WorldWideScience

Sample records for world risk index

  1. The World Bank's "Employing Workers" index

    DEFF Research Database (Denmark)

    Lee, Sangheon; McCann, Deirdre; Torm, Nina Elisabeth

    2008-01-01

    This note provides an update on the ongoing debate over the World Bank's Doing Business project with a particular focus on its "Employing Workers" index, which is intended to measure difficulty of hiring, rigidity of working hours and difficulty of firing. The authors review the findings of studi...

  2. Climate risk index for Italy

    Science.gov (United States)

    Mysiak, Jaroslav; Torresan, Silvia; Bosello, Francesco; Mistry, Malcolm; Amadio, Mattia; Marzi, Sepehr; Furlan, Elisa; Sperotto, Anna

    2018-06-01

    We describe a climate risk index that has been developed to inform national climate adaptation planning in Italy and that is further elaborated in this paper. The index supports national authorities in designing adaptation policies and plans, guides the initial problem formulation phase, and identifies administrative areas with higher propensity to being adversely affected by climate change. The index combines (i) climate change-amplified hazards; (ii) high-resolution indicators of exposure of chosen economic, social, natural and built- or manufactured capital (MC) assets and (iii) vulnerability, which comprises both present sensitivity to climate-induced hazards and adaptive capacity. We use standardized anomalies of selected extreme climate indices derived from high-resolution regional climate model simulations of the EURO-CORDEX initiative as proxies of climate change-altered weather and climate-related hazards. The exposure and sensitivity assessment is based on indicators of manufactured, natural, social and economic capital assets exposed to and adversely affected by climate-related hazards. The MC refers to material goods or fixed assets which support the production process (e.g. industrial machines and buildings); Natural Capital comprises natural resources and processes (renewable and non-renewable) producing goods and services for well-being; Social Capital (SC) addressed factors at the individual (people's health, knowledge, skills) and collective (institutional) level (e.g. families, communities, organizations and schools); and Economic Capital (EC) includes owned and traded goods and services. The results of the climate risk analysis are used to rank the subnational administrative and statistical units according to the climate risk challenges, and possibly for financial resource allocation for climate adaptation. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

  3. A general index of inherent risk

    OpenAIRE

    Schnytzer, Adi; Westreich, Sara

    2009-01-01

    We extend the pioneering work of Aumann and Serrano by presenting an index of inherent riskiness of a gamble having the desirable properties of their index, while being applicable to gambles with either positive or negative expectations. As such, our index provides a measure of riskiness which is of use for both risk lovers and risk aversive gamblers, and is defined for all discrete and a large class of continuous gambles. We analyze abstract properties of our index, and present in addition t...

  4. Risk management of stock index futures

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The Hong Kong Hang Seng index futures is taken as a study object and a method of empirical analysis is adopted in order to verify the validity of the application of the value-at-risk (VaR) method in the risk measurement of the stock index futures market. The results suggest that under normal market conditions it is feasible to apply the VaR method in the measurement of the market risks of stock index futures. The daily VaR value of the stock index futures provides a foreseeable profit and loss of the stock ...

  5. Step-indexed Kripke models over recursive worlds

    DEFF Research Database (Denmark)

    Birkedal, Lars; Reus, Bernhard; Schwinghammer, Jan

    2011-01-01

    worlds that are recursively defined in a category of metric spaces. In this paper, we broaden the scope of this technique from the original domain-theoretic setting to an elementary, operational one based on step indexing. The resulting method is widely applicable and leads to simple, succinct models...

  6. Comparative Coastal Risk Index (CCRI: A multidisciplinary risk index for Latin America and the Caribbean.

    Directory of Open Access Journals (Sweden)

    Juliano Calil

    Full Text Available As the world's population grows to a projected 11.2 billion by 2100, the number of people living in low-lying areas exposed to coastal hazards is projected to increase. Critical infrastructure and valuable assets continue to be placed in vulnerable areas, and in recent years, millions of people have been displaced by natural hazards. Impacts from coastal hazards depend on the number of people, value of assets, and presence of critical resources in harm's way. Risks related to natural hazards are determined by a complex interaction between physical hazards, the vulnerability of a society or social-ecological system and its exposure to such hazards. Moreover, these risks are amplified by challenging socioeconomic dynamics, including poorly planned urban development, income inequality, and poverty. This study employs a combination of machine learning clustering techniques (Self Organizing Maps and K-Means and a spatial index, to assess coastal risks in Latin America and the Caribbean (LAC on a comparative scale. The proposed method meets multiple objectives, including the identification of hotspots and key drivers of coastal risk, and the ability to process large-volume multidimensional and multivariate datasets, effectively reducing sixteen variables related to coastal hazards, geographic exposure, and socioeconomic vulnerability, into a single index. Our results demonstrate that in LAC, more than 500,000 people live in areas where coastal hazards, exposure (of people, assets and ecosystems and poverty converge, creating the ideal conditions for a perfect storm. Hotspot locations of coastal risk, identified by the proposed Comparative Coastal Risk Index (CCRI, contain more than 300,00 people and include: El Oro, Ecuador; Sinaloa, Mexico; Usulutan, El Salvador; and Chiapas, Mexico. Our results provide important insights into potential adaptation alternatives that could reduce the impacts of future hazards. Effective adaptation options must not only

  7. The Risk Premia Embedded in Index Options

    DEFF Research Database (Denmark)

    Andersen, Torben Gustav; Fusari, Nicola; Todorov, Viktor

    We study the dynamic relation between market risks and risk premia using time series of index option surfaces. We find that priced left tail risk cannot be spanned by market volatility (and its components) and introduce a new tail factor. This tail factor has no incremental predictive power...... for future volatility and jump risks, beyond current and past volatility, but it critical in predicting future market equity and variance risk premia. Our findings suggest a wide wedge between the dynamics of market risks and their compensation, with the latter typically displaying a far more persistent...

  8. The Risk Premia Embedded in Index Options

    DEFF Research Database (Denmark)

    Andersen, Torben Gustav; Fusari, Nicola; Todorov, Viktor

    We study the dynamic relation between market risks and risk premia using time series of index option surfaces. We find that priced left tail risk cannot be spanned by market volatility (and its components) and introduce a new tail factor. This tail factor has no incremental predictive power...... for future volatility and jump risks, beyond current and past volatility, but is critical in predicting future market equity and variance risk premia. Our findings suggest a wide wedge between the dynamics of market risks and their compensation, with the latter typically displaying a far more persistent...

  9. A novel structural risk index for primary spontaneous pneumothorax: Ankara Numune Risk Index.

    Science.gov (United States)

    Akkas, Yucel; Peri, Neslihan Gulay; Kocer, Bulent; Kaplan, Tevfik; Alhan, Aslihan

    2017-07-01

    In this study, we aimed to reveal a novel risk index as a structural risk marker for primary spontanoeus pneumothorax using body mass index and chest height, structural risk factors for pneumothorax development. Records of 86 cases admitted between February 2014 and January 2015 with or without primary spontaneous pneumothorax were analysed retrospectively. The patients were allocated to two groups as Group I and Group II. The patients were evaluated with regard to age, gender, pneumothorax side, duration of hospital stay, treatment type, recurrence, chest height and transverse diameter on posteroanterior chest graphy and body mass index. Body mass index ratio per cm of chest height was calculated by dividing body mass index with chest height. We named this risk index ratio which is defined first as 'Ankara Numune Risk Index'. Diagnostic value of Ankara Numune Risk Index value for prediction of primary spontaneous pneumothorax development was analysed with Receiver Operating Characteristics curver. Of 86 patients, 69 (80.2%) were male and 17 (19.8%) were female. Each group was composed of 43 (50%) patients. When Receiver Operating Characteristics curve analysis was done for optimal limit value 0.74 of Ankara Numune Risk Index determined for prediction of pneumothorax development risk, area under the curve was 0.925 (95% Cl, 0.872-0.977, p pneumothorax development however it is insufficient for determining recurrence. Copyright © 2015. Published by Elsevier Taiwan.

  10. Denotational World-indexed Logical Relations and Friends

    DEFF Research Database (Denmark)

    Thamsborg, Jacob Junker

    and solve the fundamental type-worlds circularity by metric-space theory. This approach scales to state-of-theart step-indexed techniques and permits unrestricted relational reasoning by the use of so-called Bohr relations. Along the way, we develop auxiliary theory; most notably a generalized version...... of separation logic with assertion variables. In particular, we give criteria for when standard, unary separation logic proofs lift to the binary setting. Phrased dierently, given a module-dependent client and a standard separation logic proof of its correctness, we ponder the default question of representation...

  11. Risk creation in a technological world

    International Nuclear Information System (INIS)

    Kuhlmann, A.

    1989-01-01

    The question ultimately facing mankind is how to establish an appropriate risk acceptance in a technological world. The systematics of the risk concept is explained in 4 theses. They imply that a heavy use of technology is linked to high risk potentials which place heavy demands on technology in coping with them, and that technology ought as far as possible to be adapted to man and the environment ought to remain under man's influence. (DG) [de

  12. High body mass index and cancer risk

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjærg-Hansen, Anne; Smith, George Davey

    2016-01-01

    of follow-up (range 0-37), 8002 developed non-skin cancer, 3347 non-melanoma skin cancer, 1396 lung cancer, 637 other smoking related cancers, 1203 colon cancer, 159 kidney cancer, 1402 breast cancer, 1062 prostate cancer, and 2804 other cancers. Participants were genotyped for five genetic variants...... with a BMI ≥ 30 versus 18.5-24.9 kg/m(2). Corresponding risk of breast cancer was 20 % (0-44 %) higher in postmenopausal women. BMI was not associated with risk of colon, kidney, other smoking related cancers, prostate cancer, or other cancers. In genetic analyses, carrying 7-10 versus 0-4 BMI increasing......High body mass index (BMI) has been associated with increased risk of some cancer. Whether these reflect causal associations is unknown. We examined this issue. Using a Mendelian randomisation approach, we studied 108,812 individuals from the general population. During a median of 4.7 years...

  13. Index-based Crop Insurance for Climate Adaptation in the Developing World

    Science.gov (United States)

    Brown, M. E.; Osgood, D. E.; Carriquiry, M. A.

    2011-12-01

    Weather has always presented a challenge to small-scale farmers, particularly in regions where poverty and lack of infrastructure has restricted the development of financial instruments to limit risk. New 'index' insurance innovations in agriculture are beginning to enable even the poorest farmers to unlock major productivity gains (e.g. insuring loans for improved seeds). Although index insurance has the potential to greatly improve productivity in developing country agriculture, the principal technical challenge to up-scaling this product is "data poverty," the absence of weather data in low-income areas needed to design robust and affordable insurance products. Earth science, particularly remote sensing, has the potential to ameliorate data poverty. However, raw use of earth science model output leads to non-optimal indexes and many obstacles remain to transform earth science products into insurance solutions. Estimation uncertainty, limited availability of consistent time series, and difficulties of predicting loses based on remote observations are reviewed in this article. The importance of multidisciplinary approaches addressing the needs of stakeholders in simple to understand indexes is highlighted. The successful use of Earth science data to support the index insurance industry in currently poor and isolated communities in the developing world would transform the ability of small farmers to increase yields, household incomes and regional economies, if the growing gap between earth science and index insurance can be closed.

  14. Value at Risk on Composite Price Share Index Stock Data

    Science.gov (United States)

    Oktaviarina, A.

    2018-01-01

    The financial servicest authority was declared Let’s Save Campaign on n commemoration of the World Savings Day that falls on this day, October 31, 2016. The activity was greeted enthusiastically by Indonesia Stock Exchange by taking out the slogan Let’s Save The Stocks. Stock is a form of investment that is expected to benefit in the future despite has risks. Value at Risk (VaR) is a method that can measure how much the risk of a financial investment. Composite Stock Price Indeks is the stock price index used by Indonesia Stock Exchange as stock volatility benchmarks in Indonesia. This study aimed to estimate Value at Risk (VaR) on closing price Composite Price Share Index Stock data on the period 20 September 2016 until 20 September 2017. Box-Pierce test results p value=0.9528 which is greater than a, that shows homoskedasticity. Value at Risk (VaR) with Variance Covariance Method is Rp.3.054.916,07 which means with 99% confindence interval someone who invests Rp.100.000.000,00 will get Rp.3.054.916,07 as a maximum loss.

  15. STORMTOOLS: Coastal Environmental Risk Index (CERI

    Directory of Open Access Journals (Sweden)

    Malcolm L. Spaulding

    2016-08-01

    Full Text Available One of the challenges facing coastal zone managers and municipal planners is the development of an objective, quantitative assessment of the risk to structures, infrastructure, and public safety that coastal communities face from storm surge in the presence of changing climatic conditions, particularly sea level rise and coastal erosion. Here we use state of the art modeling tool (ADCIRC and STWAVE to predict storm surge and wave, combined with shoreline change maps (erosion, and damage functions to construct a Coastal Environmental Risk Index (CERI. Access to the state emergency data base (E-911 provides information on structure characteristics and the ability to perform analyses for individual structures. CERI has been designed as an on line Geographic Information System (GIS based tool, and hence is fully compatible with current flooding maps, including those from FEMA. The basic framework and associated GIS methods can be readily applied to any coastal area. The approach can be used by local and state planners to objectively evaluate different policy options for effectiveness and cost/benefit. In this study, CERI is applied to RI two communities; Charlestown representing a typical coastal barrier system directly exposed to ocean waves and high erosion rates, with predominantly low density single family residences and Warwick located within Narragansett Bay, with more limited wave exposure, lower erosion rates, and higher residential housing density. Results of these applications are highlighted herein.

  16. Development and implementation of a business continuity management risk index.

    Science.gov (United States)

    Kadar, Michael

    This paper will present the building blocks for developing and implementing the BCM risk index; whether it is used as a comprehensive metric for risk or preparedness. This paper introduces the concept of a business continuity management (BCM) risk index--a comprehensive metric that measures and reports the status of the primary 'intended outcome' of the BCM programme to top management. In addition to measuring the primary programme output,;the BCM risk index can be used to demonstrate the overall value of the BCM programme to executive management. This is accomplished because the BCM risk index allows quantitative measurement of current risk levels and their comparison with established risk tolerances. The BCM Risk Index can provide executive management with reports on the risk level of individual business units, departments, subsidiaries or the enterprise in a way that drives both risk management and BCM initiatives. The name 'risk index' can be misleading, however. The BCM risk index concept can also be used to measure preparedness levels. In fact, implementation at DTE Energy has resulted in calling it the 'preparedness index', which is used to measure and report preparedness levels rather than risk levels.

  17. An Investigation into the Decision Makers's Risk Attitude Index ...

    African Journals Online (AJOL)

    An Investigation into the Decision Makers's Risk Attitude Index Ranking Technique for Fuzzy Critical Path Analysis. ... Nigerian Journal of Technology ... for a benchmark problem, the decision maker's risk attitude index ranking method produces unrealistic results when the decision maker's attitude towards risk was neutral.

  18. Earthquake Disaster Risk Index for Cities: Baku, Yerevan, Tbilisi

    International Nuclear Information System (INIS)

    Varazanashvili, O.; Mammadli, T.; Nazaretyan, S.

    2005-01-01

    For comparative analysis of seismic risk in the capitals of the South Caucasian States - Baku, Yerevan and Tbilisi - the methodology of determination of earthquake disaster risk index (EDRI) has been used. Earthquake disaster risk indexes have been determined for considered cities. EDRI-analysis is performed, some peculiarities of main risk factors are revealed and risk portraits are made in each city of the given sample. (author)

  19. Entomologic index for human risk of Lyme disease.

    Science.gov (United States)

    Mather, T N; Nicholson, M C; Donnelly, E F; Matyas, B T

    1996-12-01

    An entomologic index based on density estimates of Lyme disease spirochete-infected nymphal deer ticks (lxodes scapularis) was developed to assess human risk of Lyme disease. The authors used a standardized protocol to determine tick density and infection in numerous forested sites in six Rhode Island towns. An entomologic risk index calculated for each town was compared with the number of human Lyme disease cases reported to the Rhode Island State Health Department for the same year. A strong positive relation between entomologic risk index and the Lyme disease case rate for each town suggested that the entomologic index was predictive of Lyme disease risk.

  20. World Tax Index: New Methodology for OECD Countries, 2000-2010

    OpenAIRE

    Zuzana Machova; Igor Kotlan

    2013-01-01

    This paper follows our previous article, Kotlán and Machová (2012a), which presented an indicator of the tax burden that can be used as an alternative to the tax quota, or for implicit tax rates in macroeconomic analyses. This alternative is an overall multi-criteria index called the WTI – the World Tax Index. The aim of this paper is to present the new World Tax Index 2013 and its methodology, which allowed us to compute it for all 34 OECD countries for the 2000–2012 period, with special ref...

  1. The world price of jump and volatility risk

    NARCIS (Netherlands)

    Driessen, J.; Maenhout, P.

    2006-01-01

    Jump and volatility risk are important for understanding equity returns, option pricing and asset allocation. This paper is the first to study international integration of markets for jump and volatility risk, using data on index options for each of the three main global markets: US S&P 500 index

  2. Volatility spillover from world oil spot markets to aggregate and electricity stock index returns in Turkey

    International Nuclear Information System (INIS)

    Soytas, Ugur; Oran, Adil

    2011-01-01

    This study examines the inter-temporal links between world oil prices, ISE 100 and ISE electricity index returns unadjusted and adjusted for market effects. The traditional approaches could not detect a causal relationship running from oil returns to any of the stock returns. However, when we examine the causality using Cheung-Ng approach we discover that world oil prices Granger cause electricity index and adjusted electricity index returns in variance, but not the aggregate market index returns. Hence, our results show that the Cheung-Ng procedure with the use of disaggregated stock index returns can uncover new information that went unnoticed with the traditional causality tests using aggregated market indices. (author)

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

    Directory of Open Access Journals (Sweden)

    Muhammad Fayaz

    2017-10-01

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

  4. A Risk Severity Index for industrial plants and sites

    International Nuclear Information System (INIS)

    Planas, E.; Arnaldos, J.; Silvetti, B.; Vallee, Agnes; Casal, J.

    2006-01-01

    A risk index (Risk Severity Index, S) has been devised to allow the assessment of the risk level originated by a given installation or site over the affected zone. A set of threshold levels for thermal radiation, toxic concentration and overpressure, together with the probabilities and frequencies associated to critical events and their effects have been the basis for calculating the values of S. A computer tool has been designed to perform a quick calculation of the diverse Risk Severity Indexes (for a critical event, for a dangerous phenomenon, for a type of effect and for the whole installation) and to plot a map of the risk severity levels around the site. The methodology has been applied to diverse test cases and it has proved to be useful for risk assessment, for comparative studies and for land use planning

  5. Body mass index influences prostate cancer risk at biopsy in Japanese men.

    Science.gov (United States)

    Masuda, Hitoshi; Kagawa, Makoto; Kawakami, Satoru; Numao, Noboru; Matsuoka, Yoh; Yokoyama, Minato; Yamamoto, Shinya; Yonese, Junji; Fukui, Iwao; Kihara, Kazunori

    2013-07-01

    To determine the relationship between body mass index and prostate cancer risk at biopsy in Japanese men, and to compared the risk with that of Caucasian men. We retrospectively evaluated 3966 men with prostate-specific antigen levels from 2.5 to 19.9 ng/mL who underwent an initial extended prostate biopsy. Using logistic regression, odds ratios of each body mass index category for risk of prostate cancer and high-grade disease (Gleason score ≥4 + 3) were estimated after controlling for age, prostate-specific antigen, %free prostate-specific antigen, prostate volume, digital rectal examination findings, family history of prostate cancer and the number of biopsy cores. Patients were divided into six categories according to their body mass index (kg/m(2) ) as follows: body mass index and prostate cancer risk at biopsy, with an increased risk observed in men whose body mass index was ≥27.0 compared with the reference group. A significantly increased risk starting at body mass index ≥25.0 was found in high-grade disease. In contrast to our results, there has been no reported increase in the risk of prostate cancer at biopsy in Caucasians within the overweight range (body mass index of 25.0-29.9 based on World Health Organization classification). Japanese men within the overweight body mass index range who have an elevated prostate-specific antigen level also have a significant risk of harboring prostate cancer, especially high-grade disease. Overweight Japanese might be at greater prostate cancer risk at biopsy than overweight Caucasians. © 2012 The Japanese Urological Association.

  6. Age Patterns in Risk Taking Across the World.

    Science.gov (United States)

    Duell, Natasha; Steinberg, Laurence; Icenogle, Grace; Chein, Jason; Chaudhary, Nandita; Di Giunta, Laura; Dodge, Kenneth A; Fanti, Kostas A; Lansford, Jennifer E; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Tapanya, Sombat; Uribe Tirado, Liliana Maria; Alampay, Liane Peña; Al-Hassan, Suha M; Takash, Hanan M S; Bacchini, Dario; Chang, Lei

    2018-05-01

    Epidemiological data indicate that risk behaviors are among the leading causes of adolescent morbidity and mortality worldwide. Consistent with this, laboratory-based studies of age differences in risk behavior allude to a peak in adolescence, suggesting that adolescents demonstrate a heightened propensity, or inherent inclination, to take risks. Unlike epidemiological reports, studies of risk taking propensity have been limited to Western samples, leaving questions about the extent to which heightened risk taking propensity is an inherent or culturally constructed aspect of adolescence. In the present study, age patterns in risk-taking propensity (using two laboratory tasks: the Stoplight and the BART) and real-world risk taking (using self-reports of health and antisocial risk taking) were examined in a sample of 5227 individuals (50.7% female) ages 10-30 (M = 17.05 years, SD = 5.91) from 11 Western and non-Western countries (China, Colombia, Cyprus, India, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the US). Two hypotheses were tested: (1) risk taking follows an inverted-U pattern across age groups, peaking earlier on measures of risk taking propensity than on measures of real-world risk taking, and (2) age patterns in risk taking propensity are more consistent across countries than age patterns in real-world risk taking. Overall, risk taking followed the hypothesized inverted-U pattern across age groups, with health risk taking evincing the latest peak. Age patterns in risk taking propensity were more consistent across countries than age patterns in real-world risk taking. Results suggest that although the association between age and risk taking is sensitive to measurement and culture, around the world, risk taking is generally highest among late adolescents.

  7. The de Morton Mobility Index (DEMMI: An essential health index for an ageing world

    Directory of Open Access Journals (Sweden)

    Davidson Megan

    2008-08-01

    Full Text Available Abstract Background Existing instruments for measuring mobility are inadequate for accurately assessing older people across the broad spectrum of abilities. Like other indices that monitor critical aspects of health such as blood pressure tests, a mobility test for all older acute medical patients provides essential health data. We have developed and validated an instrument that captures essential information about the mobility status of older acute medical patients. Methods Items suitable for a new mobility instrument were generated from existing scales, patient interviews and focus groups with experts. 51 items were pilot tested on older acute medical inpatients. An interval-level unidimensional mobility measure was constructed using Rasch analysis. The final item set required minimal equipment and was quick and simple to administer. The de Morton Mobility Index (DEMMI was validated on an independent sample of older acute medical inpatients and its clinimetric properties confirmed. Results The DEMMI is a 15 item unidimensional measure of mobility. Reliability (MDC90, validity and the minimally clinically important difference (MCID of the DEMMI were consistent across independent samples. The MDC90 and MCID were 9 and 10 points respectively (on the 100 point Rasch converted interval DEMMI scale. Conclusion The DEMMI provides clinicians and researchers with a valid interval-level method for accurately measuring and monitoring mobility levels of older acute medical patients. DEMMI validation studies are underway in other clinical settings and in the community. Given the ageing population and the importance of mobility for health and community participation, there has never been a greater need for this instrument.

  8. Managing risk in an unstable world.

    Science.gov (United States)

    Bremmer, Ian

    2005-06-01

    With emerging markets like China and politically unstable countries like Saudi Arabia figuring more than ever into companies' investment calculations, business leaders are turning to political risk analysis to measure the impact of politics on potential markets, minimize risks, and make the most of global opportunities. But political risk is more subjective than its economic counterpart. It is influenced by the passage of laws, the foibles of government leaders, and the rise of popular movements. So corporate leaders must grapple not just with broad, easily observable trends but also with nuances of society and even quirks of personality. And those hard-to-quantify factors must constantly be pieced together into an ongoing narrative within historical and regional contexts. As goods, services, information, ideas, and people cross borders today with unprecedented velocity, corporations debating operational or infrastructural investments abroad increasingly need objective, rigorous assessments. One tool for measuring and presenting stability data, for example, incorporates 20 composite indicators of risk in emerging markets and scores risk variables according to both their structural and their temporal components. The indicators are then organized into four equally weighted subcategories whose ratings are aggregated into a single stability score. Countries are ranked on a scale of zero (a failed state) to100 (a fully institutionalized, stable democracy). Companies can buy political risk analyses from consultants or, as some large energy and financial services organizations have done, develop them in-house. Either way, a complete and accurate picture of any country's risk requires analysts with strong reportorial skills; timely, accurate data on a variety of social and political trends; and a framework for evaluating the impact of individual risks on stability.

  9. Childhood body mass index and multiple sclerosis risk

    DEFF Research Database (Denmark)

    Munger, Kassandra L; Bentzen, Joan; Laursen, Bjarne

    2013-01-01

    BACKGROUND: Obesity in late adolescence has been associated with an increased risk of multiple sclerosis (MS); however, it is not known if body size in childhood is associated with MS risk. METHODS: Using a prospective design we examined whether body mass index (BMI) at ages 7-13 years...

  10. Genetically Predicted Body Mass Index and Breast Cancer Risk

    DEFF Research Database (Denmark)

    Guo, Yan; Warren Andersen, Shaneda; Shu, Xiao-Ou

    2016-01-01

    BACKGROUND: Observational epidemiological studies have shown that high body mass index (BMI) is associated with a reduced risk of breast cancer in premenopausal women but an increased risk in postmenopausal women. It is unclear whether this association is mediated through shared genetic or enviro...

  11. Risk communication in the real world

    International Nuclear Information System (INIS)

    Bartley, Philip L.

    1992-01-01

    As people become more sensitive to health and environmental issues, effective communication of workplace risks becomes more important for both employers and their employees. Risk communication must be given in a clear, simple format that addresses the individual employee's work environment. It must also be provided in a manner that indicates to the employees that the company cares about their safety. Failure to provide this information may result in ineffective communication and reduced company credibility. By using events and issues from the employees every day life, these issues can be effectively managed. (author)

  12. Vector-borne disease risk indexes in spatially structured populations.

    Directory of Open Access Journals (Sweden)

    Jorge Velázquez-Castro

    2018-02-01

    Full Text Available There are economic and physical limitations when applying prevention and control strategies for urban vector borne diseases. Consequently, there are increasing concerns and interest in designing efficient strategies and regulations that health agencies can follow in order to reduce the imminent impact of viruses like Dengue, Zika and Chikungunya. That includes fumigation, abatization, reducing the hatcheries, picking up trash, information campaigns. A basic question that arise when designing control strategies is about which and where these ones should focus. In other words, one would like to know whether preventing the contagion or decrease vector population, and in which area of the city, is more efficient. In this work, we propose risk indexes based on the idea of secondary cases from patch to patch. Thus, they take into account human mobility and indicate which patch has more chance to be a corridor for the spread of the disease and which is more vulnerable, i.e. more likely to have cases?. They can also indicate the neighborhood where hatchery control will reduce more the number of potential cases. In order to illustrate the usefulness of these indexes, we run a set of numerical simulations in a mathematical model that takes into account the urban mobility and the differences in population density among the areas of a city. If we label by i a particular neighborhood, the transmission risk index (TRi measures the potential secondary cases caused by a host in that neighborhood. The vector transmission risk index (VTRi measures the potential secondary cases caused by a vector. Finally, the vulnerability risk index (VRi measures the potential secondary cases in the neighborhood. Transmission indexes can be used to give geographical priority to some neighborhoods when applying prevention and control measures. On the other hand, the vulnerability index can be useful to implement monitoring campaigns or public health investment.

  13. Testing high spatial resolution WorldView-2 imagery for retrieving the leaf area index

    Science.gov (United States)

    Tarantino, Eufemia; Novelli, Antonio; Laterza, Maurizio; Gioia, Andrea

    2015-06-01

    This work analyzes the potentiality of WorldView-2 satellite data for retrieving the Leaf Area Index (LAI) area located in Apulia, the most Eastern region of Italy, overlooking the Adriatic and Ionian seas. Lacking contemporary in-situ measurements, the semi-empiric method of Clevers (1989) (CLAIR model) was chosen as a feasible image-based LAI retrieval method, which is based on an inverse exponential relationship between the LAI and the WDVI (Weighted Difference Vegetation Index) with relation to different land covers. Results were examined in homogeneous land cover classes and compared with values obtained in recent literature.

  14. Assessing and managing multiple risks in a changing world ...

    Science.gov (United States)

    Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk—Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological c

  15. An index of harm for comparing occupational risks

    International Nuclear Information System (INIS)

    Schaaf, E.; Hennig, J.; Schnadt, H.; Becker, G.

    1986-03-01

    An index of harm is presented describing the health hazards of persons occupationally exposed to ionizing radiation, for comparison with occupational risks in conventional working areas. The criterion for evaluating injuries is the remaining lifetime affected by chronic damage. The affected years of life themselves are evaluated in a scheme considering the degree of reduced ability to work. The index of harm is based on an evaluation of a data pool collected by all F.R.G. associations for social insurance against occupational accidents, which recorded all data of first compensation for accidents. The index can be taken into consideration for assessment of risks emanating from ionizing radiation, and for evaluating the radiation protection currently provided by maximum permissible limits, etc. (DG) [de

  16. Increasing Risk Awareness: The Coastal Community Resilience Index

    Science.gov (United States)

    Thompson, Jody A.; Sempier, Tracie; Swann, LaDon

    2012-01-01

    As the number of people moving to the Gulf Coast increases, so does the risk of exposure to floods, hurricanes, and other storm-related events. In an effort to assist communities in preparing for future storm events, the Coastal Community Resilience Index was created. The end result is for communities to take actions to address the weaknesses they…

  17. Hedging with stock index futures: downside risk versus the variance

    NARCIS (Netherlands)

    Brouwer, F.; Nat, van der M.

    1995-01-01

    In this paper we investigate hedging a stock portfolio with stock index futures.Instead of defining the hedge ratio as the minimum variance hedge ratio, we considerseveral measures of downside risk: the semivariance according to Markowitz [ 19591 andthe various lower partial moments according to

  18. Flood Risk Index Assessment in Johor River Basin

    International Nuclear Information System (INIS)

    Ahmad Shakir Mohd Saudi; Hafizan Juahir; Azman Azid; Fazureen Azaman; Ahmad Shakir Mohd Saudi

    2015-01-01

    This study is focusing on constructing the flood risk index in the Johor river basin. The application of statistical methods such as factor analysis (FA), statistical process control (SPC) and artificial neural network (ANN) had revealed the most efficient flood risk index. The result in FA was water level has correlation coefficient of 0.738 and the most practicable variable to be used for the warning alert system. The upper control limits (UCL) for the water level in the river basin Johor is 4.423 m and the risk index for the water level has been set by this method consisting of 0-100.The accuracy of prediction has been evaluated by using ANN and the accuracy of the test result was R"2 = 0.96408 with RMSE= 2.5736. The future prediction for UCL in Johor river basin has been predicted and the value was 3.75 m. This model can shows the current and future prediction for flood risk index in the Johor river basin and can help local authorities for flood control and prevention of the state of Johor. (author)

  19. The construction of power grid operation index system considering the risk of maintenance

    Science.gov (United States)

    Tang, Jihong; Wang, Canlin; Jiang, Xinfan; Ye, Jianhui; Pan, Feilai

    2018-02-01

    In recent years, large-scale blackout occurred at home and abroad caused widespread concern about the operation of the grid in the world, and the maintenance risk is an important indicator of grid safety. The barrier operation of the circuit breaker exists in the process of overhaul of the power grid. The operation of the different barrier is of great significance to the change of the power flow, thus affecting the safe operation of the system. Most of the grid operating status evaluation index system did not consider the risk of maintenance, to this end, this paper from the security, economy, quality and cleanliness of the four angles, build the power grid operation index system considering the risk of maintenance.

  20. University building safety index measurement using risk and implementation matrix

    Science.gov (United States)

    Rahman, A.; Arumsari, F.; Maryani, A.

    2018-04-01

    Many high rise building constructed in several universities in Indonesia. The high-rise building management must provide the safety planning and proper safety equipment in each part of the building. Unfortunately, most of the university in Indonesia have not been applying safety policy yet and less awareness on treating safety facilities. Several fire accidents in university showed that some significant risk should be managed by the building management. This research developed a framework for measuring the high rise building safety index in university The framework is not only assessed the risk magnitude but also designed modular building safety checklist for measuring the safety implementation level. The safety checklist has been developed for 8 types of the university rooms, i.e.: office, classroom, 4 type of laboratories, canteen, and library. University building safety index determined using risk-implementation matrix by measuring the risk magnitude and assessing the safety implementation level. Building Safety Index measurement has been applied in 4 high rise buildings in ITS Campus. The building assessment showed that the rectorate building in secure condition and chemical department building in beware condition. While the library and administration center building was in less secure condition.

  1. The effect of financial ratios on systematic risk index

    Directory of Open Access Journals (Sweden)

    Ali Faez

    2013-11-01

    Full Text Available This paper investigates the relationship between financial ratios and indicator of systemic risk in the Tehran Stock Exchange. The study selects 73 manufacturing companies of the Tehran Stock Exchange market over the period 2003-2010. The study first calculates the independent variables in the form of financial ratios and then the ratios affecting the systematic risk index are extracted using entropy method. The output of this stage is the introduction of five influential financial indicators as the independent variables of the study. Using t-test and Pearson correlation coefficient the rate of independent variables effect on the systematic risk index is evaluated and finally, using stepwise regression method, the effect of independent variables on the dependent variable is examined. According to results of our survey, the correlation coefficient of such indices as “the ratio of stock price to the profit of each share”, “Current ratio”, “each share profit ratio” and “the stockholders rights return ratio” have respectively the highest correlation with the systematic risk index.

  2. 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)

  3. The world price of jump and volatility risk

    NARCIS (Netherlands)

    Driessen, J.J.A.G.; Maenhout, P.

    2013-01-01

    We study international integration of markets for jump and volatility risk, using index option data for the main global markets. To explain the cross-section of expected option returns we focus on return-based multi-factor models. For each market separately, we provide evidence that volatility and

  4. Stroke risk factors among participants of a world stroke day ...

    African Journals Online (AJOL)

    2015-04-20

    Apr 20, 2015 ... Materials and Methods: We screened 224 volunteers from Ile‑Ife during the ... Blood pressures (BP) were measured and body mass index (BMI) was ... Conclusion: Stroke risk factors such as hypertension and obesity were common among the .... an accoson mercury sphygmomanometer, with the subjects.

  5. Novel Threat-risk Index Using Probabilistic Risk Assessment and Human Reliability Analysis - Final Report

    Energy Technology Data Exchange (ETDEWEB)

    George A. Beitel

    2004-02-01

    In support of a national need to improve the current state-of-the-art in alerting decision makers to the risk of terrorist attack, a quantitative approach employing scientific and engineering concepts to develop a threat-risk index was undertaken at the Idaho National Engineering and Environmental Laboratory (INEEL). As a result of this effort, a set of models has been successfully integrated into a single comprehensive model known as Quantitative Threat-Risk Index Model (QTRIM), with the capability of computing a quantitative threat-risk index on a system level, as well as for the major components of the system. Such a threat-risk index could provide a quantitative variant or basis for either prioritizing security upgrades or updating the current qualitative national color-coded terrorist threat alert.

  6. Tourism in a World of Risks (Essay Review

    Directory of Open Access Journals (Sweden)

    Maximiliano E. KORSTANJE

    2016-06-01

    Full Text Available Though tourism combines curiosity with security, over the recent decades, we are facing an inflation of risks that caused big problems for policy makers and officials interested in promoting tourism in their respective nations. As a result of this, one might speculate that the future of industry is uncertain. This essay review explores the already existent literature in risk perception applied on tourism fields as well as introduces the theory of attachment to explain how the world is constructed.

  7. Empirical behavior of a world stock index from intra-day to monthly time scales

    Science.gov (United States)

    Breymann, W.; Lüthi, D. R.; Platen, E.

    2009-10-01

    Most of the papers that study the distributional and fractal properties of financial instruments focus on stock prices or foreign exchange rates. This typically leads to mixed results concerning the distributions of log-returns and some multi-fractal properties of exchange rates, stock prices, and regional indices. This paper uses a well diversified world stock index as the central object of analysis. Such index approximates the growth optimal portfolio, which is demonstrated under the benchmark approach, it is the ideal reference unit for studying basic securities. When denominating this world index in units of a given currency, one measures the movements of the currency against the entire market. This provides a least disturbed observation of the currency dynamics. In this manner, one can expect to disentangle, e.g., the superposition of the two currencies involved in an exchange rate. This benchmark approach to the empirical analysis of financial data allows us to establish remarkable stylized facts. Most important is the observation that the repeatedly documented multi-fractal appearance of financial time series is very weak and much less pronounced than the deviation of the mono-scaling properties from Brownian-motion type scaling. The generalized Hurst exponent H(2) assumes typical values between 0.55 and 0.6. Accordingly, autocorrelations of log-returns decay according to a power law, and the quadratic variation vanishes when going to vanishing observation time step size. Furthermore, one can identify the Student t distribution as the log-return distribution of a well-diversified world stock index for long time horizons when a long enough data series is used for estimation. The study of dependence properties, finally, reveals that jumps at daily horizon originate primarily in the stock market while at 5min horizon they originate in the foreign exchange market. The principal message of the empirical analysis is that there is evidence that a diffusion model

  8. Youth, Risk, and Equity in a Global World

    Science.gov (United States)

    Hull, Glynda; Zacher, Jessica; Hibbert, Liesel

    2009-01-01

    This article reviews educational literatures that should be relevant to helping individuals understand and improve the lot and life chances of girls and boys who are at risk in a global world. The authors began this review with a vignette from India, a country whose linguistic and ethnic diversity, whose international reputation for advances in…

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

    International Nuclear Information System (INIS)

    Van Aalst, M.

    2006-08-01

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

  10. Development of environmental risk assessment framework using index method

    International Nuclear Information System (INIS)

    Ali, M.W.; Wu, Y.

    2000-01-01

    This paper presents a newly developed framework for assessing the risk from events which are considered to be major accidents to the environment according to the classifications by the United Kingdom Department of Environment (DoE). The application of an environmental risk assessment framework using the newly developed index method is demonstrated by means of a case study. The framework makes use of Environmental Hazard Index (EHI) method by the United Kingdom AEA Technology for releases to river, but improves it by taking account to toxic dose rather than concentration; taking account of long-term effects including persistence and bio accumulation, not just short term effects; extending the method to all aspects of environment, not just rivers; and allowing account to be taken of design changes to mitigate the risk. The development of the framework has also led to a revision of the tolerability criteria to be used with the framework proposed earlier by weakness and recommend further work to improve this newly proposed environmental risk assessment framework. From the study, it is recommended that the environmental risk assessment framework be applied to a wide range of other case studies in order to further improve it. The framework should be modified to maintain consistency when the DoE revises its definitions of major accidents to the environment. Ease-of-use of the framework (and any other environmental framework) would be aided by the compilation of databases for environmental toxicity, river data and available consequence models. Further work could also be done to suggest methods of mitigating the risk and including them as numerical factors within method. (author)

  11. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: A prospective cohort study

    NARCIS (Netherlands)

    Merry, A.H.H.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2007-01-01

    Background: In the last decades, the incidence of oesophageal and gastric cardia adenocarcinoma has increased rapidly in the Western world. We investigated the association between body mass index (BMI), height and risk of oesophageal and gastric cardia adenocarcinoma. Methods: The Netherlands Cohort

  12. Creating a Flood Risk Index to Improve Community Resilience

    Science.gov (United States)

    Klima, K.; El Gammal, L.

    2017-12-01

    While flood risk reduction is an existent discourse and agenda in policy and insurance, vulnerabilities vary between communities; some communities may have aging infrastructure, or an older/poorer population less able to absorb a flood, putting them at increased risk from the hazards. As a result, some are considering environmental justice aspects of flood risk reduction. To date, catastrophe models have focused on creating floodmaps (e.g., NOAA's Sea Level Rise Viewer, Climate Central's Surging Seas), or on linking hydrological models to economic loss models (e.g., HEC-RAS + HAZUS). However, this approach may be highly inequitable between areas of different income (as well as other demographics). Some have begun work on combining hydrology with vulnerability information (e.g., USACE's North Atlantic Comprehensive Coastal Study). To our knowledge, no one has tried to adapt the more advanced known heat risk theory to water risk by combining hydrology information (e.g., HEC-RAS, floodplain maps) with the social vulnerability (e.g., Cutter et al.) of the residents. This project will create a method to combine water hazard data with a derived water vulnerability index to help a community understand their current and future water risk. We will use the case study area of Pittsburgh, PA, which faces severe precipitation and riverine flooding hazards. Building on present literature of factors influencing water vulnerability contextualized to the Pittsburgh region, we will identify, quantify, and map the top factors impacting water vulnerability. We will combine these with flood maps to identify the geospatial distribution of water risk. This work will allow policy makers to identify location-specific aspects of water vulnerability and risk in any community, thus promoting environmental justice. It is possible that this type of original research would create maps of relative water risk that may prove as understandable to the general public as other flood maps, and may also

  13. Is “economic freedom” strictly free market capitalism? A decompositional analysis of the Economic Freedom of the World index

    OpenAIRE

    Cohen, Joseph N

    2009-01-01

    The Frasier Institute’s Economic Freedom of the World is often taken as a metric of market capitalism. This paper argues that the index is an amalgam of measures capturing free markets and good governance, and analysts should remain cognizant of this conceptual conflation when using the index to develop policy prescriptions. Implicitly, the “economic freedom” literature suggests that countries embrace an “Anglo-Swiss” policy model, although the rich world offers alternative models that maximi...

  14. '(World) risk society’ or ‘new rationalities of risk’?

    DEFF Research Database (Denmark)

    Rasborg, Klaus

    2012-01-01

    ’. Moreover, Beck’s notions of second modernity, reflexivity, rationality and critique are critically examined. With the alternative positions discussed in the paper – represented by Jeffrey C. Alexander, Niklas Luhmann and Mitchell Dean – some indications are given as to how one might fruitfully elaborate...... on the problem of risk. Thus, rather than a mainly technology-driven new type of social reality, the ‘(world) risk society’ could perhaps better be seen as indicating a changing cultural self-understanding of late modern society, a new ‘semantics of crisis’, or the emergence of new forms of governmentality...... in the contemporary welfare state. In conclusion some indications are given as to how an analysis of more specific ‘risk logics’ or ‘rationalities’ could be elaborated on, and a terminology that reflects this more differentiated approach to risk in late modern society is suggested....

  15. Hazard Assessment on Chlorine Distribution Use of Chemical Transportation Risk Index

    International Nuclear Information System (INIS)

    Kim, Jeong Gon; Byun, Hun Soo

    2014-01-01

    Chlorine is one of the most produced and most used non-flammable chemical substances in the world even though its toxicity and high reactivity cause the ozone layer depletion. However, in modern life, it is impossible to live a good life without using Chlorine and its derivatives since they are being used as an typical ingredient in more than 40 percent of the manufactured goods including medicines, detergents, deodorant, fungicides, herbicides, insecticides, and plastic, etc. Even if Chlorine has been handled and distributed in various business (small and medium-sized businesses, water purification plants, distribution company, etc.), there have been few researches about its possible health hazard and transportation risks. Accordingly, the purpose of this paper is to make a detailed assessment of Chlorinerelated risks and to model an index of chemicals transportation risks that is adequate for domestic circumstances. The assessment of possible health hazard and transportation risks was made on 13 kinds of hazardous chemicals, including liquid chlorine. This research may be contributed to standardizing the risk assessment of Chlorine and other hazardous chemicals by using an index of transportation risks

  16. Hazard Assessment on Chlorine Distribution Use of Chemical Transportation Risk Index

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Gon [Hanwha Chemical Ulsan Site, Ulsan (Korea, Republic of); Byun, Hun Soo [Chonnam National University, Yeosu (Korea, Republic of)

    2014-12-15

    Chlorine is one of the most produced and most used non-flammable chemical substances in the world even though its toxicity and high reactivity cause the ozone layer depletion. However, in modern life, it is impossible to live a good life without using Chlorine and its derivatives since they are being used as an typical ingredient in more than 40 percent of the manufactured goods including medicines, detergents, deodorant, fungicides, herbicides, insecticides, and plastic, etc. Even if Chlorine has been handled and distributed in various business (small and medium-sized businesses, water purification plants, distribution company, etc.), there have been few researches about its possible health hazard and transportation risks. Accordingly, the purpose of this paper is to make a detailed assessment of Chlorinerelated risks and to model an index of chemicals transportation risks that is adequate for domestic circumstances. The assessment of possible health hazard and transportation risks was made on 13 kinds of hazardous chemicals, including liquid chlorine. This research may be contributed to standardizing the risk assessment of Chlorine and other hazardous chemicals by using an index of transportation risks.

  17. Development of a preliminary risk index to identify trauma patients at risk for an unplanned intubation.

    Science.gov (United States)

    Kim, Dennis; Kobayashi, Leslie; Chang, David; Fortlage, Dale; Coimbra, Raul

    2014-01-01

    The development of respiratory failure requiring an emergent unplanned intubation (UI) is a potentially preventable complication associated with increased morbidity and mortality. The objective of this study was to develop a clinical risk index for UI based on readily available clinical data to assist in the identification of trauma patients at risk for this complication. We also sought to determine the impact of UI on patient outcomes. This is a 3-year retrospective analysis of our Level 1 trauma center registry to identify all patients requiring a UI. Patients who required a UI were compared with patients who were never intubated. An additive risk index consisting of 10 clinical variables was created using the final significant variables from a stepwise logistic regression model. The sensitivity and specificity of every possible index score were calculated and added together to calculate the "gain in certainty" values. During the 3-year period, 7,552 patients were admitted, of whom 967 (12.8%) required intubation. Of these, 55 (5.7%) underwent a UI. The final risk index consisted of 10 variables as follows: age 55 years to 64 years, age 65 years or older, male sex, Glasgow Coma Scale (GCS) score of 9 to 13, seizures, chronic obstructive pulmonary disease, traumatic brain injury, four or more rib fractures, spine fractures, and long-bone fractures. Gain in certainty was maximized at an index score of 4, with the highest combined sensitivity and specificity of 86.0% and 74.9%, respectively. The probability of UI increased from 0.9% at a score of 1 to 2.9% at 4 and 43% at 9. UI was associated with increased overall complications, length of stay, and mortality (p the development of an additive risk index. Prospective validation of the risk index is potentially warranted. Diagnostic study, level III.

