapy among parents of children currently engaged in or waiting for hippotherapy: A pilot study.

Science.gov (United States)

Léveillé, Audrey; Rochette, Annie; Mainville, Carolyne

2017-04-01

Explore the perceived risks and benefits of hippotherapy among parents of children currently engaged in or waiting rehabilitation using hippotherapy. Phenomenological qualitative exploratory pilot study. An interview guide validated by experts was used to conduct the interviews. Summaries were written to capture first impressions. One team member coded the transcripts and the coding was validated by the research team through discussion until consensus was reached. The average age of the participants (n = 4) was 37.3 ± 6.6 years. The few risks they perceived related to physical injuries. Lack of knowledge of contraindications, lack of fear, minimization of risks, and risk-attenuation factors also emerged as important themes. Benefits accounted for a large part of the content of the interviews and were grouped under 13 themes, including motor and postural control, enjoyment and the development of a special relationship. Minimization of the perceived risks compared to the numerous perceived benefits could create clinical issues such as the client putting self at risk of injuries (e.g., bites, falls, and kicks) if not cautious enough or complications insufficiently prevented, which suggests the need to develop educational activities for an informed consent to this type of rehabilitation.

A Comparative Analysis of Value at Risk Measurement on Emerging Stock Markets: Case of Montenegro

Directory of Open Access Journals (Sweden)

Cerović Julija

2015-03-01

Full Text Available Background: The concept of value at risk gives estimation of the maximum loss of financial position at a given time for a given probability. The motivation for this analysis lies in the desire to devote necessary attention to risks in Montenegro, and to approach to quantifying and managing risk more thoroughly. Objectives: This paper considers adequacy of the most recent approaches for quantifying market risk, especially of methods that are in the basis of extreme value theory, in Montenegrin emerging market before and during the global financial crisis. In particular, the purpose of the paper is to investigate whether extreme value theory outperforms econometric and quantile evaluation of VaR in emerging stock markets such as Montenegrin market. Methods/Approach: Daily return of Montenegrin stock market index MONEX20 is analyzed for the period January, 2004 - February, 2014. Value at Risk results based on GARCH models, quantile estimation and extreme value theory are compared. Results: Results of the empirical analysis show that the assessments of Value at Risk based on extreme value theory outperform econometric and quantile evaluations. Conclusions: It is obvious that econometric evaluations (ARMA(2,0- GARCH(1,1 and RiskMetrics proved to be on the lower bound of possible Value at Risk movements. Risk estimation on emerging markets can be focused on methodology using extreme value theory that is more sophisticated as it has been proven to be the most cautious model when dealing with turbulent times and financial turmoil.

Risk management frameworks for human health and environmental risks.

Science.gov (United States)

Jardine, Cindy; Hrudey, Steve; Shortreed, John; Craig, Lorraine; Krewski, Daniel; Furgal, Chris; McColl, Stephen

2003-01-01

). - Optimal risk management demands using limited resources where they will achieve the most risk reduction of overall benefit. 5. Promise no more risk management that can be delivered (honesty).- Unrealistic expectations of risk management can be avoided with honest and candid public accounting of what we know and don't know, and what we can and can't do using risk assessment and risk management. 6. Impose no more risk that you would tolerate yourself (the Golden Rule). - The Golden Rule is important in risk management because it forces decision makers to abandon complete detachment from their decisions so they may understand the perspectives of those affected. 7. Be cautious in the face of uncertainty ("better safe than sorry"). - Risk management must adopt a cautious approach when faced with a potentially serous risk, even if the evidence is uncertain. 8. Foster informed risk decision making for all stakeholders (autonomy). - Fostering autonomous decision making involves both providing people with the opportunity to participate, and full and honest disclosure of all the information required for informed decisions. 9. Risk management processes must be flexible and evolutionary to be open to new knowledge and understanding (evolution, evaluation, iterative process). - The incorporation of new evidence requires that risk management be a flexible, evolutionary, and iterative process, and that evaluation is employed at the beginning and througthout the process. 10. the complete elimination fo risk is not possible (life is not risk free).- Risk is pervasive in our society, and cannot be totally eliminated despite an oft-expressed public desire for "zero risk". However, the level of risk that may ve tolerable by any individual is dependent on values of beliefs, as well as scientific information. Each agency must continue to employ a process that meets the needs of their specific application of risk management. A single approach cannot satisfy the diverse areas to which risk

Regulating genetically modified food. Policy trajectories, political culture, and risk perceptions in the U.S., Canada, and EU.

Science.gov (United States)

Wohlers, Anton E

2010-09-01

This paper examines whether national differences in political culture add an explanatory dimension to the formulation of policy in the area of biotechnology, especially with respect to genetically modified food. The analysis links the formulation of protective regulatory policies governing genetically modified food to both country and region-specific differences in uncertainty tolerance levels and risk perceptions in the United States, Canada, and European Union. Based on polling data and document analysis, the findings illustrate that these differences matter. Following a mostly opportunistic risk perception within an environment of high tolerance for uncertainty, policymakers in the United States and Canada modified existing regulatory frameworks that govern genetically modified food in their respective countries. In contrast, the mostly cautious perception of new food technologies and low tolerance for uncertainty among European Union member states has contributed to the creation of elaborate and stringent regulatory policies governing genetically modified food.

ACHIEVEMENT MOTIVATION OF THOSE INDIVIDUALS WITH THE PREDOMINANCE OF INDIVIDUALISTIC / COLLECTIVIST ATTITUDES WHO IS READY TO TAKE RISKS

Directory of Open Access Journals (Sweden)

Svetlana Vladimirovna Gutsunaeva

2015-03-01

Full Text Available The article reveals the results of empirical research displaying differences in achievement motivation and willingness to take risks depending on the prevalence of collectivist or individualistic attitudes of a personality. The research may contribute to profound knowledge of influence of the factor of belonging to the culture on individual features. The obtained results indicate that the young people with a predominance of individualistic attitudes are more motivated to achievements and inclined to risk than the young people who are collectivists. However, the results also demonstrate that in some socio-demographic groups collectivists – the representatives of the older generation strive to achievements, although they are more cautious in their behavior. The empirical data can be used in a cross-cultural investigations, the results of the study may be useful in the work of psychologist in predicting behavior and social success of the individual in various spheres of activity.

Prospective study of major dietary patterns and colorectal cancer risk in women.

Science.gov (United States)

Terry, P; Hu, F B; Hansen, H; Wolk, A

2001-12-15

A number of prospective cohort studies have examined the relations of individual dietary variables to risk of colorectal cancer. Few studies have addressed the broader eating patterns that reflect many dietary exposures working together. Using data from a prospective study of 61,463 women, with an average follow-up period of 9.6 years (between 1987 and 1998) and 460 incident cases of colorectal cancer, the authors conducted a factor analysis to identify and examine major dietary patterns in relation to colorectal cancer risk. Using proportional hazards regression to estimate relative risks, the authors found no clear association between a "Western," "healthy," or "drinker" dietary pattern and colorectal cancer risk. However, the data suggested that consuming low amounts of foods that constitute a "healthy" dietary pattern may be associated with increased risks of colon and rectal cancers. An inverse association with the "healthy" dietary pattern was found among women under age 50 years, although the number of cancers in this age group was limited and interpretation of this finding should be cautious. In this age group, relative risks for women in increasing quintiles of the "healthy" dietary pattern, compared with the lowest quintile, were 0.74 (95% confidence interval (CI): 0.41, 1.31), 0.69 (95% CI: 0.39, 1.24), 0.59 (95% CI: 0.32, 1.07), and 0.45 (95% CI: 0.23, 0.88) (p for trend = 0.03). The role of overall eating patterns in predicting colorectal cancer risk requires further investigation.

Risk preferences and aging: The “Certainty Effect” in older adults’ decision making

Science.gov (United States)

Mather, Mara; Mazar, Nina; Gorlick, Marissa A.; Lighthall, Nichole R.; Burgeno, Jessica; Schoeke, Andrej; Ariely, Dan

2013-01-01

A prevalent stereotype is that people become less risk taking and more cautious as they get older. However, in laboratory studies, findings are mixed and often reveal no age differences. In the current series of experiments, we examined whether age differences in risk seeking are more likely to emerge when choices include a certain option (a sure gain or a sure loss). In four experiments, we found that age differences in risk preferences only emerged when participants were offered a choice between a risky and a certain gamble but not when offered two risky gambles. In particular, Experiments 1 and 2 included only gambles about potential gains. Here, compared with younger adults, older adults preferred a certain gain over a chance to win a larger gain and thus, exhibited more risk aversion in the domain of gains. But in Experiments 3 and 4, when offered the chance to take a small sure loss rather than risking a larger loss, older adults exhibited more risk seeking in the domain of losses than younger adults. Both their greater preference for sure gains and greater avoidance of sure losses suggest that older adults weigh certainty more heavily than younger adults. Experiment 4 also indicates that older adults focus more on positive emotions than younger adults do when considering their options and that this emotional shift can at least partially account for age differences in how much people are swayed by certainty in their choices. PMID:23066800

Experiences gained in implementing a broad-based risk-informed application

International Nuclear Information System (INIS)

Schinzel, G.E.

2004-01-01

The South Texas Project was granted a first-of-kind exemption from special treatment requirements contained in 10-CFR Parts 21, 50, and 100 in August 2001. Since that time, South Texas has pursued a cautious, deliberate approach to implement these risk-informed exemption allowances. Over the past two years, South Texas has gained a unique insight into the challenges and benefits that exist in pursuing a broad-based risk-informed application. The American nuclear industry is currently pursuing similar capabilities through proposed rule 10-CFR 50.69 which is scheduled for NRC final review and approval in the July, 2004 time-frame. This proposed rule closely resembles the approach taken by South Texas in the exemption process and the allowances granted. For nuclear utilities that wish to pursue a similar broad-based risk-informed application, a well-conceived strategic approach is needed to prioritize the implementation activities as well as engage stake-holders in the implementation process. Cultural and communication challenges exist which must be addressed and effectively overcome. The goal of this paper is to communicate these challenges to the attendees, inform attendees of the safety and economic benefits to be recognized through this risk-informed approach, and to provide insight into continuing application opportunities that were not readily apparent when the broad-based exemption was originally conceived. This paper and presentation will be beneficial for both domestic and international attendees, as well as for personnel with utility or regulatory backgrounds. (author)

Visualizing risks in cancer communication: A systematic review of computer-supported visual aids.

Science.gov (United States)

Stellamanns, Jan; Ruetters, Dana; Dahal, Keshav; Schillmoeller, Zita; Huebner, Jutta

2017-08-01

Health websites are becoming important sources for cancer information. Lay users, patients and carers seek support for critical decisions, but they are prone to common biases when quantitative information is presented. Graphical representations of risk data can facilitate comprehension, and interactive visualizations are popular. This review summarizes the evidence on computer-supported graphs that present risk data and their effects on various measures. The systematic literature search was conducted in several databases, including MEDLINE, EMBASE and CINAHL. Only studies with a controlled design were included. Relevant publications were carefully selected and critically appraised by two reviewers. Thirteen studies were included. Ten studies evaluated static graphs and three dynamic formats. Most decision scenarios were hypothetical. Static graphs could improve accuracy, comprehension, and behavioural intention. But the results were heterogeneous and inconsistent among the studies. Dynamic formats were not superior or even impaired performance compared to static formats. Static graphs show promising but inconsistent results, while research on dynamic visualizations is scarce and must be interpreted cautiously due to methodical limitations. Well-designed and context-specific static graphs can support web-based cancer risk communication in particular populations. The application of dynamic formats cannot be recommended and needs further research. Copyright © 2017 Elsevier B.V. All rights reserved.

Status of Baltic grey seals: Population assessment and extinction risk

Directory of Open Access Journals (Sweden)

Karin C Harding

2007-01-01

Full Text Available The grey seal (Halichoerus grypus population in the Baltic Sea is recovering after a century of bounty hunting and 3 decades of low fertility rates caused by environmental pollution. A conservative estimate of the population size in 2003 was 19,400 animals, and available data suggest an annual rate of increase of 7.5% since 1990. The growing population has led to increased interactions with the fishery, and demands are being raised for the re-introduction of the hunt. We provide a demographic analysis and a risk assessment of the population, and make recommendations on how to decrease the risk of over exploitation. Although hunting increases the risk of quasi-extinction, the risk can be significantly reduced by the choice of a cautious hunting regime. The least hazardous regimes allow no hunting below a ‘security level’ in population size. Obviously, to implement such a hunting regime detailed knowledge of the population size and growth rate is required. It is not possible to estimate “true” risks for quasi-extinction, but we used an approach where the relative difference for different scenarios can be compared. With a security level at 5,000 females, the population quasi-extinction risk increases 50 fold at an annual hunt of 500 females compared with a scenario with no hunting. The risk of quasi-extinction is very sensitive to declines in the mean growth rate and to increased variance in growth rate. The variance in the population estimates over the last 14 years imply that it would take 9 years to detect a declinefrom 1.075 to 1.027 in the rate of population increase. We also show how the age composition of killed animals influences the impact of the hunt. The overall recommendation is that hunting should be kept to a minimum, carefully documented and accompanied by close population monitoring.

Assessment of disaster preparedness among emergency departments in Italian hospitals: a cautious warning for disaster risk reduction and management capacity.

Science.gov (United States)

Paganini, Matteo; Borrelli, Francesco; Cattani, Jonathan; Ragazzoni, Luca; Djalali, Ahmadreza; Carenzo, Luca; Della Corte, Francesco; Burkle, Frederick M Jr; Ingrassia, Pier Luigi

2016-08-15

Since the 1990s, Italian hospitals are required to comply with emergency disaster plans known as Emergency Plan for Massive Influx of Casualties. While various studies reveal that hospitals overall suffer from an insufficient preparedness level, the aim of this study was to better determine the preparedness level of Emergency Departments of Italian hospitals by assessing the knowledge-base of emergency physicians regarding basic disaster planning and procedures. A prospective observational study utilized a convenience sample of Italian Emergency Departments identified from the Italian Ministry of Health website. Anonymous telephone interviews were conducted of medical consultants in charge at the time in the respective Emergency Departments, and were structured in 3 parts: (1) general data and demographics, (2) the current disaster plan and (3) protocols and actions of the disaster plan. Eighty-five Emergency Departments met inclusion criteria, and 69 (81 %) agreed to undergo the interview. Only 45 % of participants declared to know what an Emergency Plan for Massive Influx of Casualties is, 41 % believed to know who has the authority to activate the plan, 38 % knew who is in charge of intra-hospital operations. In Part 3 physicians revealed a worrisome inconsistency in critical content knowledge of their answers. Results demonstrate a poor knowledge-base of basic hospital disaster planning concepts by Italian Emergency Department physicians-on-duty. These findings should alert authorities to enhance staff disaster preparedness education, training and follow-up to ensure that these plans are known to all who have responsibility for disaster risk reduction and management capacity.

Epidemiology of invasive pulmonary aspergillosis in patients with liver failure: Clinical presentation, risk factors, and outcomes.

Science.gov (United States)

Zhang, Xuan; Yang, Meifang; Hu, Jianhua; Zhao, Hong; Li, Lanjuan

2018-02-01

Objective Invasive pulmonary aspergillosis (IPA) is a severe and often lethal infection. The possible risk factors, clinical presentation, and treatment of patients with simultaneous liver failure and IPA have received little attention in previous studies. The aim of this study was to investigate the epidemiology of IPA in patients with liver failure in an effort to reduce patient mortality. Methods The patients with liver failure (including acute liver failure , sub-acute liver failure , acute-on-chronic liver failure and chronic liver failure) were recruited from 2011 to 2016. The clinical data of these patients were retrieved for the study. Results In total, 1077 patients with liver failure were included in this study. Of the 1077 patients, 53 (4.9%) had IPA. Forty-four (83%) patients with IPA died. Independent risk factors for IPA were male sex (hazard ratio [HR] = 2.542), hepatorenal syndrome (HR = 2.463), antibiotic use (HR = 4.631), and steroid exposure (HR = 18.615). Conclusions IPA is a fatal complication in patients with liver failure. Male sex, hepatorenal syndrome, antibiotic use, and steroid exposure were independent risk factors for IPA. When patients with liver failure have these risk factors and symptoms of pneumonia such as cough or hemoptysis, clinicians should be cautious about the possibility of IPA.

SPECIAL SECTION: Perspectives of the Scientific Community on the Status of Ecological Risk Assessment

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Power; Adams

1997-11-01

/ Views from a wide variety of practicing environmental professionals on the current status of ecological risk assessment (ERA) indicate consensus and divergence of opinion on the utility and practice of risk assessment. Central to the debate were the issues of whether ERA appropriately incorporates ecological and scientific principle into its conceptual paradigm. Advocates argue that ERA effectively does both, noting that much of the fault detractors find with the process has more to do with its practice than its purpose. Critics argue that failure to validate ERA predictions and the tendency to over-simplify ecological principles compromise the integrity of ERA and may lead to misleading advice on the appropriate responses to environmental problems. All authors felt that many improvements could be made, including validation, better definition of the ecological questions and boundaries of ERA, improved harmonization of selected methods, and improvements in the knowledge base. Despite identified deficiencies, most authors felt that ERA was a useful process undergoing evolutionary changes that will inevitably determine the range of environmental problems to which it can be appropriately applied. The views expressed give ERA a cautious vote of approval and highlight many of the critical strengths and weaknesses in one of our most important environmental assessment tools.KEY WORDS: Ecological risk assessment; Ecology; Probability

Alcohol consumption and dementia risk: a dose–response meta-analysis of prospective studies

International Nuclear Information System (INIS)

Xu, Wei; Wang, Huifu; Wan, Yu; Tan, Chenchen; Li, Jieqiong; Tan, Lan; Yu, Jin-Tai

2017-01-01

It is widely believed that light-to-moderate alcohol intake may protect against dementia while excessive drinking may instead increase the risk. Nonetheless, these findings need cautious interpretations due to varying methodologies and lack of standard definition, which hindered our transferring into preventative practice. The objective of this study is to investigate the potential dose–response association between alcohol consumption and risk of dementia. A systematic search was conducted in electronic databases to identify relevant studies. Risk estimates were combined using a random-effect model. Eleven studies with 73,330 participants and 4586 cases for all-cause dementia (ACD), five studies with 52,715 participants and 1267 cases for Alzheimer’s dementia (AD) and four studies with 49,535 participants and 542 cases for vascular dementia were included. We observed a nonlinear association between alcohol consumption and ACD risk (p_n_o_n_l_i_n_e_a_r_i_t_y < 0.05). The alcohol dose associated with lower risk of dementia was confined to at most 12.5 g/day, with the risk hitting bottom (RR ≈ 0.9) at roughly 6 g/day. Of note, the ACD risk seemed to be elevated (≈10%) when the dose surpasses certain levels: 23 drinks/week or 38 g/day. For the alcohol type, recommendation for wine is prioritized. The subgroup analysis further indicated that the effect of alcohol may be greater in younger adults (<60 years old) with regard to fighting against dementia. Modest alcohol consumption (≤12.5 g/day) is associated with a reduced risk of dementia with 6 g/day of alcohol conferring a lower risk than other levels while excessive drinking (≥38 g/day) may instead elevate the risk.

The reporting of theoretical health risks by the media: Canadian newspaper reporting of potential blood transmission of Creutzfeldt-Jakob disease

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Ahmad Nadya

2004-01-01

Full Text Available Abstract Background The media play an important role at the interface of science and policy by communicating scientific information to the public and policy makers. In issues of theoretical risk, in which there is scientific uncertainty, the media's role as disseminators of information is particularly important due to the potential to influence public perception of the severity of the risk. In this article we describe how the Canadian print media reported the theoretical risk of blood transmission of Creutzfeldt-Jakob disease (CJD. Methods We searched 3 newspaper databases for articles published by 6 major Canadian daily newspapers between January 1990 and December 1999. We identified all articles relating to blood transmission of CJD. In duplicate we extracted information from the articles and entered the information into a qualitative software program. We compared the observations obtained from this content analysis with information obtained from a previous policy analysis examining the Canadian blood system's decision-making concerning the potential transfusion transmission of CJD. Results Our search identified 245 relevant articles. We observed that newspapers in one instance accelerated a policy decision, which had important resource and health implication, by communicating information on risk to the public. We also observed that newspapers primarily relied upon expert opinion (47 articles as opposed to published medical evidence (28 articles when communicating risk information. Journalists we interviewed described the challenges of balancing their responsibility to raise awareness of potential health threats with not unnecessarily arousing fear amongst the public. Conclusions Based on our findings we recommend that journalists report information from both expert opinion sources and from published studies when communicating information on risk. We also recommend researchers work more closely with journalists to assist them in identifying

Recovery of Abnormal ABR in Neonates and Infants at Risk of Hearing Loss.

Science.gov (United States)

Psarommatis, Ioannis; Voudouris, Charalampos; Kapetanakis, Ioannis; Athanasiadi, Faselida; Douros, Konstantinos

2017-01-01

The purpose of this retrospective study is to present the clinical experience of a single institution on the recovery of ABR thresholds in a large population of neonates and infants at risk of hearing loss. Potential prognostic factors associated with this phenomenon were also investigated. Out of 2248 high risk infants, 384 had abnormal ABR at initial hearing evaluation and 168 of them had absent ABR or a threshold ≥80 dBnHL. From this subgroup, a significant percentage showed complete or partial recovery on reexamination (32.7% and 9.3%, resp.), performed 4-6 months later. The presence of normal otoacoustic emissions was associated with the ABR restoration on reexamination. Moreover, the very young age at the initial hearing screening seems to be related to higher probabilities of false positive ABR. The potential recovery of hearing in HR infants raises concerns about the very early cochlear implantation in HR infants less than one year. Such a treatment modality should be decided cautiously and only after obtaining valid and stable objective and subjective hearing thresholds. This holds especially true for infants showing an auditory neuropathy profile, as they presented a much greater probability of ABR recovery.

Colon cancer risk and different HRT formulations: a case-control study

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Thai Do

2007-05-01

Full Text Available Abstract Background Most studies have found no increased risk of colon cancer associated with hormone replacement therapy (HRT, or even a decreased risk. But information about the effects of different HRT preparations is lacking. Methods A case-control study was performed within Germany in collaboration with regional cancer registries and tumor centers. Up to 5 controls were matched to each case of colon cancer. Conditional logistic regression analysis was applied to estimate crude and adjusted odds ratios (OR and 95% confidence intervals (95% CI. Stratified analyses were performed to get an impression of the risk associated with different estrogens and progestins. Results A total of 354 cases of colon cancer were compared with 1422 matched controls. The adjusted overall risk estimate for colon cancer (ColC associated with ever-use of HRT was 0.97 (0.71 – 1.32. No clinically relevant trends for ColC risk were observed with increasing duration of HRT use, or increasing time since first or last HRT use in aggregate. Whereas the overall risk estimates were stable, the numbers in many of the sub-analyses of HRT preparation groups (estrogens and progestins were too small for conclusions. Nevertheless, if the ColC risk estimates are taken at face value, most seemed to be reduced compared with never-use of HRT, but did not vary much across HRT formulation subgroups. In particular, no substantial difference in ColC risk was observed between HRT-containing conjugated equine estrogens (CEE or medroxyprogesterone acetate (MPA and other formulations more common in Europe. Conclusion Ever-use of HRT was not associated with an increased risk of colon cancer. In contrary, most risk estimates pointed non-significantly toward a lower ColC risk in HRT ever user. They did not vary markedly among different HRT formulations (estrogens, progestins. However, the small numbers and the overlapping nature of the subgroups suggest cautious interpretation.

The Relationship Between Pregnancy Prevention and STI/HIV Prevention and Sexual Risk Behavior Among American Indian Men.

Science.gov (United States)

Rink, Elizabeth; FourStar, Kristofer; Anastario, Michael P

2017-01-01

We examined the relationship between American Indian men's attitudes toward pregnancy prevention, STI/HIV prevention, and sexual risk behavior. Attention was given to: (1) attitudes and intentions to use condoms and sexual risk behavior; (2) STI/HIV prevention characteristics and sexual risk behavior; (3) attitudes toward abstinence and monogamy and sexual risk behavior; and (4) decision-making in relationships and sexual risk behavior. Our sample included 120 heterosexual American Indian men aged 18 to 24 living on a reservation. Data were collected during in-depth interviews. A community-based participatory research framework was used to ensure the relevancy and acceptability of the study given the sensitivity of the topic. Results demonstrated that attitudinal factors were associated with sexual risk behavior, particularly inconsistent condom use. Attitudes associated with consistent condom use suggested greater levels of positive dispositions toward prevention and intention to use condoms. Consistent condom use was associated with more cautious attitudes toward sex with multiple sex partners. Study results suggested that American Indian men who reported sex with multiple partners exhibited a set of attitudes and beliefs toward pregnancy prevention and STI/HIV prevention that corresponded with a disposition resulting from their behaviors, in that engaging in sexual risk behavior elevated their levels of risk perception. Our findings suggest that heterosexual American Indian men living in rural environments need sexual and reproductive health programs and clinical services that address differing attitudes toward condom use within the context of multiple sex partners and sexual risk behavior. © 2015 National Rural Health Association.

A qualitative examination of inappropriate hospital admissions and lengths of stay

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Hammond Christina L

2009-03-01

Full Text Available Abstract Background Research has shown that a number of patients, with a variety of diagnoses, are admitted to hospital when it is not essential and can remain in hospital unnecessarily. To date, research in this area has been primarily quantitative. The purpose of this study was to explore the perceived causes of inappropriate or prolonged lengths of stay and focuses on a specific population (i.e., patients with long term neurological conditions. We also wanted to identify interventions which might avoid admission or expedite discharge as periods of hospitalisation pose particular risks for this group. Methods Two focus groups were conducted with a convenience sample of eight primary and secondary care clinicians working in the Derbyshire area. Data were analysed using a thematic content approach. Results The participants identified a number of key causes of inappropriate admissions and lengths of stay, including: the limited capacity of health and social care resources; poor communication between primary and secondary care clinicians and the cautiousness of clinicians who manage patients in community settings. The participants also suggested a number of strategies that may prevent inappropriate admissions or reduce length of stay (LoS, including: the introduction of new sub-acute care facilities; the introduction of auxiliary nurses to support specialist nursing staff and patient held summaries of specialist consultations. Conclusion Clinicians in both the secondary and primary care sectors acknowledged that some admissions were unnecessary and some patients remain in hospital for a prolonged period. These events were attributed to problems with the current capacity or structuring of services. It was noted, for example, that there is a shortage of appropriate therapeutic services and that the distribution of beds between community and sub-acute care should be reviewed.

Assessment of preoperative exams request in a teaching hospital

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Eduardo Toshiyuki Moro

2014-04-01

Background: preoperative exams aim to identify disorders that may compromise the patient´s perioperative care. However, unnecessary tests rarely change the outcome, and are expensive to institution. The aim of this study was to evaluate the preoperative tests ordered in Santa Lucinda hospital, Sorocaba - SP. Methods: after approval by the Ethics Committee of PUC-SP University, we assessed pre-anesthetic evaluation of patients undergoing elective surgery from march to August, 2011. We recorded: age, sex, ASA physical status, the presence of coexisting diseases, medication use, type of surgery and preoperative tests. They were classified as sufficient, sufficient with unnecessary tests, insufficient, or insufficient with unnecessary tests. Results: two hundred and nineteen records were evaluated, of which 52% were considered sufficient, but with unnecessary tests. For 24% of patients, the tests were insufficient, with some ordered unnecessarily. To 8% of patients, the tests were insufficient, and only 16% didn´t have insufficient and unnecessary tests. The most frequently ordered tests were hematocrit and hemoglobin. The exams most unnecessarily ordered were coagulation tests and dosage of serum urea. Among the necessary examinations, but unsolicited, there were ECG (27%, electrolytes (13% and creatinine (11%. Seventy-nine tests showed some kind of problem, but they didn´t change in behavior. Conclusions: preoperative tests unnecessarily ordered are frequent, which do not guarantee that some patients present to surgery without fundamental exams according to their risk group.

Risk-informed assessment of regulatory and design requirements for future nuclear power plants. Annual report

International Nuclear Information System (INIS)

2000-01-01

OAK B188 Risk-informed assessment of regulatory and design requirements for future nuclear power plants. Annual report. The overall goal of this research project is to support innovation in new nuclear power plant designs. This project is examining the implications, for future reactors and future safety regulation, of utilizing a new risk-informed regulatory system as a replacement for the current system. This innovation will be made possible through development of a scientific, highly risk-formed approach for the design and regulation of nuclear power plants. This approach will include the development and/or confirmation of corresponding regulatory requirements and industry standards. The major impediment to long term competitiveness of new nuclear plants in the U.S. is the capital cost component--which may need to be reduced on the order of 35% to 40% for Advanced Light Water Reactors (ALWRS) such as System 80+ and Advanced Boiling Water Reactor (ABWR). The required cost reduction for an ALWR such as AP600 or AP1000 would be expected to be less. Such reductions in capital cost will require a fundamental reevaluation of the industry standards and regulatory bases under which nuclear plants are designed and licensed. Fortunately, there is now an increasing awareness that many of the existing regulatory requirements and industry standards are not significantly contributing to safety and reliability and, therefore, are unnecessarily adding to nuclear plant costs. Not only does this degrade the economic competitiveness of nuclear energy, it results in unnecessary costs to the American electricity consumer. While addressing these concerns, this research project will be coordinated with current efforts of industry and NRC to develop risk-informed, performance-based regulations that affect the operation of the existing nuclear plants; however, this project will go further by focusing on the design of new plants

Risk-informed assessment of regulatory and design requirements for future nuclear power plants. Annual report

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-08-01

OAK B188 Risk-informed assessment of regulatory and design requirements for future nuclear power plants. Annual report. The overall goal of this research project is to support innovation in new nuclear power plant designs. This project is examining the implications, for future reactors and future safety regulation, of utilizing a new risk-informed regulatory system as a replacement for the current system. This innovation will be made possible through development of a scientific, highly risk-formed approach for the design and regulation of nuclear power plants. This approach will include the development and/or confirmation of corresponding regulatory requirements and industry standards. The major impediment to long term competitiveness of new nuclear plants in the U.S. is the capital cost component--which may need to be reduced on the order of 35% to 40% for Advanced Light Water Reactors (ALWRS) such as System 80+ and Advanced Boiling Water Reactor (ABWR). The required cost reduction for an ALWR such as AP600 or AP1000 would be expected to be less. Such reductions in capital cost will require a fundamental reevaluation of the industry standards and regulatory bases under which nuclear plants are designed and licensed. Fortunately, there is now an increasing awareness that many of the existing regulatory requirements and industry standards are not significantly contributing to safety and reliability and, therefore, are unnecessarily adding to nuclear plant costs. Not only does this degrade the economic competitiveness of nuclear energy, it results in unnecessary costs to the American electricity consumer. While addressing these concerns, this research project will be coordinated with current efforts of industry and NRC to develop risk-informed, performance-based regulations that affect the operation of the existing nuclear plants; however, this project will go further by focusing on the design of new plants.

Setting Priorities in Behavioral Interventions: An Application to Reducing Phishing Risk.

Science.gov (United States)

Canfield, Casey Inez; Fischhoff, Baruch

2018-04-01

Phishing risk is a growing area of concern for corporations, governments, and individuals. Given the evidence that users vary widely in their vulnerability to phishing attacks, we demonstrate an approach for assessing the benefits and costs of interventions that target the most vulnerable users. Our approach uses Monte Carlo simulation to (1) identify which users were most vulnerable, in signal detection theory terms; (2) assess the proportion of system-level risk attributable to the most vulnerable users; (3) estimate the monetary benefit and cost of behavioral interventions targeting different vulnerability levels; and (4) evaluate the sensitivity of these results to whether the attacks involve random or spear phishing. Using parameter estimates from previous research, we find that the most vulnerable users were less cautious and less able to distinguish between phishing and legitimate emails (positive response bias and low sensitivity, in signal detection theory terms). They also accounted for a large share of phishing risk for both random and spear phishing attacks. Under these conditions, our analysis estimates much greater net benefit for behavioral interventions that target these vulnerable users. Within the range of the model's assumptions, there was generally net benefit even for the least vulnerable users. However, the differences in the return on investment for interventions with users with different degrees of vulnerability indicate the importance of measuring that performance, and letting it guide interventions. This study suggests that interventions to reduce response bias, rather than to increase sensitivity, have greater net benefit. © 2017 Society for Risk Analysis.

Use of Insulin and Insulin Analogs and Risk of Cancer — Systematic Review and Meta-Analysis of Observational Studies

Science.gov (United States)

Karlstad, Øystein; Starup-Linde, Jacob; Vestergaard, Peter; Hjellvik, Vidar; T. Bazelier, Marloes; K. Schmidt, Marjanka; Andersen, Morten; Auvinen, Anssi; Haukka, Jari; Furu, Kari; de Vries, Frank; L. de Bruin, Marie

2014-01-01

Background: An association of insulin use and risk of cancer has been reported but evidence is conflicting and methodological issues have been identified. Objective: To summarize results regarding insulin use and cancer risk by a systematic review and meta-analysis of cohort and case-control studies examining risk of cancer associated with insulin use in patients with diabetes. Data Sources: Systematic literature search in 5 databases: PubMed, Embase, Web of Science, Scopus and Cochrane Library. Study Eligibility Criteria (PICOS): Population: diabetes patients. Exposure: Users of any exogenous insulin. Comparison: Diabetes patients with or without use of antidiabetic drugs. Outcome: Any incident cancer. Study Design: Cohort and case-control studies. Results: 42 eligible studies examined risk of any cancer and 27 site-specific cancers. Results of individual studies were heterogeneous. Meta-analyses were significant for: Insulin vs No Insulin: Increased risk for pancreas, liver, kidney, stomach and respiratory cancer, decreased risk for prostate cancer. Insulin vs Non-Insulin Antidiabetics: Increased risk for any, pancreatic and colorectal cancer. Glargine vs Non-Glargine Insulin: Increased risk for breast cancer, decreased risk for colon cancer. Limitations: Few studies available for most cancer sites and exposure contrasts, and few assess effect of dose and duration of exposure. Methodological issues in several studies. Availability of confounders. Conclusions: Insulin use was associated with risk of cancer at several sites. Cautious interpretation of results is warranted as methodological issues and limitations in several of the included studies have been identified. Choice of study design may have a profound effect on estimated cancer risk. PMID:24215311

Interventional radiography and mortality risks in U.S. radiologic technologists

Energy Technology Data Exchange (ETDEWEB)

Linet, Martha S.; Freedman, D.M.; Sigurdson, Alice J.; Doody, Michele M. [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Hauptmann, Michael [National Cancer Institute, Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Alexander, Bruce H. [University of Minnesota, Division of Environmental Health Sciences, Minneapolis, MN (United States); Miller, Jeremy [Information Management Services, Inc., Rockville, MD (United States)

2006-09-15

highest frequency of interventional radiography procedures must be interpreted cautiously in light of the small number of deaths during the relatively short follow-up. The present study cannot rule out increased risks of cerebrovascular disease, specific cancers, and diseases with low case-fatality rates or a long latency period preceding death. (orig.)

Risks of long-term use of nitrofurantoin for urinary tract prophylaxis in the older patient

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Lauren L. Rego

2016-12-01

Conclusions: Pulmonary, nerve, or liver ARs resulting from long-term NF prophylaxis in older patients treated for UTIs are potentially serious but extremely rare, and should not deter from the cautious use of NF in this population.

Framing effects in group investment decision making: role of group polarization.

Science.gov (United States)

Cheng, Pi-Yueh; Chiou, Wen-Bin

2008-02-01

Prospect theory proposes that framing effects result in a preference for risk-averse choices in gain situations and risk-seeking choices in loss situations. However, in group polarization situations, groups show a pronounced tendency to shift toward more extreme positions than those they initially held. Whether framing effects in group decision making are more prominent as a result of the group-polarization effect was examined. Purposive sampling of 120 college students (57 men, 63 women; M age = 20.1 yr., SD = 0.9) allowed assessment of relative preference between cautious and risky choices in individual and group decisions. Findings indicated that both group polarization and framing effects occur in investment decisions. More importantly, group decisions in a gain situation appear to be more cautious, i.e., risk averse, than individual decisions, whereas group decisions in the loss situation appear to be more risky than individual decisions. Thus, group decision making may expand framing effects when it comes to investment choices through group polarization.

Should psychiatrists be more cautious about the long-term prophylactic use of antipsychotics?

DEFF Research Database (Denmark)

Murray, Robin M; Quattrone, Diego; Natesan, Sridhar

2016-01-01

over the cumulative effects of antipsychotics on physical health and brain structure. Although controversy remains concerning some of the data, the wise psychiatrist should regularly review the benefit to each patient of continuing prophylactic antipsychotics against the risk of side-effects and loss...... of effectiveness through the development of supersensitivity of the dopamine D2 receptor. Psychiatrists should work with their patients to slowly reduce the antipsychotic to the lowest dose that prevents the return of distressing symptoms. Up to 40% of those whose psychosis remits after a first episode should...

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

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

2017-07-01

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

Roles of children and their parents in the reduction of radiation risk after the 2011 Fukushima Daiichi Nuclear Power Plant accident

Science.gov (United States)

Kitamura, Akiko

2017-01-01

Introduction On March 11, 2011, Japan experienced its largest recorded earthquake with a magnitude of 9.0. The resulting tsunami caused massive damage to the Fukushima Daiichi Nuclear Power Plant reactors, and the surrounding environment was contaminated with radioactive materials. During this period, some residents were exposed to high levels of radiation (up to 5 millisieverts [mSv]), but since then, many residents have been exposed to low levels of radiation (effects of lifestyle and attitude factors on external radiation exposure among Fukushima residents. Methods This community-based, cross-sectional study was conducted in Nihonmatsu City of the Fukushima Prefecture from May to July 2014. The population survey targeted 6,884 children between the ages of 0–15 years, and a personal radiation badge and questionnaire were administered to each of the residences. Multiple linear regression analysis was used to assess the impact of lifestyle and attitude factors on external radiation dose. Results The study participants (population size [n] = 4,571) had an additional mean radiation dose of 0.65 mSv/year, which is small as compared to the mean radiation dose 6 months after the disaster (1.5 mSv/year), in 2012 (1.5 mSv/year), and in 2013 (1.0 mSv/year). External radiation doses statistically varied by socio-demographic and lifestyle factors. Participants living in wooden residences (p-value<0.001) and within 100 meters of a forest (p = 0.001) had higher radiation exposure. Conversely, participants with a cautious attitude towards radiation had lower radiation exposure (beta [b] = -0.124, p = 0.003). Conclusion Having a cautious attitude towards radiation and being aware of exposure risks proved to be significant in the reduction of external radiation dose. Therefore, in the event of future radiation disasters, attitudes towards and awareness of radiation should be considered in the reduction of exposure risk and implementation of radiation protection. PMID:29236725

The Swiss regulatory framework for paediatric health research.

Science.gov (United States)

Junod, Valerie

2008-07-01

Medical research on minors entails both risks and benefits. Under Swiss law, clinical trials on children, including nontherapeutic drug trials, are permissible. However, ethics committees must systematically verify that all clinical studies have a favorable risk-benefit profile. Additional safeguards are designed to ensure that children are not unnecessarily involved in research and that proper consent is always obtained. Federal Swiss law is undergoing revision to extend these protections beyond clinical trials to a broad array of health research. The Swiss drug agency also seeks to improve the incentives for pharmaceutical firms to develop new paediatric drugs and relevant paediatric drug labels.

Does specific psychopathology predict development of psychosis in ultra high-risk (UHR) patients?

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Thompson, Andrew; Nelson, Barnaby; Bruxner, Annie; O'Connor, Karen; Mossaheb, Nilufar; Simmons, Magenta B; Yung, Alison

2013-04-01

Studies have attempted to identify additional risk factors within the group identified as 'ultra high risk' (UHR) for developing psychotic disorders in order to characterise those at highest risk. However, these studies have often neglected clinical symptom types as additional risk factors. We aimed to investigate the relationship between baseline clinical psychotic or psychotic-like symptoms and the subsequent transition to a psychotic disorder in a UHR sample. A retrospective 'case-control' methodology was used. We identified all individuals from a UHR clinic who had subsequently developed a psychotic disorder (cases) and compared these to a random sample of individuals from the clinic who did not become psychotic within the sampling time frame (controls). The sample consisted of 120 patients (60 cases, 60 controls). An audit tool was used to identify clinical symptoms reported at entry to the clinic (baseline) using the clinical file. Diagnosis at transition was assessed using the Operational Criteria for Psychotic Illness (OPCRIT) computer program. The relationship between transition to a psychotic disorder and baseline symptoms was explored using survival analysis. Presence of thought disorder, any delusions and elevated mood significantly predicted transition to a psychotic disorder. When other symptoms were adjusted for, only the presence of elevated mood significantly predicted subsequent transition (hazard ratio 2.69, p = 0.002). Thought disorder was a predictor of transition to a schizophrenia-like psychotic disorder (hazard ratio 3.69, p = 0.008). Few individual clinical symptoms appear to be predictive of transition to a psychotic disorder in the UHR group. Clinicians should be cautious about the use of clinical profile alone in such individuals when determining who is at highest risk.

Recovery of Abnormal ABR in Neonates and Infants at Risk of Hearing Loss

Directory of Open Access Journals (Sweden)

Ioannis Psarommatis

2017-01-01

Full Text Available The purpose of this retrospective study is to present the clinical experience of a single institution on the recovery of ABR thresholds in a large population of neonates and infants at risk of hearing loss. Potential prognostic factors associated with this phenomenon were also investigated. Out of 2248 high risk infants, 384 had abnormal ABR at initial hearing evaluation and 168 of them had absent ABR or a threshold ≥80 dBnHL. From this subgroup, a significant percentage showed complete or partial recovery on reexamination (32.7% and 9.3%, resp., performed 4–6 months later. The presence of normal otoacoustic emissions was associated with the ABR restoration on reexamination. Moreover, the very young age at the initial hearing screening seems to be related to higher probabilities of false positive ABR. The potential recovery of hearing in HR infants raises concerns about the very early cochlear implantation in HR infants less than one year. Such a treatment modality should be decided cautiously and only after obtaining valid and stable objective and subjective hearing thresholds. This holds especially true for infants showing an auditory neuropathy profile, as they presented a much greater probability of ABR recovery.

Vejledning ved ambulancetransport

DEFF Research Database (Denmark)

Berlac, Peter Anthony; Wammen, Susanne; Giebner, Matthias

2010-01-01

, 2) minimize the occurrence of adverse events during transport, 3) ensure that accompanying staff are trained for and skilled in transfer and retrieval medicine and 4) encourage optimal utilisation of available competencies without unnecessarily draining hospital resources.......Inter-hospital transportation poses potential risks to staff and patients. The present guidelines recommend competency-based management dictated by the patient's clinical condition and medical requirements during transfer. The guidelines aim to: 1) improve patient and staff safety during transport...

Knowledge, attitudes, and practices toward malaria risk and prevention among frequent business travelers of a major oil and gas company.

Science.gov (United States)

Berg, Johannes; Breederveld, Daan; Roukens, Anna H; Hennink, Yvonne; Schouten, Marjolijn; Wendt, Judy K; Visser, Leo G

2011-01-01

Despite significant morbidity and mortality among business travelers due to malaria, very little has been published on knowledge, attitudes, and practices (KAP) toward malaria risk. The aim of this study was to assess KAP among frequent international business travelers (FBT) and to identify recommendations for improving malaria prevention that could be applied to the wider FBT community in occupational health. A retrospective web-based survey was conducted in 2005 among self-registered FBT of an oil and gas company based in the Netherlands. The survey was completed by 328 of the 608 self-registered FBT (54%). Fifty-four percent of respondents had visited a high-risk area for malaria. Most respondents (96%) were experienced travelers; the majority (71%) sought health advice before their trip and made use of a company health resource. Fever was recognized as a malaria symptom by all FBT; travel to high-risk malaria areas was correctly identified by 96%, and 99% of these travelers adhered to use of adequate personal protective measures. The proportion of travelers carrying appropriate anti-malaria drug regimen was positively associated with receiving company advice among FBT traveling to high-risk destinations (RR = 2.10, 95% CI: 1.21-3.67), but not for those traveling to low- or no-risk destinations. Only 8% (14) of those going to a high-risk area were not carrying malaria prophylaxis. One in five of FBT traveling to no-risk areas were unnecessarily carrying malaria prophylaxis. The majority of KAP results were excellent. We postulate that a company culture with a strong focus on health, safety, security, and environment can positively contribute to high KAP scores. Notwithstanding the excellent findings, this study also provides a cautionary tale for company health functions against overprescribing of malaria prophylaxis. It demonstrates the need for constant review and audit of adherence to quality criteria. © 2011 International Society of Travel Medicine.

Balancing cardiovascular and gastrointestinal risks in patients with osteoarthritis receiving nonsteroidal anti‑inflammatory drugs. A summary of guidelines from an international expert group.

Science.gov (United States)

Mosleh, Wassim; Farkouh, Michael E

2016-01-01

Over the past 2 decades, extensive research has assessed the use of traditional nonsteroidal anti‑inflammatory drugs (NSAIDs), and the newer cyclooxygenase‑2 (COX-2) inhibitor drugs, in the treatment of chronic pain syndromes. The proper use of NSAIDs has been the subject of significant debate, bringing together multidisciplinary researchers and clinicians to discuss the risks and benefits of these therapies. Current guidelines discussing the proper use of NSAIDs do not address the issue of the risks of COX‑2‑selective NSAIDs and nonselective NSAIDs for both the gastrointestinal (GI) and cardiovascular (CV) systems in patients on low‑dose aspirin. Accordingly, a multidisciplinary expert group was organized to review the current evidence with the aim of developing statements devoted to guide clinicians in making evidence‑based and individualized selections of NSAIDs. This review will discuss and summarize the most recent evidence on this topic to give an insight into the most effective and safest therapeutic options, thus preventing serious adverse CV and GI events. NSAIDs should be used cautiously and as infrequently as possible, with nonpharmacological approaches prescribed first. If the use of NSAIDs is required, the choice should balance the possible CV and GI risks.

The Assessment of Diet Quality and Its Effects on Health Outcomes Pre-pregnancy and during Pregnancy.