  18. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  19. Body mass index and lung cancer risk in never smokers

    International Nuclear Information System (INIS)

    Kagohashi, K.; Satoh, H.; Kurishima, K.; Ishikawa, H.; Ohtsuka, M.

    2006-01-01

    Background. A relationship between body mass index (BMI) and lung cancer risk in never smokers has not been reported precisely. To evaluate the risk of lung cancer associated with BMI in never smokers, we conducted a case-control study. Methods. The relationship between BMI and the risk of lung cancer in never smokers was investigated in a study of 204 lung cancer cases and 398 controls admitted between 1987 and 2005. Controls were selected from hospitalized age-matched never-smoking patients with non-malignant respiratory disease. Results. When compared with BMI of the leanest group (BMI<20.8) in men, no inverse association between BMI and lung cancer was observed after the adjustment for age (the second BMI group: BMI≥ 20.8 to < 22.9; p=0.683, the third BMI group: BMI≥ 22.9 to < 24.9; p=0.745, and the highest BMI group: BMI≥ 25.0; p=0.327). Similarly, no association in women was found between BMI and lung cancer in these three BMI groups (the second group, p=0.639; the third group, p=0.667; the highest group, p=0.978) when compared with that of the leanest BMI group. Conclusions. Our present study indicated that the association between leanness and the risk of lung cancer might be influenced by other factors such as smoking. (author)

  20. Body mass index and risk of autoimmune diseases

    DEFF Research Database (Denmark)

    Harpsøe, Maria C; Basit, Saima; Andersson, Mikael

    2014-01-01

    .57) and type 1 diabetes mellitus (HR 2.67; 95% CI, 1.71 to 4.17). Risk of dermatitis herpetiformis increased by 14% (95% CI, 1% to 30%) per BMI unit. Conversely, risk of celiac disease and Raynaud's phenomenon decreased by 7% (95% CI, 1% to 13%) and 12% (95% CI, 4% to 19%) per BMI unit, respectively. Further......BACKGROUND: A possible aetiological link between obesity and certain autoimmune diseases (ADs) has been suggested. We investigated the associations between body mass index (BMI, kg/m2) and 43 ADs. METHODS: 75,008 women participating in the Danish National Birth Cohort were followed during a median......-up, 2430 women (3.2%) developed a total of 2607 new-onset ADs. Risk of any autoimmune disease was increased in obese women (HR, 1.27; 95% CI, 1.11 to 1.46) compared with normal weight women (18.5-≤25 kg/m2). Obese women (BMI≥30 kg/m2) were at increased risk of sarcoidosis (HR 3.59; 95% CI, 2.31 to 5...

  1. Entrepreneurship in the World: The Analysis of the Global Entrepreneurship Index in the Period 2015-2017

    Directory of Open Access Journals (Sweden)

    Grădinaru Cătălin

    2017-01-01

    Full Text Available The last decades have witnessed the rapid spread of entrepreneurship all over the world. Consequently, the state of entrepreneurship has significantly improved. The aim of the paper is to present the evolution of the top ten countries in the world according to the Global Entrepreneurship Index in the period 2015-2017. The research methodology is based on a quantitative method. The paper shows that the top ten countries in the world according to this index in the last three years were the same in a high proportion and demonstrates the absolute domination of the United States of America and the growing presence of the European countries.

  2. Hyperbaric index in the primary prevention of hypertensive complications in high-risk pregnancy.

    Science.gov (United States)

    Otero González, Alfonso; Uribe Moya, Silvia; Arenas Moncaleano, Ivan Gilberto; Borrajo Prol, María Paz; García García, María Jesús; López Sánchez, Luis

    2015-01-01

    Preeclampsia (PE) is a major cause of fetal morbidity and mortality. In the Western World, PE affects 2-7% of pregnancies and is responsible for 50,000 deaths annually. Early detection is a priority as it can change the clinical course, but there are no biomarkers or instrumental methods with high sensitivity and specificity. Only the hyperbaric index has a sensitivity and specificity of 99% for early identification of pregnant women at risk of developing PE, but its use is not widespread. To assess the usefulness of the hyperbaric index in the primary prevention of hypertensive pregnancy complications in a public healthcare area. This is a retrospective study of pregnancies that occurred in our area during the period 2007-2012 (N=11,784). The diagnosis was established by the hyperbaric index and pregnant women at risk were treated with ASA at night. In pregnant patients referred to the nephrology clinic (38.2%), diagnosed as high-risk for PE, and treated with 100mg ASA/night (from week 17), the incidence of PE episodes was reduced by 96.94. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  3. Peaking of world oil production: Impacts, mitigation, & risk management

    Energy Technology Data Exchange (ETDEWEB)

    Hirsch, R.L. (SAIC); Bezdek, Roger (MISI); Wendling, Robert (MISI)

    2005-02-01

    The peaking of world oil production presents the U.S. and the world with an unprecedented risk management problem. As peaking is approached, liquid fuel prices and price volatility will increase dramatically, and, without timely mitigation, the economic, social, and political costs will be unprecedented. Viable mitigation options exist on both the supply and demand sides, but to have substantial impact, they must be initiated more than a decade in advance of peaking.... The purpose of this analysis was to identify the critical issues surrounding the occurrence and mitigation of world oil production peaking. We simplified many of the complexities in an effort to provide a transparent analysis. Nevertheless, our study is neither simple nor brief. We recognize that when oil prices escalate dramatically, there will be demand and economic impacts that will alter our simplified assumptions. Consideration of those feedbacks will be a daunting task but one that should be undertaken. Our aim in this study is to-- • Summarize the difficulties of oil production forecasting; • Identify the fundamentals that show why world oil production peaking is such a unique challenge; • Show why mitigation will take a decade or more of intense effort; • Examine the potential economic effects of oil peaking; • Describe what might be accomplished under three example mitigation scenarios. • Stimulate serious discussion of the problem, suggest more definitive studies, and engender interest in timely action to mitigate its impacts.

  4. Statistical characteristics and stability index (si) of large-sized landslide dams around the world

    International Nuclear Information System (INIS)

    Iqbal, J.; Dai, F.; Raja, I.A.

    2014-01-01

    In the last few decades, landslide dams have received greater attention of researchers, as they have caused loss to property and human lives. Over 261 large-sized landslide dams from different countries of the world with volume greater than 1 x 105 m have been reviewed for this study. The data collected for this study shows that 58% of the catastrophic landslides were triggered by earthquakes and 21 % by rainfall, revealing that earthquake and rainfall are the two major triggers, accounting for 75% of large-sized landslide dams. These land-slides were most frequent during last two decades (1990-2010) throughout the world. The mean landslide dam volume of the studied cases was 53.39 x 10 m with mean dam height of 71.98 m, while the mean lake volume was found to be 156.62 x 10 m. Failure of these large landslide dams pose a severe threat to the property and people living downstream, hence immediate attention is required to deal with this problem. A stability index (SI) has been derived on the basis on 59 large-sized landslide dams (out of the 261 dams) with complete parametric information. (author)

  5. Aumann and Serrano’s economic index of risk for sums of gambles

    Directory of Open Access Journals (Sweden)

    Minqiang Li

    2014-12-01

    Full Text Available We study Aumann and Serrano’s (2008 risk index for sums of gambles that are not dependent. If the dependent parts are similarly ordered, then the risk index of the sum is always larger than the minimum of the risk indices of the two gambles. For negative dependence, the risk index of the sum is always smaller than the maximum. The above results agree with our intuitions of risk diversification well. These result points out another attractive property of Aumann and Serrano’s risk index. These properties are potentially useful for risk assessment purposes of financial securities.

  6. Body mass index and the risk of Parkinson disease.

    Science.gov (United States)

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

    2006-12-12

    To examine the association between body mass index (BMI) and the risk of Parkinson disease (PD). Study cohorts included 22,367 Finnish men and 23,439 women 25 to 59 years of age without a history of PD at baseline. Hazards ratios (HRs) of incident PD were estimated for different levels of BMI. During a mean follow-up period of 18.8 years, 272 men and 254 women developed incident PD. After adjustment for confounding factors (age, study years, systolic blood pressure, total cholesterol, education, leisure-time physical activity, smoking, and alcohol, coffee, and tea consumption), the HRs of PD at different levels of BMI ( or =30 kg/m(2)) were 1.00, 1.97 (95% CI: 1.21 to 3.22), 1.83 (95% CI: 1.12 to 2.99), 2.34 (95% CI: 1.45 to 3.78), and 2.44 (95% CI: 1.44 to 4.15) in men, and 1.00, 1.50 (95% CI: 0.95 to 2.37), 1.65 (95% CI: 1.05 to 2.59), 1.79 (95% CI: 1.15 to 2.80), and 1.77 (95% CI: 1.12 to 2.78) in women, and 1.00, 1.70 (95% CI: 1.23 to 2.37), 1.70 (95% CI: 1.23 to 2.37), 2.02 (95% CI: 1.46 to 2.79), and 2.03 (95% CI: 1.44 to 2.85) in men and women combined (adjusted also for sex). In both sexes combined, the multivariate-adjusted direct association between BMI and the risk of PD was present both in subjects aged 25 to 49 years and 50 to 59 years, in never smokers and smokers and in participants diagnosed PD before and after 65 years of age. Body mass index is associated with a risk of Parkinson disease. The effect is graded and independent of other risk factors.

  7. Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index.

    Science.gov (United States)

    Polzer, Stanislav; Gasser, T Christian

    2015-12-06

    A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach. © 2015 The Author(s).

  8. Incidence and Mortality of Colorectal Cancer and Relationships with the Human Development Index across the World.

    Science.gov (United States)

    Rafiemanesh, Hosein; Mohammadian-Hafshejani, Abdollah; Ghoncheh, Mahshid; Sepehri, Zahra; Shamlou, Reza; Salehiniya, Hamid; Towhidi, Farhad; Makhsosi, Behnam Reza

    2016-01-01

    This study aimed to investigate the standardized incidence and mortality rate of colorectal cancer and its relationship with the human development index (HDI) across the world in 2012. This ecologic study was conducted for assessment of the correlation between age-specific incidence rate (ASIR) and age-specific mortality rate (ASMR) with HDI and its components. Data for SIR and SMR for every country for the year 2012 were obtained from the global cancer project. We used a bivariate method for assessment of the correlation between SIR and SMR and HDI. Statistical significance was assumed at <0.05. Statistical analyses were performed using SPSS (Version 22.0, SPSS Inc.). Countries with the highest SIR of colorectal cancer in the world in 2012, were Republic of Korea, Slovakia, Hungary and countries with the highest SMR were Hungary, Croatia and Slovakia. The correlation between SIR of colorectal cancer and the HDI was 0.712 (P≤0.001), with life expectancy at birth 0.513 (P≤0.001), with mean years of schooling 0.641 (P≤0.001) and with level of income per each person of the population 0.514 (P=0.013). In addition, the correlation between SMR of colorectal cancer and the HDI was 0.628 (P≤0.001), with life expectancy at birth 0.469 (P≤0.001), with mean years of schooling 0.592 (P≤0.001) and with level of income per each person of the population 0.378 (P=0.013). The highest SIR and SMR of colorectal cancer was in the WHO Europe region. There was a positive correlation between HDI and SIR and SMR of colorectal cancer.

  9. Incidence and Mortality of Breast Cancer and their Relationship with the Human Development Index (HDI) in the World in 2012.

    Science.gov (United States)

    Ghoncheh, Mahshid; Mirzaei, Maryam; Salehiniya, Hamid

    2015-01-01

    Breast cancer is the most common malignancy in women worldwide and its incidence is generally increasing. In 2012, it was the second most common cancer in the world. It is necessary to obtain information on incidence and mortality for health planning. This study aimed to investigate the relationship between the human development index (HDI), and the incidence and mortality rates of breast cancer in the world in 2012. This ecologic study concerns incidence rate and standardized mortality rates of the cancer from GLOBOCAN in 2012, and HDI and its components extracted from the global bank site. Data were analyzed using correlation tests and regression with SPSS software (version 15). Among the six regions of WHO, the highest breast cancer incidence rate (67.6) was observed in the PAHO, and the lowest incidence rate was 27.8 for SEARO. There was a direct, strong, and meaningful correlation between the standardized incidence rate and HDI (r=0.725, p≤0.001). Pearson correlation test showed that there was a significant correlation between age-specific incidence rate (ASIR) and components of the HDI (life expectancy at birth, mean years of schooling, and GNP). On the other, a non-significant relationship was observed between ASIR and HDI overall (r=0.091, p=0.241). In total, a significant relationship was not found between age-specific mortality rate (ASMR) and components of HDI. Significant positive correlations exist between ASIR and components of the HDI. Socioeconomic status is directly related to the stage of the cancer and patient's survival. With increasing the incidence rate of the cancer, mortality rate from the cancer does not necessariloy increase. This may be due to more early detection and treatment in developed that developing countries. It is necessary to increase awareness of risk factors and early detection in the latter.

  10. A multi-attribute Systemic Risk Index for comparing and prioritizing chemical industrial areas

    International Nuclear Information System (INIS)

    Reniers, G.L.L.; Sörensen, K.; Dullaert, W.

    2012-01-01

    Measures taken to decrease interdependent risks within chemical industrial areas should be based on quantitative data from a holistic (cluster-based) point of view. Therefore, this paper examines the typology of networks representing industrial areas to formulate recommendations to more effectively protect a chemical cluster against existing systemic risks. Chemical industrial areas are modeled as two distinct complex networks and are prioritized by computing two sub-indices with respect to existing systemic safety and security risks (using Domino Danger Units) and supply chain risks (using units from an ordinal expert scale). Subsequently, a Systemic Risk Index for the industrial area is determined employing the Borda algorithm, whereby the systemic risk index considers both a safety and security network risk index and a supply chain network risk index. The developed method allows decreasing systemic risks within chemical industrial areas from a holistic (inter-organizational and/or inter-cluster) perspective. An illustrative example is given.

  11. Risk Profile Analysis on BIST30 Exchange Index

    OpenAIRE

    Ural, Mert; Demireli, Erhan

    2018-01-01

    Inthis study, a portfolio was created by using the stocks listed in BIST30 indexand the portfolio risk was measured by using Capital Asset Pricing Model. Afterthat risk decomposition was made by purifying the risk of the stocks from totalmarket risk and by this way the systematic and non-systematic risk amounts havebeen determined for both the portfolio and each stock.

  12. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients

    Directory of Open Access Journals (Sweden)

    Lim JU

    2017-08-01

    Full Text Available Jeong Uk Lim,1 Jae Ha Lee,2 Ju Sang Kim,3 Yong Il Hwang,4 Tae-Hyung Kim,5 Seong Yong Lim,6 Kwang Ha Yoo,7 Ki-Suck Jung,4 Young Kyoon Kim,8 Chin Kook Rhee8 1Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, St Paul’s Hospital, College of Medicine, The Catholic University of Korea, 2Division of Pulmonology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, 3Division of Pulmonary Medicine, Department of Internal Medicine, Incheon St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, 4Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, 5Division of Pulmonary and Critical Care Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, 6Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 7Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, 8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Introduction: A low body mass index (BMI is associated with increased mortality and low health-related quality of life in patients with COPD. The Asia-Pacific classification of BMI has a lower cutoff for overweight and obese categories compared to the World Health Organization (WHO classification. The present study assessed patients with COPD among different BMI categories according to two BMI classification systems: WHO and Asia-Pacific. Patients and methods: Patients with COPD aged 40 years or older from the Korean COPD Subtype Study cohort were selected for evaluation

  13. [Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents].

    Science.gov (United States)

    de Oliveira, Patrícia Morais; da Silva, Fabiana Almeida; Souza Oliveira, Renata Maria; Mendes, Larissa Loures; Netto, Michele Pereira; Cândido, Ana Paula Carlos

    2016-01-01

    To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. Cross-sectional study with 403 adolescents aged 10-14 years, from public and private schools. Anthropometric, clinical, biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. Regarding the nutritional status; 66.5% of the adolescents had normal weight; 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents that had high serum triglycerides, body mass index and waist circumference. Adolescents that had anthropometric, clinical and biochemical characteristics considered to be of risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  14. The Skew Risk Premium in the Equity Index Market

    OpenAIRE

    Roman Kozhan; Anthony Neuberger; Paul Schneider

    2013-01-01

    We develop a new method for measuring moment risk premiums. We find that the skew premium accounts for over 40% of the slope in the implied volatility curve in the S&P 500 market. Skew risk is tightly related to variance risk, in the sense that strategies designed to capture the one and hedge out exposure to the other earn an insignificant risk premium. This provides a new testable restriction for asset pricing models trying to capture, in particular, disaster risk premiums. We base our resul...

  15. Modeling of Ship Collision Risk Index Based on Complex Plane and Its Realization

    OpenAIRE

    Xiaoqin Xu; Xiaoqiao Geng; Yuanqiao Wen

    2016-01-01

    Ship collision risk index is the basic and important concept in the domain of ship collision avoidance. In this paper, the advantages and deficiencies of the various calculation methods of ship collision risk index are pointed out. Then the ship collision risk model based on complex plane, which can well make up for the deficiencies of the widely-used evaluation model proposed by Kearon.J and Liu ruru is proposed. On this basis, the calculation method of collision risk index under the encount...

  16. Evaluation of a risk index for advanced proximal neoplasia of the colon.

    Science.gov (United States)

    Ruco, Arlinda; Stock, David; Hilsden, Robert J; McGregor, S Elizabeth; Paszat, Lawrence F; Saskin, Refik; Rabeneck, Linda

    2015-01-01

    A clinical risk index that uses distal colorectal findings at flexible sigmoidoscopy (FS) in conjunction with easily determined risk factors for advanced proximal neoplasia (APN) may be useful for tailoring or prioritizing screening with colonoscopy. To conduct an external evaluation of a previously published risk index in a large, well-characterized cohort. Cross-sectional. Teaching hospital and colorectal cancer screening center. A total of 5139 asymptomatic persons aged 50 to 74 (54.9% women) with a mean age (±SD) of 58.3 (±6.2) years. Between 2003 and 2011, all participants underwent a complete screening colonoscopy and removal of all polyps. Participants were classified as low, intermediate, or high risk for APN, based on their composite risk index scores. The concordance or c-statistic was used to measure discriminating ability of the risk index. A total of 167 persons (3.2%) had APN. The prevalence of those with APN among low-, intermediate-, and high-risk categories was 2.1%, 2.9%, and 6.5%, respectively. High-risk individuals were 3.2 times more likely to have APN compared with those in the low-risk category. The index did not discriminate well between those in the low- and intermediate-risk categories. The c-statistic for the overall index was 0.62 (95% confidence interval, 0.58-0.66). Distal colorectal findings were derived from colonoscopies and not FS itself. The risk index discriminated between those at low risk and those at high risk, but it had limited ability to discriminate between low- and intermediate-risk categories for prevalent APN. Information on other risk factors may be needed to tailor, or prioritize, access to screening colonoscopy. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  17. Performance of a risk index for advanced proximal colorectal neoplasia among a racially/ethnically diverse patient population (risk index for advanced proximal neoplasia).

    Science.gov (United States)

    Levitzky, Benjamin E; Brown, Colin C; Heeren, Timothy C; Schroy, Paul C

    2011-06-01

    Tailoring the use of screening colonoscopy based on the risk of advanced proximal neoplasia (APN) has been advocated as a strategy for reducing demand and optimizing effectiveness. A 7-point index based on age, sex, and distal findings at sigmoidoscopy has been proposed that stratifies individuals into low, intermediate, and high-risk categories. The aim of this cross-sectional analysis was to determine the validity of this index, which was originally derived and validated among mostly whites, for black and Hispanic patients. Data, including age, sex, colonoscopic findings, and pathology, were collected retrospectively from 1,481 white, 1,329 black, and 689 Hispanic asymptomatic, average-risk patients undergoing screening colonoscopy between 2000 and 2005. Cumulative scores ranging from 0 to 7 were derived for each subject and categorized as low, intermediate, or high risk. Rates of APN were assessed for each risk category after stratification by race/ethnicity. Index performance was assessed using the C-statistic and compared across the three racial groups. Rates of APN among patients categorized as low, intermediate, or high risk increased from 1.0 to 2.8 to 3.7% for whites, 1.0 to 2.2 to 4.2% for blacks, and 0.6 to 1.9 to 3.7% for Hispanics. The index performed similarly for all three groups, but showed limited ability to discriminate low from intermediate-risk patients, with C-statistic values of 0.62 for whites, 0.63 for blacks, and 0.68 for Hispanics. A risk index based on age, sex, and distal endoscopic findings has limited ability to discriminate low from intermediate-risk white, black, and Hispanic patients for APN.

  18. Correlation Between Ki-67 Index, World Health Organization Grade and Patient Survival in Glial Tumors With Astrocytic Differentiation

    Science.gov (United States)

    Dzhenkov, Deyan L; Kitanova, Martina; Donev, Ivan S; Ghenev, Peter

    2017-01-01

    Background Glioblastoma multiforme (GBM) is a class IV astrocytic tumor, the most malignant of the four groups of World Health Organization (WHO) tumors with astrocytic differentiation. Aim The aim of this study was to estab­lish whether a correlation exists between the Ki-67 index of tumors with astrocytic differentiation, WHO grade, and patient survival. Materials and methods A retrospective non-clinical approach to patient selection was chosen for the aim of the study. A total of 47 patients diagnosed and treated for CNS tumors with astrocytic differentiation in the St. Marina University Hospital, Varna, Bulgaria, from September 2012 to July 2016 were retrospectively included into the study cohort. The cases were tested for their immunohistochemistry (IHC) reaction with Ki-67 after their original Hematoxylin and Eosin and IHC slides were reviewed by a single author and blind coded. The Ki-67 positivity index of the nuclei was estimated after digitalization of the slides and calculated by the ImmunoRatio automated count­ing tool. The individual Ki-67 index and patient survival of each case were statistically compared. Results The histopathological groups, after the blind Ki-67 index automated calculation was carried out, revealed no WHO grade I, two WHO grade II samples, four WHO grade III samples and 41 WHO grade IV cases, and these were included in the analysis. The two samples of WHO grade II astrocytic tumors had a mean Ki-67 index of 25%; however, they comprised tumors with an individual index of 43% and 7%, both individual values with a highly unlikely index for this group. The four samples of WHO grade III had a mean Ki-67 index of 4%, standard deviation ±2.16 (p>0.05), with the lowest index being 1% and the highest one being 6%. Both WHO grade II and III did not include enough samples to allow for a proper statistical analysis of patient survival. The 41 GBM cases had a mean Ki-67 index of 17.34%, standard deviation ±10.79 (p>0

  19. Development of a brief parent-report risk index for children following parental divorce.

    Science.gov (United States)

    Tein, Jenn-Yun; Sandler, Irwin N; Braver, Sanford L; Wolchik, Sharlene A

    2013-12-01

    This article reports on the development of a brief 15-item parent-report risk index (Child Risk Index for Divorced or Separated Families; CRI-DS) to predict problem outcomes of children who have experienced parental divorce. A series of analyses using 3 data sets were conducted that identified and cross-validated a parsimonious set of items representing parent report of child behavior problems and family level risk and protective factors, each of which contributed to the predictive accuracy of the index. The index predicted child behavior outcomes and substance abuse problems up to 6 years later. The index has acceptable levels of sensitivity and specificity as a screening measure to predict problem outcomes up to 1 year later. The use of the index to identify the need for preventive services is discussed, along with limitations of the study.

  20. Sensitivity analysis of the Ohio phosphorus risk index

    Science.gov (United States)

    The Phosphorus (P) Index is a widely used tool for assessing the vulnerability of agricultural fields to P loss; yet, few of the P Indices developed in the U.S. have been evaluated for their accuracy. Sensitivity analysis is one approach that can be used prior to calibration and field-scale testing ...

  1. Applying weather index insurance to agricultural pest and disease risks

    NARCIS (Netherlands)

    Norton, Michael; Sprundel, van Gert Jan; Turvey, Calum G.; Meuwissen, Miranda P.M.

    2016-01-01

    In this paper, we explore the application of weather index insurance to plant pest and disease management strategies using two distinct models: (1) insuring crop loss due to disease incidence (“Crop Insurance”) and (2) insuring the use of pesticides (“Pesticide Insurance”). We find that despite

  2. Building a Natural Disaster Risk Index for Supply Chain Operations

    OpenAIRE

    Kun Liao; Ozden Bayazit; Fang Wang

    2014-01-01

    Risk for an organization is associated with uncertainties in all areas of its operations. As firms move toward global sourcing, supply chain risk increases dramatically, which is linked to lower financial performance and market value. One major type of supply chain risk is disruptions caused by natural or man-made disasters. In this paper, major factors causing supply chain disruptions are identified based on resource dependency theory and contingency theory. As a result of the study, a compr...

  3. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  4. Idiosyncratic risk in the Dow Jones Eurostoxx50 Index

    Science.gov (United States)

    Daly, Kevin; Vo, Vinh

    2008-07-01

    Recent evidence by Campbell et al. [J.Y. Campbell, M. Lettau B.G. Malkiel, Y. Xu, Have individual stocks become more volatile? An empirical exploration of idiosyncratic risk, The Journal of Finance (February) (2001)] shows an increase in firm-level volatility and a decline of the correlation among stock returns in the US. In relation to the Euro-Area stock markets, we find that both aggregate firm-level volatility and average stock market correlation have trended upwards. We estimate a linear model of the market risk-return relationship nested in an EGARCH(1, 1)-M model for conditional second moments. We then show that traditional estimates of the conditional risk-return relationship, that use ex-post excess-returns as the conditioning information set, lead to joint tests of the theoretical model (usually the ICAPM) and of the Efficient Market Hypothesis in its strong form. To overcome this problem we propose alternative measures of expected market risk based on implied volatility extracted from traded option prices and we discuss the conditions under which implied volatility depends solely on expected risk. We then regress market excess-returns on lagged market implied variance computed from implied market volatility to estimate the relationship between expected market excess-returns and expected market risk.We investigate whether, as predicted by the ICAPM, the expected market risk is the main factor in explaining the market risk premium and the latter is independent of aggregate idiosyncratic risk.

  5. A Land-Use Perspective for Birdstrike Risk Assessment: The Attraction Risk Index.

    Directory of Open Access Journals (Sweden)

    Francesca Coccon

    Full Text Available Collisions between aircraft and birds, birdstrikes, pose a serious threat to aviation safety. The occurrence of these events is influenced by land-uses in the surroundings of airports. Airports located in the same region might have different trends for birdstrike risk, due to differences in the surrounding habitats. Here we developed a quantitative tool that assesses the risk of birdstrike based on the habitats within a 13-km buffer from the airport. For this purpose, we developed Generalized Linear Models (GLMs with binomial distribution to estimate the contribution of habitats to wildlife use of the study area, depending on season. These GLMs predictions were combined to the flight altitude of birds within the 13-km buffer, the airport traffic pattern and the severity indices associated with impacts. Our approach was developed at Venice Marco Polo International airport (VCE, located in northeast Italy and then tested at Treviso Antonio Canova International airport (TSF, which is 20 km inland. Results from the two airports revealed that both the surrounding habitats and the season had a significant influence to the pattern of risk. With regard to VCE, agricultural fields, wetlands and urban areas contributed most to the presence of birds in the study area. Furthermore, the key role of distance of land-uses from the airport on the probability of presence of birds was highlighted. The reliability of developed risk index was demonstrated since at VCE it was significantly correlated with bird strike rate. This study emphasizes the importance of the territory near airports and the wildlife use of its habitats, as factors in need of consideration for birdstrike risk assessment procedures. Information on the contribution of habitats in attracting birds, depending on season, can be used by airport managers and local authorities to plan specific interventions in the study area in order to lower the risk.

  6. Risk management in crop production based on the regional index

    Directory of Open Access Journals (Sweden)

    Kokot Željko

    2017-01-01

    Full Text Available Regional index insurance is one of the newer instruments for reducing losses in crop production. The regional index indicates the average yield or average production value in a region, representing the basis for the premium calculation and insurance benefits. The main advantage of this insurance model is that it does not require the damage assessment, which is one of major problems in the relationship between the insured and insurer. In the case of corn, wheat and sunflower production as the most important crops in the region of Ada municipality, the authors describe the methodology of application of the analysed insurance system. Implementation of this contemporary form of insurance in Serbia would reduce the negative financial consequences in agricultural production. The abovementioned model of insurance can be seen as a significant alternative to conventional insurance, which can increase insured area and number of insured, and trust and confidence in insurance companies would also be restored.

  7. Modeling of Ship Collision Risk Index Based on Complex Plane and Its Realization

    Directory of Open Access Journals (Sweden)

    Xiaoqin Xu

    2016-07-01

    Full Text Available Ship collision risk index is the basic and important concept in the domain of ship collision avoidance. In this paper, the advantages and deficiencies of the various calculation methods of ship collision risk index are pointed out. Then the ship collision risk model based on complex plane, which can well make up for the deficiencies of the widely-used evaluation model proposed by Kearon.J and Liu ruru is proposed. On this basis, the calculation method of collision risk index under the encountering situation of multi-ships is constructed, then the three-dimensional image and spatial curve of the risk index are figured out. Finally, single chip microcomputer is used to realize the model. And attaching this single chip microcomputer to ARPA is helpful to the decision-making of the marine navigators.

  8. Improving index mutual fund risk perception : Increase financial literacy or communicate better?

    NARCIS (Netherlands)

    de Goeij, Peter; Van Campenhout, Geert; Subotic, Marjana

    2017-01-01

    We investigate the effect of financial literacy and index mutual fund risk disclosure format on investors’ risk perception by examining the risk disclosure part in the Key Investor Information Document (KIID) for UCITS funds in Europe. Using an experimental survey administered to 244 university

  9. Visceral adiposity index as an indicator of cardiometabolic risk in patients treated for craniopharyngioma.

    Science.gov (United States)

    Ferraù, Francesco; Spagnolo, Federica; Cotta, Oana Ruxandra; Cannavò, Laura; Alibrandi, Angela; Russo, Giuseppina Tiziana; Aversa, Tommaso; Trimarchi, Francesco; Cannavò, Salvatore

    2017-11-01

    Craniopharyngioma is associated with metabolic alterations leading to increased cardiovascular mortality. Recently, the visceral adiposity index has been proposed as a marker of visceral adipose tissue dysfunction and of the related cardiometabolic risk. The role of the visceral adiposity index has never been explored in craniopharyngioma patients. We assessed the cardiometabolic risk on the basis of the visceral adiposity index in craniopharyngioma patients. We evaluated data of 24 patients treated for craniopharyngioma in a single-centre. We investigated the relationship among patients' clinical and biochemical features, cardiovascular risk -assessed by the Framingham and the atherosclerotic cardiovascular disease risk scores-, visceral adiposity index and adipose tissue dysfunction severity. Increased visceral adiposity index was found in 8 patients (33%). Adipose tissue dysfunction resulted to be severe, moderate or mild in 5, 2 and 1 cases. Increased visceral adiposity index significantly correlated with the occurrence of metabolic syndrome (p 0.027), IRI (p 0.001), triglycerides (p < 0.001), HOMA-IR (p < 0.001) and with lower ISI-Matsuda (p 0.005) and HDL-cholesterol (p < 0.001). Higher degree of adipose tissue dysfunction associated with increased insulin resistance. No gender difference was found for visceral adiposity index, adipose tissue dysfunction severity, and cardiovascular risk scores. Patients with adulthood onset craniopharyngioma showed higher Framingham risk score (p 0.004), atherosclerotic cardiovascular disease 10-year (p < 0.001) and lifetime (p 0.018) risk scores than those with childhood onset disease. Visceral adiposity index is increased in one third of our patients with craniopharyngioma, even if metabolic syndrome does not occur. Increased visceral adiposity index and adipose tissue dysfunction severity correlate with insulin sensitivity parameters, do not correlate with Framingham or atherosclerotic cardiovascular

  10. Draught risk index tool for building energy simulations

    DEFF Research Database (Denmark)

    Vorre, Mette Havgaard; Jensen, Rasmus Lund; Nielsen, Peter V.

    2014-01-01

    Flow elements combined with a building energy simulation tool can be used to indicate areas and periods when there is a risk of draught in a room. The study tests this concept by making a tool for post-processing of data from building energy simulations. The objective is to show indications...... of draught risk during a whole year, giving building designers a tool for the design stage of a building. The tool uses simple one-at-a-time calculations of flow elements and assesses the uncertainty of the result by counting the number of overlapping flow elements. The calculation time is low, making...... it usable in the early design stage to optimise the building layout. The tool provides an overview of the general draught pattern over a period, e.g. a whole year, and of how often there is a draught risk....

  11. Identification of cardiometabolic risk: visceral adiposity index versus triglyceride/HDL cholesterol ratio.

    Science.gov (United States)

    Salazar, Martin R; Carbajal, Horacio A; Espeche, Walter G; Aizpurúa, Marcelo; Maciel, Pablo M; Reaven, Gerald M

    2014-02-01

    The plasma concentration ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) can identify cardiometabolic risk and cardiovascular disease. The visceral adiposity index is a sex-specific index, in which measurements of body mass index and waist circumference are combined with TG and HDL-C concentrations. The current analysis was initiated to see if the visceral adiposity index would improve the ability of the TG/HDL-C to identify increased cardiometabolic risk and outcome. Cardiometabolic data were obtained in 2003 from 926 apparently healthy individuals, 796 of whom were evaluated in 2012 for evidence of incident cardiovascular disease. The relationship between TG/HDL-C and values for visceral adiposity index was evaluated by Pearson's correlation coefficient. The relative risks for first cardiovascular event between individuals above and below the TG/HDL-C sex-specific cut points, and in the top quartile of visceral adiposity index versus the remaining 3 quartiles, were estimated using Cox proportional hazard models. TG/HDL-C concentration and visceral adiposity index were highly correlated (r = 0.99) in both men and women. Although more men (133 vs121) and women (73 vs 59) were identified as being at "high risk" by an elevated TG/HDL-C ratio, the individual cardiometabolic risk factors were essentially identical with either index used. However, the hazard ratio of developing cardiovascular disease was significantly increased in individuals with an elevated TG/HDL-C, whereas it was not the case when the visceral adiposity index was used to define "high risk." The visceral adiposity index does not identify individuals with an adverse cardiometabolic profile any better than the TG/HDL-C. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Waist-to-height ratio as index of cardiometabolic risk among the doctors

    Directory of Open Access Journals (Sweden)

    Miliva Mozaffor

    2017-12-01

    Full Text Available The aim of this study was to see the cardiometabolic risk among doctors using waist-to-height ratio index as tool. Cardiometabolic risk is an umbrella term that includes all the risk factors of diabetes and cardiovascular disease. The study was conducted among 195 doctors. According to waist-to-height ratio index 167 (85.6% doctors had cardiometabolic risk. Waist-to-height ratio index was found good (area under the curve >0.5, sensitivity 88.1%, specificity 23.2%, positive predictive value 53.9%, and negative predictive value 66.7% for their predictive value of cardiometabolic risk. Age grouping was done and found that no age group was free from cardiometabolic risk.

  13. Best practice vendor risk management in today's interconnected world.

    Science.gov (United States)

    Beale, Ian

    2017-01-01

    This paper explains why vendor/third-party risk is so important to all organisations, as well as the principal risks that organisations must consider. It describes the responsibility of management to manage these risks with support from risk experts at the selection phase and through the ongoing relationship. Different sources of information about the management of the key risks and alternative ways of collecting the data are evaluated. The paper concludes by discussing how both customer and supplier organisations benefit from a balanced approach to risk management. The approach described in the paper applies to organisations of all types and sizes and can be applied to varied supply chains. The data and insights are based on research conducted by CEB.

  14. The future of risk management in an uncertain world

    OpenAIRE

    Coulson-Thomas, Colin

    2017-01-01

    Risk management approaches, practices and techniques need to change to reflect evolving risks and the inter-connected nature of contemporary organisations. Boards need to challenge and question them. The risk management community needs to adopt more pro-active and positive approaches that add more value and enable innovation and entrepreneurship. They need to contribute to solutions rather than just report problems, and focus on opportunities as well as challenges. A wider perspective and mor...

  15. Potential Risk Estimation Drowning Index for Children (PREDIC): a pilot study from Matlab, Bangladesh.

    Science.gov (United States)

    Borse, N N; Hyder, A A; Bishai, D; Baker, T; Arifeen, S E

    2011-11-01

    Childhood drowning is a major public health problem that has been neglected in many low- and middle-income countries. In Matlab, rural Bangladesh, more than 40% of child deaths aged 1-4 years are due to drowning. The main objective of this paper was to develop and evaluate a childhood drowning risk prediction index. A literature review was carried out to document risk factors identified for childhood drowning in Bangladesh. The Newacheck model for special health care needs for children was adapted and applied to construct a childhood drowning risk index called "Potential Risk Estimation Drowning Index for Children" (PREDIC). Finally, the proposed PREDIC Index was applied to childhood drowning deaths and compared with the comparison group from children living in Matlab, Bangladesh. This pilot study used t-tests and Receiver Operating Characteristic (ROC) curve to analyze the results. The PREDIC index was applied to 302 drowning deaths and 624 children 0-4 years old living in Matlab. The results of t-test indicate that the drowned children had a statistically (t=-8.58, p=0.0001) significant higher mean PREDIC score (6.01) than those in comparison group (5.26). Drowning cases had a PREDIC score of 6 or more for 68% of the children however, the comparison group had 43% of the children with score of 6 or more which was statistically significant (t=-7.36, p<0.001). The area under the curve for the Receiver Operating Characteristic curve was 0.662. Index score construction was scientifically plausible; and the index is relatively complete, fairly accurate, and practical. The risk index can help identify and target high risk children with drowning prevention programs. PREDIC index needs to be further tested for its accuracy, feasibility and effectiveness in drowning risk reduction in Bangladesh and other countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Using the Steel Vessel Material-Cost Index to Mitigate Shipbuilder Risk

    National Research Council Canada - National Science Library

    Keating, Edward G; Murphy, Robert; Schank, John F; Birkler, John

    2008-01-01

    This paper describes how the US Navy structures fixed-price and fixed-price, incentive-fee shipbuilding contracts and how labor- and material-cost indexes can mitigate shipbuilder risk in either type of contract...

  17. Body adiposity index versus body mass index and other anthropometric traits as correlates of cardiometabolic risk factors.

    Directory of Open Access Journals (Sweden)

    Charlene T Lichtash

    Full Text Available The worldwide prevalence of obesity mandates a widely accessible tool to categorize adiposity that can best predict associated health risks. The body adiposity index (BAI was designed as a single equation to predict body adiposity in pooled analysis of both genders. We compared body adiposity index (BAI, body mass index (BMI, and other anthropometric measures, including percent body fat (PBF, in their correlations with cardiometabolic risk factors. We also compared BAI with BMI to determine which index is a better predictor of PBF.The cohort consisted of 698 Mexican Americans. We calculated correlations of BAI, BMI, and other anthropometric measurements (PBF measured by dual energy X-ray absorptiometry, waist and hip circumference, height, weight with glucose homeostasis indices (including insulin sensitivity and insulin clearance from euglycemic clamp, lipid parameters, cardiovascular traits (including carotid intima-media thickness, and biomarkers (C-reactive protein, plasminogen activator inhibitor-1 and adiponectin. Correlations between each anthropometric measure and cardiometabolic trait were compared in both sex-pooled and sex-stratified groups.BMI was associated with all but two measured traits (carotid intima-media thickness and fasting glucose in men, while BAI lacked association with several variables. BAI did not outperform BMI in its associations with any cardiometabolic trait. BAI was correlated more strongly than BMI with PBF in sex-pooled analyses (r = 0.78 versus r = 0.51, but not in sex-stratified analyses (men, r = 0.63 versus r = 0.79; women, r = 0.69 versus r = 0.77. Additionally, PBF showed fewer correlations with cardiometabolic risk factors than BMI. Weight was more strongly correlated than hip with many of the cardiometabolic risk factors examined.BAI is inferior to the widely used BMI as a correlate of the cardiometabolic risk factors studied. Additionally, BMI's relationship with total adiposity

  18. World Health Organization cardiovascular risk stratification and target organ damage.

    Science.gov (United States)

    Piskorz, D; Bongarzoni, L; Citta, L; Citta, N; Citta, P; Keller, L; Mata, L; Tommasi, A

    2016-01-01

    Prediction charts allow treatment to be targeted according to simple markers of cardiovascular risk; many algorithms do not recommend screening asymptomatic target organ damage which could change dramatically the assessment. To demonstrate that target organ damage is present in low cardiovascular risk hypertensive patients and it is more frequent and severe as global cardiovascular risk increases. Consecutive hypertensive patients treated at a single Latin American center. Cardiovascular risk stratified according to 2013 WHO/ISH risk prediction chart America B. Left ventricular mass assessed by Devereux method, left ventricular hypertrophy considered >95g/m(2) in women and >115g/m(2) in men. Transmitral diastolic peak early flow velocity to average septal/lateral peak early diastolic relaxation velocity (E/e' ratio) measured cut off value >13. Systolic function assessed by tissue Doppler average interventricular septum/lateral wall mitral annulus rate systolic excursion (s wave). A total of 292 patients were included of whom 159 patients (54.5%) had cardiovascular risk of 20%. Left ventricular hypertrophy was detected in 17.6% low risk patients, 27.8% in medium risk and 23.3% in high risk (p<0.05), abnormal E/e' ratio was found in 13.8%, 31.1% and 27.9%, respectively (p<0.05). Mean s wave was 8.03+8, 8.1+9 and 8.7+1cm/s for low, intermediate and high risk patients, respectively (p<0.025). Target organ damage is more frequent and severe in high risk; one over four subjects was misclassified due to the presence of asymptomatic target organ damage. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

  19. The effect of elevated body mass index on ischemic heart disease risk

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Palmer, Tom M; Benn, Marianne

    2012-01-01

    Adiposity, assessed as elevated body mass index (BMI), is associated with increased risk of ischemic heart disease (IHD); however, whether this is causal is unknown. We tested the hypothesis that positive observational associations between BMI and IHD are causal.......Adiposity, assessed as elevated body mass index (BMI), is associated with increased risk of ischemic heart disease (IHD); however, whether this is causal is unknown. We tested the hypothesis that positive observational associations between BMI and IHD are causal....

  20. Stroke Risk Factors among Participants of a World Stroke Day ...

    African Journals Online (AJOL)

    Hypertension is the most common stroke risk factor globally as well as in the Nigerian population, however other modifiable risk factors such as obesity are becoming increasingly prevalent due to unhealthy diets and sedentary lifestyle. Materials and Methods: We screened 224 volunteers from Ile‑Ife during the 2011 and ...

  1. Body mass index and risk of Alzheimer's disease

    DEFF Research Database (Denmark)

    Nordestgaard, Liv Tybjærg; Tybjærg-Hansen, Anne; Nordestgaard, Børge G.

    2017-01-01

    between low BMI and high risk of Alzheimer's disease. Design, Setting, and Participants: Using a Mendelian randomization approach, we studied 95,578 individuals from the Copenhagen General Population Study (CGPS) with up to 36 years of follow-up and consortia data on 303,958 individuals from the Genetic...... Investigation of Anthropometric Traits (GIANT) and the International Genomics of Alzheimer's Project (IGAP). Main Outcome Measure: Risk of Alzheimer's disease. Results: The causal odds ratio for a 1-kg/m2 genetically determined lower BMI was 0.98 [95% confidence interval (CI), 0.77 to 1.23] for a weighted...... allele score in the CGPS. Using 32 BMIdecreasing variants from GIANT and IGAP the causal odds ratio for Alzheimer's disease for a 1-standard deviation (SD) lower genetically determined BMI was 1.02 (95% CI, 0.86 to 1.22). Corresponding observational hazard ratios from the CGPS were 1.07 (95% CI, 1...

  2. Childhood body mass index and risk of adult pancreatic cancer

    DEFF Research Database (Denmark)

    Nogueira, Leticia; Stolzenberg-Solomon, Rachael; Gamborg, Michael

    2017-01-01

    incident pancreatic cancer cases from 1968-2012. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazard regressions. Results: During 8,207,015 person-years of follow-up, 1,268 pancreatic cancer cases were diagnosed. Childhood BMI z-scores at ages 7-13 years were......Background: Excess weight in adulthood is one of the few modifiable risk factors for pancreatic cancer, and height has associations as well. This leads to question whether body weight and height in childhood are associated with adult pancreatic cancer. Objective: To examine if childhood body mass...... from 7-13 years is positively and linearly associated with adult pancreatic cancer; the higher the BMI, the higher the risk. Excess childhood BMI may be indicative of processes initiated early in life that lead to this cancer. Prevention of childhood adiposity may decrease the burden of pancreatic...

  3. Adolescent Eating Disorder Risk and the Online World.

    Science.gov (United States)

    Saul, Jennifer S; Rodgers, Rachel F

    2018-04-01

    The proliferation of social media and rapid increase in the use of the Internet by adolescents generates new dynamics and new risks for the development and maintenance of eating disorders. Here, the authors review different types of online content and how they are relevant to eating disorders within different theoretic frameworks, before examining the empirical evidence for the risks posed by online content in the development and maintenance of eating disorders. They describe pro-eating disorder content specifically and examine the research related to it, before considering its implications, and considering directions for future research, and prevention and intervention strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Enviromentally sensitive patch index of desertification risk applied to the main habitats of Sicily

    Science.gov (United States)

    Duro, A.; Piccione, V.; Ragusa, M. A.; Rapicavoli, V.; Veneziano, V.

    2017-07-01

    The authors applied the MEDALUS - Mediterranean Desertification and Land Use - procedure to the most representative sicilian habitat by extension, socio-economic and environmental importance, in order to assess the risk of desertification. Thanks to the ESPI, Environmentally Sensitive Patch Index, in this paper the authors estimate the current and future regional levels of desertification risk.

  5. Spatial modelling of population at risk and PM 2.5 exposure index: A ...

    African Journals Online (AJOL)

    However, monitoring, spatial representation and development of associated risk indicators have been major problems undermining formulation of relevant policy on air quality. This study used ... to environmental health. Key Words: Population at risk, PM2.5; Spatial modeling, GIS, Exposure index, environmental health ...

  6. Risk preference or financial literacy? Behavioural experiment on index insurance demand

    NARCIS (Netherlands)

    Awel, Y.; Azomahou, T.T.

    2015-01-01

    We use unique cross-sectional household data from Ethiopia to investigate the effect of risk preference, financial literacy and other socio-economic characteristics on demand for index insurance. We measure risk preference based on survey experiments using lottery choice game with real monetary

  7. An internationally generalizable risk index for mortality after one year of antiretroviral therapy

    NARCIS (Netherlands)

    Tate, Janet P.; Justice, Amy C.; Hughes, Michael D.; Bonnet, Fabrice; Reiss, Peter; Mocroft, Amanda; Nattermann, Jacob; Lampe, Fiona C.; Bucher, Heiner C.; Sterling, Timothy R.; Crane, Heidi M.; Kitahata, Mari M.; May, Margaret; Sterne, Jonathan A. C.

    2013-01-01

    Despite the success of antiretroviral therapy (ART), excess mortality continues for those with HIV infection. A comprehensive approach to risk assessment, addressing multiorgan system injury on ART, is needed. We sought to develop and validate a practical and generalizable mortality risk index for

  8. Epidemiology, incidence and mortality of lung cancer and their relationship with the development index in the world.

    Science.gov (United States)

    Rafiemanesh, Hosein; Mehtarpour, Mojtaba; Khani, Farah; Hesami, Sayed Mohammadali; Shamlou, Reza; Towhidi, Farhad; Salehiniya, Hamid; Makhsosi, Behnam Reza; Moini, Ali

    2016-06-01

    The highest incidence of lung cancer is seen in North America and the lowest incidence in central Africa. Socioeconomic factors of inequality reflect regional disparities in human development. Due to the importance of awareness about incidence and mortality of lung cancer in health programming and the possible role of the human development index (HDI), this study was done with the aim to investigate the epidemiology of lung cancer in the world and its relationship with HDI. The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components). Data about the age-specific incidence and mortality rate (ASR) for every country in 2012 were getting from the global cancer project. To analyze data, correlation tests between incidence and death rates, and HDI and its components were employed with a significance level of 0.05 using SPSS software. Lung cancer with standardized incidence rate (ASIR) and standardized mortality rate (ASMR), equal to 23.1 and 19.7 (in 100,000 people), respectively. The highest and lowest values of mortality incidence ratio (MIR) for lung cancer due to continents division were 0.93 and 0.71 for Eastern Africa and Australia/New Zealand, respectively. Univariate analysis showed significant relationship (PASMR with life expectancy at birth and mean years of schooling. The highest MIR for lung cancer was for medium human development countries. Linear regression analysis showed a reverse significant relationship between MIR and HDI.

  9. Global Credit Risk: World, Country and Industry Factors

    NARCIS (Netherlands)

    Schwaab, B.; Koopman, S.J.; Lucas, A.

    2017-01-01

    We investigate the dynamic properties of systematic default risk conditions for firms in different countries, industries and rating groups. We use a high-dimensional nonlinear non-Gaussian state-space model to estimate common components in corporate defaults in a 41 country samples between 1980:Q1

  10. Body mass index predicts risk for complications from transtemporal cerebellopontine angle surgery.

    Science.gov (United States)

    Mantravadi, Avinash V; Leonetti, John P; Burgette, Ryan; Pontikis, George; Marzo, Sam J; Anderson, Douglas

    2013-03-01

    To determine the relationship between body mass index (BMI) and risk for specific complications from transtemporal cerebellopontine angle (CPA) surgery for nonmalignant disease. Case series with chart review. Tertiary-care academic hospital. Retrospective review of 134 consecutive patients undergoing transtemporal cerebellopontine angle surgery for nonmalignant disease from 2009 to 2011. Data were collected regarding demographics, body mass index, intraoperative details, hospital stay, and complications including cerebrospinal fluid leak, wound complications, and brachial plexopathy. One hundred thirty-four patients were analyzed with a mean preoperative body mass index of 28.58. Statistical analysis demonstrated a significant difference in body mass index between patients with a postoperative cerebrospinal fluid leak and those without (P = .04), as well as a similar significant difference between those experiencing postoperative brachial plexopathy and those with no such complication (P = .03). Logistical regression analysis confirmed that body mass index is significant in predicting both postoperative cerebrospinal fluid leak (P = .004; odds ratio, 1.10) and brachial plexopathy (P = .04; odds ratio, 1.07). Elevated body mass index was not significant in predicting wound complications or increased hospital stay beyond postoperative day 3. Risk of cerebrospinal fluid leak and brachial plexopathy is increased in patients with elevated body mass index undergoing surgery of the cerebellopontine angle. Consideration should be given to preoperative optimization via dietary and lifestyle modifications as well as intraoperative somatosensory evoked potential monitoring of the brachial plexus to decrease these risks.

  11. Geopolitics of petroleum. A new market. New risks. New worlds

    International Nuclear Information System (INIS)

    Lestrange, C. de; Paillard, Ch.A.; Zelenko, P.

    2005-02-01

    The aim of this book is to shade light on a complex world in complete evolution, the stakes of which for today's societies being proportional to the energy and economical importance of petroleum. The big petroleum fear of consuming countries and the reactions linked with oil shocks are now old stories. The producing countries are today at least as vulnerable to price variations and fluxes restrictions as the consumers of developed countries. Two countries, USA and Saudi Arabia, and one organisation, the OPEC, play a key role in the regulation of this system, the equilibrium of which is now threatened by the reinforcement of preoccupations like environment and human rights protection. New challenges occur: the increase of demand, the concentration of offer, some technological changes that would limit the petroleum needs in the future, and the increasing insecurity of key oil-producing regions. At a shorter term, the geopolitical context of Middle-East is the most worrying. (J.S.)

  12. Child Development in a Changing World : Risks and Opportunities

    OpenAIRE

    Boyden, Jo; Dercon, Stefan; Singh, Abhijeet

    2015-01-01

    This review explores current understandings of child development and the consequences for children of risk exposure in low- and middle-income countries by integrating empirical evidence from development economics with insights from allied social science disciplines. It provides a holistic perspective that highlights the synergies between children's developmental domains, drawing particular attention to dimensions such as self-efficacy, self-esteem and aspirations, which have had only limited ...

  13. A water risk index for portfolio exposure to climatic extremes: conceptualization and an application to the mining industry

    Science.gov (United States)

    Bonnafous, Luc; Lall, Upmanu; Siegel, Jason

    2017-04-01

    Corporations, industries and non-governmental organizations have become increasingly concerned with growing water risks in many parts of the world. Most of the focus has been on water scarcity and competition for the resource between agriculture, urban users, ecology and industry. However, water risks are multi-dimensional. Water-related hazards include flooding due to extreme rainfall, persistent drought and pollution, either due to industrial operations themselves, or to the failure of infrastructure. Most companies have risk management plans at each operational location to address these risks to a certain design level. The residual risk may or may not be managed, and is typically not quantified at a portfolio scale, i.e. across many sites. Given that climate is the driver of many of these extreme events, and there is evidence of quasi-periodic climate regimes at inter-annual and decadal timescales, it is possible that a portfolio is subject to persistent, multi-year exceedances of the design level. In other words, for a multi-national corporation, it is possible that there is correlation in the climate-induced portfolio water risk across its operational sites as multiple sites may experience a hazard beyond the design level in a given year. Therefore, from an investor's perspective, a need exists for a water risk index that allows for an exploration of the possible space and/or time clustering in exposure across many sites contained in a portfolio. This paper represents a first attempt to develop an index for financial exposure of a geographically diversified, global portfolio to the time-varying risk of climatic extremes using long daily global rainfall datasets derived from climate re-analysis models. Focusing on extreme daily rainfall amounts and using examples from major mining companies, we illustrate how the index can be developed. We discuss how companies can use it to explore their corporate exposure, and what they may need to disclose to investors and

  14. Is “economic freedom” the same as free market capitalism? A decompositional analysis of the Economic Freedom of the World index.

    OpenAIRE

    Cohen, Joseph N

    2011-01-01

    The Frasier Institute’s Economic Freedom of the World is often taken as a metric of market capitalism, and relationships between the index and macroeconomic outcomes are presented as signaling the consequences of free markets. This paper warns analysts that the index may be conflating three distinct concepts: free markets, good governance and price stability. Analysts should remain cognizant of this conceptual conflation when using the index to develop policy prescriptions.

  15. [Application of occupational hazard risk index model in occupational health risk assessment in a decorative coating manufacturing enterprises].

    Science.gov (United States)

    He, P L; Zhao, C X; Dong, Q Y; Hao, S B; Xu, P; Zhang, J; Li, J G

    2018-01-20

    Objective: To evaluate the occupational health risk of decorative coating manufacturing enterprises and to explore the applicability of occupational hazard risk index model in the health risk assessment, so as to provide basis for the health management of enterprises. Methods: A decorative coating manufacturing enterprise in Hebei Province was chosen as research object, following the types of occupational hazards and contact patterns, the occupational hazard risk index model was used to evaluate occupational health risk factors of occupational hazards in the key positions of the decorative coating manufacturing enterprise, and measured with workplace test results and occupational health examination. Results: The positions of oily painters, water-borne painters, filling workers and packers who contacted noise were moderate harm. And positions of color workers who contacted chromic acid salts, oily painters who contacted butyl acetate were mild harm. Other positions were harmless. The abnormal rate of contacting noise in physical examination results was 6.25%, and the abnormality was not checked by other risk factors. Conclusion: The occupational hazard risk index model can be used in the occupational health risk assessment of decorative coating manufacturing enterprises, and noise was the key harzard among occupational harzards in this enterprise.

  16. ENSO-Based Index Insurance: Approach and Peru Flood Risk Management Application

    Science.gov (United States)

    Khalil, A. F.; Kwon, H.; Lall, U.; Miranda, M. J.; Skees, J. R.

    2006-12-01

    Index insurance has recently been advocated as a useful risk transfer tool for disaster management situations where rapid fiscal relief is desirable, and where estimating insured losses may be difficult, time consuming, or subject to manipulation and falsification. For climate related hazards, a rainfall or temperature index may be proposed. However, rainfall may be highly spatially variable relative to the gauge network, and in many locations data are inadequate to develop an index due to short time-series and the spatial dispersion of stations. In such cases, it may be helpful to consider a climate proxy index as a regional rainfall index. This is particularly useful if a long record is available for the climate index through an independent source and it is well correlated with the regional rainfall hazard. Here, ENSO related climate indices are explored for use as a proxy to extreme rainfall in one of the departments of Peru -- Piura. The ENSO index insurance product may be purchased by banks or microfinance institutions (MFIs) to aid agricultural damage relief in Peru. Crop losses in the region are highly correlated with floods, but are difficult to assess directly. Beyond agriculture, many other sectors suffer as well. Basic infrastructure is destroyed during the most severe events. This disrupts trade for many micro-enterprises. The reliability and quality of the local rainfall data is variable. Averaging the financial risk across the region is desirable. Some issues with the implementation of the proxy ENSO index are identified and discussed. Specifically, we explore (a) the reliability of the index at different levels of probability of exceedance of maximum seasonal rainfall; (b) the potential for clustering of payoffs; (c) the potential that the index could be predicted with some lead time prior to the flood season; and (d) evidence for climate change or non-stationarity in the flood exceedance probability from the long ENSO record. Finally, prospects for

  17. Risk analysis and the law: international law, the World Trade Organization, Codex Alimentarius and national legislation.

    Science.gov (United States)

    Horton, L R

    2001-12-01

    This paper discusses the place of risk analysis in international trade from a US perspective, through looking at the activities of the World Trade Organization and the Codex Alimentarius Commission. After examining what the trade agreements say about risk analysis and how international bodies are advancing and using risk analysis, the paper goes on to assess how risk analysis is used at a national level. Finally, recommendations are made for strengthening international food safety initiatives.

  18. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study.

    Science.gov (United States)

    Buckland, G; Travier, N; Huerta, J M; Bueno-de-Mesquita, H B As; Siersema, P D; Skeie, G; Weiderpass, E; Engeset, D; Ericson, U; Ohlsson, B; Agudo, A; Romieu, I; Ferrari, P; Freisling, H; Colorado-Yohar, S; Li, K; Kaaks, R; Pala, V; Cross, A J; Riboli, E; Trichopoulou, A; Lagiou, P; Bamia, C; Boutron-Ruault, M C; Fagherazzi, G; Dartois, L; May, A M; Peeters, P H; Panico, S; Johansson, M; Wallner, B; Palli, D; Key, T J; Khaw, K T; Ardanaz, E; Overvad, K; Tjønneland, A; Dorronsoro, M; Sánchez, M J; Quirós, J R; Naccarati, A; Tumino, R; Boeing, H; Gonzalez, C A

    2015-08-01

    Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behaviors on GC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The analysis included 461,550 participants (662 first incident GC cases) with a mean follow-up of 11.4 years. A healthy lifestyle index was constructed, assigning 1 point for each healthy behavior related to smoking status, alcohol consumption and diet quality (represented by the Mediterranean diet) for assessing overall GC and also body mass index for cardia GC and 0 points otherwise. Risk of GC was calculated using Cox proportional hazards regression models while adjusting for relevant confounders. The highest versus lowest score in the healthy lifestyle index was associated with a significant lower risk of GC, by 51% overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23 95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32, 0.87), p-trendshealthy lifestyle behaviors of this index. Adopting several healthy lifestyle behaviors including not smoking, limiting alcohol consumption, eating a healthy diet and maintaining a normal weight is associated with a large decreased risk of GC. © 2014 UICC.

  19. [Development of a portable fall risk index for elderly people living in the community].

    Science.gov (United States)

    Toba, Kenji; Okochi, Jiro; Takahashi, Tai; Matsubayashi, Kozo; Nishinaga, Masanori; Yamada, Shizuru; Takahashi, Ryutaro; Nishijima, Reiko; Kobayashi, Yoshio; Machida, Ayako; Akishita, Masahiro; Sasaki, Hidetada

    2005-05-01

    To develop a portable risk index for falls. Risk factors were chosen from previously established factors then we added several environmental factors to the risk index; previous falls in the last 12 month, trippig or stumbling, inability to ascend or descend stairs without help, decreased walking speed, inability to cross a road within the green signal interval, inability to walk 1km without a break, inability to stand on one leg for 5 seconds (eyes open), using a cane, inability to wring out a towel, dizziness or faintness, stooped or rounded back, knee joint pain, visual disturbance, hearing disturbance, cognitive decline, fear of falling, receiving 5 or more prescribed drugs, sensation of darkness at home, obstacles inside, barrier on the carpet or floor, using steps daily at home, steep slopes around home. The questionnaire sheet was completed by 2,439 community-dwelling elderly subjects (76.3 +/- 7.4 years old). The frequency of each items of fall risk index was compared between fallers (history of fall within one year) and non-fallers. Multiple regression analysis was performed to identify independent risk factors for previous falls. Except barrier, step use and steep slope around home, all items in the fall risk index were more frequent in fallers. Multivariate analysis revealed that tripping or stumbling, inability to cross a road within the green signal interval, dizziness or faintness, obstacles inside, inability to wring out a towel, cane use and knee joint pain were independent risk factors for previous falls. These 7 selected items were further analyzed as predictors. The maximum sum of sensitivity and specificity was reached at the cut-off point of 2/3 (sensitivity 0.65, specificity 0.72) by receiver operating curve. Portable fall risk index is useful for clinical settings to identify high-risk subjects.

  20. Association of waist circumference, body mass index and conicity index with cardiovascular risk factors in postmenopausal women.

    Science.gov (United States)

    Shidfar, Farzad; Alborzi, Fatemeh; Salehi, Maryam; Nojomi, Marzieh

    2012-09-01

    In menopause, changes in body fat distribution lead to increasing risk of cardiovascular disease and metabolic disorders. The aim of this study was to assess the association of adiposity using the conicity index (CI), body mass index (BMI) and waist circumference (WC) with cardiovascular risk factors (hypertension, diabetes and dyslipidaemia). The sample of this cross-sectional study was collected from June to October 2010 and 165 consecutive menopausal women who had attended the Health and Treatment Centre and Endocrine Research Centre of Firoozgar Hospital in Tehran, Iran were assessed. Age, weight, height, WC, waist-hip ratio (WHR), CI and fat mass were measured. Systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose, insulin, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) levels were also determined. All statistical analyses were performed by SPSS version 17 (SPSS Inc, Chicago, IL, USA). Results showed that BMI was positively and significantly associated with SBP (r = 0.21; p = 0.009). WC was positively and significantly correlated with SBP (r = 0.26; p = 0.02) and DBP (r = 0.16; p = 0.05). WHR was also significantly and positively associated with SBP (r = 0.29; p = 0.001). Age and WC were associated with CI quartiles at the 0.05 significance level. The correlation of CI quartiles with SBP and weight were at the 0.01 significance level. We showed a significant association of WC with SBP and DBP, and that BMI could be an important determining factor of SBP. For assessing the association between CI and cardiovascular risk factors, future studies with larger sample sizes are recommended.

  1. Extinction risk and conservation of the world's sharks and rays

    OpenAIRE

    Dulvy, Nicholas K.; Fowler, Sarah L.; Musick, John A.; Cavanagh, Rachel D.; Kyne, Peter M.; Harrison, Lucy R.; Carlson, John K.; Davidson, Lindsay N. K.; Fordham, Sonja V.; Francis, Malcolm P.; Pollock, Caroline M.; Simpfendorfer, Colin A.; Burgess, George H.; Carpenter, Kent E.; Compagno, Leonard J. V.

    2013-01-01

    eLife digest Ocean ecosystems are under pressure from overfishing, climate change, habitat destruction and pollution. These pressures have led to documented declines of some fishes in some places, such as those living in coral reefs and on the high seas. However, it is not clear whether these population declines are isolated one-off examples or, instead, if they are sufficiently widespread to risk the extinction of large numbers of species. Most fishes have a skeleton that is made of bone, bu...

  2. Temporal constraints on predation risk assessment in a changing world

    International Nuclear Information System (INIS)

    Chivers, Douglas P.; Ramasamy, Ryan A.; McCormick, Mark I.; Watson, Sue-Ann; Siebeck, Ulrike E.; Ferrari, Maud C.O.

    2014-01-01

    Habitat degradation takes various forms and likely represents the most significant threat to our global biodiversity. Recently, we have seen considerable attention paid to increasing global CO 2 emissions which lead to ocean acidification (OA). Other stressors, such as changing levels of ultraviolet radiation (UVR), also impact biodiversity but have received much less attention in the recent past. Here we examine fundamental questions about temporal aspects of risk assessment by coral reef damselfish and provide critical insights into how OA and UVR influence this assessment. Chemical cues released during a predator attack provide a rich source of information that other prey animals use to mediate their risk of predation and are the basis of the majority of trait-mediated indirect interactions in aquatic communities. However, we have surprisingly limited information about temporal aspects of risk assessment because we lack knowledge about how long chemical cues persist after they are released into the environment. Here, we showed that under ambient CO 2 conditions (∼ 385 μatm), alarm cues of ambon damselfish (Pomacentrus amboinensis) did not degrade within 30 min in the absence of ultraviolet radiation (UVR), but were degraded within 15 min when the CO 2 was increased to ∼ 905 μatm. In experiments that used filters to eliminate UVR, we found minimal degradation of alarm cues within 30 min, whereas under ambient UVR conditions, alarm cues were completely degraded within 15 min. Moreover, in the presence of both UVR and elevated CO 2 , alarm cues were broken down within 5 min. Our results highlight that alarm cues degrade surprisingly quickly under natural conditions and that anthropogenic changes have the potential to dramatically change rates of cue degradation in the wild. This has considerable implications for risk assessment and consequently the importance of trait-mediated indirect interactions in coral-reef communities. - Highlights: • We have limited

  3. Temporal constraints on predation risk assessment in a changing world

    Energy Technology Data Exchange (ETDEWEB)

    Chivers, Douglas P., E-mail: doug.chivers@usask.ca [Department of Biology, University of Saskatchewan, Saskatoon, SK S7N 5E2 (Canada); Ramasamy, Ryan A.; McCormick, Mark I.; Watson, Sue-Ann [ARC Centre of Excellence for Coral Reef Studies, James Cook University, Townsville Qld4811 (Australia); School of Marine and Tropical Biology, James Cook University, Townsville Qld4811 (Australia); Siebeck, Ulrike E. [School of Biomedical Sciences, University of Queensland, Brisbane Qld4072 (Australia); Ferrari, Maud C.O. [Department of Biomedical Sciences, WCVM, University of Saskatchewan, Saskatoon, SK S7W 5B4 (Canada)

    2014-12-01

    Habitat degradation takes various forms and likely represents the most significant threat to our global biodiversity. Recently, we have seen considerable attention paid to increasing global CO{sub 2} emissions which lead to ocean acidification (OA). Other stressors, such as changing levels of ultraviolet radiation (UVR), also impact biodiversity but have received much less attention in the recent past. Here we examine fundamental questions about temporal aspects of risk assessment by coral reef damselfish and provide critical insights into how OA and UVR influence this assessment. Chemical cues released during a predator attack provide a rich source of information that other prey animals use to mediate their risk of predation and are the basis of the majority of trait-mediated indirect interactions in aquatic communities. However, we have surprisingly limited information about temporal aspects of risk assessment because we lack knowledge about how long chemical cues persist after they are released into the environment. Here, we showed that under ambient CO{sub 2} conditions (∼ 385 μatm), alarm cues of ambon damselfish (Pomacentrus amboinensis) did not degrade within 30 min in the absence of ultraviolet radiation (UVR), but were degraded within 15 min when the CO{sub 2} was increased to ∼ 905 μatm. In experiments that used filters to eliminate UVR, we found minimal degradation of alarm cues within 30 min, whereas under ambient UVR conditions, alarm cues were completely degraded within 15 min. Moreover, in the presence of both UVR and elevated CO{sub 2}, alarm cues were broken down within 5 min. Our results highlight that alarm cues degrade surprisingly quickly under natural conditions and that anthropogenic changes have the potential to dramatically change rates of cue degradation in the wild. This has considerable implications for risk assessment and consequently the importance of trait-mediated indirect interactions in coral-reef communities. - Highlights:

  4. Predictive value of body mass index to metabolic syndrome risk factors in Syrian adolescents.

    Science.gov (United States)

    Al-Bachir, Mahfouz; Bakir, Mohamad Adel

    2017-06-25

    Obesity has become a serious epidemic health problem in both developing and developed countries. There is much evidence that obesity among adolescents contributed significantly to the development of type 2 diabetes and coronary heart disease in adulthood. Very limited information exists on the prevalence of overweight, obesity, and associated metabolic risk factors among Syrian adolescents. Therefore, the purpose of this study was to determine the relationship between obesity determined by body mass index and the major metabolic risk factors among Syrian adolescents. A cross-sectional study of a randomly selected sample of 2064 apparently healthy Syrian adolescents aged 18 to 19 years from Damascus city, in Syria, was performed. Body mass index and blood pressure were measured. Serum concentrations of glucose, triglycerides, total cholesterol, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol were determined. Metabolic syndrome was defined using the national criteria for each determined metabolic risk factor. Individuals with a body mass index 25 to 29.9 were classified as overweight, whereas individuals with a body mass index ≥30 were classified as obese. A receiver operating characteristics curve was drawn to determine appropriate cut-off points of the body mass index for defining overweight and obesity, and to indicate the performance of body mass index as a predictor of risk factors. The obtained data showed that blood pressure and the overall mean concentrations of fasting blood sugar, triglycerides, cholesterol, low-density lipoprotein-cholesterol, and triglycerides/high-density lipoprotein-cholesterol were significantly higher in overweight and obese adolescent groups (p index and some metabolic risks, the data suggest the best body mass index cut-offs ranged between 23.25 and 24.35 kg/m 2 . A strong association between overweight and obesity as determined by body mass index and high concentrations of metabolic syndrome

  5. Rainfall Intensity and Frequency Explain Production Basis Risk in Cumulative Rain Index Insurance

    Science.gov (United States)

    Muneepeerakul, Chitsomanus P.; Muneepeerakul, Rachata; Huffaker, Ray G.

    2017-12-01

    With minimal moral hazard and adverse selection, weather index insurance promises financial resilience to farmers struck by harsh weather conditions through swift compensation at affordable premium. Despite these advantages, the very nature of indexing gives rise to production basis risk as the selected weather indexes do not sufficiently correspond to actual damages. To address this problem, we develop a stochastic yield model, built upon a stochastic soil moisture model driven by marked Poisson rainfall. Our analysis shows that even under similar temperature and rainfall amount yields can differ significantly; this was empirically supported by a 2-year field experiment in which rain-fed maize was grown under very similar total rainfall. Here, the year with more intense, less-frequent rainfall produces a better yield—a rare counter evidence to most climate change projections. Through a stochastic yield model, we demonstrate the crucial roles of rainfall intensity and frequency in determining the yield. Importantly, the model allows us to compute rainfall pattern-related basis risk inherent in cumulative rain index insurance. The model results and a case study herein clearly show that total rainfall is a poor indicator of yield, imposing unnecessary production basis risk on farmers and false-positive payouts on insurers. Incorporating rainfall intensity and frequency in the design of rain index insurance can offer farmers better protection, while maintaining the attractive features of the weather index insurance and thus fulfilling its promise of financial resilience.

  6. Business risk assessment of the companies on the Mexican Stock Exchange’s sustainable index

    Directory of Open Access Journals (Sweden)

    José Antonio Morales Castro

    2014-12-01

    Full Text Available (Received: 2014/10/27 - Accepted: 2014/12/15This work evaluated the business risk change of 20 companies included on the sustainable index of the Mexican Stock Exchange (BMV. The unlevered beta coefficient was used for this analysis. Two periods were compared: the one before, and the one after including the companies on the index. For each of the 20 companies it was used financial information, stocks closing prices and the stock market index value, over a period of 234 weeks. Then, considering the two periods, the statistical difference between the unlevered beta coefficient averages was calculated. Finally, a hypothesis proof was made to evaluate the business risk change. It was found that for 12 out of the 20 companies, the unlevered beta coefficient suffered a reduction. The findings suggest that it is not enough for the companies to certify as sustainable in order to reduce its business risk.

  7. The c-index is not proper for the evaluation of $t$-year predicted risks.

    Science.gov (United States)

    Blanche, Paul; Kattan, Michael W; Gerds, Thomas A

    2018-02-16

    We show that the widely used concordance index for time to event outcome is not proper when interest is in predicting a $t$-year risk of an event, for example 10-year mortality. In the situation with a fixed prediction horizon, the concordance index can be higher for a misspecified model than for a correctly specified model. Impropriety happens because the concordance index assesses the order of the event times and not the order of the event status at the prediction horizon. The time-dependent area under the receiver operating characteristic curve does not have this problem and is proper in this context.

  8. Vulnerability Risk Index Profile for Elder Abuse in Community-Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.

    2013-01-01

    Objectives Elder abuse is associated with increased morbidity and mortality. This study aims to develop a vulnerability index for elder abuse in a community-dwelling population. Design Population-based study Setting Geographically defined community in Chicago. Participants A population-based study was conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 8,157 participants in the CHAP study, 213 participants were reported to social services agency for suspected elder abuse. Measurements A vulnerability index for elder abuse was constructed from sociodemographic, health-related, and psychosocial factors. The outcomes of interest were reported and confirmed elder abuse. Logistic regression models were used to determine the accuracy of the index with respect to elder abuse outcomes. Results Out of the selected risk index for elder abuse, every one point increase in the 9 item vulnerability index items, there was a two fold increase in the risk for reported elder abuse (OR, 2.19 (2.00–2.40) and confirmed elder abuse (OR, 2.19 (1.94–2.47). Compared to the reference group, older adults with 3–4 vulnerability index items had increased risk for reported elder abuse (OR, 2.98 (1.98–4.49) and confirmed elder abuse (OR, 3.90, (2.07–7.36); and older adults with 5 or more risk index items, there was an 18 fold increase in risk for reported elder abuse (OR, 18.46 (12.15–28.04) and confirmed elder abuse (OR, 26.79 (14.18–50.61). Receiver Operating Characteristic (ROC) statistically derived curves for identifying reported elder abuse ranged between 0.77–0.84 and for predicting confirmed elder abuse ranged between 0.79–0.86. Conclusion The vulnerability risk index demonstrates value for identifying individuals at risk for elder abuse. Additional studies are needed to validate this index in other community dwelling populations. PMID:25180376

  9. Body mass index, waist circumference, body adiposity index, and risk for type 2 diabetes in two populations in Brazil: general and Amerindian.

    Directory of Open Access Journals (Sweden)

    Rafael de Oliveira Alvim

    Full Text Available The use of the anthropometric indices of adiposity, especially body mass index and waist circumference in the prediction of diabetes mellitus has been widely explored. Recently, a new body composition index, the body adiposity index was proposed. The aim of this study was to compare the effectiveness of body mass index, waist circumference, and body adiposity index in the risk assessment for type 2 diabetes mellitus.A total of 1,572 individuals from the general population of Vitoria City, Brazil and 620 Amerindians from the Aracruz Indian Reserve, Brazil were randomly selected. BMI, waist circumference, and BAI were determined according to a standard protocol. Type 2 diabetes mellitus was diagnosed by the presence of fasting glucose ≥126 mg/dL or by the use of antidiabetic drugs.The area under the curve was similar for all anthropometric indices tested in the Amerindian population, but with very different sensitivities or specificities. In women from the general population, the area under the curve of waist circumference was significantly higher than that of the body adiposity index. Regarding risk assessment for type 2 diabetes mellitus, the body adiposity index was a better risk predictor than body mass index and waist circumference in the Amerindian population and was the index with highest odds ratio for type 2 diabetes mellitus in men from the general population, while in women from the general population waist circumference was the best risk predictor.Body adiposity index was the best risk predictor for type 2 diabetes mellitus in the Amerindian population and men from the general population. Our data suggest that the body adiposity index is a useful tool for the risk assessment of type 2 diabetes mellitus in admixture populations.

  10. Discontinuation risk comparison among 'real-world' newly anticoagulated atrial fibrillation patients

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Pan, Xianying; Kamble, Shital

    2018-01-01

    Discontinuation of oral anticoagulants may expose non-valvular atrial fibrillation (NVAF) patients to an increased risk of stroke. This study describes the real-world discontinuation rates and compared the risk of drug discontinuation among NVAF patients initiating apixaban, warfarin, dabigatran,...

  11. Development of a risk index for the prediction of chronic post-surgical pain.

    Science.gov (United States)

    Althaus, A; Hinrichs-Rocker, A; Chapman, R; Arránz Becker, O; Lefering, R; Simanski, C; Weber, F; Moser, K-H; Joppich, R; Trojan, S; Gutzeit, N; Neugebauer, E

    2012-07-01

    The incidence of chronic post-surgical pain (CPSP) after various common operations is 10% to 50%. Identification of patients at risk of developing chronic pain, and the management and prevention of CPSP remains inadequate. The aim of this study was to develop an easily applicable risk index for the detection of high-risk patients that takes into account the multifactorial aetiology of CPSP. A comprehensive item pool was derived from a systematic literature search. Items that turned out significant in bivariate analyses were then analysed multivariately, using logistic regression analyses. The items that yielded significant predictors in the multivariate analyses were compiled into an index. The cut-off score for a high risk of developing CPSP with an optimal trade-off between sensitivity and specificity was identified. The data of 150 patients who underwent different types of surgery were included in the analyses. Six months after surgery, 43.3% of the patients reported CPSP. Five predictors multivariately contributed to the prediction of CPSP: capacity overload, preoperative pain in the operating field, other chronic preoperative pain, post-surgical acute pain and co-morbid stress symptoms. These results suggest that several easily assessable preoperative and perioperative patient characteristics can predict a patient's risk of developing CPSP. The risk index may help caregivers to tailor individual pain management and to assist high-risk patients with pain coping. © 2011 European Federation of International Association for the Study of Pain Chapters.

  12. Currency risk management of non-financial public limited companies listed on WIG30 index

    Directory of Open Access Journals (Sweden)

    Alicja Mikołajewicz-Woźniak

    2013-12-01

    Full Text Available The objects of the study are selected aspects of currency risk management of nonfinancial public limited companies listed on WIG30 index. The estimation of net profit sensitivity to currencies exchange rates was used to determine importance of currency risk management for functioning of analyzed entities. The indication of the methods and tools used in currency risk management process became the basis for evaluation of taken actions. The determination of the relationship between hedging accounting and risk management results enabled the verification to what extent Polish companies exploit existing opportunities.

  13. Comparison between frailty index of deficit accumulation and fracture risk assessment tool (FRAX) in prediction of risk of fractures.

    Science.gov (United States)

    Li, Guowei; Thabane, Lehana; Papaioannou, Alexandra; Adachi, Jonathan D

    2015-08-01

    A frailty index (FI) of deficit accumulation could quantify and predict the risk of fractures based on the degree of frailty in the elderly. We aimed to compare the predictive powers between the FI and the fracture risk assessment tool (FRAX) in predicting risk of major osteoporotic fracture (hip, upper arm or shoulder, spine, or wrist) and hip fracture, using the data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) 3-year Hamilton cohort. There were 3985 women included in the study, with the mean age of 69.4 years (standard deviation [SD] = 8.89). During the follow-up, there were 149 (3.98%) incident major osteoporotic fractures and 18 (0.48%) hip fractures reported. The FRAX and FI were significantly related to each other. Both FRAX and FI significantly predicted risk of major osteoporotic fracture, with a hazard ratio (HR) of 1.03 (95% confidence interval [CI]: 1.02-1.05) and 1.02 (95% CI: 1.01-1.04) for per-0.01 increment for the FRAX and FI respectively. The HRs were 1.37 (95% CI: 1.19-1.58) and 1.26 (95% CI: 1.12-1.42) for an increase of per-0.10 (approximately one SD) in the FRAX and FI respectively. Similar discriminative ability of the models was found: c-index = 0.62 for the FRAX and c-index = 0.61 for the FI. When cut-points were chosen to trichotomize participants into low-risk, medium-risk and high-risk groups, a significant increase in fracture risk was found in the high-risk group (HR = 2.04, 95% CI: 1.36-3.07) but not in the medium-risk group (HR = 1.23, 95% CI: 0.82-1.84) compared with the low-risk women for the FI, while for FRAX the medium-risk (HR = 2.00, 95% CI: 1.09-3.68) and high-risk groups (HR = 2.61, 95% CI: 1.48-4.58) predicted risk of major osteoporotic fracture significantly only when survival time exceeded 18months (550 days). Similar findings were observed for hip fracture and in sensitivity analyses. In conclusion, the FI is comparable with FRAX in the prediction of risk of future fractures, indicating that

  14. A partner-related risk behavior index to identify people at elevated risk for sexually transmitted infections.

    Science.gov (United States)

    Crosby, Richard; Shrier, Lydia A

    2013-04-01

    The purpose of this study was to develop and test a sexual-partner-related risk behavior index to identify high-risk individuals most likely to have a sexually transmitted infection (STI). Patients from five STI and adolescent medical clinics in three US cities were recruited (N = 928; M age = 29.2 years). Data were collected using audio-computer-assisted self-interviewing. Of seven sexual-partner-related variables, those that were significantly associated with the outcomes were combined into a partner-related risk behavior index. The dependent variables were laboratory-confirmed infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and/or Trichomonas vaginalis. Nearly one-fifth of the sample (169/928; 18.4%) tested positive for an STI. Three of the seven items were significantly associated with having one or more STIs: sex with a newly released prisoner, sex with a person known or suspected of having an STI, and sexual concurrency. In combined form, this three-item index was significantly associated with STI prevalence (p one or more of three STIs. This index could be used to prioritize and guide intensified clinic-based counseling for high-risk patients of STI and other clinics.

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

    OpenAIRE

    Olan T. Henry; Nilss Olekalns; Kalvinder Shields

    2004-01-01

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

  16. A novel index for quantifying the risk of early complications for patients undergoing cervical spine surgeries.

    Science.gov (United States)

    Passias, Peter G; Diebo, Bassel G; Marascalchi, Bryan J; Jalai, Cyrus M; Horn, Samantha R; Zhou, Peter L; Paltoo, Karen; Bono, Olivia J; Worley, Nancy; Poorman, Gregory W; Challier, Vincent; Dixit, Anant; Paulino, Carl; Lafage, Virginie

    2017-11-01

    OBJECTIVE It is becoming increasingly necessary for surgeons to provide evidence supporting cost-effectiveness of surgical treatment for cervical spine pathology. Anticipating surgical risk is critical in accurately evaluating the risk/benefit balance of such treatment. Determining the risk and cost-effectiveness of surgery, complications, revision procedures, and mortality rates are the most significant limitations. The purpose of this study was to determine independent risk factors for medical complications (MCs), surgical complications (SCs), revisions, and mortality rates following surgery for patients with cervical spine pathology. The most relevant risk factors were used to structure an index that will help quantify risk and anticipate failure for such procedures. METHODS The authors of this study performed a retrospective review of the National Inpatient Sample (NIS) database for patients treated surgically for cervical spine pathology between 2001 and 2010. Multivariate models were performed to calculate the odds ratio (OR) of the independent risk factors that led to MCs and repeated for SCs, revisions, and mortality. The models controlled for age ( 65 years old), sex, race, revision status (except for revision analysis), surgical approach, number of levels fused/re-fused (2-3, 4-8, ≥ 9), and osteotomy utilization. ORs were weighted based on their predictive category: 2 times for revision surgery predictors and 4 times for mortality predictors. Fifty points were distributed among the predictors based on their cumulative OR to establish a risk index. RESULTS Discharges for 362,989 patients with cervical spine pathology were identified. The mean age was 52.65 years, and 49.47% of patients were women. Independent risk factors included medical comorbidities, surgical parameters, and demographic factors. Medical comorbidities included the following: pulmonary circulation disorder, coagulopathy, metastatic cancer, renal failure, congestive heart failure

  17. Competitive electricity markets around the world: approaches to price risk management

    International Nuclear Information System (INIS)

    Masson, G.S.

    1999-01-01

    This chapter focuses on wholesale electricity markets, and traces the histories of the US and UK power industries. Risk management in the new electricity market is examined covering price risk, location basis risk, volume risk, and margin and cross-commodity risk. Specific competitive market systems that have been implemented around the world including mandatory pools, voluntary pools, and bilateral markets are discussed. Panels describing the functions of ancillary services, electricity price volatility, and the problems of capacity payments and the UK pool are presented

  18. THE ASSESSMENT OF LIFE STYLE AND THE VISCERAL ADIPOSITY INDEX AS CARDIOMETABOLIC RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Sigina R. GÂRGAVU

    2018-06-01

    Full Text Available Introduction. The patients with cardiometabolic/ cardiovascular risk are commonly found in clinics and ambulatory clinics. The cardiovascular (CV or cardiometabolic (CM risk factors and biomarkers are certain characteristics of the person without CV disease, which are independently correlated with the subsequent occurrence of CV disease, without necessarily having a causal relationship between factor and disease. The visceral adiposity index (VAI indicates the function of visceral adipose tissue and its growth is independently correlated with cardiovascular and cerebrovascular risk. The objective of the study was to evaluate the lifestyle and visceral adiposity index as possible cardiometabolic risk factors in patients with diabetes, prediabetes, and in the general population. Methods. The study was epidemiological, transversal, noninterventional, and was performed by analyzing 300 subjects, divided into three groups: group 1 (100 patients with type 2 diabetes, group 2 (100 pre-diabetic patients, and group 3 (control consisting of 100 individuals randomly recruited without diabetes. Results. The accumulation of cardiovascular risk factors results is an increased risk of cardiovascular disease. We found statistically significant differences between the three groups in terms of BMI, CT, VAI, CT, HDL-c and LDL-c values, which were higher in patients with diabetes mellitus (DM than in prediabetics or in the general population, which also coincided with higher cardiovascular risk in these patients. Conclusions. We emphasize the importance of both early cardiovascular risk assessment and the importance of controlling cardiovascular risk factors, both by non-pharmacological methods, and by associating early drug therapy when necessary.

  19. A new index of risks for lethal diseases by ionizing radiation

    International Nuclear Information System (INIS)

    Sato, Fumiaki; Higuti, Isao.

    1979-01-01

    Estimates of the somatic risk of radiation exposure have mainly been based on the incidence of fatal cancers. An improvement on the estimates of the risk will be made by taking mean ages at deaths into consideration in addition to the incidence of cancer. The authors report on an index of contribution of each cause of death to life shortening. The index is the sum of three terms. The first term indicates a contribution of change in incidence and the second term indicates that of changes in mean age at death from the cause of death in question. The last term is an interaction term of the two factors mentioned above. If a radiation exposure increases incidence of a cause of death and shortens the mean age at death from the cause of death, the index gives a large positive value. On the other hand, an increase in incidence of a late occurring cause of death will bring about a small positive or sometimes negative value for the index. The index proposed here will be promising in estimating risks by ionizing radiation. (author)

  20. Italian Mediterranean Index and risk of colorectal cancer in the Italian section of the EPIC cohort.

    Science.gov (United States)

    Agnoli, Claudia; Grioni, Sara; Sieri, Sabina; Palli, Domenico; Masala, Giovanna; Sacerdote, Carlotta; Vineis, Paolo; Tumino, Rosario; Giurdanella, Maria Concetta; Pala, Valeria; Berrino, Franco; Mattiello, Amalia; Panico, Salvatore; Krogh, Vittorio

    2013-03-15

    Colorectal cancer is among the commonest cancers worldwide. Dietary factors have been linked to colorectal cancer risk, however, few studies have evaluated the relationship between a priori dietary patterns and colorectal cancer risk. We evaluated the effect of adherence to a Mediterranean dietary pattern, as measured by the Italian Mediterranean Index, on the risk of colorectal cancer in the 45,275 participants of the Italian section of the EPIC study who completed a dietary questionnaire. Hazard ratios (HRs) with 95% confidence intervals (CIs) for colorectal cancer in relation to categories of Italian Mediterranean Index score were estimated by multivariate Cox models adjusted for known risk factors, on the whole cohort, on men and women and according to cancer subsite. During a mean follow-up of 11.28 years, 435 colorectal cancer cases were identified. The Italian Mediterranean Index was inversely associated with colorectal cancer risk (HR: 0.50; 95% CI: 0.35-0.71 for the highest category compared to the lowest, P-trend: 0.043). Results did not differ by sex. Highest Italian Mediterranean Index score was also significantly associated with reduced risks of any colon cancer (HR: 0.54, 95% CI: 0.36-0.81), distal colon cancer (HR: 0.44, 95% CI: 0.26-0.75) and rectal cancer (HR: 0.41, 95% CI: 0.20-0.81), but not of proximal colon cancer. These findings suggest that adherence to a Mediterranean diet (as measured by the Italian Mediterranean Index) protects against colorectal cancer in general but not against cancer developing in the proximal colon. Copyright © 2012 UICC.

  1. [Diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours].

    Science.gov (United States)

    Treviño-Báez, Joaquín Darío; Cantú-Cruz, Javier Alejandro; Medina-Mercado, Javier; Abundis, Alberto

    2016-01-01

    The purpose of the diagnostic evaluation of adnexal tumours is to exclude the possibility of malignancy. The malignancy risk index II identifies patients at high risk for ovarian cancer. The cut-off value is greater than 200. To evaluate the diagnostic accuracy of malignancy risk index II in post-menopausal women with adnexal tumours in relation to the histopathological results. A total of 138 women with an adnexal mass were studied. The malignancy risk index II was determined in all of them. They were divided into two groups according to the histopathology results; 69 patients with benign tumours and 69 patients with malignant tumours. A diagnostic test type analysis was performed with respect to the results of malignancy risk index II ≤ 200 or greater than this. The percentages and 95% confidence intervals were calculated. The accuracy was 81.8% (75.5-88.3), sensitivity 76.8% (66.9-86.7), specificity 87% (79.1-94.9), with a positive predictive value of 85.5% (76.7-94.3), and a negative predictive value of 78.9% (69.7-88.1). The positive likelihood ratio was 590, and the negative likelihood ratio was 0.266. The malignancy risk index II has good performance in the proper classification of post-menopausal women with adnexal masses, both benign and malignant, with an accuracy of 81.8%. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  2. Innovation in drought risk management: exploring the potential of weather index insurance

    Science.gov (United States)

    Iglesias, E.; Baez, K.

    2012-04-01

    Many family farming and indigenous communities depend on grazing livestock activities and are particularly prone to drought risks. Vulnerability to drought limits the ability of these households to exit poverty and in many cases leads to environmental degradation. It is well known that uninsured exposure exacerbates income inequality in farming systems and eventually results in welfare losses for rural families. The advantages of farmers who have access to financial tools have been widely acknowledged. However, high administrative costs of traditional insurance hinder small farmers' access to risk management tools. One of the main problems in insurance design relates to the lack of quality data to estimate the risk premium. In rural areas where there are no historical records of farm production data on adverse events such as drought. New technologies such as remote sensing help to overcome this problem and generate information from these areas that otherwise would be impossible or too expensive to obtain. In this paper, we use a satellite based vegetation index (NDVI) and develop a stochastic model to analyse the potential of index insurance to address the risk of drought in Chilean grazing lands. Our results suggest that contract design is a key issue to improve the correlation of the index with individual farm losses, thus reducing basis risk. In particular, we find that the definition of homogeneous areas and the selection of the triggering index threshold are critical issues and show the incidence of different contract designs on (i) the probability that the farmer experience losses but does not receive compensation (false negative) and (ii) the probability that the index triggers compensation but the farmer does not experience drought losses (false negative). Both aspects are key issues to offer the farmer an adequate protection against droughts and guarantee the affordability of the risk premium.

  3. GLOBALISATION AND THE UNPREDICTABILITY OF CRISIS EPISODES: AN EMPIRICAL ANALYSIS OF COUNTRY RISK INDEXES

    Directory of Open Access Journals (Sweden)

    San-Martín-Albizuri, Nerea

    2012-05-01

    Full Text Available The ongoing globalisation process has not put an end to international financial crises. On the contrary, it seems to have contributed to their appearance and to accentuating their degrees of unpredictability. In this context, the main objective of the present study is to establish whether the values of the best-known and most widely used country risk indexes, namely, the Euromoney index and the International Country Risk Group (ICRG, and the values of their representative variables could have forecasted well in advance the crises that took place between 1994 and 2002, a period which is herein termed the ‘globalisation era’. The results show that, although the selected indexes and their representative variables were able to identify certain vulnerabilities, they could not accurately identify the political, economic, and/or financial factors that developed prior to these crisis episodes.

  4. Childhood body mass index and height and risk of histologic subtypes of endometrial cancer

    DEFF Research Database (Denmark)

    Aarestrup, J.; Gamborg, M.; Ulrich, L. G.

    2016-01-01

    BACKGROUND: Endometrial cancer risk factors include adult obesity and taller stature, but the influence of size earlier in life is incompletely understood. We examined whether childhood body mass index (BMI; kg m(-2)) and height were associated with histologic subtypes of endometrial cancer...