Science.gov (United States)

Martin, Julie C; Zhou, Shao J; Flynn, Angela C; Malek, Lenka; Greco, Rebecca; Moran, Lisa

2016-03-01

Overweight and obesity pre pregnancy or during pregnancy is associated with an increased risk for maternal obstetric and fetal complications. Diet is one modifiable risk factor that women may be motivated to improve. General healthy eating guidelines, micronutrient sufficiency and macronutrient quantity and quality are important nutrition considerations pre and during pregnancy. With regards to specific nutrients, health authorities have recommendations for folate and/or iodine supplementation; but not consistently for iron and omega-3 despite evidence for their association with health outcomes. There are modest additional requirements for energy and protein, but not fat or carbohydrate, in mid-late pregnancy. Diet indices and dietary pattern analysis are additional tools or methodologies used to assess diet quality. These tools have been used to determine dietary intakes and patterns and their association with pregnancy complications and birth outcomes pre or during pregnancy. Women who may unnecessarily resist foods due to fear of food contamination from listeriosis and methylmercury may limit their diet quality and a balanced approached is required. Dietary intake may also vary according to certain population characteristics. Additional support for women who are younger, less educated, overweight and obese, from socially disadvantaged areas, smokers and those who unnecessarily avoid healthy foods, is required to achieve a higher quality diet and optimal lifestyle peri conception. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Assessment of the Density of Suppression to Identify Risk of Intractable Diplopia in the United Kingdom.

Science.gov (United States)

Newsham, David; O'Connor, Anna R

2016-06-01

Occlusion used to treat amblyopia towards the end of the developmental component of the critical period gives a risk of inducing intractable diplopia. In the United Kingdom, the density of suppression is assessed via the Sbisa/Bagolini filter bar, but there is very little research evidence to guide clinical practice or interpretation of the tests used. The aims of this study were to determine current practice and estimate the incidence of intractable diplopia following amblyopia treatment. Current practice and incidence of intractable diplopia following amblyopia were determined via a questionnaire distributed to head orthoptists in every eye department in the United Kingdom. The questionnaire explored testing and test conditions, interpretation of the test results, and cases of intractable diplopia over the last 5 years. There was considerable variation in clinical practice of the measurement of the density of suppression and interpretation of the results to guide the treatment of amblyopia. The minimum age of patients taking the test ranged from 2 to 8 years and the minimum filter considered still safe to continue treatment ranged from 4 to 17. It is estimated there were 24 cases of intractable diplopia over the last 5 years. The issue of intractable diplopia and amblyopia treatment is likely to become increasingly important as there appears to be greater plasticity and scope to treat amblyopia in teenagers and adults than was previously thought. Lack of knowledge of how to evaluate the risk may lead to more cases of intractable diplopia or alternatively treatment being withheld unnecessarily.

Men's perspectives on fall risk and fall prevention following participation in a group-based programme conducted at Men's Sheds, Australia.

Science.gov (United States)

Liddle, Jeannine L M; Lovarini, Meryl; Clemson, Lindy M; Jang, Haeyoung; Willis, Karen; Lord, Stephen R; Sherrington, Catherine

2017-05-01

Research on older men's views regarding fall prevention is limited. The purpose of this qualitative study was to explore the experiences and perspectives of older men regarding fall risk and prevention so that fall prevention programmes can better engage older men. Eleven men who had taken part in a group-based fall prevention programme called Stepping On conducted at Men's Sheds in Sydney, Australia, participated in semi-structured interviews during June and July 2015 which were audio-recorded and transcribed. Data were coded and analysed using constant comparative methods. Over-arching theoretical categories were developed into a conceptual framework linking programme context and content with effects of programme participation on men. Men's Sheds facilitated participation in the programme by being inclusive, male-friendly places, where Stepping On was programmed into regular activities and was conducted in an enjoyable, supportive atmosphere. Programme content challenged participants to think differently about themselves and their personal fall risk, and provided practical options to address fall risk. Two major themes were identified: adjusting the mindset where men adopted a more cautious mindset paying greater attention to potential fall risks, being careful, concentrating and slowing down; and changing the ways where men acted purposefully on environmental hazards at home and incorporated fall prevention exercises into their routine schedules. Practitioners can engage and support older men to address falls by better understanding men's perspectives on personal fall risk and motivations for action. © 2016 John Wiley & Sons Ltd.

A Prospective Cohort Study of Absconsion Incidents in Forensic Psychiatric Settings: Can We Identify Those at High-Risk?

Directory of Open Access Journals (Sweden)

Alexis E Cullen

and substance use, are strong predictors of absconsion in forensic settings; the absence of these factors may enable clinical teams to identify unnecessarily restricted low-risk individuals.

Modifying Evaluations and Decisions in Risky Situations.

Science.gov (United States)

Maldonado, Antonio; Serra, Sara; Catena, Andrés; Cándido, Antonio; Megías, Alberto

2016-09-20

The main aim of this research was to investigate the decision making process in risky situations. We studied how different types of feedback on risky driving behaviors modulate risk evaluation and risk-taking. For a set of risky traffic situations, participants had to make evaluative judgments (judge the situation as risky or not) and urgent decisions (brake or not). In Experiment 1, participants received feedback with and without negative emotional content when they made risky behaviors. In Experiment 2 we investigated the independent effects of feedback and negative emotional stimuli. The results showed three important findings: First, urgent decisions were faster [F(1, 92) = 6.76, p = .01] and more cautious [F(1, 92) = 17.16, p towards more cautious responses [F(1, 111) = 14.09, p emotional stimuli had an effect only when they were presented as feedback. The results of this research increase our understanding of the processes involved in risky driving behavior and suggest efficient ways to control risk taking through the use of feedback.

Profile and effects of consumer involvement in fresh meat.

Science.gov (United States)

Verbeke, Wim; Vackier, Isabelle

2004-05-01

This study investigates the profile and effects of consumer involvement in fresh meat as a product category based on cross-sectional data collected in Belgium. Analyses confirm that involvement in meat is a multidimensional construct including four facets: pleasure value, symbolic value, risk importance and risk probability. Four involvement-based meat consumer segments are identified: straightforward, cautious, indifferent, and concerned. Socio-demographic differences between the segments relate to gender, age and presence of children. The segments differ in terms of extensiveness of the decision-making process, impact and trust in information sources, levels of concern, price consciousness, claimed meat consumption, consumption intention, and preferred place of purchase. The two segments with a strong perception of meat risks constitute two-thirds of the market. They can be typified as cautious meat lovers versus concerned meat consumers. Efforts aiming at consumer reassurance through quality improvement, traceability, labelling or communication may gain effectiveness when targeted specifically to these two segments. Whereas straightforward meat lovers focus mainly on taste as the decisive criterion, indifferent consumers are strongly price oriented.

How to be Cautious but Open to Learning: Time to Update Biotechnology and GMO Legislation.

Science.gov (United States)

Hansson, Sven Ove

2016-08-01

Precautionary measures to protect human health and the environment should be science based. This implies that they should be directed at a potential danger for which there is credible scientific evidence (although that evidence need not be conclusive). Furthermore, protective measures should be updated as relevant science advances. This means that decisionmakers should be prepared to strengthen the precautionary measures if the danger turns out to be greater than initially suspected, and to reduce or lift them, should the danger prove to be smaller. Most current legislation on agricultural biotechnology has not been scientifically updated. Therefore, it reflects outdated criteria for identifying products that can cause problems. Modern knowledge in genetics, plant biology, and ecology has provided us with much better criteria that risk analysts can use to identify the potentially problematic breeding projects at which precautionary measures should be directed. Legislation on agricultural biotechnology should be scientifically updated. Furthermore, legislators should learn from this example that regulations based on the current state of science need to have inbuilt mechanisms for revisions and adjustments in response to future developments in science. © 2016 Society for Risk Analysis.

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

Science.gov (United States)

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

2016-12-01

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

Personalized Treatment of Mothers With ADHD and Their Young At-Risk Children: A SMART Pilot.

Science.gov (United States)

Chronis-Tuscano, Andrea; Wang, Christine H; Strickland, Jennifer; Almirall, Daniel; Stein, Mark A

2016-01-01

Young children of mothers with adult attention-deficit/hyperactivity disorder (ADHD) are at risk for ADHD by virtue of genetics and environmental factors. Moreover, parent ADHD is associated with maladaptive parenting and poor child behavioral treatment response. Thus, a combined approach consisting of behavioral parent training (BPT) and maternal stimulant medication (MSM) may be needed to effectively treat ADHD within families. However, providing combined BPT+MSM initially to all families may be unnecessarily burdensome because not all families likely need combined treatment. The purpose of this study is to examine how to combine, sequence, and personalize treatment for these multiplex families in order to yield benefits to both the parent and child, thereby impacting the course of child ADHD and disruptive behavior symptoms. This article presents our rationale for, design of, and preliminary experiences (based on 26 participants) with an ongoing pilot Sequential Multiple Assessment Randomized Trial (SMART) designed to answer questions regarding the feasibility and acceptability of study protocols and interventions. This article also describes how the subsequent full-scale SMART might change based on what is learned in the SMART pilot and illustrates how the full-scale SMART could be used to inform clinical decision making about how to combine, sequence, and personalize treatment for complex children and families in which a parent has ADHD.

Access to benznidazole for Chagas disease in the United States-Cautious optimism?

Directory of Open Access Journals (Sweden)

Jonathan D Alpern

2017-09-01

Full Text Available Drugs for neglected tropical diseases (NTD are being excessively priced in the United States. Benznidazole, the first-line drug for Chagas disease, may become approved by the Food and Drug Administration (FDA and manufactured by a private company in the US, thus placing it at risk of similar pricing. Chagas disease is an NTD caused by Trypanosoma cruzi; it is endemic to Latin America, infecting 8 million individuals. Human migration has changed the epidemiology causing nonendemic countries to face increased challenges in diagnosing and managing patients with Chagas disease. Only 2 drugs exist with proven efficacy: benznidazole and nifurtimox. Benznidazole has historically faced supply problems and drug shortages, limiting accessibility. In the US, it is currently only available under an investigational new drug (IND protocol from the CDC and is provided free of charge to patients. However, 2 companies have stated that they intend to submit a New Drug Application (NDA for FDA approval. Based on recent history of companies acquiring licensing rights for NTD drugs in the US with limited availability, it is likely that benznidazole will become excessively priced by the manufacturer-paradoxically making it less accessible. However, if the companies can be taken at their word, there may be reason for optimism.

Access to benznidazole for Chagas disease in the United States-Cautious optimism?

Science.gov (United States)

Alpern, Jonathan D; Lopez-Velez, Rogelio; Stauffer, William M

2017-09-01

Drugs for neglected tropical diseases (NTD) are being excessively priced in the United States. Benznidazole, the first-line drug for Chagas disease, may become approved by the Food and Drug Administration (FDA) and manufactured by a private company in the US, thus placing it at risk of similar pricing. Chagas disease is an NTD caused by Trypanosoma cruzi; it is endemic to Latin America, infecting 8 million individuals. Human migration has changed the epidemiology causing nonendemic countries to face increased challenges in diagnosing and managing patients with Chagas disease. Only 2 drugs exist with proven efficacy: benznidazole and nifurtimox. Benznidazole has historically faced supply problems and drug shortages, limiting accessibility. In the US, it is currently only available under an investigational new drug (IND) protocol from the CDC and is provided free of charge to patients. However, 2 companies have stated that they intend to submit a New Drug Application (NDA) for FDA approval. Based on recent history of companies acquiring licensing rights for NTD drugs in the US with limited availability, it is likely that benznidazole will become excessively priced by the manufacturer-paradoxically making it less accessible. However, if the companies can be taken at their word, there may be reason for optimism.

Japanese professional nurses spend unnecessarily long time doing nursing assistants' tasks.

Science.gov (United States)

Kudo, Yasushi; Yoshimura, Emiko; Shahzad, Machiko Taruzuka; Shibuya, Akitaka; Aizawa, Yoshiharu

2012-09-01

In environments in which professional nurses do simple tasks, e.g., laundry, cleaning, and waste disposal, they cannot concentrate on technical jobs by utilizing their expertise to its fullest benefit. Particularly, in Japan, the nursing shortage is a serious problem. If professional nurses take their time to do any of these simple tasks, the tasks should be preferentially allocated to nursing assistants. Because there has been no descriptive study to investigate the amount of time Japanese professional nurses spent doing such simple tasks during their working time, their actual conditions remain unclear. Professional nurses recorded their total working time and the time they spent doing such simple tasks during the week of the survey period. The time an individual respondent spent doing one or more simple tasks during that week was summed up, as was their working time. Subsequently, the percentage of the summed time he or she spent doing any of those tasks in his or her summed working time was calculated. A total of 1,086 respondents in 19 hospitals that had 87 to 376 beds were analyzed (response rate: 53.3%). The average time (SD) that respondents spent doing those simple tasks and their total working time were 2.24 (3.35) hours and 37.48 (10.88) hours, respectively. The average percentage (SD) of the time they spent doing the simple tasks in their working time was 6.00% (8.39). Hospital administrators must decrease this percentage. Proper working environments in which professional nurses can concentrate more on their technical jobs must be created.

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.

Fall incidence and associated risk factors among people with a lower limb amputation during various stages of recovery - a systematic review.

Science.gov (United States)

Steinberg, Noam; Gottlieb, Amihai; Siev-Ner, Itzhak; Plotnik, Meir

2018-03-14

The objective of this study was to estimate fall incidence and describe associated risk factors among people with a lower limb amputation (LLA) during various stages of recovery: the surgical ward, in-patient rehabilitation and return to community life. A systematic search of relevant English language articles was performed using PubMed and EMBASE. Out of 310 initial "hits," six retrospective cohort studies, one prospective cohort study and eleven cross-sectional studies from which fall incidence and risk factors could be extracted, were selected for critical review. Fall incidence and associated risk factors were extracted and analyzed in the context of various clinical stages of recovery after amputation. The studies were evaluated for quality using the "Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies." Results showed that during all stages of recovery, people with a LLA are at increased risk of falling compared with able-bodied individuals, as well as other clinical populations. Each stage of recovery is associated with different fall risk factors. The current review is limited mainly by the paucity of studies on the topic. Specialised care focusing on the most relevant risk factors for each stage of recovery may enhance fall prevention during post-fall recovery. Implications for rehabilitation •  People with a lower limb amputation are at a high risk of falling in all stages of their clinical course.      •  Health professionals should be aware that people with a lower limb amputation in the first 4 years ofamputation or with four or more health-related problems are at an increased risk.      •  Health professionals should also be aware that increased gait variability, excess confidence in balance andwalking abilities and less cautious stair walking, impose an elevated risk of falling and should focus theirefforts in reducing these factors.

Nuclear Energy Research Initiative. Risk Informed Assessment of Regulatory and Design Requirements for Future Nuclear Power Plants. Annual Report

International Nuclear Information System (INIS)

Ritterbusch, S.E.

2000-01-01

The overall goal of this research project is to support innovation in new nuclear power plant designs. This project is examining the implications, for future reactors and future safety regulation, of utilizing a new risk-informed regulatory system as a replacement for the current system. This innovation will be made possible through development of a scientific, highly risk-informed approach for the design and regulation of nuclear power plants. This approach will include the development and.lor confirmation of corresponding regulatory requirements and industry standards. The major impediment to long term competitiveness of new nuclear plants in the U.S. is the capital cost component--which may need to be reduced on the order of 35% to 40% for Advanced Light Water Reactors (ALWRs) such as System 80+ and Advanced Boiling Water Reactor (ABWR). The required cost reduction for an ALWR such as AP600 or AP1000 would be expected to be less. Such reductions in capital cost will require a fundamental reevaluation of the industry standards and regulatory bases under which nuclear plants are designed and licensed. Fortunately, there is now an increasing awareness that many of the existing regulatory requirements and industry standards are not significantly contributing to safety and reliability and, therefore, are unnecessarily adding to nuclear plant costs. Not only does this degrade the economic competitiveness of nuclear energy, it results in unnecessary costs to the American electricity consumer. While addressing these concerns, this research project will be coordinated with current efforts of industry and NRC to develop risk-informed, performance-based regulations that affect the operation of the existing nuclear plants; however, this project will go farther by focusing on the design of new plants

Nuclear Energy Research Initiative. Risk Informed Assessment of Regulatory and Design Requirements for Future Nuclear Power Plants. Annual Report

Energy Technology Data Exchange (ETDEWEB)

Ritterbusch, S.E.

2000-08-01

The overall goal of this research project is to support innovation in new nuclear power plant designs. This project is examining the implications, for future reactors and future safety regulation, of utilizing a new risk-informed regulatory system as a replacement for the current system. This innovation will be made possible through development of a scientific, highly risk-informed approach for the design and regulation of nuclear power plants. This approach will include the development and.lor confirmation of corresponding regulatory requirements and industry standards. The major impediment to long term competitiveness of new nuclear plants in the U.S. is the capital cost component--which may need to be reduced on the order of 35% to 40% for Advanced Light Water Reactors (ALWRs) such as System 80+ and Advanced Boiling Water Reactor (ABWR). The required cost reduction for an ALWR such as AP600 or AP1000 would be expected to be less. Such reductions in capital cost will require a fundamental reevaluation of the industry standards and regulatory bases under which nuclear plants are designed and licensed. Fortunately, there is now an increasing awareness that many of the existing regulatory requirements and industry standards are not significantly contributing to safety and reliability and, therefore, are unnecessarily adding to nuclear plant costs. Not only does this degrade the economic competitiveness of nuclear energy, it results in unnecessary costs to the American electricity consumer. While addressing these concerns, this research project will be coordinated with current efforts of industry and NRC to develop risk-informed, performance-based regulations that affect the operation of the existing nuclear plants; however, this project will go farther by focusing on the design of new plants.

Treating childhood asthma

African Journals Online (AJOL)

asthma is under control for at least three months, consider reducing the therapy. Apply extra cautious when reducing therapy (even if good control is achieved) in children who have experienced previous life-threatening asthma, or who have concomitant severe food allergies /anaphylaxis due to the increased risks of severe ...

Swallowing Tablets and Capsules Increases the Risk of Penetration and Aspiration in Patients with Stroke-Induced Dysphagia.

Science.gov (United States)

Schiele, Julia T; Penner, Heike; Schneider, Hendrik; Quinzler, Renate; Reich, Gabriele; Wezler, Nikolai; Micol, William; Oster, Peter; Haefeli, Walter E

2015-10-01

We evaluated the prevalence of difficulties swallowing solid dosage forms in patients with stroke-induced dysphagia and whether swallowing tablets/capsules increases their risk of penetration and aspiration. Concurrently, we explored whether routinely performed assessment tests help identify patients at risk. Using video endoscopy, we evaluated how 52 patients swallowed four different placebos (round, oval, and oblong tablets and a capsule) with texture-modified water (TMW, pudding consistency) and milk and rated their swallowing performance according to the Penetration Aspiration Scale (PAS). Additionally, Daniels Test, Bogenhausener Dysphagiescore, Scandinavian Stroke Scale, Barthel Index, and Tinetti's Mobility Test were conducted. A substantial proportion of the patients experienced severe difficulties swallowing solid oral dosage forms (TMW: 40.4 %, milk: 43.5 %). Compared to the administration of TMW/milk alone, the placebos increased the PAS values in the majority of the patients (TMW: median PAS from 1.5 to 2.0; milk: median PAS from 1.5 to 2.5, each p value <0.0001) and residue values were significantly higher (p < 0.05). Whereas video-endoscopic examination reliably identified patients with difficulties swallowing medication, neither patients' self-evaluation nor one of the routinely performed bedside tests did. Therefore, before video-endoscopic evaluation, many drugs were modified unnecessarily and 20.8 % of these were crushed inadequately, although switching to another dosage form or drug would have been possible. Hence, safety and effectiveness of swallowing tablets and capsules should be evaluated routinely in video-endoscopic examinations, tablets/capsules should rather be provided with TMW than with milk, and the appropriateness of "non per os except medication" orders for dysphagic stroke patients should be questioned.

A Systematic Approach to Discussing Active Surveillance with Patients with Low-risk Prostate Cancer.

Science.gov (United States)

Ehdaie, Behfar; Assel, Melissa; Benfante, Nicole; Malhotra, Deepak; Vickers, Andrew

2017-06-01

Physicians report difficulty convincing patients with prostate cancer about the merits of active surveillance (AS); as a result, a majority of patients unnecessarily choose to undergo radical treatment. To develop and evaluate a systematic approach for physicians to counsel patients with low-risk prostate cancer to increase acceptance of AS. A systematic counseling approach was developed and piloted in one clinic. Then five surgeons participated in a 1-h training session in which they learned about the approach. A total of 1003 patients with Gleason 3+3 prostate cancer were included in the study. We compared AS rates for 761 patients who were counseled over a 24-mo period before the training intervention with AS rates for 242 patients who were counseled over a 12-mo period afterwards, controlling for temporal trends and case mix. A systematic approach for communicating the merits of AS using appropriate framing techniques derived from principles studied by negotiation scholars. The rate of AS acceptance by patients for management of low-risk prostate cancer. In the pilot phase, 81 of 86 patients (94%) accepted AS after counseling by the physician who developed the counseling approach. In the subsequent study, the cohort for the training intervention comprised 1003 consecutive patients, 80% of whom met the Epstein criteria for very low-risk disease. The proportion of patients who selected AS increased from 69% before the training intervention to 81% afterwards. After adjusting for time trends and case mix, the rate of AS after the intervention was 9.1% higher (95% confidence interval -0.4% to 19.4%) than expected, a relative reduction of approximately 30% in the risk of unnecessary curative treatment. A systematic approach to counseling can be taught to physicians in a 1-h lecture. We found evidence that even this minimal intervention can decrease overtreatment. Our novel approach offers a framework to help address cancer screening-related overtreatment that occurs

Delivering Left-Skewed Portfolio Payoff Distributions in the Presence of Transaction Costs

Directory of Open Access Journals (Sweden)

Jacek B Krawczyk

2015-08-01

Full Text Available For pension-savers, a low payoff is a financial disaster. Such investors will most likely prefer left-skewed payoff distributions over right-skewed payoff distributions. We explore how such distributions can be delivered. Cautious-relaxed utility measures are cautious in ensuring that payoffs don’t fall much below a reference value, but relaxed about exceeding it. We find that the payoff distribution delivered by a cautious-relaxed utility measure has appealing features which payoff distributions delivered by traditional utility functions don’t. In particular, cautious-relaxed distributions can have the mass concentrated on the left, hence be left-skewed. However, cautious-relaxed strategies prescribe frequent portfolio adjustments which may be expensive if transaction costs are charged. In contrast, more traditional strategies can be time-invariant. Thus we investigate the impact of transaction costs on the appeal of cautious-relaxed strategies. We find that relatively high transaction fees are required for the cautious-relaxed strategy to lose its appeal. This paper contributes to the literature which compares utility measures by the payoff distributions they produce and finds that a cautious-relaxed utility measure will deliver payoffs that many investors will prefer.

Risk associated with bee venom therapy: a systematic review and meta-analysis.

Science.gov (United States)

Park, Jeong Hwan; Yim, Bo Kyung; Lee, Jun-Hwan; Lee, Sanghun; Kim, Tae-Hun

2015-01-01

The safety of bee venom as a therapeutic compound has been extensively studied, resulting in the identification of potential adverse events, which range from trivial skin reactions that usually resolve over several days to life-threating severe immunological responses such as anaphylaxis. In this systematic review, we provide a summary of the types and prevalence of adverse events associated with bee venom therapy. We searched the literature using 12 databases from their inception to June 2014, without language restrictions. We included all types of clinical studies in which bee venom was used as a key intervention and adverse events that may have been causally related to bee venom therapy were reported. A total of 145 studies, including 20 randomized controlled trials, 79 audits and cohort studies, 33 single-case studies, and 13 case series, were evaluated in this review. The median frequency of patients who experienced adverse events related to venom immunotherapy was 28.87% (interquartile range, 14.57-39.74) in the audit studies. Compared with normal saline injection, bee venom acupuncture showed a 261% increased relative risk for the occurrence of adverse events (relative risk, 3.61; 95% confidence interval, 2.10 to 6.20) in the randomized controlled trials, which might be overestimated or underestimated owing to the poor reporting quality of the included studies. Adverse events related to bee venom therapy are frequent; therefore, practitioners of bee venom therapy should be cautious when applying it in daily clinical practice, and the practitioner's education and qualifications regarding the use of bee venom therapy should be ensured.

Risk associated with bee venom therapy: a systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Jeong Hwan Park

Full Text Available The safety of bee venom as a therapeutic compound has been extensively studied, resulting in the identification of potential adverse events, which range from trivial skin reactions that usually resolve over several days to life-threating severe immunological responses such as anaphylaxis. In this systematic review, we provide a summary of the types and prevalence of adverse events associated with bee venom therapy.We searched the literature using 12 databases from their inception to June 2014, without language restrictions. We included all types of clinical studies in which bee venom was used as a key intervention and adverse events that may have been causally related to bee venom therapy were reported.A total of 145 studies, including 20 randomized controlled trials, 79 audits and cohort studies, 33 single-case studies, and 13 case series, were evaluated in this review. The median frequency of patients who experienced adverse events related to venom immunotherapy was 28.87% (interquartile range, 14.57-39.74 in the audit studies. Compared with normal saline injection, bee venom acupuncture showed a 261% increased relative risk for the occurrence of adverse events (relative risk, 3.61; 95% confidence interval, 2.10 to 6.20 in the randomized controlled trials, which might be overestimated or underestimated owing to the poor reporting quality of the included studies.Adverse events related to bee venom therapy are frequent; therefore, practitioners of bee venom therapy should be cautious when applying it in daily clinical practice, and the practitioner's education and qualifications regarding the use of bee venom therapy should be ensured.

A cautious approach to a new market

International Nuclear Information System (INIS)

Jackson, D.

1993-01-01

As companies like Shell (London), Total (Paris), and Norsk Hydro (Oslo) spearhead the push into developing Vietnam's largely untapped oil and gas reserves, chemical firms are carefully monitoring events. Some already have fledgling operations there - ICI (London), for example, has established activities covering paints, titanium dioxide, and explosives. But most are waiting for others to go in first, says Patrick Looram, senior associate and director/Southeast Asia with Technomic Consultants, speaking at CW's 1993 Asia/Pacific Chemical Industry conference in Singapore. Describing Vietnam, with its 70-million population, as the 'last great Asian market,' Looram says the most important industries for the chemicals sector in the shorter terms are likely to include textiles, packaging, plastics, food and agriculture, and pharmaceuticals. But he notes the country's chemicals requirements are still at a very early stage, with 1992 plastics demand, for example, put at less than 100,000 m.t. Basic infrastructure requirements are put at $30 billion-$40 billion. Vietnam has a range of measures in place to establish a market economy, such as decentralized control over industry, freeing up of price controls, and liberal foreign investment laws. Fewer than 1,000 of Vietnam's 12,000-plus state enterprises are owned by national government; control is in the hands of the provinces and municipalities. But to get results, Looram says it is necessary to deal directly with plants. Many of these operations, however, are nearly insolvent, and Looram says about a third are expected to close over the next couple of years. The strength of other Asian economies is crucial to Vietnam's development, Looram says, while a lifting of the US embargo on vietnam will play an important role

The refeeding syndrome and glucose load.

Science.gov (United States)

O'Connor, Graeme; Goldin, Jonathon

2011-03-01

A 10-year-old girl with anorexia nervosa developed the refeeding syndrome following cautious reintroduction of nutrition, emphasizing that even with cautious refeeding a shift in fluid, glucose, and electrolytes can still occur, increasing the risk of morbidity and mortality in this ever growing vulnerable group. Biochemical, nutritional, and anthropometrical monitoring in the patient, who followed a conservative refeeding program after a prolonged period of nutritional inadequacy. The refeeding syndrome presented itself with hypophosphatemia, hypotension, and cardiac abnormalities whilst refeeding at 25 kcal/kg (600 kcal/day). Comprises of a literature review, highlighting this case as the youngest reported case of refeeding syndrome in anorexia nervosa. Discussion focuses on the possible deleterious affects that carbohydrates may have in exacerbating the refeeding syndrome. Copyright © 2009 Wiley Periodicals, Inc.

Exposure to ionizing radiation during dental X-rays is not associated with risk of developing meningioma: a meta-analysis based on seven case-control studies.

Science.gov (United States)

Xu, Ping; Luo, Hong; Huang, Guang-Lei; Yin, Xin-Hai; Luo, Si-Yang; Song, Ju-Kun

2015-01-01

Many observational studies have found that exposure to dental X-rays is associated with the risk of development of meningioma. However, these findings are inconsistent. We conducted a meta-analysis to assess the relationship between exposure to dental X-rays and the risk of development of meningioma. The PubMed and EMBASE databases were searched to identify eligible studies. Summary odds ratio (OR) estimates and 95% confidence intervals (95% CIs) were used to compute the risk of meningioma development according to heterogeneity. Subgroup and sensitivity analyses were performed to further explore the potential heterogeneity. Finally, publication bias was assessed. Seven case-control studies involving 6,174 patients and 19,459 controls were included in the meta-analysis. Neither exposure to dental X-rays nor performance of full-mouth panorex X-rays was associated with an increased risk of development of meningioma (overall: OR, 0.97; 95% CI, 0.70-1.32; dental X-rays: OR, 1.05; 95% CI, 0.89-1.25; panorex X-rays: OR, 1.01; 95% CI, 0.76-1.34). However, exposure to bitewing X-rays was associated with a slightly increased risk of development of meningioma (OR, 1.73; 95% CI, 1.28-2.34). Similar results were obtained in the subgroup and sensitivity analyses. Little evidence of publication bias was observed. Based on the currently limited data, there is no association between exposure to dental X-rays and the risk of development of meningioma. However, these results should be cautiously interpreted because of the heterogeneity among studies. Additional large, high-quality clinical trials are needed to evaluate the association between exposure to dental X-rays and the risk of development of meningioma.

Does behaviour modification affect post-stroke risk factor control? Three-year follow-up of a randomized controlled trial.

Science.gov (United States)

McManus, Julie Ann; Craig, Alison; McAlpine, Christine; Langhorne, Peter; Ellis, Graham

2009-02-01

Little is known about the long-term effectiveness after stroke of interventions for behaviour modification and ensuring concordance with therapies. We describe a follow-up study of a previous randomized controlled trial of a brief period of behaviour modification. The aim of this study was to determine outcomes three years after the initial intervention. Survivors of the original cohort were contacted and asked to attend for follow-up interview, within a geriatric day hospital. This study was carried out in the Geriatric Day Hospital at Stobhill Hospital, Balornock Road, Glasgow. Details of risk factor control, including blood pressure, cholesterol levels and diabetic control, were assessed. Questionnaires used in the initial study were repeated including the Geriatric Depression Scale score, Euroqol Perceived Health Status and Stroke Services Satisfaction Questionnaire. Primary outcome was collective risk factor control. Clinical outcomes including recurrent cerebrovascular events, medication persistence and perceived health status were also recorded. Mean length of follow-up was 3.6 years (SD 0.43). Of the 205 patients enrolled in the initial study, 102 patients attended for repeat interview(49 intervention/53 control). There were no significant differences in the percentage of controlled risk factors between groups (intervention 51.7% versus control 55.9%, P = 0.53). Similarities were observed in the number of recurrent clinical events and medication persistence between groups. No overall difference was observed in perceived health status, satisfaction with care or depression scores. Brief intervention with respect to behaviour modification and risk factor control does not appear to have any long-term benefit. These results must be cautiously interpreted in light of the small study number and further research is required.

Port interface requirements

International Nuclear Information System (INIS)

O'Neil, R.

1978-01-01

In a land-based reactor programme the Administration are usually confronted with a specific design in a particular environment. Safety and Reliability criteria necessary to the designer can be specified on the basis of acceptable risk to the population. However for the successful implementation of a nuclear ship programme on a broad commercial basis it is necessary to have agreed standards of risks from ships yet to be designed and agreed standards of acceptable risks to the population at likely ports of call yet to be specified, consulted, or agreed. At first sight it would seem that this double uncertainty must either lead to unnecessarily high safety standards for the ship or unacceptably conservative standards for berth selection. The paper discusses the problem and proposes a possible solution based on the concept of a 'Standard Port' and a 'Standard Ship' and indicates the level of risk implied by such a concept

Buffering social influence: neural correlates of response inhibition predict driving safety in the presence of a peer.

Science.gov (United States)

Cascio, Christopher N; Carp, Joshua; O'Donnell, Matthew Brook; Tinney, Francis J; Bingham, C Raymond; Shope, Jean T; Ouimet, Marie Claude; Pradhan, Anuj K; Simons-Morton, Bruce G; Falk, Emily B

2015-01-01

Adolescence is a period characterized by increased sensitivity to social cues, as well as increased risk-taking in the presence of peers. For example, automobile crashes are the leading cause of death for adolescents, and driving with peers increases the risk of a fatal crash. Growing evidence points to an interaction between neural systems implicated in cognitive control and social and emotional context in predicting adolescent risk. We tested such a relationship in recently licensed teen drivers. Participants completed an fMRI session in which neural activity was measured during a response inhibition task, followed by a separate driving simulator session 1 week later. Participants drove alone and with a peer who was randomly assigned to express risk-promoting or risk-averse social norms. The experimentally manipulated social context during the simulated drive moderated the relationship between individual differences in neural activity in the hypothesized cognitive control network (right inferior frontal gyrus, BG) and risk-taking in the driving context a week later. Increased activity in the response inhibition network was not associated with risk-taking in the presence of a risky peer but was significantly predictive of safer driving in the presence of a cautious peer, above and beyond self-reported susceptibility to peer pressure. Individual differences in recruitment of the response inhibition network may allow those with stronger inhibitory control to override risky tendencies when in the presence of cautious peers. This relationship between social context and individual differences in brain function expands our understanding of neural systems involved in top-down cognitive control during adolescent development.

[Overdiagnosis in cancer screening].

Science.gov (United States)

Cervera Deval, J; Sentís Crivillé, M; Zulueta, J J

2015-01-01

In screening programs, overdiagnosis is defined as the detection of a disease that would have gone undetected without screening when that disease would not have resulted in morbimortality and was treated unnecessarily. Overdiagnosis is a bias inherent in screening and an undesired effect of secondary prevention and improved sensitivity of diagnostic techniques. It is difficult to discriminate a priori between clinically relevant diagnoses and those in which treatment is unnecessary. To minimize the effects of overdiagnosis, screening should be done in patients at risk. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Injuries in epilepsy: a review of its prevalence, risk factors, type of injuries and prevention

Directory of Open Access Journals (Sweden)

Jose Tellez-Zenteno

2009-12-01

Full Text Available Currently, there is intense clinical research into various aspects of the medical risks relating to epilepsy, including total and cause-specific mortality, accidents and injuries in patients with epilepsy and mortality related with seizures. Seizures occurring in precarious situations and resulting in injuries are still an important concern for patients with epilepsy, their employers and their caregivers. Submersion injuries, motor vehicle accidents, burns, and head injuries are among the most feared epilepsy-related injuries. These concerns seem valid because the hallmark of epilepsy, episodic impairment of consciousness and motor control, may occur during interictal EEG epileptiform discharges, even in the absence of a clinical seizure. In addition, psychomotor comorbidity and side effects of antiepileptic drugs may contribute to the risk of injuries in patients with epilepsy. Published risk factors for injuries include the number of antiepileptic drugs, history of generalized seizures, and seizure frequency. In general, epidemiological information about incidence of injuries has been conflicting and sparse. In general, studies focusing on populations with more severe forms of epilepsy tend to report substantially higher risks of injuries than those involving less selected populations. On the other hand, studies based on non-selected populations of people with epilepsy have not shown an increased frequency of injuries in people with epilepsy compared with the general population. Some studies have shown that patients with epilepsy are more frequently admitted to the hospital following an injury. Possible explanations include: more cautious attitude of clinicians toward injuries occurring in the setting of seizures; hospitalization required because of seizures and not to the injuries themselves; and hospitalization driven by other issues, such as comorbidities, which are highly prevalent in patients with epilepsy. Potentially the high rate of

Exposure to ionizing radiation during dental X-rays is not associated with risk of developing meningioma: a meta-analysis based on seven case-control studies.

Directory of Open Access Journals (Sweden)

Ping Xu

Full Text Available Many observational studies have found that exposure to dental X-rays is associated with the risk of development of meningioma. However, these findings are inconsistent. We conducted a meta-analysis to assess the relationship between exposure to dental X-rays and the risk of development of meningioma.The PubMed and EMBASE databases were searched to identify eligible studies. Summary odds ratio (OR estimates and 95% confidence intervals (95% CIs were used to compute the risk of meningioma development according to heterogeneity. Subgroup and sensitivity analyses were performed to further explore the potential heterogeneity. Finally, publication bias was assessed.Seven case-control studies involving 6,174 patients and 19,459 controls were included in the meta-analysis. Neither exposure to dental X-rays nor performance of full-mouth panorex X-rays was associated with an increased risk of development of meningioma (overall: OR, 0.97; 95% CI, 0.70-1.32; dental X-rays: OR, 1.05; 95% CI, 0.89-1.25; panorex X-rays: OR, 1.01; 95% CI, 0.76-1.34. However, exposure to bitewing X-rays was associated with a slightly increased risk of development of meningioma (OR, 1.73; 95% CI, 1.28-2.34. Similar results were obtained in the subgroup and sensitivity analyses. Little evidence of publication bias was observed.Based on the currently limited data, there is no association between exposure to dental X-rays and the risk of development of meningioma. However, these results should be cautiously interpreted because of the heterogeneity among studies. Additional large, high-quality clinical trials are needed to evaluate the association between exposure to dental X-rays and the risk of development of meningioma.

Gender stereotypes and superior conformity of the self in a sample of cyclists.

Science.gov (United States)

Félonneau, Marie-Line; Causse, Elsa; Constant, Aymery; Contrand, Benjamin; Messiah, Antoine; Lagarde, Emmanuel

2013-01-01

In the field of driving, people tend to think they are more competent and more cautious than others. This is the superior conformity of the self (SCS). Our main hypothesis was that, among cyclists, women would show a higher SCS on cautiousness, though men would show a higher SCS concerning competence. 1799 cyclists provided a self-assessment of their own cautiousness and of other people's cautiousness. The same procedure was used for competence. Consistent with the hypothesis, the SCS was gender-specific: it was more prominent for women concerning cautiousness and more prominent for men concerning competence. These results could explain why people tend to ignore the safety campaigns. They also indicate the importance of adapting messages concerning safety measures to gender. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Ethical challenges of genetic manipulation and research with animals].

Science.gov (United States)

Rodríguez Yunta, Eduardo

2012-01-01

Research with animals presents ethical questions both for being used as models of human diseases and for being a prerequisite for trials in humans, as in the introduction of genetic modifications. Some of these questions refer to the fact that, as models, they do not fully represent the human condition; that conducting toxicity tests causes great harm to animals; that their nature is altered by genetic modifications and that introducing genetically modified organisms is a risk. The use of animals in research for the benefit of humans imposes the moral responsibility to respect them, not making them suffer unnecessarily, since they are living beings capable of feeling.

Public health protection priorities

International Nuclear Information System (INIS)

Alexander, R.E.

1990-01-01

Although the inhalation and ingestion of small quantities of radioactive material are not known to be hazardous, tradition, popular demand and governmental directives are imposing costly standards of cleanliness normally associated with confirmed, highly dangerous biological and chemical agents. Examination of the radiation risk data base discloses that these standards are unnecessarily stringent, even if the risks (only hypothesized at low doses) were real. The justifications given are the persuasive axioms that no level of radiation is without risk and that more is known about radiation than any other carcinogen. Actually, the knowledge of this risk to humans does not extend to low doses or even to high doses if the exposure is protracted. Permitted levels are orders of magnitude below those known to be carcinogenic. With the costs of compliance now sufficiently large to cause national tax increases, federal program cuts, or both, an ethical question arises. Should taxes be increased and beneficial programs cut to pay for protection against risks that are trivial at worst and possibly imaginary, when additional resources are needed to combat dangers known to be real?

Risk assessment of silica nanoparticles on liver injury in metabolic syndrome mice induced by fructose.

Science.gov (United States)

Li, Jianmei; He, Xiwei; Yang, Yang; Li, Mei; Xu, Chenke; Yu, Rong

2018-07-01

This study aims to assess the effects and the mechanisms of silica nanoparticles (SiNPs) on hepatotoxicity in both normal and metabolic syndrome mouse models induced by fructose. Here, we found that SiNPs exposure lead to improved insulin resistance in metabolic syndrome mice, but markedly worsened hepatic ballooning, inflammation infiltration, and fibrosis. Moreover, SiNPs exposure aggravated liver injury in metabolic syndrome mice by causing serious DNA damage. Following SiNPs exposure, liver superoxide dismutase and catalase activities in metabolic syndrome mice were stimulated, which is accompanied by significantly increased malondialdehyde and 8-hydroxy-2-deoxyguanosine levels as compared to normal mice. Scanning electron microscope (SEM) revealed that SiNPs were more readily deposited in the liver mitochondria of metabolic syndrome mice, resulting in more severe mitochondrial injury as compared to normal mice. We speculated that SiNPs-induced mitochondrial injury might be the cause of hepatic oxidative stress, which further lead to a series of liver lesions as observed in mice following SiNPs exposure. Based on these results, it is likely that SiNPs will increase the risk and severity of liver disease in individuals with metabolic syndrome. Therefore, SiNPs should be used cautiously in food additives and clinical settings. Copyright © 2018 Elsevier B.V. All rights reserved.

Viability and Risk Assessment in Species Restoration: Planning Reintroductions for the Wild Boar, a Potential Disease Reservoir

Directory of Open Access Journals (Sweden)

Néstor Fernández

2006-06-01

Full Text Available The reintroduction of large mammals is often considered a priority conservation action in highly industrialized countries in which many of these species have been depleted. However, species reintroduction after decades of absence may involve important risks for human activities and ecological communities, such as favoring the spread of diseases. An example of a potentially troublesome reintroduction is the wild boar, which may act as a reservoir of diseases, e.g., classical swine fever, and cause high economic losses, and has become a species of concern in several European countries for both ecological and recreational reasons. Failure to prevent the disease consequences of species restoration can negate its conservation benefits. Here we evaluated the probability of both successfully reintroducing wild boar into Denmark and limiting their contact with domestic pig farms to which they might spread disease. For this purpose, we developed a spatially explicit, individual-based population model that incorporates information on boar habitat and demography information from Central European populations. We then compared model predictions with the spatial distribution of farms to achieve a spatial assessment of the contact risk. The most restrictive model scenario predicted that nearly 6% of Denmark provides habitat conditions that would allow wild boar to reproduce. The best habitats for reintroduction were aggregated in seven different areas throughout the country in which the extinction probability was < 5%. However, the expected population expansion was very limited in most of these areas. Both the number of suitable areas and the potential for population expansion greatly increased when we relaxed our habitat assumptions about boar forest requirements; this provided a more conservative scenario for a cautious risk analysis. We additionally found that part of the risk of contact with piggeries was associated with the magnitude of the expansion

Do Geriatric Conditions Increase Risk of Adverse Drug Reactions in Ambulatory Elders? Results From the VA GEM Drug Study

Science.gov (United States)

Hanlon, Joseph T.; Sloane, Richard J.; Boscardin, W. John; Schmader, Kenneth E.

2011-01-01

Background. Many clinicians prescribe cautiously to older adults with common geriatric conditions for fear of causing adverse drug reactions (ADRs). However, little is known about the association between these conditions and risk of ADRs. Methods. Using data from the VA Geriatric Evaluation and Management Drug Study, we determined any, preventable, and serious ADRs in 808 elders for 12 months after hospital discharge using a validated process involving patient self-report and chart review adjudicated by two health care professionals. Eight common geriatric conditions (activities of daily living, dementia, incontinence, falls, difficulty ambulating, malnourishment, depression, and prolonged bed rest) were evaluated at study baseline through self-report and structured assessments. We used Poisson regression to model the relationship between these geriatric conditions and ADRs. Results. Participants had a mean of 2.9 ± 1.2 geriatric conditions. Over the 12-month follow-up period, 497 ADRs occurred in 269 participants, including 187 ADRs considered preventable and 127 considered severe. On multivariable analyses, participants with dependency in one or more activities of daily living were less likely to suffer ADRs than those who were fully independent (incidence rate ratio: 0.78, 95% confidence interval = 0.62–1.00). None of the other seven geriatric conditions assessed were associated with ADR risk. Results were similar for preventable and serious ADRs, although participants with a history of falls were more likely to develop serious ADRs (incidence rate ratio: 1.49, 95% confidence interval = 1.00–2.21). Conclusions. Many geriatric conditions were not associated with risk of ADRs. Although it is prudent to prescribe judiciously in patients with these conditions, excessive caution may not be warranted. PMID:21321003

Genotypes of Mycobacterium tuberculosis in patients at risk of drug resistance in Bolivia.

Science.gov (United States)

Monteserin, Johana; Camacho, Mirtha; Barrera, Lucía; Palomino, Juan Carlos; Ritacco, Viviana; Martin, Anandi

2013-07-01

Bolivia ranks among the 10 Latin American countries with the highest rates of tuberculosis (TB) and multidrug resistant (MDR) TB. In view of this, and of the lacking information on the population structure of Mycobacterium tuberculosis in the country, we explored genotype associations with drug resistance and clustering by analyzing isolates collected in 2010 from 100 consecutive TB patients at risk of drug resistance in seven of the nine departments in which Bolivia is divided. Fourteen isolates were MDR, 29 had other drug resistance profiles, and 57 were pansusceptible. Spoligotype family distribution was: Haarlem 39.4%, LAM 26.3%, T 22.2%, S 2.0%, X 1.0%, orphan 9.1%, with very low intra-family diversity and absence of Beijing genotypes. We found 66 different MIRU-VNTR patterns; the most frequent corresponded to Multiple Locus Variable Analysis (MLVA) MtbC15 patterns 860, 372 and 873. Twelve clusters, each with identical MIRU-VNTR and spoligotypes, gathered 35 patients. We found no association of genotype with drug resistant or MDR-TB. Clustering associated with SIT 50 and the H3 subfamily to which it belongs (pBolivia. However, results should be taken cautiously because the sample is small and includes a particular subset of M. tuberculosis population. Copyright © 2013 Elsevier B.V. All rights reserved.

The linear hypothesis and radiation carcinogenesis

International Nuclear Information System (INIS)

Roberts, P.B.

1981-10-01

An assumption central to most estimations of the carcinogenic potential of low levels of ionising radiation is that the risk always increases in direct proportion to the dose received. This assumption (the linear hypothesis) has been both strongly defended and attacked on several counts. It appears unlikely that conclusive, direct evidence on the validity of the hypothesis will be forthcoming. We review the major indirect arguments used in the debate. All of them are subject to objections that can seriously weaken their case. In the present situation, retention of the linear hypothesis as the basis of extrapolations from high to low dose levels can lead to excessive fears, over-regulation and unnecessarily expensive protection measures. To offset these possibilities, support is given to suggestions urging a cut-off dose, probably some fraction of natural background, below which risks can be deemed acceptable

Predicting salt intrusion into freshwater aquifers resulting from CO2 injection – A study on the influence of conservative assumptions

DEFF Research Database (Denmark)

Walter, Lena; Binning, Philip John; Class, Holger

2013-01-01

. A crucial task is to choose an appropriate conceptual model and relevant scenarios. Overly conservative assumptions may lead to estimation of unacceptably high risks, and thus prevent the implementation of a CO2 storage project unnecessarily. On the other hand, risk assessment should not lead...... to an underestimation of hazards. This study compares two conceptual model approaches for the numerical simulation of brine-migration scenarios through a vertical fault and salt intrusion into a fresh water aquifer. The first approach calculates salt discharge into freshwater using an immiscible two-phase model...... with constant salinity in the brine phase. The second approach takes compositional effects into account and considers salinity as a variable parameter in the water phase. A spatial model coupling is introduced to adapt the increased model complexity to the required complexity of the physics. The immiscible two...

Benefits and risks of preoperative bowel cleansing in the pediatric population

Directory of Open Access Journals (Sweden)

Silvia Cordero Castro

2013-10-01

Full Text Available This article has as aim to announce the results of a clinical question referred about the intestinal cleanliness method most adapted for the pediatric population before a colorectal surgery, in order to diminish the electrolytic alterations for the utilization of the same ones and hereby to provide a better intestinal preparation with the minor risks. Is true the method of intestinal cleanliness it is a medical indication, the infirmary professionals must think about his work and wonder it brings over of his own practice and to work in a surest way (Young, 2003. There was realized a search, review and analysis of the scientific literature for that there were use different databases, as for example seeker academic GOOGLE, administrators of articles PUBMED, MEDLINE, EMBASE, SCIELO and Cochrane in Spanish and English language. Found 31 investigations that refer to the interest topic in indirect form. The conclusion were that the fosfosoda oral is effective and better tolerated in the intestinal cleanlinesses with the exception of the magnesium citrate who overcomes in flavor, for this could be an option for the use in pediatric populations. Nevertheless to use cautiously it's recommended to take renal function test and electrolytic pre, trans and post administration, added to the use of intravenous solutions mixed or electrolytic balanced intravenous as reinstatement to the losses. Nevertheless, there is no forceful evidence to determine which method of intestinal cleanliness is better and less risky for the children.

Seizing the Digital High Ground: Military Operations and Politics in the Social Media Era

Science.gov (United States)

2015-04-13

a participatory and collaborative fashion. User Generated Content can be seen as the sum of all ways in which people use social media. See Andreas M...government policies at anytime and from anywhere. In democracies , this is not necessarily a significant factor; in semi-authoritarian states, it can...reduced. A possible by-product of this in democracies might be for politicians to become increasingly risk averse and cautious when making decisions

Evaluation of end-user satisfaction among employees participating in a web-based health risk assessment with tailored feedback.

Science.gov (United States)

Vosbergen, Sandra; Laan, Eva K; Colkesen, Ersen B; Niessen, Maurice A J; Kraaijenhagen, Roderik A; Essink-Bot, Marie-Louise; Peek, Niels

2012-10-30

Web technology is increasingly being used to provide individuals with health risk assessments (HRAs) with tailored feedback. End-user satisfaction is an important determinant of the potential impact of HRAs, as this influences program attrition and adherence to behavioral advice. The aim of this study was to evaluate end-user satisfaction with a web-based HRA with tailored feedback applied in worksite settings, using mixed (quantitative and qualitative) methods. Employees of seven companies in the Netherlands participated in a commercial, web-based, HRA with tailored feedback. The HRA consisted of four components: 1) a health and lifestyle assessment questionnaire, 2) a biometric evaluation, 3) a laboratory evaluation, and 4) tailored feedback consisting of a personal health risk profile and lifestyle behavior advice communicated through a web portal. HRA respondents received an evaluation questionnaire after six weeks. Satisfaction with different parts of the HRA was measured on 5-point Likert scales. A free-text field provided the opportunity to make additional comments. In total, 2289 employees participated in the HRA program, of which 637 (27.8%) completed the evaluation questionnaire. Quantitative analysis showed that 85.6% of the respondents evaluated the overall HRA positively. The free-text field was filled in by 29.7 % of the respondents (189 out of 637), who made 315 separate remarks. Qualitative evaluation of these data showed that these respondents made critical remarks. Respondents felt restricted by the answer categories of the health and lifestyle assessment questionnaire, which resulted in the feeling that the corresponding feedback could be inadequate. Some respondents perceived the personal risk profile as unnecessarily alarming or suggested providing more explanations, reference values, and a justification of the behavioral advice given. Respondents also requested the opportunity to discuss the feedback with a health professional. Most people

Risk Factors Associated with Renal Involvement in Childhood Henoch-Schönlein Purpura: A Meta-Analysis

Science.gov (United States)

Chan, Han; Tang, Yan-Ling; Lv, Xiao-Hang; Zhang, Gao-Fu; Wang, Mo; Yang, Hai-Ping; Li, Qiu

2016-01-01

Background and objective Henoch-Schönlein purpura (HSP) is an important cause of chronic kidney disease in children. This meta-analysis identified risk factors associated with renal involvement in childhood HSP. Methods PubMed, Embase, and Web of Science were searched. The quality of all eligible studies was assessed using the Newcastle-Ottawa scale criteria. An analysis of possible risk factors was conducted to report the odds ratio (OR) and weighted mean difference (WMD). Results Thirteen studies (2398 children) revealed 20 possible and 13 significant risk factors associated with renal involvement in HSP, with the following meta-analysis estimates of OR and WMD, with 95% confidence intervals: older age (0.90, 0.61–1.19); age > 10 y (3.13, 1.39–7.07); male gender (1.36, 1.07–1.74); abdominal pain (1.94,1.24–3.04); gastrointestinal bleeding (1.86, 1.30–2.65); severe bowel angina (3.38, 1.17–9.80); persistent purpura (4.02, 1.22–13.25); relapse (4.70, 2.42–9.14); WBC > 15 × 109/L (2.42, 1.39–4.22); platelets > 500 × 109/L (2.98, 1.22–7.25); elevated antistreptolysin O (ASO) (2.17, 1.29–3.64); and decreased complement component 3 (C3) (3.13, 1.62–6.05). Factors not significantly associated with renal involvement were: blood pressure; orchitis; elevated C-reactive protein; elevated erythrocyte sedimentation rate (ESR); and elevated serum IgA/IgE or IgG. Arthritis/arthralgia may be a risk factor according to the criteria of the American College of Rheumatology (1.41, 1.01–1.96). Conclusion The following are associated with renal involvement in pediatric HSP: male gender; > 10 y old; severe gastrointestinal symptoms (abdominal pain, gastrointestinal bleeding, and severe bowel angina); arthritis/arthralgia; persistent purpura or relapse; WBC > 15 × 109/L; platelets > 500 × 109/L; elevated ASO; and low C3. Relevant clinical interventions for these risk factors may exert positive effects on the prevention of kidney disease during the early

Risk of Deep vein thrombosis in neurosurgery: State of the art on prophylaxis protocols and best clinical practices.

Science.gov (United States)

Ganau, Mario; Prisco, Lara; Cebula, Helene; Todeschi, Julien; Abid, Houssem; Ligarotti, Gianfranco; Pop, Raoul; Proust, Francois; Chibbaro, Salvatore

2017-11-01

To analytically discuss some protocols in Deep vein thrombosis (DVT)/pulmonary Embolism (PE) prophylaxis currently use in Neurosurgical Departments around the world. Analysis of the prophylaxis protocols in the English literature: An analytical and narrative review of literature concerning DVT prophylaxis protocols in Neurosurgery have been conducted by a PubMed search (back to 1978). 80 abstracts were reviewed, and 74 articles were extracted. The majority of DVT seems to develop within the first week after a neurosurgical procedure, and a linear correlation between the duration of surgery and DVT occurrence has been highlighted. The incidence of DVT seems greater for cranial (7.7%) than spinal procedures (1.5%). Although intermittent pneumatic compression (IPC) devices provided adequate reduction of DVT/PE in some cranial and combined cranial/spinal series, low-dose subcutaneous unfractionated heparin (UFH) or low molecular-weight heparin (LMWH) further reduced the incidence, not always of DVT, but of PE. Nevertheless, low-dose heparin-based prophylaxis in cranial and spinal series risks minor and major postoperative haemorrhages: 2-4% in cranial series, 3.4% minor and 3.4% major haemorrhages in combined cranial/spinal series, and a 0.7% incidence of major/minor haemorrhages in spinal series. This analysis showed that currently most of the articles are represented by case series and case reports. As long as clear guidelines will not be defined and universally applied to this diverse group of patients, any prophylaxis for DVT and PE should be tailored to the individual patient with cautious assessment of benefits versus risks. Copyright © 2017 Elsevier Ltd. All rights reserved.

Rejection or selection: influence of framing in investment decisions.

Science.gov (United States)

Cheng, Pi-Yueh; Chiou, Wen-Bin

2010-02-01

According to prospect theory, reflection effects result in preferences for risk-averse choices in gain situations and risk-seeking choices in loss situations. However, relevant literature in regard to decision making has suggested that positive information receives more weight in a selection task, whereas negative information receives more weight in a rejection task. The present study examined whether the nature of a decision task (selection vs rejection) would moderate the reflection effects. Undergraduates (47 men, 49 women; M age = 20.5 yr., SD = 1.1), selected according to specific screening criteria, participated in an experimental study. Typical reflection effects were observed in both selection and rejection task conditions. More importantly, negative information (i.e., the information about probable loss in risky choice of gain situations and the information about certain loss in cautious choice of loss situations) provided in the context of a rejection task received more weight and resulted in more frequent endorsements of the cautious choice in gain situations and of the risky choice in loss situations. Hence, the findings suggest that a decision context characterized by rejection may expand the reflection effects and thereby provide important information about situations in which investment decisions occur in a context characterized by rejection.

Risk Factors Associated with Discordant Ki-67 Levels between Preoperative Biopsy and Postoperative Surgical Specimens in Breast Cancers.

Directory of Open Access Journals (Sweden)

Hyung Sun Kim

values should be cautious considering types of specimens and clinicopathological risk factors.

Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients

International Nuclear Information System (INIS)

Hernandez, M. R.; Gamboa-deBuen, I.; Dies, P.; Rickards, J.; Ruiz, C.

2008-01-01

Computerised tomography (CT) is a favourite method of medical diagnosis. Its use has thus increased rapidly throughout the world, particularly in studies relating to children. However to avoid administering unnecessarily high doses of radiation to paediatric patients it is important to have correct dose reference levels to minimize risk. The research is being developed within the public health sector at the Hospital Infantil de Mexico ''Dr. Federico Gomez.'' We measured the entrance surface air kerma (K P ) in paediatric patients, during the radiological studies of control in CT (studies of head, thorax and abdomen). Phantom was used to evaluate image quality as the tomograph requires a high resolution image in order to operate at its optimum level

A survey of risk factors for digit injuries among dogs training and competing in agility events.

Science.gov (United States)

Sellon, Debra C; Martucci, Katherine; Wenz, John R; Marcellin-Little, Denis J; Powers, Michelle; Cullen, Kimberley L

2018-01-01

OBJECTIVE To identify potential risk factors for digit injuries in dogs training and competing in agility events. DESIGN Internet-based, retrospective, cross-sectional survey. ANIMALS 1,081 dogs training or competing in agility events. PROCEDURES Data were collected for eligible animals via retrospective surveys distributed electronically to handlers of dogs participating in agility-related activities. Variables evaluated included demographic (handlers) and signalment (dogs) information, physical characteristics of dogs, and injury characteristics. A separate survey of dogs competing in similar agility-related activities but without digit injuries was also administered. Multivariable logistic regression was used to develop a model for assessment of risk factors. RESULTS Data were collected from 207 agility dogs with digit injuries and 874 agility dogs without digit injuries. Factors associated with significantly increased odds of injury included Border Collie breed (OR, 2.3; 95% confidence interval [CI], 1.5 to 3.3), long nails (OR, 2.4; 95% CI, 1.3 to 4.5), absence of front dewclaws (OR, 1.9; 95% CI, 1.3 to 2.6), and greater weight-to-height ratio (OR, 1.5; 95% CI, 1.1 to 2.0). Odds of injury decreased with increasing age of the dog (OR, 0.8; 95% CI, 0.76 to 0.86). CONCLUSIONS AND CLINICAL RELEVANCE Results should be cautiously interpreted because of potential respondent and recall bias and lack of review of medical records. Nevertheless, results suggested that retaining healthy dewclaws, maintaining lean body mass, and trimming nails short for training and competition may decrease the likelihood of digit injuries. Research to investigate training practices, obstacle construction specifcations, and surface considerations for dogs competing in agility activities is indicated.

Seven cases of upper gastrointestinal bleeding after cold biopsy

OpenAIRE

Alneaimi, Khaled; Abdelmoula, Ali; Vincent, Magalie; Savale, Camille; Baye, Birane; Lesur, Gilles

2016-01-01

Background and study aims: Routine biopsy of the upper gastrointestinal tract is performed with increasing frequency. It is generally considered to be safe without significant complication. However, gastrointestinal bleeding as a result of cold biopsy is a known complication. We report seven cases of upper gastrointestinal bleeding after cold biopsy and discuss clinical data, risks factors, severity and management of this event. We suggest that physicians must be more cautious with this rare ...

Reirradiation of normal tissues: Preclinical radiobiological data; Reirradiation des tissus sains: donnees radiobiologiques precliniques

Energy Technology Data Exchange (ETDEWEB)

Bourgier, C.; Vozenin, M.C.; Deutsch, E. [Departement de radiotherapie et laboratoire Upres EA2710, institut Gustave-Roussy, 94 - Villejuif (France)

2010-10-15

Reirradiation represent an unfrequent particular clinical situation. The risk/benefit ratio assessment must be taken into account, considering both clinical and dosimetric aspects. There is a relatively limited amount of preclinical data available to date and clinicians should cautiously perform re-irradiations in selected indications. This review summarizes the experimental data available on reirradiation of normal tissues, the consequences on early and late toxicities as well as the intrinsic limitations of these models. (authors)

Risk of new acute myocardial infarction hospitalization associated with use of oral and parenteral non-steroidal anti-inflammation drugs (NSAIDs: a case-crossover study of Taiwan's National Health Insurance claims database and review of current evidence

Directory of Open Access Journals (Sweden)

Shau Wen-Yi

2012-02-01

Full Text Available Abstract Background Previous studies have documented the increased cardiovascular risk associated with the use of some nonsteroidal anti-inflammatory drugs (NSAIDs. Despite this, many old NSAIDs are still prescribed worldwide. Most of the studies to date have been focused on specific oral drugs or limited by the number of cases examined. We studied the risk of new acute myocardial infarction (AMI hospitalization with current use of a variety of oral and parenteral NSAIDs in a nationwide population, and compared our results with existing evidence. Methods We conducted a case-crossover study using the Taiwan's National Health Insurance claim database, identifying patients with new AMI hospitalized in 2006. The 1-30 days and 91-120 days prior to the admission were defined as case and matched control period for each patient, respectively. Uses of NSAIDs during the respective periods were compared using conditional logistic regression and adjusted for use of co-medications. Results 8354 new AMI hospitalization patients fulfilled the study criteria. 14 oral and 3 parenteral NSAIDs were selected based on drug utilization profile among 13.7 million NSAID users. The adjusted odds ratio, aOR (95% confidence interval, for risk of AMI and use of oral and parenteral non-selective NSAIDs were 1.42 (1.29, 1.56 and 3.35 (2.50, 4.47, respectively, and significantly greater for parenteral than oral drugs (p for interaction Conclusions The collective evidence revealed the tendency of increased AMI risk with current use of some NSAIDs. A higher AMI risk associated with use of parenteral NSAIDs was observed in the present study. Ketorolac had the highest associated risk in both oral and parenteral NSAIDs studied. Though further investigation to confirm the association is warranted, prescribing physicians and the general public should be cautious about the potential risk of AMI when using NSAIDs.

High-risk respiratory patients' experiences of bronchoscopy with conscious sedation and analgesia: A qualitative study.

Science.gov (United States)

Saxon, Catherine; Fulbrook, Paul; Fong, Kwun M; Ski, Chantal F

2017-10-20

To understand the experiences of high-risk respiratory patients undergoing bronchoscopy with conscious sedation. Due to possible complications, high-risk respiratory patients are usually given smaller, cautious doses of sedation and analgesia for bronchoscopy. Described as "conscious sedation," this facilitates depression of the patient's consciousness without causing respiratory compromise. Previously, studies have investigated patient experience using quantitative methods. This is the first study that has explored the patient experience during bronchoscopy from a qualitative perspective. Qualitative, phenomenological approach as described by Van Manen. The setting was an endoscopy unit within an Australian tertiary hospital. Unstructured interviews were conducted with 13 patients with chronic obstructive pulmonary disease who underwent day-case bronchoscopy. All participants received conscious sedation. They were interviewed twice, within a week, postprocedure. Interviews were transcribed verbatim and analysed using Van Manen's interpretive approach. Participants had varying experiences. Five themes emerged from the analysis: Frustration and fear; Comfort and safety; Choking and coughing; Being aware; and Consequences. Whilst not all participants experienced procedural awareness or remembered it, for those who did it was a significant event. Overall, experiences were found to be negative; however, participants accepted and tolerated them, perceiving them as necessary to obtain a diagnostic result. The findings demonstrate that often patients are aware during the procedure and their experience may be uncomfortable and distressing. These findings have implications for patient preparation pre- and post-bronchoscopy in terms of what they might expect, and to discuss what has happened after the procedure. Some practices of the bronchoscopy team during the procedure may need modification. For example, in anticipation of the possibility that the patient may be aware

V/STOL Shipboard Recovery: "It's Not Just Another Carrier Landing"

National Research Council Canada - National Science Library

Shorter, Andrew

2002-01-01

.... The USMC Harrier force trains and operates at less than its full potential because of the tendency to unnecessarily apply conventional aircraft carrier training and operating procedures to the Harrier...

Selecting An Open Access Journal for Publication: Be Cautious

Science.gov (United States)

Hoffecker, Lilian; Hastings-Tolsma, Marie; Vincent, Deborah; Zuniga, Heidi

2015-12-04

Nurse scholars and clinicians seek to publish their research and scholarly findings to strengthen both nursing science and clinical practice. Traditionally subscription-based publications have been the mainstay of knowledge dissemination. However, subscription costs have tended to restrict access to many journals to a small, specialized, academic community, a limitation that has contributed to the development of open access (OA) publications. OA journals have a powerful appeal as they allow greater access to scholars and consumers on a global level. However, many OA journals depend on an author-pays model that may lead to unintended and undesirable consequences for authors. Today, it is easier than ever to share scholarly findings, but authors need to be vigilant when selecting a journal in which to publish. In this article, we discuss the background of open access journals and describe key consideration to distinguish between reputable publications and those that may lead authors astray. We conclude that despite controversy and concerns related to publishing in OA journals, these journals do provide opportunities for researchers and clinicians to raise the profile of their work and ensure a robust, scholarly communication system.

Governments should implement energy-efficiency standards and labels--cautiously

International Nuclear Information System (INIS)

Wiel, Stephen; McMahon, James E.

2003-01-01

Energy-efficiency standards and labels can be the most effective long-term energy-efficiency policy any government can implement. This paper describes: (1) the benefits that can be obtained through this policy, (2) which countries are implementing standards and labels and for which products, (3) the processes they are using at each step along the way including the reasons why each step must be done carefully and thoroughly, and (4) the relationship of standard-setting and labeling to other energy-efficiency policies

S. Korea nuclear: a cautious path to self-reliance

International Nuclear Information System (INIS)

Anon.

1994-01-01

The South Korean nuclear power industry is described in this article. By comparing policy on nuclear technology in North and South Korea, differing political allegiances are highlighted. South Korea, rather than pursuing nuclear weapons capability like North Korea, has worked hard to produce a rapidly expanding nuclear powered electricity supply industry, which is described. Government targets which aim to meet predicted increases in demand for electricity are noted, but the problems of waste management and reprocessing have yet to be solved. (UK)

Limits for Beam Induced Damage: Reckless or too Cautious?

CERN Document Server

Bertarelli, A; Carra, F; Cerutti, F; Dallocchio, A; Mariani, N; Peroni, L; Scapin, M

2011-01-01

Accidental events implying direct beam impacts on collimators are of the utmost importance as they may lead to serious limitations of the overall LHC Performance. In order to assess damage threshold of components impacted by high energy density beams, entailing changes of phase and extreme pressures, state-of-the-art numerical simulation methods are required. In this paper, a review of the different dynamic response regimes induced by particle beams is given along with an indication of the most suited tools to treat each regime. Particular attention is paid to the most critical case, that of shock waves, for which standard Finite Element codes are totally unfit. A novel category of numerical tools, named Hydrocodes, has been adapted and used to analyse the consequences of an asynchronous beam abort on Phase 1 Tertiary Collimators (TCT). A number of simulations has been carried out with varying beam energy, number of bunches and bunch sizes allowing to identify different damage levels for the TCT up to catastr...

African Journal of Drug & Alcohol Studies, 14(2), 2015 Copyright ...

African Journals Online (AJOL)

Barriers to the management of substance use disorders included the following: perceived high costs ... unnecessarily long waiting time, attitudinal problems, cultural issues resulting in relapse, perceived ..... health services to Asian Americans.

Depression and Anxiety Prevention Based on Cognitive Behavioral Therapy for At-Risk Adolescents: A Meta-Analytic Review

Directory of Open Access Journals (Sweden)

Sanne P. A. Rasing

2017-06-01

Full Text Available Depression and anxiety disorders are among the most common mental disorders during adolescence. During this life phase, the incidence of these clinical disorders rises dramatically, and even more adolescents suffer from symptoms of depression or anxiety that are just below the clinical threshold. Both clinical and subclinical levels of depression or anxiety symptoms are related to decreased functioning in various areas, such as social and academic functioning. Prevention of depression and anxiety in adolescents is therefore imperative. We conducted a meta-analytic review of the effects of school-based and community-based prevention programs that are based on cognitive behavioral therapy with the primary goal preventing depression, anxiety, or both in high risk adolescents. Articles were obtained by searching databases and hand searching reference lists of relevant articles and reviews. The selection process yielded 32 articles in the meta-analyses. One article reported on two studies and three articles reported on both depression and anxiety. This resulted in a total of 36 studies, 23 on depression and 13 on anxiety. For depression prevention aimed at high risk adolescents, meta-analysis showed a small effect of prevention programs directly after the intervention, but no effect at 3–6 months and at 12 months follow-up. For anxiety prevention aimed at high risk adolescents, no short-term effect was found, nor at 12 months follow-up. Three to six months after the preventive intervention, symptoms of anxiety were significantly decreased. Although effects on depression and anxiety symptoms were small and temporary, current findings cautiously suggest that depression and anxiety prevention programs based on CBT might have small effects on mental health of adolescents. However, it also indicates that there is still much to be gained for prevention programs. Current findings and possibilities for future research are discussed in order to further

Pharmacotherapy at the end-of-life.

LENUS (Irish Health Repository)

O'Mahony, Denis

2011-07-01

Older people reaching end-of-life status are particularly at risk from inter-related adverse effects of pharmacotherapy, including polypharmacy, inappropriate medications and adverse drug events. These adverse effects of pharmacotherapy may be highly detrimental, as well as highly expensive. End-of-life pharmacotherapy is sometimes perceived to be complex and challenging, probably unnecessarily. This relates in part to the poorly developed evidence base and lack of high-quality research in this area. In this article, we deal with some of the key issues relating to pharmacotherapy in end-of-life patients, namely (i) the guiding principles of drug selection, (ii) the main drugs and drug classes that are best avoided, (iii) the benefits of \\'oligopharmacy\\' (i.e. deliberate avoidance of polypharmacy) in end-of-life patients.

Dairy farms testing positive for Mycobacterium avium ssp. paratuberculosis have poorer hygiene practices and are less cautious when purchasing cattle than test-negative herds.

Science.gov (United States)

Wolf, R; Barkema, H W; De Buck, J; Orsel, K

2016-06-01

Mycobacterium avium ssp. paratuberculosis (MAP), the causative agent of Johne's disease, is present on most dairy farms in Alberta, causing economic losses and presenting a potential public health concern. The objective of this cross-sectional study was to identify risk factors for Alberta dairy herds being MAP-positive based on environmental samples (ES). Risk assessments were conducted and ES were collected on 354 Alberta dairy farms (62% of eligible producers) voluntarily participating in the Alberta Johne's Disease Initiative. In univariate logistic regression, risk factors addressing animal and pen hygiene, as well as the use of feeding equipment to remove manure and manure application on pastures, were all associated with the number of positive ES. Furthermore, based on factor analysis, risk factors were clustered and could be summarized as 4 independent factors: (1) animal, pen, and feeder contamination; (2) shared equipment and pasture contamination; (3) calf diet; and (4) cattle purchase. Using these factor scores as independent variables in multivariate logistic regression models, a 1-unit increase in animal, pen, and feeder contamination resulted in 1.31 times higher odds of having at least 1 positive ES. Furthermore, a 1-unit increase in cattle purchase also resulted in 1.31 times the odds of having at least 1 positive ES. Finally, a 100-cow increase in herd size resulted in an odds ratio of 2.1 for having at least 1 positive ES. In conclusion, cleanliness of animals, pens, and feeders, as well as cattle purchase practices, affected risk of herd infection with MAP. Therefore, improvements in those management practices should be the focus of effective tools to control MAP on dairy farms. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Cancer and low dose responses In Vivo: implications for radiation protection

Energy Technology Data Exchange (ETDEWEB)

Mitchel, R.E.J. [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada)

2006-12-15

This paper discusses the linear no-threshold (LNT) hypothesis, risk prediction and radiation protection. The summary implications for the radiation protection system are that at low doses the conceptual basis of the present system appears to be incorrect. The belief that the current system embodies the precautionary principle and that the LNT assumption is cautious appears incorrect. The concept of dose additivity appears incorrect. Effective dose (Sievert) and the weighting factors on which it is based appear to be invalid. There may be no constant and appropriate value of DDREF for radiological protection dosimetry. The use of dose as a predictor of risk needs to be re-examined. The use of dose limits as a means of limiting risk need to be re-evaluated.

Mountain biking. Breezy ups and traumatic downs

International Nuclear Information System (INIS)

Schueller, G.

2010-01-01

For more than two decades the popularity of mountain biking as a national pastime as well as a competitive sport has been undiminished. However, its related risks are not monitored as closely as those, for example, of skiing. The injuries caused by mountain biking are specific and cannot be compared with those caused by other cycling sports. This is due not only to the characteristics of the terrain but also to the readiness to assume a higher risk compared to cycle racing. The particular value of radiology is in the acute trauma setting. Most often musculoskeletal lesions must be examined and digital radiography and MRI are the most useful techniques. Severe trauma of the cranium, face, spine, thorax and abdomen are primarily evaluated with CT, particularly in dedicated trauma centers. Therefore, radiology can play a role in the rapid diagnosis and optimal treatment of the trauma-related injuries of mountain biking. Thus, the unnecessarily high economical damage associated with mountain biking can be avoided. (orig.) [de

[Mountain biking : Breezy ups and traumatic downs].

Science.gov (United States)

Schueller, G

2010-05-01

For more than two decades the popularity of mountain biking as a national pastime as well as a competitive sport has been undiminished. However, its related risks are not monitored as closely as those, for example, of skiing. The injuries caused by mountain biking are specific and cannot be compared with those caused by other cycling sports. This is due not only to the characteristics of the terrain but also to the readiness to assume a higher risk compared to cycle racing.The particular value of radiology is in the acute trauma setting. Most often musculoskeletal lesions must be examined and digital radiography and MRI are the most useful techniques. Severe trauma of the cranium, face, spine, thorax and abdomen are primarily evaluated with CT, particularly in dedicated trauma centers. Therefore, radiology can play a role in the rapid diagnosis and optimal treatment of the trauma-related injuries of mountain biking. Thus, the unnecessarily high economical damage associated with mountain biking can be avoided.

Economic valuation of a toll road concession with traffic guarantees and the abandonment option

Directory of Open Access Journals (Sweden)

Frances Fischberg Blank

2016-03-01

Full Text Available Abstract Governments worldwide have been encouraging private participation in transportation infrastructure. To increase the feasibility of a project, public-private partnership (PPP may include guarantees or other support to reduce the risks for private investors. It is necessary to value these opportunities under a real options framework and thereby analyze the project's economic feasibility and risk allocation. However, within this structure, sponsors have an implicit option to abandon the project that should be simultaneously valued. Thus, this article proposes a hypothetical toll road concession in Brazil with a minimum traffic guarantee, a maximum traffic ceiling, and an implicit abandonment option. Different combinations of the minimum and maximum levels are presented, resulting in very high or even negative value added to the net present value (NPV. The abandonment option impacts the level of guarantee to be given. Governments should calibrate an optimal level of guarantees to avoid unnecessarily high costs, protect the returns of the sponsor, and lower the probability of abandonment.

Combined use of drugs inhibiting the renin-angiotensin system: prescribing patterns and risk of acute kidney injury in German nursing home residents.

Science.gov (United States)

Dörks, Michael; Herget-Rosenthal, Stefan; Hoffmann, Falk; Jobski, Kathrin

2018-01-01

In 2012, the European Medicines Agency reviewed the safety of dual renin-angiotensin system (RAS) blockade because of potentially increased risks for inter alia acute kidney injury (AKI). Since residents of nursing homes are particularly vulnerable to adverse drug outcomes, the aims of our study were to describe RAS-inhibiting drug use in German nursing home residents and examine the risk of AKI associated with dual RAS blockade. Based on claims data, a nested case-control study within a cohort of RAS-inhibiting drug users was conducted. Using conditional logistic regression, confounder-adjusted odds ratios (aORs) and 95% confidence intervals (CI) were obtained for the risk of AKI associated with dual RAS blockade. Subgroup analyses were performed in patients with diabetes or chronic kidney disease and both comorbidities. Of all 127,227 nursing home residents, the study cohort included 64,567 (50.7%) who were treated with at least one RAS-inhibiting drug. More than three quarters of the study population were female (77.1%). Mean age was 86.0 ± 6.8 years. Most residents were treated with angiotensin-converting enzyme inhibitors (77.8%), followed by angiotensin II receptor blockers (21.6%) and aliskiren (0.2%). Annual prevalence of dual RAS blockade declined from 9.6 (95% CI 7.8-11.8) in 2010 to 4.7 (95% CI 4.0-5.4) per 1,000 users in 2014. In the overall cohort, AKI was not significantly associated with dual RAS blockade (aOR 1.99; 0.77-5.17). However, significantly increased aORs were observed when considering patients with diabetes (3.47; 1.27-9.47), chronic kidney disease (4.74; 1.24-18.13) or both (11.17; 2.65-47.15). Prescribing of drugs inhibiting the RAS is common in German nursing homes. Though the prevalence of dual RAS blockade declined, our study showed an increased risk of AKI in patients with diabetes and/or chronic kidney disease. Therefore, cautious use is warranted in these vulnerable patients.

Joint Hub Network Development

OpenAIRE

Cruijssen, F.C.A.M.; Borm, P.E.M.; Dullaert, W.; Hamers, H.J.M.

2007-01-01

This paper introduces a framework for joint hub network development. Building a joint physical hub for transhipment of goods is expensive and therefore involves considerable risks for the cooperating companies. In a practical setting, it is unlikely that an entire network will be built at once. Rather, the partners will have a more cautious attitude and build the hub facilities one-by-one. In the proposed framework, every time a new hub is introduced, partners will have the opportunity to dec...

Poker Player Behavior After Big Wins and Big Losses

OpenAIRE

Gary Smith; Michael Levere; Robert Kurtzman

2009-01-01

We find that experienced poker players typically change their style of play after winning or losing a big pot--most notably, playing less cautiously after a big loss, evidently hoping for lucky cards that will erase their loss. This finding is consistent with Kahneman and Tversky's (Kahneman, D., A. Tversky. 1979. Prospect theory: An analysis of decision under risk. Econometrica 47(2) 263-292) break-even hypothesis and suggests that when investors incur a large loss, it might be time to take ...

Henok Abebe Gebeyehu The Anti-Terrorism Proclamation of ...

African Journals Online (AJOL)

2009-08-28

Aug 28, 2009 ... National Intelligence and Security Service a power to conduct surveillance or intercept any ..... The government prohibits the distribution and sale of ...... An absolute denial of the privilege will unnecessarily hamper the media.

Assessment of children's nutritional attitudes before oral food challenges to identify patients at risk of food reintroduction failure: a prospective study.

Science.gov (United States)

Polloni, L; Ferruzza, E; Ronconi, L; Toniolo, A; Lazzarotto, F; Bonaguro, R; Celegato, N; Muraro, A

2017-05-01

Inappropriate dietary eliminations may impair quality of life, affect children's growth and unnecessarily impact on healthcare costs. Previous retrospective studies reported that around 25% of children continue a food-avoidance diet despite a negative oral food challenge (OFC). A definite pattern has not been found yet for patients not reintroducing the food. This study aimed to examine the role of child's nutritional attitudes and maternal anxiety in reintroducing food after a negative OFC. A prospective study was conducted involving 81 mothers of children with IgE-mediated food allergy. They completed a survey on nutritional behaviour and attitudes and the State-Trait Anxiety Inventory on the day of OFC and 6 months later. In total, 11.1% of children never or rarely ate the food after a negative OFC. Consumption of the reintroduced food is positively correlated to child's interest in tasting new foods before and after OFC and to changes in child's nutritional habits after OFC. It is negatively correlated to monotony of the diet after OFC. No correlations were found with other participants' characteristics or maternal anxiety. State anxiety significantly decreased after the OFC. A correlation was found between trait and state anxiety and the degree of change in nutritional habits after OFC. Evaluating child's approach towards food before the OFC is a promising approach to identify patients at risk of food reintroduction failure. Furthermore, it underlined the importance of reassessing food consumption in all patients after a negative OFC and supporting patients in the reintroduction of food. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Use of Cone Beam Computed Tomography in endodontics: rational case selection criteria].

Science.gov (United States)

Rosen, E; Tsesis, I

2016-01-01

To present rational case selection criteria for the use of CBCT (Cone Beam Computed Tomography) in endodontics. This article reviews the literature concerning the benefits of CBCT in endodontics, alongside its radiation risks, and present case selection criteria for referral of endodontic patients to CBCT. Up to date, the expected ultimate benefit of CBCT to the endodontic patient is yet uncertain, and the current literature is mainly restricted to its technical efficacy. In addition, the potential radiation risks of CBCT scan are stochastic in nature and uncertain, and are worrying especially in pediatric patients. Both the efficacy of CBCT in supporting the endodontic practitioner decision making and in affecting treatment outcomes, and its long term potential radiation risks are yet uncertain. Therefore, a cautious rational decision making is essential when a CBCT scan is considered in endodontics. Risk-benefit considerations are presented.

On high-temperature reactor accident topology

International Nuclear Information System (INIS)

Fassbender, J.; Kroeger, W.; Wolters, J.

1981-01-01

American and German risk studies for an HTGR and independent investigations of hypothetical accident sequences led to a fundamental understanding of the topology of HTGR accident sequences. The dominating importance of core heat-up accidents was confirmed and the initiating events were identified. Complications of core heat-up accidents by air or water ingress are of minor importance for the risk, whereas the long-term development of accidents during days and weeks plays an important role for the environmental impact. The risk caused by an HTGR at a German site cannot yet be determined exactly, because no modern German HTGR design has passed a licensing procedure. Cautious estimates show that risk will appear to be substantially smaller than the LWR risk. The main reasons are the considerably reduced release of fission procucts and the slow development of core heat-up accidents leaving much time for measures which reduce the risk. (orig.) [de

Search Results | Page 23 | IDRC - International Development ...

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

Results 221 - 230 of 8491 ... Filter by type .... Scholars from Asia and Africa exchange knowledge at CPR South Conference in Myanmar ... In much of the developing world, women unnecessarily suffer higher rates of maternal mortality and ...

When and How to Take Antibiotics

Science.gov (United States)

... bacterial balance, it may cause stomach upsets, diarrhea, vaginal infections, or other problems. If you take antibiotics unnecessarily ... before taking antibiotics? Antibiotics often lead to a vaginal yeast infection. Because antibiotics kill the normal bacteria in the ...

Evaluation of gait characteristics and ground reaction forces in cognitively declined older adults with an emphasis on slip-induced falls.

Science.gov (United States)

Lockhart, Thurmon; Kim, Sukwon; Kapur, Radhika; Jarrott, Shannon

2009-01-01

The objective of the present study was to evaluate the relationship between gait adaptation and slip/fall risk of older adults with cognitive impairments. The study investigated the gait characteristics of six healthy older adults and five older adults with dementia. Participants walked on an instrumented walkway at their preferred walking speeds. After ensuring that the preferred walking speeds were consistent, participants' natural posture and ground reaction forces were measured. The results suggested that participants with dementia walked more cautiously yet demanded more friction at the shoe/floor interface at the time of heel contact, increasing the risk of slip initiation. To reduce the risk of slip-induced falls among older adults with dementia, specific gait training to reduce friction demand requirements by increasing the transfer speed of the whole body mass is suggested.

Passive muscle properties are altered in children with cerebral palsy before the age of 3 years and are difficult to distinguish clinically from spasticity

DEFF Research Database (Denmark)

Willerslev-Olsen, Maria; Lorentzen, Jakob; Sinkjær, Thomas

2013-01-01

AIM: Clinical determination of spasticity is confounded by the difficulty in distinguishing reflex from passive contributions to muscle stiffness. There is, therefore, a risk that children with cerebral palsy (CP) receive antispasticity treatment unnecessarily. To investigate this, we aimed...... to determine the contribution of reflex mechanisms to changes in the passive elastic properties of muscles and tendons in children with CP. METHOD: Biomechanical and electrophysiological measures were used to determine the relative contribution of reflex and passive mechanisms to ankle muscle stiffness in 35...... tetraplegia. According to the Gross Motor Function Classification System, 31 children were classified in level I, two in level II, and two in level III. RESULTS: Only seven children with spastic CP showed reflex stiffness outside the range of the control children. In contrast, 20 children with spastic CP...

Radiation protection for the parent and child in diagnostic nuclear medicine

International Nuclear Information System (INIS)

Mountford, P.J.

1991-01-01

Administration of a radiopharmaceutical to a parent or child for diagnostic purposes will result in certain specific radiation hazards, yet it can yield information vital to patient management. These hazards have been cited as a reason for the reluctance of some referring clinicians and, indeed, nuclear medicine practitioners to exploit paediatric radiopharmaceutical investigations (Piepsz et al. 1991). Ignorance of these hazards has the following consequences. Firstly, a valuable diagnostic procedure could be denied to a parent or child patient without justification, thereby compromising their management. Secondly, inappropriate recommendations could result in either excessive restrictions or an unnecessarily high radiation dose to a patient's family and to hospital staff. All members of a nuclear medicine service should be familiar with these radiation risks in order to provide appropriate guidance and to dispel any unwarranted fears. (orig.)

Power and Caution: The Ethics of Self-Disclosure

Science.gov (United States)

Ejsing, Anette

2007-01-01

Good teaching is both powerful and cautious. It is powerful insofar as it creates engaged students. Because an engaged mind is particularly receptive, however, good teaching is also cautious insofar as it provides students with focused guidance through the process of appropriating the learning material. This article reflects critically on…

Combination of uncertainty theories and decision-aiding methods for natural risk management in a context of imperfect information

Science.gov (United States)

Tacnet, Jean-Marc; Dupouy, Guillaume; Carladous, Simon; Dezert, Jean; Batton-Hubert, Mireille

2017-04-01

In mountain areas, natural phenomena such as snow avalanches, debris-flows and rock-falls, put people and objects at risk with sometimes dramatic consequences. Risk is classically considered as a combination of hazard, the combination of the intensity and frequency of the phenomenon, and vulnerability which corresponds to the consequences of the phenomenon on exposed people and material assets. Risk management consists in identifying the risk level as well as choosing the best strategies for risk prevention, i.e. mitigation. In the context of natural phenomena in mountainous areas, technical and scientific knowledge is often lacking. Risk management decisions are therefore based on imperfect information. This information comes from more or less reliable sources ranging from historical data, expert assessments, numerical simulations etc. Finally, risk management decisions are the result of complex knowledge management and reasoning processes. Tracing the information and propagating information quality from data acquisition to decisions are therefore important steps in the decision-making process. One major goal today is therefore to assist decision-making while considering the availability, quality and reliability of information content and sources. A global integrated framework is proposed to improve the risk management process in a context of information imperfection provided by more or less reliable sources: uncertainty as well as imprecision, inconsistency and incompleteness are considered. Several methods are used and associated in an original way: sequential decision context description, development of specific multi-criteria decision-making methods, imperfection propagation in numerical modeling and information fusion. This framework not only assists in decision-making but also traces the process and evaluates the impact of information quality on decision-making. We focus and present two main developments. The first one relates to uncertainty and imprecision

Adolescents' risk perceptions on mobile phones and their base stations, their trust to authorities and incivility in using mobile phones: a cross-sectional survey on 2240 high school students in Izmir, Turkey.

Science.gov (United States)

Hassoy, Hur; Durusoy, Raika; Karababa, Ali Osman

2013-01-25

Use of mobile phones has rapidly risen among adolescents despite a lack of scientific certainty on their health risks. Risk perception is an important determinant of behavior, and studies on adolescents' risk perceptions of mobile phones or base stations are very scarce. This study aims to evaluate high school students' risk perceptions on mobile phones and base stations, their trust to authorities, their opinions regarding incivility while using mobile phones and to assess associated factors. For this cross-sectional study, 2530 students were chosen with stratified cluster sampling among 20,493 high school students studying in Bornova district of Izmir, Turkey, among whom 2240 (88.5%) participated. Risk perceptions and opinions were questioned with a 5-point Likert scale for 24 statements grouped under four dimensions. The mean responses to the four dimensions were categorized as mobile phone, base station, trust to authority and incivility dimensions were 3.69 ± 0.89, 4.34 ± 0.78, 3.77 ± 0.93, 3.16 ± 0.93 and the prevalence of high risk perception was 65.1%, 86.7%, 66.2%, 39.7%, respectively. In the mobile phone dimension; students attending industrial technical high school had lower risk perceptions while female students, lower mothers' education groups and students not using mobile phones (OR = 2.82, 95% CI = 1.80-4.40) had higher risk perceptions. In the base station dimension girls had higher risk perceptions (OR = 1.68, 95% CI = 1.20-2.37). Girls and students attending industrial technical high school had significantly lower risk perception however 11-12th grade group perceived the risk higher (OR = 1.45 95% CI = 1.15-1.84) in the trust to authority dimension. For the incivility dimension, female students (OR = 1.44, 95% CI = 1.14-1.82), illiterate/only literate mothers (OR = 1.79, 95% CI = 1.04-2.75) and students not using mobile phones (OR = 2.50, 95% CI = 1.62-3.87) perceived higher risk. Understanding the effects of these determinants might aid in

Eksamen påvirker alment velbefindende

DEFF Research Database (Denmark)

Louring-Andersen, Martin; Qazi, Saddiq; Schroeder, Torben V

2010-01-01

Objective structured clinical examination (OSCE) is a new and professionally acknowledged examination used in the evaluation of medical students. Students have criticized OSCE for being unnecessarily stressful. This study examines the effects of OSCE on students, examiners and examination...

Regulation of online pharmacy: an Australian perspective.

Science.gov (United States)

Bernath, Paul

2003-02-01

This article argues that existing Australian regulations do not adequately cover online pharmacies or Internet advertising of medicines and that existing penalties and sanctions are often ineffective, potentially placing public health and safety at risk. Suggestions are made for future regulatory approaches. It is concluded that as well as an effective program of public education, cautious domestic legislative reform is necessary to ensure specific regulation of Australian online pharmacy practice and Internet advertising of medicines. In addition, the global nature of the Internet demands international co-operation and increased regulator and consumer vigilance.

Health disparities and clinical trial recruitment: Is there a duty to tweet?

Science.gov (United States)

Friesen, Phoebe

2017-01-01

While it is well known that the homogeneity of clinical trial participants often threatens the goal of attaining generalizable knowledge, researchers often cite issues with recruitment, including a lack of interest from participants, shortages of resources, or difficulty accessing particular populations, to explain the lack of diversity within sampling. It is proposed that social media might provide an opportunity to overcome these obstacles through affordable, targeted recruitment advertisements or messages. Recruiters are warned, however, to be cautious using these means, since risks related to privacy and transparency can take on a new hue. PMID:28249024

Supervising UAVs : improving operator performance by optimizing the human factor

NARCIS (Netherlands)

Breda, L. van; Jansen, C.; Veltman, J.A.

2005-01-01

Tele-operated unmanned aerial vehicles (UAVs) have no operators on board and therefore enable extension of the present sensing and communication capabilities in civil and military missions, without unnecessarily endangering personnel or deploying expensive material. One should also realize that

Cuff deflation: rehabilitation in critical care.

Science.gov (United States)

Bach, John R; Gonçalves, Miguel R; Rodriguez, Pedro Landete; Saporito, Louis; Soares, Luisa

2014-08-01

This is a case series of rehabilitation failures that resulted in severe reactive depression from patients unnecessarily bereft of verbal communication by being left to breathe or be ventilated via tracheostomy tubes, with or without inflated cuffs, for months to years.

Determinants of Patient Waiting Time in the General Outpatient ...

African Journals Online (AJOL)

obtaining services and keeping patients waiting unnecessarily can be a cause of stress for both .... Simple random sampling was done for the first two patients to get the starting ... record clerks (12% [9/76]), and jumping of queue by patients.

The overprotection of Mars

Science.gov (United States)

Fairén, Alberto G.; Schulze-Makuch, Dirk

2013-07-01

Planetary protection policies aim to guard Solar System bodies from biological contamination from spacecraft. Costly efforts to sterilize Mars spacecraft need to be re-evaluated, as they are unnecessarily inhibiting a more ambitious agenda to search for extant life on Mars.

Should patient groups accept money from drug companies? No

OpenAIRE

Mintzes, Barbara

2007-01-01

Patient groups provide valuable support and advocacy for vulnerable people but funding the work can be difficult. Alastair Kent argues that not accepting industry money will unnecessarily limit the groups' effectiveness, but Barbara Mintzes believes that the money undermines their independence

Should patient groups accept money from drug companies? Yes

OpenAIRE

Kent, Alastair

2007-01-01

Patient groups provide valuable support and advocacy for vulnerable people but funding the work can be difficult. Alastair Kent argues that not accepting industry money will unnecessarily limit the groups' effectiveness, but Barbara Mintzes believes that the money undermines their independence

The influence of readibility of examination questions on achievement in senior secondary school mathematics : a study on verbal problems with special reference to second language readers

NARCIS (Netherlands)

Prins, E.D.