  5. Work Ability Index as Tool to Identify Workers at Risk of Premature Work Exit

    NARCIS (Netherlands)

    Roelen, Corne A. M.; Heymans, Martijn W.; Twisk, Jos W. R.; van der Klink, Jac J. L.; Groothoff, Johan W.; van Rhenen, Willem

    2014-01-01

    Purpose To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Methods Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at

  6. Flood risk index pattern assessment: case study in Langat River Basin

    African Journals Online (AJOL)

    This study focus on the creation of flood risk index in the study area based on secondary data derived from the Department of Drainage and Irrigation (DID) since 1982-2012. Based on the result, it shows that the water level is the best variable to be taken for the purposed of flood warning alert system as the result for ...

  7. Parent/Student Risk and Protective Factors in Understanding Early Adolescent's Body Mass Index

    Science.gov (United States)

    Fitzpatrick, Kevin M.; Willis, Don

    2016-01-01

    This article's aim is to examine correlates of middle school students' body mass index (BMI). Little research simultaneously has considered both child and parent correlates in predicting child's BMI; we examine the interrelationships between middle school students and their parent's risks and protective factors and their impact on the child's BMI.…

  8. Overall glycaemic index and glycaemic load of habitual diet and risk of heart disease

    DEFF Research Database (Denmark)

    Grau, Katrine; Tetens, Inge; Bjørnsbo, Kirsten S

    2011-01-01

    Objective To test the hypothesis that diets with high glycaemic index (GI) and glycaemic load (GL) increase the risk of heart disease. Design Overall GI and GL were assessed from 7 d diet records or diet history interviews. Setting Information on hospitalization and death due to CVD and CHD was o...

  9. Predicting nosocomial lower respiratory tract infections by a risk index based system

    NARCIS (Netherlands)

    Chen, Yong; Shan, Xue; Zhao, Jingya; Han, Xuelin; Tian, Shuguang; Chen, Fangyan; Su, Xueting; Sun, Yansong; Huang, Liuyu; Grundmann, Hajo; Wang, Hongyuan; Han, Li

    2017-01-01

    Although belonging to one of the most common type of nosocomial infection, there was currently no simple prediction model for lower respiratory tract infections (LRTIs). This study aims to develop a risk index based system for predicting nosocomial LRTIs based on data from a large point-prevalence

  10. Work ability index as tool to identify workers at risk of premature work exit

    NARCIS (Netherlands)

    Roelen, C.A.M.; Heymans, M.W.; Twisk, J.W.R.; van der Klink, J.J.L.; Groothoff, J.W.; van Rhenen, W.

    2014-01-01

    Purpose To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Methods Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at

  11. Generation of a landslide risk index map for Cuba using spatial multi-criteria evaluation

    NARCIS (Netherlands)

    Castellanos Abella, E.A.

    2007-01-01

    his paper explains the procedure for the generation of a landslide risk index map at national level in Cuba, using a semiquantitative model with ten indicator maps and a cell size of 90× 90 m. The model was designed and implemented using spatial multi-criteria evaluation techniques in a GIS system.

  12. The Aggregate Risk Index: An intuitive tool providing the health risks of air pollution to health care community and public

    Science.gov (United States)

    Sicard, Pierre; Talbot, Charles; Lesne, Olivia; Mangin, Antoine; Alexandre, Nicolas; Collomp, Rémy

    2012-01-01

    In the framework of the European project PASODOBLE (FP7), we set up downstream information services by combining environmental and health data with a view to support the health care community and to improve vulnerable people welfare. Indeed there is a profound relationship between human health, well-being and air pollution levels. The main objectives are to establish correlations between air quality, exposure of populations and their reactivity, to develop and validate air quality indexes and to construct a prediction model of this sanitary index. This index will be implemented on 3 European sites: Greece (Athens and Thessaloniki), the Netherlands and "Provence Alpes Côte d'Azur" (South East of France). The selected region and cities are among the most affected by the atmospheric pollution in Europe and leads to serious sanitary concerns. The service aims to provide up-to-date, detailed information on air quality discomfort. The Aggregate Risk Index is based on the Cairncross's concept, obtained from the Relative Risk associated with short-term exposure to common air pollutants and takes into account the possible effects of a mixture of pollutants. This communication tool, easy to use and intuitive, about the levels of air pollution and the associated health risks, will be used to communicate information to the general population, authorities and to the health care community and will provide advanced warning of potentially health-damaging air pollution events.

  13. A Risk Prediction Index for Advanced Colorectal Neoplasia at Screening Colonoscopy.

    Science.gov (United States)

    Schroy, Paul C; Wong, John B; O'Brien, Michael J; Chen, Clara A; Griffith, John L

    2015-07-01

    Eliciting patient preferences within the context of shared decision making has been advocated for colorectal cancer screening. Risk stratification for advanced colorectal neoplasia (ACN) might facilitate more effective shared decision making when selecting an appropriate screening option. Our objective was to develop and validate a clinical index for estimating the probability of ACN at screening colonoscopy. We conducted a cross-sectional analysis of 3,543 asymptomatic, mostly average-risk patients 50-79 years of age undergoing screening colonoscopy at two urban safety net hospitals. Predictors of ACN were identified using multiple logistic regression. Model performance was internally validated using bootstrapping methods. The final index consisted of five independent predictors of risk (age, smoking, alcohol intake, height, and a combined sex/race/ethnicity variable). Smoking was the strongest predictor (net reclassification improvement (NRI), 8.4%) and height the weakest (NRI, 1.5%). Using a simplified weighted scoring system based on 0.5 increments of the adjusted odds ratio, the risk of ACN ranged from 3.2% (95% confidence interval (CI), 2.6-3.9) for the low-risk group (score ≤2) to 8.6% (95% CI, 7.4-9.7) for the intermediate/high-risk group (score 3-11). The model had moderate to good overall discrimination (C-statistic, 0.69; 95% CI, 0.66-0.72) and good calibration (P=0.73-0.93). A simple 5-item risk index based on readily available clinical data accurately stratifies average-risk patients into low- and intermediate/high-risk categories for ACN at screening colonoscopy. Uptake into clinical practice could facilitate more effective shared decision-making for CRC screening, particularly in situations where patient and provider test preferences differ.

  14. Assessing and managing multiple risks in a changing world-The Roskilde recommendations.

    Science.gov (United States)

    Selck, Henriette; Adamsen, Peter B; Backhaus, Thomas; Banta, Gary T; Bruce, Peter K H; Burton, G Allen; Butts, Michael B; Boegh, Eva; Clague, John J; Dinh, Khuong V; Doorn, Neelke; Gunnarsson, Jonas S; Hauggaard-Nielsen, Henrik; Hazlerigg, Charles; Hunka, Agnieszka D; Jensen, John; Lin, Yan; Loureiro, Susana; Miraglia, Simona; Munns, Wayne R; Nadim, Farrokh; Palmqvist, Annemette; Rämö, Robert A; Seaby, Lauren P; Syberg, Kristian; Tangaa, Stine R; Thit, Amalie; Windfeld, Ronja; Zalewski, Maciej; Chapman, Peter M

    2017-01-01

    Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk-Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological context for assessments in human-modified systems; 8) assess risks and benefits to humans and the ecosystem and consider unintended consequences of management actions; 9) avoid excessive conservatism or possible underprotection resulting from sole reliance on binary, numerical benchmarks; and 10) develop adaptive risk-management and regulatory goals based on ranges of uncertainty. Environ Toxicol Chem 2017;36:7-16. © 2016 SETAC. © 2016 SETAC.

  15. Comparison of China's oil import risk. Results based on portfolio theory and a diversification index approach

    International Nuclear Information System (INIS)

    Wu, Gang; Liu, Lan-Cui; Wei, Yi-Ming

    2009-01-01

    In recent years, the international oil price has fluctuated violently, bringing about huge risk for the international oil trade. In fact, the risk of crude oil and petroleum product imports is different because of the different import origins and prices. Which import risk is lower for China? From the perspective of oil supply security, how should China portfolio crude oil and petroleum product imports to minimize its oil import risk? Using portfolio theory and a diversification index approach, this paper compares and analyzes the supply, price and transport risks of crude oil and petroleum product imports. Our results show that the following: (1) Specific risk (diversification risk) and marine transport risk of China's petroleum product imports are lower than that of crude oil imports. (2) The average rate of return of China's petroleum product imports is higher than that of crude oil imports. Moreover, the average import price variance of petroleum product imports is lower than that of crude oil imports. Thus, the systematic risk (price risk) of petroleum products is lower too. Therefore, from the perspective of oil supply security, China should increase petroleum product imports to decrease its oil import risk. (author)

  16. The Perinatal Risk Index: Early Risks Experienced by Domestic Adoptees in the United States.

    Science.gov (United States)

    Marceau, Kristine; De Araujo-Greecher, Marielena; Miller, Emily S; Massey, Suena H; Mayes, Linda C; Ganiban, Jody M; Reiss, David; Shaw, Daniel S; Leve, Leslie D; Neiderhiser, Jenae M

    2016-01-01

    We aimed to assess comprehensively the prevalence of perinatal risks experienced by a potentially high-risk yet understudied population of children domestically adopted in the United States. Data are from participant report and medical records from mothers (n = 580) who completed a domestic adoption placement with nonrelatives at or near birth (Mean placement age = 7 days). We describe a comprehensive measure of perinatal risks, including divergences from previous assessment tools and the incorporation of multiple reporters, and report the prevalence of various types of perinatal risks. The prevalence of each specific risk factor was generally low, although several risks were more prevalent in this sample than estimates from nationally representative publicly available data. Nearly the entire sample (99%) experienced some type of risk exposure. Birth mothers who placed their children for adoption domestically in the US experience higher levels of perinatal risks than the national average, but not for all specific types of risk. Thus, the developmental trajectories of children adopted domestically may systematically differ from the general population to the extent that these specific perinatal risks impact development.

  17. Epidemiology, Incidence and Mortality of Bladder Cancer and their Relationship with the Development Index in the World.

    Science.gov (United States)

    Mahdavifar, Neda; Ghoncheh, Mahshid; Pakzad, Reza; Momenimovahed, Zohre; Salehiniya, Hamid

    2016-01-01

    Bladder cancer is an international public health problem. It is the ninth most common cancer and the fourteenth leading cause of death due to cancer worldwide. Given aging populations, the incidence of this cancer is rising. Information on the incidence and mortality of the disease, and their relationship with level of economic development is essential for better planning. The aim of the study was to investigate bladder cancer incidence and mortality rates, and their relationship with the the Human Development Index (HDI) in the world. Data were obtained from incidence and mortality rates presented by GLOBOCAN in 2012. Data on HDI and its components were extracted from the global bank site. The number and standardized incidence and mortality rates were reported by regions and the distribution of the disease were drawn in the world. For data analysis, the relationship between incidence and death rates, and HDI and its components was measured using correlation coefficients and SPSS software. The level of significance was set at 0.05. In 2012, 429,793 bladder cancer cases and 165,084 bladder death cases occurred in the world. Five countries that had the highest age-standardized incidence were Belgium 17.5 per 100,000, Lebanon 16.6/100,000, Malta 15.8/100,000, Turkey 15.2/100,000, and Denmark 14.4/100,000. Five countries that had the highest age-standardized death rates were Turkey 6.6 per 100,000, Egypt 6.5/100,000, Iraq 6.3/100,000, Lebanon 6.3/100,000, and Mali 5.2/100,000. There was a positive linear relationship between the standardized incidence rate and HDI (r=0.653, Pincidence rate with life expectancy at birth, average years of schooling, and the level of income per person of population. A positive linear relationship was also noted between the standardized mortality rate and HDI (r=0.308, Pincidence of bladder cancer in developed countries and parts of Africa was higher, while the highest mortality rate was observed in the countries of North Africa and the

  18. Radiation risk index for pediatric CT. A patient-derived metric

    International Nuclear Information System (INIS)

    Samei, Ehsan; Tian, Xiaoyu; Paul Segars, W.; Frush, Donald P.

    2017-01-01

    There is a benefit in characterizing radiation-induced cancer risk in pediatric chest and abdominopelvic CT: a singular metric that represents the whole-body radiation burden while also accounting for age, gender and organ sensitivity. To compute an index of radiation risk for pediatric chest and abdominopelvic CT. Using a protocol approved by our institutional review board, 42 pediatric patients (age: 0-16 years, weight: 2-80 kg) were modeled into virtual whole-body anatomical models. Organ doses were estimated for clinical chest and abdominopelvic CT examinations of the patients using validated Monte Carlo simulations of two major scanner models. Using age-, size- and gender-specific organ risk coefficients, the values were converted to normalized effective dose (by dose length product) (denoted as the k factor) and a normalized risk index (denoted as the q factor). An analysis was performed to determine how these factors are correlated with patient age and size for both males and females to provide a strategy to better characterize individualized risk. The k factor was found to be exponentially correlated with the average patient diameter. For both genders, the q factor also exhibited an exponential relationship with both the average patient diameter and with patient age. For both factors, the differences between the scanner models were less than 8%. The study defines a whole-body radiation risk index for chest and abdominopelvic CT imaging, that incorporates individual estimated organ dose values, organ radiation sensitivity, patient size, exposure age and patient gender. This indexing metrology enables the assessment and potential improvement of chest and abdominopelvic CT performance through surveillance of practice dose profiles across patients and may afford improved informed communication. (orig.)

  19. Radiation risk index for pediatric CT. A patient-derived metric

    Energy Technology Data Exchange (ETDEWEB)

    Samei, Ehsan [Duke University Medical Center, Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Durham, NC (United States); Duke University Medical Center, Department of Biomedical Engineering, Electrical and Computer Engineering, Durham, NC (United States); Duke University Medical Center, Medical Physics Graduate Program, Durham, NC (United States); Tian, Xiaoyu [Duke University Medical Center, Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Durham, NC (United States); Paul Segars, W. [Duke University Medical Center, Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Durham, NC (United States); Duke University Medical Center, Medical Physics Graduate Program, Durham, NC (United States); Frush, Donald P. [Duke University Medical Center, Medical Physics Graduate Program, Durham, NC (United States); Duke University Medical Center, Division of Pediatric Radiology, Department of Radiology, Durham, NC (United States)

    2017-12-15

    There is a benefit in characterizing radiation-induced cancer risk in pediatric chest and abdominopelvic CT: a singular metric that represents the whole-body radiation burden while also accounting for age, gender and organ sensitivity. To compute an index of radiation risk for pediatric chest and abdominopelvic CT. Using a protocol approved by our institutional review board, 42 pediatric patients (age: 0-16 years, weight: 2-80 kg) were modeled into virtual whole-body anatomical models. Organ doses were estimated for clinical chest and abdominopelvic CT examinations of the patients using validated Monte Carlo simulations of two major scanner models. Using age-, size- and gender-specific organ risk coefficients, the values were converted to normalized effective dose (by dose length product) (denoted as the k factor) and a normalized risk index (denoted as the q factor). An analysis was performed to determine how these factors are correlated with patient age and size for both males and females to provide a strategy to better characterize individualized risk. The k factor was found to be exponentially correlated with the average patient diameter. For both genders, the q factor also exhibited an exponential relationship with both the average patient diameter and with patient age. For both factors, the differences between the scanner models were less than 8%. The study defines a whole-body radiation risk index for chest and abdominopelvic CT imaging, that incorporates individual estimated organ dose values, organ radiation sensitivity, patient size, exposure age and patient gender. This indexing metrology enables the assessment and potential improvement of chest and abdominopelvic CT performance through surveillance of practice dose profiles across patients and may afford improved informed communication. (orig.)

  20. A probabilistic method for computing quantitative risk indexes from medical injuries compensation claims.

    Science.gov (United States)

    Dalle Carbonare, S; Folli, F; Patrini, E; Giudici, P; Bellazzi, R

    2013-01-01

    The increasing demand of health care services and the complexity of health care delivery require Health Care Organizations (HCOs) to approach clinical risk management through proper methods and tools. An important aspect of risk management is to exploit the analysis of medical injuries compensation claims in order to reduce adverse events and, at the same time, to optimize the costs of health insurance policies. This work provides a probabilistic method to estimate the risk level of a HCO by computing quantitative risk indexes from medical injury compensation claims. Our method is based on the estimate of a loss probability distribution from compensation claims data through parametric and non-parametric modeling and Monte Carlo simulations. The loss distribution can be estimated both on the whole dataset and, thanks to the application of a Bayesian hierarchical model, on stratified data. The approach allows to quantitatively assessing the risk structure of the HCO by analyzing the loss distribution and deriving its expected value and percentiles. We applied the proposed method to 206 cases of injuries with compensation requests collected from 1999 to the first semester of 2007 by the HCO of Lodi, in the Northern part of Italy. We computed the risk indexes taking into account the different clinical departments and the different hospitals involved. The approach proved to be useful to understand the HCO risk structure in terms of frequency, severity, expected and unexpected loss related to adverse events.

  1. The EVIDENT diet quality index is associated with cardiovascular risk and arterial stiffness in adults

    Directory of Open Access Journals (Sweden)

    Carmela Rodríguez-Martin

    2017-04-01

    Full Text Available Abstract Background We aimed to simplify information from food frequency questionnaires (FFQs in a single parameter that allows for rapid identification of quality of patient diet and its relationship to cardiovascular risk and pulse wave velocity (PWV. Methods The sample from the EVIDENT study, consisting of 1553 subjects (aged 20–80 years with no cardiovascular disease selected by random sampling among those attending primary care clinics, was used. The EVIDENT diet index (range 0–100 was calculated based on the results of a FFQ. Evaluation of dietary habits also included adherence to the Mediterranean diet (MD. Cardiovascular risk was estimated, and carotid-femoral pulse wave velocity was measured. Results Mean subject age was 54.9 ± 13.8 years, and 60.3% of subjects were female. The mean value of the EVIDENT diet index was 52.1 ± 3.2 points. Subjects in the third tertile (the highest score had the greatest adherence to MD and the highest energy intake, with greater amounts of carbohydrates, protein, and fiber. The best cut-off point of the EVIDENT diet index for predicting good adherence to the MD is 52.3 (0.71 sensitivity, 0.61 specificity. In a multiple regression analysis, after a complete adjustment, it was estimated that for each one-point increase in the EVIDENT diet index, cardiovascular risk (CVR, blood-pressure, waist circumference, and PWV decreased by 0.14, 0.43, 0.24, and 0.09 respectively (p < 0.05, all. Conclusions The diet quality index developed is associated to CVR and its components, and also with arterial stiffness, as measured with PWV. This index is also a good predictor of adherence to MD.

  2. An index for drought induced financial risk in the mining industry

    Science.gov (United States)

    Bonnafous, L.; Lall, U.; Siegel, J.

    2017-02-01

    Water scarcity has emerged as a potential risk for mining operations. High capital spending for desalination and water conflicts leading to asset stranding have recently occurred. Investors in mining companies are interested in the exposure to such risks across portfolios of mining assets (whether the practical at-site consequences are foregone production, higher OPEX and CAPEX and ensuing lost revenues, or asset-stranding). In this paper, an index of the potential financial exposure of a portfolio is developed and its application is illustrated. Since the likely loss at each mine is hard to estimate a priori, one needs a proxy for potential loss. The index considers drought duration, severity and frequency (defined by a return-level in years) at each mining asset, and provides a measure of financial exposure through weighing of production or Net Asset Value. Changes in human needs are not considered, but are relevant, and could be incorporated if global data on mine and other water use were available at the appropriate resolution. Potential for contemporaneous drought incidence across sites in a portfolio is considered specifically. Through an appropriate choice of drought thresholds, an analyst can customize a scenario to assess potential losses in production value or profits, or whether conflicts could emerge that would lead to stranded assets or capital expenditure to secure alternate water supplies. Global climate data sets that allow a customized development of such an index are identified, and selected mining company portfolios are scored as to the risk associated with one publicly available drought index.

  3. Mendelian Randomization Study of Body Mass Index and Colorectal Cancer Risk

    DEFF Research Database (Denmark)

    Thrift, Aaron P.; Gong, Jian; Peters, Ulrike

    2015-01-01

    Background: High body mass index (BMI) is consistently linked to increased risk of colorectal cancer for men, whereas the association is less clear for women. As risk estimates from observational studies may be biased and/or confounded, we conducted a Mendelian randomization study to estimate...... the causal association between BMI and colorectal cancer. Methods: We used data from 10,226 colorectal cancer cases and 10,286 controls of European ancestry. The Mendelian randomization analysis used a weighted genetic risk score, derived from 77 genome-wide association study–identified variants associated......, rather than overall obesity, is a more important risk factor for men requires further investigation. Impact: Overall, conventional epidemiologic and Mendelian randomization studies suggest a strong association between obesity and the risk of colorectal cancer....

  4. Insurance World in Transition: Changes in Global Risk Taking and Risk Assessment

    Science.gov (United States)

    Michel, Gero; Tiampo, Kristy

    2015-04-01

    Catastrophe insurance risk assessment, risk taking, and regulation has evolved over the last 20 years and is gearing up for significant further change in the years ahead. Changes in regulation and influx of capital have put profit margins for catastrophe risk products under pressure despite the fact that changes in climate as well as increasing insurance penetration is expected to heighten demand. As a result, reinsurance strategies are moving away from catastrophe risk. In addition, lower margins require cheaper and more efficient risk assessment methods and processes which are contrary to evolving analytical tools and methods that had increased expenses in line with growing margins over the last decade. New capital providers are less familiar with and less willing to accept complex supply chains for risk management, relationship-driven business and tedious data exchange and management processes. Risk takers claim new measures and ask for more flexibility in the use of tools. The current concepts of catastrophe insurance risk assessment are hence under thorough scrutiny. This presentation deals with the changing landscape in catastrophe insurance risk assessment and risk hedging and discusses changes in catastrophe risk assessment products and demand. How likely is it that private, small and nimble hazard and risk consulting groups - increasingly emanating from larger science organizations - will replace large established firms in their role to assess risk? What role do public-private academic partnerships play in assuming risk for catastrophe insurance and what role could they play in the future? What are the opportunities and downsides of the current changes in risk taking and hedging? What is needed from the scientific community in order to fill the gaps in risk management and who is likely to take advantage of the current changes?

  5. Familial psychosocial risk classes and preschooler body mass index: The moderating effect of caregiver feeding style.

    Science.gov (United States)

    Horodynski, Mildred A; Brophy-Herb, Holly E; Martoccio, Tiffany L; Contreras, Dawn; Peterson, Karen; Shattuck, Mackenzie; Senehi, Neda; Favreau, Zachary; Miller, Alison L; Sturza, Julie; Kaciroti, Niko; Lumeng, Julie C

    2018-04-01

    Early child weight gain predicts adolescent and adult obesity, underscoring the need to determine early risk factors affecting weight status and how risk factors might be mitigated. Socioeconomic status, food insecurity, caregiver depressive symptomology, single parenthood, and dysfunctional parenting each have been linked to early childhood weight status. However, the associations between these risk factors and children's weight status may be moderated by caregiver feeding styles (CFS). Examining modifiable factors buffering risk could provide key information to guide early obesity intervention efforts. This analysis used baseline data from the Growing Healthy project that recruited caregivers/child dyads (N = 626) from Michigan Head Start programs. Caregivers were primarily non-Hispanic white (62%) and African American (30%). After using latent class analysis to identify classes of familial psychosocial risk, CFS was tested as a moderator of the association between familial psychosocial risk class and child body mass index (BMI) z-score. Latent class analysis identified three familial psychosocial risk classes: (1) poor, food insecure and depressed families; (2) poor, single parent families; and (3) low risk families. Interactive effects for uninvolved feeding styles and risk group indicated that children in poor, food insecure, and depressed families had higher BMI z-scores compared to children in the low risk group. Authoritative feeding styles in low risk and poor, food insecure, and depressed families showed lower child BMI z-scores relative to poor, single parent families with authoritative feeding styles. Uninvolved feeding styles intensified the risk and an authoritative feeding style muted the risk conferred by living in a poor, food-insecure, and depressed family. Interventions that promote responsive feeding practices could help decrease the associations of familial psychosocial risks with early child weight outcomes. Copyright © 2017 Elsevier Ltd

  6. Index-Based Dietary Patterns and Colorectal Cancer Risk: A Systematic Review123

    Science.gov (United States)

    Steck, Susan E; Guinter, Mark; Zheng, Jiali; Thomson, Cynthia A

    2015-01-01

    Colorectal cancer (CRC) is the third most common cancer in both men and women in the United States. Various a priori dietary patterns that take into account diet complexity have been associated with CRC risk. This systematic review augments the evidence for an association between CRC risk and the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), and provides new evidence for a novel Dietary Inflammatory Index (DII). Human studies published in English after 31 December 2008 were reviewed. Five case-control studies and 7 prospective cohort studies conducted in the United States and Europe were identified. Five of the studies examined the MDS, 4 examined the HEI, and 4 examined the DII. Comparing highest to lowest score groups, higher MDSs were associated with an 8–54% lower CRC risk, and higher HEI scores were associated with a 20–56% lower CRC risk. More proinflammatory diet scores were associated with a 12–65% higher CRC risk compared with more anti-inflammatory diets in studies that used the DII. The results reported by sex suggested similar associations for men and women. This review builds upon the evidence supporting the association between higher overall diet quality and lower risk of CRC. Increasing scores of MDS and HEI and anti-inflammatory DII scores are characterized by high intake of plant-based foods and low intake of animal products. Future studies in more diverse populations and with consistent scoring calculations are recommended. PMID:26567200

  7. Geriatric nutritional risk index as a prognostic factor in patients with diffuse large B cell lymphoma.

    Science.gov (United States)

    Kanemasa, Yusuke; Shimoyama, Tatsu; Sasaki, Yuki; Hishima, Tsunekazu; Omuro, Yasushi

    2018-06-01

    The geriatric nutritional risk index (GNRI) is a simple and well-established nutritional assessment tool that is a significant prognostic factor for various cancers. However, the role of the GNRI in predicting clinical outcomes of diffuse large B cell lymphoma (DLBCL) patients has not been investigated. To address this issue, we retrospectively analyzed a total of 476 patients with newly diagnosed de novo DLBCL. We defined the best cutoff value of the GNRI as 96.8 using a receiver operating characteristic curve. Patients with a GNRI risk by National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI), the 5-year OS was significantly lower in patients with a GNRI risk, 59.5 vs. 75.2%, P = 0.006; high risk, 37.4 vs. 64.9%, P = 0.033). In the present study, we demonstrated that the GNRI was an independent prognostic factor in DLBCL patients. The GNRI could identify a population of poor-risk patients among those with high-intermediate and high-risk by NCCN-IPI.

  8. Theory and methodology of social, political and economic processes risks determining in different countries of the world

    Directory of Open Access Journals (Sweden)

    Yashina Nadezhda, I.

    2015-06-01

    Full Text Available The study deals with the problems of the theory and methodology of social, political and economic processes risks in different countries with relative indicators of the socio-economic development level, as well as the size and condition of the public debt. Developed by the authors the methodology of determining the risks of social, political and economic processes of public policy around the world revealed close relationship between socio-economic situation of the countries and their public debt. Within the framework of this methodology two groups of factors characterizing the socio-political and economic processes in the country are being developed. After that each exponent and indicator are being processed, using expert procedures. Maximum statutory values for tentatively referenced countries with effective and ineffective government policies are identified. Then standardization (specification and definition of integral (generalized indexes of socio-political and economic processes in the country are taking place. After that the ranking of countries by aggregated standardized ratio is arranged, taking into account the significance of the developed indicators. The final phase of implementation methodology is identifying risks of social, political and economic processes of public policy around the world. This is the ranking of countries by ratio of stability in public policy (stability of economic and socio-political processes in the country. As the result of implementation methodology the following output was received: what really makes a difference is not the amount of the country's debt, but how effectively it manages this debt, whether it has a goal to improve social and economic indicators. Practical testing methodology has proven that studied indicators fully characterize the development of the countries, their political, social and economic situation on the world stage.

  9. Epidemiology, incidence and mortality of oral cavity and lips cancer and their relationship with the human development index in the world

    OpenAIRE

    Fariba Ramezani Siakholak; Mahshid Ghoncheh; Reza Pakzad; Hamidreza Sadeghi Gandomani; Fereshteh Ghorat; Hamid Salehiniya

    2016-01-01

    Introduction: According to the importance of knowledge about incidence and mortality of oral cavity and lip cancer in health planning, this study was performed with the aim of investigating the incidence and mortality rate of oral cavity and lip cancer and its relation with the Human Development Index in the world in 2012. Methods: The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components). Data about the age-specific inc...

  10. Relation of body mass index to risk of stent thrombosis after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Schmiegelow, Michelle; Torp-Pedersen, Christian; Gislason, Gunnar H

    2012-01-01

    Stent thrombosis is a devastating complication after percutaneous coronary intervention (PCI), but the influence of obesity on risk of stent thrombosis is unclear, and it is unknown if this relation is dependent on stent type. The objective of this study was to examine the relation between body...... mass index (BMI) and stent thrombosis after PCI with bare-metal stent (BMS) or drug-eluting stent (DES). We followed 5,515 patients who underwent PCI with implantation of ≥1 BMS or DES at a high-volume tertiary invasive cardiology center from 2000 through 2006. Only patients with a single type of stent...... (BMS or DES) implanted at the index PCI were included. Median follow-up period was 26 months (interquartile range 12 to 44) and definite stent thrombosis occurred in 78 patients. Hazard ratio of definite stent thrombosis adjusted for number of stents at the index PCI was 0.92 (95% confidence interval...

  11. A simplified donor risk index for predicting outcome after deceased donor kidney transplantation.

    Science.gov (United States)

    Watson, Christopher J E; Johnson, Rachel J; Birch, Rhiannon; Collett, Dave; Bradley, J Andrew

    2012-02-15

    We sought to determine the deceased donor factors associated with outcome after kidney transplantation and to develop a clinically applicable Kidney Donor Risk Index. Data from the UK Transplant Registry on 7620 adult recipients of adult deceased donor kidney transplants between 2000 and 2007 inclusive were analyzed. Donor factors potentially influencing transplant outcome were investigated using Cox regression, adjusting for significant recipient and transplant factors. A United Kingdom Kidney Donor Risk Index was derived from the model and validated. Donor age was the most significant factor predicting poor transplant outcome (hazard ratio for 18-39 and 60+ years relative to 40-59 years was 0.78 and 1.49, respectively, Pinformed consent.

  12. The association between aortic augmentation index and cardiovascular risk factors in a large unselected population

    DEFF Research Database (Denmark)

    Janner, Julie Hjortsø; Godtfredsen, N S; Ladelund, S

    2011-01-01

    The augmentation index (AIx) is a measure of systemic arterial stiffness, and previous studies have demonstrated an association between AIx and risk factors of cardiovascular disease (CVD). However, there is limited knowledge about the age and gender differences of the observed associations...... is primarily a marker of CVD in younger subjects.Journal of Human Hypertension advance online publication, 9 June 2011; doi:10.1038/jhh.2011.59....

  13. Poverty Risk Index as A New Methodology for Social Inequality Distribution Assessment

    Science.gov (United States)

    Swiader, Małgorzata; Szewrański, Szymon; Kazak, Jan

    2017-10-01

    The paper presents new concept of poverty risk index measurement due to dynamics of urban development among years. The rapid urbanization could seriously surpass the capacity of the most cities, which may lead to insufficient services of their inhabitants. Consequence of this situation could be polarized, social differentiated cities with high rates of urban poverty. The measurement and analysis of urban poverty phenomenon requires the dedicated tools and techniques. The data based assessment could allow planners and public policy makers to develop more socially integrated cities. This paper presents analysis of urban poverty phenomenon in Wrocław city (Poland) during period 2010-2012. This analysis was conducted for ten Social Assistance Terrain Units (SATU) delineated at the city area. Our primary study objective concerns the proposal and calculation of poverty risk index based on diagnostic features, which represent the most common causes of social benefits granting, as: number of single households granted permanent benefits, number of people in families granted permanent benefits, number of people in families granted temporary benefits due to unemployment, number of people in families granted temporary benefits due to disability, number of people in families granted meals for children. The calculation was conducted by using the theory of development pattern - Hellwig’s economic development measure. The analysis of poverty risk index showed that commonly the central and south-eastern part of the city is characterized by the highest poverty risk index. The obtained results of the inequalities spatial distribution relate to European and American patterns of poverty concentration in urban structures.

  14. Creating a spatially-explicit index: a method for assessing the global wildfire-water risk

    Science.gov (United States)

    Robinne, François-Nicolas; Parisien, Marc-André; Flannigan, Mike; Miller, Carol; Bladon, Kevin D.

    2017-04-01

    The wildfire-water risk (WWR) has been defined as the potential for wildfires to adversely affect water resources that are important for downstream ecosystems and human water needs for adequate water quantity and quality, therefore compromising the security of their water supply. While tools and methods are numerous for watershed-scale risk analysis, the development of a toolbox for the large-scale evaluation of the wildfire risk to water security has only started recently. In order to provide managers and policy-makers with an adequate tool, we implemented a method for the spatial analysis of the global WWR based on the Driving forces-Pressures-States-Impacts-Responses (DPSIR) framework. This framework relies on the cause-and-effect relationships existing between the five categories of the DPSIR chain. As this approach heavily relies on data, we gathered an extensive set of spatial indicators relevant to fire-induced hydrological hazards and water consumption patterns by human and natural communities. When appropriate, we applied a hydrological routing function to our indicators in order to simulate downstream accumulation of potentially harmful material. Each indicator was then assigned a DPSIR category. We collapsed the information in each category using a principal component analysis in order to extract the most relevant pixel-based information provided by each spatial indicator. Finally, we compiled our five categories using an additive indexation process to produce a spatially-explicit index of the WWR. A thorough sensitivity analysis has been performed in order to understand the relationship between the final risk values and the spatial pattern of each category used during the indexation. For comparison purposes, we aggregated index scores by global hydrological regions, or hydrobelts, to get a sense of regional DPSIR specificities. This rather simple method does not necessitate the use of complex physical models and provides a scalable and efficient tool

  15. Dietary Inflammatory Index and Cardiometabolic Risk Parameters in Overweight and Sedentary Subjects

    OpenAIRE

    Camargo-Ramos, Claudia Marcela; Correa-Bautista, Jorge Enrique; Correa-Rodríguez, María; Ramírez-Vélez, Robinson

    2017-01-01

    Nutrition has been established as a relevant factor in the development of cardiovascular disease (CVD). We aimed to investigate the relationship between the dietary inflammatory index (DII) and cardiometabolic risk parameters in a cohort of 90 overweight and sedentary adults from Bogotá, Colombia. A 24-h dietary record was used to calculate the DII. Body composition variables, flow-mediated dilation (FMD), pulse wave velocity (PWV), lipid profile, glucose, glycosylated hemoglobin (Hb1Ac), and...

  16. Food consumption, body mass index and risk for oral health in adolescents.

    Science.gov (United States)

    Bica, Isabel; Cunha, Madalena; Reis, Margarida; Costa, José; Costa, Patricia; Bica, Alexandra

    2014-11-01

    The food intake has great influence on the oral health of adolescents, being relevant to analyze the type of food consumed by adolescents and their relationship with the DMFT index (decayed, missing and filled), the plaque index (PI) and the body mass index (BMI). Epidemiological study conducted in public schools of the 3rd cycle of basic education, central Portugal. The sociodemographic and dietary habits and frequency characterization was obtained through a self-administered questionnaire completed by adolescents and validated for the population under study. The DMFT index was evaluated according to WHO criteria, oral hygiene was evaluated based on the plaque index and BMI through weight and height in adolescents. Random sample by clusters (schools) with 661 adolescents, 84.1% female and 15.9% male. Adolescents with mean age 13.22 years (± 1.139). The mean DMFT was 2.23 (± 2.484), the prevalence of PI was 96.4%, and ≥ 5 BMI cariogenic foods (r=0.160; P=.000). Adolescents with a higher BMI consume less cariogenic foods (r=-0.1343; P=.001). The value of t reveals that the consumption of cariogenic foods explains 1.8% of the variance of the BMI and 2.6% DMFT. The cariogenic foods are presented as a risk factor for dental caries. The results suggest that it is important to develop up actions for health education. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  17. Gingival immunologic defense index: a new indicator for evaluating dental plaque infection risk in allergic children

    Directory of Open Access Journals (Sweden)

    Seno Pradopo

    2008-03-01

    Full Text Available There is a possible relationship between dental plaque and children allergic diseases. According to literatures, gingivitis suffered mostly by allergic children than control. Case reports also revealed that dental plaque control therapy was able to reduce, even eliminate rhinosinusitis and asthmatic symptoms without additional medications. However, the exact method for confirming the gingivitis-related allergy is still uncertain. Allergic diseases have multifactorial etiologies and dental plaque had been proposed as a new trigger of allergic symptoms. Nevertheless, since not every child with gingivitis suffered from allergy or vice versa, this uncertain phenomenon may lead to patients or other clinician disbelief. The objective of the present study was to propose a new method, which involving the Gingival immunologic defense index (GIDI to evaluate the susceptibility to allergic diseases. GIDI is an index that had been developed earlier for evaluating gingival immunologic defense with respect to immunoglobulin A (IgA levels. This index based on the simple count of the inflamed gingival surfaces of a child plus the measurement of salivary IgA content. It provides clinicians with important information about the immunologic defense potential of each subject. Interestingly, most allergic children also had inherited IgA deficiency, thus this concept is likely. Based on literatures, GIDI could be a potential index for evaluating the risk of allergic diseases through gingival health assessment. However, prior investigation to the value of Indonesian GIDI index which related to allergy should be conducted.

  18. [Childhood body mass index and the risk of coronary heart disease in adulthood

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Olsen, L.W.; Sørensen, Thorkild I.A.

    2008-01-01

    The severity of the long term consequences of the current childhood obesity epidemic on coronary heart disease is unknown. Therefore we investigated the association between body mass index (BMI) at ages 7-13 years and heart disease in adulthood among 276,835 Danish schoolchildren. We found...... that higher BMI during this period of childhood is associated with an increased risk of any, non-fatal and fatal heart disease in adulthood. Worldwide, as children are becoming heavier, our findings suggest that greater numbers of children are at risk of having coronary heart disease in adulthood...

  19. Ponderal index at birth associates with later risk of gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Crusell, Mie; Damm, Peter; Hansen, Torben

    2017-01-01

    PURPOSE: Low birth weight (BW) and low ponderal index (PI) are associated with increased risk of type 2 diabetes mellitus. This study has two purposes: first to investigate the influence of PI on the risk of gestational diabetes mellitus (GDM); second, to study the association between glucose...... metabolism and BW in women with previous GDM. METHODS: GDM cohort: 185 women with GDM in 1978-1996, attending a follow-up study in 2000-2002. Control cohort: 1137 women from a population-based diabetes screening study (Inter99) in a neighbouring county in 1999-2001. BW and birth length were collected from...

  20. Assessing global exposure and vulnerability towards natural hazards: the Disaster Risk Index

    Directory of Open Access Journals (Sweden)

    P. Peduzzi

    2009-07-01

    Full Text Available This paper presents a model of factors influencing levels of human losses from natural hazards at the global scale, for the period 1980–2000. This model was designed for the United Nations Development Programme as a building stone of the Disaster Risk Index (DRI, which aims at monitoring the evolution of risk. Assessing what countries are most at risk requires considering various types of hazards, such as droughts, floods, cyclones and earthquakes. Before assessing risk, these four hazards were modelled using GIS and overlaid with a model of population distribution in order to extract human exposure. Human vulnerability was measured by crossing exposure with selected socio-economic parameters. The model evaluates to what extent observed past losses are related to population exposure and vulnerability. Results reveal that human vulnerability is mostly linked with country development level and environmental quality. A classification of countries is provided, as well as recommendations on data improvement for future use of the model.

  1. Multivariate market risk evaluation between Malaysian Islamic stock index and sectoral indices

    Directory of Open Access Journals (Sweden)

    Sew Lai Ng

    2017-03-01

    Full Text Available Without an efficient financial risk management, it may cause massive consequences to a financial institution as well as individual. Therefore, developing a methodology which gives precise estimates to reduce the exposure of risk to a minimum is of great importance. This paper uses an asymmetric BEKK-GARCH model to examine the return and volatility linkages between the FTSE Bursa Malaysia Emas Shariah (FBMS index and the sectoral indices under a normal market. The findings suggest that the FBMS plays a leading role in the mean return spillover effect. There is a strong evidence of significant transmission of past shocks, volatilities and leverage effects are observed on the current conditional variance-covariance in all the pair-wise models. These empirical results are helpful in quantifying the cross-market risk evaluation, risk minimizing weight and cross-market hedge ratio for strategizing appropriate portfolio selection.

  2. Adult body mass index and risk of ovarian cancer by subtype

    DEFF Research Database (Denmark)

    Dixon, Suzanne C; Nagle, Christina M; Thrift, Aaron P

    2016-01-01

    BACKGROUND: Observational studies have reported a positive association between body mass index (BMI) and ovarian cancer risk. However, questions remain as to whether this represents a causal effect, or holds for all histological subtypes. The lack of association observed for serous cancers may......, for instance, be due to disease-associated weight loss. Mendelian randomization (MR) uses genetic markers as proxies for risk factors to overcome limitations of observational studies. We used MR to elucidate the relationship between BMI and ovarian cancer, hypothesizing that genetically predicted BMI would...... be associated with increased risk of non-high grade serous ovarian cancers (non-HGSC) but not HGSC. METHODS: We pooled data from 39 studies (14 047 cases, 23 003 controls) in the Ovarian Cancer Association Consortium. We constructed a weighted genetic risk score (GRS, partial F-statistic = 172), summing alleles...

  3. Development of prolonged standing strain index to quantify risk levels of standing jobs.

    Science.gov (United States)

    Halim, Isa; Omar, Abdul Rahman

    2012-01-01

    Many occupations in industry such as metal stamping workers, electronics parts assembly operators, automotive industry welders, and lathe operators require working in a standing posture for a long time. Prolonged standing can contribute to discomfort and muscle fatigue particularly in the back and legs. This study developed the prolonged standing strain index (PSSI) to quantify the risk levels caused by standing jobs, and proposed recommendations to minimize the risk levels. Risk factors associated with standing jobs, such as working posture, muscles activity, standing duration, holding time, whole-body vibration, and indoor air quality, were the basis for developing the PSSI. All risk factors were assigned multipliers, and the PSSI was the product of those multipliers. Recommendations for improvement are based on the PSSI; however, extensive studies are required to validate their effectiveness. multipliers, and the PSSI was the product of those multipliers. Recommendations for improvement are based on the PSSI; however, extensive studies are required to validate their effectiveness.

  4. Environmental risk index: A tool to assess the safety of dams for leachate

    International Nuclear Information System (INIS)

    Colomer Mendoza, Francisco J.; Gallardo Izquierdo, Antonio

    2009-01-01

    Dams for leachate store very toxic substances that contain a large amount of organic material and, probably, heavy metals; they therefore constitute an important threat to the environment. Existing models of environmental risk assessment for landfills do not take into consideration the specific risk that leachate dams may represent for the environment. In this paper a methodology to improve the environmental safety is presented according to the parameters used in their construction and management. In order to do that, the following characteristics of the dam must be known: (1) geotechnical stability, (2) erosion of downstream slope, (3) type of sealing of the dam, (4) overtopping probability, (5) volume of leachate stored inside the dam and (6) pollution load of leachate. Once these parameters have been calculated, they are transformed by means of rating curves into homogeneous units, so as to make it possible to operate between them. From the study and analysis of these parameters an environmental risk index for a dam for leachate can be calculated. If the environmental risk index exceeds an established value then it involves a dam for leachate with high environmental risk, therefore preventive measures in its design, construction and management would be necessary

  5. Atherogenic index and coronarian risk – comparative assessment regarding the particularities of chronic autoimmune thyroiditis presence

    Directory of Open Access Journals (Sweden)

    Seceleanu Mihaela

    2015-08-01

    Full Text Available Objectives: Assessment of autoimmune cause hypothyroidism and dyslipidemia involvement in the apparition of major vascular complications. Methods: A total of 152 patients were investigated appreciating in comparison to a healthy control lot the hormone serum level, the presence of antimicrosomal thyroid antibodies and the serum levels of lipids. Atherogenic index and coronarian risk were calculated and correlated with the incidence of coronarian and cerebral vascular accidents. Results: Among the patients with goiter it was noted a high incidence of a subclinical hypothyroidism (31,58%. Thyroid autoimmunity was involved in 94,4% of the patients with clinical hypothyroidism, in 93,7 % with subclinical hypothyroidism and 100% in the patients with thyrotoxicosis. Low serum level of HDL-cholesterol was identified in 66,6% of patients with clinical hypothyroidism and 64,5% patients with subclinical hypothyroidism. The assessment of atherogenic index and coronarian risk was significantly higher (p<0,01 in patients with hypothyroidism in comparison to healthy control subjects. The incidence of vascular accidents was significantly higher (p<0,01 among the hypothyroid patients ( 19,7%/ 10,8%, of masculine gender (12,7% where the main cause of hypothyroidism was autoimmunity. Conclusions: The atherogenic index and coronarian risk were higher in patients with hypothyroidism associated to thyroid autoimmunity resulting in an increased probability in producing vascular accidents

  6. Pre-prepregnancy body mass index and the risk of gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Rudić-Grujić Vesna

    2017-01-01

    Full Text Available Introduction/Objective. Not only do pre-pregnancy overweight or obesity increase the risk of adverse maternal and perinatal outcomes but they also lead to the development of gestational diabetes mellitus. The objective of this study was to estimate the prevalence of pre-pregnancy overweight and obesity in the Republic of Srpska and to investigate its association with hyperglycemia and risk of gestational diabetes mellitus. Methods. A cross-sectional study was carried out during the period from February to October 2012 among 555 pregnant women in gestational period from 24 to 28 weeks. The criterion for exclusion from the sample was previously diagnosed type 1 or type 2 diabetes. Results. Before pregnancy, 20.39% of participants had increased body mass index, while 4.04 % [95% confidence interval (CI; 2.62–6.13] were obese. Gestational diabetes mellitus was diagnosed in 10.91% (95% CI, 8.44–13.98 of them. The increase in body mass index by 1 increased the risk of gestational diabetes mellitus by 1.09 times [odds ratio (OR = 1.09; 95% CI; 1.02–1.16]. Pregnant women who were overweight had a 4.88 times greater risk (OR = 4.88; 95% CI, 1.23–29.41 of developing gestational diabetes. Conclusion. Every fifth pregnant woman in this study was overweight or obese before pregnancy. The increase in body mass index by 1 increased the risk of gestational diabetes by 1.09 times (OR = 1.09; 95% CI; 1.02–1.16. Counselling is necessary for overweight and obese women planning pregnancy.

  7. The influence of freezer storage of urine samples on the BONN-Risk-Index for calcium oxalate crystallization.

    Science.gov (United States)

    Laube, Norbert; Zimmermann, Diana J

    2004-01-01

    This study was performed to quantify the effect of a 1-week freezer storage of urine on its calcium oxalate crystallization risk. Calcium oxalate is the most common urinary stone material observed in urolithiasis patients in western and affluent countries. The BONN-Risk-Index of calcium oxalate crystallization risk in human urine is determined from a crystallization experiment performed on untreated native urine samples. We tested the influence of a 1-week freezing on the BONN-Risk-Index value as well as the effect of the sample freezing on the urinary osmolality. In vitro crystallization experiments in 49 native urine samples from stone-forming and non-stone forming individuals were performed in order to determine their calcium oxalate crystallization risk according to the BONN-Risk-Index approach. Comparison of the results derived from original sample investigations with those obtained from the thawed aliquots by statistical evaluation shows that i) no significant deviation from linearity between both results exists and ii) both results are identical by statistical means. This is valid for both, the BONN-Risk-Index and the osmolality data. The differences in the BONN-Risk-Index results of both procedures of BONN-Risk-Index determination, however, exceed the clinically acceptable difference. Thus, determination of the urinary calcium oxalate crystallization risk from thawed urine samples cannot be recommended.

  8. SUITABILITY OF VISCERAL ADIPOSITY INDEX AS A MARKER FOR CARDIOMETABOLIC RISKS IN JORDANIAN ADULTS.

    Science.gov (United States)

    Numan Ahmad, Mousa; Halim Haddad, Fares

    2015-12-01

    visceral adiposity index (VAI) has recently been proposed as a predictor of cardiometabolic risk, but its usefulness has not been confirmed. to evaluate the association between VAI and conventional adiposity and cardiometabolic risk indices and examine VAI risk predictive ability and compare it with other adiposity indices. a total of 1 622 Jordanian adults, 686 men and 936 women, aged 20-80 years were included this study. VAI, body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR) were examined and high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), fasting serum glucose (FSG), systolic (SBP), and diastolic (DBP) blood pressure were determined. Associations and age-and gender specific distribution and differences were evaluated. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used for risk predictive ability comparison. VAI of women (6.82±6.43) was higher than of men (4.15±4.62). VAI severity increased with age in a dose-response trend (padiposity and cardiometabolic indices. VAI markedly associated with TG, HDL-C, FSG, SBP and DBP or WHR, WC, WHtR and BMI in respective order of correlation potency for cardiometabolic or adiposity risk indices. In men and women respectively, the largest AUC was for VAI (0.79 vs. 0.77), followed by WHR (0.73 vs. 0.75), WC (0.69 vs. 0.74), WHtR (0.65 vs. 0.71) and BMI (0.53 vs. 0.51). the findings suggest that VAI potentially associates with cardiometabolic risks and proves to be superior to other adiposity indices in predicting such risk. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. Body mass index, exercise capacity, and mortality risk in male veterans with hypertension.

    Science.gov (United States)

    Faselis, Charles; Doumas, Michael; Panagiotakos, Demosthenes; Kheirbek, Raya; Korshak, Lauren; Manolis, Athanasios; Pittaras, Andreas; Tsioufis, Costas; Papademetriou, Vasilios; Fletcher, Ross; Kokkinos, Peter

    2012-04-01

    Overweight and obesity are associated with increased risk of chronic diseases and mortality. Exercise capacity is inversely associated with mortality risk. However, little is known on the interaction between fitness, fatness, and mortality risk in hypertensive individuals. Thus, we assessed the interaction between exercise capacity, fatness, and all-cause mortality in hypertensive males. A graded exercise test was performed in 4,183 hypertensive veterans (mean age ± s.d.; 63.3 ± 10.5 years) at the Veterans Affairs Medical Center, Washington, DC. We defined three body weight categories based on body mass index (BMI): normal weight (BMI 7.5 METs). During a median follow-up period of 7.2 years, there were 1,000 deaths. The association between exercise capacity and mortality risk was strong, inverse, and graded. For each 1-MET increase in exercise capacity the adjusted risk was 20% for normal weight, 12% for overweight, and 25% for obese (P exercise capacity is associated with lower mortality risk in hypertensive males regardless of BMI. The risk for overweight and obese but fit individuals was significantly lower when compared to normal weight but unfit. These findings suggest that in older hypertensive men, it may be healthier to be fit regardless of standard BMI category than unfit and normal weight.

  10. Prognostic Value of the Nutritional Risk Index in Heart Transplant Recipients.

    Science.gov (United States)

    Barge-Caballero, Eduardo; García-López, Fernando; Marzoa-Rivas, Raquel; Barge-Caballero, Gonzalo; Couto-Mallón, David; Paniagua-Martín, María J; Solla-Buceta, Miguel; Velasco-Sierra, Carlos; Pita-Gutiérrez, Francisco; Herrera-Noreña, José M; Cuenca-Castillo, José J; Vázquez-Rodríguez, José Manuel; Crespo-Leiro, María G

    2017-08-01

    To study the prognostic impact of preoperative nutritional status, as assessed through the nutritional risk index (NRI), on postoperative outcomes after heart transplantation (HT). We conducted a retrospective, single-center study of 574 patients who underwent HT from 1991 to 2014. Preoperative NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (body weight [kg] / ideal body weight [kg]). The association between preoperative NRI and postoperative outcomes was analyzed by means of multivariable logistic regression and multivariable Cox regression. Mean NRI before HT was 100.9 ± 9.9. According to this parameter, the prevalence of severe nutritional risk (NRI risk (83.5 ≤ NRI risk (97.5 ≤ NRI risk of postoperative infection (adjusted OR, 0.97; 95%CI, 0.95-1.00; P = .027) and prolonged postoperative ventilator support (adjusted OR, 0.96; 95%CI, 0.94-0.98; P = .001). Patients at moderate or severe nutritional risk had significantly higher 1-year post-HT mortality (adjusted HR, 1.55; 95%CI, 1.22-1.97; P risk of postoperative complications and mortality after HT. Preoperative NRI determination may help to identify HT candidates who might benefit from nutritional intervention. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  11. The strain index and TLV for HAL: risk of lateral epicondylitis in a prospective cohort.

    Science.gov (United States)

    Garg, Arun; Kapellusch, Jay M; Hegmann, Kurt T; Thiese, Matthew S; Merryweather, Andrew S; Wang, Ying-Chih; Malloy, Elizabeth J

    2014-03-01

    This study's objective was to quantify exposure-response relationships between job physical exposure (JPE) and incidence of lateral epicondylitis (LE). A cohort of 536 workers was enrolled from 10 manufacturing facilities and followed monthly for 6 years to ascertain changes in JPE and health status. JPE was individually measured and quantified using the Strain Index (SI) and TLV for HAL. Worker demographics, medical history, psychosocial factors, and current musculoskeletal disorders were obtained. Fifty-six workers developed LE. In multivariate models JPE, age, family problems, and swimming were associated with increased risk of LE. SI showed an exposure-response relationship with maximum hazard ratio (HR) of 4.5(P = 0.04). TLV for HAL showed a non-statistically significant trend for increased risk of LE (P = 0.19). JPE is associated with increased risk of LE. The SI and TLV for HAL are useful metrics for estimating JPE. © 2013 Wiley Periodicals, Inc.

  12. The Authoritative Parenting Index: predicting health risk behaviors among children and adolescents.

    Science.gov (United States)

    Jackson, C; Henriksen, L; Foshee, V A

    1998-06-01

    Public health research demonstrates increasing interest in mobilizing parental influence to prevent health risk behaviors among children and adolescents. This research focuses on authoritative parenting, which previous studies suggest can prevent health risk behaviors among youth. To evaluate the reliability and validity of a new survey measure of authoritative parenting, data from studies of (1) substance use in a sample of 1,236 fourth- and sixth-grade students; (2) weapon carrying and interpersonal violence in a sample of 1,490 ninth- and tenth-grade students, and (3) anger, alienation, and conflict resolution in a sample of 224 seventh- and eighth-grade students were analyzed. The Authoritative Parenting Index had a factor structure consistent with a theoretical model of the construct; had acceptable reliability; showed grade, sex, and ethnic differences consistent with other studies; and identified parenting types that varied as hypothesized with multiple indicators of social competence and health risk behaviors among children and adolescents.

  13. Air quality trends and potential health effects - Development of an aggregate risk index

    Science.gov (United States)

    Sicard, Pierre; Lesne, Olivia; Alexandre, Nicolas; Mangin, Antoine; Collomp, Rémy

    2011-02-01

    The "Provence Alpes Côte d'Azur" (PACA) region, in the South East of France, is one of Europe's regions most influenced by the atmospheric pollution. During the last 15 years, the industrial emissions decrease caused an evolution of the atmospheric pollution nature. Nowadays, atmospheric pollution is more and more influenced by the road traffic, the dominating pollution source in urban zones for the PACA region. Combined with this intense road traffic, the strong hot season of the Mediterranean climate contributes to the region bad air quality; it is known to be one of the worse in Europe. The recognized air pollution effects over public health include increased risk of hospital admissions and mortality by respiratory or cardiovascular diseases. The combination of these serious pollution related health hazards with senior and children vulnerabilities leads to serious sanitary concerns. Over the 1990-2005 period, we obtained, using the non-parametric Mann-Kendall test from annual mortality dataset (CépiDC), decreasing trends for Asthma (-5.00% year -1), Cardiovascular (-0.73% year -1), Ischemic (-0.69% year -1) and cerebrovascular diseases (-3.10% year -1). However, for "Other heart diseases" (+0.10% year -1) and "Respiratory" (+0.10% year -1) an increase was observed. The development of an adequate tool to understand impacts of pollution levels is of utmost importance. Different pollutants have different health endpoints, information may be lost through the use of a single index consequently, in this study we present the modified formula of air quality index, based on Cairncross's concept the Aggregate Risk Index (ARI). ARI is based on the relative risk of the well-established increased daily mortality, or morbidity, enabling an assessment of additive effects of short-term exposure to the main air pollutants: PM 2.5, PM 10, SO 2, O 3 and NO 2 in order to account for the reality of the multiple exposures impacts of chemical agents. The ARI, developed per pathology

  14. Allogeneic Hematopoietic Cell Transplantation for Older Patients: Prognosis Determined by Disease Risk Index.

    Science.gov (United States)

    He, Fiona; Cao, Qing; Lazaryan, Aleksandr; Brunstein, Claudio; Holtan, Shernan; Warlick, Erica; Ustun, Celalettin; McClune, Brian; Arora, Mukta; Rashidi, Armin; Eckfeldt, Craig; Weisdorf, Daniel J; Bejanyan, Nelli

    2017-09-01

    The treatment of elderly patients with advanced hematological malignancies has expanded to include reduced-intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (alloHCT) as a potentially curative option. We studied the association between Disease Risk Index (DRI) and clinical outcomes of 196 elderly patients (median age, 64.8; range, 60 to 75 years) with hematological malignancies receiving RIC alloHCT (2000 to 2014). Donors were related and unrelated adults (n = 100, 51.1%) or umbilical cord blood (n = 96, 48.9%). DRI classified 12 patients (6.1%) as low risk (LR), 146 patients (74.5%) as intermediate risk (IR), and 38 patients (19.4%) as high risk (HR). Two-year overall survival (OS) was 47% (52% for LR/IR versus 29% for HR, P risk of relapse (hazard ratio, 2.07; 95% confidence interval [CI], 1.34 to 3.33; P = .02) and treatment failure (hazard ratio, 2.07; 95% CI, 1.35 to 3.18; P risk of relapse leading to poor survival in HR DRI, participation in clinical trials offering relapse prevention strategies after RIC alloHCT should be encouraged when available. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  15. Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis

    NARCIS (Netherlands)

    Blum, Johannes; Lockwood, Diana N. J.; Visser, Leo; Harms, Gundel; Bailey, Mark S.; Caumes, Eric; Clerinx, Jan; van Thiel, Pieter P. A. M.; Morizot, Gloria; Hatz, Christoph; Buffet, Pierre

    2012-01-01

    This review addresses the question of whether the risk of developing mucosal leishmaniasis (ML) warrants systemic treatment in all patients with New World cutaneous leishmaniasis (CL) or whether local treatment might be an acceptable alternative. The risk of patients with New World CL developing ML

  16. Body mass index cut-points to identify cardiometabolic risk in black South Africans.

    Science.gov (United States)

    Kruger, H Salome; Schutte, Aletta E; Walsh, Corinna M; Kruger, Annamarie; Rennie, Kirsten L

    2017-02-01

    To determine optimal body mass index (BMI) cut-points for the identification of cardiometabolic risk in black South African adults. We performed a cross-sectional study of a weighted sample of healthy black South Africans aged 25-65 years (721 men, 1386 women) from the North West and Free State Provinces. Demographic, lifestyle and anthropometric measures were taken, and blood pressure, fasting serum triglycerides, high-density lipoprotein (HDL) cholesterol and blood glucose were measured. We defined elevated cardiometabolic risk as having three or more risk factors according to international metabolic syndrome criteria. Receiver operating characteristic curves were applied to identify an optimal BMI cut-point for men and women. BMI had good diagnostic performance to identify clustering of three or more risk factors, as well as individual risk factors: low HDL-cholesterol, elevated fasting glucose and triglycerides, with areas under the curve >.6, but not for high blood pressure. Optimal BMI cut-points averaged 22 kg/m 2 for men and 28 kg/m 2 for women, respectively, with better sensitivity in men (44.0-71.9 %), and in women (60.6-69.8 %), compared to a BMI of 30 kg/m 2 (17-19.1, 53-61.4 %, respectively). Men and women with a BMI >22 and >28 kg/m 2 , respectively, had significantly increased probability of elevated cardiometabolic risk after adjustment for age, alcohol use and smoking. In black South African men, a BMI cut-point of 22 kg/m 2 identifies those at cardiometabolic risk, whereas a BMI of 30 kg/m 2 underestimates risk. In women, a cut-point of 28 kg/m 2 , approaching the WHO obesity cut-point, identifies those at risk.

  17. Managing hydroclimatological risk to water supply with option contracts and reservoir index insurance

    Science.gov (United States)

    Brown, Casey; Carriquiry, Miguel

    2007-11-01

    This paper explores the performance of a system of economic instruments designed to facilitate the reduction of hydroclimatologic variability-induced impacts on stakeholders of shared water supply. The system is composed of bulk water option contracts between urban water suppliers and agricultural users and insurance indexed on reservoir inflows. The insurance is designed to cover the financial needs of the water supplier in situations where the option is likely to be exercised. Insurance provides the irregularly needed funds for exercising the water options. The combined option contract - reservoir index insurance system creates risk sharing between sectors that is currently lacking in many shared water situations. Contracts are designed for a shared agriculture - urban water system in Metro Manila, Philippines, using optimization and Monte Carlo analysis. Observed reservoir inflows are used to simulate contract performance. Results indicate the option - insurance design effectively smooths water supply costs of hydrologic variability for both agriculture and urban water.

  18. ENVIRONMENTAL SCIENCE. Profiling risk and sustainability in coastal deltas of the world.

    Science.gov (United States)

    Tessler, Z D; Vörösmarty, C J; Grossberg, M; Gladkova, I; Aizenman, H; Syvitski, J P M; Foufoula-Georgiou, E

    2015-08-07

    Deltas are highly sensitive to increasing risks arising from local human activities, land subsidence, regional water management, global sea-level rise, and climate extremes. We quantified changing flood risk due to extreme events using an integrated set of global environmental, geophysical, and social indicators. Although risks are distributed across all levels of economic development, wealthy countries effectively limit their present-day threat by gross domestic product-enabled infrastructure and coastal defense investments. In an energy-constrained future, such protections will probably prove to be unsustainable, raising relative risks by four to eight times in the Mississippi and Rhine deltas and by one-and-a-half to four times in the Chao Phraya and Yangtze deltas. The current emphasis on short-term solutions for the world's deltas will greatly constrain options for designing sustainable solutions in the long term. Copyright © 2015, American Association for the Advancement of Science.

  19. A Risk-Free Protection Index Model for Portfolio Selection with Entropy Constraint under an Uncertainty Framework

    Directory of Open Access Journals (Sweden)

    Jianwei Gao

    2017-02-01

    Full Text Available This paper aims to develop a risk-free protection index model for portfolio selection based on the uncertain theory. First, the returns of risk assets are assumed as uncertain variables and subject to reputable experts’ evaluations. Second, under this assumption, combining with the risk-free interest rate we define a risk-free protection index (RFPI, which can measure the protection degree when the loss of risk assets happens. Third, note that the proportion entropy serves as a complementary means to reduce the risk by the preset diversification requirement. We put forward a risk-free protection index model with an entropy constraint under an uncertainty framework by applying the RFPI, Huang’s risk index model (RIM, and mean-variance-entropy model (MVEM. Furthermore, to solve our portfolio model, an algorithm is given to estimate the uncertain expected return and standard deviation of different risk assets by applying the Delphi method. Finally, an example is provided to show that the risk-free protection index model performs better than the traditional MVEM and RIM.

  20. World-wide risk assessment of the transportation of radioactive materials

    International Nuclear Information System (INIS)

    Ericsson, A.M.; Elert, M.

    1983-01-01

    The aim of the project reported in this paper is to develop the means and methods for a risk analysis of the transportation of radioactive materials throughout the world. The project was initiated by the Standing Advisory Group on the Safe Transport of Radioactive Materials (SAGSTRAM) of the IAEA. In 1979 the Swedish Nuclear Power Inspectorate and the IAEA signed an agreement on the development of a model for calculation of the transport risk. Member States of the IAEA are invited to use the model for a risk assessment of the transportation of radioactive materials in their own country. These assessments will be collected and analyzed and a world-wide risk assessment performed. The IAEA has the overall responsibility for the project and administers it. Sweden manages the project and has performed the applied research with the assistance of research support groups which have supplied data and analyses and performed some other parts of the project. An Oversight Committee with participants from eight Member States has reviewed the progress and has given valuable recommendations. It was important that the model had the sophistication and flexibility required for its use by all Member States but still was easy to handle. The risk calculations are performed by the computer code INTERTRAN which is based on the American computer code RADTRAN II developed by Sandia National Laboratories, Albuquerque, NM. The methodology of the RADTRAN II as well as data and format of the input and output was changed to make the code more internationally oriented. 2 references

  1. Insulin Secretion and Risk for Future Diabetes in Subjects with a Nonpositive Insulinogenic Index

    Directory of Open Access Journals (Sweden)

    Daisuke Aono

    2018-01-01

    Full Text Available Aim. To characterize subjects with a nonpositive insulinogenic index and longitudinally observe changes in their glucose tolerance. Subjects and Methods. A historical cohort study was conducted using data from the medical checkups of public school workers. Indices of insulin secretion and insulin sensitivity derived from oral glucose tolerance test (OGTT and the incidences of diabetes and impaired glucose tolerance (IGT were compared among subgroups of subjects with different insulinogenic index (change in insulin/change in glucose over the first 30 min on the OGTT. Results. Of the 1464 nondiabetic subjects at baseline, 72 (4.9% subjects had a nonpositive insulinogenic index: 42 of those subjects had a nonpositive glucose response (ΔGlu0–30 ≤ 0 and 30 had a nonpositive insulin response (ΔIns0–30 ≤ 0. Compared with subjects who had normal glucose tolerance (NGT with insulinogenic index ≥ 0.4, subjects with a nonpositive glucose response had a higher first-phase Stumvoll and lower incidences of diabetes and IGT based on a log-rank test (p<0.05, whereas subjects with a nonpositive insulin response had lower indices of insulin secretion and a higher incidence of diabetes (p<0.05. Conclusions. These results demonstrate that in the first 30 min on the OGTT, subjects with a nonpositive insulinogenic index due to a nonpositive glucose response (ΔGlu0–30 ≤ 0 had a lower risk for future diabetes and that subjects with nonpositive insulin response (ΔIns0–30 ≤ 0 had a higher risk for future one.

  2. Validation of the What Matters Index: A brief, patient-reported index that guides care for chronic conditions and can substitute for computer-generated risk models.

    Science.gov (United States)

    Wasson, John H; Ho, Lynn; Soloway, Laura; Moore, L Gordon

    2018-01-01

    Current health care delivery relies on complex, computer-generated risk models constructed from insurance claims and medical record data. However, these models produce inaccurate predictions of risk levels for individual patients, do not explicitly guide care, and undermine health management investments in many patients at lesser risk. Therefore, this study prospectively validates a concise patient-reported risk assessment that addresses these inadequacies of computer-generated risk models. Five measures with well-documented impacts on the use of health services are summed to create a "What Matters Index." These measures are: 1) insufficient confidence to self-manage health problems, 2) pain, 3) bothersome emotions, 4) polypharmacy, and 5) adverse medication effects. We compare the sensitivity and predictive values of this index with two representative risk models in a population of 8619 Medicaid recipients. The patient-reported "What Matters Index" and the conventional risk models are found to exhibit similar sensitivities and predictive values for subsequent hospital or emergency room use. The "What Matters Index" is also reliable: akin to its performance during development, for patients with index scores of 1, 2, and ≥3, the odds ratios (with 95% confidence intervals) for subsequent hospitalization within 1 year, relative to patients with a score of 0, are 1.3 (1.1-1.6), 2.0 (1.6-2.4), and 3.4 (2.9-4.0), respectively; for emergency room use, the corresponding odds ratios are 1.3 (1.1-1.4), 1.9 (1.6-2.1), and 2.9 (2.6-3.3). Similar findings were replicated among smaller populations of 1061 mostly older patients from nine private practices and 4428 Medicaid patients without chronic conditions. In contrast to complex computer-generated risk models, the brief patient-reported "What Matters Index" immediately and unambiguously identifies fundamental, remediable needs for each patient and more sensibly directs the delivery of services to patient categories based on

  3. Body mass index and risk for mental stress induced ischemia in coronary artery disease.

    Science.gov (United States)

    Soufer, Robert; Fernandez, Antonio B; Meadows, Judith; Collins, Dorothea; Burg, Matthew M

    2016-05-19

    Acute emotionally reactive mental stress (MS) can provoke prognostically relevant deficits in cardiac function and myocardial perfusion, and chronic inflammation increases risk for this ischemic phenomenon. We have described parasympathetic withdrawal and generation of inflammatory factors in MS. Adiposity is also associated with elevated markers of chronic inflammation. High body mass index (BMI) is frequently used as a surrogate for assessment of excess adiposity, and associated with traditional CAD risk factors, and CAD mortality. BMI is also associated with autonomic dysregulation, adipose tissue derived proinflammatory cytokines, which are also attendant to emotion provoked myocardial ischemia. Thus, we sought to determine if body mass index (BMI) contributes to risk of developing myocardial ischemia provoked by mental stress. We performed a prospective interventional study in a cohort of 161 patients with stable CAD. They completed an assessment of myocardial blood flow with single photon emission computed tomography (SPECT) simultaneously during 2 conditions: laboratory mental stress and at rest. Multivariate logistic regression determined the independent contribution of BMI to the occurrence of mental-stress induced ischemia. Mean age was 65.6±9.0 years; 87.0% had a history of hypertension, and 28.6% had diabetes. Mean BMI was 30.4±4.7. Prevalence of mental stress ischemia was 39.8%. BMI was an independent predictor of mental stress ischemia, OR=1.10, 95% CI [1.01-1.18] for one-point increase in BMI and OR=1.53, 95% CI [1.06-2.21] for a 4.7 point increase in BMI (one standard deviation beyond the cohort BMI mean), p=0.025 for all. These data suggest that BMI may serve as an independent risk marker for mental stress ischemia. The factors attendant with greater BMI, which include autonomic dysregulation and inflammation, may represent pathways by which high BMI contribute to this risk and serve as a conceptual construct to replicate these findings in larger

  4. Portfolio optimization for heavy-tailed assets: Extreme Risk Index vs. Markowitz

    OpenAIRE

    Mainik, Georg; Mitov, Georgi; Rüschendorf, Ludger

    2015-01-01

    Using daily returns of the S&P 500 stocks from 2001 to 2011, we perform a backtesting study of the portfolio optimization strategy based on the extreme risk index (ERI). This method uses multivariate extreme value theory to minimize the probability of large portfolio losses. With more than 400 stocks to choose from, our study seems to be the first application of extreme value techniques in portfolio management on a large scale. The primary aim of our investigation is the potential of ERI in p...

  5. Body mass index and risk of BPH: a meta-analysis.

    Science.gov (United States)

    Wang, S; Mao, Q; Lin, Y; Wu, J; Wang, X; Zheng, X; Xie, L

    2012-09-01

    Epidemiological studies have reported conflicting results relating obesity to BPH. A meta-analysis of cohort and case-control studies was conducted to pool the risk estimates of the association between obesity and BPH. Eligible studies were retrieved by both computer searches and review of references. We analyzed abstracted data with random effects models to obtain the summary risk estimates. Dose-response meta-analysis was performed for studies reporting categorical risk estimates for a series of exposure levels. A total of 19 studies met the inclusion criteria of the meta-analysis. Positive association with body mass index (BMI) was observed in BPH and lower urinary tract symptoms (LUTS) combined group (odds ratio=1.27, 95% confidence intervals 1.05-1.53). In subgroup analysis, BMI exhibited a positive dose-response relationship with BPH/LUTS in population-based case-control studies and a marginal positive association was observed between risk of BPH and increased BMI. However, no association between BPH/LUTS and BMI was observed in other subgroups stratified by study design, geographical region or primary outcome. The overall current literatures suggested that BMI was associated with increased risk of BPH. Further efforts should be made to confirm these findings and clarify the underlying biological mechanisms.

  6. Predicting dyslexia at age 11 from a risk index questionnaire at age 5.

    Science.gov (United States)

    Helland, Turid; Plante, Elena; Hugdahl, Kenneth

    2011-08-01

    This study focused on predicting dyslexia in children ahead of formal literacy training. Because dyslexia is a constitutional impairment, risk factors should be seen in preschool. It was hypothesized that data gathered at age 5 using questions targeting the dyslexia endophenotype should be reliable and valid predictors of dyslexia at age 11. A questionnaire was given to caretakers of 120 5-year-old children, and a risk index score was calculated based on questions regarding health, laterality, motor skills, language, special needs education and heredity. An at-risk group (n = 25) and matched controls (n = 24) were followed until age 11, when a similar questionnaire and literacy tests were administered to the children who participated in the follow-up study (22 at risk and 20 control). Half of the at-risk children and two of the control children at age 5 were identified as having dyslexia at age 11 (8 girls and 5 boys). It is concluded that it is possible to identify children at the age of 5 who will have dyslexia at the age of 11 through a questionnaire approach. Copyright © 2011 John Wiley & Sons, Ltd.

  7. A risk index for multicriterial selection of a logging system with low environmental impact

    Energy Technology Data Exchange (ETDEWEB)

    Horodnic, Sergiu Andrei, E-mail: horodnic@usv.ro

    2015-02-15

    Setting up the working stages in forest operations is conditioned by environmental protection and forest health requirements. This paper exposes a method for improving the decision-making process by choosing the most environmentally effective logging systems according to terrain configuration and stand characteristics. Such a methodology for selecting machines or logging systems accounting for environment, safety as well as economics, becomes mandatory in the context of sustainable management of forest with multiple functions. Based on analytic hierarchy process analysis the following classification of the environmental performance for four considered alternatives was obtained: skyline system (42.43%), forwarder system (20.22%), skidder system (19.92%) and horse logging system (17.43%). Further, an environmental risk matrix for the most important 28 risk factors specific to any work equipment used in forest operations was produced. In the end, a multicriterial analysis generated a risk index RI ranging between 1.0 and 3.5, which could help choosing the optimal combination of logging system and logging equipment with low environmental impact. In order to demonstrate the usefulness of the proposed approach, a simple application in specific conditions of a harvesting site is presented. - Highlights: • We propose a decision-making algorithm to select eco-friendly logging systems. • Analytic hierarchy process was applied for ranking 4 types of logging systems. • An environmental risk matrix with 28 risk factors in forest operations was made up.

  8. A risk index for multicriterial selection of a logging system with low environmental impact

    International Nuclear Information System (INIS)

    Horodnic, Sergiu Andrei

    2015-01-01

    Setting up the working stages in forest operations is conditioned by environmental protection and forest health requirements. This paper exposes a method for improving the decision-making process by choosing the most environmentally effective logging systems according to terrain configuration and stand characteristics. Such a methodology for selecting machines or logging systems accounting for environment, safety as well as economics, becomes mandatory in the context of sustainable management of forest with multiple functions. Based on analytic hierarchy process analysis the following classification of the environmental performance for four considered alternatives was obtained: skyline system (42.43%), forwarder system (20.22%), skidder system (19.92%) and horse logging system (17.43%). Further, an environmental risk matrix for the most important 28 risk factors specific to any work equipment used in forest operations was produced. In the end, a multicriterial analysis generated a risk index RI ranging between 1.0 and 3.5, which could help choosing the optimal combination of logging system and logging equipment with low environmental impact. In order to demonstrate the usefulness of the proposed approach, a simple application in specific conditions of a harvesting site is presented. - Highlights: • We propose a decision-making algorithm to select eco-friendly logging systems. • Analytic hierarchy process was applied for ranking 4 types of logging systems. • An environmental risk matrix with 28 risk factors in forest operations was made up

  9. Strong influence of El Niño Southern Oscillation on flood risk around the world

    Science.gov (United States)

    Ward, Philip J.; Jongman, B; Kummu, M.; Dettinger, Mike; Sperna Weiland, F.C; Winsemius, H.C

    2014-01-01

    El Niño Southern Oscillation (ENSO) is the most dominant interannual signal of climate variability and has a strong influence on climate over large parts of the world. In turn, it strongly influences many natural hazards (such as hurricanes and droughts) and their resulting socioeconomic impacts, including economic damage and loss of life. However, although ENSO is known to influence hydrology in many regions of the world, little is known about its influence on the socioeconomic impacts of floods (i.e., flood risk). To address this, we developed a modeling framework to assess ENSO’s influence on flood risk at the global scale, expressed in terms of affected population and gross domestic product and economic damages. We show that ENSO exerts strong and widespread influences on both flood hazard and risk. Reliable anomalies of flood risk exist during El Niño or La Niña years, or both, in basins spanning almost half (44%) of Earth’s land surface. Our results show that climate variability, especially from ENSO, should be incorporated into disaster-risk analyses and policies. Because ENSO has some predictive skill with lead times of several seasons, the findings suggest the possibility to develop probabilistic flood-risk projections, which could be used for improved disaster planning. The findings are also relevant in the context of climate change. If the frequency and/or magnitude of ENSO events were to change in the future, this finding could imply changes in flood-risk variations across almost half of the world’s terrestrial regions.

  10. Strong influence of El Niño Southern Oscillation on flood risk around the world

    Science.gov (United States)

    Ward, Philip J.; Jongman, Brenden; Kummu, Matti; Dettinger, Michael D.; Sperna Weiland, Frederiek C.; Winsemius, Hessel C.

    2014-01-01

    El Niño Southern Oscillation (ENSO) is the most dominant interannual signal of climate variability and has a strong influence on climate over large parts of the world. In turn, it strongly influences many natural hazards (such as hurricanes and droughts) and their resulting socioeconomic impacts, including economic damage and loss of life. However, although ENSO is known to influence hydrology in many regions of the world, little is known about its influence on the socioeconomic impacts of floods (i.e., flood risk). To address this, we developed a modeling framework to assess ENSO’s influence on flood risk at the global scale, expressed in terms of affected population and gross domestic product and economic damages. We show that ENSO exerts strong and widespread influences on both flood hazard and risk. Reliable anomalies of flood risk exist during El Niño or La Niña years, or both, in basins spanning almost half (44%) of Earth’s land surface. Our results show that climate variability, especially from ENSO, should be incorporated into disaster-risk analyses and policies. Because ENSO has some predictive skill with lead times of several seasons, the findings suggest the possibility to develop probabilistic flood-risk projections, which could be used for improved disaster planning. The findings are also relevant in the context of climate change. If the frequency and/or magnitude of ENSO events were to change in the future, this finding could imply changes in flood-risk variations across almost half of the world’s terrestrial regions. PMID:25331867

  11. A Madison-Numeracy Citation Index (2008-2015: Implementing a Vision for a Quantitatively Literate World

    Directory of Open Access Journals (Sweden)

    Nathan D. Grawe

    2017-01-01

    Full Text Available This editorial recognizes the contributions made by Bernard Madison to the field of quantitative literacy with a bibliographic index of his papers, edited volumes, and works contained therein that were cited in the first eight volumes (2008-2015 of Numeracy. In total, 61 citing papers ("sources" cite 42 Madison works ("citations" a total of 218 times. The source and citation indexes provided in the appendix at the end of this editorial make it easy to see the direct contribution of Madison's work to the arguments and debates contained in the founding years of the journal. For those who are new to the field of quantitative reasoning, the citation index also provides an essential reading list. Most of the citations and sources are open-access and links within the indexes aid easy access to Madison's important contribution to Numeracy and the quantitative literacy movement.

  12. Is risk of degenerative musculoskeletal conditions associated with pre-pregnancy body mass index and parity?

    DEFF Research Database (Denmark)

    Bliddal, Mette; Pottegård, Anton; Kirkegaard, Helene

    Background Obesity among women may influence the risk of degenerative musculoskeletal conditions (MSCs) and contribute to poor quality of life. Parity, which constitutes a sudden natural increase in weight as well it affects long-term body mass index (BMI), may put strain on the musculoskeletal....... Information on height and weight prior to pregnancy was obtained from telephone interviews and parity from the Danish Medical Birth Registry. Diagnoses on degenerative MSC including osteoarthritis, disc disorders, low back pain, and soft tissue disorders were obtained from the National Patient Registry......% confidence interval 1.41-1.83]). Conclusions High pre-pregnancy BMI increased the occurrence of degenerative MSC in the years following pregnancy and childbirth. In combination with increasing pre-pregnancy BMI, higher parity added to an already elevated risk. Prevention of maternal overweight may reduce...

  13. Glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases

    Directory of Open Access Journals (Sweden)

    Tatiana Uchôa Passos

    2015-03-01

    Full Text Available The objective was to determine the glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases. Nine fruits were investigated: coconut water (for the purpose of this study, coconut water was classified as a “fruit”, guava, tamarind, passion fruit, custard apple, hog plum, cashew, sapodilla, and soursop. The GI and GL were determined according to the Food and Agriculture Organization protocol. The GL was calculated taking into consideration intake recommendation guidelines; 77.8% of the fruits had low GI although significant oscillations were observed in some graphs, which may indicate potential risks of disease. Coconut water and custard apple had a moderate GI, and all fruits had low GL. The fruits evaluated are healthy and can be consumed following the daily recommended amount. However, caution is recommended with fruits causing early glycemic peak and the fruits with moderated GI (coconut water and custard apple.

  14. Evaluation of a temporal fire risk index in Mediterranean forests from NOAA thermal IR

    International Nuclear Information System (INIS)

    Vidal, A.; Pinglo, F.; Durand, H.; Devaux-Ros, C.; Maillet, A.

    1994-01-01

    Mediterranean forests are regularly subjected to a large number of fires; 537,000 ha were burned during the severe European drought of 1990. The French Ministries of Environment, Interior, and Agriculture are trying to implement efficient methods to prevent forest fires and to reduce their incidence. Fire risk is composed of human, ecological, and climatic factors that are already accounted for in prevention methods. However, the importance of biophysical factors, especially the water status of forest trees, bushes, grasses, and litter should also be considered. In a first step, thermal infrared data from NOAA-AVHRR daily images covering an 18-month period were used to estimate temporal variations of forest evapotranspiration through an energy budget-based relationship. Results were related to statistics on fire starts, in order to derive a fire risk index that can be used for a real-time regional alarm. (author)

  15. Prostate Health Index improves multivariable risk prediction of aggressive prostate cancer.

    Science.gov (United States)

    Loeb, Stacy; Shin, Sanghyuk S; Broyles, Dennis L; Wei, John T; Sanda, Martin; Klee, George; Partin, Alan W; Sokoll, Lori; Chan, Daniel W; Bangma, Chris H; van Schaik, Ron H N; Slawin, Kevin M; Marks, Leonard S; Catalona, William J

    2017-07-01

    To examine the use of the Prostate Health Index (PHI) as a continuous variable in multivariable risk assessment for aggressive prostate cancer in a large multicentre US study. The study population included 728 men, with prostate-specific antigen (PSA) levels of 2-10 ng/mL and a negative digital rectal examination, enrolled in a prospective, multi-site early detection trial. The primary endpoint was aggressive prostate cancer, defined as biopsy Gleason score ≥7. First, we evaluated whether the addition of PHI improves the performance of currently available risk calculators (the Prostate Cancer Prevention Trial [PCPT] and European Randomised Study of Screening for Prostate Cancer [ERSPC] risk calculators). We also designed and internally validated a new PHI-based multivariable predictive model, and created a nomogram. Of 728 men undergoing biopsy, 118 (16.2%) had aggressive prostate cancer. The PHI predicted the risk of aggressive prostate cancer across the spectrum of values. Adding PHI significantly improved the predictive accuracy of the PCPT and ERSPC risk calculators for aggressive disease. A new model was created using age, previous biopsy, prostate volume, PSA and PHI, with an area under the curve of 0.746. The bootstrap-corrected model showed good calibration with observed risk for aggressive prostate cancer and had net benefit on decision-curve analysis. Using PHI as part of multivariable risk assessment leads to a significant improvement in the detection of aggressive prostate cancer, potentially reducing harms from unnecessary prostate biopsy and overdiagnosis. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  16. Obesity-risk behaviours and their associations with body mass index (BMI) in Korean American children.

    Science.gov (United States)

    Jang, Myoungock; Grey, Margaret; Sadler, Lois; Jeon, Sangchoon; Nam, Soohyun; Song, Hee-Jung; Whittemore, Robin

    2017-08-03

    To describe obesity-risk behaviours (diet, physical activity and sedentary behaviour) and examine the relationships of the obesity-risk behaviours with body mass index (BMI) in school-aged Korean American children. Korean American children have a risk of becoming overweight or obese and developing obesity-related complications; however, there is limited research about obesity-risk behaviours in Korean American children. A cross-sectional study. Obesity-risk behaviours of children were assessed with well-validated self-report questionnaires (i.e., Elementary-level School-based Nutrition Monitoring Questionnaire) from children and their mothers. Height and weight of children were measured. Data were analysed with bivariate and multivariate analyses using mixed effects models to incorporate the correlation within siblings. A total of 170 Korean American children (mean age 10.9 [2.0] years; 52.4% girls; mean BMI 19.3 [3.2]; 28.7% ≥85 percentiles) participated in the study. Only 38.3% of Korean American children met established recommendations of five fruits/vegetables per day; 56.5% met recommendations for more than 3 days per week of vigorous physical activity; and 40.8% met recommendations for obesity in Korean American children and initiate clinical interventions to improve obesity-risk behaviours, especially sedentary behaviour, in Korean American children. Clinical assessment and management of the risk of developing overweight and obesity as well as obesity-related behaviours are important to improve obesity-related complications in overall Korean Americans. © 2017 John Wiley & Sons Ltd.

  17. Body mass index, physical activity, and risk of adult meningioma and glioma: A meta-analysis.

    Science.gov (United States)

    Niedermaier, Tobias; Behrens, Gundula; Schmid, Daniela; Schlecht, Inga; Fischer, Beate; Leitzmann, Michael F

    2015-10-13

    Whether adiposity and lack of physical activity affect the risk for developing meningioma and glioma is poorly understood. Our objective was to characterize these associations in detail. We conducted a systematic review and meta-analysis of adiposity and physical activity in relation to meningioma and glioma using cohort and case-control studies published through February 2015. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We identified 12 eligible studies of body mass index (BMI) and 6 studies of physical activity, comprising up to 2,982 meningioma cases and 3,057 glioma cases. Using normal weight as the reference group, overweight (summary relative risk [RR] = 1.21, 95% confidence interval [CI] = 1.01-1.43) and obesity (RR = 1.54, 95% CI = 1.32-1.79) were associated with increased risk of meningioma. In contrast, overweight (RR = 1.06, 95% CI = 0.94-1.20) and obesity (RR = 1.11, 95% CI = 0.98-1.27) were unrelated to glioma. Similarly, dose-response meta-analyses revealed a statistically significant positive association of BMI with meningioma, but not glioma. High vs low physical activity levels showed a modest inverse relation to meningioma (RR = 0.73, 95% CI = 0.61-0.88) and a weak inverse association with glioma (RR = 0.86, 95% CI = 0.76-0.97). Relations persisted when the data were restricted to prospective studies, except for the association between physical activity and glioma, which was rendered statistically nonsignificant (RR = 0.91, 95% CI = 0.77-1.07). Adiposity is related to enhanced risk for meningioma but is unassociated with risk for glioma. Based on a limited body of evidence, physical activity is related to decreased risk of meningioma but shows little association with risk of glioma. © 2015 American Academy of Neurology.

  18. Spontaneous baroreflex sensitivity: toward an ideal index of cardiovascular risk in hypertension?

    Science.gov (United States)

    Lantelme, Pierre; Khettab, Fouad; Custaud, Marc-Antoine; Rial, Marie-Odile; Joanny, Christiane; Gharib, Claude; Milon, Hugues

    2002-05-01

    Estimating the risk entailed by classical risk factors like blood pressure (BP) or serum cholesterol may be difficult because of their variability and the often unknown duration of exposure. Having variables integrating the impact of those classical risk factors on the cardiovascular system would probably aid the prediction of cardiovascular events. The present study aimed at determining whether cardiac baroreflex sensitivity (BRS), correlates with several risk factors and thus is a good candidate for being such an integrative variable. As a comparison, left ventricular mass (LVM), pulse wave velocity (PWV), and creatinine were also tested for association with risk factors. A total of 302 subjects referred for hypertension, were considered. They had a 24-h BP recording and a determination of BRS by two different methods (sequence and alpha coefficient), in two different positions (lying and standing). They were also tested for the presence of left ventricular hypertrophy (LVH) (by echocardiography and electrocardiogram) and had a PWV measurement. Biological testing included serum lipids, blood glucose, creatinine, proteinuria and urinary excretion of microalbumin. There was a strong correlation between the two methods of BRS measurement in each position (P < 0.001). BRS determined by the sequence method in the lying position was correlated significantly and independently with age, 24-h systolic BP, heart rate, and serum cholesterol with P values < 0.001, < 0.001, < 0.01, and < 0.05, respectively. In an univariate analysis, BRS was also correlated with echocardiographic LVM index (r = -0.21, P < 0.05) and PWV (r = -0.27, P < 0.001), which possibly reflects its dependence on both vascular and cardiac damages. The present study supports the hypothesis that BRS could encompass the impact over time of several risk factors on the cardiovascular system. Thus, it may constitute a valuable parameter in assessing more precisely the risk of cardiovascular events.

  19. Assessing heat-related health risk in Europe via the Universal Thermal Climate Index (UTCI)

    Science.gov (United States)

    Di Napoli, Claudia; Pappenberger, Florian; Cloke, Hannah L.

    2018-03-01

    In this work, the potential of the Universal Thermal Climate Index (UTCI) as a heat-related health risk indicator in Europe is demonstrated. The UTCI is a bioclimate index that uses a multi-node human heat balance model to represent the heat stress induced by meteorological conditions to the human body. Using 38 years of meteorological reanalysis data, UTCI maps were computed to assess the thermal bioclimate of Europe for the summer season. Patterns of heat stress conditions and non-thermal stress regions are identified across Europe. An increase in heat stress up to 1 °C is observed during recent decades. Correlation with mortality data from 17 European countries revealed that the relationship between the UTCI and death counts depends on the bioclimate of the country, and death counts increase in conditions of moderate and strong stress, i.e., when UTCI is above 26 and 32 °C. The UTCI's ability to represent mortality patterns is demonstrated for the 2003 European heatwave. These findings confirm the importance of UTCI as a bioclimatic index that is able to both capture the thermal bioclimatic variability of Europe, and relate such variability with the effects it has on human health.

  20. Injury risk curves for the WorldSID 50th male dummy.

    Science.gov (United States)

    Petitjean, Audrey; Trosseille, Xavier; Petit, Philippe; Irwin, Annette; Hassan, Joe; Praxl, Norbert

    2009-11-01

    The development of the WorldSID 50th percentile male dummy was initiated in 1997 by the International Organisation for Standardisation (ISO/SC12/TC22/WG5) with the objective of developing a more biofidelic side impact dummy and supporting the adoption of a harmonised dummy into regulations. More than 45 organizations from all around the world have contributed to this effort including governmental agencies, research institutes, car manufacturers and dummy manufacturers. The first production version of the WorldSID 50th male dummy was released in March 2004 and demonstrated an improved biofidelity over existing side impact dummies. Full scale vehicle tests covering a wide range of side impact test procedures were performed worldwide with the WorldSID dummy. However, the vehicle safety performance could not be assessed due to lack of injury risk curves for this dummy. The development of these curves was initiated in 2004 within the framework of ISO/SC12/TC22/WG6 (Injury criteria). In 2008, the ACEA- Dummy Task Force (TFD) decided to contribute to this work and offered resources for a project manager to coordinate of the effort of a group of volunteer biomechanical experts from international institutions (ISO, EEVC, VRTC/NHTSA, JARI, Transport Canada), car manufacturers (ACEA, Ford, General Motors, Honda, Toyota, Chrysler) and universities (Wayne State University, Ohio State University, John Hopkins University, Medical College of Wisconsin) to develop harmonized injury risk curves. An in-depth literature review was conducted. All the available PMHS datasets were identified, the test configurations and the quality of the results were checked. Criteria were developed for inclusion or exclusion of PMHS tests in the development of the injury risk curves. Data were processed to account for differences in mass and age of the subjects. Finally, injury risk curves were developed using the following statistical techniques, the certainty method, the Mertz/Weber method, the

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

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

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

  2. Determination of the health of Lunyangwa wetland using Wetland Classification and Risk Assessment Index

    Science.gov (United States)

    Wanda, Elijah M. M.; Mamba, Bhekie B.; Msagati, Titus A. M.; Msilimba, Golden

    2016-04-01

    Wetlands are major sources of various ecological goods and services including storage and distribution of water in space and time which help in ensuring the availability of surface and groundwater throughout the year. However, there still remains a poor understanding of the range of values of water quality parameters that occur in wetlands either in its impacted state or under natural conditions. It was thus imperative to determine the health of Lunyangwa wetland in Mzuzu City in Malawi in order to classify and determine its state. This study used the Escom's Wetland Classification and Risk Assessment Index Field Guide to determine the overall characteristics of Lunyangwa wetland and to calculate its combined Wetland Index Score. Data on site information, field measurements (i.e. EC, pH, temperature and DO) and physical characteristics of Lunyangwa wetland were collected from March, 2013 to February, 2014. Results indicate that Lunyangwa wetland is a largely open water zone which is dominated by free-floating plants on the water surface, beneath surface and emergent in substrate. Furthermore, the wetland can be classified as of a C ecological category (score = 60-80%), which has been moderately modified with moderate risks of the losses and changes occurring in the natural habitat and biota in the wetland. It was observed that the moderate modification and risk were largely because of industrial, agricultural, urban/social catchment stressors on the wetland. This study recommends an integrated and sustainable management approach coupled with continuous monitoring and evaluation of the health of the wetland for all stakeholders in Mzuzu City. This would help to maintain the health of Lunyangwa wetland which is currently at risk of being further modified due to the identified catchment stressors.