1995-01-01

This study investigates the influence of readability of mathematics examination questions on achievement. The aim of any mathematics examination is to assess whether the aims of a specific mathematics programme have been realized. Readability factors that unnecessarily prevent a clear understanding

Prescribing medical cannabis in Canada: Are we being too cautious?

Science.gov (United States)

Lake, Stephanie; Kerr, Thomas; Montaner, Julio

2015-04-30

There has been much recent discussion and debate surrounding cannabis in Canada, including the prescribing of medical cannabis for therapeutic purposes. Certain commentators - including the Canadian Medical Association (CMA) - have denounced the prescribing of cannabis for medical purposes due to a perceived lack of evidence related to the drug's efficacy, harms, and mechanism of action. In this commentary, we present arguments in favour of prescribing medical cannabis in Canada. We believe the anti-cannabis position taken by CMA and other commentators is not entirely evidence-based. Using the example of neuropathic pain, we present and summarize the clinical evidence surrounding smoked or vapourized cannabis, including recent evidence pertaining to the effectiveness of cannabis in comparison to existing standard pharmacotherapies for neuropathy. Further, we outline how the concerns expressed regarding cannabis' mechanism of action are inconsistent with current decision-making processes related to the prescribing of many common pharmaceuticals. Finally, we discuss potential secondary public health benefits of prescribing cannabis for pain-related disorders in Canada and North America.

IRANIAN SCIENCE: Iran's Scientists Cautiously Reach Out to the World.

Science.gov (United States)

Koenig, R

2000-11-24

Two decades after Iran's Islamic revolution, science in this politically isolated but oil-rich nation may be on the verge of resurgence. The nation's reform-minded president, Mohammad Khatami, and his allies are promising more money for R&D, reorganizing universities to beef up graduate education and research, and cracking open the door to closer cooperation with scientists abroad, including those in the United States. But Iran's government is walking a tightrope between hard-liners on the right who oppose reforms and liberal university students eager for change.

Lithuania is cautious regarding sanctions against Minsk / Rokas M. Tracevskis

Index Scriptorium Estoniae

Tracevskis, Rokas M.

2011-01-01

23. mail toimus Valgevenes devalvatsioon. Poola välisminister Radoslaw Sikorski üritab veenda Euroopa Liitu Valgevene suhtes majandussanktsioone rakendama. Läti ja Leedu ei ole sellega nõus. 23. mail toimunud president Dalia Grybauskaite ja peaminister Andrius Kubiliuse kohtumisel räägiti Valgevene teemadel

Bold or cautious : behavioural characteristics and dominance in great tits

NARCIS (Netherlands)

Verbeek, M.

1998-01-01

Social dominance affects territory acquisition, reproduction and survival in many species. It plays a major role in the life of an individual, and has important consequences for its fitness. Several factors that can influence dominance relationships between individuals have been well

Integrity management of offshore structures and its implication on computation of structural action effects and resistance

Science.gov (United States)

Moan, T.

2017-12-01

An overview of integrity management of offshore structures, with emphasis on the oil and gas energy sector, is given. Based on relevant accident experiences and means to control the associated risks, accidents are categorized from a technical-physical as well as human and organizational point of view. Structural risk relates to extreme actions as well as structural degradation. Risk mitigation measures, including adequate design criteria, inspection, repair and maintenance as well as quality assurance and control of engineering processes, are briefly outlined. The current status of risk and reliability methodology to aid decisions in the integrity management is briefly reviewed. Finally, the need to balance the uncertainties in data, methods and computational efforts and the cautious use and quality assurance and control in applying high fidelity methods to avoid human errors, is emphasized, and with a plea to develop both high fidelity as well as efficient, simplified methods for design.

Signal treatments to reduce heavy vehicle crash-risk at metropolitan highway intersections.

Science.gov (United States)

Archer, Jeffery; Young, William

2009-05-01

Heavy vehicle red-light running at intersections is a common safety problem that has severe consequences. This paper investigates alternative signal treatments that address this issue. A micro-simulation analysis approach was adopted as a precursor to a field trial. The simulation model emulated traffic conditions at a known problem intersection and provided a baseline measure to compare the effects of: an extension of amber time; an extension of green for heavy vehicles detected in the dilemma zone at the onset of amber; an extension of the all-red safety-clearance time based on the detection of vehicles considered likely to run the red light at two detector locations during amber; an extension of the all-red safety-clearance time based on the detection of potential red-light runners during amber or red; and a combination of the second and fourth alternatives. Results suggested safety improvements for all treatments. An extension of amber provided the best safety effect but is known to be prone to behavioural adaptation effects and wastes traffic movement time unnecessarily. A green extension for heavy vehicles detected in the dilemma zone and an all-red extension for potential red-light runners were deemed to provide a sustainable safety improvement and operational efficiency.

Implementation of a chest pain management service improves patient care and reduces length of stay.

Science.gov (United States)

Scott, Adam C; O'Dwyer, Kristina M; Cullen, Louise; Brown, Anthony; Denaro, Charles; Parsonage, William

2014-03-01

Chest pain is one of the most common complaints in patients presenting to an emergency department. Delays in management due to a lack of readily available objective tests to risk stratify patients with possible acute coronary syndromes can lead to an unnecessarily lengthy admission placing pressure on hospital beds or inappropriate discharge. The need for a co-ordinated system of clinical management based on enhanced communication between departments, timely and appropriate triage, clinical investigation, diagnosis, and treatment was identified. An evidence-based Chest Pain Management Service and clinical pathway were developed and implemented, including the introduction of after-hours exercise stress testing. Between November 2005 and March 2013, 5662 patients were managed according to a Chest Pain Management pathway resulting in a reduction of 5181 admission nights by more timely identification of patients at low risk who could then be discharged. In addition, 1360 days were avoided in high-risk patients who received earlier diagnosis and treatment. The creation of a Chest Pain Management pathway and the extended exercise stress testing service resulted in earlier discharge for low-risk patients; and timely treatment for patients with positive and equivocal exercise stress test results. This service demonstrated a significant saving in overnight admissions.

Behavioral risk factors of breast cancer in Bangui of Central African Republic: A retrospective case-control study.

Directory of Open Access Journals (Sweden)

Augustin Balekouzou

, groundnut, soybean, alcohol, habit of keeping money in bras, overweight and obesity were associated with breast cancer risk among Central African women living in Bangui. Women living in Bangui should be more cautious on the behavioral risk associated with breast cancer.

Design for Six Sigma in healthcare: developing an employee influenza vaccination process

NARCIS (Netherlands)

Kaplan, S.; Bisgaard, S.; Truesdell, D.; Zetterholm, S.

2009-01-01

Nonclinical healthcare processes are sometimes created on an ad hoc basis and hence over time may grow unnecessarily complex and difficult to assess, teach, improve, or transfer. Intentionally designing processes are more likely to yield an efficient and effective process. Originally developed in

75 FR 61541 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Science.gov (United States)

2010-10-05

... other corporate reorganization; providing venture capital, equity lines of credit, private investment... unnecessarily impacting the capital formation process.\\15\\ However, according to FINRA, if a member maintains... rule while avoiding an unnecessary impact on capital formation. In addition, by replacing references to...

Environmental and health impacts of successive mineral fertilization in Egypt

Energy Technology Data Exchange (ETDEWEB)

Abdelhafez, Ahmed A. [Soils, Water and Environment Research Institute (SWERI), Agricultural Research Center (ARC), Giza (Egypt); Key Laboratory of Yangtze River Water Environment, Ministry of Education, Tongji University, Shanghai (China); Abbas, Hassan H.; Abd-El-Aal, Rafat S. [Faculty of Agriculture, Benha University (Egypt); Kandil, Nabil F. [Soils, Water and Environment Research Institute (SWERI), Agricultural Research Center (ARC), Giza (Egypt); Li, Jianhua [Key Laboratory of Yangtze River Water Environment, Ministry of Education, Tongji University, Shanghai (China); Mahmoud, Wahballah [Center of Excellence of Biotechnology Research, King Saud University, Riyadh (Saudi Arabia)

2012-04-15

Excessive amounts of mineral fertilizers are unnecessarily applied to agricultural soils in Egypt to increase crop yield. The current study aims at assessing the impacts of fertilization with different mineral fertilizers for different cultivation periods on the accumulation of heavy metals in soils and plants grown thereon. In addition, human risks resulted due to the exposure to these metal ions through ingestion, and dermal routes were evaluated. Soil and plant samples were collected from several locations in El-Behira Governorate, Egypt and their heavy metal contents were measured. The result indicated that there is a continuous accumulation of heavy metals in the soils and the plants grown thereon. Calculation of the hazard index (HI) revealed that humans, especially children, have a potential health risk for both Pb and Cd, which have levels greater than the safe level (1). Finally, the obtained results showed that the continuous application of mineral fertilizers containing high levels of heavy metals pose a potential health threat. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

Re-activation of bovine tuberculosis in a patient treated with infliximab

DEFF Research Database (Denmark)

Larsen, Mette Vang; Thomsen, V Ø; Sørensen, Inge Juul

2008-01-01

Treatment with tumour necrosis factor-alpha inhibitors increases the risk of tuberculosis (TB). Screening for latent TB infection (LTBI) and prophylactic treatment has become mandatory. A 79-yr-old female with a history of severe erosive sero-positive rheumatoid arthritis was screened for LTBI......-infected cattle. Re-activation of bovine tuberculosis is a risk in people with recent or previous exposure to unpasteurised dairy products. The QuantiFERON-TB test has the potential to detect Mycobacterium bovis infection. Indeterminate test results reflect either anergy, due to poor immunity, or technical...... problems and should be cautiously interpreted and as a minimum be repeated. Studies are ongoing to determine the role of QuantiFERON-TB testing in the screening for latent tuberculosis infection....

Radiation protection for the parent and child in diagnostic nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Mountford, P.J. (Kent and Canterbury Hospital (UK). Dept. of Nuclear Medicine)

1991-12-01

Administration of a radiopharmaceutical to a parent or child for diagnostic purposes will result in certain specific radiation hazards, yet it can yield information vital to patient management. These hazards have been cited as a reason for the reluctance of some referring clinicians and, indeed, nuclear medicine practitioners to exploit paediatric radiopharmaceutical investigations (Piepsz et al. 1991). Ignorance of these hazards has the following consequences. Firstly, a valuable diagnostic procedure could be denied to a parent or child patient without justification, thereby compromising their management. Secondly, inappropriate recommendations could result in either excessive restrictions or an unnecessarily high radiation dose to a patient's family and to hospital staff. All members of a nuclear medicine service should be familiar with these radiation risks in order to provide appropriate guidance and to dispel any unwarranted fears. (orig.).

Indeterminacy and Spatiotemporal Data

DEFF Research Database (Denmark)

Pfoser, D.; Tryfona, N.; Jensen, Christian Søndergaard

2005-01-01

For some spatiotemporal applications, it can be assumed that the modeled world is precise and bounded, and that our record of it is precise. While these simplifying assumptions are sufficient in applications like a land information system, they are unnecessarily crude for many other applications...

Philips Electronics synchronizes its supply chain to end the bullwhip effect

NARCIS (Netherlands)

Kok, de A.G.; Janssen, F.B.S.L.P.; van Doremalen, J.B.M.; Wachem, van E.; Clerkx, M.J.R.; Peeters, W.

2005-01-01

Demand variability increases as one moves up a supply chain. The demand for finished products is less variable than for subassemblies, which is less variable than for individual components. This phenomenon is known as the bullwhip or Forrester effect. It increases inventory unnecessarily and makes

Automation technology for intelligent energy management. Communication with LON; Automatisierungstechnik ermoeglicht intelligentes Energiemanagement. Kommunikation mit LON

Energy Technology Data Exchange (ETDEWEB)

Leja, C. [Kriwan Industrie-Elektronik GmbH, Forchtenberg (Germany)

2008-09-15

Parallel operation of loads causes high load peaks and unnecessarily high energy cost. Energy management systems solve this problem by disconnecting loads selectively according to preset specifications. This contribution presents various strategies for LON-based automation systems, as well as some practical examples. (orig.)

A STUDY OF TWO DIRECTORIAL APPROACHES TO J. P. CLARK ...

African Journals Online (AJOL)

Mitch

Clark- Bekederemo is influenced by the Greeks in his creation of his Song of a Goat and ... figures making their actions seem unnecessarily arbitrary. (260). ..... as a person who does not feel any sense of guilt for the decision he takes. He does ...

Signal-to-Noise ratio and design complexity based on Unified Loss ...

African Journals Online (AJOL)

Taguchi's quality loss function for larger-the-better performance characteristics uses a reciprocal transformation to compute quality loss. This paper suggests that reciprocal transformation unnecessarily complicates and may distort results. Examples of this distortion include the signal-to-noise ratio based on mean squared ...

Sharpen Your Skills: Mathematics and Science Braille.

Science.gov (United States)

Eulert, Von E.; Cohn, Doris

1984-01-01

Three articles about mathematics and science braille are provided for braille transcribers and teachers of the visually handicapped. The first article discusses common problems such as setting braille writers incorrectly, duplicating transcribed materials unnecessarily, and incorrectly transcribing from typescript. The second article provides a…

Tariff Policy Applied in the Adriatic Oil Pipeline

International Nuclear Information System (INIS)

Skodlar, Z.; Poljak, J.

1995-01-01

The policy of energy costs of crude oil transportation by pipeline strongly encourages an operational regime which results in poor pump efficiency. Oil is being unnecessarily and for too long time retained in oil storage tanks, thus increasing evaporation losses. (author). 3 figs., 2 tabs

Data sharing and dual-use issues.

Science.gov (United States)

Bezuidenhout, Louise

2013-03-01

The concept of dual-use encapsulates the potential for well-intentioned, beneficial scientific research to also be misused by a third party for malicious ends. The concept of dual-use challenges scientists to look beyond the immediate outcomes of their research and to develop an awareness of possible future (mis)uses of scientific research. Since 2001 much attention has been paid to the possible need to regulate the dual-use potential of the life sciences. Regulation initiatives fall under two broad categories-those that develop the ethical education of scientists and foster an awareness and responsibility of dual-use issues, and those which assess the regulation of information being generated by current research. Both types of initiatives are premised on a cautious, risk-adverse philosophy which advocates careful examination of all future endpoints of research endeavors. This caution advocated within initiatives such as pre-publication review of journal articles contrasts to the obligation to share underpinning data sharing discussions. As the dual-use debate has yet to make a significant impact on data sharing discussions (and vice versa) it is possible that these two areas of knowledge control may present areas of ethical conflict for scientists, and thus need to be more closely examined. This paper examines the tension between the obligation to share exemplified by data sharing principles and the concerns raised by the risk-cautious culture of the dual-use debates. The paper concludes by reflecting on the issues of responsibility as raised by dual-use as relating to data sharing, such as the chain of custody for shared data.

A NEW GIS NITROGEN TRADING TOOL CONCEPT FOR CONSERVATION AND REDUCTION OF REACTIVE NITROGEN LOSSES TO THE ENVIRONMENT

Science.gov (United States)

Nitrogen inputs to agricultural systems are important for their sustainability. However, when N inputs are unnecessarily high, the excess can contribute to greater agricultural N losses that impact air, surface water and groundwater quality. It is paramount to reduce off-site transport of N by using...

Ongoing Activities to Facilitate Access to Supplementary Materials for Cartographic Education.

Science.gov (United States)

Anderson, Paul S.

A wealth of unpublished or unstructured educational materials for all aspects of cartographic instruction are widely dispersed and unnecessarily difficult to obtain. The Cartography Assistance Brochures Project of the Cartography Specialty Group of the Association of American Geographers (AAG), the North American Cartographic Information Society,…

Untreated pain, narcotics regulation, and global health ideologies.

Science.gov (United States)

King, Nicholas B; Fraser, Veronique

2013-01-01

Pain management is marginalized or ignored, with millions of people worldwide unnecessarily living with untreated pain. Reducing global inequalities in untreated pain requires a concerted global effort, say Veronique Fraser and colleagues, which must attend to the complexity of pain and promote multimodal, multidisciplinary pain management.

Restrictive Citizenship: Civic-Oriented Service-Learning Opportunities for All Students

Science.gov (United States)

Mann, Jay A.; Dymond, Stacy K.; Bonati, Michelle L.; Neeper, Lance S.

2015-01-01

Citizenship education that uses service-learning continues to be implemented in a manner that may restrict many students from full, meaningful participation. The authors contend that much of the literature on civic-oriented service-learning unnecessarily positions successful projects at the extremes: (a) political socialization versus civic…

Search Results | Page 28 | IDRC - International Development ...

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

Results 271 - 280 of 8531 ... ... INDIA (300) Apply INDIA filter · Governance (291) Apply Governance filter .... In much of the developing world, women unnecessarily suffer higher rates of ... of sickness or death affecting mothers and infants are easily preventable. ... the links between urban violence, poverty, and inequality.

Search Results | Page 28 | IDRC - International Development ...

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

Results 271 - 280 of 8531 ... ... INDIA (300) Apply INDIA filter · Governance (289) Apply Governance filter .... In much of the developing world, women unnecessarily suffer higher rates of ... of sickness or death affecting mothers and infants are easily preventable. ... the links between urban violence, poverty, and inequality.

Search Results | Page 28 | IDRC - International Development ...

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

Results 271 - 280 of 8528 ... ... INDIA (300) Apply INDIA filter · Governance (292) Apply Governance filter .... In much of the developing world, women unnecessarily suffer higher rates of ... of sickness or death affecting mothers and infants are easily preventable. ... the links between urban violence, poverty, and inequality.

The Asian Crisis, the IMF and Dr Mahathir, Intereconomics 34:4, 1999.

NARCIS (Netherlands)

Visser, H.; Wengel, J. ter

2005-01-01

In the 1997-8 Asian crisis, the IMF's strategy was to impose deflationary measures on Thailand and Korea. With the help of the dependent-economy model it is found that this strategy was unnecessarily restrictive and that Malaysia's solution of introducing temporary capital controls was not

Is clinical cognition binary or continuous?

Science.gov (United States)

Norman, Geoffrey; Monteiro, Sandra; Sherbino, Jonathan

2013-08-01

A dominant theory of clinical reasoning is the so-called "dual processing theory," in which the diagnostic process may proceed through a rapid, unconscious, intuitive process (System 1) or a slow, conceptual, analytical process (System 2). Diagnostic errors are thought to arise primarily from cognitive biases originating in System 1. In this issue, Custers points out that this model is unnecessarily restrictive and that it is more likely that diagnostic tasks may proceed through a variety of mental strategies ranging from "analytical" to "intuitive."The authors of this commentary agree that the notion that System 1 and System 2 processes are somehow in competition and will necessarily lead to different conclusions is unnecessarily restrictive. On the other hand, they argue that there is substantial evidence in support of a dual processing model, and that most objections to dual processing theory can be easily accommodated by simply presuming that both processes operate in concertand that solving any task may rely to varying degrees on both processes.

How dangerous are mobile phones, transmission masts, and electricity pylons?

Science.gov (United States)

Wood, A W

2006-04-01

Electrical power and mobile communications deliver enormous benefit to society, but there are concerns whether the electric and magnetic field (EMF) emissions associated with the delivery of this benefit are linked to cancer or other health hazards. This article reviews the strength of the available epidemiological and laboratory evidence and notes that this falls short of what is normally required to establish a causal link. However, because of scientific uncertainty a cautious approach is often advocated, but here, too, there may be a tendency to judge these risks more harshly than those in other areas with similar strength of evidence.

Conducting financial due diligence of medical practices.

Science.gov (United States)

Louiselle, P

1995-12-01

Many healthcare organizations are acquiring medical practices in an effort to build more integrated systems of healthcare products and services. This acquisition activity must be approached cautiously to ensure that medical practices being acquired do not have deficiencies that would jeopardize integration efforts. Conducting a thorough due diligence analysis of medical practices before finalizing the transaction can limit the acquiring organizations' legal and financial exposure and is a necessary component to the acquisition process. The author discusses the components of a successful financial due diligence analysis and addresses some of the risk factors in a practice acquisition.

Service innovation in glaucoma management: using a Web-based electronic patient record to facilitate virtual specialist supervision of a shared care glaucoma programme.

Science.gov (United States)

Wright, Heathcote R; Diamond, Jeremy P

2015-03-01

To assess the importance of specialist supervision in a new model of glaucoma service delivery. An optometrist supported by three technicians managed each glaucoma clinic. Patients underwent testing and clinical examination before the optometrist triaged them into one of five groups: 'normal', 'stable', 'low risk', 'unstable' and 'high risk'. Patient data were uploaded to an electronic medical record to facilitate virtual review by a glaucoma specialist. 24 257 glaucoma reviews at three glaucoma clinics during a 31-month period were analysed. The clinic optometrists and glaucoma specialists had substantial agreement (κ 0.69). 13 patients were identified to be high risk by the glaucoma specialist that had not been identified as such by the optometrist. Glaucoma specialists amended 13% of the optometrists' interim decisions resulting in an overall reduction in review appointments by 2.4%. Employing technicians and optometrists to triage glaucoma patients into groups defined by risk of blindness allows higher risk patients to be directed to a glaucoma specialist. Virtual review allows the glaucoma specialist to remain in overall control while reducing the risk that patients are treated or followed-up unnecessarily. Demand for glaucoma appointments can be reduced allowing scarce medical resources to be directed to patients most in need. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Risk control of traditional Chinese medicines containing aristolochis acids (AAs) based on influencing factors of content of AAs].

Science.gov (United States)

Tian, Jing-Zhuo; Liang, Ai-Hua; Liu, Jing; Zhang, Bo-Li

2017-12-01

Aristolochic acids (AAs) widely exist in such plants as Aristolochia and Asarum. The renal toxicity of AAs as well as its carcinogenicity to urinary system have been widely known. In 2003 and 2004, China prohibited the use of Aristolochiae Radix, Aristolochiae Manshuriensis Caulis and Aristolochiae Fangchi Radix, and required administering other AAs-containing medicines in accordance with the regulations for prescription drugs. In this paper, we retrieved literatures on the content determination of AAs in recent 10 years in China. It suggested that the AAs content is lower in Asarum herb, especially in its roots and rhizomes, and most of which do not show detectable amount of AA-I. Some of traditional Chinese medicines show fairly small amount of detectable AA-I. The AAs content in Aristolochia herb (including Fructus Aristolochiae, kaempfer dutchmanspipe root) is relatively high; however, there are fewer literatures for studying the content determination of AAs in Chinese patent medicines. There were many factors affecting AAs content, including the parts used, origins, processing methods, extraction process. It suggested that we should pay attention to the toxicity of Chinese medicines containing AAs and use these decoction pieces and traditional Chinese medicines cautiously. In addition, basic studies for the origins, processing methods and extraction process of Chinese patent medicines containing AAs, as well as supervision and detection of AAs content in traditional Chinese medicinal materials, decoction pieces and Chinese patent medicines shall be strengthened for reducing medication risk and guaranteeing clinical medication safety. Copyright© by the Chinese Pharmaceutical Association.

Magnetically Coupled Impedance-Source Inverters

DEFF Research Database (Denmark)

Loh, Poh Chiang; Blaabjerg, Frede

2013-01-01

input-to-output gain and the presence of an impedance network. The former means a high dc-link voltage, which can stress the semiconductor switches unnecessarily. The latter leads to increases in cost and size, which similarly are undesirable. To lessen these concerns, an interesting approach is to use...

Representations for Semantic Learning Webs: Semantic Web Technology in Learning Support

Science.gov (United States)

Dzbor, M.; Stutt, A.; Motta, E.; Collins, T.

2007-01-01

Recent work on applying semantic technologies to learning has concentrated on providing novel means of accessing and making use of learning objects. However, this is unnecessarily limiting: semantic technologies will make it possible to develop a range of educational Semantic Web services, such as interpretation, structure-visualization, support…

The Modularization of Women.

Science.gov (United States)

Peterson, Yen; Brockmann, C. Thomas

The standard classification of women's roles into the traditional, dual career, and single parent constellations is unnecessarily restrictive and stereotyping. These categories reflect neither the myriad of role choices facing women today, nor the forces shaping the resulting contexts. This paper focuses upon modules, the component task or…

77 FR 24840 - Safety Zone; Crowley Barge 750-2, Bayou Casotte, Pascagoula, MS

Science.gov (United States)

2012-04-26

... its possible commercial and contractual obligations. Under 5 U.S.C. 553(d)(3), the Coast Guard finds... process would unnecessarily interfere with launching the barge and its possible commercial and contractual obligations. Basis and Purpose VT-Halter Pascagoula is a ship yard and repair facility located on Bayou...

The Effects of Age, Priming, and Working Memory on Decision-Making.

Science.gov (United States)

Wood, Meagan; Black, Sheila; Gilpin, Ansley

2016-01-11

In the current study, we examined the effects of priming and personality on risky decision-making while playing the Game of Dice Task (GDT). In the GDT, participants decide how risky they wish to be on each trial. In this particular study prior to playing the GDT, participants were randomly assigned to one of three priming conditions: Risk-Aversive, Risk-Seeking, or Control. In the Risk-Seeking condition, a fictional character benefitted from risky behavior while in the Risk-Aversive condition, a fictional character benefitted from exercising caution. Although not explicitly stated in the instructions, participants need to make "safe" rather than risky choices to optimize performance on the GDT. Participants were also given Daneman and Carpenter's assessment of working memory task. Interestingly, although older adults self-reported being more cautious than younger adults on the Domain Specific Risk Attitude scale (DOSPERT), older adults made riskier decisions than younger adults on the GDT. However, after controlling for working memory, the age differences on the GDT became insignificant, indicating that working memory mediated the relation between age and risky decisions on the GDT.

Irradiation: An effective mode of processing food for safety

International Nuclear Information System (INIS)

Mossel, D.A.A.

1985-01-01

Markedly improved measures of hygiene, including those attaining generally accepted GMP, are effective in reducing the contamination rate markedly, without completely eliminating the pathogens concerned though. Attempts to identify contaminated consignments by sampling examination were demonstrated to be unsuccessful, even when linked to certification by producing countries. The only practicable solution of this serious health problem has to rely on terminal processing for safety, as introduced in the twenties in the dairy industry and somewhat later in the manufacture of egg products. Gamma irradiation (radicidation) at a level of <= 4 kGy was found to be most effective for a more than adequate degree of elimination of pathogens as judged by Risk Analysis. Radicidation for this purpose did not entail immediate flora changes or even shifts in the microbial community structure secondary to slight temperature abuse, that presented any health risk. Neither were organisms isolated that could not be identified with types customarily encountered in fresh or processed food. Consequently, health authorities and the food industry alike henceforth have means available to protect consumers against the perennial food-transmitted enteric infectious diseases by the application of low amounts of ionizing energy. They should not postpone these or similar measures of intervention unnecessarily because otherwise they risk being blamed by history for being reprehensibly over-anxious

Man is not a big rat: concerns with traditional human risk assessment of phthalates based on their anti-androgenic effects observed in the rat foetus.

Science.gov (United States)

Habert, René; Livera, Gabriel; Rouiller-Fabre, Virginie

2014-01-01

Phthalates provide one of the most documented example evidencing how much we must be cautious when using the traditional paradigm based on extrapolation of experimental data from rodent studies for human health risk assessment of endocrine disruptors (EDs). Since foetal testis is known as one of the most sensitive targets of EDs, phthalate risk assessment is routinely based on the capacity of such compounds to decrease testosterone production by the testis or to impair masculinization in the rat during foetal life. In this paper, the well-established inhibiting effects of phthalates of the foetal Leydig cells function in the rat are briefly reviewed. Then, data obtained in humans and other species are carefully analysed. Already in January 2009, using the organotypic culture system named Fetal Testis Assay (FeTA) that we developed, we reported that phthalates might not affect testosterone production in human foetal testes. Several recent experimental studies using xenografts confirm the absence of detectable anti-androgenic effect of phthalates in the human foetal testes. Epidemiological studies led to contradictory results. Altogether, these findings suggest that phthalates effects on foetal Leydig cells are largely species-specific. Consequently, the phthalate threshold doses that disturb foetal steroidogenesis in rat testes and that are presently used to define the acceptable daily intake levels for human health protection must be questioned. This does not mean that phthalates are safe because these compounds have many deleterious effects upon germ cell development that may be common to the different studied species including human. More generally, the identification of common molecular, cellular or/and phenotypic targets in rat and human testes should precede the choice of the toxicological endpoint in rat to accurately assess the safety threshold of any ED in humans.

Building reliable evidence from real-world data: methods, cautiousness and recommendations

Directory of Open Access Journals (Sweden)

Giovanni Corrao

2013-09-01

Full Text Available Routinely stored information on healthcare utilisation in everyday clinical practice has proliferated over the past several decades. There is, however, some reluctance on the part of many health professionals to use observational data to support healthcare decisions, especially when data are derived from large databases. Challenges in conducting observational studies based on electronic databases include concern about the adequacy of study design and methods to minimise the effect of both misclassifications (in the absence of direct assessments of exposure and outcome validity and confounding (in the absence of randomisation. This paper points out issues that may compromise the validity of such studies, and approaches to managing analytic challenges. First, strategies of sampling within a large cohort, as an alternative to analysing the full cohort, will be presented. Second, methods for controlling outcome and exposure misclassifications will be described. Third, several techniques that take into account both measured and unmeasured confounders will also be presented. Fourth, some considerations regarding random uncertainty in the framework of observational studies using healthcare utilisation data will be discussed. Finally, some recommendations for good research practice are listed in this paper. The aim is to provide researchers with a methodological framework, while commenting on the value of new techniques for more advanced users.

Commercial Lysogeny Broth culture media and oxidative stress: a cautious tale.

Science.gov (United States)

Ezraty, Benjamin; Henry, Camille; Hérisse, Marion; Denamur, Erick; Barras, Frédéric

2014-09-01

Lysogeny Broth (LB), most often misnamed Luria-Bertani medium, ranks among the most commonly used growth media in microbiology. Surprisingly, we observed that oxidative levels vary with the commercial origin of the LB ready to use powder. Indeed, growth on solid media of Escherichia coli and Salmonella derivatives lacking antioxidative stress defenses, such as oxyR mutant devoid of the H2O2-sensing transcriptional activator or Hpx(-) strains lacking catalases and peroxidases, exhibit different phenotypes on LB-Sigma or LB-Difco. Using gene fusion and exogenously added catalase, we found that LB-Sigma contains higher levels of H2O2 than LB-Difco. Also we observed differences in population counts of 82 clinical and environmental isolates of E. coli, depending on the LB used. Further investigations revealed a significant influence of the commercial origin of agar as well. Besides being a warning to the wide population of LB users, our observations provide researchers in the oxidative stress field with a tool to appreciate the severity of mutations in antioxidative stress defenses. Copyright © 2014 Elsevier Inc. All rights reserved.

29 CFR 1604.2 - Sex as a bona fide occupational qualification.

Science.gov (United States)

2010-07-01

... narrowly. Label—“Men's jobs” and “Women's jobs”—tend to deny employment opportunities unnecessarily to one... example, the assumption that the turnover rate among women is higher than among men. (ii) The refusal to hire an individual based on stereotyped characterizations of the sexes. Such stereotypes include, for...

Simple and Practical Efficiency Lessons

Science.gov (United States)

Kolpin, Van

2018-01-01

The derivation of conditions necessary for Pareto efficient production and exchange is a lesson frequently showcased in microeconomic theory textbooks. Traditional delivery of this lesson is, however, limited in its scope of application and can be unnecessarily convoluted. The author shows that the universe of application is greatly expanded and a…

Search Results | Page 24 | IDRC - International Development ...

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

Results 231 - 240 of 8494 ... ... India (907) Apply India filter · South America (869) Apply South .... In much of the developing world, women unnecessarily suffer higher rates of maternal mortality and morbidity— but most of the causes of sickness or death affecting ... the links between urban violence, poverty, and inequality.

Is the golden hour optimally used in South Africa for children ...

African Journals Online (AJOL)

Results. Fifty-five children were included in the final analysis. The median duration of stay in the Trauma Unit was 205 minutes (interquartile range 135 - 274). Conclusion. Several factors were identified that unnecessarily prolonged the time that patients stayed in the trauma unit following arrival in hospital for polytrauma ...

Adequacy of published screening criteria for retinopathy of prematurity.

Science.gov (United States)

Taranath, Deepa A; Oh, Dickson D-S; Keane, Miriam C; Fabel, Helen; Marshall, Peter

2016-03-01

Criteria for screening preterm infants for retinopathy of prematurity vary around the world. We aimed to analyse the efficacy of alternative screening criteria. We collected retrospective data at a tertiary level neonatal nursery. Our participants were 1007 babies, born between 1997 and 2011, at prematurity. We determined whether disease would be detected using an alternative Australian screening model (gestational age prematurity is our main outcome. Using several of the alternative criteria, two neonates with clinically significant retinopathy of prematurity, one of whom required laser treatment to preserve sight, would not have been screened, and their disease may have gone undetected. Use of prematurity may risk clinically significant cases being missed and others may screen babies unnecessarily. Alternative criteria should be considered and '<30 weeks gestational age and/or <1500 g birth weight' appears a viable option. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

Modification of an x-ray diffraction unit to comply with the NH and MRC code of practice

International Nuclear Information System (INIS)

Ibbetson, V.J.; Young, J.G.

2004-01-01

X-ray analysis units are commonly used in research and industrial laboratories throughout Australia. Despite a well-established Code of Practice and working protocols for the safe use of such units, there are all too many stories of users by-passing safety features significantly increasing the risk of accidental exposure to the primary X-ray beam. Since the output of such units may be as high as 300 Gy x s 1 , such accidental exposures could have very serious consequences. Australian Radiation Services Pty Ltd undertook a compliance audit of an X-ray diffraction unit with respect to the NH and MRC Code of Practice for protection against ionising radiation emitted from X-ray analysis equipment. This paper discusses the findings from the initial inspection and the modifications recommended for the XRD unit to ensure compliance with the Code, without unnecessarily restricting its use. Copyright (2004) Australasian Radiation Protection Society Inc

Promise and peril: Dissemination of findings from studies of drugs used in pregnancy and their association with birth defects.

Science.gov (United States)

Patrick, Stephen W; Cooper, William O

2015-08-01

When and how to publish birth defects research can be complex, especially in the context of drugs used in pregnancy. Such research frequently involves multiple stakeholders, including regulatory agencies. Researchers must balance the potential peril of an unnecessarily panicked populace versus the benefit of protecting the public's health. We use a case presentation and contemporary literature to highlight the potential tradeoffs that researchers must consider. We highlight important considerations including the public health impact, examining the likelihood of causality, understanding common considerations when using large data sources, the role of peer review and working in partnership with regulatory agencies. We suggest that plans for analyses, dissemination and risk communication are done best a priori and not post hoc. Rigorous research evaluating the impact of drugs used in pregnancy, coupled with effective dissemination strategies, has the potential improve outcomes for mothers and their infants for generations. © 2015 Wiley Periodicals, Inc.

Combined use of drugs inhibiting the renin–angiotensin system: prescribing patterns and risk of acute kidney injury in German nursing home residents

Directory of Open Access Journals (Sweden)

Dörks M

2018-05-01

common in German nursing homes. Though the prevalence of dual RAS blockade declined, our study showed an increased risk of AKI in patients with diabetes and/or chronic kidney disease. Therefore, cautious use is warranted in these vulnerable patients. Keywords: dual RAS blockade, nested case-control study, long-term care

Report on the Audit of DoD Immunity From State Taxation

Science.gov (United States)

1991-02-15

This is our final report on the audit of DOD Immunity from State Taxation for your information and use. We made the audit from July to September 1990...The objective of the audit was to determine whether DoD was unnecessarily paying state sales taxes. We also determined if sales taxes were being

Search Results | Page 23 | IDRC - International Development ...

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

Results 221 - 230 of 8491 ... ... India (906) Apply India filter · South America (868) Apply South .... In much of the developing world, women unnecessarily suffer higher rates of maternal mortality and morbidity— but most of the causes of sickness or death affecting ... Closing the gender gap in financial inclusion on a large scale.

78 FR 78472 - Registration and Financial Security Requirements for Brokers of Property and Freight Forwarders...

Science.gov (United States)

2013-12-26

... shippers from the abuse of market power or that the transaction or service is of limited scope; and Is in... protect shippers from the abuse of market power . . . and . . . is not in the public interest.'' AIPBA... abuse of market power.'' According to AIPBA, ``[t]he unnecessarily high $75,000 broker bond requirement...

Noninvasive Prenatal Diagnosis of Congenital Adrenal Hyperplasia.

Science.gov (United States)

Khattab, Ahmed; Yuen, Tony; Sun, Li; Yau, Mabel; Barhan, Ariella; Zaidi, Mone; Lo, Y M Dennis; New, Maria I

2016-01-01

A major hallmark of classical congenital adrenal hyperplasia (CAH) is genital ambiguity noted at birth in affected females, which leads to psychological and psychosexual issues in adult life. Attempts to correct genital ambiguity through surgical intervention have been partially successful. Fetal hyperandrogenemia and genital ambiguity have been shown to be preventable by prenatal administration of low-dose dexamethasone initiated before the 9th week of gestation. In 7 of 8 at-risk pregnancies, the unaffected fetus is unnecessarily exposed to dexamethasone for weeks until the diagnosis of classical CAH is ruled out by invasive procedures. This therapeutic dilemma calls for early prenatal diagnosis so that dexamethasone treatment can be directed to affected female fetuses only. We describe the utilization of cell-free fetal DNA in mothers carrying at-risk fetuses as early as 6 gestational weeks by targeted massively parallel sequencing of the genomic region including and flanking the CYP21A2 gene. Our highly personalized and innovative approach should permit the diagnosis of CAH before genital development begins, therefore restricting the purposeful administration of dexamethasone to mothers carrying affected females. © 2016 S. Karger AG, Basel.

ヘイト・スピーチに対する非強制的施策に関する原理的考察（二） : Corey Brettschneider の価値民主主義（Value Democracy）論と民主的説得（Democratic Persuasion）論の考察を中心として

OpenAIRE

山邨, 俊英

2017-01-01

The legal situation regarding hate speech regulation in Japan is currently at a turning point, owing to the introduction of a law and ordinance to restrict hate speech, the first of its kind in Japan. The legislation assumes the “cautious approach of regulation”, deemed a majority theory in the scholarly debate on hate speech regulation. Following such a cautious approach, legal regulation of hate speech (in particular, criminal sanctions) has limited effectiveness. It has been suggested that...

ヘイト・スピーチに対する非強制的施策に関する原理的考察（三・完） : Corey Brettschneider の価値民主主義（Value Democracy）論と民主的説得（Democratic Persuasion）論の考察を中心として

OpenAIRE

山邨, 俊英

2017-01-01

The legal situation regarding hate speech regulation in Japan is currently at a turning point, owing to the introduction of a law and ordinance to restrict hate speech, the first of its kind in Japan. The legislation assumes the “cautious approach of regulation”, deemed a majority theory in the scholarly debate on hate speech regulation. Following such a cautious approach, legal regulation of hate speech (in particular, criminal sanctions) has limited effectiveness. It has been suggested that...

ヘイト・スピーチに対する非強制的施策に関する原理的考察（一） : Corey Brettschneider の価値民主主義（Value Democracy）論と民主的説得（Democratic Persuasion）論の考察を中心として

OpenAIRE

山邨, 俊英

2016-01-01

The legal situation regarding hate speech regulation in Japan is currently at a turning point, owing to the introduction of a law and ordinance to restrict hate speech, the first of its kind in Japan. The legislation assumes the “cautious approach of regulation”, deemed a majority theory in the scholarly debate on hate speech regulation. Following such a cautious approach, legal regulation of hate speech (in particular, criminal sanctions) has limited effectiveness. It has been suggested that...

Absolute risk, absolute risk reduction and relative risk

Directory of Open Access Journals (Sweden)

Jose Andres Calvache

2012-12-01

Full Text Available This article illustrates the epidemiological concepts of absolute risk, absolute risk reduction and relative risk through a clinical example. In addition, it emphasizes the usefulness of these concepts in clinical practice, clinical research and health decision-making process.

How the millennial generation is transforming employee benefits.

Science.gov (United States)

Howe, Neil

2014-01-01

According to a number of recent studies, the millennial generation, today's incoming young-adult employees, shows far more interest than older generations in a broad spectrum of employee bene its to protect them from various life risks. They are more cautious than boomers or Gen Xers in choosing their financial portfolios and more focused on planning for their long-term future. Millennials even value health insurance almost as much as older adults--despite the fact they're much less likely to use it. These findings are in broad alignment with broader millennial generational traits that LifeCourse Associates has been studying fo many years.

Benzodiazepine abuse among the elderly

Directory of Open Access Journals (Sweden)

Shalini Singh

2016-01-01

Full Text Available Benzodiazepines belong to the hypnotic-sedative class of drugs which have anxiolytic, sedative, and hypnotic properties. These drugs have been in clinical use for at least half a century. The propensity for development of dependence, especially on prescription benzodiazepines, coupled with the risk of falls and cognitive impairment due to benzodiazepines makes the elderly population susceptible to adverse outcomes with the use of benzodiazepines, and hence, cautious use is desired in this population. This review discusses the various aspects pertaining to benzodiazepine abuse in the elderly including pharmacology, prevalence of abuse, adverse consequences of benzodiazepine abuse, and subsequently assessment and management of elderly patients with benzodiazepine abuse.

Inflammation is a Continuous Trait in Children regardless of Asthma Symptoms

DEFF Research Database (Denmark)

Schoos, Ann-Marie Malby; Chawes, Bo Lund Krogsgaard; Bønnelykke, Klaus

2011-01-01

asymptomatic children to children with intermittent asthmatic symptoms and children with persistent asthma. Methods: An unselected group of 196 six-year-old children were included from the Copenhagen Prospective Study on Asthma in Childhood (COPSAC) birth cohort born of mothers with asthma. Bronchial...... for a dichotomized approach to asthma diagnosis. Childhood asthma remains a clinical diagnosis and surrogate markers may only be used cautiously as supportive evidence.......Rationale: Elevated fractional exhaled nitric oxide (FeNO) and bronchial hyperresponsiveness are used as surrogate markers of asthma. Objective: To investigate the association between FeNO and bronchial responsiveness in a population of high risk children including the full spectrum from...

Breast fibroadenoma with increased activity on 68Ga-DOTATATE PET/CT

Science.gov (United States)

Papadakis, Georgios Z.; Millo, Corina; Sadowski, Samira M.; Karantanas, Apostolos H.; Bagci, Ulas; Patronas, Nicholas J.

2016-01-01

Fibroadenoma is the most common benign breast tumor in women of reproductive age, carrying little to no risk of breast cancer development. We report on a case of a woman with history of neuroendocrine tumor (NET), who on follow-up imaging tests underwent whole-body PET/CT study using 68Ga-DOTATATE. The scan showed increased focal activity in the right breast, which was biopsied revealing a fibroadenoma. The presented data suggests cell surface over-expression of somatostatin receptors (SSTRs) by this benign breast tumor. Moreover, this finding emphasizes the need for cautious interpretation of 68Ga-DOTATATE avid breast lesions which could mimic malignancy in NET patients. PMID:27879489

Breast Fibroadenoma With Increased Activity on 68Ga DOTATATE PET/CT.

Science.gov (United States)

Papadakis, Georgios Z; Millo, Corina; Sadowski, Samira M; Karantanas, Apostolos H; Bagci, Ulas; Patronas, Nicholas J

2017-02-01

Fibroadenoma is the most common benign breast tumor in women of reproductive age, carrying little to no risk of breast cancer development. We report on a case of a woman with history of neuroendocrine tumor who on follow-up imaging tests underwent whole-body PET/CT study using Ga DOTATATE. The scan showed increased focal activity in the right breast, which was biopsied revealing a fibroadenoma. The presented data suggests cell surface overexpression of somatostatin receptors by this benign breast tumor. Moreover, this finding emphasizes the need for cautious interpretation of Ga DOTATATE-avid breast lesions that could mimic malignancy in neuroendocrine tumor patients.

The radiologic quality of water supply in France, 2005-2007

International Nuclear Information System (INIS)

2009-01-01

This report, while proposing many graphs, tables and maps, firstly describes the context of water radioactivity (definition, origin, population exposure, water radiologic quality indicators, uranium in water) and then the methodology of the regional sanitary controls, of the national survey on radiologic quality of tap water, and the radionuclide analyses (notably uranium isotopes) from which these data are obtained. Results and data from these controls, survey and analyses are then presented and discussed. The authors highlight the fact that some results must be cautiously interpreted as they may depend on sampling and analysis modalities, and on the sanitary control frequency. They also assess the chemical and radiological risk associated to uranium

Safety and ethical aspects on retrievability: A Swedish nuclear regulator's view

International Nuclear Information System (INIS)

Toverud, Oe.; Wingefors, S.

2000-01-01

An important contribution to the discussion on retrieval in Sweden has been the ethical principle of the Swedish National Council for Nuclear Waste (KASAM). ''The KASAM Principle'' means that the present generation, which has reaped the benefits of nuclear energy, must also take care of the waste and not transfer the responsibility to future generations; a repository should be designed and constructed so that monitoring and remedial actions are not necessary in the future. However, future generations, probably with better knowledge and other values, must still have the freedom to make their own decisions; we should therefore not make monitoring and remedial action unnecessarily difficult. SKI generally supports the KASAM principle but its application in the individual case should be based on solid evidence that both aspects have been covered in a suggested repository design. There may be a number of possible reasons for retrieval of spent nuclear fuel from a repository and they range from technical to purely political. SKI supports that the repository shall not be designed so that it unnecessarily impairs future attempts to retrieve the waste, monitor or ''repair'' the repository. However, measures to facilitate any kind of access to the repository must not reduce the long term safety of the repository. SKI concludes that: Future generations may wish to retrieve the spent fuel from a sealed repository. Disposal method and repository design should consider this and not make such retrieval unnecessarily difficult. On the other hand, any measures taken to facilitate retrieval must not significantly impair the long term safety functions of the repository. It must be shown that the safety aspects have been adequately considered. Retrievability must always be discussed with caution, so that it will not give the impression of doubts concerning the safety of the repository. (author)

Avoiding Complications in Bone and Soft Tissue Ablation

International Nuclear Information System (INIS)

Kurup, A. Nicholas; Schmit, Grant D.; Morris, Jonathan M.; Atwell, Thomas D.; Schmitz, John J.; Weisbrod, Adam J.; Woodrum, David A.; Eiken, Patrick W.; Callstrom, Matthew R.