  3. Cumulative Mass and NIOSH Variable Lifting Index Method for Risk Assessment: Possible Relations.

    Science.gov (United States)

    Stucchi, Giulia; Battevi, Natale; Pandolfi, Monica; Galinotti, Luca; Iodice, Simona; Favero, Chiara

    2018-02-01

    Objective The aim of this study was to explore whether the Variable Lifting Index (VLI) can be corrected for cumulative mass and thus test its efficacy in predicting the risk of low-back pain (LBP). Background A validation study of the VLI method was published in this journal reporting promising results. Although several studies highlighted a positive correlation between cumulative load and LBP, cumulative mass has never been considered in any of the studies investigating the relationship between manual material handling and LBP. Method Both VLI and cumulative mass were calculated for 2,374 exposed subjects using a systematic approach. Due to high variability of cumulative mass values, a stratification within VLI categories was employed. Dummy variables (1-4) were assigned to each class and used as a multiplier factor for the VLI, resulting in a new index (VLI_CMM). Data on LBP were collected by occupational physicians at the study sites. Logistic regression was used to estimate the risk of acute LBP within levels of risk exposure when compared with a control group formed by 1,028 unexposed subjects. Results Data showed greatly variable values of cumulative mass across all VLI classes. The potential effect of cumulative mass on damage emerged as not significant ( p value = .6526). Conclusion When comparing VLI_CMM with raw VLI, the former failed to prove itself as a better predictor of LBP risk. Application To recognize cumulative mass as a modifier, especially for lumbar degenerative spine diseases, authors of future studies should investigate potential association between the VLI and other damage variables.

  4. Past and future trends in cancer and biomedical research: a comparison between Egypt and the world using PubMed-indexed publications.

    Science.gov (United States)

    Zeeneldin, Ahmed Abdelmabood; Taha, Fatma Mohamed; Moneer, Manar

    2012-07-10

    PubMed is a free web literature search service that contains almost 21 millions of abstracts and publications with almost 5 million user queries daily. The purposes of the study were to compare trends in PubMed-indexed cancer and biomedical publications from Egypt to that of the world and to predict future publication volumes. The PubMed was searched for the biomedical publications between 1991 and 2010 (publications dates). Affiliation was then limited to Egypt. Further limitation was applied to cancer, human and animal publications. Poisson regression model was used for prediction of future number of publications between 2011 and 2020. Cancer publications contributed 23% to biomedical publications both for Egypt and the world. Egyptian biomedical and cancer publications contributed about 0.13% to their world counterparts. This contribution was more than doubled over the study period. Egyptian and world's publications increased from year to year with rapid rise starting the year 2003. Egyptian as well as world's human cancer publications showed the highest increases. Egyptian publications had some peculiarities; they showed some drop at the years 1994 and 2002 and apart from the decline in the animal: human ratio with time, all Egyptian publications in the period 1991-2000 were significantly more than those in 2001-2010 (P PubMed publications, respectively. The Egyptian contribution to world's biomedical and cancer publications needs significant improvements through research strategic planning, setting national research priorities, adequate funding and researchers' training.

  5. A World at Risk: Aggregating Development Trends to Forecast Global Habitat Conversion.

    Science.gov (United States)

    Oakleaf, James R; Kennedy, Christina M; Baruch-Mordo, Sharon; West, Paul C; Gerber, James S; Jarvis, Larissa; Kiesecker, Joseph

    2015-01-01

    A growing and more affluent human population is expected to increase the demand for resources and to accelerate habitat modification, but by how much and where remains unknown. Here we project and aggregate global spatial patterns of expected urban and agricultural expansion, conventional and unconventional oil and gas, coal, solar, wind, biofuels and mining development. Cumulatively, these threats place at risk 20% of the remaining global natural lands (19.68 million km2) and could result in half of the world's biomes becoming >50% converted while doubling and tripling the extent of land converted in South America and Africa, respectively. Regionally, substantial shifts in land conversion could occur in Southern and Western South America, Central and Eastern Africa, and the Central Rocky Mountains of North America. With only 5% of the Earth's at-risk natural lands under strict legal protection, estimating and proactively mitigating multi-sector development risk is critical for curtailing the further substantial loss of nature.

  6. A new hazard index for the determination of risk potentials of disposed radioactive wastes

    International Nuclear Information System (INIS)

    Kirchner, Gerald

    1990-01-01

    On the basis of a discussion of advantages and limitations of hazard calculations of nuclear waste, a new hazard index is presented. The model deals with environmental processes that determine radiation exposure to man after failure of a geologic repository and release of radionuclides into the biosphere. Included in the model are isotopic composition of the waste, probability for transport of nuclides to man, cycling in the biosphere, radiotoxicity to man and changes of the risk potential which are due to radioactive build-up and decay processes after the waste nuclides enter the biosphere. Nuclide-specific data necessary for the use of the new index are compiled. Calculations for wastes from different nuclear power reactor types and fuel cycle options indicate that 237 Np and 241 Am are the waste constituents with the most demanding requirements in regard to the long-term isolation potential of a repository. Isolation times required for the wastes analyzed are of the order of 10 7 years. Hazard analyses of nuclear wastes with negligible heat generation from various sources show that secondary wastes from nuclear fuel reprocessing and mixed-oxide fuel fabrication have long-term risk potentials which are about two orders of magnitude higher than those from other wastes. They should be disposed of together with high-level wastes. (author)

  7. The precautionary principle and/or risk assessment in World Trade Organization decisions: a possible role for risk perception.

    Science.gov (United States)

    Goldstein, Bernard; Carruth, Russellyn S

    2004-04-01

    Risk analysis has been recognized and validated in World Trade Organization (WTO) decision processes. In recent years the precautionary principle has been proposed as an additional or alternative approach to standard risk assessment. The precautionary principle has also been advocated by some who see it as part of postmodern democracy in which more power is given to the public on health and safety matters relative to the judgments of technocrats. A more cynical view is that the precautionary principle is particularly championed by the European Community as a means to erect trade barriers. The WTO ruling against the European Community's trade barrier against beef from hormone-treated cattle seemed to support the use of risk assessment and appeared to reject the argument that the precautionary principle was a legitimate basis for trade barriers. However, a more recent WTO decision on asbestos contains language suggesting that the precautionary principle, in the form of taking into account public perception, may be acceptable as a basis for a trade barrier. This decision, if followed in future WTO trade disputes, such as for genetically modified foods, raises many issues central to the field of risk analysis. It is too early to tell whether the precautionary principle will become accepted in WTO decisions, either as a supplement or a substitute for standard risk assessment. But it would undermine the value of the precautionary principle if this principle were misused to justify unwarranted trade barriers.

  8. Childhood body mass index in relation to future risk of oesophageal adenocarcinoma

    DEFF Research Database (Denmark)

    Cook, M B; Freedman, N D; Gamborg, M

    2015-01-01

    BACKGROUND: Middle-aged obese adults are at substantially elevated risk of oesophageal adenocarcinoma. It is unclear whether this risk originates earlier in life. METHODS: We assessed associations between childhood body mass index (BMI) and height-measured annually between ages 7 and 13-with adult....... RESULTS: During 5.4 million person-years of follow-up, 254 (216 males) incident oesophageal adenocarcinomas occurred. At each examined age, cancer risk increased linearly per unit BMI z-score, although associations were only statistically significant for ages 9-13. The HR for the age of 13 years was 1.......31 (95% CI: 1.13, 1.51) per unit BMI z-score. Associations were similar in men and women and across birth cohorts. Childhood height was not related to cancer risk in men but was in women, although these analyses included just 38 female cases. HRs per unit height z-score at the age of 13 years were 1...

  9. Percent body fat is a better predictor of cardiovascular risk factors than body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Qiang; Dong, Sheng-Yong; Sun, Xiao-Nan; Xie, Jing; Cui, Yi [International Medical Center, Chinese PLA General Hospital, Beijing (China)

    2012-04-20

    The objective of the present study was to evaluate the predictive values of percent body fat (PBF) and body mass index (BMI) for cardiovascular risk factors, especially when PBF and BMI are conflicting. BMI was calculated by the standard formula and PBF was determined by bioelectrical impedance analysis. A total of 3859 ambulatory adult Han Chinese subjects (2173 males and 1686 females, age range: 18-85 years) without a history of cardiovascular diseases were recruited from February to September 2009. Based on BMI and PBF, they were classified into group 1 (normal BMI and PBF, N = 1961), group 2 (normal BMI, but abnormal PBF, N = 381), group 3 (abnormal BMI, but normal PBF, N = 681), and group 4 (abnormal BMI and PBF, N = 836). When age, gender, lifestyle, and family history of obesity were adjusted, PBF, but not BMI, was correlated with blood glucose and lipid levels. The odds ratio (OR) and 95% confidence interval (CI) for cardiovascular risk factors in groups 2 and 4 were 1.88 (1.45-2.45) and 2.06 (1.26-3.35) times those in group 1, respectively, but remained unchanged in group 3 (OR = 1.32, 95%CI = 0.92-1.89). Logistic regression models also demonstrated that PBF, rather than BMI, was independently associated with cardiovascular risk factors. In conclusion, PBF, and not BMI, is independently associated with cardiovascular risk factors, indicating that PBF is a better predictor.

  10. Ponderal index at birth associates with later risk of gestational diabetes mellitus.

    Science.gov (United States)

    Crusell, Mie; Damm, Peter; Hansen, Torben; Pedersen, Oluf; Glümer, Charlotte; Vaag, Allan; Lauenborg, Jeannet

    2017-08-01

    Low birth weight (BW) and low ponderal index (PI) are associated with increased risk of type 2 diabetes mellitus. This study has two purposes: first to investigate the influence of PI on the risk of gestational diabetes mellitus (GDM); second, to study the association between glucose metabolism and BW in women with previous GDM. GDM cohort: 185 women with GDM in 1978-1996, attending a follow-up study in 2000-2002. Control cohort: 1137 women from a population-based diabetes screening study (Inter99) in a neighbouring county in 1999-2001. BW and birth length were collected from the original midwifery records. BW and PI were stratified into tertiles for analysis. PI in the lower tertiles was associated with an increased risk of GDM [odds ratio 1.59 (95% confidence interval 1.07-2.36, p = 0.021)]. Among women with previous GDM, the area under the curve (AUC) for plasma levels of glucose and insulin during an OGTT was highest for the lower tertiles of BW (for AUCglucose p = 0.048, for AUCinsulin p = 0.047 adjusted for age and BMI). Lower PI is associated with increased risk of GDM. In women with previous GDM, lower BW is associated with a more severe impairment of glucose metabolism one to two decades after the pregnancy complicated by GDM.

  11. Percent body fat is a better predictor of cardiovascular risk factors than body mass index

    International Nuclear Information System (INIS)

    Zeng, Qiang; Dong, Sheng-Yong; Sun, Xiao-Nan; Xie, Jing; Cui, Yi

    2012-01-01

    The objective of the present study was to evaluate the predictive values of percent body fat (PBF) and body mass index (BMI) for cardiovascular risk factors, especially when PBF and BMI are conflicting. BMI was calculated by the standard formula and PBF was determined by bioelectrical impedance analysis. A total of 3859 ambulatory adult Han Chinese subjects (2173 males and 1686 females, age range: 18-85 years) without a history of cardiovascular diseases were recruited from February to September 2009. Based on BMI and PBF, they were classified into group 1 (normal BMI and PBF, N = 1961), group 2 (normal BMI, but abnormal PBF, N = 381), group 3 (abnormal BMI, but normal PBF, N = 681), and group 4 (abnormal BMI and PBF, N = 836). When age, gender, lifestyle, and family history of obesity were adjusted, PBF, but not BMI, was correlated with blood glucose and lipid levels. The odds ratio (OR) and 95% confidence interval (CI) for cardiovascular risk factors in groups 2 and 4 were 1.88 (1.45-2.45) and 2.06 (1.26-3.35) times those in group 1, respectively, but remained unchanged in group 3 (OR = 1.32, 95%CI = 0.92-1.89). Logistic regression models also demonstrated that PBF, rather than BMI, was independently associated with cardiovascular risk factors. In conclusion, PBF, and not BMI, is independently associated with cardiovascular risk factors, indicating that PBF is a better predictor

  12. Individual and shared effects of social environment and polygenic risk scores on adolescent body mass index.

    Science.gov (United States)

    Coleman, Jonathan R I; Krapohl, Eva; Eley, Thalia C; Breen, Gerome

    2018-04-20

    Juvenile obesity is associated with adverse health outcomes. Understanding genetic and environmental influences on body mass index (BMI) during adolescence could inform interventions. We investigated independent and interactive effects of parenting, socioeconomic status (SES) and polygenic risk on BMI pre-adolescence, and on the rate of change in BMI across adolescence. Genome-wide genotype data, BMI and child perceptions of parental warmth and punitive discipline were available at 11 years old, and parental SES was available from birth on 3,414 unrelated participants. Linear models were used to test the effects of social environment and polygenic risk on pre-adolescent BMI. Change in BMI across adolescence was assessed in a subset (N = 1943). Sex-specific effects were assessed. Higher genetic risk was associated with increased BMI pre-adolescence and across adolescence (p parenting was not significantly associated with either phenotype, but lower SES was associated with increased BMI pre-adolescence. No interactions passed correction for multiple testing. Polygenic risk scores from adult GWAS meta-analyses are associated with BMI in juveniles, suggesting a stable genetic component. Pre-adolescent BMI was associated with social environment, but parental style has, at most, a small effect.

  13. Extinction risk is most acute for the world's largest and smallest vertebrates.

    Science.gov (United States)

    Ripple, William J; Wolf, Christopher; Newsome, Thomas M; Hoffmann, Michael; Wirsing, Aaron J; McCauley, Douglas J

    2017-10-03

    Extinction risk in vertebrates has been linked to large body size, but this putative relationship has only been explored for select taxa, with variable results. Using a newly assembled and taxonomically expansive database, we analyzed the relationships between extinction risk and body mass (27,647 species) and between extinction risk and range size (21,294 species) for vertebrates across six main classes. We found that the probability of being threatened was positively and significantly related to body mass for birds, cartilaginous fishes, and mammals. Bimodal relationships were evident for amphibians, reptiles, and bony fishes. Most importantly, a bimodal relationship was found across all vertebrates such that extinction risk changes around a body mass breakpoint of 0.035 kg, indicating that the lightest and heaviest vertebrates have elevated extinction risk. We also found range size to be an important predictor of the probability of being threatened, with strong negative relationships across nearly all taxa. A review of the drivers of extinction risk revealed that the heaviest vertebrates are most threatened by direct killing by humans. By contrast, the lightest vertebrates are most threatened by habitat loss and modification stemming especially from pollution, agricultural cropping, and logging. Our results offer insight into halting the ongoing wave of vertebrate extinctions by revealing the vulnerability of large and small taxa, and identifying size-specific threats. Moreover, they indicate that, without intervention, anthropogenic activities will soon precipitate a double truncation of the size distribution of the world's vertebrates, fundamentally reordering the structure of life on our planet.

  14. Changes in geriatric nutritional risk index and risk of major adverse cardiac and cerebrovascular events in incident peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Mi Jung Lee

    2017-12-01

    Full Text Available Background: Geriatric nutritional risk index (GNRI is a validated nutritional assessment method, and lower GNRI values are closely associated with adverse clinical outcomes in dialysis patients. This study investigated the impact of changes in GNRI during the first year of dialysis on cardiovascular outcomes in incident peritoneal dialysis (PD patients. Methods: We reviewed medical records in 133 incident PD patients to determine GNRI at the start of PD and after 12 months. Patients were categorized into improved (delta GNRI > 0 and worsening/stationary (delta GNRI ≤ 0 groups. The primary outcome was major adverse cardiac and cerebrovascular events (MACCEs. Results: During a mean follow-up of 51.1 months, the primary outcome was observed in 42 patients (31.6%. The baseline GNRI at PD initiation was not significantly associated with MACCEs (log-rank test, P = 0.40. However, the cumulative event-free rate was significantly lower in the worsening or stationary GNRI group than in the improved group (log-rank test, P = 0.004. Multivariate Cox analysis revealed that a worsening or stationary GNRI was independently associated with higher risk for MACCEs (hazard ratio, 2.47; 95% confidence interval, 1.15–5.29; P = 0.02. In subgroup analysis, patients with worsening or stationary GNRI were at significantly greater risk for MACCEs in both the lower (P = 0.04 and higher (P = 0.01 baseline GNRI groups. Conclusion: Baseline GNRI was not associated with MACCEs, but patients with deteriorating or stationary nutritional status were at significantly greater risk for MACCEs, suggesting that serial monitoring of nutritional status is important to stratify cardiovascular risk in incident PD patients.

  15. The Relationship between Native American Ancestry, Body Mass Index and Diabetes Risk among Mexican-Americans.

    Science.gov (United States)

    Hu, Hao; Huff, Chad D; Yamamura, Yuko; Wu, Xifeng; Strom, Sara S

    2015-01-01

    Higher body mass index (BMI) is a well-established risk factor for type 2 diabetes, and rates of obesity and type 2 diabetes are substantially higher among Mexican-Americans relative to non-Hispanic European Americans. Mexican-Americans are genetically diverse, with a highly variable distribution of Native American, European, and African ancestries. Here, we evaluate the role of Native American ancestry on BMI and diabetes risk in a well-defined Mexican-American population. Participants were randomly selected among individuals residing in the Houston area who are enrolled in the Mexican-American Cohort study. Using a custom Illumina GoldenGate Panel, we genotyped DNA from 4,662 cohort participants for 87 Ancestry-Informative Markers. On average, the participants were of 50.2% Native American ancestry, 42.7% European ancestry and 7.1% African ancestry. Using multivariate linear regression, we found BMI and Native American ancestry were inversely correlated; individuals with ancestry were 2.5 times more likely to be severely obese compared to those with >80% Native American ancestry. Furthermore, we demonstrated an interaction between BMI and Native American ancestry in diabetes risk among women; Native American ancestry was a strong risk factor for diabetes only among overweight and obese women (OR = 1.190 for each 10% increase in Native American ancestry). This study offers new insight into the complex relationship between obesity, genetic ancestry, and their respective effects on diabetes risk. Findings from this study may improve the diabetes risk prediction among Mexican-American individuals thereby facilitating targeted prevention strategies.

  16. Work Ability Index as tool to identify workers at risk of premature work exit.

    Science.gov (United States)

    Roelen, Corné A M; Heymans, Martijn W; Twisk, Jos W R; van der Klink, Jac J L; Groothoff, Johan W; van Rhenen, Willem

    2014-12-01

    To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at baseline and reported their work status (employed, unemployed, disability pension, or retired) after mean 2.3 years of follow-up. Associations between WAI scores and work status were investigated by multinomial logistic regression analysis. The ability of the WAI to discriminate between workers at high and low risk of premature work exit was analyzed by the area (AUC) under the receiver operating characteristic curve. 9,530 (83 %) construction workers had complete data for analysis. At follow-up, 336 (4 %) workers reported disability pension, 125 (1 %) unemployment, and 255 (3 %) retirement. WAI scores were prospectively associated with the risk of disability pension at follow-up, but not with the risk of unemployment and early retirement. The WAI showed fair discrimination to identify workers at risk of disability pension [AUC = 0.74; 95 % confidence interval (CI) 0.70-0.77]. The discriminative ability decreased with age from AUC = 0.78 in workers aged 30-39 years to AUC = 0.69 in workers ≥50 years of age. Discrimination failed for unemployment (AUC = 0.51; 95 % CI 0.47-0.55) and early retirement (AUC = 0.58; 95 % CI 0.53-0.61). The WAI can be used to identify construction workers <50 years of age at increased risk of disability pension and invite them for preventive interventions.

  17. Sleep duration and cancer risk: time to use a "sleep-years" index?

    Science.gov (United States)

    Erren, Thomas C

    2012-09-01

    With a focus on melatonin, a recent paper in the Journal investigated the hypothesis that endometrial cancer might be associated with the duration, and ultimately, amount of sleep. The authors found that "[s]elf-reported sleep duration may not adequately represent melatonin levels." The authors also concluded that there was "weak evidence of an association between sleep duration and endometrial cancer risk." Overall, these are interesting observations because primarily experimental and mechanistic research from many angles supports the study's notion that inappropriate sleep may be a determinant of cancer risk. To find out whether this is so in man, rather than assigning study individuals to fixed or average "baseline sleep categories" i.e., ≤5, 6, 7, 8, ≥9 h of habitual sleep in the present study, the accumulated amount of sleep over decades should be reconstructed in retrospective or constructed in prospective studies. To achieve this end, future epidemiological studies may want to use a sleep-years index [SYI]. This simple exposure parameter promises to be a sensible, feasible, and affordable way to approximate cumulative time spent at sleep in critical time windows over many years which we should expect to be relevant for the development of cancer. The SYI could be tested and used in observational studies which promise to be comparable and can be merged. This commentary provides roots of the index and explains why and how it should be used and how it could be interpreted in rigorous studies of biologically plausible links between sleep, on the one hand, and the development of internal cancers, on the other. This commentary also points out limitations of interpreting the SYI. It is emphasized that, where possible, the SYI should be assessed independently of (a) other sleep facets--such as quality--and of (b) known or suspected cancer risk factors. The respective contribution of (a) and (b) to risk must then be assessed during the analyses. Overall, the

  18. Severe caloric restriction in young women during World War II and subsequent breast cancer risk.

    Science.gov (United States)

    Vin-Raviv, N; Barchana, M; Linn, S; Keinan-Boker, L

    2012-10-01

    The objective of the study was to examine the impact of WWII-related caloric restriction (CR) on subsequent breast cancer (BC) risk based on individual exposure experiences and whether this effect was modified by age at exposure. We compared 65 breast cancer patients diagnosed between 2005-2010 to 200 controls without breast cancer who were all members of various organizations for Jewish WWII survivors in Israel. All participants were Jewish women born in Europe prior to 1945 who lived at least 6 months under Nazi rule during WWII and immigrated to Israel after the war. We estimated CR using a combined index for hunger and used logistic regression models to estimate the association between CR and BC, adjusting for potential confounders. Women who were severely exposed to hunger had an increased risk of BC (OR=5.0, 95% CI= 2.3-10.8) compared to women who were mildly exposed. The association between CR and BC risk was stronger for women who were exposed at a younger age (0-7 years) compared to the risk of BC in women exposed at ≥ 14 years (OR= 2.8, 95% CI=1.3-6.3). Severe exposure to CR is associated with a higher risk for BC decades later, and may be generalized to other cases of severe starvation during childhood that may have long-term effects on cancer in adulthood. © 2012 Blackwell Publishing Ltd.

  19. Climate Risk and Production Shocks: Using Index Insurance to Link Climate Science to Policy for Sustainable Development

    Science.gov (United States)

    McCarney, G. R.; Osgood, D. E.

    2011-12-01

    Smallholder farmers in developing countries are often severely impacted by droughts and other climate related events. However, agricultural insurance programs are largely unavailable in lower-income countries because of limitations in traditional loss-based indemnity insurance. As a result, it is often the case that farmers who are the most vulnerable to climate shocks lack access to the insurance tools that could help to reduce their production risk. Index insurance, a recent financial innovation, has the potential to increase access to insurance for smallholder farmers (Barrett et al. 2007). Index insurance allows farmers to insure their production risk based on a weather index (such as total seasonal rainfall) rather than on crop yields. The use of a weather index addresses many of the perverse incentive problems found in traditional crop insurance, and greatly reduces the costs of insuring smallholder farmers. The trade-off in index insurance, however, is limited accuracy in calibrating payouts to actual losses, a phenomenon commonly known as basis risk. While index insurance has promise as a risk-smoothing instrument, many argue it has greater promise as a mechanism for improving access to credit for smallholder farmers in developing countries (e.g. Barnett, Barrett & Skees 2008). In these areas, farmers are often fully exposed to climate shocks, which greatly affect their willingness to borrow. By smoothing the uncertainty in climate shocks, insurance may allow farmers to take credit for productive risks. There has been much discussion as to the optimal strategy for combining index insurance with credit, specifically if the financial institutions or the individual farmers themselves should hold the insurance policy. Many existing insurance implementations insure the farmer directly. However, since a weather index is a proxy for yield loss based on regional data, there is basis risk due to uninsured idiosyncratic differences between farmers. As a response to

  20. World Alliance for Risk Factor Surveillance White Paper on Surveillance and Health Promotion

    Directory of Open Access Journals (Sweden)

    Stefano Campostrini

    2015-02-01

    Full Text Available This is not a research paper on risk factor surveillance. It is an effort by a key group of researchers and practitioners of risk factor surveillance to define the current state of the art and to identify the key issues involved in the current practice of behavioral risk factor surveillance. Those of us who are the principal authors have worked and carried out research in this area for some three decades. As a result of a series of global meetings beginning in 1999 and continuing every two years since then, a collective working group of the International Union of Health Promotion and Education (IUHPE was formed under the name World Alliance of Risk Factor Surveillance (WARFS. Under this banner the organization sought to write a comprehensive statement on the importance of surveillance to health promotion and public health. This paper, which has been revised and reviewed by established peers in the field, is the result. It provides the reader with a clear summary of the major issues that need to be considered by any and all seeking to carry out behavioral risk factor surveillance.

  1. Diet index-based and empirically derived dietary patterns are associated with colorectal cancer risk.

    Science.gov (United States)

    Miller, Paige E; Lazarus, Philip; Lesko, Samuel M; Muscat, Joshua E; Harper, Gregory; Cross, Amanda J; Sinha, Rashmi; Ryczak, Karen; Escobar, Gladys; Mauger, David T; Hartman, Terryl J

    2010-07-01

    Previous studies have derived patterns by measuring compliance with preestablished dietary guidance or empirical methods, such as principal components analysis (PCA). Our objective was to examine colorectal cancer risk associated with patterns identified by both methods. The study included 431 incident colorectal cancer cases (225 men, 206 women) and 726 healthy controls (330 men, 396 women) participating in a population-based, case-control study. PCA identified sex-specific dietary patterns and the Healthy Eating Index-2005 (HEI-05) assessed adherence to the 2005 Dietary Guidelines for Americans. A fruits and vegetables pattern and a meat, potatoes, and refined grains pattern were identified among men and women; a third pattern (alcohol and sweetened beverages) was identified in men. The fruits and vegetables pattern was inversely associated with risk among men [odds ratio (OR) = 0.38, 95% CI = 0.21-0.69 for the highest compared with the lowest quartile] and women (OR = 0.35, 95% CI = 0.19-0.65). The meat, potatoes, and refined grains pattern was positively associated with risk in women (OR = 2.20, 95% CI = 1.08-4.50) and there was a suggestion of a positive association among men (OR = 1.56, 95% CI = 0.84-2.90; P-trend = 0.070). Men and women with greater HEI-05 scores had a significantly reduced risk of colorectal cancer (OR = 0.56, 95% CI = 0.31-0.99; OR = 0.44, 95% CI = 0.24-0.77, respectively). Following the Dietary Guidelines or a dietary pattern lower in meat, potatoes, high fat, and refined foods and higher in fruits and vegetables may reduce colorectal cancer risk.

  2. Nontraditional risk factors for cardiovascular disease and visceral adiposity index among different body size phenotypes.

    Science.gov (United States)

    Du, T; Zhang, J; Yuan, G; Zhang, M; Zhou, X; Liu, Z; Sun, X; Yu, X

    2015-01-01

    Increased cardiovascular disease and mortality risk in metabolically healthy obese (MHO) individuals remain highly controversial. Several studies suggested risk while others do not. The traditional cardiovascular risk factors may be insufficient to demonstrate the complete range of metabolic abnormalities in MHO individuals. Hence, we aimed to compare the prevalence of elevated lipoprotein (a), apolipoprotein B, and uric acid (UA) levels, apolipoprotein B/apolipoprotein A1 ratio, and visceral adiposity index (VAI) scores, and low apolipoprotein A1 levels among 6 body size phenotypes (normal weight with and without metabolic abnormalities, overweight with and without metabolic abnormalities, and obese with or without metabolic abnormalities). We conducted a cross-sectional analysis of 7765 Chinese adults using data from the nationwide China Health and Nutrition Survey 2009. MHO persons had intermediate prevalence of elevated apolipoprotein B and UA levels, apolipoprotein B/apolipoprotein A1 ratio and VAI scores, and low apolipoprotein A1 levels between metabolically healthy normal-weight (MHNW) and metabolically abnormal obese individuals (P < 0.001 for all comparisons). Elevated apolipoprotein B and UA concentrations, apolipoprotein B/apolipoprotein A1 ratio, and VAI scores were all strongly associated with the MHO phenotype (all P < 0.01). Prevalence of elevated apolipoprotein B and UA levels, apolipoprotein B/apolipoprotein A1 ratio and VAI scores, and low levels of apolipoprotein A1 was higher among MHO persons than among MHNW individuals. The elevated levels of the nontraditional risk factors and VAI scores in MHO persons could contribute to the increased cardiovascular disease risk observed in long-term studies. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Towards a Comparative Index of Seaport Climate-Risk: Development of Indicators from Open Data

    Science.gov (United States)

    McIntosh, R. D.; Becker, A.

    2016-02-01

    Seaports represent an example of coastal infrastructure that is at once critical to global trade, constrained to the land-sea interface, and exposed to weather and climate hazards. Seaports face impacts associated with projected changes in sea level, sedimentation, ocean chemistry, wave dynamics, temperature, precipitation, and storm frequency and intensity. Port decision-makers have the responsibility to enhance resilience against these impacts. At the multi-port (regional or national) scale, policy-makers must prioritize adaptation efforts to maximize the efficiency of limited physical and financial resources. Prioritization requires comparing across seaports, and comparison requires a standardized assessment method, but efforts to date have either been limited in scope to exposure-only assessments or limited in scale to evaluate one port in isolation from a system of ports. In order to better understand the distribution of risk across ports and to inform transportation resilience policy, we are developing a comparative assessment method to measure the relative climate-risk faced by a sample of ports. Our mixed-methods approach combines a quantitative, data-driven, indicator-based assessment with qualitative data collected via expert-elicitation. In this presentation, we identify and synthesize over 120 potential risk indicators from open data sources. Indicators represent exposure, sensitivity, and adaptive capacity for a pilot sample of 20 ports. Our exploratory data analysis, including Principal Component Analysis, uncovered sources of variance between individual ports and between indicators. Next steps include convening an expert panel representing the perspectives of multiple transportation system agencies to find consensus on a suite of robust indicators and metrics for maritime freight node climate risk assessment. The index will be refined based on expert feedback, the sample size expanded, and additional indicators sought from closed data sources

  4. Body mass index in relation to serum prostate-specific antigen levels and prostate cancer risk.

    Science.gov (United States)

    Bonn, Stephanie E; Sjölander, Arvid; Tillander, Annika; Wiklund, Fredrik; Grönberg, Henrik; Bälter, Katarina

    2016-07-01

    High Body mass index (BMI) has been directly associated with risk of aggressive or fatal prostate cancer. One possible explanation may be an effect of BMI on serum levels of prostate-specific antigen (PSA). To study the association between BMI and serum PSA as well as prostate cancer risk, a large cohort of men without prostate cancer at baseline was followed prospectively for prostate cancer diagnoses until 2015. Serum PSA and BMI were assessed among 15,827 men at baseline in 2010-2012. During follow-up, 735 men were diagnosed with prostate cancer with 282 (38.4%) classified as high-grade cancers. Multivariable linear regression models and natural cubic linear regression splines were fitted for analyses of BMI and log-PSA. For risk analysis, Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) and natural cubic Cox regression splines producing standardized cancer-free probabilities were fitted. Results showed that baseline Serum PSA decreased by 1.6% (95% CI: -2.1 to -1.1) with every one unit increase in BMI. Statistically significant decreases of 3.7, 11.7 and 32.3% were seen for increasing BMI-categories of 25 prostate cancer risk although results were indicative of a positive association to incidence rates of high-grade disease and an inverse association to incidence of low-grade disease. However, findings regarding risk are limited by the short follow-up time. In conclusion, BMI was inversely associated to PSA-levels. BMI should be taken into consideration when referring men to a prostate biopsy based on serum PSA-levels. © 2016 UICC.

  5. Fall Risk Index predicts functional decline regardless of fall experiences among community-dwelling elderly.

    Science.gov (United States)

    Ishimoto, Yasuko; Wada, Taizo; Kasahara, Yoriko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wenling; Hirosaki, Mayumi; Nakatsuka, Masahiro; Fujisawa, Michiko; Sakamoto, Ryota; Ishine, Masayuki; Okumiya, Kiyohito; Otsuka, Kuniaki; Matsubayashi, Kozo

    2012-10-01

    The 21-item Fall Risk Index (FRI-21) has been used to detect elderly persons at risk for falls. The aim of this longitudinal study was to evaluate the FRI-21 as a predictor of decline in basic activities of daily living (BADL) among Japanese community-dwelling elderly persons independent of fall risk. The study population consisted of 518 elderly participants aged 65 years and older who were BADL independent at baseline in Tosa, Japan. We examined risk factors for BADL decline from 2008 to 2009 by multiple logistic regression analysis on the FRI-21 and other functional status measures in all participants. We carried out the same analysis in selected participants who had no experience of falls to remove the effect of falls. A total of 45 of 518 participants showed decline in BADL within 1 year. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.05-1.20), FRI-21 ≥ 10 (OR 3.81, 95% CI 1.49-9.27), intellectual activity dependence (OR 3.25, 95% CI 1.42-7.44) and history of osteoarthropathy (OR 3.17, 95% CI 1.40-7.21) were significant independent risk factors for BADL decline within 1 year. FRI-21 ≥ 10 and intellectual activity dependence (≤ 3) remained significant predictors, even in selected non-fallers. FRI-21 ≥ 10 and intellectual activity dependence were significant predictive factors of BADL decline, regardless of fall experience, after adjustment for confounding variables. The FRI-21 is a brief, useful tool not only for predicting falls, but also future decline in functional ability in community-dwelling elderly persons. © 2012 Japan Geriatrics Society.

  6. Body mass index and risk of colorectal carcinoma subtypes classified by tumor differentiation status.

    Science.gov (United States)

    Hanyuda, Akiko; Cao, Yin; Hamada, Tsuyoshi; Nowak, Jonathan A; Qian, Zhi Rong; Masugi, Yohei; da Silva, Annacarolina; Liu, Li; Kosumi, Keisuke; Soong, Thing Rinda; Jhun, Iny; Wu, Kana; Zhang, Xuehong; Song, Mingyang; Meyerhardt, Jeffrey A; Chan, Andrew T; Fuchs, Charles S; Giovannucci, Edward L; Ogino, Shuji; Nishihara, Reiko

    2017-05-01

    Previous studies suggest that abnormal energy balance status may dysregulate intestinal epithelial homeostasis and promote colorectal carcinogenesis, yet little is known about how host energy balance and obesity influence enterocyte differentiation during carcinogenesis. We hypothesized that the association between high body mass index (BMI) and colorectal carcinoma incidence might differ according to tumor histopathologic differentiation status. Using databases of the Nurses' Health Study and Health Professionals Follow-up Study, and duplication-method Cox proportional hazards models, we prospectively examined an association between BMI and the incidence of colorectal carcinoma subtypes classified by differentiation features. 120,813 participants were followed for 26 or 32 years and 1528 rectal and colon cancer cases with available tumor pathological data were documented. The association between BMI and colorectal cancer risk significantly differed depending on the presence or absence of poorly-differentiated foci (P heterogeneity  = 0.006). Higher BMI was associated with a higher risk of colorectal carcinoma without poorly-differentiated foci (≥30.0 vs. 18.5-22.4 kg/m 2 : multivariable-adjusted hazard ratio, 1.87; 95% confidence interval, 1.49-2.34; P trend   0.03, with the adjusted α of 0.01). High BMI was associated with risk of colorectal cancer subtype containing no poorly-differentiated focus. Our findings suggest that carcinogenic influence of excess energy balance might be stronger for tumors that retain better intestinal differentiation throughout the tumor areas.

  7. Low amniotic fluid index in high risk pregnancy and poor apgar score at birth

    International Nuclear Information System (INIS)

    Sultana, S.; Akhtar, K.A.K.

    2008-01-01

    To determine the accuracy of antepartum Amniotic Fluid Index (AFI) of 5 cm was labeled as predictor of good outcome at birth. The subjects in both the groups were demographically matched and fulfilled the inclusion and exclusion criteria. The Apgar score was calculated at 5 minutes of birth. The newborns, with Apgar score 6 were labeled as healthy. AFI was compared with Apgar score, using Chi-square and a p-value was calculated to determine the statistical significance. Sensitivity, specificity, efficiency and the predictive values of AFI at a cut off point of < 5 cm as a predictor of adverse outcome at birth (Apgar score of < 6 at 5 minutes of birth) in high-risk pregnancy were calculated. Only 8 neonates of 50 women with low AFI had low Apgar score. Similarly, 6 neonates of 50 women with normal AFI had poor Apgar score. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and efficiency of AFI as test were 57.1%, 51.3%, 16%, 88% and 52% respectively. Low AFI is a poor predictor of adverse outcome for high-risk term patients. AFI is not a good screening test for high-risk pregnant women at term for birth of an infant with low Apgar score. (author)

  8. Vibrotactile tilt feedback improves dynamic gait index: a fall risk indicator in older adults.

    Science.gov (United States)

    Wall, Conrad; Wrisley, Diane M; Statler, Kennyn D

    2009-07-01

    The purpose of this study was to determine the effectiveness of vibrotactile feedback of body tilt in improving dynamic gait index (DGI) a fall risk indicator in community dwelling older adults. Twelve healthy elderly subjects (three males and nine females, age 79.7+/-5.4 yrs) were tested in an institutional balance rehabilitation laboratory to investigate changes between the feedback off and on conditions. Subjects were acutely exposed to a vibrotactile display that indicated the magnitude and direction of their body tilt from the vertical. DGI and mediolateral (ML) sway were determined during locomotion with, and without, vibrotactile tilt feedback (VTTF). All subjects were at risk for falls based on their initial DGI Score (range: 15-19, mean 17.4+/-1.56), which was taken with the vibratory stimulus turned off. Subjects learned to use the trunk tilt information from the vibrotactile feedback vest through 20-30 min of gait and balance training consisting of activities that challenged their balance. Subjects were then retested on the DGI. Statistically significant changes were demonstrated for the DGI total score while using the vibrotactile tilt feedback. DGI total scores improved from 17.1+/-0.4 to 20.8+/-0.3 (pfall risk indicators for this population.

  9. The poor quality of information about laparoscopy on the World Wide Web as indexed by popular search engines.

    Science.gov (United States)

    Allen, J W; Finch, R J; Coleman, M G; Nathanson, L K; O'Rourke, N A; Fielding, G A

    2002-01-01

    This study was undertaken to determine the quality of information on the Internet regarding laparoscopy. Four popular World Wide Web search engines were used with the key word "laparoscopy." Advertisements, patient- or physician-directed information, and controversial material were noted. A total of 14,030 Web pages were found, but only 104 were unique Web sites. The majority of the sites were duplicate pages, subpages within a main Web page, or dead links. Twenty-eight of the 104 pages had a medical product for sale, 26 were patient-directed, 23 were written by a physician or group of physicians, and six represented corporations. The remaining 21 were "miscellaneous." The 46 pages containing educational material were critically reviewed. At least one of the senior authors found that 32 of the pages contained controversial or misleading statements. All of the three senior authors (LKN, NAO, GAF) independently agreed that 17 of the 46 pages contained controversial information. The World Wide Web is not a reliable source for patient or physician information about laparoscopy. Authenticating medical information on the World Wide Web is a difficult task, and no government or surgical society has taken the lead in regulating what is presented as fact on the World Wide Web.

  10. Assessing systematic risk in the S&P500 index between 2000 and 2011: A Bayesian nonparametric approach

    OpenAIRE

    Rodríguez, Abel; Wang, Ziwei; Kottas, Athanasios

    2017-01-01

    We develop a Bayesian nonparametric model to assess the effect of systematic risks on multiple financial markets, and apply it to understand the behavior of the S&P500 sector indexes between January 1, 2000 and December 31, 2011. More than prediction, our main goal is to understand the evolution of systematic and idiosyncratic risks in the U.S. economy over this particular time period, leading to novel sector-specific risk indexes. To accomplish this goal, we model the appearance of extreme l...

  11. Association Between NCAP Ratings and Real-World Rear Seat Occupant Risk of Injury.

    Science.gov (United States)

    Metzger, Kristina B; Gruschow, Siobhan; Durbin, Dennis R; Curry, Allison E

    2015-01-01

    Several studies have evaluated the correlation between U.S. or Euro New Car Assessment Program (NCAP) ratings and injury risk to front seat occupants, in particular driver injuries. Conversely, little is known about whether NCAP 5-star ratings predict real-world risk of injury to restrained rear seat occupants. The NHTSA has identified rear seat occupant protection as a specific area under consideration for improvements to its NCAP. In order to inform NHTSA's efforts, we examined how NCAP's current 5-star rating system predicts risk of moderate or greater injury among restrained rear seat occupants in real-world crashes. We identified crash-involved vehicles, model year 2004-2013, in NASS-CDS (2003-2012) with known make and model and nonmissing occupant information. We manually matched these vehicles to their NCAP star ratings using data on make, model, model year, body type, and other identifying information. The resultant linked NASS-CDS and NCAP database was analyzed to examine associations between vehicle ratings and rear seat occupant injury risk; risk to front seat occupants was also estimated for comparison. Data were limited to restrained occupants and occupant injuries were defined as any injury with a maximum Abbreviated Injury Scale (AIS) score of 2 or greater. We linked 95% of vehicles in NASS-CDS to a specific vehicle in NCAP. The 18,218 vehicles represented an estimated 6 million vehicles with over 9 million occupants. Rear seat passengers accounted for 12.4% of restrained occupants. The risk of injury in all crashes for restrained rear seat occupants was lower in vehicles with a 5-star driver rating in frontal impact tests (1.4%) than with 4 or fewer stars (2.6%, P =.015); results were similar for the frontal impact passenger rating (1.3% vs. 2.4%, P =.024). Conversely, side impact driver and passenger crash tests were not associated with rear seat occupant injury risk (driver test: 1.7% for 5-star vs. 1.8% for 1-4 stars; passenger test: 1.6% for 5

  12. The portfolio risk management and diversification benefits from the South African rand currency index (rain

    Directory of Open Access Journals (Sweden)

    F.Y. Jordaan

    2012-12-01

    Full Text Available This study attempts to explain the source of risk management and diversification benefits that investors may gain from the South African Rand Currency Index (RAIN as it relates to an equity portfolio with stock market exposure (locally or international. These diversification benefits may result from the negative correlation between RAIN and the South African All Share Index (ALSI. To explain and fully exploit the benefits of RAIN, the main variables that represent South Africa’s trading partner equity and bond markets movements, were identified. To account for the interaction of RAIN with the ALSI, the latter was firstly decomposed into its economic groups and secondly into its various sub-sectors. Various analyses were carried out to determine which variables describe the relationship between the ALSI and RAIN. The variables that describe the relationship with a high adjusted R2, were identified. The findings suggest that when the ALSI is decomposed into its ten economic groups and thirty-seven sub-groups, the quadratic as opposed to linear models using response surface regressions, explained the majority of the variation in RAIN over the entire period. The linear models, however, explained more of the variation in RAIN during the recent 2008/2009 financial crisis

  13. Accounting for the risks of phosphorus losses through tile drains in a phosphorus index.

    Science.gov (United States)

    Reid, D Keith; Ball, Bonnie; Zhang, T Q

    2012-01-01

    Tile drainage systems have been identified as a significant conduit for phosphorus (P) losses to surface water, but P indices do not currently account for this transport pathway in a meaningful way. Several P indices mention tile drains, but most account for either the reduction in surface runoff or the enhanced transport through tiles rather than both simultaneously. A summary of the current state of how tile drains are accounted for within P indices is provided, and the challenges in predicting the risk of P losses through tile drains that are relative to actual losses are discussed. A framework for a component P Index is described, along with a proposal to incorporate predictions of losses through tile drains as a component within this framework. Options for calibrating and testing this component are discussed. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  14. Prognostic value of exercise echocardiography: validation of a new risk index combining echocardiographic, treadmill, and exercise electrocardiographic parameters.

    Science.gov (United States)

    Mazur, Wojciech; Rivera, Jose M; Khoury, Alexander F; Basu, Abhijeet G; Perez-Verdia, Alejandro; Marks, Gary F; Chang, Su Min; Olmos, Leopoldo; Quiñones, Miguel A; Zoghbi, William A

    2003-04-01

    Exercise (Ex) echocardiography has been shown to have significant prognostic power, independent of other known predictors of risk from an Ex stress test. The purpose of this study was to evaluate a risk index, incorporating echocardiographic and conventional Ex variables, for a more comprehensive risk stratification and identification of a very low-risk group. Two consecutive, mutually exclusive populations referred for treadmill Ex echocardiography with the Bruce protocol were investigated: hypothesis-generating (388 patients; 268 males; age 55 +/- 13 years) and hypothesis-testing (105 patients; 61 males age: 54 +/- 14 years).Cardiac events included cardiac death, myocardial infarction, late revascularization (>90 days), hospital admission for unstable angina, and admission for heart failure. Mean follow-up in the hypothesis-generating population was 3.1 years. There were 38 cardiac events. Independent predictors of events by multivariate analysis were: Ex wall motion score index (odds ratio [OR] = 2.77/Unit; P or = 1 mm (OR = 2.84; P =.002); and treadmill time (OR = 0.87/min; P =.037). A risk index was generated on the basis of the multivariate Cox regression model as: risk index = 1.02 (Ex wall motion score index) + 1.04 (S-T change) - 0.14 (treadmill time). The validity of this index was tested in the hypothesis-testing population. Event rates at 3 years were lowest (0%) in the lower quartile of risk index (-1.22 to -0.47), highest (29.6%) in the upper quartile (+0.66 to +2.02), and intermediate (19.2% to 15.3%) in the intermediate quartiles. The OR of the risk index for predicting cardiac events was 2.94/Unit ([95% confidence interval: 1.4 to 6.2]; P =.0043). Echocardiographic and Ex parameters are independent powerful predictors of cardiac events after treadmill stress testing. A risk index can be derived with these parameters for a more comprehensive risk stratification with Ex echocardiography.

  15. Predictive Value of Triglyceride Glucose Index for the Risk of Incident Diabetes: A 4-Year Retrospective Longitudinal Study.

    Science.gov (United States)

    Lee, Da Young; Lee, Eun Seo; Kim, Ji Hyun; Park, Se Eun; Park, Cheol-Young; Oh, Ki-Won; Park, Sung-Woo; Rhee, Eun-Jung; Lee, Won-Young

    The Triglyceride Glucose Index (TyG index) is considered a surrogate marker of insulin resistance. The aim of this study is to investigate whether the TyG index has a predictive role in identifying individuals with a high risk of incident diabetes and to compare it with other indicators of metabolic health. A total 2900 non-diabetic adults who attended five consecutive annual health check-ups at Kangbuk Samsung Hospital was divided into four subgroups using three methods: (1) baseline TyG index; (2) obesity status (body mass index ≥25 kg/m2) and cutoff value of TyG index; (3) obesity status and metabolic health, defined as having fewer than two of the five components of high blood pressure, fasting blood glucose, triglyceride, low high-density lipoprotein cholesterol, and highest decile of homeostasis model assessment-insulin resistance. The development of diabetes was assessed annually using self-questionnaire, fasting glucose, and glycated hemoglobin. We compared the risk of incident diabetes using multivariate Cox analysis. During 11623 person-years there were 101 case of incident diabetes. Subjects with high TyG index had a high risk of diabetes. For TyG index quartiles, hazard ratios (HRs) of quartiles 3 and 4 were 4.06 (p = 0.033) and 5.65 (p = 0.006) respectively. When the subjects were divided by obesity status and cutoff value of TyG index of 8.8, the subgroups with TyG index ≥ 8.8 regardless of obesity had a significantly high risk for diabetes (HR 2.40 [p = 0.024] and 2.25 [p = 0.048]). For obesity status and metabolic health, the two metabolically unhealthy subgroups regardless of obesity had a significantly high risk for diabetes (HRs 2.54 [p = 0.024] and 2.73 [p = 0.021]). In conclusion, the TyG index measured at a single time point may be an indicator of the risk for incident diabetes. The predictive value of the TyG index was comparable to that of metabolic health.

  16. Corruption perception index as an indicator of the level of corruption in an individual country and the world

    Directory of Open Access Journals (Sweden)

    Irina A. Moiseeva

    2018-03-01

    Full Text Available Objective to evaluate the methodology of corruption analysis based on the corruption perception index. nbsp Methods the author used such sociological method as nonparticipant simple observation methods of expert assessments and analysis of documents grouping and summarizing calculation of generalizing indicators analysis economicmathematical and statistical techniques. nbsp Results the corruption perception index like any other method of studying corruption available in science cannot be recognized as a universal indicator of its measurement. It does not meet the requirements of measurement reliability the number of data sources and countries included in the index changed new surveys emerged and some studies were discontinued changes to the calculation methodology were made. Therefore the only reliable technique is to compare the data on a particular state from the same specific source over a period of time. However the author believes that the monitoring of changes of this indicator in a particular state may be important for assessing the achievement of the statersquos tasks aimed at improving the investment climate. nbsp Scientific novelty despite numerous studies of certain aspects of anticorruption the search for a universal method for evaluating the effectiveness of this struggle continues. Basing on the data studied by the author a quantitative sociologicalstatistical assessment of the effectiveness of anticorruption measures in the Republic of Belarus and neighboring countries is given. The article also substantiates the proposal to develop the anticorruption index for the countries which are similar in the standards of doing business and a common understanding of national interests and methods of achieving them namely the Customs Union CIS BRICS and SCO countries. Practical significance the provisions and conclusions of the research can be used by the state authorities and public organizations for the formation and implementation of the

  17. Health Care Workers and Researchers Traveling to Developing-World Clinical Settings: Disease Transmission Risk and Mitigation

    Science.gov (United States)

    2010-01-01

    INVITED ARTICLE James M. Hughes and Mary E. Wilson, Section Editors Health Care Workers and Researchers Traveling to Developing-World Clinical...for risk mitigation. Few data on the epidemiology of infectious diseases occurring among traveling health care workers (HCWs) exist. Surveillance... Health Care Workers and Researchers Traveling to Developing-World Clinical Settings: Disease Transmission Risk and Mitigation 5a. CONTRACT NUMBER 5b

  18. Evaluation of a clinical risk index for advanced colorectal neoplasia among a North American population of screening age.

    Science.gov (United States)

    Ruco, Arlinda; Stock, David; Hilsden, Robert J; McGregor, S Elizabeth; Paszat, Lawrence F; Saskin, Refik; Rabeneck, Linda

    2015-11-19

    A clinical risk index employing age, sex, family history of colorectal cancer (CRC), smoking history and body mass index (BMI) may be useful for prioritizing screening with colonoscopy. The aim of this study was to conduct an external evaluation of a previously published risk index for advanced neoplasia (AN) in a large, well-characterized cohort. Five thousand one hundred thirty-seven asymptomatic persons aged 50 to 74 (54.9 % women) with a mean age (SD) of 58.3 (6.2) years were recruited for the study from a teaching hospital and colorectal cancer screening centre between 2003 and 2011. All participants underwent a complete screening colonoscopy and removal of all polyps. AN was defined as cancer or a tubular adenoma, traditional serrated adenoma (TSA), or sessile serrated adenoma (SSA) with villous characteristics (≥25% villous component), and/or high-grade dysplasia and/or diameter ≥10 mm. Risk scores for each participant were summed to derive an overall score (0-8). The c-statistic was used to measure discriminating ability of the risk index. The prevalence of AN in the study cohort was 6.8 %. The likelihood of detecting AN increased from 3.6 to 13.1 % for those with a risk score of 1 to 6 respectively. The c-statistic for the multivariable logistic model in our cohort was 0.64 (95 % CI = 0.61-067) indicating modest overlap between risk scores. The risk index for AN using age, sex, family history, smoking history and BMI was found to be of limited discriminating ability upon external validation. The index requires further refinement to better predict AN in average risk persons of screening age.

  19. Reducing Production Basis Risk through Rainfall Intensity Frequency (RIF) Indexes: Global Sensitivity Analysis' Implication on Policy Design

    Science.gov (United States)

    Muneepeerakul, Chitsomanus; Huffaker, Ray; Munoz-Carpena, Rafael

    2016-04-01

    The weather index insurance promises financial resilience to farmers struck by harsh weather conditions with swift compensation at affordable premium thanks to its minimal adverse selection and moral hazard. Despite these advantages, the very nature of indexing causes the presence of "production basis risk" that the selected weather indexes and their thresholds do not correspond to actual damages. To reduce basis risk without additional data collection cost, we propose the use of rain intensity and frequency as indexes as it could offer better protection at the lower premium by avoiding basis risk-strike trade-off inherent in the total rainfall index. We present empirical evidences and modeling results that even under the similar cumulative rainfall and temperature environment, yield can significantly differ especially for drought sensitive crops. We further show that deriving the trigger level and payoff function from regression between historical yield and total rainfall data may pose significant basis risk owing to their non-unique relationship in the insured range of rainfall. Lastly, we discuss the design of index insurance in terms of contract specifications based on the results from global sensitivity analysis.

  20. Modified Creatinine Index and the Risk of Bone Fracture in Patients Undergoing Hemodialysis: The Q-Cohort Study.

    Science.gov (United States)

    Yamada, Shunsuke; Taniguchi, Masatomo; Tokumoto, Masanori; Yoshitomi, Ryota; Yoshida, Hisako; Tatsumoto, Narihito; Hirakata, Hideki; Fujimi, Satoru; Kitazono, Takanari; Tsuruya, Kazuhiko

    2017-08-01

    Hemodialysis patients are at increased risk for bone fracture and sarcopenia. There is close interplay between skeletal muscle and bone. However, it is still unclear whether lower skeletal muscle mass increases the risk for bone fracture. Cross-sectional study and prospective longitudinal cohort study. An independent cohort of 78 hemodialysis patients in the cross-sectional study and 3,030 prevalent patients undergoing maintenance hemodialysis prospectively followed up for 4 years. Skeletal muscle mass measured by bioelectrical impedance analysis (BIA) and modified creatinine index, an estimate of skeletal muscle mass based on age, sex, Kt/V for urea, and serum creatinine level. Bone fracture at any site. In the cross-sectional study, modified creatinine index was significantly correlated with skeletal muscle mass measured by BIA. During a median follow-up of 3.9 years, 140 patients had bone fracture. When patients were divided into sex-specific quartiles based on modified creatinine index, risk for bone fracture estimated by a Fine-Gray proportional subdistribution hazards model with all-cause death as a competing risk was significantly higher in the lower modified creatinine index quartiles (Q1 and Q2) compared to the highest modified creatinine index quartile (Q4) as the reference value in both sexes (multivariable-adjusted HRs for men were 7.81 [95% CI, 2.63-23.26], 5.48 [95% CI, 2.08-14.40], 2.24 [95% CI, 0.72-7.00], and 1.00 [P for trend creatinine index; no data for residual kidney function and fracture sites and causes. Modified creatinine index was correlated with skeletal muscle mass measured by BIA. Lower modified creatinine index was associated with increased risk for bone fracture in male and female hemodialysis patients. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  1. The Little Schmidy Pediatric Hospital Fall Risk Assessment Index: A diagnostic accuracy study.

    Science.gov (United States)

    Franck, Linda S; Gay, Caryl L; Cooper, Bruce; Ezrre, Suzanne; Murphy, Barbette; Chan, June Shu-Ling; Buick, Maureen; Meer, Carrie R

    2017-03-01

    Falls are among the most common potentially preventable adverse events. Current pediatric falls risk assessment methods have poor precision and accuracy. To evaluate an inpatient pediatric fall risk assessment index, known as the Little Schmidy, and describe characteristics of pediatric falls. Retrospective case control and descriptive study. The dataset included 114 reported falls and 151,678 Little Schmidy scores documented in medical records during the 5-year study period (2007-2011). Pediatric medical and surgical inpatient units of an academic medical center in the western United States. Pediatric hospital inpatients fall risk each day and night shift throughout the patient's hospitalization. Conditional fixed-effects logistic regressions were used to examine predictive relationships between Little Schmidy scores (at admission, highest prior to fall, and just prior to fall) and the patient's fall status (fell or not). The sensitivity and specificity of different cut-off scores were explored. Associations between Little Schmidy scores and patient and hospitalization factors were examined using multilevel mixed-effects logistic regression and multilevel mixed-effects ordinal logistic regression. Little Schmidy scores were significantly associated with pediatric falls (pfall risk with sensitivity of 79% and specificity of 49%. Patients with an LS4 score ≥1 were 4 times more likely to fall before the next assessment than patients with a score of 0. LS4 scores indicative of fall risk were associated with age ≥5 years, neurological diagnosis, multiple hospitalizations, and night shift, but not with sex, length of hospital stay, or hospital unit. Of the 114 reported falls, 64% involved a male patient, nearly one third (32%) involved adolescents (13-17 years), most resulted in no (59%) or mild (36%) injury, and most (54%) were related to diagnosis or clinical characteristics. For 60% of the falls, fall precautions had been implemented prior to the fall. The

  2. African genetic ancestry interacts with body mass index to modify risk for uterine fibroids.

    Science.gov (United States)

    Giri, Ayush; Edwards, Todd L; Hartmann, Katherine E; Torstenson, Eric S; Wellons, Melissa; Schreiner, Pamela J; Velez Edwards, Digna R

    2017-07-01

    Race, specifically African ancestry, and obesity are important risk factors for uterine fibroids, and likely interact to provide the right conditions for fibroid growth. However, existing studies largely focus on the main-effects rather than their interaction. Here, we firstly provide evidence for interaction between categories of body mass index (BMI) and reported-race in relation to uterine fibroids. We then investigate whether the association between inferred local European ancestry and fibroid risk is modified by BMI in African American (AA) women in the Vanderbilt University Medical Center bio-repository (BioVU) (539 cases and 794 controls) and the Coronary Artery Risk Development in Young Adults study (CARDIA, 264 cases and 173 controls). We used multiple logistic regression to evaluate interactions between local European ancestry and BMI in relation to fibroid risk, then performed fixed effects meta-analysis. Statistical significance threshold for local-ancestry and BMI interactions was empirically estimated with 10,000 permutations (p-value = 1.18x10-4). Admixture mapping detected an association between European ancestry and fibroid risk which was modified by BMI (continuous-interaction p-value = 3.75x10-5) around ADTRP (chromosome 6p24); the strongest association was found in the obese category (ancestry odds ratio (AOR) = 0.51, p-value = 2.23x10-5). Evaluation of interaction between genotyped/imputed variants and BMI in this targeted region suggested race-specific interaction, present in AAs only; strongest evidence was found for insertion/deletion variant (6:11946435), again in the obese category (OR = 1.66, p-value = 1.72x10-6). We found nominal evidence for interaction between local ancestry and BMI at a previously reported region in chromosome 2q31-32, which includes COL5A2, and TFPI, an immediate downstream target of ADTRP. Interactions between BMI and SNPs (single nucleotide polymorphisms) found in this region in AA women were also detected in an

  3. BMI and risk of serious upper body injury following motor vehicle crashes: concordance of real-world and computer-simulated observations.

    Directory of Open Access Journals (Sweden)

    Shankuan Zhu

    2010-03-01

    Full Text Available Men tend to have more upper body mass and fat than women, a physical characteristic that may predispose them to severe motor vehicle crash (MVC injuries, particularly in certain body regions. This study examined MVC-related regional body injury and its association with the presence of driver obesity using both real-world data and computer crash simulation.Real-world data were from the 2001 to 2005 National Automotive Sampling System Crashworthiness Data System. A total of 10,941 drivers who were aged 18 years or older involved in frontal collision crashes were eligible for the study. Sex-specific logistic regression models were developed to analyze the associations between MVC injury and the presence of driver obesity. In order to confirm the findings from real-world data, computer models of obese subjects were constructed and crash simulations were performed. According to real-world data, obese men had a substantially higher risk of injury, especially serious injury, to the upper body regions including head, face, thorax, and spine than normal weight men (all p<0.05. A U-shaped relation was found between body mass index (BMI and serious injury in the abdominal region for both men and women (p<0.05 for both BMI and BMI(2. In the high-BMI range, men were more likely to be seriously injured than were women for all body regions except the extremities and abdominal region (all p<0.05 for interaction between BMI and sex. The findings from the computer simulation were generally consistent with the real-world results in the present study.Obese men endured a much higher risk of injury to upper body regions during MVCs. This higher risk may be attributed to differences in body shape, fat distribution, and center of gravity between obese and normal-weight subjects, and between men and women. Please see later in the article for the Editors' Summary.

  4. The index of harm: a useful measure for comparing occupational risk across industries

    International Nuclear Information System (INIS)

    Solomon, K.A.; Abraham, S.C.

    1980-01-01

    This paper presents an index of harm methodology which compares occupational risk among workers exposed to radiological and nonradiological harms. It extends the work of the International Commission on Radiological Protection by considering American rather than European and Japanese industry groups, by treating the relative importance of various occupational harms as a parameter rather than an arbitrary constant, and by identifying several ways in which both the methodology and the data base could be improved. In the analysis, the risk affects are examined of six occupational harms-three nonradiological (death, accidental injury and disease or illness) and three radiological (somatic effects, genetic effects, and somatic effects to the fetus or embryo of pregnant women). The analysis was performed under five different assumptions about the relative importance of degree of aversion of the six harms in question. The results of this analysis show that radiological workers exposed to the current industry average of 0.35 rem/yr are among the safest of all industry groupings, and the riskiest industries appear to be mining; agriculture, fishing and farming; construction; transportation; and manufacturing, roughly in that order. (author)

  5. Development of a lane change risk index using vehicle trajectory data.

    Science.gov (United States)

    Park, Hyunjin; Oh, Cheol; Moon, Jaepil; Kim, Seongho

    2018-01-01

    Surrogate safety measures (SSMs) have been widely used to evaluate crash potential, which is fundamental for the development of effective safety countermeasures. Unlike existing SSMs, which are mainly focused on the evaluation of longitudinal vehicle maneuvering leading to rear-end crashes, this study proposes a new method for estimating crash risk while a subject vehicle changes lanes, referred to as the lane change risk index (LCRI). A novel feature of the proposed methodology is its incorporation of the amount of exposure time to potential crash and the expected crash severity level by applying a fault tree analysis (FTA) to the evaluation framework. Vehicle interactions between a subject vehicle and adjacent vehicles in the starting lane and the target lane are evaluated in terms of crash potential during lane change. Vehicle trajectory data obtained from a traffic stream, photographed using a drone flown over a freeway segment, is used to investigate the applicability of the proposed methodology. This study compares the characteristics of compulsory and discretionary lane changes observed in a work zone section and a general section of a freeway using the LCRI. It is expected that the outcome of this study will be valuable in evaluating the effectiveness of various traffic operations and control strategies in terms of lane change safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Dietary Inflammatory Index and Cardiometabolic Risk Parameters in Overweight and Sedentary Subjects.

    Science.gov (United States)

    Camargo-Ramos, Claudia Marcela; Correa-Bautista, Jorge Enrique; Correa-Rodríguez, María; Ramírez-Vélez, Robinson

    2017-10-06

    Nutrition has been established as a relevant factor in the development of cardiovascular disease (CVD). We aimed to investigate the relationship between the dietary inflammatory index (DII) and cardiometabolic risk parameters in a cohort of 90 overweight and sedentary adults from Bogotá, Colombia. A 24-h dietary record was used to calculate the DII. Body composition variables, flow-mediated dilation (FMD), pulse wave velocity (PWV), lipid profile, glucose, glycosylated hemoglobin (Hb1Ac), and blood pressure were measured and a cardiometabolic risk score (MetScore) was calculated. A lower DII score (anti-inflammatory diet) was significantly associated with higher high-density lipoprotein-cholesterol (HDL-C) and FMD, and lower Hb1Ac and MetScore ( p diet) showed a positive relationship with MetScore ( r = 0.410, p diet was inversely associated with an improved cardiometabolic profile, suggesting the importance of promoting anti-inflammatory diets as an effective strategy for preventing CVD.

  7. Feasibility Study of Land Cover Classification Based on Normalized Difference Vegetation Index for Landslide Risk Assessment

    Directory of Open Access Journals (Sweden)

    Thilanki Dahigamuwa

    2016-10-01

    Full Text Available Unfavorable land cover leads to excessive damage from landslides and other natural hazards, whereas the presence of vegetation is expected to mitigate rainfall-induced landslide potential. Hence, unexpected and rapid changes in land cover due to deforestation would be detrimental in landslide-prone areas. Also, vegetation cover is subject to phenological variations and therefore, timely classification of land cover is an essential step in effective evaluation of landslide hazard potential. The work presented here investigates methods that can be used for land cover classification based on the Normalized Difference Vegetation Index (NDVI, derived from up-to-date satellite images, and the feasibility of application in landslide risk prediction. A major benefit of this method would be the eventual ability to employ NDVI as a stand-alone parameter for accurate assessment of the impact of land cover in landslide hazard evaluation. An added benefit would be the timely detection of undesirable practices such as deforestation using satellite imagery. A landslide-prone region in Oregon, USA is used as a model for the application of the classification method. Five selected classification techniques—k-nearest neighbor, Gaussian support vector machine (GSVM, artificial neural network, decision tree and quadratic discriminant analysis support the viability of the NDVI-based land cover classification. Finally, its application in landslide risk evaluation is demonstrated.

  8. A scoring system for ascertainment of incident stroke; the Risk Index Score (RISc).

    Science.gov (United States)

    Kass-Hout, T A; Moyé, L A; Smith, M A; Morgenstern, L B

    2006-01-01

    The main objective of this study was to develop and validate a computer-based statistical algorithm that could be translated into a simple scoring system in order to ascertain incident stroke cases using hospital admission medical records data. The Risk Index Score (RISc) algorithm was developed using data collected prospectively by the Brain Attack Surveillance in Corpus Christi (BASIC) project, 2000. The validity of RISc was evaluated by estimating the concordance of scoring system stroke ascertainment to stroke ascertainment by physician and/or abstractor review of hospital admission records. RISc was developed on 1718 randomly selected patients (training set) and then statistically validated on an independent sample of 858 patients (validation set). A multivariable logistic model was used to develop RISc and subsequently evaluated by goodness-of-fit and receiver operating characteristic (ROC) analyses. The higher the value of RISc, the higher the patient's risk of potential stroke. The study showed RISc was well calibrated and discriminated those who had potential stroke from those that did not on initial screening. In this study we developed and validated a rapid, easy, efficient, and accurate method to ascertain incident stroke cases from routine hospital admission records for epidemiologic investigations. Validation of this scoring system was achieved statistically; however, clinical validation in a community hospital setting is warranted.

  9. The evolution of electricity prices in an uncertain world. Contracting and managing the price risk

    International Nuclear Information System (INIS)

    Vassilopoulos, Ph.; Rapin, D.

    2004-01-01

    With the liberalization of the electricity market, the large industrial consumers saw their electric bill changing nature. Before, this price reflected a long term negotiation with the monopoly, now it is established in a free way via wholesale markets. This evolution marks a transfer of the management of price risk from the producer towards the consumer. This change is not in itself a problem if the hedging instruments are adapted. We note a contamination of the price of the derivative products by the spot while at the same time the traditional relation between cash and term is not always valid for electricity because of its non storability. When well even the price of the derivative products would be formed in an autonomous way, it poses a second problem: that of their indexing on price references like Platt's whose result is assimilated more to a survey of large producers than a true confrontation of supply and demand. This article proposes to examine this change of nature and behaviour of electricity prices. After having explained the intrinsically volatile characteristic of spot prices, we will recall that the products in the long term are not always optimal solutions to decrease this price risk. Lastly, we will highlight a solution of skirting at the risks mentioned above: contracting between producers and consumers. (authors)

  10. The role of risk assessment in the work of the World Health Organization in Europe

    International Nuclear Information System (INIS)

    Heijden, Kees A. van der; Stern, Richard M.

    1992-01-01

    The World Health Organization, through its Headquarters in Geneva (WHO/HQ), and its Regional Office for Europe (WHO/EURO) in Copenhagen, has the responsibility for providing national governments with advice on formulation and implementation of public health policy globally and in Europe, respectively. Globally, the major areas for health related risk assessment/management is the provision of adequate and safe drinking water and food and control of vector borne and parasitic disease. In the industrialized countries of Europe, a wide number of issues are dealt with which require the development and application of risk assessment and risk management tools and strategies. Primary areas of application are in monitoring trends and status of public health, harmonization of issues of chemical safety, development of criteria documents for environmental pollutants, and providing decision support and technical cooperation, especially in the area of development policies and environment management and their potential health impact. An emerging concern is the need for the introduction of these methodologies in the Countries of Central and Eastern Europe, and harmonization of approaches used by international and intergovernmental organizations and the Member States. One of the first steps towards the management of the environment as a resource for health in Europe, the mandate given WHO/EURO by the European Charter for Environment and Health (Frankfurt, 1989), has been the creation of the European Centre for Environment and Health (ECEH) with support from the Netherlands and Italian Governments. The initial task of EDEH is a description of the current state of the environment and the current state of public health in the European Region, using harmonized methodologies for information gathering. The production of this report, 'Concern for Europe's tomorrow', provides the basic elements of a unified region wide approach to priority setting for the risk assessment and risk

  11. The role of risk assessment in the work of the World Health Organization in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Heijden, Kees A. van der; Stern, Richard M [World Health Organization Regional Office for Europe, European Centre for Environment and Health, Bilthoven Division, Copenhagen (Denmark)

    1992-07-01

    The World Health Organization, through its Headquarters in Geneva (WHO/HQ), and its Regional Office for Europe (WHO/EURO) in Copenhagen, has the responsibility for providing national governments with advice on formulation and implementation of public health policy globally and in Europe, respectively. Globally, the major areas for health related risk assessment/management is the provision of adequate and safe drinking water and food and control of vector borne and parasitic disease. In the industrialized countries of Europe, a wide number of issues are dealt with which require the development and application of risk assessment and risk management tools and strategies. Primary areas of application are in monitoring trends and status of public health, harmonization of issues of chemical safety, development of criteria documents for environmental pollutants, and providing decision support and technical cooperation, especially in the area of development policies and environment management and their potential health impact. An emerging concern is the need for the introduction of these methodologies in the Countries of Central and Eastern Europe, and harmonization of approaches used by international and intergovernmental organizations and the Member States. One of the first steps towards the management of the environment as a resource for health in Europe, the mandate given WHO/EURO by the European Charter for Environment and Health (Frankfurt, 1989), has been the creation of the European Centre for Environment and Health (ECEH) with support from the Netherlands and Italian Governments. The initial task of EDEH is a description of the current state of the environment and the current state of public health in the European Region, using harmonized methodologies for information gathering. The production of this report, 'Concern for Europe's tomorrow', provides the basic elements of a unified region wide approach to priority setting for the risk assessment and risk

  12. Body Size, Extinction Risk and Knowledge Bias in New World Snakes

    Science.gov (United States)

    Vilela, Bruno; Villalobos, Fabricio; Rodríguez, Miguel Ángel; Terribile, Levi Carina

    2014-01-01

    Extinction risk and body size have been found to be related in various vertebrate groups, with larger species being more at risk than smaller ones. We checked whether this was also the case for snakes by investigating extinction risk–body size relationships in the New World's Colubroidea species. We used the IUCN Red List risk categories to assign each species to one of two broad levels of threat (Threatened and Non-Threatened) or to identify it as either Data Deficient or Not-Evaluated by the IUCN. We also included the year of description of each species in our analysis as this could affect the level of threat assigned to it (earlier described species had more time to gather information about them, which might have facilitated their evaluation). Also, species detectability could be a function of body size, with larger species tending to be described earlier, which could have an impact in extinction risk–body size relationships. We found a negative relationship between body size and description year, with large-bodied species being described earlier. Description year also varied among risk categories, with Non-Threatened species being described earlier than Threatened species and both species groups earlier than Data Deficient species. On average, Data Deficient species also presented smaller body sizes, while no size differences were detected between Threatened and Non-Threatened species. So it seems that smaller body sizes are related with species detectability, thus potentially affecting both when a species is described (smaller species tend to be described more recently) as well as the amount of information gathered about it (Data Deficient species tend to be smaller). Our data also indicated that if Data Deficient species were to be categorized as Threatened in the future, snake body size and extinction risk would be negatively related, contrasting with the opposite pattern commonly observed in other vertebrate groups. PMID:25409293

  13. Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement

    Directory of Open Access Journals (Sweden)

    Marek L. Kowalski

    2016-10-01

    Full Text Available Abstract One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin testing, deliberate induction in the office of allergic symptoms to offending compounds (provocation tests or intentional application of potentially dangerous substances (allergy vaccine to sensitized patients. These situations may be associated with a significant risk of unwanted, excessive or even dangerous reactions, which in many instances cannot be completely avoided. However, adverse reactions can be minimized or even avoided if a physician is fully aware of potential risk and is prepared to appropriately handle the situation. Information on the risk of diagnostic and therapeutic procedures in allergic diseases has been accumulated in the medical literature for decades; however, except for allergen specific immunotherapy, it has never been presented in a systematic fashion. Up to now no single document addressed the risk of the most commonly used medical procedures in the allergy office nor attempted to present general requirements necessary to assure the safety of these procedures. Following review of available literature a group of allergy experts within the World Allergy Organization (WAO, representing various continents and areas of allergy expertise, presents this report on risk associated with diagnostic and therapeutic procedures in allergology and proposes a consensus on safety requirements for performing procedures in allergy offices. Optimal safety measures including appropriate location, type and required time of supervision, availability of safety equipment, access to specialized emergency services, etc. for various procedures have been recommended. This document should be useful for allergists with already established

  14. Body mass index and the risk of dementia among Louisiana low income diabetic patients.

    Directory of Open Access Journals (Sweden)

    Gang Hu

    Full Text Available The association between obesity and dementia risk remains debatable and no studies have assessed this association among diabetic patients. The aim of our study was to investigate the association between body mass index (BMI and dementia risk among middle and low income diabetic patients.The sample included 44,660 diabetic patients (19,618 white and 25,042 African American 30 to 96 years of age without a history of dementia in the Louisiana State University Hospital-Based Longitudinal Study. During a mean follow-up period of 3.9 years, 388 subjects developed incident dementia. The age- and sex-adjusted hazards ratios (HRs for incident dementia at different levels of BMI (≤ 25, 25-26.9, 27-29.9, 30-34.9, and ≥ 35 kg/m(2 were 1.00, 0.53 (95% CI 0.34-0.83, 0.29 (0.18-0.45, 0.37 (0.25-0.56, and 0.31 (0.21-0.48 (P(trend<0.001 in white diabetic patients, and 1.00, 1.00 (95% CI 0.62-1.63, 0.62 (0.39-0.98, 0.56 (0.36-0.86, and 0.65 (0.43-1.01 (P(trend = 0.029 in African American diabetic patients. Further adjustment for other confounding factors affected the results only slightly. There was a significant interaction between race and BMI on dementia risk (χ(2 = 5.52, 1df, p<0.025, such that the association was stronger in white patients. In stratified analyses, the multivariate-adjusted inverse association between BMI and risk of dementia was present in subjects aged 55-64 years, 65-74 years, and ≥ 75 years, in men and women, in non-smokers and smokers, and in subjects with different types of health insurance.Higher baseline BMI was associated with a lower risk of dementia among diabetic patients, and this association was stronger among white than among African American diabetic patients.

  15. Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach

    International Nuclear Information System (INIS)

    Chang, J.W.; Yan, B.R.; Chang, M.H.; Tseng, S.H.; Kao, Y.M.; Chen, J.C.; Lee, C.C.

    2014-01-01

    Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP (i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP (i + n) in 0–6-yr-old children accounted for 91% (79–107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0–3-yr-old children and 4–6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods. - Graphical abstract: In seven phthalates, the 95th percentile of the average daily dose (ADD) for ΣDBP (i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) in 0–3-yr-old male (0–3 M) and female (0–3 F) children accounted for 97% and 84% of TDIs, respectively. For 4–6-yr-old and 7–12-yr-old males and 7–12-yr-old females, ADDs for ΣDBP (i + n) accounted for 79%, 72%, and 65% of TDIs, respectively. - Highlights: • A cumulative risk assessment of PAEs was used in a severe plasticizer-contaminated food episode. • ΣDBP (i + n) posed the highest risk potential of all the dietary phthalates. • Females 4–6 yr old had the highest risk for anti-androgenic effects. • Beverages, milk and dairy products were the major contributors to average daily dose of phthalate esters. - The health of young Taiwanese may be adversely affected by overexposure of plasticizer-contaminated food

  16. Predictive Value of Triglyceride Glucose Index for the Risk of Incident Diabetes: A 4-Year Retrospective Longitudinal Study

    OpenAIRE

    Lee, Da Young; Lee, Eun Seo; Kim, Ji Hyun; Park, Se Eun; Park, Cheol-Young; Oh, Ki-Won; Park, Sung-Woo; Rhee, Eun-Jung; Lee, Won-Young

    2016-01-01

    The Triglyceride Glucose Index (TyG index) is considered a surrogate marker of insulin resistance. The aim of this study is to investigate whether the TyG index has a predictive role in identifying individuals with a high risk of incident diabetes and to compare it with other indicators of metabolic health. A total 2900 non-diabetic adults who attended five consecutive annual health check-ups at Kangbuk Samsung Hospital was divided into four subgroups using three methods: (1) baseline TyG ind...

  17. El Niño-Southern Oscillation-based index insurance for floods: Statistical risk analyses and application to Peru

    Science.gov (United States)

    Khalil, Abedalrazq F.; Kwon, Hyun-Han; Lall, Upmanu; Miranda, Mario J.; Skees, Jerry

    2007-10-01

    Index insurance has recently been advocated as a useful risk transfer tool for disaster management situations where rapid fiscal relief is desirable and where estimating insured losses may be difficult, time consuming, or subject to manipulation and falsification. For climate-related hazards, a rainfall or temperature index may be proposed. However, rainfall may be highly spatially variable relative to the gauge network, and in many locations, data are inadequate to develop an index because of short time series and the spatial dispersion of stations. In such cases, it may be helpful to consider a climate proxy index as a regional rainfall index. This is particularly useful if a long record is available for the climate index through an independent source and it is well correlated with the regional rainfall hazard. Here El Niño-Southern Oscillation (ENSO) related climate indices are explored for use as a proxy to extreme rainfall in one of the districts of Peru, Piura. The ENSO index insurance product may be purchased by banks or microfinance institutions to aid agricultural damage relief in Peru. Crop losses in the region are highly correlated with floods but are difficult to assess directly. Beyond agriculture, many other sectors suffer as well. Basic infrastructure is destroyed during the most severe events. This disrupts trade for many microenterprises. The reliability and quality of the local rainfall data are variable. Averaging the financial risk across the region is desirable. Some issues with the implementation of the proxy ENSO index are identified and discussed. Specifically, we explore (1) the reliability of the index at different levels of probability of exceedance of maximum seasonal rainfall, (2) the effect of sampling uncertainties and the strength of the proxy's association to local outcome, (3) the potential for clustering of payoffs, (4) the potential that the index could be predicted with some lead time prior to the flood season, and (5) evidence

  18. Banding the world together; the global growth of control banding and qualitative occupational risk management.

    Science.gov (United States)

    Zalk, David M; Heussen, Ga Henri

    2011-12-01

    Control Banding (CB) strategies to prevent work-related illness and injury for 2.5 billion workers without access to health and safety professionals has grown exponentially this last decade. CB originates from the pharmaceutical industry to control active pharmaceutical ingredients without a complete toxicological basis and therefore no occupational exposure limits. CB applications have broadened into chemicals in general - including new emerging risks like nanomaterials and recently into ergonomics and injury prevention. CB is an action-oriented qualitative risk assessment strategy offering solutions and control measures to users through "toolkits". Chemical CB toolkits are user-friendly approaches used to achieve workplace controls in the absence of firm toxicological and quantitative exposure information. The model (technical) validation of these toolkits is well described, however firm operational analyses (implementation aspects) are lacking. Consequentially, it is often not known if toolkit use leads to successful interventions at individual workplaces. This might lead to virtual safe workplaces without knowing if workers are truly protected. Upcoming international strategies from the World Health Organization Collaborating Centers request assistance in developing and evaluating action-oriented procedures for workplace risk assessment and control. It is expected that to fulfill this strategy's goals, CB approaches will continue its important growth in protecting workers.

  19. Banding the World Together; The Global Growth of Control Banding and Qualitative Occupational Risk Management

    Directory of Open Access Journals (Sweden)

    David M. Zalk

    2011-12-01

    Full Text Available Control Banding (CB strategies to prevent work-related illness and injury for 2.5 billion workers without access to health and safety professionals has grown exponentially this last decade. CB originates from the pharmaceutical industry to control active pharmaceutical ingredients without a complete toxicological basis and therefore no occupational exposure limits. CB applications have broadened into chemicals in general - including new emerging risks like nanomaterials and recently into ergonomics and injury prevention. CB is an action-oriented qualitative risk assessment strategy offering solutions and control measures to users through “toolkits”. Chemical CB toolkits are user-friendly approaches used to achieve workplace controls in the absence of firm toxicological and quantitative exposure information. The model (technical validation of these toolkits is well described, however firm operational analyses (implementation aspects are lacking. Consequentially, it is often not known if toolkit use leads to successful interventions at individual workplaces. This might lead to virtual safe workplaces without knowing if workers are truly protected. Upcoming international strategies from the World Health Organization Collaborating Centers request assistance in developing and evaluating action-oriented procedures for workplace risk assessment and control. It is expected that to fulfill this strategy’s goals, CB approaches will continue its important growth in protecting workers.

  20. Effectiveness of Palivizumab in Preventing RSV Hospitalization in High Risk Children: A Real-World Perspective

    Directory of Open Access Journals (Sweden)

    Nusrat Homaira

    2014-01-01

    Full Text Available Infection with respiratory syncytial virus (RSV is one of the major causes globally of childhood respiratory morbidity and hospitalization. Palivizumab, a humanized monoclonal antibody, has been recommended for high risk infants to prevent severe RSV-associated respiratory illness. This recommendation is based on evidence of efficacy when used under clinical trial conditions. However the real-world effectiveness of palivizumab outside of clinical trials among different patient populations is not well established. We performed a systematic review focusing on postlicensure observational studies of the protective effect of palivizumab prophylaxis for reducing RSV-associated hospitalizations in infants and children at high risk of severe infection. We searched studies published in English between 1 January 1999 and August 2013 and identified 420 articles, of which 20 met the inclusion criteria. This review supports the recommended use of palivizumab for reducing RSV-associated hospitalization rates in premature infants born at gestational age < 33 weeks and in children with chronic lung and heart diseases. Data are limited to allow commenting on the protective effect of palivizumab among other high risk children, including those with Down syndrome, cystic fibrosis, and haematological malignancy, indicating further research is warranted in these groups.

  1. A World at Risk: Aggregating Development Trends to Forecast Global Habitat Conversion.

    Directory of Open Access Journals (Sweden)

    James R Oakleaf

    Full Text Available A growing and more affluent human population is expected to increase the demand for resources and to accelerate habitat modification, but by how much and where remains unknown. Here we project and aggregate global spatial patterns of expected urban and agricultural expansion, conventional and unconventional oil and gas, coal, solar, wind, biofuels and mining development. Cumulatively, these threats place at risk 20% of the remaining global natural lands (19.68 million km2 and could result in half of the world's biomes becoming >50% converted while doubling and tripling the extent of land converted in South America and Africa, respectively. Regionally, substantial shifts in land conversion could occur in Southern and Western South America, Central and Eastern Africa, and the Central Rocky Mountains of North America. With only 5% of the Earth's at-risk natural lands under strict legal protection, estimating and proactively mitigating multi-sector development risk is critical for curtailing the further substantial loss of nature.

  2. Pulmonary edema predictive scoring index (PEPSI), a new index to predict risk of reperfusion pulmonary edema and improvement of hemodynamics in percutaneous transluminal pulmonary angioplasty.

    Science.gov (United States)

    Inami, Takumi; Kataoka, Masaharu; Shimura, Nobuhiko; Ishiguro, Haruhisa; Yanagisawa, Ryoji; Taguchi, Hiroki; Fukuda, Keiichi; Yoshino, Hideaki; Satoh, Toru

    2013-07-01

    This study sought to identify useful predictors for hemodynamic improvement and risk of reperfusion pulmonary edema (RPE), a major complication of this procedure. Percutaneous transluminal pulmonary angioplasty (PTPA) has been reported to be effective for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH). PTPA has not been widespread because RPE has not been well predicted. We included 140 consecutive procedures in 54 patients with CTEPH. The flow appearance of the target vessels was graded into 4 groups (Pulmonary Flow Grade), and we proposed PEPSI (Pulmonary Edema Predictive Scoring Index) = (sum total change of Pulmonary Flow Grade scores) × (baseline pulmonary vascular resistance). Correlations between occurrence of RPE and 11 variables, including hemodynamic parameters, number of target vessels, and PEPSI, were analyzed. Hemodynamic parameters significantly improved after median observation period of 6.4 months, and the sum total changes in Pulmonary Flow Grade scores were significantly correlated with the improvement in hemodynamics. Multivariate analysis revealed that PEPSI was the strongest factor correlated with the occurrence of RPE (p PEPSI to be a useful marker of the risk of RPE (cutoff value 35.4, negative predictive value 92.3%). Pulmonary Flow Grade score is useful in determining therapeutic efficacy, and PEPSI is highly supportive to reduce the risk of RPE after PTPA. Using these 2 indexes, PTPA could become a safe and common therapeutic strategy for CTEPH. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis.

    Science.gov (United States)

    Rahman, M M; Abe, S K; Kanda, M; Narita, S; Rahman, M S; Bilano, V; Ota, E; Gilmour, S; Shibuya, K

    2015-09-01

    We conducted a systematic review and meta-analysis of population-based cohort studies of maternal body mass index (BMI) and risk of adverse birth and health outcomes in low- and middle-income countries. PubMed, Embase, CINAHL and the British Nursing Index were searched from inception to February 2014. Forty-two studies were included. Our study found that maternal underweight was significantly associated with higher risk of preterm birth (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.01-1.27), low birthweight (OR, 1.66; 95% CI, 1.50-1.84) and small for gestational age (OR, 1.85; 95% CI, 1.69-2.02). Compared with mothers with normal BMI, overweight or obese mothers were at increased odds of gestational diabetes, pregnancy-induced hypertension, pre-eclampsia, caesarean delivery and post-partum haemorrhage. The population-attributable risk (PAR) indicated that if women were entirely unexposed to overweight or obesity during the pre-pregnancy or early pregnancy period, 14% to 35% fewer women would develop gestational diabetes, pre-eclampsia or pregnancy-induced hypertension in Brazil, China, India, Iran or Thailand. The highest PAR of low birthweight attributable to maternal underweight was found in Iran (20%), followed by India (18%), Thailand (10%) and China (8%). Treatment and prevention of maternal underweight, overweight or obesity may help reduce the burden on maternal and child health in developing countries. © 2015 World Obesity.

  4. "RISK ASSESSMENT OF DEVELOPING DISTAL UPPER EXTREMITY DISORDERS BY STRAIN INDEX METHOD IN AN ASSEMBLING ELECTRONIC INDUSTRY"

    OpenAIRE

    M. Pourmahabadian; J.N. Saraji; M. Aghabeighi H. Saddeghi-Naeeni

    2005-01-01

    The strain index (SI) is a substantial advancement and has been devised to analyze ergonomic risks for distal upper extremity (DUE) disorders. This semi-quantitative tool allows for the measurement of hazards and does not require unduly lengthy training to begin to use it accurately. Uses of the strain index include analysis of a current job to assess whether it is safe or hazardous, quantification of the risks, and assistance in the initial design of a job or in the redesign of a job. The ai...

  5. Yield risks in global maize markets: Historical evidence and projections in key regions of the world

    Directory of Open Access Journals (Sweden)

    Nelson B. Villoria

    2018-03-01

    Full Text Available Simultaneous worldwide crop failures stemming from a more unstable climate may reduce the scope for international trade to compensate food shortages and stabilize food prices across the various regions of the world. Understanding the effects of changes in crop productivity on global markets requires knowledge about the extent to which crop yields may be systematically related across producing and consuming centers. This short communication contributes to this knowledge by investigating the potential changes in the strength of two key sources of supply risks in global maize markets: yield variance and cross-country yield correlation. We focus on the largest producing and consuming countries of the world. We capitalize on yield projections from the Global Gridded Crop Model Intercomparison project. Exploratory analysis of the skill of the underlying GGCMI models in reproducing key moments of the distribution of observed yields reveals that they overstate observed variances but faithfully reproduce observed patterns of cross-country correlations. We find no evidence of an increase in the degree of cross-country dependency of maize yields. We also find a higher incidence of what would be considered extremely low maize yields by present-time standards stemming from the projected downward trend in yields levels toward mid-century. The weak dependency of maize yields across countries, an the possibility of reducing the higher incidence of extremes through policies aimed to reverse the climate-induced downward trends in yields, suggest that international trade can become a valuable tool to ameliorate the effects of more unstable crop yields. Keywords: Extremely low yields, Maize markets, Food prices, Agricultural yields, Systemic risk in agriculture, Global agriculture, AgMIP, Global gridded crop model intercomparison

  6. Definition and GIS-based characterization of an integral risk index applied to a chemical/petrochemical area.

    Science.gov (United States)

    Nadal, Martí; Kumar, Vikas; Schuhmacher, Marta; Domingo, José L

    2006-08-01

    A risk map of the chemical/petrochemical industrial area of Tarragona (Catalonia, Spain) was designed following a two-stage procedure. The first step was the creation of a ranking system (Hazard Index) for a number of different inorganic and organic pollutants: heavy metals, polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs) and polychlorinated aromatic hydrocarbons (PAHs) by applying self-organizing maps (SOM) to persistence, bioaccumulation and toxicity properties of the chemicals. PCBs seemed to be the most hazardous compounds, while the light PAHs showed the minimum values. Subsequently, an Integral Risk Index was developed taking into account the Hazard Index and the concentrations of all pollutants in soil samples collected in the assessed area of Tarragona. Finally, a risk map was elaborated by representing the spatial distribution of the Integral Risk Index with a geographic information system (GIS). The results of the present study seem to indicate that the development of an integral risk map might be useful to help in making-decision processes concerning environmental pollutants.

  7. Elevated body mass index and risk of postoperative CSF leak following transsphenoidal surgery

    Science.gov (United States)

    Dlouhy, Brian J.; Madhavan, Karthik; Clinger, John D.; Reddy, Ambur; Dawson, Jeffrey D.; O’Brien, Erin K.; Chang, Eugene; Graham, Scott M.; Greenlee, Jeremy D. W.

    2012-01-01

    Object Postoperative CSF leakage can be a serious complication after a transsphenoidal surgical approach. An elevated body mass index (BMI) is a significant risk factor for spontaneous CSF leaks. However, there is no evidence correlating BMI with postoperative CSF leak after transsphenoidal surgery. The authors hypothesized that patients with elevated BMI would have a higher incidence of CSF leakage complications following transsphenoidal surgery. Methods The authors conducted a retrospective review of 121 patients who, between August 2005 and March 2010, underwent endoscopic endonasal transsphenoidal surgeries for resection of primarily sellar masses. Patients requiring extended transsphenoidal approaches were excluded. A multivariate statistical analysis was performed to investigate the association of BMI and other risk factors with postoperative CSF leakage. Results In 92 patients, 96 endonasal endoscopic transsphenoidal surgeries were performed that met inclusion criteria. Thirteen postoperative leaks occurred and required subsequent treatment, including lumbar drainage and/or reoperation. The average BMI of patients with a postoperative CSF leak was significantly greater than that in patients with no postoperative CSF leak (39.2 vs 32.9 kg/m2, p = 0.006). Multivariate analyses indicate that for every 5-kg/m2 increase in BMI, patients undergoing a transsphenoidal approach for a primarily sellar mass have 1.61 times the odds (95% CI 1.10–2.29, p = 0.016, by multivariate logistic regression) of having a postoperative CSF leak. Conclusions Elevated BMI is an independent predictor of postoperative CSF leak after an endonasal endoscopic transsphenoidal approach. The authors recommend that patients with BMI greater than 30 kg/m2 have meticulous sellar reconstruction at surgery and close monitoring postoperatively. PMID:22443502

  8. Prepregnancy body mass index and risk of preterm birth: association heterogeneity by preterm subgroups.

    Science.gov (United States)

    Parker, Margaret G; Ouyang, Fengxiu; Pearson, Colleen; Gillman, Matthew W; Belfort, Mandy B; Hong, Xiumei; Wang, Guoying; Heffner, Linda; Zuckerman, Barry; Wang, Xiaobin

    2014-04-30

    To evaluate the association between prepregnancy body mass index (BMI) is associated with early vs. late and medically-induced vs. spontaneous preterm birth (PTB) subtypes. Using data from the Boston Birth Cohort, we examined associations of prepregnancy BMI with 189 early (PTBs and 320 early and 610 late spontaneous PTBs vs. 3281 term births (37-44 weeks) in multinomial regression. To assess for mediation by important pregnancy complications, we performed sequential models with and without hypertensive disorders of pregnancy, chorioamnionitis, and gestational diabetes. Prevalence of prepregnancy obesity (BMI ≥ 30.0 kg/m2) was 28% among mothers with medically-induced PTBs, 18% among mothers with spontaneous PTBs, and 18% among mothers with term births (p = <0.001). After adjustment for demographic and known risk factors for PTB, prepregnancy obesity was associated with higher odds of both early [OR 1.78 (1.19, 2.66)] and late [OR 1.49 (1.09, 2.04)] medically-induced PTB. These effect estimates were attenuated with inclusion of hypertensive disorders of pregnancy and gestational diabetes. For spontaneous deliveries, prepregnancy obesity was associated with decreased odds of PTB (0.76 [0.58, 0.98]) and underweight was nearly associated with increased odds of PTB (1.46 [0.99, 2.16]). Prepregnancy obesity is associated with higher risk of medically-induced, but not spontaneous PTB. Hypertensive disorders of pregnancy and gestational diabetes appear to partially explain the association between prepregnancy obesity and early and late medically-induced PTB.