2017-01-01

As with percutaneous ablation of tumors in the liver, lungs, and kidneys, ablation of bone and non-visceral soft tissue tumors carries risk, primarily from collateral damage to vital structures in proximity to the target tumor. Certain risks are of particular interest when ablating bone and non-visceral soft tissue tumors, namely neural or skin injury, bowel injury, fracture, and gas embolism from damaged applicators. Ablation of large volume tumors also carries special risk. Many techniques may be employed by the interventional radiologist to minimize complications when treating tumors in the musculoskeletal system. These methods include those to depict, displace, or monitor critical structures. Thus, measures to provide thermoprotection may be active, such as careful ablation applicator placement and use of various displacement techniques, as well as passive, including employment of direct temperature, radiographic, or neurophysiologic monitoring techniques. Cementoplasty should be considered in certain skeletal locations at risk of fracture. Patients treated with large volume tumors should be monitored for renal dysfunction and properly hydrated. Finally, ablation applicators should be cautiously placed in the constrained environment of intact bone.

Avoiding Complications in Bone and Soft Tissue Ablation

Energy Technology Data Exchange (ETDEWEB)

Kurup, A. Nicholas, E-mail: kurup.anil@mayo.edu; Schmit, Grant D., E-mail: schmit.grant@mayo.edu; Morris, Jonathan M., E-mail: morris.jonathan@mayo.edu; Atwell, Thomas D., E-mail: atwell.thomas@mayo.edu; Schmitz, John J., E-mail: schmitz.john@mayo.edu; Weisbrod, Adam J., E-mail: weisbrod.adam@mayo.edu; Woodrum, David A., E-mail: woodrum.david@mayo.edu; Eiken, Patrick W., E-mail: eiken.patrick@mayo.edu; Callstrom, Matthew R., E-mail: callstrom.matthew@mayo.edu [Mayo Clinic, Department of Radiology (United States)

2017-02-15

As with percutaneous ablation of tumors in the liver, lungs, and kidneys, ablation of bone and non-visceral soft tissue tumors carries risk, primarily from collateral damage to vital structures in proximity to the target tumor. Certain risks are of particular interest when ablating bone and non-visceral soft tissue tumors, namely neural or skin injury, bowel injury, fracture, and gas embolism from damaged applicators. Ablation of large volume tumors also carries special risk. Many techniques may be employed by the interventional radiologist to minimize complications when treating tumors in the musculoskeletal system. These methods include those to depict, displace, or monitor critical structures. Thus, measures to provide thermoprotection may be active, such as careful ablation applicator placement and use of various displacement techniques, as well as passive, including employment of direct temperature, radiographic, or neurophysiologic monitoring techniques. Cementoplasty should be considered in certain skeletal locations at risk of fracture. Patients treated with large volume tumors should be monitored for renal dysfunction and properly hydrated. Finally, ablation applicators should be cautiously placed in the constrained environment of intact bone.

Life after Y2K: Not your father's electricity business

Energy Technology Data Exchange (ETDEWEB)

Draper, E.L. Jr.

1999-12-01

As the industry advances to a fully competitive marketplace, the head of American Electric Power argues that merger-review processes must be streamlined, investor-owned utilities should no longer be disadvantaged versus government-supported alternatives, the restructuring debate should not be unnecessarily complicated by environmental riders, and fuel diversity will be a critical generation strategy.

A Time of Quiet Activism: Research, Practice, and Policy in American Women's Higher Education, 1945-1965

Science.gov (United States)

Eisenmann, Linda

2005-01-01

This article reflects on three narratives that affected American women's participation in higher education during the first twenty years after World War II. In hindsight, the educators of the 1950s and early 1960s may seem gratuitously meek and self-effacing. In comparison to later efforts, their activism can appear unnecessarily limited and too…

Cochlear Implant: the complexity involved in the decision making process by the family.

Science.gov (United States)

Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

2014-01-01

to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention.

HealthMarts, HIPCs (health insurance purchasing cooperatives), MEWAs (multiple employee welfare arrangements), and AHPs (association health plans): a guide for the perplexed.

Science.gov (United States)

Hall, M A; Wicks, E K; Lawlor, J S

2001-01-01

This paper considers how pending proposals to authorize new forms of group purchasing arrangements for health insurance would fit and function within the existing, highly complex market and regulatory landscape and whether these proposals are likely to meet their stated objectives and avoid unintended consequences. Cost savings are more likely to result from increased risk segmentation than through true market efficiencies. Thus, these proposals could erode previous market reforms whose goal is increased risk pooling. On the other hand, these proposals contain important enhancements, clarifications, and simplification of state and federal regulatory oversight of group purchasing vehicles. Also, they address some of the problems that have hampered the performance of purchasing cooperatives. On balance, although these proposals should receive cautious and careful consideration, they are not likely to produce a significant overall reduction in premiums or increase in coverage.

Risk of hepatotoxicity associated with the use of telithromycin: a signal detection using data mining algorithms.

Science.gov (United States)

Chen, Yan; Guo, Jeff J; Healy, Daniel P; Lin, Xiaodong; Patel, Nick C

2008-12-01

With the exception of case reports, limited data are available regarding the risk of hepatotoxicity associated with the use of telithromycin. To detect the safety signal regarding the reporting of hepatotoxicity associated with the use of telithromycin using 4 commonly employed data mining algorithms (DMAs). Based on the Adverse Events Reporting System (AERS) database of the Food and Drug Administration, 4 DMAs, including the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the information component (IC), and the Gamma Poisson Shrinker (GPS), were applied to examine the association between the reporting of hepatotoxicity and the use of telithromycin. The study period was from the first quarter of 2004 to the second quarter of 2006. The reporting of hepatotoxicity was identified using the preferred terms indexed in the Medical Dictionary for Regulatory Activities. The drug name was used to identify reports regarding the use of telithromycin. A total of 226 reports describing hepatotoxicity associated with the use of telithromycin were recorded in the AERS. A safety problem of telithromycin associated with increased reporting of hepatotoxicity was clearly detected by 4 algorithms as early as 2005, signaling the problem in the first quarter by the ROR and the IC, in the second quarter by the PRR, and in the fourth quarter by the GPS. A safety signal was indicated by the 4 DMAs suggesting an association between the reporting of hepatotoxicity and the use of telithromycin. Given the wide use of telithromycin and serious consequences of hepatotoxicity, clinicians should be cautious when selecting telithromycin for treatment of an infection. In addition, further observational studies are required to evaluate the utility of signal detection systems for early recognition of serious, life-threatening, low-frequency drug-induced adverse events.

VALUE AT RISK - CORPORATE RISK MEASUREMENT

Directory of Open Access Journals (Sweden)

Anis Cecilia-Nicoleta

2011-12-01

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

What Is Evidence-Based Practice? Research-to-Results Brief. Publication #2007-14

Science.gov (United States)

Metz, Allison J. R.; Espiritu, Rachele; Moore, Kristin A.

2007-01-01

This brief represents part 1 in a series on fostering the adoption of evidence-based practices in out-of-school time programs. The lag between discovering effective practices and using them "on the ground" can be unnecessarily long, sometimes taking 15 to 20 years! The purpose of this brief is to provide practitioners with a better understanding…

Risk and risk acceptance by society

International Nuclear Information System (INIS)

Statt, C.

1977-01-01

Various dimensions of risk are identified which relate to the manner in which risk is perceived and evaluated, and several self-consistent risk characteristics are explored. Factors which are thought to influence the perception of risk include the degree of personal control over the risk, the potential of episodic events, and the probable severity of injury if a risk event occurs. Risk-benefit analysis can be applied to three problems: the allocation of resources for safety expenditures, the setting of standards, and societal risk taking decisions. Calculations of benefit are needed for the third area of application, methods for the other two frequently do not require such a measure. (orig./RW) [de

A One Health Message about Bats Increases Intentions to Follow Public Health Guidance on Bat Rabies.

Directory of Open Access Journals (Sweden)

Hang Lu

Full Text Available Since 1960, bat rabies variants have become the greatest source of human rabies deaths in the United States. Improving rabies awareness and preventing human exposure to rabid bats remains a national public health priority today. Concurrently, conservation of bats and the ecosystem benefits they provide is of increasing importance due to declining populations of many bat species. This study used a visitor-intercept experiment (N = 521 in two U.S. national parks where human and bat interactions occur on an occasional basis to examine the relative persuasiveness of four messages differing in the provision of benefit and uncertainty information on intentions to adopt a rabies exposure prevention behavior. We found that acknowledging benefits of bats in a risk message led to greater intentions to adopt the recommended rabies exposure prevention behavior without unnecessarily stigmatizing bats. These results signify the importance of communicating benefits of bats in bat rabies prevention messages to benefit both human and wildlife health.

Landslide-dammed lake at Tangjiashan, Sichuan province, China (triggered by the Wenchuan Earthquake, May 12, 2008): Risk assessment, mitigation strategy, and lessons learned

Science.gov (United States)

Cui, P.; Dang, C.; Zhuang, J.; You, Y.; Chen, X.; Scott, K.M.

2012-01-01

initial breach erosion was slow, later erosion was judged uncontrollably rapid; increased slope of the engineered channel and adoption of a compound, trapezoid-triangular cross-section can be considered, as can other measures to control the rate of breach incision. Evacuees from Mianyang City spent an unnecessarily long time (12 days) in temporary settlements; more precise risk management planning can reduce this time in the future. ?? 2010 Springer-Verlag.

The Effects of Age, Priming, and Working Memory on Decision-Making

Directory of Open Access Journals (Sweden)

Meagan Wood

2016-01-01

Full Text Available In the current study, we examined the effects of priming and personality on risky decision-making while playing the Game of Dice Task (GDT. In the GDT, participants decide how risky they wish to be on each trial. In this particular study prior to playing the GDT, participants were randomly assigned to one of three priming conditions: Risk-Aversive, Risk-Seeking, or Control. In the Risk-Seeking condition, a fictional character benefitted from risky behavior while in the Risk-Aversive condition, a fictional character benefitted from exercising caution. Although not explicitly stated in the instructions, participants need to make “safe” rather than risky choices to optimize performance on the GDT. Participants were also given Daneman and Carpenter’s assessment of working memory task. Interestingly, although older adults self-reported being more cautious than younger adults on the Domain Specific Risk Attitude scale (DOSPERT, older adults made riskier decisions than younger adults on the GDT. However, after controlling for working memory, the age differences on the GDT became insignificant, indicating that working memory mediated the relation between age and risky decisions on the GDT.

Breast cancer risks and risk prediction models.

Science.gov (United States)

Engel, Christoph; Fischer, Christine

2015-02-01

BRCA1/2 mutation carriers have a considerably increased risk to develop breast and ovarian cancer. The personalized clinical management of carriers and other at-risk individuals depends on precise knowledge of the cancer risks. In this report, we give an overview of the present literature on empirical cancer risks, and we describe risk prediction models that are currently used for individual risk assessment in clinical practice. Cancer risks show large variability between studies. Breast cancer risks are at 40-87% for BRCA1 mutation carriers and 18-88% for BRCA2 mutation carriers. For ovarian cancer, the risk estimates are in the range of 22-65% for BRCA1 and 10-35% for BRCA2. The contralateral breast cancer risk is high (10-year risk after first cancer 27% for BRCA1 and 19% for BRCA2). Risk prediction models have been proposed to provide more individualized risk prediction, using additional knowledge on family history, mode of inheritance of major genes, and other genetic and non-genetic risk factors. User-friendly software tools have been developed that serve as basis for decision-making in family counseling units. In conclusion, further assessment of cancer risks and model validation is needed, ideally based on prospective cohort studies. To obtain such data, clinical management of carriers and other at-risk individuals should always be accompanied by standardized scientific documentation.

Java project on periodontal diseases. The natural development of periodontitis: risk factors, risk predictors and risk determinants : risk factors, risk predictors and risk determinants

NARCIS (Netherlands)

Van der Velden, U.; Abbas, F.; Armand, S.; Loos, B. G.; Timmerman, M. F.; Van der Weijden, G. A.; Van Winkelhoff, A. J.; Winkel, E. G.

Objective: To identify risk factors, risk predictors and risk determinants for onset and progression of periodontitis. Material and Methods: For this longitudinal, prospective study all subjects in the age range 15-25 years living in a village of approximately 2000 inhabitants at a tea estate on

Therapeutic effects of low radiation doses

Energy Technology Data Exchange (ETDEWEB)

Trott, K.R. (Dept. of Radiation Biology, St. Bartholomew' s Medical College, London (United Kingdom))

1994-01-01

This editorial explores the scientific basis of radiotherapy with doses of < 1 Gy for various non-malignant conditions, in particular dose-effect relationships, risk-benefit considerations and biological mechanisms. A review of the literature, particularly clinical and experimental reports published more than 50 years ago was conducted to clarify the following problems. 1. The dose-response relationships for the therapeutic effects on three groups of conditions: non-malignant skin disease, arthrosis and other painful degenerative joint disorders and anti-inflammatory radiotherapy; 2. risks after radiotherapy and after the best alternative treatments; 3. the biological mechanisms of the different therapeutic effects. Radiotherapy is very effective in all three groups of disease. Few dose-finding studies have been performed, all demonstrating that the optimal doses are considerable lower than the generally recommended doses. In different conditions, risk-benefit analysis of radiotherapy versus the best alternative treatment yields very different results: whereas radiotherapy for acute postpartum mastitis may not be justified any more, the risk-benefit ratio of radiotherapy of other conditions and particularly so in dermatology and some anti-inflammatory radiotherapy appears to be more favourable than the risk-benefit ratio of the best alternative treatments. Radiotherapy can be very effective treatment for various non-malignant conditions such as eczema, psoriasis, periarthritis humeroscapularis, epicondylitis, knee arthrosis, hydradenitis, parotitis and panaritium and probably be associated with less acute and long-term side effects than similarly effective other treatments. Randomized clinical studies are required to find the optimal dosage which, at present, may be unnecessarily high.

On New Cautious Structural Reliability Models in the Framework of imprecise Probabilities

DEFF Research Database (Denmark)

Utkin, Lev V.; Kozine, Igor

2010-01-01

models and gen-eralizing conventional ones to imprecise probabili-ties. The theoretical setup employed for this purpose is imprecise statistical reasoning (Walley 1991), whose general framework is provided by upper and lower previsions (expectations). The appeal of this theory is its ability to capture......Uncertainty of parameters in engineering design has been modeled in different frameworks such as inter-val analysis, fuzzy set and possibility theories, ran-dom set theory and imprecise probability theory. The authors of this paper for many years have been de-veloping new imprecise reliability...... both aleatory (stochas-tic) and epistemic uncertainty and the flexibility with which information can be represented. The previous research of the authors related to generalizing structural reliability models to impre-cise statistical measures is summarized in Utkin & Kozine (2002) and Utkin (2004...

Education and Training for Sustainable Tourism: Problems, Possibilities and Cautious First Steps.

Science.gov (United States)

Gough, Stephen; Scott, William

1999-01-01

Advances a possible theoretical approach to education for sustainable tourism and describes a small-scale research project based on this approach. Seeks to integrate education for sustainable tourism into an established management curriculum using an innovative technique based on the idea of an adaptive concept. (Author/CCM)

Cautiously utopian goals : Philosophical analyses of climate change objectives and sustainability targets

OpenAIRE

Baard, Patrik

2016-01-01

In this thesis, the framework within which long-term goals are set and subsequently achieved or approached is analyzed. Sustainable development and climate change are areas in which goals have tobe set despite uncertainties. The analysis is divided into the normative motivations for setting such goals, what forms of goals could be set given the empirical and normative uncertainties, and how tomanage doubts regarding achievability or values after a goal has been set. Paper I discusses a set of...

Sustainable rangeland management, economic growth, and a cautious role for the SRM

Science.gov (United States)

Interest in the art and science of rangeland management increased dramatically during the 20th century and it was out of this interest that the profession of rangeland management was born. As public interest in rangeland management grew, so did the number, breadth, and depth of rangeland management ...

Cochlear Implant: the complexity involved in the decision making process by the family1

Science.gov (United States)

Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

2014-01-01

Objective to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. Method qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). Results knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. Conclusion deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention. PMID:25029052

Cochlear Implant: the complexity involved in the decision making process by the family

Directory of Open Access Journals (Sweden)

Sheila de Souza Vieira

2014-06-01

Full Text Available OBJECTIVE: to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child.METHOD: qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants.RESULTS: knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant.CONCLUSION: deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention.

Nanomedicine: Governing uncertainties

Science.gov (United States)

Trisolino, Antonella

Nanomedicine is a promising and revolutionary field to improve medical diagnoses and therapies leading to a higher quality of life for everybody. Huge benefits are expected from nanomedicine applications such as in diagnostic and therapeutic field. However, nanomedicine poses several issues on risks to the human health. This thesis aims to defense a perspective of risk governance that sustains scientific knowledge process by developing guidelines and providing the minimum safety standards acceptable to protect the human health. Although nanomedicine is in an early stage of its discovery, some cautious measures are required to provide regulatory mechanisms able to response to the unique set of challenges associated to nanomedicine. Nanotechnology offers an unique opportunity to intensify a major interplay between different disciplines such as science and law. This multidisciplinary approach can positively contributes to find reliable regulatory choices and responsive normative tools in dealing with challenges of novel technologies.

[Travel medicine for HIV-infected patients].

Science.gov (United States)

Rossi, M; Furrer, H

2001-06-01

Many HIV-infected persons travel from temperate zones to (sub)tropical destinations. HIV-specific immigration issues, medical resources abroad and problems regarding travelling with multiple medications have to be anticipated. When prescribing immunizations and specific chemoprophylaxis, the stage of immunodeficiency as well as drug interactions with antiretrovirals and medicaments against opportunistic infections have to be taken into account. Live vaccines may be contraindicated. Immunocompromised HIV-infected travellers have a higher risk for serious courses of diseases by enteropathogens. Therefore a good information about food hygiene is important and a prescription of an antibiotic to take in case of severe diarrhea may be indicated. A new antiretroviral combination therapy should not be started immediately before travelling to the tropics. The possibility to continue an established HIV treatment during travel has to be evaluated cautiously. With good pre-travel advice the risk of severe health problems is low for most HIV-infected travellers.

Decision making under uncertainty and information processing in positive and negative mood states.

Science.gov (United States)

Mohanty, Sachi Nandan; Suar, Damodar

2014-08-01

This study examines whether mood states (a) influence decision making under uncertainty and (b) affect information processing. 200 students at the Indian Institute of Technology Kharagpur participated in this study. Positive mood was induced by showing comedy movie clips to 100 participants and negative mood was induced by showing tragedy movie clips to another 100 participants. The participants were administered a questionnaire containing hypothetical situations of financial gains and losses, and a health risk problem. The participants selected a choice for each situation, and stated the reasons for their choice. Results suggested that the participants preferred cautious choices in the domain of gain and in health risk problems and risky choices in the domain of loss. Analysis of the reasons for the participants' choices suggested more fluency, originality, and flexibility of information in a negative mood compared to a positive mood. A negative (positive) mood state facilitated systematic (heuristic) information processing.

Factors affecting world and Russian domestic oil prices: the domestic implications - a Russian perspective

International Nuclear Information System (INIS)

Khartukov, E.M.

2001-01-01

This paper modestly aims at answering two formally related but unnecessarily interconnected questions about international and Russian domestic pricing of crude oil. The first of them is what, in our opinion, chiefly determines price dynamics of the contemporary world oil market. And the second one is in which way (if at all) world oil price dynamics affect Russia's internal market. (author)

Osteoma of the superior petrous portion of the temporal bone

Directory of Open Access Journals (Sweden)

Cynthia Tsay

2017-11-01

Conclusion: In patients with auditory symptoms such as tinnitus or hearing loss with abnormal osseous findings on MRI, CT can assist in diagnosis. The differential diagnosis of such lesions includes osteomas, pneumoceles, pneumocephalus, parosteal osteosarcoma and osteoblastoma. Thorough radiological assessment can be valuable in reaching the correct diagnosis, and can prevent unnecessarily aggressive management and treatment for benign osseous lesions.

Screening mammography. A risk versus risk decision

International Nuclear Information System (INIS)

Ritenour, E.R.; Hendee, W.R.

1989-01-01

The potential risk of a radiologic procedure often is compared with the potential benefit of the procedure. While risk vs. benefit analysis has been useful as a step toward increased communication and understanding among radiologists, referring physicians, and the general public, it has the disadvantage that risk and benefit are fundamentally different quantities. Hence, their juxtaposition for purposes of comparison presents contextual difficulties. In this article, the concept is presented of comparing the risk of doing a procedure with the risk of choosing not to do the procedure. An example of risk vs. risk analysis of screening mammography for women over the age of 50 is given, with the conclusion that the risk of having yearly mammograms is less than 1/10 the risk of early death caused by failure to diagnose breast cancer by x-ray mammography. This approach to risk analysis would yield interesting data for examinations that are part of more complicated diagnostic pathways.19 references

Probabilistic risk analysis and terrorism risk.

Science.gov (United States)

Ezell, Barry Charles; Bennett, Steven P; von Winterfeldt, Detlof; Sokolowski, John; Collins, Andrew J

2010-04-01

Since the terrorist attacks of September 11, 2001, and the subsequent establishment of the U.S. Department of Homeland Security (DHS), considerable efforts have been made to estimate the risks of terrorism and the cost effectiveness of security policies to reduce these risks. DHS, industry, and the academic risk analysis communities have all invested heavily in the development of tools and approaches that can assist decisionmakers in effectively allocating limited resources across the vast array of potential investments that could mitigate risks from terrorism and other threats to the homeland. Decisionmakers demand models, analyses, and decision support that are useful for this task and based on the state of the art. Since terrorism risk analysis is new, no single method is likely to meet this challenge. In this article we explore a number of existing and potential approaches for terrorism risk analysis, focusing particularly on recent discussions regarding the applicability of probabilistic and decision analytic approaches to bioterrorism risks and the Bioterrorism Risk Assessment methodology used by the DHS and criticized by the National Academies and others.

Risk control and the minimum significant risk

International Nuclear Information System (INIS)

Seiler, F.A.; Alvarez, J.L.

1996-01-01

Risk management implies that the risk manager can, by his actions, exercise at least a modicum of control over the risk in question. In the terminology of control theory, a management action is a control signal imposed as feedback on the system to bring about a desired change in the state of the system. In the terminology of risk management, an action is taken to bring a predicted risk to lower values. Even if it is assumed that the management action taken is 100% effective and that the projected risk reduction is infinitely well known, there is a lower limit to the desired effects that can be achieved. It is based on the fact that all risks, such as the incidence of cancer, exhibit a degree of variability due to a number of extraneous factors such as age at exposure, sex, location, and some lifestyle parameters such as smoking or the consumption of alcohol. If the control signal is much smaller than the variability of the risk, the signal is lost in the noise and control is lost. This defines a minimum controllable risk based on the variability of the risk over the population considered. This quantity is the counterpart of the minimum significant risk which is defined by the uncertainties of the risk model. Both the minimum controllable risk and the minimum significant risk are evaluated for radiation carcinogenesis and are shown to be of the same order of magnitude. For a realistic management action, the assumptions of perfectly effective action and perfect model prediction made above have to be dropped, resulting in an effective minimum controllable risk which is determined by both risk limits. Any action below that effective limit is futile, but it is also unethical due to the ethical requirement of doing more good than harm. Finally, some implications of the effective minimum controllable risk on the use of the ALARA principle and on the evaluation of remedial action goals are presented

Challenges in Risk Assessment: Quantitative Risk Assessment

OpenAIRE

Jacxsens, Liesbeth; Uyttendaele, Mieke; De Meulenaer, Bruno

2016-01-01

The process of risk analysis consists out of three components, risk assessment, risk management and risk communication. These components are internationally well spread by Codex Alimentarius Commission as being the basis for setting science based standards, criteria on food safety hazards, e.g. setting maximum limits of mycotoxins in foodstuffs. However, the technical component risk assessment is hard to elaborate and to understand. Key in a risk assessment is the translation of biological or...

Inflammation in Depression and the Potential for Anti-Inflammatory Treatment

DEFF Research Database (Denmark)

Kohler, Ole; Krogh, Jesper; Mors, Ole

2016-01-01

Accumulating evidence supports an association between depression and inflammatory processes, a connection that seems to be bidirectional. Clinical trials have indicated antidepressant treatment effects for anti-inflammatory agents, both as add-on treatment and as monotherapy. In particular......, nonsteroidal anti-inflammatory drugs (NSAIDs) and cytokine-inhibitors have shown antidepressant treatment effects compared to placebo, but also statins, poly-unsaturated fatty acids, pioglitazone, minocycline, modafinil, and corticosteroids may yield antidepressant treatment effects. However, the complexity...... of the inflammatory cascade, limited clinical evidence, and the risk for side effects stress cautiousness before clinical application. Thus, despite proof-of-concept studies of anti-inflammatory treatment effects in depression, important challenges remain to be investigated. Within this paper, we review...

Diagnosis and Treatment of Polycystic Ovary Syndrome in Pediatric Gynaecology

Directory of Open Access Journals (Sweden)

М.Yu. Serhiienko

2015-03-01

Full Text Available Diagnosis of polycystic ovary syndrome (PCOS in adolescence still raises many questions. The problem is that the characteristics of normal puberty often coincide with PCOS symptoms, so a number of researchers suggest to apply more stringent requirements to diagnosing. We use a cautious approach to a final diagnosis of PCOS because of its interpretation as a global problem of somatic health — endocrine and metabolic status, cardiovascular and oncogenic risk. In addition, one of the main therapies for PCOS is application of combined oral contraceptives, which are undesirable to use in adolescent girls with oligo- and amenorrhea without careful examination and use of all the abilities of vitamine therapy, phytotherapy and gestagens.

How could disclosing incidental information from whole-genome sequencing affect patient behavior?

Science.gov (United States)

Christensen, Kurt D; Green, Robert C

2013-06-01

In this article, we argue that disclosure of incidental findings from whole-genome sequencing has the potential to motivate individuals to change health behaviors through psychological mechanisms that differ from typical risk assessment interventions. Their ability to do so, however, is likely to be highly contingent upon the nature of the incidental findings and how they are disclosed, the context of the disclosure and the characteristics of the patient. Moreover, clinicians need to be aware that behavioral responses may occur in unanticipated ways. This article argues for commentators and policy makers to take a cautious but optimistic perspective while empirical evidence is collected through ongoing research involving whole-genome sequencing and the disclosure of incidental information.

Risk management

OpenAIRE

Mcmanus, John

2009-01-01

Few projects are completed on time, on budget, and to their original requirement or specifications. Focusing on what project managers need to know about risk in the pursuit of delivering projects, Risk Management covers key components of the risk management process and the software development process, as well as best practices for risk identification, risk planning, and risk analysis. The book examines risk planning, risk analysis responses to risk, the tracking and modelling of risks, intel...

Risk and risk aversion in our society

Energy Technology Data Exchange (ETDEWEB)

Cohen, B L [Pittsburgh Univ., PA (USA)

1985-01-01

The best way to understand the magnitude of a risk is to compare it with other risks with which we are familiar, and a convenient way of doing this is to compare risks on the basis of Loss of Life Expectancy, LLE, that they cause. The LLE due to various risks including energy generation is listed. The cost of programs to save lives by medical screening, highway safety and other methods is summarised. The public's perception of radiation risks is grossly exaggerated relative to other risks.

Risk and risk aversion in our society

International Nuclear Information System (INIS)

Cohen, B.L.

1985-01-01

The best way to understand the magnitude of a risk is to compare it with other risks which we are familiar, and a convenient way of doing this is to compare risks on the basis of Loss of Life Expectancy, LLE, that they cause. The LLE due to various risks including energy generation is listed. The cost of programs to save lives by medical screening, highway safety and other methods is summarised. The public's perception of radiation risks is grossly exaggerated relative to other risks

Not all risks are equal: the risk taking inventory for high-risk sports.

Science.gov (United States)

Woodman, Tim; Barlow, Matt; Bandura, Comille; Hill, Miles; Kupciw, Dominika; Macgregor, Alexandra

2013-10-01

Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.

New integrated and multiscale decision-aiding framework in a context of imperfect information: application to the assessment of torrent checkdams' effectiveness.

Science.gov (United States)

Tacnet, Jean-Marc; Carladous, Simon; Dezert, Jean; Batton-Hubert, Mireille

2017-04-01

Mountain natural phenomena (e.g. torrential floods) put people and buildings at risk. Civil engineering protection works such as torrent check-dams are designed to mitigate those natural risks. Protection works act on both causes and effects of phenomena to reduce consequences and therefore risks. For instance, check-dams control sediment production and liquid/solid flow of torrential floods: several series of dams are located in the headwaters of a watershed, each having specific functions. All those works are damaged by time passing and flood impacts. Effectiveness assessment is needed to define, compare or choose strategies for investment and maintenance which are essential issues in risk management process. Decision support tools are expected to analyze at different scales both their technical effectiveness (related to their structural state and functional effects on phenomena such as stopping, braking, guiding, etc.) and their economic efficiency through comparison between benefits and costs. Several methods, often based on expert knowledge, have already been developed to care about decision under risk. But uncertainty has also to be considered, since decisions are indeed often taken in a context of lack of information and knowledge on natural phenomena, heterogeneity of available information and, finally, reliability of sources. First methods derived from classical industrial contexts, such as dependability analysis, are used to formalize expert knowledge used for decision-making. After having defined the concept of effectiveness, dependability analysis are used to identify decision contexts and problems: criteria and indicators are identified in relation with structural or functional features. Then, innovative and multi-scales multi-criteria decision-making methods (MCDMs) and frameworks are proposed to help assessing protection works effectiveness. They combine classical MCDM approaches, belief function, fuzzy sets and possibility theories. Those methods

Risk communication and environmental risk assessment

International Nuclear Information System (INIS)

Petts, J.

1994-01-01

This paper attempts to provide a broad context for consideration of appropriate risk communication approaches. It examines the basis of public concerns and in particular the non-risk dimensions. The latter are so important in any risk decision that means of communication which can deal with them are required which extend beyond understanding how to present risk estimates. These means relate to (a) the decision processes themselves and the extent to which they provide for involvement of the public in decisions, (b) the communication skills of experts, and (c) the robustness of the risk information which is available. (Author)

Exploration Health Risks: Probabilistic Risk Assessment

Science.gov (United States)

Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

2006-01-01

Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

Quantile uncertainty and value-at-risk model risk.

Science.gov (United States)

Alexander, Carol; Sarabia, José María

2012-08-01

This article develops a methodology for quantifying model risk in quantile risk estimates. The application of quantile estimates to risk assessment has become common practice in many disciplines, including hydrology, climate change, statistical process control, insurance and actuarial science, and the uncertainty surrounding these estimates has long been recognized. Our work is particularly important in finance, where quantile estimates (called Value-at-Risk) have been the cornerstone of banking risk management since the mid 1980s. A recent amendment to the Basel II Accord recommends additional market risk capital to cover all sources of "model risk" in the estimation of these quantiles. We provide a novel and elegant framework whereby quantile estimates are adjusted for model risk, relative to a benchmark which represents the state of knowledge of the authority that is responsible for model risk. A simulation experiment in which the degree of model risk is controlled illustrates how to quantify Value-at-Risk model risk and compute the required regulatory capital add-on for banks. An empirical example based on real data shows how the methodology can be put into practice, using only two time series (daily Value-at-Risk and daily profit and loss) from a large bank. We conclude with a discussion of potential applications to nonfinancial risks. © 2012 Society for Risk Analysis.

Maternal dietary fat intake in association with autism spectrum disorders.

Science.gov (United States)

Lyall, Kristen; Munger, Kassandra L; O'Reilly, Éilis J; Santangelo, Susan L; Ascherio, Alberto

2013-07-15

Our goal in this study was to determine whether maternal fat intake before or during pregnancy was associated with risk of autism spectrum disorder (ASD) in the offspring. Our primary analysis included 317 mothers who reported a child with ASD and 17,728 comparison mothers from the Nurses' Health Study II (index births in 1991-2007). Dietary information was collected prospectively through a validated food frequency questionnaire. Binomial regression was used to estimate crude and adjusted risk ratios. Maternal intake of linoleic acid was significantly inversely associated with ASD risk in offspring, corresponding to a 34% reduction in risk in the highest versus lowest quartiles of intake. Mothers in the lowest 5% of ω-3 fatty acid intake had a significant increase in offspring ASD risk as compared with the remaining distribution (risk ratio = 1.53, 95% confidence interval: 1.00, 2.32); this association was also seen in the subgroup of women (86 cases and 5,798 noncases) for whom dietary information during pregnancy was available (risk ratio = 2.42, 95% confidence interval: 1.19, 4.91). Thus, variations in intake of polyunsaturated fats within the range commonly observed among US women could affect fetal brain development and ASD risk. Because the number of women with diet assessed during pregnancy was small, however, these results should be interpreted cautiously.

Obstetric outcomes of patients with abortus imminens in the first trimester.

Science.gov (United States)

Evrenos, Ayşe Nur; Cakir Gungor, Ayse Nur; Gulerman, Cavidan; Cosar, Emine

2014-03-01

We aimed to find out the effect of abortus imminens (AI) on obstetric outcomes of pregnancies which continued beyond the 24th week of gestation. In this prospective study, 309 patients with AI were divided into high-risk group (with a risk factor for spontaneous abortus) (n = 92) and low-risk group (without a risk factor) (n = 217). The control group (n = 308) was chosen randomly. In AI group, preterm delivery, preterm premature rupture of membranes (PPROM), cesarean section (C/S) delivery, postpartum uterine atony and need of a neonatal intensive care unit (NICU) rates were significantly higher than control group. Gestational diabetes mellitus, PPROM, still birth, low APGAR scores were seen more frequently in the high-risk patients than in the control group. Furthermore in the high-risk group, preterm delivery, malpresentation, C/S delivery and need of NICU were increased much more than in the low-risk group. Gestational hypertension/preeclampsia, oligo/polyhydramniosis, intrauterine growth retardation, placenta previa, abruption of placenta, chorioamnionitis, congenital abnormalities, delivery induction, cephalopelvic disproportion, fetal distress and manual removal of placenta were not different among the groups. Patients with AI history, especially with high-risk factors can have adverse obstetric and neonatal results. So their antenatal follow-up has to be done cautiously for the early signs and symptoms of these complications.

The Role of risk perception for risk management

International Nuclear Information System (INIS)

Renn, Ortwin

1999-01-01

The list of individual and social factors that shape risk perception demonstrates that the intuitive understanding of risk is a multidimensional concept and cannot be reduced to the product of probabilities and consequences. Although risk perceptions differ considerably among social and cultural groups, the multi-dimensionality of risk and the integration of beliefs related to risk, the cause of risk, and its circumstances into a consistent belief system appear to be common characteristics of public risk perception in almost all countries in which such studies have been performed. Furthermore, the experience of risk is not limited to the threat of facing harm in the future. It includes subjective predictions of possible outcomes, the social and cultural context in which the risk is experienced, the mental images the risk situation evokes, the perception of the players who are involved in the risk situation and the judgments about fairness and equity related to the distribution of potential hazardous events. In this sense, risk is a social construct rather than a physical entity. Risk communication and conflict resolution is therefore a crucial element of any risk management strategy. The goal of risk communication and conflict resolution should not be to persuade people to accept whatever the communicator thinks is best for them. The ideal communication program envisions a receiver who processes all the available information to form a well-balanced judgement in accordance with the factual evidence, the arguments of all sides, and his/her own interests and preferences. The ultimate goal of risk communication is to reconcile expertise, interests, and public preferences. (EHS)

Concept of risk: risk assessment and nuclear safety

International Nuclear Information System (INIS)

Thompson, P.B.

1980-01-01

The dissertation is a critical examination of risk assessment and its role in public policy. Nuclear power safety safety issues are selected as the primary source of illustrations and examples. The dissertation examines how risk assessment studies develop a concept of risk which becomes decisive for policy choices. Risk-assessment techniques are interpreted as instruments which secure an evaluation of risk which, in turn, figures prominently in technical reports on nuclear power. The philosophical critique is mounted on two levels. First, an epistemological critique surveys distinctions between the technical concept of risk and more familiar senses of risk. The critique shows that utilization of risk assessment re-structures the concept of risk. The technical concept is contrasted to the function of risk within a decision-maker's conceptual agenda and hierarchy of values. Second, an ethical critique exposes the value commitments of risk assessment recommendations. Although some of these values might be defended for policy decisions, the technical character of risk assessment obfuscates normative issues. Risk assessment is shown to be a form of factual enquiry which, nonetheless, represents a commitment to a specific selection of ethical and social values. Risk assessment should not be interpreted as a primary guide to decision unless the specific values incorporated into its concept of risk are stated explicitly and justified philosophically. Such a statement would allow value questions which have been sublimated by the factual tone of the analytic techniques to be debated on clear, social and ethical grounds

SGLT2-I in the Hospital Setting: Diabetic Ketoacidosis and Other Benefits and Concerns.

Science.gov (United States)

Levine, Joshua A; Karam, Susan L; Aleppo, Grazia

2017-07-01

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the newest class of antihyperglycemic agents. They are increasingly being prescribed in the outpatient diabetic population. In this review, we examine the risks and benefits of continuation and initiation of SGLT2 inhibitors in the inpatient setting. There are currently no published data regarding safety and efficacy of SGLT2 inhibitor use in the hospital. Outpatient data suggests that SGLT2 inhibitors have low hypoglycemic risk. They also decrease systolic blood pressure and can prevent cardiovascular death. The EMPA-REG study also showed a decrease in admissions for acute decompensated heart failure. There have been increasing cases of diabetic ketoacidosis, and specifically the euglycemic manifestation, associated with SGLT2 inhibitors use. We present two cases of inpatient SGLT2 inhibitor use, one of continuation of outpatient therapy and one of new initiation of therapy. We then discuss potential risks and methods to mitigate these as well as benefits of these medications in the inpatient setting. We cautiously suggest the use of SGLT2 inhibitors in the hospital. However, these must be used judiciously and the practitioner must be aware of euglycemic diabetic ketoacidosis and its risk factors in this population.

Environmental Risk Communication through Qualitative Risk Assessment

Directory of Open Access Journals (Sweden)

Sabre J. Coleman

2014-06-01

Full Text Available Environmental analysts are often hampered in communicating the risks of environmental contaminants due to the myriad of regulatory requirements that are applicable. The use of a qualitative, risk-based control banding strategy for assessment and control of potential environmental contaminants provides a standardized approach to improve risk communication. Presented is a model that provides an effective means for determining standardized responses and controls for common environmental issues based on the level of risk. The model is designed for integration within an occupational health and safety management system to provide a multidisciplinary environmental and occupational risk management approach. This environmental model, which utilizes multidisciplinary control banding strategies for delineating risk, complements the existing Risk Level Based Management System, a proven method in a highly regulated facility for occupational health and safety. A simplified environmental risk matrix is presented that is stratified over four risk levels. Examples of qualitative environmental control banding strategies are presented as they apply to United States regulations for construction, research activities, facility maintenance, and spill remediation that affect air, water, soil, and waste disposal. This approach offers a standardized risk communication language for multidisciplinary issues that will improve communications within and between environmental health and safety professionals, workers, and management.

Risk, Risk Perception, Risk Management – a Review of the Literature

OpenAIRE

Tamás Vasvári

2015-01-01

Risks have become an integral part of our society. In this context, the aim of this paper is to provide a summary of the findings of risk research conducted in different fields of study and to trace the effect of these findings on risk management practices. The basic approaches to risk presented in this paper show that the notions of probability employed in studying processes in any area of life belong in the province of epistemology rather than ontology. Therefore, subjectivity cannot be com...

Factors related to the occurrence of precocious menarche in female primary school students in Makassar

Science.gov (United States)

Renjani, Rizky Swastika; Mappaware, Nasrudin A.; Nontji, Werna; Marniati

2017-09-01

Precocious menarche currently affects 1 in 5000 girls and likely to occur as many as 10 times and possess greater risk to the emergence of cancer in women. The aim of this research is to determine the relationship of nutrition status and lipid profile with precocious menarche occurrence onstudents of primary school in Makassar city. The design of this research was cross sectional design. The samples werethe students of grades IV, V and VI who have already menarche occurrence as many as 20 studentscollected with purposive sampling. The data were analyzed with Mann Whitney U test. The results indicate that there are 17 students (85%) do not undergoprecocious menarche, normal nutrition status is 11 persons (55%), normal cholesterol levelis 12 persons (60%), and level of normal LDL = 19 persons (95%). While the respondents who undergo precocious menarche is 3 persons (15%), fat nutrition status is 9 persons (45%), cautious cholesterol level is 8 persons (40%) and cautious LDL level is 1 person (5%). Based on Mann Whitney U test, there is relationship between nutrition status and precocious menarche occurrence (p = 0.043) and there is correlation of total cholesterol and LDLcholesterollevelswith precocious menarche (p = 0.025) and (p = 0.017). The decrease of knowledge about health of reproduction can be promoted in school by making cooperation with nutritionist to give information to parents and students of primary schools about good and healthy food.

Judging risk behaviour and risk preference: the role of the evaluative connotation of risk terms.

NARCIS (Netherlands)

van Schie, E.C.M.; van der Pligt, J.; van Baaren, K.

1993-01-01

Two experiments investigated the impact of the evaluative connotation of risk terms on the judgment of risk behavior and on risk preference. Exp 1 focused on the evaluation congruence of the risk terms with a general risk norm and with Ss' individual risk preference, and its effects on the extremity

Risk indicators as a tool for risk control

International Nuclear Information System (INIS)

Oien, K.

2001-01-01

This paper presents a general methodology for the establishment of risk indicators that can be used as a tool for risk control during operation of offshore petroleum installations. The risk indicators established are based on the platform specific quantitative risk analysis (QRA). The general methodology is evaluated against comparable approaches both in offshore and nuclear industry. There are two distinct features of this methodology. The first is that it is truly risk-based with the intention of covering the total risk picture. The second is that the identification of the risk factors contributing most to the total risk is based on realistic changes of each factor assessed by the platform personnel, not a theoretically assumed change. The set of risk indicators for one specific installation is presented along with test results

Structure of safeguards systems

International Nuclear Information System (INIS)

Shipley, J.P.

1978-06-01

An effective safeguards system for domestic nuclear fuel cycle facilities consists of several important subsystems that must coordinate their functions with plant management and process control. The safeguards system must not unnecessarily disrupt plant operations, compromise safety requirements, or infringe on employee working conditions. This report describes concepts, which have been developed with the cooperation of the nuclear industry and the safeguards community, for achieving these objectives

Consumer behavior: a quadrennium.

Science.gov (United States)

Jacoby, J; Johar, G V; Morrin, M

1998-01-01

Consumer behavior continued to attract additional researchers and publication outlets from 1993 through 1996. Both general interest and domain-specific scholarly contributions are discussed, along with limitations and suggested areas for future research. A concluding section observes that the integrity of consumer research is unnecessarily compromised by the failure of the major scholarly association in the field to develop and adopt a code of researcher ethics.

Balancing compliance and cost when implementing a Quality Assurance program

International Nuclear Information System (INIS)

Pickering, S.Y.

1997-12-01

When implementing a Quality Assurance (QA) program, compliance and cost must be balanced. A QA program must be developed that hits the mark in terms of adequate control and documentation, but does not unnecessarily expand resources. As the Waste Isolation Pilot Plant (WIPP) has moved towards certification, Sandia National Laboratories has learned much about balancing compliance and costs. Some of these lessons are summarized here

Forecasting Long-Run Electricity Prices

International Nuclear Information System (INIS)

Hamm, Gregory; Borison, Adam

2006-01-01

Estimation of long-run electricity prices is extremely important but it is also very difficult because of the many uncertainties that will determine future prices, and because of the lack of sufficient historical and forwards data. The difficulty is compounded when forecasters ignore part of the available information or unnecessarily limit their thinking about the future. The authors present a practical approach that addresses these problems. (author)

Concentration risk

Directory of Open Access Journals (Sweden)

Matić Vesna

2016-01-01

Full Text Available Concentration risk has been gaining a special dimension in the contemporary financial and economic environment. Financial institutions are exposed to this risk mainly in the field of lending, mostly through their credit activities and concentration of credit portfolios. This refers to the concentration of different exposures within a single risk category (credit risk, market risk, operational risk, liquidity risk.

Risk Jyouhou Navi (risk information navigator). Web tool for fostering of risk literacy. Set of data

International Nuclear Information System (INIS)

Mitsui, Seiichiro

2003-06-01

In addition to the conventional public understanding activities, Risk communication study team of Japan Nuclear Cycle Development Institutes (JNC) Tokai Works has started practical studies to promote risk communication with its local communities. Since its establishment in 2001, Risk communication study team has conducted analyses of already available results of public attitude surveys, case studies of domestic and overseas risk communication activities, and development of risk communication tools. A web tool for fostering of risk literacy 'Risk Jyouhou Navi (risk information navigator in English)', was developed as a web content for the official home page of Techno Kouryuu Kan Ricotti (Techno Community Square Ricotti in English)'. The objectives of this content are to provide risk information for public and to provide an electronic platform for promoting risk communication with the local community. To develop 'Risk Jyouhou Navi', the following concepts were considered. 1) To create public interest in risks in daily lives and in global risks. 2) To provide risk knowledge and information. 3) To support risk communication activities in Techno community square ricotti. (author)

Risk perception versus seismic risk: An introduction

International Nuclear Information System (INIS)

Cubeddu, Francesca

2015-01-01

A seismic event generally has consequences on the social relationships, economy and culture of the impacted territory. As Mary Douglas quotes, a change into the social perception of risk as consequence of an earthquake may have effects on the lifestyle of the local community. The above mentioned statement is the starting point of this article. illustrating the difference between peril and risk is the second point. According to the Aristotelian theory of categories, risk can be considered as a human characteristic depending on social and cultural factors. Risk is here intended as a social category and cannot be de facto reported as a statistical or stochastic function based on a mathematical formula, as long assumed in the past. This approach, then, requires a deep revision. In this sense, and following the concept of risk perception, seismic risk is analysed in this article in terms of impacts, precautionary measures, risk assessment and management. Knowledge of this topic cannot be intended as a simple philosophical exercise, since right on awareness depend risk reduction, humans and goods too [it

Risk assessment

International Nuclear Information System (INIS)

1983-01-01

The report is in sections, entitled: preface; summary and conclusions; introduction (historical and organizational); estimating engineering risks (techniques of risk estimation and forms of expression of risk); laboratory experiments for estimation of biological risks; estimation of risk from observations on man (travel, medical procedures; occupations; sport); the perception of risks; (as an example of attitudes towards a single hazard, studies of nuclear power are considered among other topics in this section); risk management (estimation; perception; acceptability, analysis of risk, costs and benefits; safety standards; decision-making process; possible guidelines). (U.K.)

Seismic Risk Perception compared with seismic Risk Factors

Science.gov (United States)

Crescimbene, Massimo; La Longa, Federica; Pessina, Vera; Pino, Nicola Alessandro; Peruzza, Laura

2016-04-01

The communication of natural hazards and their consequences is one of the more relevant ethical issues faced by scientists. In the last years, social studies have provided evidence that risk communication is strongly influenced by the risk perception of people. In order to develop effective information and risk communication strategies, the perception of risks and the influencing factors should be known. A theory that offers an integrative approach to understanding and explaining risk perception is still missing. To explain risk perception, it is necessary to consider several perspectives: social, psychological and cultural perspectives and their interactions. This paper presents the results of the CATI survey on seismic risk perception in Italy, conducted by INGV researchers on funding by the DPC. We built a questionnaire to assess seismic risk perception, with a particular attention to compare hazard, vulnerability and exposure perception with the real data of the same factors. The Seismic Risk Perception Questionnaire (SRP-Q) is designed by semantic differential method, using opposite terms on a Likert scale to seven points. The questionnaire allows to obtain the scores of five risk indicators: Hazard, Exposure, Vulnerability, People and Community, Earthquake Phenomenon. The questionnaire was administered by telephone interview (C.A.T.I.) on a statistical sample at national level of over 4,000 people, in the period January -February 2015. Results show that risk perception seems be underestimated for all indicators considered. In particular scores of seismic Vulnerability factor are extremely low compared with house information data of the respondents. Other data collected by the questionnaire regard Earthquake information level, Sources of information, Earthquake occurrence with respect to other natural hazards, participation at risk reduction activities and level of involvement. Research on risk perception aims to aid risk analysis and policy-making by

76 FR 1889 - Risk-Based Capital Guidelines: Market Risk

Science.gov (United States)

2011-01-11

... ``three-pillar'' framework that includes (i) risk-based capital requirements for credit risk, market risk... incremental risk capital requirement to capture default and credit quality migration risk for non... (advanced approaches rules) (collectively, the credit risk capital rules) \\8\\ by requiring any bank subject...

Images of alcoholism among adolescents in individualistic and collectivistic geographies

Directory of Open Access Journals (Sweden)

Rolando Sara

2014-04-01

Full Text Available AIM - This article compares adolescents’ images of alcoholism in two different drinking geographies, namely Helsinki (Finland and Turin (Italy, with the aim to better understand the persisting variance in youth drinking within Europe. DESIGN - Altogether 28 focus group interviews were conducted at schools among 15-year-old pupils (N=145. To assure reliable qualitative comparison across language boundaries, we applied a structured qualitative focus-group methodology called the Reception Analytical Group Interview (RAGI. CONCLUSIONS - Collectivist images of alcoholism can be considered more protective in terms of alcohol-related risk behaviour as they 1 emphasise interpersonal responsibility, 2 enhance the value of norms and traditions, and 3 highlight causes of alcoholism which are beyond the control of the individual (that is, contextual, social and inherent in the substance, making the attitude towards alcohol more cautious. A greater emphasis on the individual competence may correspondingly result in a lower perception about the risks of drinking

Register-based studies of cardiovascular disease

DEFF Research Database (Denmark)

Abildstrøm, Steen Z; Torp-Pedersen, Christian; Madsen, Mette

2011-01-01

Introduction: The use of the unique personal identification number in the Nordic database systems enables the researchers to link the registers at the individual level. The registers can be used for both defining specific patient populations and to identify later events during follow-up. This rev...... the hospitalisation rate and treatment of cardiovascular disease. The risk of unmeasured factors affecting the results calls for cautious interpretation of the results.......-up. This review gives three examples within cardiovascular epidemiology to illustrate the use of the national administrative registers available to all researchers upon request. Research topics: The hospitalisation rate of acute myocardial infarction (AMI) was expected to be increased and case-fatality rate......-based treatment increased significantly over time and adherence to treatment was high. Finally, use of specific nonsteroidal antiinflammatory drugs by healthy subjects was associated with a dose-dependent increase in cardiovascular risk. CONCLUSION: The nationwide registers have proven very useful in monitoring...

Radon and lung cancer among New Jersey women

International Nuclear Information System (INIS)

Schoenberg, J.; Klotz, J.; Wilcox, H.; Nicholls, G.

1990-01-01

An epidemiologic study previously conducted in New Jersey women was extended to examine the association of lung cancer with radon exposure. The substudy included 433 cases and 402 controls who lived in a single index residence for 10+ years during the period 10--30 years prior to diagnosis or selection. Lung cancer risks showed a significant trend (p = 0.04) with increasing year-round living area radon concentrations (based on alpha track measurements), and a weaker (p = 0.09) trend with estimated cumulative radon exposure. The relative risk coefficient of 3.4% per working level month (WLM) was consistent with the range of 0.5--4%/WLM generally reported for underground miners. This paper results must be interpreted cautiously due to the small number of subjects with high radon exposures and the possibility of selection biases. Nevertheless, the study suggests that findings of radon-related lung cancer in miners can be applied to the residential setting

Nuclear detonation, thyroid cancer and potassium iodide prophylaxis

Directory of Open Access Journals (Sweden)

Viroj Wiwanitkit

2011-01-01

Full Text Available The recent nuclear disaster at Japan has raised global concerns about effects of radioactive leakage in the environment, associated hazards, and how they can be prevented. In this article, we have tried to explain about the guidelines laid down by World Health Organization for a potassium iodide prophylaxis following a nuclear disaster, and its mechanism of action in preventing thyroid cancer. Data was collected mainly from the studies carried out during the Chernobyl disaster of Russia in 1986 and the hazardous effects especially on the thyroid gland were studied. It was seen that radioactive iodine leakage from the nuclear plants mainly affected the thyroid gland, and especially children were at a higher risk at developing the cancers. Potassium Iodide prophylaxis can be administered in order to prevent an increase in the incidence of thyroid cancers in the population of an area affected by a nuclear disaster. However, one has to be cautious while giving it, as using it without indication has its own risks.

Risk management.

Science.gov (United States)

Chambers, David W

2010-01-01

Every plan contains risk. To proceed without planning some means of managing that risk is to court failure. The basic logic of risk is explained. It consists in identifying a threshold where some corrective action is necessary, the probability of exceeding that threshold, and the attendant cost should the undesired outcome occur. This is the probable cost of failure. Various risk categories in dentistry are identified, including lack of liquidity; poor quality; equipment or procedure failures; employee slips; competitive environments; new regulations; unreliable suppliers, partners, and patients; and threats to one's reputation. It is prudent to make investments in risk management to the extent that the cost of managing the risk is less than the probable loss due to risk failure and when risk management strategies can be matched to type of risk. Four risk management strategies are discussed: insurance, reducing the probability of failure, reducing the costs of failure, and learning. A risk management accounting of the financial meltdown of October 2008 is provided.

CONSIDERATIONS IN RISK COMMUNICATION: A DIGEST OF RISK COMMUNICATION AS A RISK MANAGEMENT TOOL

Science.gov (United States)

Risk communication is the process of informing people about hazards. Like all communication, communicating risk is a two-way exchange in which you inform the target community about possible hazards, but also gather information about those affected by the risk. The purpose of risk...

Risk communication. Risk studies in social science; Risk communication. Risk kenkyu eno shakai kagakuteki approach

Energy Technology Data Exchange (ETDEWEB)

Asami, M. [Keio Univ., Tokyo (Japan)

1995-11-05

It is recently, that is, in and after the 1980s that socio-scientific approaches began to be made to studies on `risk`. It started to be made clear that the progress of the scientific technology does not necessarily bring about good news to man, and obvious estrangement has begun to appear between scientific evaluation and social evaluation of risk. The subject of risk communication (RC) study is to tackle a proposition whether the estrangement will continue to exist as estrangement or the estrangement can be made smaller by any means. This paper explains the recent trend of the study. For example, as for how each individual thinks about risk, that is, the risk perception, a new framework is trially being constructed by introduction of the quantitative method using psychometrics. A duty of RC is to serve to bridge the gap between scientific technology and society which are controlled by values which are incompatible with each other. Therefore, RC will be more and more important. 15 refs., 1 fig., 2 tabs.

Neural correlates of value, risk, and risk aversion contributing to decision making under risk.

Science.gov (United States)

Christopoulos, George I; Tobler, Philippe N; Bossaerts, Peter; Dolan, Raymond J; Schultz, Wolfram

2009-10-07

Decision making under risk is central to human behavior. Economic decision theory suggests that value, risk, and risk aversion influence choice behavior. Although previous studies identified neural correlates of decision parameters, the contribution of these correlates to actual choices is unknown. In two different experiments, participants chose between risky and safe options. We identified discrete blood oxygen level-dependent (BOLD) correlates of value and risk in the ventral striatum and anterior cingulate, respectively. Notably, increasing inferior frontal gyrus activity to low risk and safe options correlated with higher risk aversion. Importantly, the combination of these BOLD responses effectively decoded the behavioral choice. Striatal value and cingulate risk responses increased the probability of a risky choice, whereas inferior frontal gyrus responses showed the inverse relationship. These findings suggest that the BOLD correlates of decision factors are appropriate for an ideal observer to detect behavioral choices. More generally, these biological data contribute to the validity of the theoretical decision parameters for actual decisions under risk.

Okul Öncesi Öğretmenlerinin Riskli Oyunlara Yönelik Görüş ve Algıları

Directory of Open Access Journals (Sweden)

B. İpek Güler

2016-08-01

participated in this study. Data were collected by using a questionnaire form, which was developed by researchers and participants were interviewed individually. Document analysis was conducted on the documents obtained by these interviews. As a result of the study, it was indicated that teachers’ approaches to risky play was cautious. The importance given to children’s physical health was seemed to an obstacle for taking risk. As a reason for this foundings, it was observed that risk was perceived as a dangerous and damaging. Also, it was observed that attitudes of parents and school managers toward teachers and physical infrastructure issues could be other factors that prevent risky play.

Probabilistic risk assessment as an aid to risk management

International Nuclear Information System (INIS)

Garrick, B.J.

1982-01-01

Probabilistic risk assessments are providing important insights into nuclear power plant safety. Their value is two-fold: first as a means of quantifying nuclear plant risk including contributors to risk, and second as an aid to risk management. A risk assessment provides an analytical plant model that can be the basis for performing meaningful decision analyses for controlling safety. It is the aspect of quantitative risk management that makes probabilistic risk assessment an important technical discipline of the future

[Risk Assessment and Risk Management of Chemicals in China].

Science.gov (United States)

Wang, Tie-yu; Zhou, Yun-qiao; Li, Qi-feng; Lü, Yong-long

2016-02-15

Risk assessment and risk management have been increasingly approved as an effective approach for appropriate disposal and scientific management of chemicals. This study systematically analyzed the risk assessment methods of chemicals from three aspects including health risk, ecological risk and regional risk. Based on the current situation of classification and management towards chemicals in China, a specific framework of risk management on chemicals was proposed by selecting target chemicals, predominant industries and related stakeholders as the objects. The results of the present study will provide scientific support for improving risk assessment and reasonable management of chemicals in China.

Fracture Risk and Risk Factors for Osteoporosis.

Science.gov (United States)

Schürer, Christian; Wallaschofski, Henri; Nauck, Matthias; Völzke, Henry; Schober, Hans-Christof; Hannemann, Anke

2015-05-25

As the population ages, diseases of the elderly are becoming more common, including osteoporosis. Ways to assess the risk of fracture and the distribution and effects of known risk factors for osteoporosis will be important in planning for future healthcare needs, as well as in the development of preventive strategies. The study population included 6029 men and women aged 20-90 who underwent examination in the second follow-up wave of the Study of Health in Pomerania (SHIP-2) or in the basal SHIP-Trend Study. The risk of fracture was estimated on the basis of quantitative ultrasonography of the calcaneus. Prior fractures and risk factors for osteoporosis were ascertained in standardized interviews. 4.6% of the male subjects and 10.6% of the female subjects were judged to have an elevated risk of fracture. The corresponding percentages among subjects over age 65 were 8.8% for men and 28.2% for women. Even among subjects under age 55, risk factors for osteoporosis were associated with lower bone stiffness: the mean stiffness index was 103/98 (men/women) without risk factors, 99/96 with one risk factor, and 93/95 with more than one risk factor. Logistic regression analysis yielded an odds ratio of 1.89 (95% confidence interval: 1.44-2.50; p<0.01) for prevalent fractures among subjects aged 75 and older compared to subjects under age 55. The data indicate a high prevalence of osteoporosis from age 65 onward. These findings are consistent with those of other studies from Germany and across Europe. Younger men and women should already begin taking steps to counteract modifiable risk factors.

Helping to reduce turbomachinery losses through advanced technology and on-line expertise

Energy Technology Data Exchange (ETDEWEB)

Feigel, R.E. [Hartford Steam Boiler Inspection & Insurance Co., Hartford, CT (United States)

1994-12-31

It`s clear that turbomachinery poses a set of unique problems for risk managers. The size of the equipment, the role it often takes in production and the severity of a loss all combine to make a risk manager`s job that much more difficult. But while the job may be difficult, it`s not impossible. Through a combination of advanced technology, regular predictive maintenance and some expert advice, today`s risk managers, working with plant operational personnel, are reducing major turbomachinery losses. There are several telltale signs that warn plant personnel of an impending turbomachinery failure. One is vibration. All turbomachinery will vibrate at some level, even when in good working condition. But a change in the vibration level usually indicates a change in the machine`s performance. If plant personnel can detect a change early enough, they may be able to avoid an unscheduled shutdown. Hartford Steam Boiler recently introduced a periodic vibration data collection program called DATALERT{trademark} to help its customers separate problem from non-problem machines. As a result, companies can focus resources on equipment that needs immediate attention. And equipment in good working condition doesn`t tie up resources unnecessarily at the next maintenance turnaround. DATALERT is an integrated machinery vibration data collecting and expert analysis system developed by Hartford Steam Boiler to assist customers in preventing rotating machine downtime or losses. The data collection program is described.

Performance of the "CCS Algorithm" in real world patients.

Science.gov (United States)

LaHaye, Stephen A; Olesen, Jonas B; Lacombe, Shawn P

2015-06-01

With the publication of the 2014 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation, the Canadian Cardiovascular Society Atrial Fibrillation Guidelines Committee has introduced a new triage and management algorithm; the so-called "CCS Algorithm". The CCS Algorithm is based upon expert opinion of the best available evidence; however, the CCS Algorithm has not yet been validated. Accordingly, the purpose of this study is to evaluate the performance of the CCS Algorithm in a cohort of real world patients. We compared the CCS Algorithm with the European Society of Cardiology (ESC) Algorithm in 172 hospital inpatients who are at risk of stroke due to non-valvular atrial fibrillation in whom anticoagulant therapy was being considered. The CCS Algorithm and the ESC Algorithm were concordant in 170/172 patients (99% of the time). There were two patients (1%) with vascular disease, but no other thromboembolic risk factors, which were classified as requiring oral anticoagulant therapy using the ESC Algorithm, but for whom ASA was recommended by the CCS Algorithm. The CCS Algorithm appears to be unnecessarily complicated in so far as it does not appear to provide any additional discriminatory value above and beyond the use of the ESC Algorithm, and its use could result in under treatment of patients, specifically female patients with vascular disease, whose real risk of stroke has been understated by the Guidelines.

Life span studies on mice exposed to heavy charged particles or photons: preliminary results

International Nuclear Information System (INIS)

Ainsworth, E.J.

1980-01-01

This chapter summarizes the results currently available where dose-dependent mortality is compared among the single cohort that received fractionated doses of carbon ions and the first replicate that received single doses. At this time, 17% mortality has occurred in both groups and had enhanced life shortening been produced by fractionation of the carbon ion dose, somewhat higher mortality might be expected. Cautious interpretation of these preliminary results is necessary, but the mortality data available at this time provides no evidence for enhancement by dose fractionation with carbon ions. In sum, at this time, it appears the Q factor used for fission spectrum neutrons could be conservative if it were used for assessment of risk following exposure to 400 MeV carbon ions

Nonsurgical management of an extensive endodontic lesion in an orthodontic patient by calcium-enriched mixture apical plug

Directory of Open Access Journals (Sweden)

Saeed Asgary

2014-01-01

Full Text Available Periapical lesion is a general term used to describe the periapical inflammatory process that occurs in response to the invasion of micro-organisms in the root canal system as well as inflamed vital pulp. This phenomenon necessitates endodontic intervention and if the necrosis has occurred prior to tooth maturation, wide patency of the apical foramen requires some treatment modalities such as apexification or apical plug. Orthodontic treatment, on the other hand, is cautiously done for previously traumatized teeth due to increased risk for necrosis of the compromised tooth. This article tends to review the successful treatment process with calcium-enriched mixture (CEM cement apical plug for an immature previously traumatized incisor tooth with an extensive periapical lesion, which was under orthodontic treatment as well.

A 3-Year Follow-up of Sun Behavior in Patients With Cutaneous Malignant Melanoma

DEFF Research Database (Denmark)

Idorn, Luise Winkel; Datta, Pameli; Heydenreich, Jakob

2014-01-01

IMPORTANCE UV radiation (UVR) exposure is the primary environmental risk factor for developing cutaneous malignant melanoma (CMM). OBJECTIVE To measure changes in sun behavior from the first until the third summer after the diagnosis of CMM using matched controls as a reference. DESIGN, SETTING...... that measured time-related UVR in standard erythema dose (SED) and corresponding sun diaries (mean, 74 days per participant each participation year). RESULTS Patients' daily UVR dose and UVR dose in connection with various behaviors increased during follow-up (quantified as an increase in daily UVR dose each...... suggest that patients with CMM do not maintain a cautious sun behavior in connection with an increase in UVR exposure, especially on days with body exposure, when abroad, and on holidays....

Restructuring supervision and reconfiguration of skill mix in community pharmacy: Classification of perceived safety and risk.

Science.gov (United States)

Bradley, Fay; Willis, Sarah C; Noyce, Peter R; Schafheutle, Ellen I

2016-01-01

Broadening the range of services provided through community pharmacy increases workloads for pharmacists that could be alleviated by reconfiguring roles within the pharmacy team. To examine pharmacists' and pharmacy technicians (PTs)' perceptions of how safe it would be for support staff to undertake a range of pharmacy activities during a pharmacist's absence. Views on supervision, support staff roles, competency and responsibility were also sought. Informed by nominal group discussions, a questionnaire was developed and distributed to a random sample of 1500 pharmacists and 1500 PTs registered in England. Whilst focused on community pharmacy practice, hospital pharmacy respondents were included, as more advanced skill mix models may provide valuable insights. Respondents were asked to rank a list of 22 pharmacy activities in terms of perceived risk and safety of these activities being performed by support staff during a pharmacist's absence. Descriptive and comparative statistic analyses were conducted. Six-hundred-and-forty-two pharmacists (43.2%) and 854 PTs (57.3%) responded; the majority worked in community pharmacy. Dependent on agreement levels with perceived safety, from community pharmacists and PTs, and hospital pharmacists and PTs, the 22 activities were grouped into 'safe' (n = 7), 'borderline' (n = 9) and 'unsafe' (n = 6). Activities such as assembly and labeling were considered 'safe,' clinical activities were considered 'unsafe.' There were clear differences between pharmacists and PTs, and sectors (community pharmacy vs. hospital). Community pharmacists were most cautious (particularly mobile and portfolio pharmacists) about which activities they felt support staff could safely perform; PTs in both sectors felt significantly more confident performing particularly technical activities than pharmacists. This paper presents novel empirical evidence informing the categorization of pharmacy activities into 'safe,' 'borderline' or 'unsafe

LIQUIDITY MANAGEMENT AND CORPORATE RISK

Directory of Open Access Journals (Sweden)

Fenyves Veronika

2011-07-01

Full Text Available The consequence of the economic crisis, the access of the external financing resources was narrowed significantly and lenders had became more cautious. This meant that the external source providers analyze more thoroughly the source claimants, and they also need to be more aware of their situation, to submit well founded loan applications to financial institutions. The other aspect is why the indicators presented in the study, the firms should be addressed much more thoroughly than ever before to have a much better understanding their situation, to recognize the sources of internal funding opportunities, and to use more efficiently the available internal resources. However, analysts should be aware of which are the ratios which should be paid a special attention and which ones are essential to assess a given situation, knowing them they can properly inform the leaders as well as to give an appropriate help to the decision makers. To ensure the appropriate level of internal resources the company's activity is continuous financing closely related to the working capital management. The other reason is why the working capital management coming into view - which is linked to the previous one - that longer and longer payment periods have emerged in the corporate sales, in point of fact there is a significant increase in commercial lending period, the companies must be able to finance this period. The working capital is essential for companies to determine their short-term financial positions. A significant change in working capital provides an important information to the company's various stakeholders, and this is especially true for the net working capital. The working capital analysis is one way the company's creditability evaluation, and helps also to better understand the company's normal business cycle.

The risks of measuring risk

International Nuclear Information System (INIS)

Berg, G.G.

1982-01-01

The author gives an overview of the Thirteenth Rochester International Conference on Environmental Toxicity, which examined both the logical soundness of the inference of risk and the validity of the environmental evidence of damage. Examples are itemized, concise introductions are given for each published paper in the proceedings, and an appropriate keynote is given by way of stating the established and alternate approach to risk measurement. The volume is described as ''more than a review of advance in measurement of risks to health . . . (but also) a landmark of a change in scientific opinion.''

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.

77 FR 53059 - Risk-Based Capital Guidelines: Market Risk

Science.gov (United States)

2012-08-30

...'' framework that includes (1) Risk-based capital requirements for credit risk, market risk, and operational... default and credit quality migration risk for non-securitization credit products. With respect to... securitization positions, the revisions assign a specific risk- weighting factor based on the credit rating of a...

The Community Intervention Team as a means of Improving the transition from hospital to home for patients

OpenAIRE

Kearns, Michelle; Curran, Margaret; Collier, Dorcas; Burke, Mary; Lawler, Michelle

2017-01-01

Introduction: Too frequently patients are discharged from hospital to their home without local support from healthcare professionals. Without this support patients are often readmitted to hospital unnecessarily.Short description of practice change implemented: Networked Community intervention team (CIT) services make a unique contribution in facilitating the transition between hospital and home.Aim and theory of change: The aim is to facilitate early discharge from an acute setting, providing...

Improving publication rates in a collaborative clinical trials research network

OpenAIRE

Archer, Stephanie Wilson; Carlo, Waldemar A.; Truog, William E.; Stevenson, David K.; Van Meurs, Krisa P.; Sánchez, Pablo J.; Das, Abhik; Devaskar, Uday; Nelin, Leif D.; Petrie Huitema, Carolyn M.; Crawford, Margaret M.; Higgins, Rosemary D.

2016-01-01

Unpublished results can bias biomedical literature, favoring positive over negative findings, primary over secondary analyses, and can lead to duplicate studies that unnecessarily endanger subjects and waste resources. The Neonatal Research Network’s (NRN) publication policies for approving, reviewing, and tracking abstracts and papers work to combat these problems. In 2003, the NRN restricted investigators with unfinished manuscripts from proposing new ones and in 2010, urged authors to comp...

Nuclear power is not only necessary, but it can also be mastered

International Nuclear Information System (INIS)

Koof, A.P.

1977-01-01

Isn't the energy problem being unnecessarily dramatized. Will oil really become as short and expensive as nuclear power promoters tell us. Do nuclear power opponents have serious motives. Shouldn't clean energy sources like coal, natural gas and solar heat be promoted instead of nuclear power. Does the EC need a community energy policy. Coolly calculated answers to hotly discussed problems, arguments instead of emotions. (orig.) [de

Suggestions of radiation protection instruments in ships used for transporting spent fuel elements from nuclear power plants to central stores and further to fuel reprocessing plants

International Nuclear Information System (INIS)

Warenmo, G.

1979-01-01

Some radiation protection measures are necessary in ships which will be used for transporting spent fuel elements from nuclear power plants to central stores and further to fuel reprocessing plants in order to protect the crew from unnecessarily high radiation doses and to ensure that not allowable values occur. Such measures are discussed in this report as well as suitable radiation protection instruments for such ships. (E.R.)

Image Dependent Relative Formation Navigation for Autonomous Aerial Refueling

Science.gov (United States)

2011-03-01

and local variations of the Earth’s surface make a mathematical model difficult to create and use. The definition of an equipotential surface ...controlled with flight control surfaces attached to it. To refuel using this method, the receiver pilot flies the aircraft to within a defined refueling...I-frame would unnecessarily complicate aircraft navigation that, by definition, is limited to altitudes relatively close to the surface of the Earth

Bullying through the eyes of the beholder: Neural activation of salience networks among adolescent bullies when viewing social exclusion

OpenAIRE

Moreira, Joao; Perino, Michael; Telzer, Eva

2017-01-01

Bullying is a pervasive societal problem. In spite of the serious consequences, current interventions have been shown to be only marginally successful. We hypothesize the reason for the limited utility of current treatments may be due to relying on unnecessarily constrained theories regarding bullying. Neuroscientists studying bullying have primarily focused on the psychopathology of diagnosable offenders or the resulting symptomatology of victimization, with little attention paid to theories...

Risk assessment and risk management of mycotoxins.

Science.gov (United States)

2012-01-01

Risk assessment is the process of quantifying the magnitude and exposure, or probability, of a harmful effect to individuals or populations from certain agents or activities. Here, we summarize the four steps of risk assessment: hazard identification, dose-response assessment, exposure assessment, and risk characterization. Risk assessments using these principles have been conducted on the major mycotoxins (aflatoxins, fumonisins, ochratoxin A, deoxynivalenol, and zearalenone) by various regulatory agencies for the purpose of setting food safety guidelines. We critically evaluate the impact of these risk assessment parameters on the estimated global burden of the associated diseases as well as the impact of regulatory measures on food supply and international trade. Apart from the well-established risk posed by aflatoxins, many uncertainties still exist about risk assessments for the other major mycotoxins, often reflecting a lack of epidemiological data. Differences exist in the risk management strategies and in the ways different governments impose regulations and technologies to reduce levels of mycotoxins in the food-chain. Regulatory measures have very little impact on remote rural and subsistence farming communities in developing countries, in contrast to developed countries, where regulations are strictly enforced to reduce and/or remove mycotoxin contamination. However, in the absence of the relevant technologies or the necessary infrastructure, we highlight simple intervention practices to reduce mycotoxin contamination in the field and/or prevent mycotoxin formation during storage.

Escape route simulator utilizing augmented reality

Energy Technology Data Exchange (ETDEWEB)

Mattos, Karen Salazar Ribeiro de; Mó, Antônio Carlos de A.; Santo, André Cotelli do E.; Silva, Marcio Henrique, E-mail: karensalazar.1190@gmail.com [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Centro Universitário Carioca (UniCarioca), Rio de Janeiro, RJ (Brazil)

2017-07-01

Due to increasing demand and interest in the interaction of technology platforms and integration of different types of systems and technologies, some tools are already providing practical ways to develop integrated applications. The tools explored by this article are Unity, a platform for game development, and Vuforia, an SDK, software development kit, for augmented reality creation. The coalition proposal of these resources is to create an intuitive escape route that can be used for the evacuation of buildings or open spaces in view of imminent danger, such as radiation leakage, and that can be accessed from a target available at the institution. It has also the intention of simulating situations that involve training of personnel in order to obtain methods that allow to save financial resources, and even to avoid that those who are involved are exposed to risks unnecessarily. The simulator is expected to help design, test, and improve ways to maintain the physical integrity of the facility and provide end users with a better sense of immersion and attractiveness. (author)

The Development of English Semi-detached Dwellings During the Nineteenth Century

Directory of Open Access Journals (Sweden)

Pamela Lofthouse

2013-02-01

Full Text Available Buildings in England are heritage listed if they are of special architectural or historical interest, and based on the significance, appropriate conservation priorities can be determined.But to list, and then conserve, one must first identify, then research and assess. The problem is being able to recognise an important example of a semi-detached house (semi if it is neither very old nor aesthetically appealing. The semi is the most common dwelling type in England, yet because it is typically suburban and ordinary, very little research into its origins and development has been carried out. As a result, semis are under-represented in heritage listings. And once listed, it is difficult, if not impossible, to set priorities for ongoing conservation work or adaptive reuse, without knowledge of the historical or social underpinnings of its significance. Even those ordinary buildings which do not reach the thresholds for listing risk being unnecessarily degraded, through demolition, decay or unsympathetic alterations, if there is no understanding of their stories or meanings, and no safeguards are built into the planning guidelines.

Hair and bare skin discrimination for laser-assisted hair removal systems.

Science.gov (United States)

Cayir, Sercan; Yetik, Imam Samil

2017-07-01

Laser-assisted hair removal devices aim to remove body hair permanently. In most cases, these devices irradiate the whole area of the skin with a homogenous power density. Thus, a significant portion of the skin, where hair is not present, is burnt unnecessarily causing health risks. Therefore, methods that can distinguish hair regions automatically would be very helpful avoiding these unnecessary applications of laser. This study proposes a new system of algorithms to detect hair regions with the help of a digital camera. Unlike previous limited number of studies, our methods are very fast allowing for real-time application. Proposed methods are based on certain features derived from histograms of hair and skin regions. We compare our algorithm with competing methods in terms of localization performance and computation time and show that a much faster real-time accurate localization of hair regions is possible with the proposed method. Our results show that the algorithm we have developed is extremely fast (around 45 milliseconds) allowing for real-time application with high accuracy hair localization ( 96.48 %).

Escape route simulator utilizing augmented reality

International Nuclear Information System (INIS)

Mattos, Karen Salazar Ribeiro de; Mó, Antônio Carlos de A.; Santo, André Cotelli do E.; Silva, Marcio Henrique

2017-01-01

Due to increasing demand and interest in the interaction of technology platforms and integration of different types of systems and technologies, some tools are already providing practical ways to develop integrated applications. The tools explored by this article are Unity, a platform for game development, and Vuforia, an SDK, software development kit, for augmented reality creation. The coalition proposal of these resources is to create an intuitive escape route that can be used for the evacuation of buildings or open spaces in view of imminent danger, such as radiation leakage, and that can be accessed from a target available at the institution. It has also the intention of simulating situations that involve training of personnel in order to obtain methods that allow to save financial resources, and even to avoid that those who are involved are exposed to risks unnecessarily. The simulator is expected to help design, test, and improve ways to maintain the physical integrity of the facility and provide end users with a better sense of immersion and attractiveness. (author)

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.

Impact of risk factors on cardiovascular risk: a perspective on risk estimation in a Swiss population.

Science.gov (United States)

Chrubasik, Sigrun A; Chrubasik, Cosima A; Piper, Jörg; Schulte-Moenting, Juergen; Erne, Paul

2015-01-01

In models and scores for estimating cardiovascular risk (CVR), the relative weightings given to blood pressure measurements (BPMs), and biometric and laboratory variables are such that even large differences in blood pressure lead to rather low differences in the resulting total risk when compared with other concurrent risk factors. We evaluated this phenomenon based on the PROCAM score, using BPMs made by volunteer subjects at home (HBPMs) and automated ambulatory BPMs (ABPMs) carried out in the same subjects. A total of 153 volunteers provided the data needed to estimate their CVR by means of the PROCAM formula. Differences (deltaCVR) between the risk estimated by entering the ABPM and that estimated with the HBPM were compared with the differences (deltaBPM) between the ABPM and the corresponding HBPM. In addition to the median values (= second quartile), the first and third quartiles of blood pressure profiles were also considered. PROCAM risk values were converted to European Society of Cardiology (ESC) risk values and all participants were assigned to the risk groups low, medium and high. Based on the PROCAM score, 132 participants had a low risk for suffering myocardial infarction, 16 a medium risk and 5 a high risk. The calculated ESC scores classified 125 participants into the low-risk group, 26 into the medium- and 2 into the high-risk group for death from a cardiovascular event. Mean ABPM tended to be higher than mean HBPM. Use of mean systolic ABPM or HBPM in the PROCAM formula had no major impact on the risk level. Our observations are in agreement with the rather low weighting of blood pressure as risk determinant in the PROCAM score. BPMs assessed with different methods had relatively little impact on estimation of cardiovascular risk in the given context of other important determinants. The risk calculations in our unselected population reflect the given classification of Switzerland as a so-called cardiovascular "low risk country".

Role of Endothelial Nitric Oxide Synthase Gene Polymorphisms in Predicting Aneurysmal Subarachnoid Hemorrhage in South Indian Patients

Directory of Open Access Journals (Sweden)

Linda Koshy

2008-01-01

Full Text Available Endothelial nitric oxide synthase (eNOS gene polymorphisms have been implicated as predisposing genetic factors that can predict aneurysmal subarachnoid hemorrhage (aSAH, but with controversial results from different populations. Using a case-control study design, we tested the hypothesis whether variants in eNOS gene can increase risk of aSAH among South Indian patients, either independently, or by interacting with other risk factors of the disease. We enrolled 122 patients, along with 224 ethnically matched controls. We screened the intron-4 27-bp VNTR, the promoter T-786C and the exon-7 G894T SNPs in the eNOS gene. We found marked interethnic differences in the genotype distribution of eNOS variants when comparing the South Indian population with the reported frequencies from Caucasian and Japanese populations. Genotype distributions in control and patient populations were found to be in Hardy-Weinberg equilibrium. In patients, the allele, genotype and estimated haplotype frequencies did not differ significantly from the controls. Multiple logistic regression indicated hypertension and smoking as risk factors for the disease, however the risk alleles did not have any interaction with these risk factors. Although the eNOS polymorphisms were not found to be a likely risk factor for aSAH, the role of factors such as ethnicity, gender, smoking and hypertension should be evaluated cautiously to understand the genotype to phenotype conversion.

Supporting Risk Assessment: Accounting for Indirect Risk to Ecosystem Components.

Directory of Open Access Journals (Sweden)

Cathryn Clarke Murray

Full Text Available The multi-scalar complexity of social-ecological systems makes it challenging to quantify impacts from human activities on ecosystems, inspiring risk-based approaches to assessments of potential effects of human activities on valued ecosystem components. Risk assessments do not commonly include the risk from indirect effects as mediated via habitat and prey. In this case study from British Columbia, Canada, we illustrate how such "indirect risks" can be incorporated into risk assessments for seventeen ecosystem components. We ask whether (i the addition of indirect risk changes the at-risk ranking of the seventeen ecosystem components and if (ii risk scores correlate with trophic prey and habitat linkages in the food web. Even with conservative assumptions about the transfer of impacts or risks from prey species and habitats, the addition of indirect risks in the cumulative risk score changes the ranking of priorities for management. In particular, resident orca, Steller sea lion, and Pacific herring all increase in relative risk, more closely aligning these species with their "at-risk status" designations. Risk assessments are not a replacement for impact assessments, but-by considering the potential for indirect risks as we demonstrate here-they offer a crucial complementary perspective for the management of ecosystems and the organisms within.

The risks of risk aversion in drug regulation.

Science.gov (United States)

Eichler, Hans-Georg; Bloechl-Daum, Brigitte; Brasseur, Daniel; Breckenridge, Alasdair; Leufkens, Hubert; Raine, June; Salmonson, Tomas; Schneider, Christian K; Rasi, Guido

2013-12-01

Drugs are approved by regulatory agencies on the basis of their assessment of whether the available evidence indicates that the benefits of the drug outweigh its risks. In recent years, regulatory agencies have been criticized both for being overly tolerant of risks or being excessively risk-averse, which reflects the challenge in determining an appropriate balance between benefit and risk with the limited data that is typically available before drug approval. The negative consequences of regulatory tolerance in allowing drugs onto the market that turn out to be unsafe are obvious, but the potential for adverse effects on public health owing to the absence of new drugs because of regulatory risk-aversion is less apparent. Here, we discuss the consequences of regulatory risk-aversion for public health and suggest what might be done to best align acceptance of risk and uncertainty by regulators with the interests of public health.

'Development as Freedom': Moving Economics Beyond Commodities - The Cautious Boldness of Amartya Sen

NARCIS (Netherlands)

D.R. Gasper (Des)

2000-01-01

textabstractAbstract: Amartya Sen’s 1998 Nobel Prize and his recent synthesis of his views in Development as Freedom provide an opportunity to assess his intellectual contribution and style. The paper identifies entitlements analysis and capabilities analysis as the areas which make him stand out

Ohio Schools Cautiously Rebuild: Uncertainty in State and Local Funds Affects Strategies. Budget

Science.gov (United States)

Patton, Wendy

2015-01-01

Policy Matters Ohio periodically surveys schools about fiscal conditions and operational strategies. The Ohio Association of School Business Officials provided a link to such a survey in their newsletter of December 2014 through February 2015. Fifty-three respondents, representing 8.6 percent of districts and including representatives from all…

Risk management with options and futures under liquidity risk

OpenAIRE

Adam-Müller, A F A; Panaretou, A

2009-01-01

Futures hedging creates liquidity risk through marking to market. Liquidity risk matters if interim losses on a futures position have to be financed at a markup over the risk-free rate. This study analyzes the optimal risk management and production decisions of a firm facing joint price and liquidity risk. It provides a rationale for the use of options on futures in imperfect capital markets. If liquidity risk materializes, the firm sells options on futures in order to partly cover this liqui...

Calculating excess lifetime risk in relative risk models

International Nuclear Information System (INIS)

Vaeth, M.; Pierce, D.A.

1990-01-01

When assessing the impact of radiation exposure it is common practice to present the final conclusions in terms of excess lifetime cancer risk in a population exposed to a given dose. The present investigation is mainly a methodological study focusing on some of the major issues and uncertainties involved in calculating such excess lifetime risks and related risk projection methods. The age-constant relative risk model used in the recent analyses of the cancer mortality that was observed in the follow-up of the cohort of A-bomb survivors in Hiroshima and Nagasaki is used to describe the effect of the exposure on the cancer mortality. In this type of model the excess relative risk is constant in age-at-risk, but depends on the age-at-exposure. Calculation of excess lifetime risks usually requires rather complicated life-table computations. In this paper we propose a simple approximation to the excess lifetime risk; the validity of the approximation for low levels of exposure is justified empirically as well as theoretically. This approximation provides important guidance in understanding the influence of the various factors involved in risk projections. Among the further topics considered are the influence of a latent period, the additional problems involved in calculations of site-specific excess lifetime cancer risks, the consequences of a leveling off or a plateau in the excess relative risk, and the uncertainties involved in transferring results from one population to another. The main part of this study relates to the situation with a single, instantaneous exposure, but a brief discussion is also given of the problem with a continuous exposure at a low-dose rate

The relationship between lateral differences in tympanic membrane temperature and behavioral impulsivity.

Science.gov (United States)

Helton, William S

2010-11-01

In this study lateral differences in tympanic membrane temperature (T(Ty)) were explored as a correlate of either impulsive or cautious responding in Go-No-Go tasks. Thirty-two women and men performed two sustained attention to response tasks (Go-No-Go tasks). Those with warmer right in comparison to left tympanic membranes were more cautious, and those with warmer left in comparison to right tympanic membranes were more impulsive. This finding is in line with previous research and theory indicating a hemispheric bias for active and passive behavior. T(Ty) may be a useful addition to the techniques employed by neuropsychologists. Copyright 2010 Elsevier Inc. All rights reserved.

Emerging Technological Risk Underpinning the Risk of Technology Innovation

CERN Document Server

Anderson, Stuart

2012-01-01

Classes of socio-technical hazards allow a characterization of the risk in technology innovation and clarify the mechanisms underpinning emergent technological risk. Emerging Technological Risk provides an interdisciplinary account of risk in socio-technical systems including hazards which highlight: ·         How technological risk crosses organizational boundaries, ·         How technological trajectories and evolution develop from resolving tensions emerging between social aspects of organisations and technologies and ·         How social behaviour shapes, and is shaped by, technology. Addressing an audience from a range of academic and professional backgrounds, Emerging Technological Risk is a key source for those who wish to benefit from a detail and methodical exposure to multiple perspectives on technological risk. By providing a synthesis of recent work on risk that captures the complex mechanisms that characterize the emergence of risk in technology innovation, Emerging Tec...

Risk-adaptive optimization: Selective boosting of high-risk tumor subvolumes

International Nuclear Information System (INIS)

Kim, Yusung; Tome, Wolfgang A.

2006-01-01

Background and Purpose: A tumor subvolume-based, risk-adaptive optimization strategy is presented. Methods and Materials: Risk-adaptive optimization employs a biologic objective function instead of an objective function based on physical dose constraints. Using this biologic objective function, tumor control probability (TCP) is maximized for different tumor risk regions while at the same time minimizing normal tissue complication probability (NTCP) for organs at risk. The feasibility of risk-adaptive optimization was investigated for a variety of tumor subvolume geometries, risk-levels, and slopes of the TCP curve. Furthermore, the impact of a correlation parameter, δ, between TCP and NTCP on risk-adaptive optimization was investigated. Results: Employing risk-adaptive optimization, it is possible in a prostate cancer model to increase the equivalent uniform dose (EUD) by up to 35.4 Gy in tumor subvolumes having the highest risk classification without increasing predicted normal tissue complications in organs at risk. For all tumor subvolume geometries investigated, we found that the EUD to high-risk tumor subvolumes could be increased significantly without increasing normal tissue complications above those expected from a treatment plan aiming for uniform dose coverage of the planning target volume. We furthermore found that the tumor subvolume with the highest risk classification had the largest influence on the design of the risk-adaptive dose distribution. The parameter δ had little effect on risk-adaptive optimization. However, the clinical parameters D 5 and γ 5 that represent the risk classification of tumor subvolumes had the largest impact on risk-adaptive optimization. Conclusions: On the whole, risk-adaptive optimization yields heterogeneous dose distributions that match the risk level distribution of different subvolumes within the tumor volume

Risk and reliability allocation to risk control

International Nuclear Information System (INIS)

Vojnovic, D.; Kozuh, M.

1992-01-01

The risk allocation procedure is used as an analytical model to support the optimal decision making for reliability/availability improvement planning. Both levels of decision criteria, the plant risk measures and plant performance indices, are used in risk allocation procedure. Decision support system uses the multi objective decision making concept. (author) [sl

Risk Analysis in Road Tunnels – Most Important Risk Indicators

DEFF Research Database (Denmark)

Berchtold, Florian; Knaust, Christian; Thöns, Sebastian

2016-01-01

Methodologies on fire risk analysis in road tunnels consider numerous factors affecting risks (risk indicators) and express the results by risk measures. But only few comprehensive studies on effects of risk indicators on risk measures are available. For this reason, this study quantifies...... the effects and highlights the most important risk indicators with the aim to support further developments in risk analysis. Therefore, a system model of a road tunnel was developed to determine the risk measures. The system model can be divided into three parts: the fire part connected to the fire model Fire...... Dynamics Simulator (FDS); the evacuation part connected to the evacuation model FDS+Evac; and the frequency part connected to a model to calculate the frequency of fires. This study shows that the parts of the system model (and their most important risk indicators) affect the risk measures in the following...

Thinking through cancer risk: characterizing smokers' process of risk determination.

Science.gov (United States)

Hay, Jennifer; Shuk, Elyse; Cruz, Gustavo; Ostroff, Jamie

2005-10-01

The perception of cancer risk motivates cancer risk reduction behaviors. However, common measurement strategies for cancer risk perceptions, which involve numerical likelihood estimates, do not adequately capture individuals' thoughts and feelings about cancer risk. To guide the development of novel measurement strategies, the authors used semistructured interviews to examine the thought processes used by smokers (N = 15) as they considered their cancer risk. They used grounded theory to guide systematic data coding and develop a heuristic model describing smokers' risk perception process that includes a cognitive, primarily rational process whereby salient personal risk factors for cancer are considered and combined, and an affective/attitudinal process, which shifts risk perceptions either up or down. The model provides a tentative explanation concerning how people hold cancer risk perceptions that diverge from rational assessment of their risks and will be useful in guiding the development of non-numerical measurements strategies for cancer risk perceptions.

Health risks in perspective: Judging health risks of energy technologies

Energy Technology Data Exchange (ETDEWEB)

Rowe, M.D.

1992-09-18

Almost daily, Americans receive reports from the mass news media about some new and frightening risk to health and welfare. Most such reports emphasize the newsworthiness of the risks -- the possibility of a crisis, disagreements among experts, how things happened, who is responsible for fixing them, how much will it cost, conflict among parties involved, etc. As a rule, the magnitudes of the risks, or the difficulty of estimating those magnitudes, have limited newsworthiness, and so they are not mentioned. Because of this emphasis in the news media, most people outside the risk assessment community must judge the relative significance of the various risks to which we all are exposed with only that information deemed newsworthy by reporters. This information is biased and shows risks in isolation. There is no basis for understanding and comparing the relative importance of risks among themselves, or for comparing one risk, perhaps a new or newly-discovered one, in the field of all risks. The purpose of this report is to provide perspective on the various risks to which we are routinely exposed. It serves as a basis for understanding the meaning of quantitative risk estimates and for comparing new or newly-discovered risks with other, better-understood risks. Specific emphasis is placed on health risks of energy technologies.

Supporting Risk Assessment: Accounting for Indirect Risk to Ecosystem Components

Science.gov (United States)

Mach, Megan E.; Martone, Rebecca G.; Singh, Gerald G.; O, Miriam; Chan, Kai M. A.

2016-01-01

The multi-scalar complexity of social-ecological systems makes it challenging to quantify impacts from human activities on ecosystems, inspiring risk-based approaches to assessments of potential effects of human activities on valued ecosystem components. Risk assessments do not commonly include the risk from indirect effects as mediated via habitat and prey. In this case study from British Columbia, Canada, we illustrate how such “indirect risks” can be incorporated into risk assessments for seventeen ecosystem components. We ask whether (i) the addition of indirect risk changes the at-risk ranking of the seventeen ecosystem components and if (ii) risk scores correlate with trophic prey and habitat linkages in the food web. Even with conservative assumptions about the transfer of impacts or risks from prey species and habitats, the addition of indirect risks in the cumulative risk score changes the ranking of priorities for management. In particular, resident orca, Steller sea lion, and Pacific herring all increase in relative risk, more closely aligning these species with their “at-risk status” designations. Risk assessments are not a replacement for impact assessments, but—by considering the potential for indirect risks as we demonstrate here—they offer a crucial complementary perspective for the management of ecosystems and the organisms within. PMID:27632287

Enterprise risk management

Energy Technology Data Exchange (ETDEWEB)

Eaton, C. [Enbridge, Calgary, AB (Canada)

2015-07-01

Enterprise risk management (ERM) is a relative new, holistic and strategic approach for managing risks in modern organizations. ERM builds on and extends traditional risk management (RM). Risk is the effect of uncertainty on objectives - positive and/or negative. Risk management is a set of practices used to understand and address risk. ERM is a form of RM that emphasizes risk aggregation and integration. Risk aggregation is combining individual risks into categories ({sup r}olled up{sup )}. risk integration is embedding RM into organizational contexts ({sup b}uilt in{sup )}.

Risk perception and credibility of risk communication

Energy Technology Data Exchange (ETDEWEB)

Sjoeberg, L

1992-10-01

Experts and the public frequently disagree when it comes to risk assessment. The reasons for such disagreement are discussed, and it is pointed out that disagreement among experts and lack of full understanding of real risks contributes to skepticism among the public. The notion that people are in general reacting in a highly emotional and non-rational, phobic, manner is rejected. The very conditions for risk assessment present to the public, and common-sense cognitive dynamics, are better explanations of risk perception, as are some social psychological concepts. If trust is to be established in a country where it is quite low some kind of politically regulated public influence on decision making and risk monitoring is probably needed, e.g. by means of a publicly elected and responsible ombudsman. 57 refs, 8 figs, 5 tabs.

Risk perception and credibility of risk communication

International Nuclear Information System (INIS)

Sjoeberg, L.

1992-10-01

Experts and the public frequently disagree when it comes to risk assessment. The reasons for such disagreement are discussed, and it is pointed out that disagreement among experts and lack of full understanding of real risks contributes to skepticism among the public. The notion that people are in general reacting in a highly emotional and non-rational, phobic, manner is rejected. The very conditions for risk assessment present to the public, and common-sense cognitive dynamics, are better explanations of risk perception, as are some social psychological concepts. If trust is to be established in a country where it is quite low some kind of politically regulated public influence on decision making and risk monitoring is probably needed, e.g. by means of a publicly elected and responsible ombudsman. 57 refs, 8 figs, 5 tabs

Cattle farmers’ perceptions of risk and risk management strategies

DEFF Research Database (Denmark)

Bishu, Kinfe G.; O'Reilly, Seamus; Lahiff, Edward

2018-01-01

This study analyzes cattle farmers’ perceptions of risk and risk management strategies in Tigray, Northern Ethiopia. We use survey data from a sample of 356 farmers based on multistage random sampling. Factor analysis is employed to classify scores of risk and management strategies, and multiple...... utilization were perceived as the most important strategies for managing risks. Livestock disease and labor shortage were perceived as less of a risk by farmers who adopted the practice of zero grazing compared to other farmers, pointing to the potential of this practice for risk reduction. We find strong...... evidence that farmers engage in multiple risk management practices in order to reduce losses from cattle morbidity and mortality. The results suggest that government strategies that aim at reducing farmers’ risk need to be tailored to specific farm and farmer characteristics. Findings from this study have...

Risk ON/Risk OFF: Risk-Taking Varies with Subjectively Preferred and Disliked Music.

Science.gov (United States)

Halko, Marja-Liisa; Kaustia, Markku

2015-01-01

In this paper we conduct a within-subjects experiment in which teenagers go over 256 gambles with real money gains and losses. For each risky gamble they choose whether to participate in it, or pass. Prior to this main experiment subjects identify specific songs belonging to their favorite musical genre, as well as songs representing a style they dislike. In the main experiment we vary the music playing in the background, so that each subject hears some of their favorite music, and some disliked music, alternating in blocks of 16 gambles. We find that favorite music increases risk-taking ('risk on'), and disliked music suppresses risk-taking ('risk off'), compared to a baseline of no music. Literature in psychology proposes several mechanisms by which mood affects risk-taking, but none of them fully explain the results in our setting. The results are, however, consistent with the economics notion of preference complementarity, extended to the domain of risk preference. The preference structure implied by our results is more complex than previously thought, yet realistic, and consistent with recent theoretical models. More generally, this mechanism offers a potential explanation to why risk-taking is known to change over time and across contexts.

The role of risk perception for risk management

International Nuclear Information System (INIS)

Renn, Ortwin

1998-01-01

Are risks social constructions of different societal actors that can be checked at best against standards of consistency, cohesion and internal conventions of deduction, but cannot claim any validity outside of the actor's logical framework? Or are technical estimates of risk representations of real hazards that can and will affect people as predicted by the statistical values, regardless of the beliefs or convictions of those who conduct the assessments? Which of the two sides one takes determines the legitimate function of risk perception for management purposes. The paper argues that both extremes, the constructivist and the realist perspective, miss the point, as risks are always mental representations of threats that are capable of claiming real losses. Over the last two decades, risk analysts have dealt with both sides of risk in an additive fashion. In times in which risk management has been under serious pressure to demonstrate effectiveness and cost-efficiency, the parallel approach of pleasing the technical elite and the public alike has lost legitimacy. In order to integrate risk assessment and perception, the paper analyses the strengths and weaknesses of each approach to risk analysis and highlights the potential contributions that the technical sciences and the social sciences can offer to risk management. Technical assessments provide the best estimate for judging the average probability of an adverse effect linked to an object or activity. First, public perception should govern the selection of criteria on which acceptability or tolerability are to be judged. Second, public input is needed to determine the trade-offs between criteria. Third, public preferences are needed to design resilient strategies for coping with remaining uncertainties. A public participation model is introduced that promises an integration of analytic knowledge and deliberative process involving those who will be affected by the respective risk

Surrounding Risks

Directory of Open Access Journals (Sweden)

Mogens Steffensen

2013-05-01

Full Text Available Research in insurance and finance was always intersecting although they were originally and generally viewed as separate disciplines. Insurance is about transferring risks between parties such that the burdens of risks are borne by those who can. This makes insurance transactions a beneficial activity for the society. It calls on detection, modelling, valuation, and controlling of risks. One of the main sources of control is diversification of risks and in that respect it becomes an issue in itself to clarify diversifiability of risks. However, many diversifiable risks are not, by nature or by contract design, separable from non-diversifiable risks that are, on the other hand, sometimes traded in financial markets and sometimes not. A key observation is that the economic risk came before the insurance contract: Mother earth destroys and kills incidentally and mercilessly, but the uncertainty of economic consequences can be more or less cleverly distributed by the introduction of an insurance market.

The globalization of risk and risk perception: why we need a new model of risk communication for vaccines.

Science.gov (United States)

Larson, Heidi; Brocard Paterson, Pauline; Erondu, Ngozi

2012-11-01

Risk communication and vaccines is complex and the nature of risk perception is changing, with perceptions converging, evolving and having impacts well beyond specific geographic localities and points in time, especially when amplified through the Internet and other modes of global communication. This article examines the globalization of risk perceptions and their impacts, including the example of measles and the globalization of measles, mumps and rubella (MMR) vaccine risk perceptions, and calls for a new, more holistic model of risk assessment, risk communication and risk mitigation, embedded in an ongoing process of risk management for vaccines and immunization programmes. It envisions risk communication as an ongoing process that includes trust-building strategies hand-in-hand with operational and policy strategies needed to mitigate and manage vaccine-related risks, as well as perceptions of risk.

Risk perception as a driver for risk management policies

Science.gov (United States)

Carmona, María; Mañez, María

2016-04-01

Risk is generally defined as the "combination of the probability of the occurrence of an event and its negative consequences" ( UNISDR, 2009). However, the perception of a risk differs among cultures regarding different features such as the context,causes, benefits or damage. Risk perception is the subjective valuation of the probability of an event happening and how concerned individuals or groups are with the consequences (Sjöberg, 2004). Our study is based on an existing framework for risk perception (Rehn and Rohrmann, 2000). We analyse the characteristics of the risk perception regarding extreme events (e.g.droughts) and how the perception of the group drives the action to manage the risk. We do this to achieve an overview of the conditions that let stakeholders join each other to improve risk management especially when governments are not reacting properly. For our research, attention is paid on risk perception of Multi-Sector Partnerships not taking into account the individual level of risk perception. We focus on those factors that make risk management effective and increase resilience. Multi-Sector Partnerships, considered as significant governance structures for risk management, might contribute to reduce vulnerability in prone areas to natural hazards and disasters. The Multi-Sector Partnerships used for our research are existing partnerships identified in the cases studies of the European project ENHANCE. We implement a survey to analyse the perception of risk in the case studies. That survey is based on the Cultural Theory (Douglas and Wildavsky, 1982)and the Protection Motivation Theory (Rogers, 1975). We analyse the results using the Qualitative-Comparative Analysis proposed by Ragin in 1987. The results show the main characteristics of a risk culture that are beneficial to manage a risk. Those characteristics are shaped by the perception of risk of the people involved in the partnership, which in turn shapes their risk management. Nevertheless, we

Value at Risk models for Energy Risk Management

OpenAIRE

Novák, Martin

2010-01-01

The main focus of this thesis lies on description of Risk Management in context of Energy Trading. The paper will predominantly discuss Value at Risk and its modifications as a main overall indicator of Energy Risk.

Risk assessment

International Nuclear Information System (INIS)

Kinchin, G.H.

1983-01-01

After defining risk and introducing the concept of individual and societal risk, the author considers each of these, restricting considerations to risk of death. Some probabilities of death arising from various causes are quoted, and attention drawn to the care necessary in making comparisons between sets of data and to the distinction between voluntary and involuntary categories and between early and delayed deaths. The presentation of information on societal risk is discussed and examples given. The history of quantified risk assessment is outlined, particularly related to the nuclear industry, the process of assessing risk discussed: identification of hazard causes, the development of accident chains and the use of event trees, the evaluation of probability through the collection of data and their use with fault trees, and the assessment of consequences of hazards in terms of fatalities. Reference is made to the human element and common-made failures, and to studies supporting the development of reliability assessment techniques. Acceptance criteria are discussed for individual and societal risk in the nuclear field, and it is shown that proposed criteria lead to risks conservative by comparison with risks from day-to-day accidents and other potentially hazardous industries. (U.K.)

Risk

Science.gov (United States)

Cole, Stephen R.; Hudgens, Michael G.; Brookhart, M. Alan; Westreich, Daniel

2015-01-01

The epidemiologist primarily studies transitions between states of health and disease. The purpose of the present article is to define a foundational parameter for such studies, namely risk. We begin simply and build to the setting in which there is more than 1 event type (i.e., competing risks or competing events), as well as more than 1 treatment or exposure level of interest. In the presence of competing events, the risks are a set of counterfactual cumulative incidence functions for each treatment. These risks can be depicted visually and summarized numerically. We use an example from the study of human immunodeficiency virus to illustrate concepts. PMID:25660080

NGNP Risk Management Database: A Model for Managing Risk

International Nuclear Information System (INIS)

Collins, John

2009-01-01

To facilitate the implementation of the Risk Management Plan, the Next Generation Nuclear Plant (NGNP) Project has developed and employed an analytical software tool called the NGNP Risk Management System (RMS). A relational database developed in Microsoft(reg s ign) Access, the RMS provides conventional database utility including data maintenance, archiving, configuration control, and query ability. Additionally, the tool's design provides a number of unique capabilities specifically designed to facilitate the development and execution of activities outlined in the Risk Management Plan. Specifically, the RMS provides the capability to establish the risk baseline, document and analyze the risk reduction plan, track the current risk reduction status, organize risks by reference configuration system, subsystem, and component (SSC) and Area, and increase the level of NGNP decision making.

NGNP Risk Management Database: A Model for Managing Risk

Energy Technology Data Exchange (ETDEWEB)

John Collins

2009-09-01

To facilitate the implementation of the Risk Management Plan, the Next Generation Nuclear Plant (NGNP) Project has developed and employed an analytical software tool called the NGNP Risk Management System (RMS). A relational database developed in Microsoft® Access, the RMS provides conventional database utility including data maintenance, archiving, configuration control, and query ability. Additionally, the tool’s design provides a number of unique capabilities specifically designed to facilitate the development and execution of activities outlined in the Risk Management Plan. Specifically, the RMS provides the capability to establish the risk baseline, document and analyze the risk reduction plan, track the current risk reduction status, organize risks by reference configuration system, subsystem, and component (SSC) and Area, and increase the level of NGNP decision making.

Who is responsible for food risks? The influence of risk type and risk characteristics

DEFF Research Database (Denmark)

Leikas, Sointu; Lindeman, Marjaana; Roininen, Katariina

2009-01-01

The influence of food risk type and risk characteristics on food risk responsibility judgments was studied. A total of 1270 Finnish consumers judged their personal responsibility and the responsibility of three non-personal targets, industry, retail, and society, in relation to six food...

Lifetime risks for aneurysmal subarachnoid haemorrhage: multivariable risk stratification.

Science.gov (United States)

Vlak, Monique H M; Rinkel, Gabriel J E; Greebe, Paut; Greving, Jacoba P; Algra, Ale

2013-06-01

The overall incidence of aneurysmal subarachnoid haemorrhage (aSAH) in western populations is around 9 per 100 000 person-years, which confers to a lifetime risk of around half per cent. Risk factors for aSAH are usually expressed as relative risks and suggest that absolute risks vary considerably according to risk factor profiles, but such estimates are lacking. We aimed to estimate incidence and lifetime risks of aSAH according to risk factor profiles. We used data from 250 patients admitted with aSAH and 574 sex-matched and age-matched controls, who were randomly retrieved from general practitioners files. We determined independent prognostic factors with multivariable logistic regression analyses and assessed discriminatory performance using the area under the receiver operating characteristic curve. Based on the prognostic model we predicted incidences and lifetime risks of aSAH for different risk factor profiles. The four strongest independent predictors for aSAH, namely current smoking (OR 6.0; 95% CI 4.1 to 8.6), a positive family history for aSAH (4.0; 95% CI 2.3 to 7.0), hypertension (2.4; 95% CI 1.5 to 3.8) and hypercholesterolaemia (0.2; 95% CI 0.1 to 0.4), were used in the final prediction model. This model had an area under the receiver operating characteristic curve of 0.73 (95% CI 0.69 to 0.76). Depending on sex, age and the four predictors, the incidence of aSAH ranged from 0.4/100 000 to 298/100 000 person-years and lifetime risk between 0.02% and 7.2%. The incidence and lifetime risk of aSAH in the general population varies widely according to risk factor profiles. Whether persons with high risks benefit from screening should be assessed in cost-effectiveness studies.

Societal perspectives on risk awareness and risk competence.

Science.gov (United States)

Koller, Michael; Hoffrage, Ulrich

2015-01-01

Medical risks can be assessed by objectifiable therapeutic features; however, these risks are also characterised to a considerable degree by individual and social values. People tend to strive towards both freedom as well as safety; in a medical context, these two aims are taken into account by shared decision-making models and by stricter regulations in the pharmaceutical sector. Media reports on medical risks are caught between providing information and economic interests, and this conflict particularly complicates rational discussions about unexpected risks (for instance, in the field of natural medicine). Thus, it is necessary to create the type of information culture which allows differentiating between real and less pronounced risks.

Risk factors

International Nuclear Information System (INIS)

Dennery, M.; Dupont, M.A.

2007-01-01

This article deals with the development of risk management in the gas sector business: why a risk factor legal mention must precede any published financial information? Do gas companies have to face new risks? Is there specific risks bound to gas activities? Why companies want to master their risks? Is it mandatory or just a new habit? Do they expect a real benefit in return? These are the risk management questions that are analyzed in this article which is based on the public communication of 15 gas companies randomly selected over the world. The information comes from their annual reports or from documents available on their web sites. The intention of this document is not to be exhaustive or to make statistics but only to shade light on the risk factors of the gas sector. (J.S.)

Risk perception in women with high-risk pregnancies

OpenAIRE

Lee, S.

2014-01-01

Risk perception in women with high risk pregnancies affects the decisions they make about antenatal care and so may therefore influence the wellbeing of mother and baby. This article addresses the factors which influence women when making risk assessments and how these assessments may differ from those of healthcare professionals.\\ud \\ud Women use multiple sources of information to determine their risk status including advice from professionals, from other trusted sources, and their own intui...

Risk assessment and risk evaluation

International Nuclear Information System (INIS)

Niehaus, F.

1978-01-01

With the help of results of investigations and model calculations the risk of nuclear energy in routine operation is shown. In this context it is pointed out that the excellent operation results of reactors all over the world have led to the acceptability of risks from local loads no longer being in question. The attention of radiation protection is therefore focused on the emissions of long-living isotopes which collect in the atmosphere. With LWRs the risk of accidents is so minimal that statistical data is, and never will be available. One has to therefore fall back upon the so-called fault tree analyses. On the subject of risk evalution the author referred to a poll in Austria. From the result of this investigation one might conclude that nuclear energy serves as a crystallization point for a discussion of varying concepts for future development. More attention should be paid to this aspect from both sides, in order to objectify the further expansion of this source of energy. (orig./HP) [de

The risk

International Nuclear Information System (INIS)

Olin, N.; Delmestre, A.; Baumont, G.; El Jammal, M.H.; Brucker, G.; Mettendorf, M.; Kervern, G.Y.; Amalberti, R.; Digoin, A.; Lagrange, V.; Duval, D.; Setbon, M.; Godard, O.; Lagadec, P.; Heriard Dubreuil, G.; Miserey, Y.; Delalonde, J.C.; Solomarska, E.

2006-01-01

In this issue is studied the risk analysis in nuclear industry. The different chapters are the risk, its perception and its control; the measure of the perception of risks; misunderstanding, a limit for transparency policy. About the running systems on risk, the practical applications of research on the science of danger are detailed; human factors approaches, errors and risk is tackled and also human factors at the centre of safety progress by taking expert methods and transforming them into practical tools for managers; an example is given through the technological risks analysis rule in Total industrial group, or how harmonizing the methods to increase the performance; Some thoughts about the risks and its perception, the principle of precaution, the emergencies and breaking situations on the borderline of chaos; the civil society at the heart of the governance of activities generating risks; two stories, one is about the difficulties to get information, including about the passage of the cloud from Chernobyl, the second one is the account of an inhabitant of Chernobyl. (N.C.)

Panel data nonparametric estimation of production risk and risk preferences

DEFF Research Database (Denmark)

Czekaj, Tomasz Gerard; Henningsen, Arne

approaches for obtaining firm-specific measures of risk attitudes. We found that Polish dairy farmers are risk averse regarding production risk and price uncertainty. According to our results, Polish dairy farmers perceive the production risk as being more significant than the risk related to output price......We apply nonparametric panel data kernel regression to investigate production risk, out-put price uncertainty, and risk attitudes of Polish dairy farms based on a firm-level unbalanced panel data set that covers the period 2004–2010. We compare different model specifications and different...

[Safety grade of application of traditional Chinese medicines during pregnancy].

Science.gov (United States)

Wang, Yu-Guang; Jin, Rui; Kong, Xiang-Wen; Zhang, Bing

2016-01-01

The efficacy and safety of application of traditional Chinese medicines (TCMs) during the pregnancy is a hotspot among scholars. However, the traditional pregnancy contraindication content has certain historical limitations, and cannot meet the needs of the current pregnant women for rational drug use. We need to refine and interpret it with modern medical science. In this paper, we summarized the ancient and modern knowledge about pregnancy contradiction and tried to establish a grading safety system, based on the actual clinical practices and thte medication grading concept of western medicines. Specifically speaking, in this paper, we compared the connotations of forbidden/contradiction and cautious use, and focused on the safe herbs that included in the prescriptions for dietary therapy. Meanwhile, in this paper, we summarized the core content of the famous theories of ″You Gu Wu Yun (pregnancy disease)″ and ″Shuai Qi Da Ban Er Zhi (therapy during pregnancy)″, and studied the dangerous and unknown risk of TCMs during pregnancy. At last, a five-grade safety system of TCMs applied on the pregnant women was established, including forbidden, contraindicated, cautious, uncertain and available medicines. We classified medicines with the embryotoxicity (e.g. teratogenic, mutagenic, ageneisa), the traditional toxicity (e.g. abortion), the fierce herbal property (e.g. removing blood stasis, promoting Qi circulation) and reliable edible medicinal herbs. We also place an ″uncertain″ category based on objective reality. Meanwhile, 33 sample TCMs were preliminarily determined. This paper proposed the preference and ideas for the rational herbal use in pregnancy. Copyright© by the Chinese Pharmaceutical Association.

Risk indices in comparative risk assessment studies

International Nuclear Information System (INIS)

Hubert, P.

1984-01-01

More than a decade ago the development of comparative risk assessment studies aroused overwhelming interest. There was no doubt that data on the health and safety aspects of energy systems would greatly benefit, or even end, the debate on nuclear energy. Although such attempts are still strongly supported, the rose-coloured expectations of the early days have faded. The high uncertainties, and the contradictory aspect, of the first results might explain this evolution. The loose connection between the range of computed risk indices and the questions on which the debate was focused is another reason for this decline in interest. Important research work is being carried out aiming at reducing the different kinds of uncertainties. Rather than the uncertainties, the paper considers the meaning of available risk indices and proposes more significant indices with respect to the goals of risk assessment. First, the indices which are of frequent use in comparative studies are listed. The stress is put on a French comparative study from which most examples are drawn. Secondly, the increase in magnitude of the indices and the decrease in the attributability of the risk to a given system is shown to be a consequence of the trend towards more comprehensive analyses. Thirdly, the ambiguity of such indices as the collective occupational risk is underlined, and a possible solution is suggested. Whenever risk assessments are related to pragmatic decision making problems it is possible to find satisfactory risk indices. The development of cost-effectiveness analyses and the proposals for quantitative safety goals clearly demonstrate this point. In the field of comparison of social impacts some proposals are made, but there remain some gaps still to be filled. (author)

Energy Optimization Assessment at U.S. Army Installations: West Point Military Academy, NY

Science.gov (United States)

2008-09-01

chillers to work unnecessarily more than needed. Other buildings had setpoints at different areas above 55 °F. Many buildings are air-conditioned and... optimal . The cost of 12.5 cents/KWh makes it unlikely, especially where steam adsorption chillers exist. 11.8.2 Solution Use the existing steam...ER D C/ CE R L TR -0 8 -1 4 Energy Optimization Assessment at U.S. Army Installations West Point Military Academy, NY David M

Practical, Reliable Error Bars in Quantum Tomography

OpenAIRE

Faist, Philippe; Renner, Renato

2015-01-01

Precise characterization of quantum devices is usually achieved with quantum tomography. However, most methods which are currently widely used in experiments, such as maximum likelihood estimation, lack a well-justified error analysis. Promising recent methods based on confidence regions are difficult to apply in practice or yield error bars which are unnecessarily large. Here, we propose a practical yet robust method for obtaining error bars. We do so by introducing a novel representation of...

The impact of the internet on the practice of general practitioners and community pharmacists in Northern Ireland

Directory of Open Access Journals (Sweden)

Brian McCaw

2008-01-01

Conclusions Both professions used the internet regularly as a source of health-related information and both had to deal with 'internet-informed', (or sometimes misinformed patients. Community pharmacists were more likely to feel challenged by these patients and GPs sometimes had to deal with unnecessarily worried patients or patients with unrealistic expectations. Both professions will have to change working practices to accommodate the impact of the internet. This will have significant future training implications.

Why doesn’t everyone love reading e-books?

OpenAIRE

Myrberg, Caroline

2017-01-01

Why do many students still prefer paper books to e-books? This article summarizes a number of problems with e-books mentioned in different studies by students of higher education, but it also discusses some of the unexploited possibilities with e-books. Problems that students experience with e-books include eye strain, distractions, a lack of overview, inadequate navigation features and insufficient annotation and highlighting functionality. They also find it unnecessarily complicated to down...

A New Dynamic Pricing Model for the Effective Sustainability of Perishable Product Life Cycle

OpenAIRE

Pırıl Tekin; Rızvan Erol

2017-01-01

Perishable products run their life cycle in a short period of time due to the shortness of their shelf lives. Product efficiency falls when especially non-recyclable products are thrown away without being used. Furthermore, this kind of products that unnecessarily occupy shelves of supermarkets cause supermarkets to follow an insufficient stock management policy. Unconscious and unplanned use of our limited natural resources will deteriorate the product portfolio for future generations. Such ...

Best Practices for Optimizing DoD Contractor Safety and Occupational Health Program Performance

Science.gov (United States)

2012-12-01

acts and omissions. DoD’s duty arises under OSHA’s Multi-Employer Citation Policy, and in tort and admiralty law, as discussed in Section 2.6...unnecessarily subject the government to legal liability for on-the-job injuries under the Federal Tort Claims Act (FTCA). (b) The government may...housing or any other contractual context. Furthermore, DoD can place itself in a similar position via negligence , or contractual actions as well as

Cardiovascular risk-factor knowledge and risk perception among HIV-infected adults.

Science.gov (United States)

Cioe, Patricia A; Crawford, Sybil L; Stein, Michael D

2014-01-01

Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in HIV-infected adults. Research in noninfected populations has suggested that knowledge of CVD risk factors significantly influences perceptions of risk. This cross-sectional study describes CVD risk factor knowledge and risk perception in HIV-infected adults. We recruited 130 HIV-infected adults (mean age = 48 years, 62% male, 56% current smokers, mean years since HIV diagnosis, 14.7). The mean CVD risk factor knowledge score was fairly high. However, controlling for age, CVD risk factor knowledge was not predictive of perceived risk [F(1, 117) = 0.13, p > .05]. Estimated risk and perceived risk were weakly but significantly correlated; r (126) = .24, p = .01. HIV-infected adults are at increased risk for CVD. Despite having adequate risk-factor knowledge, CVD risk perception was inaccurate. Improving risk perception and developing CVD risk reduction interventions for this population are imperative. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Effects of changes along the risk chain on flood risk

Science.gov (United States)

Duha Metin, Ayse; Apel, Heiko; Viet Dung, Nguyen; Guse, Björn; Kreibich, Heidi; Schröter, Kai; Vorogushyn, Sergiy; Merz, Bruno

2017-04-01

Interactions of hydrological and socio-economic factors shape flood disaster risk. For this reason, assessment of flood risk ideally takes into account the whole flood risk chain from atmospheric processes, through the catchment and river system processes to the damage mechanisms in the affected areas. Since very different processes at various scales are interacting along the flood risk, the impact of the single components is rather unclear. However for flood risk management, it is required to know the controlling factor of flood damages. The present study, using the flood-prone Mulde catchment in Germany, discusses the sensitivity of flood risk to disturbances along the risk chain: How do disturbances propagate through the risk chain? How do different disturbances combine or conflict and affect flood risk? In this sensitivity analysis, the five components of the flood risk change are included. These are climate, catchment, river system, exposure and vulnerability. A model framework representing the complete risk chain is combined with observational data to understand how the sensitivities evolve along the risk chain by considering three plausible change scenarios for each of five components. The flood risk is calculated by using the Regional Flood Model (RFM) which is based on a continuous simulation approach, including rainfall-runoff, 1D river network, 2D hinterland inundation and damage estimation models. The sensitivity analysis covers more than 240 scenarios with different combinations of the five components. It is investigated how changes in different components affect risk indicators, such as the risk curve and expected annual damage (EAD). In conclusion, it seems that changes in exposure and vulnerability seem to outweigh changes in hazard.

Risks of tobacco

Science.gov (United States)

Secondhand smoke - risks; Cigarette smoking - risks; Smoking and smokeless tobacco - risks; Nicotine - risks ... tobacco that are known to cause cancer. HEALTH RISKS OF SMOKING OR USING SMOKELESS TOBACCO Knowing the ...

Nuclear insurance risk assessment using risk-based methodology

International Nuclear Information System (INIS)

Wendland, W.G.

1992-01-01

This paper presents American Nuclear Insurers' (ANI's) and Mutual Atomic Energy Liability Underwriters' (MAELU's) process and experience for conducting nuclear insurance risk assessments using a risk-based methodology. The process is primarily qualitative and uses traditional insurance risk assessment methods and an approach developed under the auspices of the American Society of Mechanical Engineers (ASME) in which ANI/MAELU is an active sponsor. This process assists ANI's technical resources in identifying where to look for insurance risk in an industry in which insurance exposure tends to be dynamic and nonactuarial. The process is an evolving one that also seeks to minimize the impact on insureds while maintaining a mutually agreeable risk tolerance

Technological risks

International Nuclear Information System (INIS)

Klinke, A.; Renn, O.

1998-01-01

The empirical part about the technological risks deals with different technologies: nuclear energy, early warning systems of nuclear weapons and NBC-weapons, and electromagnetic fields. The potential of damage, the contemporary management strategies and the relevant characteristics will be described for each technology: risks of nuclear energy; risks of early warning systems of nuclear weapons and NBC-weapons; risks of electromagnetic fields. (authors)

Technological risks

Energy Technology Data Exchange (ETDEWEB)

Klinke, A.; Renn, O. [Center of Technology Assessment in Baden-Wuerttemberg, Stuttgart (Germany)

1998-07-01

The empirical part about the technological risks deals with different technologies: nuclear energy, early warning systems of nuclear weapons and NBC-weapons, and electromagnetic fields. The potential of damage, the contemporary management strategies and the relevant characteristics will be described for each technology: risks of nuclear energy; risks of early warning systems of nuclear weapons and NBC-weapons; risks of electromagnetic fields. (authors)

Milk intake and risk of mortality and fractures in women and men: cohort studies.

Science.gov (United States)

Michaëlsson, Karl; Wolk, Alicja; Langenskiöld, Sophie; Basu, Samar; Warensjö Lemming, Eva; Melhus, Håkan; Byberg, Liisa

2014-10-28

To examine whether high milk consumption is associated with mortality and fractures in women and men. Cohort studies. Three counties in central Sweden. Two large Swedish cohorts, one with 61,433 women (39-74 years at baseline 1987-90) and one with 45,339 men (45-79 years at baseline 1997), were administered food frequency questionnaires. The women responded to a second food frequency questionnaire in 1997. Multivariable survival models were applied to determine the association between milk consumption and time to mortality or fracture. During a mean follow-up of 20.1 years, 15,541 women died and 17,252 had a fracture, of whom 4259 had a hip fracture. In the male cohort with a mean follow-up of 11.2 years, 10,112 men died and 5066 had a fracture, with 1166 hip fracture cases. In women the adjusted mortality hazard ratio for three or more glasses of milk a day compared with less than one glass a day was 1.93 (95% confidence interval 1.80 to 2.06). For every glass of milk, the adjusted hazard ratio of all cause mortality was 1.15 (1.13 to 1.17) in women and 1.03 (1.01 to 1.04) in men. For every glass of milk in women no reduction was observed in fracture risk with higher milk consumption for any fracture (1.02, 1.00 to 1.04) or for hip fracture (1.09, 1.05 to 1.13). The corresponding adjusted hazard ratios in men were 1.01 (0.99 to 1.03) and 1.03 (0.99 to 1.07). In subsamples of two additional cohorts, one in males and one in females, a positive association was seen between milk intake and both urine 8-iso-PGF2α (a biomarker of oxidative stress) and serum interleukin 6 (a main inflammatory biomarker). High milk intake was associated with higher mortality in one cohort of women and in another cohort of men, and with higher fracture incidence in women. Given the observational study designs with the inherent possibility of residual confounding and reverse causation phenomena, a cautious interpretation of the results is recommended. © Michaëlsson et al 2014.

Risk management guide

International Nuclear Information System (INIS)

Briscoe, G.J.

1977-06-01

Risk management requires an assessment or a knowledge of risk. This, in turn, requires identification of hazards (sources of risk) and a determination of risk (evaluation of the hazard degree). The hazard identification and risk analysis techniques presented in this Guide are, in general, based on the MORT concept that accidents result from unwanted energy flow in the absence of adequate controls and/or barriers. This Guide presents an analytical tree designed to prevent oversight of specific energy sources in risk identification. Hazard identification by field personnel is also discussed. Quantitative risk analysis is discussed in the following section. A method for summary of the risks for each energy classification is given. This method uses a graphical log-normal projection so that low probability events, which are not adequately represented in the experience data, are included in the risk assessment. This permits a more acceptable risk assessment since catastrophes are not ignored, even though the actual risk is only approximated. In addition, a few examples of risk analysis of specific hazards are given. Rudimentary probability and fault tree theory are used in these examples. Total risk assessment and resource allocation and safety performance trend analysis are discussed

Background risk information to assist in risk management decision making

International Nuclear Information System (INIS)

Hammonds, J.S.; Hoffman, F.O.; White, R.K.; Miller, D.B.

1992-10-01

The evaluation of the need for remedial activities at hazardous waste sites requires quantification of risks of adverse health effects to humans and the ecosystem resulting from the presence of chemical and radioactive substances at these sites. The health risks from exposure to these substances are in addition to risks encountered because of the virtually unavoidable exposure to naturally occurring chemicals and radioactive materials that are present in air, water, soil, building materials, and food products. To provide a frame of reference for interpreting risks quantified for hazardous waste sites, it is useful to identify the relative magnitude of risks of both a voluntary and involuntary nature that are ubiquitous throughout east Tennessee. In addition to discussing risks from the ubiquitous presence of background carcinogens in the east Tennessee environment, this report also presents risks resulting from common, everyday activities. Such information should, not be used to discount or trivialize risks from hazardous waste contamination, but rather, to create a sensitivity to general risk issues, thus providing a context for better interpretation of risk information

RISK LOAN PORTFOLIO OPTIMIZATION MODEL BASED ON CVAR RISK MEASURE

Directory of Open Access Journals (Sweden)

Ming-Chang LEE

2015-07-01

Full Text Available In order to achieve commercial banks liquidity, safety and profitability objective requirements, loan portfolio risk analysis based optimization decisions are rational allocation of assets.  The risk analysis and asset allocation are the key technology of banking and risk management.  The aim of this paper, build a loan portfolio optimization model based on risk analysis.  Loan portfolio rate of return by using Value-at-Risk (VaR and Conditional Value-at-Risk (CVaR constraint optimization decision model reflects the bank's risk tolerance, and the potential loss of direct control of the bank.  In this paper, it analyze a general risk management model applied to portfolio problems with VaR and CVaR risk measures by using Using the Lagrangian Algorithm.  This paper solves the highly difficult problem by matrix operation method.  Therefore, the combination of this paper is easy understanding the portfolio problems with VaR and CVaR risk model is a hyperbola in mean-standard deviation space.  It is easy calculation in proposed method.

Characteristics of e-cigarette users and their perceptions of the benefits, harms and risks of e-cigarette use: survey results from a convenience sample in Ottawa, Canada.

Science.gov (United States)

Volesky, K D; Maki, A; Scherf, C; Watson, L M; Cassol, E; Villeneuve, P J

2016-07-01

Although e-cigarette use ("vaping") is increasing in Canada, few attempts have been made to describe e-cigarette users ("vapers"). In this context, we conducted a study in Ottawa, Canada, to describe e-cigarette users' perceptions of the benefits, harms and risks of e-cigarettes. We also collected information on why, how and where they use e-cigarettes as well as information on side effects. A 24-item online survey was administered to individuals who purchased e-cigarettes or e-cigarette-related supplies at one of Ottawa's 17 e-cigarette shops. Descriptive analyses characterized respondents, and logistic regression models were fitted to evaluate the relationship between respondents' characteristics and their perception of e-cigarette harms. The mean age of the 242 respondents was 38.1 years (range: 16-70 years); 66% were male. Nearly all had smoked 100 or more cigarettes in their lifetime (97.9%). More than 80% indicated that quitting smoking was a very important reason for starting to use e-cigarettes and 60% indicated that they intend to stop using e-cigarettes at some point. About 40% reported experiencing some side effects within 2 hours of using e-cigarettes. Those who did not report experiencing any of the listed side effects had approximately 3.2 times higher odds of perceiving e-cigarettes as harmless than those who reported having side effects (odds ratio = 3.17; 95% confidence interval: 1.75-5.73). Our findings suggest that most e-cigarette users are using them to reduce or stop smoking cigarettes and perceive them as harmless. Due to our use of convenience sampling, the reader should be cautious in generalizing our findings to all Canadian e-cigarette users.

Risk management overview

International Nuclear Information System (INIS)

McGovern, S.

1995-01-01

Launching of the first natural gas contract by the New York Mercantile Exchange (NYMEX) in April 1990 was a huge success which allowed natural gas to surpass crude oil as the most successful launch of any commodity contract. Despite this unprecedented initial success it must be kept in mind that in a competitive marketplace there are risks of many kinds (market risks, price risks, basis risks, currency risks and timing risks), that parties must deal with in everyday operations. The concept of risk management was defined, techniques and issues in risk management were explained, a glossary of fully explained industry terms, and basic financial tools most often used in risk management, were provided. 11 figs

12 CFR 567.6 - Risk-based capital credit risk-weight categories.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Risk-based capital credit risk-weight... CAPITAL Regulatory Capital Requirements § 567.6 Risk-based capital credit risk-weight categories. (a) Risk...)(2) of this section), plus risk-weighted recourse obligations, direct credit substitutes, and certain...

Comparison Study of Electromagnet and Permanent Magnet Systems for an Accelerator Using Cost-Based Failure Modes and Effects Analysis

International Nuclear Information System (INIS)

Spencer, C

2004-01-01

The next generation of particle accelerators will be one-of-a-kind facilities, and to meet their luminosity goals they must have guaranteed availability over their several decade lifetimes. The Next Linear Collider (NLC) is one viable option for a 1 TeV electron-positron linear collider, it has an 85% overall availability goal. We previously showed how a traditional Failure Modes and Effects Analysis (FMEA) of a SLAC electromagnet leads to reliability-enhancing design changes. Traditional FMEA identifies failure modes with high risk but does not consider the consequences in terms of cost, which could lead to unnecessarily expensive components. We have used a new methodology, ''Life Cost-Based FMEA'', which measures risk of failure in terms of cost, in order to evaluate and compare two different technologies that might be used for the 8653 NLC magnets: electromagnets or permanent magnets. The availabilities for the two different types of magnet systems have been estimated using empirical data from SLAC's accelerator failure database plus expert opinion on permanent magnet failure modes and industry standard failure data. Labor and material costs to repair magnet failures are predicted using a Monte Carlo simulation of all possible magnet failures over a 30-year lifetime. Our goal is to maximize up-time of the NLC through magnet design improvements and the optimal combination of electromagnets and permanent magnets, while reducing magnet system lifecycle costs

Risk management and analysis: risk assessment (qualitative and quantitative)

OpenAIRE

Valentin Mazareanu

2007-01-01

We use to define risk as the possibility of suffering a loss. Starting this, risk management is defined as a business process whose purpose is to ensure that the organization is protected against risks and their effects. In order to prioritize, to develop a response plan and after that to monitor the identified risks we need to asses them. But at this point a question is born: should I choose a qualitative approach or a quantitative one? This paper will make a short overview over the risk eva...

Debunking vaccination myths: strong risk negations can increase perceived vaccination risks.

Science.gov (United States)

Betsch, Cornelia; Sachse, Katharina

2013-02-01

Information about risks is often contradictory, especially in the health domain. A vast amount of bizarre information on vaccine-adverse events (VAE) can be found on the Internet; most are posted by antivaccination activists. Several actors in the health sector struggle against these statements by negating claimed risks with scientific explanations. The goal of the present work is to find optimal ways of negating risk to decrease risk perceptions. In two online experiments, we varied the extremity of risk negations and their source. Perception of the probability of VAE, their expected severity (both variables serve as indicators of perceived risk), and vaccination intentions. Paradoxically, messages strongly indicating that there is "no risk" led to a higher perceived vaccination risk than weak negations. This finding extends previous work on the negativity bias, which has shown that information stating the presence of risk decreases risk perceptions, while information negating the existence of risk increases such perceptions. Several moderators were also tested; however, the effect occurred independently of the number of negations, recipient involvement, and attitude. Solely the credibility of the information source interacted with the extremity of risk negation: For credible sources (governmental institutions), strong and weak risk negations lead to similar perceived risk, while for less credible sources (pharmaceutical industries) weak negations lead to less perceived risk than strong negations. Optimal risk negation may profit from moderate rather than extreme formulations as a source's trustworthiness can vary.

The influence of narrative risk communication on feelings of cancer risk.

Science.gov (United States)

Janssen, Eva; van Osch, Liesbeth; de Vries, Hein; Lechner, Lilian

2013-05-01

Evidence is accumulating for the importance of feelings of risk in explaining cancer preventive behaviours, but best practices for influencing these feelings are limited. The aim of this experimental study was to compare the effects of narrative and non-narrative risk communication about sunbed use on ease of imagination and feelings of cancer risk. A total of 233 female sunbed users in the general Dutch population were randomly assigned to one of three conditions: a narrative message (i.e., personal testimonial), a non-narrative cognitive message (i.e., factual risk information using cognitive-laden words), or a non-narrative affective message (i.e., factual risk information using affective-laden words). Ease of imagination and feelings of risk were assessed directly after the risk information was given (T1). Three weeks after the baseline session, feelings of risk were measured again (T2). The results revealed that sunbed users who were exposed to narrative risk information could better imagine themselves developing skin cancer and reported higher feelings of skin cancer risk at T1. Moreover, ease of imagination mediated the effects of message type on feelings of risk at T1 and T2. The findings provide support for the effects of narrative risk communication in influencing feelings of cancer risk through ease of imagination. Cancer prevention programmes may therefore benefit from including narrative risk information. Future research is important to investigate other mechanisms of narrative information and their most effective content and format. What is already known on this subject? Evidence is growing for the importance of feelings of risk in explaining cancer preventive behaviours. Narratives have increasingly been considered as an effective format for persuasive risk messages and studies have shown narrative risk communication to be effective in influencing cognitive risk beliefs. What does this study add? Increasing understanding of how feelings of cancer

Effects of risk communication on natural hazards on real estate owners' risk perception and risk behaviour

Science.gov (United States)

Buchecker, M.; Maidl, E.

2012-04-01

In the last decade, in most of the European countries risk maps on natural hazards have been elaborated but there is so far little experience how to efficiently communicate these maps to the public. Recently, the public authorities of Zurich informed the owners of buildings located within the hazard zone on urban flood risks The owners received official letters containing information on potential danger, the probability of flood events, constructional safety measures, and guidelines for appropriate actions in case of an immediate flood. In the cover letter they were also encouraged to achieve more detailed information about the particular risks for their building using an online accessible risk map within a geographic information system (GIS). This risk communication campaign was based on the expectation that informing citizens increases their risk awareness and that citizens aware of risks are more likely to undertake actions to protect themselves and their property. There is, however, little empirical evidence that these expected outcomes can be achieved by written forms of risk communication. With this project we aim to find out to which degree a campaign of written risk communication can shape land owners risk perception and risk behaviour, and which other factors (e.g. trust in authorities, risk, risk zone category of the building) contributed to these outcomes... In collaboration with public authorities we conducted a survey among 1500 owners of buildings in the hazard zones in Zurich (50 % in blue zone, 50 % in yellow and yellow-white zone), that is 14% of all persons who were addressed by the authorities of the city. The standardized questionnaire comprises in particular items measuring respondents' evaluation of the virtual and physical information material, the time they spent for studying the information material, the dimensions of their risk perception, their acceptability of risks and their preparedness to implement constructional and other safety

The third spatial dimension risk approach for individual risk and group risk in multiple use of space

International Nuclear Information System (INIS)

Suddle, Shahid; Ale, Ben

2005-01-01

Buildings above roads and railways are examples of multiple use of space. Safety is one of the critical issues for such projects. Risk analyses can be undertaken to investigate what safety measures that are required to realise these projects. The results of these analyses can also be compared to risk acceptance criteria, if they are applicable. In The Netherlands, there are explicit criteria for acceptability of individual risk and societal risk. Traditionally calculations of individual risk result in contours of equal risk on a map and thus are considered in two-dimensional space only. However, when different functions are layered the third spatial dimension, height, becomes an important parameter. The various activities and structures above and below each other impose mutual risks. There are no explicit norms or policies about how to deal with the individual or group risk approach in the third dimension. This paper proposes an approach for these problems and gives some examples. Finally, the third dimension risk approach is applied in a case study of Bos en Lommer, Amsterdam

Got Risk? Using Risk Transfers to Control Costs

Science.gov (United States)

Bambino, Robert

2010-01-01

For public school districts, risk financing is the financial outlay associated with litigation, such as settlements, verdicts, and the cost of legal defense. Even when districts purchase insurance to finance risk, a viable risk transfer program can still benefit districts in different ways: (1) Liability policies are generally experience-rated;…

Environmental modeling and health risk analysis (ACTS/RISK)

National Research Council Canada - National Science Library

Aral, M. M

2010-01-01

... presents a review of the topics of exposure and health risk analysis. The Analytical Contaminant Transport Analysis System (ACTS) and Health RISK Analysis (RISK) software tools are an integral part of the book and provide computational platforms for all the models discussed herein. The most recent versions of these two softwa...

Negative Affect, Risk Perception, and Adolescent Risk Behavior

Science.gov (United States)

Curry, Laura A.; Youngblade, Lise M.

2006-01-01

The prevalence, etiology, and consequences of adolescent risk behavior have stimulated much research. The current study examined relationships among anger and depressive symptomatology (DS), risk perception, self-restraint, and adolescent risk behavior. Telephone surveys were conducted with 290 14- to 20-year-olds (173 females; M = 15.98 years).…

Risk and society

International Nuclear Information System (INIS)

Tubiana, M.; Vrousos, C.; Pages, J.P.; Carde, C.

1999-01-01

This book brings together the communications presented at the colloquium 'risk and society' held in Paris (France) on November 1998. During this colloquium, the various aspects of risk and of its management were discussed by medical specialists, historians, industrialists, engineers, philosophers, lawyers, politicians and administration representatives. The first theme concerns the controversies generated by the development of some activities (genetics, bio-technologies, nuclear and radiations use). The second theme concerns the management of risks and the way to conciliate the point of view of authorities and citizens (confidence of the public with respect to experts, scientists, industrialists, government and administrative representatives, role played by the media). The debates that took place during the colloquium have shown that the public opinion concerning the nuclear activities or the new technologies greatly depends on the ideological attitudes and on the public's likes and dislikes with respect to some categories of actors (distrust with respect to public decisions, fears with respect to changes and future, nostalgia of the past). The following aspects are reviewed: Notions of risk and hazard (risk and health, risk in today's society, medicine and society, the point of view of the industrialists and of the scientific and technical specialists); from the psychological aspects of the risk to its social aspects (survey of the risk assessment battlefield, social attenuation and amplification of risk, the feeling of risks in Europe, insecurity and delinquency, controversies around radioactivity and health); the negotiation and communication about risks (risk and public health, negotiation around risks, risks and information dissemination about the public debate, communication and crisis, evolution of risk communication, comparison between American and European approaches, the Seveso directive); the public debate and the evolution of risks management (the

Business risks, functions, methods of assessment and ways to reduce risk

Directory of Open Access Journals (Sweden)

A.V. Mihalchuk

2015-06-01

Full Text Available For successful existence in a market economy entrepreneur have to take bold actions, and this increases the risk. The article describes the concept of entrepreneurship and business risk, positive and negative aspects of functions of risk in business. Therefore, it is necessary to assess the risk properly and be able to manage it to achieve the most effective results in the market. In market conditions the problem of assessing and accounting market becomes independent theoretical and practical significance as an important component of the theory and practice of management. Risk - a key element of business activities. Development of risk situations can lead to both the occurrence of adverse effects (losses, lost profits, and positive results for a company in the form of increased profit. This article describes: the concept of entrepreneurship, risk and business risks, characteristic of positive and negative aspects of risk functions in business, methods of assessment and risk reduction, shows formulae and examples you can use to assess risk in an enterprise. Analyzing already established methods of risk assessment a number of rules were proposed in order to reduce business risk.

A metasynthesis of risk perception in women with high risk pregnancies.

Science.gov (United States)

Lee, Suzanne; Ayers, Susan; Holden, Des

2014-04-01

risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies. a systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that reported qualitative research into risk perception in relation to high risk pregnancy. A metasynthesis was developed to describe and interpret the studies. the synthesis resulted in the identification of five themes: determinants of risk perception; not seeing it the way others do; normality versus risk; if the infant is ok, I׳m ok; managing risk. this metasynthesis suggests women at high risk during pregnancy use multiple sources of information to determine their risk status. It shows women are aware of the risks posed by their pregnancies but do not perceive risk in the same way as healthcare professionals. They will take steps to ensure the health of themselves and their infants but these may not include following all medical recommendations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Radiation effects and risks: overview and a new risk perception index

International Nuclear Information System (INIS)

Rehani, M.M.

2015-01-01

Uncertainty provides opportunities for differences in perception, and radiation risks at low level of exposures involved in few computed tomography scans fall in this category. While there is good agreement among national and international organisations on risk probability of cancer, risk perception has barely been dealt with by these organisations. Risk perception is commonly defined as the subjective judgment that people make about the characteristics and severity of a risk. Severity and latency are important factors in perception. There is a need to connect all these. Leaving risk perception purely as a subjective judgement provides opportunities for people to amplifying risk. The author postulates a risk perception index as severity divided by latency that becomes determining factor for risk perception. It is hoped that this index will bring rationality in risk perception. (authors)

From risk-seeking to risk-averse: The development of economic risk preference from early childhood to adulthood.

Directory of Open Access Journals (Sweden)

David J. Paulsen

2012-09-01

Full Text Available Adolescence is often described as a period of heightened risk-taking. Adolescents are notorious for impulsivity, emotional volatility, and risky behaviors such as drinking under the influence of alcohol. By contrast, we found that risk-taking declines linearly from childhood to adulthood when individuals make choices over monetary gambles. Further, with age we found increases in the sensitivity to economic risk, defined as the degree to which a preference for assured monetary gains over a risky payoff depends upon the variability in the risky payoff. These findings indicate that decisions about economic risk may follow a different developmental trajectory than other kinds of risk taking, and that changes in sensitivity to risk may be a major factor in the development of mature risk aversion.

High-Risk and Low-Risk Human Papillomavirus and the Absolute Risk of Cervical Intraepithelial Neoplasia or Cancer

DEFF Research Database (Denmark)

Thomsen, Louise T; Frederiksen, Kirsten; Munk, Christian

2014-01-01

OBJECTIVE: To determine the absolute risk of cervical intraepithelial neoplasia (CIN) grade 3 or cervical cancer (CIN 3 or worse) after detection of low-risk human papillomavirus (HPV) and after a negative high-risk HPV test. METHODS: In this prospective cohort study, consecutive liquid......-based cervical cytology samples were collected from women screened for cervical cancer in Copenhagen, Denmark, during 2002-2005. Samples were tested with a clinical test for 13 high-risk and five low-risk HPV types. The cohort (N=35,539; aged 14-90 years) was monitored in a nationwide pathology register for up...... cytology. Detection of low-risk HPV does not predict CIN 3 or worse. Cervical cancer screening should not include testing for low-risk HPV types. LEVEL OF EVIDENCE: II....

Quantifying Cardiometabolic Risk Using Modifiable Non–Self-Reported Risk Factors

Science.gov (United States)

Marino, Miguel; Li, Yi; Pencina, Michael J.; D’Agostino, Ralph B.; Berkman, Lisa F.; Buxton, Orfeu M.

2014-01-01

Background Sensitive general cardiometabolic risk assessment tools of modifiable risk factors would be helpful and practical in a range of primary prevention interventions or for preventive health maintenance. Purpose To develop and validate a cumulative general cardiometabolic risk score that focuses on non–self-reported modifiable risk factors such as glycosylated hemoglobin (HbA1c) and BMI so as to be sensitive to small changes across a span of major modifiable risk factors, which may not individually cross clinical cut off points for risk categories. Methods We prospectively followed 2,359 cardiovascular disease (CVD)-free subjects from the Framingham offspring cohort over a 14–year follow-up. Baseline (fifth offspring examination cycle) included HbA1c and cholesterol measurements. Gender–specific Cox proportional hazards models were considered to evaluate the effects of non–self-reported modifiable risk factors (blood pressure, total cholesterol, high–density lipoprotein cholesterol, smoking, BMI, and HbA1c) on general CVD risk. We constructed 10–year general cardiometabolic risk score functions and evaluated its predictive performance in 2012–2013. Results HbA1c was significantly related to general CVD risk. The proposed cardiometabolic general CVD risk model showed good predictive performance as determined by cross-validated discrimination (male C-index=0.703, 95% CI=0.668, 0.734; female C-index=0.762, 95% CI=0.726, 0.801) and calibration (lack-of-fit χ2=9.05 [p=0.338] and 12.54 [p=0.128] for men and women, respectively). Conclusions This study presents a risk factor algorithm that provides a convenient and informative way to quantify cardiometabolic risk based on modifiable risk factors that can motivate an individual’s commitment to prevention and intervention. PMID:24951039

Quantifying cardiometabolic risk using modifiable non-self-reported risk factors.

Science.gov (United States)

Marino, Miguel; Li, Yi; Pencina, Michael J; D'Agostino, Ralph B; Berkman, Lisa F; Buxton, Orfeu M

2014-08-01

Sensitive general cardiometabolic risk assessment tools of modifiable risk factors would be helpful and practical in a range of primary prevention interventions or for preventive health maintenance. To develop and validate a cumulative general cardiometabolic risk score that focuses on non-self-reported modifiable risk factors such as glycosylated hemoglobin (HbA1c) and BMI so as to be sensitive to small changes across a span of major modifiable risk factors, which may not individually cross clinical cut-off points for risk categories. We prospectively followed 2,359 cardiovascular disease (CVD)-free subjects from the Framingham offspring cohort over a 14-year follow-up. Baseline (fifth offspring examination cycle) included HbA1c and cholesterol measurements. Gender-specific Cox proportional hazards models were considered to evaluate the effects of non-self-reported modifiable risk factors (blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking, BMI, and HbA1c) on general CVD risk. We constructed 10-year general cardiometabolic risk score functions and evaluated its predictive performance in 2012-2013. HbA1c was significantly related to general CVD risk. The proposed cardiometabolic general CVD risk model showed good predictive performance as determined by cross-validated discrimination (male C-index=0.703, 95% CI=0.668, 0.734; female C-index=0.762, 95% CI=0.726, 0.801) and calibration (lack-of-fit chi-square=9.05 [p=0.338] and 12.54 [p=0.128] for men and women, respectively). This study presents a risk factor algorithm that provides a convenient and informative way to quantify cardiometabolic risk on the basis of modifiable risk factors that can motivate an individual's commitment to prevention and intervention. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

A Protection Motivation Theory application to date rape education.

Science.gov (United States)

Singh, Shweta; Orwat, John; Grossman, Susan

2011-12-01

Date rape risk communication is a key component of education-based Date Rape Prevention Programs, common across colleges. In such programs, risk assessment in date rape is approached cautiously in order to avoid a tone of "victim blaming." Since it is important in the assessment of any risk to understand the surrounding social context of the risky situation and the individual's unique relationship with that social context, this study examines Protection Motivation Theory as it applies to handling the risk of date rape without victim blaming. The paper links individual personality and social contexts with risk communication. The study sample comprised 367 undergraduate women enrolled in a large Southern Public University. The study examines the relationships between dating activity, social competency, and type of information provided with the dependents variables of date rape related protection behavior (intent), belief, and knowledge. A factorial multiple analysis of covariance analysis found that the dependent variables had a significant relationship with aspects of social competency and dating activity. The exposure to varying information about date rape was not significantly related to the dependent variables of date rape-related protection behavior (intent), belief, and knowledge. The identification of social competency and dating activity status as protective factors in this study makes a significant contribution to the practice and research efforts in date rape education.

A semi-quantitative model for risk appreciation and risk weighing

DEFF Research Database (Denmark)

Bos, Peter M.J.; Boon, Polly E.; van der Voet, Hilko

2009-01-01

Risk managers need detailed information on (1) the type of effect, (2) the size (severity) of the expected effect(s) and (3) the fraction of the population at risk to decide on well-balanced risk reduction measures. A previously developed integrated probabilistic risk assessment (IPRA) model...... provides quantitative information on these three parameters. A semi-quantitative tool is presented that combines information on these parameters into easy-readable charts that will facilitate risk evaluations of exposure situations and decisions on risk reduction measures. This tool is based on a concept...... detailed information on the estimated health impact in a given exposure situation. These graphs will facilitate the discussions on appropriate risk reduction measures to be taken....

Existential risks: exploring a robust risk reduction strategy.

Science.gov (United States)

Jebari, Karim

2015-06-01

A small but growing number of studies have aimed to understand, assess and reduce existential risks, or risks that threaten the continued existence of mankind. However, most attention has been focused on known and tangible risks. This paper proposes a heuristic for reducing the risk of black swan extinction events. These events are, as the name suggests, stochastic and unforeseen when they happen. Decision theory based on a fixed model of possible outcomes cannot properly deal with this kind of event. Neither can probabilistic risk analysis. This paper will argue that the approach that is referred to as engineering safety could be applied to reducing the risk from black swan extinction events. It will also propose a conceptual sketch of how such a strategy may be implemented: isolated, self-sufficient, and continuously manned underground refuges. Some characteristics of such refuges are also described, in particular the psychosocial aspects. Furthermore, it is argued that this implementation of the engineering safety strategy safety barriers would be effective and plausible and could reduce the risk of an extinction event in a wide range of possible (known and unknown) scenarios. Considering the staggering opportunity cost of an existential catastrophe, such strategies ought to be explored more vigorously.

Risk Assessment Overview

Science.gov (United States)

Prassinos, Peter G.; Lyver, John W., IV; Bui, Chinh T.

2011-01-01

Risk assessment is used in many industries to identify and manage risks. Initially developed for use on aeronautical and nuclear systems, risk assessment has been applied to transportation, chemical, computer, financial, and security systems among others. It is used to gain an understanding of the weaknesses or vulnerabilities in a system so modification can be made to increase operability, efficiency, and safety and to reduce failure and down-time. Risk assessment results are primary inputs to risk-informed decision making; where risk information including uncertainty is used along with other pertinent information to assist management in the decision-making process. Therefore, to be useful, a risk assessment must be directed at specific objectives. As the world embraces the globalization of trade and manufacturing, understanding the associated risk become important to decision making. Applying risk assessment techniques to a global system of development, manufacturing, and transportation can provide insight into how the system can fail, the likelihood of system failure and the consequences of system failure. The risk assessment can identify those elements that contribute most to risk and identify measures to prevent and mitigate failures, disruptions, and damaging outcomes. In addition, risk associated with public and environment impact can be identified. The risk insights gained can be applied to making decisions concerning suitable development and manufacturing locations, supply chains, and transportation strategies. While risk assessment has been mostly applied to mechanical and electrical systems, the concepts and techniques can be applied across other systems and activities. This paper provides a basic overview of the development of a risk assessment.

Statin-induced bilateral foot drop in a case of hypothyroidism

Directory of Open Access Journals (Sweden)

Neera Chaudhary

2015-01-01

Full Text Available Muscle involvement is a common manifestation of both clinical and subclinical hypothyroidism, with serum creatine kinase (CK elevation being probably the most common manifestation, and is seen in up to 90% of patients, but is usually mild (less than 10 times the upper limit of normal. Rhabdomyolysis is a distinctively uncommon presentation of hypothyroidism described usually in the setting of precipitating events such as strenuous exercise, alcohol, or statin use. Rarely rhabdomyolysis and myoedema seen in hypothyroidism can be complicated by the development of anterior compartment syndrome leading to neurovascular compression. We describe a case of a patient with hypothyroidism who developed acute onset bilateral foot drop on initiation of statins. This case highlights the need for cautious use of statins in patients at risk for rhabdomyolysis.

Vaginal prostaglandin gel to induce labour in women with one previous caesarean section.

LENUS (Irish Health Repository)

Agnew, G

2012-02-01

This retrospective study reviewed the mode of delivery when vaginal prostaglandins were used to induce labour in women with a single previous lower segment caesarean section. Over a 4-year period, PGE 2 gel was used cautiously in low doses in 54 women. Induction with PGE 2 gel was associated with an overall vaginal birth after caesarean section (VBAC) rate of 74%, which compared favourably with the 74% VBAC rate in women who went into spontaneous labour (n = 1969). There were no adverse outcomes recorded after the prostaglandin inductions but the number reported are too small to draw any conclusions about the risks, such as uterine rupture. We report our results because they may be helpful in assessing the chances of a successful VBAC in the uncommon clinical circumstances where prostaglandin induction is being considered.

Mixed-strategy Nash equilibrium for a discontinuous symmetric N-player game

Science.gov (United States)

Hilhorst, H. J.; Appert-Rolland, C.

2018-03-01

We consider a game in which each player must find a compromise between more daring strategies that carry a high risk for him to be eliminated, and more cautious ones that, however, reduce his final score. For two symmetric players this game was originally formulated in 1961 by Dresher, who modeled a duel between two opponents. The game has also been of interest in the description of athletic competitions. We extend here the two-player game to an arbitrary number N of symmetric players. We show that there is a mixed-strategy Nash equilibrium and find its exact analytic expression, which we analyze in particular in the limit of large N, where mean-field behavior occurs. The original game with N  =  2 arises as a singular limit of the general case.

Taking the Risk Out of Risk Assessment

Science.gov (United States)

2005-01-01

The ability to understand risks and have the right strategies in place when risky events occur is essential in the workplace. More and more organizations are being confronted with concerns over how to measure their risks or what kind of risks they can take when certain events transpire that could have a negative impact. NASA is one organization that faces these challenges on a daily basis, as effective risk management is critical to the success of its missions especially the Space Shuttle missions. On July 29, 1996, former NASA Administrator Daniel Goldin charged NASA s Office of Safety and Mission Assurance with developing a probabilistic risk assessment (PRA) tool to support decisions on the funding of Space Shuttle upgrades. When issuing the directive, Goldin said, "Since I came to NASA [in 1992], we've spent billions of dollars on Shuttle upgrades without knowing how much they improve safety. I want a tool to help base upgrade decisions on risk." Work on the PRA tool began immediately. The resulting prototype, the Quantitative Risk Assessment System (QRAS) Version 1.0, was jointly developed by NASA s Marshall Space Flight Center, its Office of Safety and Mission Assurance, and researchers at the University of Maryland. QRAS software automatically expands the reliability logic models of systems to evaluate the probability of highly detrimental outcomes occurring in complex systems that are subject to potential accident scenarios. Even in its earliest forms, QRAS was used to begin PRA modeling of the Space Shuttle. In parallel, the development of QRAS continued, with the goal of making it a world-class tool, one that was especially suited to NASA s unique needs. From the beginning, an important conceptual goal in the development of QRAS was for it to help bridge the gap between the professional risk analyst and the design engineer. In the past, only the professional risk analyst could perform, modify, use, and perhaps even adequately understand PRA. NASA wanted

Industrial risks

International Nuclear Information System (INIS)

Okrent, D.

1981-01-01

A brief look is taken at the status of progress, or the lack of it, towards a quantitative approach to the estimation and assessment of risk for several technologies in the United States. The increase of interest in the consideration of comparative risks in decision-making is also discussed. Finally, a recently proposed trial approach to quantitative safety goals for light-water nuclear power reactors is summarized. The approach is divided into two major tasks: the predominantly social and political task of setting safety criteria, and the technical task of estimating the risks and deciding whether the safety criteria have been met. The safety criteria include the following: limits on hazard states within the reactor; limits on risk to the individual; limits on societal risk; a cost-effectiveness criterion as low as reasonably achievable; a small element of risk aversion. (author)

Risk in Science Instruction. The Realist and Constructivist Paradigms of Risk

Science.gov (United States)

Hansen, Julia; Hammann, Marcus

2017-11-01

Risk is always present in people's lives: diseases, new technologies, socio-scientific issues (SSIs) such as climate change, and advances in medicine—to name just a few examples—all carry risks. To be able to navigate risks in everyday life, as well as to participate in social debate on risk-related issues, students need to develop risk competence. Science education can be a powerful tool in supporting students' risk competence, which is an important component of scientific literacy. As there are different definitions of risk within the scientific community, the aims of this article are (1) to review the literature on two major theoretical frameworks for conceptualising risk, the realist, and the constructivist paradigms of risk and (2) to connect both in order to suggest a working definition of what can be understood as risk competence in science instruction.

Climatic risks

International Nuclear Information System (INIS)

Lamarre, D.; Favier, R.; Bourg, D.; Marchand, J.P.

2005-04-01

The climatic risks are analyzed in this book under the cross-vision of specialists of different domains: philosophy, sociology, economic history, law, geography, climatology and hydrology. The prevention of risks and the precautionary principle are presented first. Then, the relations between climatic risk and geography are analyzed using the notion of territoriality. The territory aspect is in the core of the present day debates about the geography of risks, in particular when the links between climate change and public health are considered. Then the main climatic risks are presented. Droughts and floods are the most damaging ones and the difficulties of prevention-indemnification coupling remain important. (J.S.)

riskRegression

DEFF Research Database (Denmark)

Ozenne, Brice; Sørensen, Anne Lyngholm; Scheike, Thomas

2017-01-01

In the presence of competing risks a prediction of the time-dynamic absolute risk of an event can be based on cause-specific Cox regression models for the event and the competing risks (Benichou and Gail, 1990). We present computationally fast and memory optimized C++ functions with an R interface...... for predicting the covariate specific absolute risks, their confidence intervals, and their confidence bands based on right censored time to event data. We provide explicit formulas for our implementation of the estimator of the (stratified) baseline hazard function in the presence of tied event times. As a by...... functionals. The software presented here is implemented in the riskRegression package....

Nuclear power plant risk assembly and decomposition for risk management

International Nuclear Information System (INIS)

Iden, D.C.

1985-01-01

The state-of-the-art method for analyzing the risk from nuclear power plants is probabilistic risk assessment (PRA). The intermediate results of a PRA are first assembled to quantify the risk from operating a nuclear power plant in the form of (1) core damage (or core melt) frequency, (2) plant damage state frequencies, (3) release category frequencies, and (4) the frequency of exceeding specific levels of offsite consequences. Once the overall PRA results have been quantified, the next step is to decompose those results into the individual contributors to each of the four forms of risk in some rank order. The way in which the PRA model is set up to assemble and decompose the plant risk determines the ease and usefulness of the PRA model as a risk management tool for evaluating perturbations to the PRA model. These perturbations can take the form of technical specification changes, hardware modifications, procedural changes, etc. The matrix formalism developed by Dr. Stan Kaplan for risk assembly and decomposition represents a significant breakthrough in making the PRA model an effective risk management tool. The key to understanding the matrix formalism and making it a useful tool for managing nuclear power plant risk is the structure of the PRA model. PRA risk model structure and decomposition of the risk results are discussed with the Seabrook PRA as an example

Cocoa Polyphenols: Evidence from Epidemiological Studies.

Science.gov (United States)

Matsumoto, Chisa

2018-01-01

Accumulating evidence suggests potential preventive effects of chocolate/cocoa on the risk of cardio vascular disease (CVD). However, cocoa products also contain high levels of sugar and fat, which increase CVD risk factors. Even, the identity of the substance in chocolate/cocoa that has a favorable effect on CVD and CVD risk factors remains unclear, growing evidence from experimental studies suggests that cocoa polyphenols might be a major contributor to cardiovascular-protective effects. However, epidemiological studies, which are necessary to evaluate an association between the risk of CVD and cocoa polyphenol, remain sparse. We will discuss recent evidence regarding the association between cocoa polyphenol consumption and the risks of CVD and its risk factors by reviewing recent epidemiological studies. We shall also provide some guidance for patient counseling and will discuss the public health implications for recommending cocoa polyphenol consumption to prevent CVD. Epidemiological studies evaluating the association between cocoa polyphenol itself and the risk of CVD are sparse. However, evidence from limited epidemiological studies suggests that cocoa polyphenol consumption may lower the risk of CVD. Given the potential adverse effects of the consumption of cocoa products with high fat and sugar and the fact that the most appropriate dose of cocoa polyphenol for cardio-protective effects has not yet been established, health care providers should remain cautious about recommending cocoa/cocoa polyphenol consumption to their patients to reduce the risk of CVD, taking the characteristics of individual patients into careful consideration. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

An approach to societal risk acceptance criteria and risk management

International Nuclear Information System (INIS)

Okrent, D.; Whipple, C.

1977-06-01

A quantitative approach to risk acceptance criteria and risk management is proposed for activities involving risk to individuals not receiving direct benefits, such as employment, from the activity. Societal activities are divided into major facilities or technologies, all or part of which are categorized as essential, beneficial, or peripheral, and a decreasing level of acceptable risk to the most exposed individual is proposed (say, 0.0002/year for essential, 0.00001/year for beneficial, and 0.000002/year for peripheral activity). The risk would be assessed at a high confidence level (say, 90%), thereby providing an incentive to the gaining of better knowledge. Each risk-producing facility, technology, etc., would have to undergo assessment both of risk to the individual and to society. The cost of the latter would have to be internalized, probably via a tax paid to the Federal Government, which in turn would redistribute the benefit as national health insurance or reduced taxes to the individual. Risk aversion to large events would be built into the internalization of the cost of risk

Benefits and Harms of Treatment of Asymptomatic Bacteriuria: A Systematic Review and Meta-analysis by the European Association of Urology Urological Infection Guidelines Panel.

Science.gov (United States)

Köves, Bela; Cai, Tommaso; Veeratterapillay, Rajan; Pickard, Robert; Seisen, Thomas; Lam, Thomas B; Yuan, Cathy Yuhong; Bruyere, Franck; Wagenlehner, Florian; Bartoletti, Riccardo; Geerlings, Suzanne E; Pilatz, Adrian; Pradere, Benjamin; Hofmann, Fabian; Bonkat, Gernot; Wullt, Björn

2017-12-01

People with asymptomatic bacteriuria (ABU) are often unnecessarily treated with antibiotics risking adverse effects and antimicrobial resistance. We performed a systematic review to determine any benefits and harms of treating ABU in particular patient groups. Relevant databases were searched and eligible trials were assessed for risk-of-bias and Grading of Recommendations, Assessment, Development and Education quality. Where possible, a meta-analysis of extracted data was performed or a narrative synthesis of the evidence was presented. After screening 3626 articles, 50 studies involving 7088 patients were included. Overall, quality of evidence ranged from very low to low. There was no evidence of benefit for patients with no risk factors, patients with diabetes mellitus, postmenopausal women, elderly institutionalised patients, patients with renal transplants, or patients prior to joint replacement, and treatment was harmful for patients with recurrent urinary tract infection (UTI). Treatment of ABU resulted in a lower risk of postoperative UTI after transurethral resection surgery. In pregnant women, we found evidence that treatment of ABU decreased risk of symptomatic UTI, low birthweight, and preterm delivery. ABU should be treated prior to transurethral resection surgery. In addition, current evidence also suggests that ABU treatment is required in pregnant women, although the results of a recent trial have challenged this view. We reviewed available scientific studies to see if people with bacteria in their urine but without symptoms of urinary tract infection should be treated with antibiotics to eliminate bacteria. For most people, treatment was not beneficial and may be harmful. Antibiotic treatment did appear to benefit women in pregnancy and those about to undergo urological surgery. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Risk monitor riskangel for risk-informed applications in nuclear power plants

International Nuclear Information System (INIS)

Wang, Fang; Wang, Jiaqun; Wang, Jin; Li, Yazhou; Hu, Liqin; Wu, Yican

2016-01-01

Highlights: • A general risk monitor riskangel with high-speed cutsets generator engine. • Benchmarks of actual nuclear power plant (NPP) instantaneous risk models. • Applications in daily operation, maintenance plan and component out of service. - Abstract: This paper studied the requirements of risk monitor software and its applications as a plant specific risk monitor, which supports risk-informed configuration risk management for the two CANDU 6 units at the Third Qinshan nuclear power plant (TQNPP) in China. It also describes the regulatory prospective on risk-informed Probabilistic Safety Assessment (PSA) applications and the use of risk monitor at operating nuclear power plants, high level technical and functional requirements for the development of CANDU specific risk monitor software, and future development trends.

Probabilistic risk assessment methodology for risk management and regulatory applications

International Nuclear Information System (INIS)

See Meng Wong; Kelly, D.L.; Riley, J.E.

1997-01-01

This paper discusses the development and potential applications of PRA methodology for risk management and regulatory applications in the U.S. nuclear industry. The new PRA methodology centers on the development of This paper discusses the time-dependent configuration risk profile for evaluating the effectiveness of operational risk management programs at U.S. nuclear power plants. Configuration-risk profiles have been used as risk-information tools for (1) a better understanding of the impact of daily operational activities on plant safety, and (2) proactive planning of operational activities to manage risk. Trial applications of the methodology were undertaken to demonstrate that configuration-risk profiles can be developed routinely, and can be useful for various industry and regulatory applications. Lessons learned include a better understanding of the issues and characteristics of PRA models available to industry, and identifying the attributes and pitfalls in the developement of risk profiles

Supply chain risk management in newspaper company: House of risk approach

Science.gov (United States)

Ratnasari, Sintya; Hisjam, Muhammad; Sutopo, Wahyudi

2018-02-01

In the supply chain (SC) of newspapers, the printing company is the main entity that has several processes, i.e. procure raw materials, print plate and newspapers, and also distribute newspaper to consumers. The existing risks in the newspaper printing company are quite high. A wide range of disturbances or risks needs to be identified to map out the characteristics of the risk sources that will impact on the performance of the supply chain. Therefore, the printing companies need to manage their supply chain risk of the five major SC processes (such as plan, source, deliver, make, and return). In a case study of a newspaper company in Surakarta, the company have not implemented a risk management process that affects the company. This study is aimed to map the risks in the printing company and formulate risk mitigation alternatives to mitigate the risks. The house of risk (HOR) method was chosen to select a set of proactive actions deemed cost-effective in managing SC Risks in the newspaper company. The model consisting of two stages, the first stage (HOR1) was done by identifying risk, risk causing agents and then measured the severity and occurrences to calculate the Aggregate Risk Priority (ARP) value. The second stage (HOR2) is intended to formulate and prioritize the action of mitigation that the company should pursue to reduce the probability of risk agents to occur. The result shows that the innovative model of HOR in Newspaper Company was presented. There are 24 risk events, 20 causing agents and two priority risks in HOR1. The HOR 2 was proposed 9 ranks of mitigation strategy for priority risk agents, from the easiest to the hardest strategy for the company to implement it.

Impact Of Exogenous And Endogenous Risks On Systemic Risk In Indonesian Banking

Directory of Open Access Journals (Sweden)

Alfiana

2015-08-01

Full Text Available Weaknesses of the Banking Pressure Index and Financial Stability Index as an early detection system were not to involve contagion and bank run. This study aimed at determining impacts of endogenous and exogenous risks on systemic risks. It was a descriptive verificatory study using monthly secondary data of 2011-2014 and multiple regressions. Utilizing credit risk liquidity risk market risk capital adequacy risk contagion bank run inflation BI rate exchange rate and systemic risk variables of the 2011-2014 period it turned out that only endogenous risks of contagion and bank run variables impacted on systemic risk in Indonesian banking. The result showed that after the test of classical linear regression assumption credit risk capital adequacy risk contagion bank run and inflation variables simultaneously impacted on systemic risk and contributed to the movement of systemic risk. However our findings suggested that only contagion CONT bank run BR and inflation INF variables significantly impacted on systemic risk in a positive direction.

Cross-Cutting Risk Framework: Mining Data for Common Risks Across the Portfolio

Science.gov (United States)

Klein, Gerald A., Jr.; Ruark, Valerie

2017-01-01

The National Aeronautics and Space Administration (NASA) defines risk management as an integrated framework, combining risk-informed decision making and continuous risk management to foster forward-thinking and decision making from an integrated risk perspective. Therefore, decision makers must have access to risks outside of their own project to gain the knowledge that provides the integrated risk perspective. Through the Goddard Space Flight Center (GSFC) Flight Projects Directorate (FPD) Business Change Initiative (BCI), risks were integrated into one repository to facilitate access to risk data between projects. With the centralized repository, communications between the FPD, project managers, and risk managers improved and GSFC created the cross-cutting risk framework (CCRF) team. The creation of the consolidated risk repository, in parallel with the initiation of monthly FPD risk managers and risk governance board meetings, are now providing a complete risk management picture spanning the entire directorate. This paper will describe the challenges, methodologies, tools, and techniques used to develop the CCRF, and the lessons learned as the team collectively worked to identify risks that FPD programs projects had in common, both past and present.

Quantifying risk and accuracy in cancer risk assessment: the process and its role in risk management problem-solving.

Science.gov (United States)

Turturro, A; Hart, R W

1987-01-01

A better understanding of chemical-induced cancer has led to appreciation of similarities to problems addressed by risk management of radiation-induced toxicity. Techniques developed for cancer risk assessment of toxic substances can be generalized to toxic agents. A recent problem-solving approach for risk management of toxic substances developed for the U.S. Department of Health and Human Services, and the role of risk assessment and how uncertainty should be treated within the context of this approach, is discussed. Finally, two different methods, research into the assumptions underlying risk assessment and the modification of risk assessment/risk management documents, are used to illustrate how the technique can be applied.

Perceived risk and risk-taking behavior during the festival firework.

Science.gov (United States)

Saadat, Soheil; Naseripour, Masoud; Karbakhsh, Mojgan; Rahimi-Movaghar, Vafa

2010-01-01

To investigate the relationship between perceived risk and risk-taking behaviors during the Iranian Last Wednesday Eve Fireworks (ILWEF). A random sample of 2475 Tehranian households were asked on perceived risk of injury, risk-taking behaviors, experience of injuries, and their perception of ability to manage the harmful events during the ILWEF. Lower perceived injury risk and higher perceived ability of managing an injured household member were associated with participation in fireworks practice and incidence of injury. These findings can be of practical importance to increase safety during festivals by improving risk perception in the community.

Measuring Risk Perception in Later Life: The Perceived Risk Scale.

Science.gov (United States)

Lifshitz, Rinat; Nimrod, Galit; Bachner, Yaacov G

2016-11-01

Risk perception is a subjective assessment of the actual or potential threat to one's life or, more broadly, to one's psychological well-being. Given the various risks associated with later life, a valid and reliable integrative screening tool for assessing risk perception among the elderly is warranted. The study examined the psychometric properties and factor structure of a new integrative risk perception instrument, the Perceived Risk Scale. This eight-item measure refers to various risks simultaneously, including terror, health issues, traffic accidents, violence, and financial loss, and was developed specifically for older adults. An online survey was conducted with 306 participants aged 50 years and older. The scale was examined using exploratory factor analysis and concurrent validity testing. Factor analysis revealed a two-factor structure: later-life risks and terror risks A high percentage of explained variance, as well as internal consistency, was found for the entire scale and for both factors. Concurrent validity was supported by significant positive associations with participants' depression and negative correlations with their life satisfaction. These findings suggest that the Perceived Risk Scale is internally reliable, valid, and appropriate for evaluating risk perception in later life. The scale's potential applications are discussed. © The Author(s) 2016.

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

Fundamentals of risk management understanding, evaluating and implementing effective risk management

CERN Document Server

Hopkin, Paul

2012-01-01

Now more than ever, organizations must plan, response and recognize all forms of risks that they face. "Fundamentals of Risk Management", now in its second edition, provides a comprehensive introduction to the subject of commercial and business risk for anyone studying for a career in risk as well as a broad range of risk professionals. It examines the key components of risk management and its application with examples to demonstrate its benefit to organisations in the public and private sector. The second edition has been completely updated to take into account the greater influence of ISO 3100, the emergence of Governance Risk and Compliance (GRC) and the wide use of the bowtie method to illustrate risk management. In addition, there is now a chapter on the skills and competencies required by an effective risk manager.

Risk Management and Risk Psychology in Romanian Sme’s

Directory of Open Access Journals (Sweden)

Irina Dănciulescu

2015-12-01

Full Text Available Risk is one of the biggest and most fascinating challenges of all times for humanity, because of its presence in all fields. Risk management as a component of modern management, has become a main concern for the modern world and one of the “key mechanisms” of economic development, a complex processn that includes a series of activities meant to alleviate the impact of risk over business and planed or foreseen results. This paper wants to bring to attention the importance of risks and their management in today’s economic crisis. The sector presented is the IT& C, especially software, because Romania had a growth in this area for a few years but beginning the crisis this segment in economy had known a serious decrease. This paper tries to connect risk management and risk psychology to Romanian economy, culture and mentality. The paper presents in short some of risk management characteristics, definitions and few opinions; why in Romania this subject is not treated with the appropriate attention. The paper at hand focuses on the psychology of risk and how it affects the life of individuals and the existence of companies, the importance it should have on day to day basis, especially in Romania

Flood Risk and Flood hazard maps - Visualisation of hydrological risks

International Nuclear Information System (INIS)

Spachinger, Karl; Dorner, Wolfgang; Metzka, Rudolf; Serrhini, Kamal; Fuchs, Sven

2008-01-01

Hydrological models are an important basis of flood forecasting and early warning systems. They provide significant data on hydrological risks. In combination with other modelling techniques, such as hydrodynamic models, they can be used to assess the extent and impact of hydrological events. The new European Flood Directive forces all member states to evaluate flood risk on a catchment scale, to compile maps of flood hazard and flood risk for prone areas, and to inform on a local level about these risks. Flood hazard and flood risk maps are important tools to communicate flood risk to different target groups. They provide compiled information to relevant public bodies such as water management authorities, municipalities, or civil protection agencies, but also to the broader public. For almost each section of a river basin, run-off and water levels can be defined based on the likelihood of annual recurrence, using a combination of hydrological and hydrodynamic models, supplemented by an analysis of historical records and mappings. In combination with data related to the vulnerability of a region risk maps can be derived. The project RISKCATCH addressed these issues of hydrological risk and vulnerability assessment focusing on the flood risk management process. Flood hazard maps and flood risk maps were compiled for Austrian and German test sites taking into account existing national and international guidelines. These maps were evaluated by eye-tracking using experimental graphic semiology. Sets of small-scale as well as large-scale risk maps were presented to test persons in order to (1) study reading behaviour as well as understanding and (2) deduce the most attractive components that are essential for target-oriented risk communication. A cognitive survey asking for negative and positive aspects and complexity of each single map complemented the experimental graphic semiology. The results indicate how risk maps can be improved to fit the needs of different user

Synthetic risks, risk potency, and carcinogen regulation.

Science.gov (United States)

Viscusi, W K; Hakes, J K

1998-01-01

This article analyzes a comprehensive sample of over 350 chemicals tested for carcinogenicity to assess the determinants of the probability of regulation. Controlling for differences in the risk potency and noncancer risks, synthetic chemicals have a significantly higher probability of regulation overall: this is due to the greater likelihood of U.S. Food and Drug Administration (FDA) regulation. Measures of risk potency increase the probability of regulation by the U.S. Environmental Protection Agency (EPA), have a somewhat weaker positive effect on regulation by the U.S. Occupational Safety and Health Administration (OSHA), and decrease the likelihood of regulation by the FDA. The overall regulatory pattern is one in which the FDA targets synthetic chemicals and chemicals that pose relatively minor cancer risk. The EPA particularly performed more sensibly than many critics have suggested.

Synthesizing Risk from Summary Evidence Across Multiple Risk Factors.

Science.gov (United States)

Shrier, Ian; Colditz, Graham A; Steele, Russell J

2018-07-01

Although meta-analyses provide summary effect estimates that help advise patient care, patients often want to compare their overall health to the general population. The Harvard Cancer Risk Index was published in 2004 and uses risk ratio estimates and prevalence estimates from original studies across many risk factors to provide an answer to this question. However, the published version of the formula only uses dichotomous risk factors and its derivation was not provided. The objective of this brief report was to provide the derivation of a more general form of the equation that allows the incorporation of risk factors with three or more levels.

Risk

Science.gov (United States)

Barshi, Immanuel

2016-01-01

Speaking up, i.e. expressing ones concerns, is a critical piece of effective communication. Yet, we see many situations in which crew members have concerns and still remain silent. Why would that be the case? And how can we assess the risks of speaking up vs. the risks of keeping silent? And once we do make up our minds to speak up, how should we go about it? Our workshop aims to answer these questions, and to provide us all with practical tools for effective risk assessment and effective speaking-up strategies..

Atrazine and nitrate in drinking water and the risk of preterm delivery and low birth weight in four Midwestern states.

Science.gov (United States)

Stayner, Leslie Thomas; Almberg, Kirsten; Jones, Rachael; Graber, Judith; Pedersen, Marie; Turyk, Mary

2017-01-01

.08,1.25) when well use was restricted to 20% and the exposure was averaged over 9 months prior to birth. The positive and negative findings from our study need to be interpreted cautiously given its ecologic design, and limitations in the data for the exposures and other risk factors. Nonetheless, our findings do raise concerns about the potential adverse effects of these common water contaminants on human development and health, and the adequacy of current regulatory standards. Further studies of these issues are needed with individual level outcome data and more refined estimates of exposure. Copyright © 2016 Elsevier Inc. All rights reserved.

Nuclear risk

International Nuclear Information System (INIS)

Levenson, M.

1989-01-01

The title of our session, Nuclear Risk Versus Other Power Options, is provocative. It is also a title with different meanings to different people. To the utility chief executive officer, nuclear power is a high-risk financial undertaking because of political and economic barriers to cost recovery. To the utility dispatcher, it is a high-risk future power source since plant completion and start-up dates can be delayed for very long times due to uncertain legal and political issues. To the environmentalist, concerned about global effects such as greenhouse and acid rain, nuclear power is a relatively low risk energy source. To the financial people, nuclear power is a cash cow turned sour because of uncertainties as to what new plants will cost and whether they will even be allowed to operate. The statistics on risk are known and the results of probability risk assessment calculations of risks are known. The challenge is not to make nuclear power safer, it is already one of the safest, if not the safest, source of power currently available. The challenge is to find a way to communicate this to the public

Hospital Capacity, Waiting Times and Sick Leave Duration - an Empirical Analysis of a Norwegian Health Policy Reform

OpenAIRE

Aakvik, Arild; Holmås, Tor Helge; Kjerstad, Egil

2012-01-01

A health policy reform aiming to reduce hospital waiting times and sickness absences, the Faster Return to Work (FRW) scheme, is evaluated by creating treatment and control groups to facilitate causal interpretations of the empirical results. We use a unique dataset on individuals where we match hospital data with social security data and socio-economic characteristics. The main idea behind the reform is that long waiting times for hospital treatment lead to unnecessarily long periods of sick...

Telling parents their child has severe congenital anomalies.

OpenAIRE

Ryan, S.

1995-01-01

A large number of potential malformations exist, but the key skills in communicating with the parents of a malformed baby are the same. Dissatisfaction is common in this situation and has prompted a national initiative in improving standards of disclosure of disability and malformation--the Right from the start strategy (see appendix). Key skills include keeping the family together, ie, not removing the baby unnecessarily, knowing how parents like to be informed, listening, checking that pare...

Paediatric challenges in Sub-Saharan Africa

OpenAIRE

Robert Hilliard

2016-01-01

The United Nations Millennium Development Goals (MDGs) project is coming to an end in 2015 and is being replaced by ambitious and aspirational Sustainable Development Goals (SDGs). Although the MDGs have been nearly achieved, this is not true in Sub-Saharan Africa where there is still unnecessarily high infant and childhood mortality and where there are many challenges to providing modern child health care. To achieve the SDGs in the next fifteen years, in low-income countries, national minis...

Moving beyond the GM debate.

Directory of Open Access Journals (Sweden)

Ottoline Leyser

2014-06-01

Full Text Available Once again, there are calls to reopen the debate on genetically modified (GM crops. I find these calls frustrating and unnecessarily decisive. In my opinion the GM debate, on both sides, continues to hamper the urgent need to address the diverse and pressing challenges of global food security and environmental sustainability. The destructive power of the debate comes from its conflation of unrelated issues, coupled with deeply rooted misconceptions of the nature of agriculture.

Childhood cataract: home to hospital.

OpenAIRE

Muhit, MA

2004-01-01

Globally, there are 190,000 children who are blind from cataract.1 Cataract in children may be present at birth (congenital cataract) or may appear anytime during the first few years of life (developmental cataract). Childhood cataract is the most common treatable cause of childhood blindness, being responsible for 10-30% of all childhood blindness. A recent national study in Bangladesh showed that 1 in every 3 blind children is unnecessarily blind from congenital/developmental cataract.

New MoM code incorporating multiple domain basis functions

CSIR Research Space (South Africa)

Lysko, AA

2011-08-01

Full Text Available piecewise linear approximation of geometry. This often leads to an unnecessarily great number of unknowns used to model relatively small loop and spiral antennas, coils and other curved structures. This is because the program creates a dense mesh... to accelerate computation of the elements of the impedance matrix and showed acceleration factor exceeding an order of magnitude, subject to a high accuracy requirement. 3. On Code Functionality and Application Results The package of programs was written...

The "polyenviromic risk score": Aggregating environmental risk factors predicts conversion to psychosis in familial high-risk subjects.

Science.gov (United States)

Padmanabhan, Jaya L; Shah, Jai L; Tandon, Neeraj; Keshavan, Matcheri S

2017-03-01

Young relatives of individuals with schizophrenia (i.e. youth at familial high-risk, FHR) are at increased risk of developing psychotic disorders, and show higher rates of psychiatric symptoms, cognitive and neurobiological abnormalities than non-relatives. It is not known whether overall exposure to environmental risk factors increases risk of conversion to psychosis in FHR subjects. Subjects consisted of a pilot longitudinal sample of 83 young FHR subjects. As a proof of principle, we examined whether an aggregate score of exposure to environmental risk factors, which we term a 'polyenviromic risk score' (PERS), could predict conversion to psychosis. The PERS combines known environmental risk factors including cannabis use, urbanicity, season of birth, paternal age, obstetric and perinatal complications, and various types of childhood adversity, each weighted by its odds ratio for association with psychosis in the literature. A higher PERS was significantly associated with conversion to psychosis in young, familial high-risk subjects (OR=1.97, p=0.009). A model combining the PERS and clinical predictors had a sensitivity of 27% and specificity of 96%. An aggregate index of environmental risk may help predict conversion to psychosis in FHR subjects. Copyright © 2016 Elsevier B.V. All rights reserved.

NASA's Risk Management System

Science.gov (United States)

Perera, Jeevan S.

2011-01-01

Leadership is key to success. Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks -- risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

Engineering risks

International Nuclear Information System (INIS)

Hauptmanns, U.; Werner, W.

1991-01-01

The book describes the methods of risk analysis and explains the procedures and results of a number of studies including the German Risk Study, Phase B and NUREG-1150. After defining basic concepts the methods of risk analysis are treated. In the field of nuclear energy studies for light water, fast breeder and high temperature reactors and for the nuclear fuel cycle are discussed; their relevant results are presented. Additionally, precursors to severe accidents are dealt with. Risk studies for process plants are described; their objectives and methods of analysis are examined. Furthermore, their approaches are compared with that of the German Risk Study, Phase A. Risk comparisons for nuclear, conventional and renewable energy sources are critically examined. Technical and legal aspects of the safety evaluation for nuclear power plants in the FRG and the potential of the combined use of the deterministic and probabilistic approaches are discussed. The book concludes with an overview of probabilistic safety goals in different countries. (orig.) With 52 figs

Project Risk Management

Science.gov (United States)

Jr., R. F. Miles

1995-01-01

Project risk management is primarily concerned with performance, reliability, cost, and schedule. Environmental risk management is primarily concerned with human health and ecological hazards and likelihoods. This paper discusses project risk management and compares it to environmental risk management, both with respect to goals and implementation. The approach of the Jet Propulsion Laboratory to risk management is presented as an example of a project risk management approach that is an extension to NASA NHB 7120.5: Management of Major System Programs and Projects.

Catalog of risks

Energy Technology Data Exchange (ETDEWEB)

Cohen, B L; Lee, I S [Pittsburgh Univ., PA (USA). Dept. of Physics

1979-06-01

Information on risks is collected from various sources and converted into loss of life expectancy throughout life and in various age ranges. Risks included are radiation, accidents of various types, various diseases, overweight, tobacco use, alcohol and drugs, coffee, saccharin, and The Pill, occupational risks, socioeconomic factors, marital status, geography, serving in U.S. armed forces in Vietnam, catastrophic events, energy production, and technology in general. Information is also included on methods for reducing risks, risks in individual actions, very-hazardous activities, and priorities and perspective. Risks of natural and occupational radiation and exposure to radioactivity from the nuclear industry are compared with risks of similar or competing activities.

Fuzzy risk matrix

International Nuclear Information System (INIS)

Markowski, Adam S.; Mannan, M. Sam

2008-01-01

A risk matrix is a mechanism to characterize and rank process risks that are typically identified through one or more multifunctional reviews (e.g., process hazard analysis, audits, or incident investigation). This paper describes a procedure for developing a fuzzy risk matrix that may be used for emerging fuzzy logic applications in different safety analyses (e.g., LOPA). The fuzzification of frequency and severity of the consequences of the incident scenario are described which are basic inputs for fuzzy risk matrix. Subsequently using different design of risk matrix, fuzzy rules are established enabling the development of fuzzy risk matrices. Three types of fuzzy risk matrix have been developed (low-cost, standard, and high-cost), and using a distillation column case study, the effect of the design on final defuzzified risk index is demonstrated