  9. Cardiometabolic risks and omega-3 index in recent-onset bipolar I disorder.

    Science.gov (United States)

    Wulsin, Lawson R; Blom, Thomas J; Durling, Michelle; Welge, Jeffrey A; DelBello, Melissa P; Adler, Caleb M; McNamara, Robert K; Strakowski, Stephen M

    2018-02-26

    The aims of the present study were to characterize cardiometabolic risk factors in a cohort of bipolar disorder patients with limited exposure to psychotropic medications, and to evaluate their associations with mood symptoms and omega-3 polyunsaturated fatty acid (PUFA) blood levels. Cardiometabolic risk assessments were compared in individuals with bipolar I disorder experiencing a first manic or mixed episode or an early depressive episode (n=117) and healthy subjects (n=56). Patients were medication free at assessment and had no or limited exposure to mood-stabilizer or antipsychotic medications prior to the current admission. Associations among cardiometabolic parameters and Clinical Global Impression-Severity scale (CGI-S), manic (Young Mania Rating Scale [YMRS]), and depressive (Hamilton Depression Rating Scale [HDRS]) symptom ratings were evaluated within the bipolar group. Following adjustment for demographic variables (i.e., age, gender, and parental education), significantly higher fasting triglyceride levels were observed in the bipolar group compared to the healthy group (121.7 mg/dL vs 87.0 mg/dL; Pbipolar group and 6% of the healthy group met the criteria for metabolic syndrome (P=.23). The omega-3 index was lower in the bipolar group (3.4% vs 3.9%; Pbipolar group, no associations were found between the cardiometabolic parameters and CGI-S, YMRS, and HDRS symptom ratings. Recent-onset medication-free bipolar disorder is associated with higher triglyceride levels. These findings are suggestive of early metabolic dysregulation prior to long-term psychotropic medication exposure. Lower omega-3 PUFA levels in individuals with bipolar I disorder represent a potential therapeutic target for additional investigation. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Quantitative autistic trait measurements index background genetic risk for ASD in Hispanic families.

    Science.gov (United States)

    Page, Joshua; Constantino, John Nicholas; Zambrana, Katherine; Martin, Eden; Tunc, Ilker; Zhang, Yi; Abbacchi, Anna; Messinger, Daniel

    2016-01-01

    Recent studies have indicated that quantitative autistic traits (QATs) of parents reflect inherited liabilities that may index background genetic risk for clinical autism spectrum disorder (ASD) in their offspring. Moreover, preferential mating for QATs has been observed as a potential factor in concentrating autistic liabilities in some families across generations. Heretofore, intergenerational studies of QATs have focused almost exclusively on Caucasian populations-the present study explored these phenomena in a well-characterized Hispanic population. The present study examined QAT scores in siblings and parents of 83 Hispanic probands meeting research diagnostic criteria for ASD, and 64 non-ASD controls, using the Social Responsiveness Scale-2 (SRS-2). Ancestry of the probands was characterized by genotype, using information from 541,929 single nucleotide polymorphic markers. In families of Hispanic children with an ASD diagnosis, the pattern of quantitative trait correlations observed between ASD-affected children and their first-degree relatives (ICCs on the order of 0.20), between unaffected first-degree relatives in ASD-affected families (sibling/mother ICC = 0.36; sibling/father ICC = 0.53), and between spouses (mother/father ICC = 0.48) were in keeping with the influence of transmitted background genetic risk and strong preferential mating for variation in quantitative autistic trait burden. Results from analysis of ancestry-informative genetic markers among probands in this sample were consistent with that from other Hispanic populations. Quantitative autistic traits represent measurable indices of inherited liability to ASD in Hispanic families. The accumulation of autistic traits occurs within generations, between spouses, and across generations, among Hispanic families affected by ASD. The occurrence of preferential mating for QATs-the magnitude of which may vary across cultures-constitutes a mechanism by which background genetic liability

  11. Past and future trends in cancer and biomedical research: a comparison between Egypt and the World using PubMed-indexed publications

    Directory of Open Access Journals (Sweden)

    Zeeneldin Ahmed Abdelmabood

    2012-07-01

    Full Text Available Abstract Background PubMed is a free web literature search service that contains almost 21 millions of abstracts and publications with almost 5 million user queries daily. The purposes of the study were to compare trends in PubMed-indexed cancer and biomedical publications from Egypt to that of the world and to predict future publication volumes. Methods The PubMed was searched for the biomedical publications between 1991 and 2010 (publications dates. Affiliation was then limited to Egypt. Further limitation was applied to cancer, human and animal publications. Poisson regression model was used for prediction of future number of publications between 2011 and 2020. Results Cancer publications contributed 23% to biomedical publications both for Egypt and the world. Egyptian biomedical and cancer publications contributed about 0.13% to their world counterparts. This contribution was more than doubled over the study period. Egyptian and world’s publications increased from year to year with rapid rise starting the year 2003. Egyptian as well as world’s human cancer publications showed the highest increases. Egyptian publications had some peculiarities; they showed some drop at the years 1994 and 2002 and apart from the decline in the animal: human ratio with time, all Egyptian publications in the period 1991-2000 were significantly more than those in 2001-2010 (P  Conclusions The Egyptian contribution to world’s biomedical and cancer publications needs significant improvements through research strategic planning, setting national research priorities, adequate funding and researchers’ training.

  12. Does the Mediterranean dietary pattern or the Healthy Diet Index influence the risk of breast cancer in a large British cohort of women?

    Science.gov (United States)

    Cade, J E; Taylor, E F; Burley, V J; Greenwood, D C

    2011-08-01

    To assess the risk of developing breast cancer associated with consumption of two common dietary patterns: a Mediterranean dietary pattern and a dietary pattern, which conforms to the World Health Organization Healthy Diet Index (WHO HDI). Dietary data from a 217-item food frequency questionnaire were used to generate two dietary patterns according to pre-defined criteria in women from the UK Women's Cohort Study. Survival analysis using Cox regression was used to estimate hazards ratios for risk of breast cancer adjusted for known confounders. This analysis included 828 incident cases of breast cancer in 33,731 women with a mean follow-up of 9 years. There were no statistically significant associations between either the Mediterranean dietary pattern or the WHO HDI and risk of breast cancer. In premenopausal women, there was a nonsignificant trend suggesting that increasing compliance with the Mediterranean diet was associated with lower risk of breast cancer. Maximal adherence to the Mediterranean diet was associated with hazards ratio=0.65 (95% confidence interval: 0.42-1.02, P trend=0.09) compared with minimal adherence. In postmenopausal women, no clear trends were observed. In this study, no strong association between the risk of breast cancer and the consumption of either a Mediterranean-type diet or one characterized by adherence to the WHO HDI was observed. In premenopausal, but not postmenopausal women, there was a nonsignificant inverse association with increasing adherence to the Mediterranean diet pattern.

  13. Risk of malignancy index in the preoperative evaluation of patients with ovarian masses

    International Nuclear Information System (INIS)

    Jabeen, R.; Khan, S.A.; Naveed, S.

    2015-01-01

    Objective: To evaluate the ability of RMI in preoperative discrimination of benign from malignant ovarian mass among women presenting at Nishtar Hospital Multan Pakistan. Methodology: It was a prospective study conducted at department of obstetrics/gynae Nishtar Hospital Multan between September 2008 to August 2009. 60 patients of more than 30 years of age admitted in gynaecology department for surgical exploration of ovarian mass were included. All the women in whom ovarian malignancy had already been diagnosed and admitted for second laparotomy were excluded. Results: The median age at presentation of ovarian malignancy is 56 years. The sensitivity of RMI in our group was 82.3%,the specificity was 88.3%, positive predictive value was 73.7% and the negative predictive value was 92.6%. Receiver operating curves reveal that RMI was a better diagnostic marker than CA-125 or ultrasound score alone for the prediction of malignancy in ovarian masses. Conclusion: The risk of malignancy index has high specificity and sensitivity. It yielded a better diagnostic performance as compared to CA-125 or ultrasound score alone in differentiating benign from malignant ovarian lesions. (author)

  14. Can the Air Pollution Index be used to communicate the health risks of air pollution?

    Science.gov (United States)

    Li, Li; Lin, Guo-Zhen; Liu, Hua-Zhang; Guo, Yuming; Ou, Chun-Quan; Chen, Ping-Yan

    2015-10-01

    The validity of using the Air Pollution Index (API) to assess health impacts of air pollution and potential modification by individual characteristics on air pollution effects remain uncertain. We applied distributed lag non-linear models (DLNMs) to assess associations of daily API, specific pollution indices for PM10, SO2, NO2 and the weighted combined API (APIw) with mortality during 2003-2011 in Guangzhou, China. An increase of 10 in API was associated with a 0.88% (95% confidence interval (CI): 0.50, 1.27%) increase of non-accidental mortality at lag 0-2 days. Harvesting effects appeared after 2 days' exposure. The effect estimate of API over lag 0-15 days was statistically significant and similar with those of pollutant-specific indices and APIw. Stronger associations between API and mortality were observed in the elderly, females and residents with low educational attainment. In conclusion, the API can be used to communicate health risks of air pollution. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Body Mass Index: A Risk Factor for Retinopathy in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Snježana Kaštelan

    2013-01-01

    Full Text Available The aim of the study was to investigate whether body mass index (BMI independently or in correlation with other risk factors is associated with diabetic retinopathy (DR progression. The study included 545 patients with type 2 diabetes. According to DR status, they were divided into three groups: group 1 (no retinopathy; n=296, group 2 (mild/moderate nonproliferative DR; n=118, and group 3 (severe/very severe NPDR or proliferative DR; n=131. Patients without DR were younger than those with signs of retinopathy at time of diabetes onset whilst diabetes duration was longer in groups with severe NPDR and PDR. DR progression was correlated with diabetes duration, BMI, HbA1c, hypertension, and cholesterol. Statistical analyses showed that the progression of retinopathy increased significantly with higher BMI (gr. 1: 26.50 ± 2.70, gr. 2: 28.11 ± 3.00, gr. 3: 28.69 ± 2.50; P<0.01. We observed a significant deterioration of HbA1c and a significant increase in cholesterol and hypertension with an increase in BMI. Correlation between BMI and triglycerides was not significant. Thus, BMI in correlation with HbA1c cholesterol and hypertension appears to be associated with the progression of DR in type 2 diabetes and may serve as a predictive factor for the development of this important cause of visual loss in developed countries.

  16. Environmental risk assessment of registered insecticides in Iran using Environmental Impact Quotient (EIQ index

    Directory of Open Access Journals (Sweden)

    S. Moinoddini

    2016-05-01

    Full Text Available In the last decades, pesticides have been used extensively, in order to control pests and plant diseases, but negative impacts of pesticides caused several environmental problems and put human health in danger. In order to decrease environmental hazards of pesticide, risk of pesticide application should be measured briefly and precisely. In this study environmental impacts of registered insecticides in Iran which applied in 2001-2002, 2003-2004, 2004-2005, are considered using environmental impact quotient (EIQ index. Results showed that among considered insecticides, Imidacloprid, Fipronil and Tiodicarb, potentially (EIQ were the most hazardous insecticides, respectively. Taking rate of application and active ingredient of insecticide in to account, environmental impact (practical toxicity per cultivated hectare (EIQ Field of each provinces were investigated. In this regard, among different province of Iran, Kerman, Mazandaran and Golestan were in danger more than the others, respectively. Besides, considering the amount of agricultural production in provinces, environmental impact per ton of production were calculated for each provinces which three northern provinces of Mazandaran, Golestan and Guilan, respectively endure the most environmental impact per ton of production. Eventually based on environmental impact quotient, results demonstrated that majority of environmental impacts of insecticide in Iran were due to inadequate knowledge and also overuse of a few number of insecticides. Therefore, by improving knowledge about environmental impact of pesticides and also developing environmental friendly and ecological based methods, negative environmental impacts of insecticides will be reduced significantly.

  17. Body Mass Index and Subjective Social Status: The Coronary Artery Risk Development in Young Adults Study.

    Science.gov (United States)

    Dhurandhar, Emily J; Pavela, Gregory; Kaiser, Kathryn A; Dutton, Gareth R; Fontaine, Kevin R; Kim, Daniel; Shikany, James M; Allison, David B; Lewis, Cora E

    2018-02-01

    Subjective social status (SSS), or perceived social status, may explain, in part, the relationship between socioeconomic status (SES) and obesity. The objective of this study was to test whether SSS mediates the relationship between two indicators of SES (income and education) and body mass index (BMI). A cross-sectional, structural equation path analysis was applied to the Coronary Artery Risk Development in Young Adults (CARDIA) study (n = 2,624). The analysis tested whether SSS (MacArthur scale), education, and income were associated with BMI at the year 20 examination (adjusting for sex, age, and race), and it was hypothesized that the associations of education and income with BMI would be at least partly mediated by SSS. SSS had a significant direct effect on BMI (-0.21, P = 0.018). Education had a significant direct relationship with SSS (0.11, P SSS (-0.02, P = 0.022). Although income did not have a significant direct relationship with BMI, it did have a significant indirect relationship through SSS (b = -0.05, P = 0.019). Results are consistent with the hypothesized model in which SSS partially mediates the relationship between SES indicators and BMI. © 2017 The Obesity Society.

  18. Risk of asthma in adult twins with type 2 diabetes and increased body mass index

    DEFF Research Database (Denmark)

    Thomsen, S F; Duffy, D L; Kyvik, K O

    2011-01-01

    . RESULTS: The risk of asthma was increased in subjects with type 2 diabetes relative to nondiabetic subjects both in men (13.5%vs 7.5%), P = 0.001 and in women (16.6%vs 9.6%), P = 0.001. The result remained significant after adjustment for age, BMI, smoking, symptoms of chronic bronchitis, marital status...... asthma and type 2 diabetes, 0.20 (0.01-0.40), P = 0.047; between asthma and BMI in women, 0.15 (0.07-0.22), P type 2 diabetes, 0.40 (0.29-0.43), P type 2 diabetes and increased BMI are strongly associated in adults, particularly in women......AIM: To examine the relationship between asthma, type 2 diabetes and increased body mass index (BMI) in adult twins. METHODS: We performed record linkage between questionnaire-defined asthma and BMI, and hospital discharge diagnoses of type 2 diabetes in 34,782 Danish twins, 20-71 years of age...

  19. The Omega-3 Index and relative risk for coronary heart disease mortality: Estimation from 10 cohort studies.

    Science.gov (United States)

    Harris, William S; Del Gobbo, Liana; Tintle, Nathan L

    2017-07-01

    A recent 19-cohort meta-analysis examined the relationships between biomarkers of omega-3 fatty acids and risk for coronary heart disease (CHD). That study did not, however, report hazard ratios (HRs) specifically as a function of erythrocyte eicosapentaenoic (EPA) plus docosahexaenoic (DHA) levels, a metric called the Omega-3 Index in which EPA + DHA content is expressed as a percent of total fatty acids. The Omega-3 Index has been used in several recent studies and is a validated biomarker of omega-3 fatty acid tissue levels, but additional data are needed to confirm (or refute) the originally-proposed clinical cut-points of Omega-3 Index and median quintile values for this metric across 10 of the cohorts for which the needed data were available. The overall mean (SD) for the Omega-3 Index in these 10 cohort studies was 6.1% (2.1%), and the HR for a 1-SD increase was 0.85 (95% confidence interval, 0.80-0.91). Median quintile 1 and 5 levels were 4.2% vs. 8.3%, respectively. Based on these values, we estimate that risk for fatal CHD would have been reduced by about 30% moving from an Omega-3 Index of 4%-8%. These findings support the use of 8% as reasonable therapeutic targets for the Omega-3 Index. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Risk Quantitative Determination of Fire and Explosion in a Process Unit By Dow’s Fire and Explosion Index

    Directory of Open Access Journals (Sweden)

    S. Varmazyar

    2008-04-01

    Full Text Available Background and aims   Fire and explosion hazards are the first and second of major hazards in process industries, respectively. This study has been done to determine fire and explosion risk severity,radius of exposure and estimating of most probable loss.   Methods   In this quantitative study process unit has been selected with affecting parameters on  fire and explosion risk. Then, it was analyzed by DOW's fire and explosion index (F&EI. Technical data were obtained from process documents and reports, fire and explosion guideline.After calculating of DOW's index, radius of exposure determined and finally most  probable loss was estimated.   Results   The results showed an F&EI value of 226 for this process unit.The F&EI was extremely  high and unacceptable.Risk severity was categorized in sever class.Radius of exposure and damage factor were calculated 57 meters and 83%,respectively. As well as most probable loss was  estimated about 6.7 million dollars.   Conclusion   F&EI is a proper technique for risk assessment and loss estimation of fire and  explosion in process industries.Also,It is an important index for detecting high risk and low risk   areas in an industry. At this technique, all of factors affecting on fire and explosion risk was  showed as index that is a base for judgement risk class. Finally, estimated losses could be used as  a base of fire and explosion insurance.

  1. Association between Dietary Inflammatory Index (DII) and risk of prediabetes: a case-control study.

    Science.gov (United States)

    Vahid, Farhad; Shivappa, Nitin; Karamati, Mohsen; Naeini, Alireza Jafari; Hebert, James R; Davoodi, Sayed Hossein

    2017-04-01

    The possible relationship between diet-related inflammation and the risk of prediabetes requires further investigation, especially in non-Western populations. We examined the ability of the dietary inflammatory index (DII) to predict the risk of prediabetes in a case-control study conducted at specialized centers in Esfahan, Iran. A total of 214 incident cases of prediabetes were selected with the nonrandom sampling procedure, and the 200 controls randomly selected from the same clinics were frequency-matched on age (±5 years) and sex. DII scores were computed based on dietary intake assessed using a validated and reproducible 168-item food-frequency questionnaire. Linear and logistic regression models were used to estimate multivariable beta estimates and odds ratios (ORs). Subjects in tertile 3 versus tertile 1 (T3VS1) of DII had significantly higher fasting plasma glucose (DII T3VS1 : b = 4.49; 95% CI 1.89, 7.09), oral glucose tolerance (DII T3VS1 : b = 8.76; 95% CI 1.78, 15.73), HbA1c (DII T3VS1 : b = 0.30; 95% CI 0.17, 0.42), low-density lipoprotein (DII T3VS1 : b = 16.37; 95% CI 11.04, 21.69), triglyceride (DII T3VS1 : b = 21.01; 95% CI 8.61, 33.42) and body fat (DII T3VS1 : b = 2.41; 95% CI 0.56, 4.26) and lower high-density lipoprotein (DII T3VS1 : b = -3.39; 95% CI -5.94, -0.84) and lean body mass (DII T3VS1 : b = -3.11; 95% CI -4.83, -1.39). After multivariate adjustment, subjects in the most pro-inflammatory DII group had 19 times higher odds of developing prediabetes compared with subjects in tertile 1 (DII T3VS1 : OR = 18.88; 95% CI 7.02, 50.82). Similar results were observed when DII was used as a continuous variable, (DII continuous : OR = 3.62; 95% CI 2.50, 5.22). Subjects who consumed a more pro-inflammatory diet were at increased risk of prediabetes compared with those who consumed a more anti-inflammatory diet.

  2. Change of flood risk under climate change based on Discharge Probability Index in Japan

    Science.gov (United States)

    Nitta, T.; Yoshimura, K.; Kanae, S.; Oki, T.

    2010-12-01

    Water-related disasters under the climate change have recently gained considerable interest, and there have been many studies referring to flood risk at the global scale (e.g. Milly et al., 2002; Hirabayashi et al., 2008). In order to build adaptive capacity, however, regional impact evaluation is needed. We thus focus on the flood risk over Japan in the present study. The output from the Regional Climate Model 20 (RCM20), which was developed by the Meteorological Research Institute, was used. The data was first compared with observed data based on Automated Meteorological Data Acquisition System and ground weather observations, and the model biases were corrected using the ratio and difference of the 20-year mean values. The bias-corrected RCM20 atmospheric data were then forced to run a land surface model and a river routing model (Yoshimura et al., 2007; Ngo-Duc, T. et al. 2007) to simulate river discharge during 1981-2000, 2031-2050, and 2081-2100. Simulated river discharge was converted to Discharge Probability Index (DPI), which was proposed by Yoshimura et al based on a statistical approach. The bias and uncertainty of the models are already taken into account in the concept of DPI, so that DPI serves as a good indicator of flood risk. We estimated the statistical parameters for DPI using the river discharge for 1981-2000 with an assumption that the parameters stay the same in the different climate periods. We then evaluated the occurrence of flood events corresponding to DPI categories in each 20 years and averaged them in 9 regions. The results indicate that low DPI flood events (return period of 2 years) will become more frequent in 2031-2050 and high DPI flood events (return period of 200 years) will become more frequent in 2081-2100 compared with the period of 1981-2000, though average precipitation will become larger during 2031-2050 than during 2081-2100 in most regions. It reflects the increased extreme precipitation during 2081-2100.

  3. The association between a body shape index and cardiovascular risk in overweight and obese children and adolescents.

    Science.gov (United States)

    Mameli, Chiara; Krakauer, Nir Y; Krakauer, Jesse C; Bosetti, Alessandra; Ferrari, Chiara Matilde; Moiana, Norma; Schneider, Laura; Borsani, Barbara; Genoni, Teresa; Zuccotti, Gianvincenzo

    2018-01-01

    A Body Shape Index (ABSI) and normalized hip circumference (Hip Index, HI) have been recently shown to be strong risk factors for mortality and for cardiovascular disease in adults. We conducted an observational cross-sectional study to evaluate the relationship between ABSI, HI and cardiometabolic risk factors and obesity-related comorbidities in overweight and obese children and adolescents aged 2-18 years. We performed multivariate linear and logistic regression analyses with BMI, ABSI, and HI age and sex normalized z scores as predictors to examine the association with cardiometabolic risk markers (systolic and diastolic blood pressure, fasting glucose and insulin, total cholesterol and its components, transaminases, fat mass % detected by bioelectrical impedance analysis) and obesity-related conditions (including hepatic steatosis and metabolic syndrome). We recruited 217 patients (114 males), mean age 11.3 years. Multivariate linear regression showed a significant association of ABSI z score with 10 out of 15 risk markers expressed as continuous variables, while BMI z score showed a significant correlation with 9 and HI only with 1. In multivariate logistic regression to predict occurrence of obesity-related conditions and above-threshold values of risk factors, BMI z score was significantly correlated to 7 out of 12, ABSI to 5, and HI to 1. Overall, ABSI is an independent anthropometric index that was significantly associated with cardiometabolic risk markers in a pediatric population affected by overweight and obesity.

  4. The association between a body shape index and cardiovascular risk in overweight and obese children and adolescents.

    Directory of Open Access Journals (Sweden)

    Chiara Mameli

    Full Text Available A Body Shape Index (ABSI and normalized hip circumference (Hip Index, HI have been recently shown to be strong risk factors for mortality and for cardiovascular disease in adults. We conducted an observational cross-sectional study to evaluate the relationship between ABSI, HI and cardiometabolic risk factors and obesity-related comorbidities in overweight and obese children and adolescents aged 2-18 years. We performed multivariate linear and logistic regression analyses with BMI, ABSI, and HI age and sex normalized z scores as predictors to examine the association with cardiometabolic risk markers (systolic and diastolic blood pressure, fasting glucose and insulin, total cholesterol and its components, transaminases, fat mass % detected by bioelectrical impedance analysis and obesity-related conditions (including hepatic steatosis and metabolic syndrome. We recruited 217 patients (114 males, mean age 11.3 years. Multivariate linear regression showed a significant association of ABSI z score with 10 out of 15 risk markers expressed as continuous variables, while BMI z score showed a significant correlation with 9 and HI only with 1. In multivariate logistic regression to predict occurrence of obesity-related conditions and above-threshold values of risk factors, BMI z score was significantly correlated to 7 out of 12, ABSI to 5, and HI to 1. Overall, ABSI is an independent anthropometric index that was significantly associated with cardiometabolic risk markers in a pediatric population affected by overweight and obesity.

  5. The triglycerides and glucose index is associated with cardiovascular risk factors in normal-weight children and adolescents.

    Science.gov (United States)

    Simental-Mendía, Luis E; Hernández-Ronquillo, Gabriela; Gómez-Díaz, Rita; Rodríguez-Morán, Martha; Guerrero-Romero, Fernando

    2017-12-01

    BackgroundGiven the usefulness of the product of triglycerides and glucose (TyG) to recognize individuals at high risk for developing cardiovascular events, the aim of this study was to determine whether the TyG index is associated with the presence of cardiovascular risk factors in apparently healthy normal-weight children and adolescents.MethodsApparently healthy children and adolescents with normal weight, aged 6-15 years, were enrolled in a population-based cross-sectional study. The children were allocated into groups with and without cardiovascular risk factors. Cardiovascular risk factors were considered as the occurrence of at least one of the following: elevated blood pressure, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), or hyperglycemia.ResultsA total of 2,117 children and adolescents were enrolled in the study; of them, 1,078 (50.9%) participants exhibited cardiovascular risk. The adjusted logistic regression analysis showed that elevated TyG index was significantly associated with hypertriglyceridemia (odds ratio (OR)=96.45, 95% confidence interval (CI): 48.44-192.04), low HDL-C (OR=2.07, 95% CI: 1.46-2.92), and hyperglycemia (OR=3.11, 95% CI: 2.05-4.72), but not with elevated blood pressure (OR=1.39, 95% CI: 0.89-2.16).ConclusionThe elevated TyG index is associated with the presence of cardiovascular risk factors in healthy normal-weight children and adolescents.

  6. Model or Myopia? Exploiting Water Markets to Address Population and Drought Risks in a Changing World

    Science.gov (United States)

    Reed, P. M.

    2012-12-01

    Climate change, population demands, and evolving land-use represent strong risks to the sustainable development and stability of world-wide urban water supplies. There is a growing consensus that non-structural supply management instruments such as water markets have significant potential to reduce the risks and vulnerabilities in complex urban water systems. This paper asks a common question, what are the tradeoffs for a city using water market supply instruments?. This question emerges quickly in policy and management, but its answer is deceptively difficult to attain using traditional planning tools and management frameworks. This research demonstrates new frameworks that facilitate rapid evaluation of hypotheses on the reliability, resiliency, adaptability, and cost-effectiveness of urban water supply systems. This study considers a broader exploration of the issues of "nonstationarity" and "uncertainty" in urban water planning. As we invest in new information and prediction frameworks for the coupled human-natural systems that define our water, our problem definitions (i.e., objectives, constraints, preferences, and hypotheses) themselves evolve. From a formal mathematical perspective, this means that our management problems are structurally uncertain and nonstationary (i.e., the definition of optimality changes across regions, times, and stakeholders). This uncertainty and nonstationarity in our problem definitions needs to be more explicitly acknowledged in adaptive management and integrated water resources management. This study demonstrates the potential benefits of exploring these issues in the context of a city in the Lower Rio Grande Valley (LRGV) of Texas, USA determining how to use its regional water market to manage population and drought risks.

  7. Childhood Height and Body Mass Index Were Associated with Risk of Adult Thyroid Cancer in a Large Cohort Study

    DEFF Research Database (Denmark)

    Kitahara, Cari M; Gamborg, Michael; Berrington de González, Amy

    2014-01-01

    Taller stature and obesity in adulthood have been consistently associated with an increased risk of thyroid cancer, but few studies have investigated the role of childhood body size. Using data from a large prospective cohort, we examined associations for height and body mass index (BMI) at ages 7...

  8. Shortened version of the work ability index to identify workers at risk of long-term sickness absence

    NARCIS (Netherlands)

    Schouten, Lianne S.; Bultmann, Ute; Heymans, Martijn W.; Joling, Catelijne I.; Twisk, Jos W. R.; Roelen, Corne A. M.

    2016-01-01

    Background: The Work Ability Index (WAI) identifies non-sicklisted workers at risk of future long-term sickness absence (LTSA). The WAI is a complicated instrument and inconvenient for use in large-scale surveys. We investigated whether shortened versions of the WAI identify non-sicklisted workers

  9. Political, socio-economic, legal and civilizational risks on the way of Russia and the slavonic world towards sustainable development

    Directory of Open Access Journals (Sweden)

    Sergey N. Baburin

    2017-06-01

    Full Text Available Objective to identify the political socioeconomic and legal risks on the way of Russia and the Slavonic world towards sustainable development. Methods dialectical approach to cognition of social phenomena allowing to analyze them in historical development and functioning in the context of the totality of objective and subjective factors that determined the choice of the following research methods systematic and structural formallegal and comparativelegal. Results the article views the system of risks on the way of Russia and the Slavonic world towards sustainable development which includes political socioeconomic legal and civilizational risks. Scientific recommendations are formulated for the identification analysis and elimination of risks. The main tendencies of the world order are identified changes in the structure of the statesrsquo national interests strengthening the role of nonstate actors promotion of democratic values and ideals the increasing role of international and interstate cooperation. Scientific novelty the article proposes a classification of risks that stand in the way of Russia and the Slavonic world towards sustainable development the necessity of their complex including constitutional overcoming and identifies the causes and conditions contributing to the emergence of the risks. Practical significance the main provisions and conclusions of the article can be used in scientific and educational activities in addressing the issues of planning and predicting the state and legal phenomena and processes.

  10. Maternal Body Mass Index in Early Pregnancy and Risk of Epilepsy in Offspring.

    Science.gov (United States)

    Razaz, Neda; Tedroff, Kristina; Villamor, Eduardo; Cnattingius, Sven

    2017-06-01

    There is growing concern about the long-term neurologic effects of prenatal exposure to maternal overweight and obesity. The causes of epilepsy are poorly understood and, in more than 60% of the patients, no definitive cause can be determined. To investigate the association between early pregnancy body mass index (BMI) and the risk of childhood epilepsy and examine associations between obesity-related pregnancy and neonatal complications and risks of childhood epilepsy. A population-based cohort study of 1 441 623 live single births at 22 or more completed gestational weeks in Sweden from January 1, 1997, to December 31, 2011, was conducted. The diagnosis of epilepsy as well as obesity-related pregnancy and neonatal complications were based on information from the Sweden Medical Birth Register and National Patient Register. Multivariate Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HRs) and 95% CIs after adjusting for maternal age, country of origin, educational level, cohabitation with partner, height, smoking, maternal epilepsy, and year of delivery. Data analysis was conducted from June 1 to December 15, 2016. Risk of childhood epilepsy. Of the 1 421 551 children born between January 1, 1997, and December 31, 2011, with covariate information available, 7592 (0.5%) were diagnosed with epilepsy through December 31, 2012. Of these 3530 (46.5%) were female. The overall incidence of epilepsy in children aged 28 days to 16 years was 6.79 per 10 000 child-years. Compared with offspring of normal-weight mothers (BMI 18.5 to epilepsy by maternal BMI categories were as follows: overweight (BMI 25.0 to epilepsy were considerably increased for children with malformations of the nervous system (adjusted HR, 46.4; 95% CI, 42.2-51.0), hypoxic ischemic encephalopathy (adjusted HR, 23.6; 95% CI, 20.6-27.1), and neonatal convulsions (adjusted HR, 33.5; 95% CI, 30.1-37.4). The rates of epilepsy were doubled among children with

  11. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    Science.gov (United States)

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  12. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China

    Science.gov (United States)

    Yao, Hong; Li, Weixin; Qian, Xin

    2015-01-01

    Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution. PMID:26308032

  13. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China.

    Science.gov (United States)

    Yao, Hong; Li, Weixin; Qian, Xin

    2015-08-21

    Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution.

  14. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI in the Multi-Provincial Boundary Region of the Taihu Basin, China

    Directory of Open Access Journals (Sweden)

    Hong Yao

    2015-08-01

    Full Text Available Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution.

  15. Combined detection of depression and anxiety in epilepsy patients using the Neurological Disorders Depression Inventory for Epilepsy and the World Health Organization well-being index

    DEFF Research Database (Denmark)

    Hansen, Christian Pilebæk; Amiri, Moshgan

    2015-01-01

    PURPOSE: To validate the Danish version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and compare it with the World Health Organization index for psychological well-being (WHO-5) as screening tests for depression and anxiety in epilepsy patients. METHODS: Epilepsy...... outpatients filled out NDDI-E and WHO-5. A Mini International Neuropsychiatric Interview (MINI) as gold standard for psychiatric diagnoses was carried out with every patient. RESULTS: We included 124 epilepsy patients. According to MINI, 5% had depression without anxiety, 6% anxiety without depression, and 6...... there are 17% false positives. CONCLUSION: NDDI-E in Danish is valid and slightly better than WHO-5 in the detection of depression in epilepsy patients. WHO-5 is valid for the detection of anxiety disorders. Combined use of NDDI-E and WHO-5 is recommended, since 95% of all epilepsy patients with depression and...

  16. The application of visceral adiposity index in identifying type 2 diabetes risks based on a prospective cohort in China.

    Science.gov (United States)

    Chen, Chen; Xu, Yan; Guo, Zhi-rong; Yang, Jie; Wu, Ming; Hu, Xiao-shu

    2014-07-08

    Visceral adiposity index (VAI), a novel sex-specific index for visceral fat measurement, has been proposed recently. We evaluate the efficacy of VAI in identifying diabetes risk in Chinese people, and compare the predictive ability between VAI and other body fatness indices, i.e., waist circumference (WC), body mass index (BMI) and waist- to- height ratio (WHtR). Participants (n=3,461) were recruited from an ongoing cohort study in Jiangsu Province, China. Hazard ratio (HR) and corresponding 95% confidence interval (CI) between diabetes risk and different body fatness indices were evaluated by Cox proportional hazard regression model. Receiver operating characteristic (ROC) curve and area under curve (AUC) were applied to compare the ability of identifying diabetes risk between VAI, WC, WHtR and BMI. A total number of 160 new diabetic cases occurred during the follow-up, with an incidence of 4.6%. Significant positive associations were observed for VAI with blood pressure, fasting plasma glucose, triglyceride, WC, BMI and WHtR. Moreover, increased VAI was observed to be associated with higher diabetes risk with a positive dose-response trend (p for trendconvenience surrogate marker for visceral adipose measurement and could be used in identifying the risk of diabetes in large-scale epidemiologic studies.

  17. Redefining high-risk patients with stage II colon cancer by risk index and microRNA-21: results from a population-based cohort

    DEFF Research Database (Denmark)

    Hansen, T F; Kjær-Frifeldt, S; Christensen, R D

    2014-01-01

    Background:The aim of the present study was to analyse the prognostic value of microRNA-21 (miRNA-21) in patients with stage II colon cancer aiming at a risk index for this group of patients.Methods:A population-based cohort of 554 patients was included. MicroRNA-21 was analysed by qPCR based.......001). The overall survival (OS) index identified three different subgroups (Pcolon cancer. Furthermore...... on tumour tissue. An index was created using the coefficients obtained from a collective multiple Cox regression. The entire procedure was cross-validated (10-fold). The performance of the index was quantified by time-dependent receiver operating characteristics curves.Results:High miRNA-21 expression...

  18. Hypoglycaemic and coronary risk index lowering effects of Bauhinia thoningii in alloxan induced diabetic rats.

    Science.gov (United States)

    Ojezele, M O; Abatan, O M

    2011-03-01

    Disease, one of humanity's greatest adversaries, has in recent times showed an intimidating increase in numerical and pathological strength. This stretched the available medications to the limit thereby necessitating the need for the discovery of new and alternative medications to combat the menace of disease. Diabetic mellitus is one disease condition for which ideal synthetic drugs are yet to be discovered. To this end, pharmaceuticals are looking in the direction of medicinal plants. This work aimed at screening Bauhinia thoningii (leaves) for its hypoglycaemic effect. The effect of the extract on lipid profile as a Coronary Risk Index (CRI) was also evaluated. Aqueous crude extract of the plant was administered orally to alloxan induced diabetic rats and fasting blood glucose monitored over a period of 7 days. Blood samples collected from the rats were assayed for full lipid profile and the CRI calculated. Bauhinia thoningii caused 81.37% reduction in blood glucose of the experimental animals over a period of 7 days from an initial 365 mg/dl to 68 mg/dl. The plant extract was also observed to have the capacity to ameliorate diabetic complications like cardiovascular disorders. The extract reduced the Low Density lipoprotein (LDL) and reduced the CRI. Results from this study confirmed the hypoglycaemic efficacy of the extract and ability to ameliorate coronary diabetic complications. Further study is required to purify the plant extract to identify the fraction(s) that are responsible for the hypoglycaemic effects observed. This will also help to isolate the active components and elucidate the likely mechanism of action of the plant extract.

  19. Healthy Food Intake Index (HFII – Validity and reproducibility in a gestational-diabetes-risk population

    Directory of Open Access Journals (Sweden)

    Jelena Meinilä

    2016-07-01

    Full Text Available Abstract Background The aim was to develop and validate a food-based diet quality index for measuring adherence to the Nordic Nutrition Recommendations (NNR in a pregnant population with high risk of gestational diabetes (GDM. Methods This study is a part of the Finnish Gestational Diabetes Prevention Study (RADIEL, a lifestyle intervention conducted between 2008 and 2014. The 443 pregnant participants (61 % of those invited, were either obese or had a history of GDM. Food frequency questionnaires collected at 1st trimester served for composing the HFII; a sum of 11 food groups (available score range 0–17 with higher scores reflecting higher adherence to the NNR. Results The average HFII of the participants was 10.2 (SD 2.8, range 2–17. Factor analysis for the HFII component matrix revealed three factors that explained most of the distribution (59 % of the HFII. As an evidence of the component relevance 9 out of 11 of the HFII components independently contributed to the total score (item-rest correlation coefficients <0.31. Saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, sucrose, and fiber intakes (among other nutrients showed linearity across the HFII categories (P ≤ 0.030 for all nutrients tested; the higher the HFII, the closer the nutrient intake to the recommended intake level. Educational attainment (P = 0.0045, BMI (P = 0.0098, smoking (P = 0.007, and leisure time physical exercise (P = 0.038 showed linearity across the HFII categories. Intra-class correlation coefficient for the HFII was 0.85 (CI 0.79, 0.90. Conclusions The HFII components reflect the food guidelines of the NNR, intakes of relevant nutrients, and characteristics known to vary with diet quality. It largely ignores energy intake, its components have independent contribution to the HFII, and it exhibits reproducibility. The main shortcomings are absence of red and processed meat component, and the validation in a

  20. Assessing a new hip index as a risk predictor for diabetes mellitus.

    Science.gov (United States)

    He, Sen; Zheng, Yi; Chen, Xiaoping

    2017-09-30

    Recently, a new anthropometric parameter (a new hip index [HI]) was developed, and the HI shows a U-shaped relationship to mortality in the USA population. It is well known that there is an inverse relationship between hip circumference (HC) and the risk of diabetes mellitus. Accordingly, the study sought to investigate whether HI could predict future diabetes mellitus, as compared with HC and the waist-to-hip ratio (WHR), in a general Chinese population. In 2007, we carried out a health examination of 687 participants (mean age 48.1 ± 6.2 years, male 58.1%). Development of diabetes mellitus by the 2007 examination was studied in relation to data from a baseline health examination carried out in 1992. During the follow up, 74 participants were diagnosed with diabetes mellitus. Across the quintiles of baseline HI, the incidence rates of diabetes mellitus were 12.4, 12.4, 9.9, 7.8 and 11.3% in quintile (Q)1, Q2, Q3, Q4 and Q5, respectively (P = 0.698). With the lowest quintile (Q1) as reference, univariate and multivariate Cox regression analyses showed that HI was not associated with diabetes mellitus. In contrast, HC and WHR could predict future diabetes mellitus. Furthermore, WHR had the best discriminatory power for diabetes mellitus (area under the receiver operating characteristic curve 0.691, 95% confidence interval 0.621-0.761), followed by HC (area under the receiver operating characteristic curve 0.623, 95% confidence interval 0.558-0.689) and HI (area under the receiver operating characteristic curve 0.464, 95% confidence interval 0.396-0.531). Compared with HC and WHR, HI was not an independent risk factor for diabetes mellitus in the Chinese population. More studies are required to delineate the limits of the utility of HI. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  1. Development of a New Fall Risk Assessment Index for Older Adults

    Directory of Open Access Journals (Sweden)

    Minoru Yamada, RPT, PhD

    2012-09-01

    Conclusion: We have demonstrated that the new index is a reliable indicator for falls in elderly people who have higher levels of functional capacity. Our data suggest that a score of more than 1 point by the new index can predict falls in robust elderly people.

  2. Socioeconomic inequalities in risk factors for non communicable diseases in low-income and middle-income countries: results from the World Health Survey.

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kunst, Anton; Harper, Sam; Guthold, Regina; Rekve, Dag; d'Espaignet, Edouard Tursan; Naidoo, Nirmala; Chatterji, Somnath

    2012-10-28

    Monitoring inequalities in non communicable disease risk factor prevalence can help to inform and target effective interventions. The prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking were quantified and compared across wealth and education levels in low- and middle-income country groups. This study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002-2004 World Health Survey. Data were stratified by sex and low- or middle-income country status. The main outcome measurements were risk factor prevalence rates reported by wealth quintile and five levels of educational attainment. Socioeconomic inequalities were measured using the slope index of inequality, reflecting differences in prevalence rates, and the relative index of inequality, reflecting the prevalence ratio between the two extremes of wealth or education accounting for the entire distribution. Data were adjusted for confounding factors: sex, age, marital status, area of residence, and country of residence. Smoking and low fruit and vegetable consumption were significantly higher among lower socioeconomic groups. The highest wealth-related absolute inequality was seen in smoking among men of low- income country group (slope index of inequality 23.0 percentage points; 95% confidence interval 19.6, 26.4). The slope index of inequality for low fruit and vegetable consumption across the entire distribution of education was around 8 percentage points in both sexes and both country income groups. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries (relative index of inequality: (men) 0.46, 95% confidence interval 0.33, 0.64; (women) 0.52, 95% confidence interval 0.42, 0.65). Mixed patterns were found for heavy drinking. Disaggregated analysis of the prevalence of non-communicable disease risk factors demonstrated different

  3. Development of new index for forest fire risk using satellite images in Indonesia through the direct spectral measurements of soil

    Science.gov (United States)

    Hashimoto, A.; Akita, M.; Takahashi, Y.; Suzuki, H.; Hasegawa, Y.; Ogino, Y.; Naruse, N.; Takahashi, Y.

    2016-12-01

    In recent years, the smoke caused by the forest fires in Indonesia has become a serious problem. Most of the land in Indonesia is covered with peat moss, which occurs the expanding of fires due to the burning itself. Thus, the surface soil water, reflecting the amount of precipitation in the area, can become the indication of the risk of fires. This study aims to develop a new index reflecting the risk of forest fires in Indonesia using satellite remote sensing through the direct spectral measurements of peat moss soil.We have prepared the peat moss in 7 steps of soil water content measured at an accuracy of ±15 percent (Field pro, WD-3). We obtained spectra between 400nm and 1050nm (Source: halogen lamp, spectroscope: self-made space time, spectral analysis kit) from the peat moss.The obtained spectra show the difference from the previous spectral measurement for the soil in various water content. There are the features, especially, in the wavelength range of ultraviolet (400-450nm) and infrared (530-800nm) as shown in the figure; the more the soil water increases, the lower the reflectance becomes. We have developed a new index using the New deep blue band (433 453nm and NIR band 845 885nm of Landsat 8. The resulting satellite images calculated by our original index appears to reflect the risk of forest fires rather than well-known indices such as Normalized Difference Water Index and Normalized difference Soil Index.In conclusion, we have created a new index that highly reflects to the degree of soil water of a peat soil in Indonesia.

  4. Adherence to a Healthy Nordic Food Index Is Associated with a Lower Risk of Type-2 Diabetes

    DEFF Research Database (Denmark)

    Lacoppidan, Sandra Amalie; Kyrø, Cecilie; Loft, Steffen

    2015-01-01

    BACKGROUND: Type-2 diabetes (T2D) prevalence is rapidly increasing worldwide. Lifestyle factors, in particular obesity, diet, and physical activity play a significant role in the etiology of the disease. Of dietary patterns, particularly the Mediterranean diet has been studied, and generally......, suggesting that regional diets other than the Mediterranean may also be recommended for prevention of T2D....... a protective association has been identified. However, other regional diets are less explored. OBJECTIVE: The aim of the present study was to investigate the association between adherence to a healthy Nordic food index and the risk of T2D. The index consists of six food items: fish, cabbage, rye bread, oatmeal...

  5. Health risks of climate change in the World Health Organization South-East Asia Region.

    Science.gov (United States)

    Bowen, Kathryn J; Ebi, Kristie L

    2017-09-01

    Countries in the World Health Organization (WHO) South-East Asia Region are particularly vulnerable to a changing climate. Changes in extreme weather events, undernutrition and the spread of infectious diseases are projected to increase the number of deaths due to climate change by 2030, indicating the need to strengthen activities for adaptation and mitigation. With support from the WHO Regional Office for South-East Asia and others, countries have started to include climate change as a key consideration in their national public health policies. Further efforts are needed to develop evidence-based responses; garner the necessary support from partner ministries; and access funding for activities related to health and climate change. National action plans for climate change generally identify health as one of their priorities; however, limited information is available on implementation processes, including which ministries and departments would be involved; the time frame; stakeholder responsibilities; and how the projects would be financed. While progress is being made, efforts are needed to increase the capacity of health systems to manage the health risks of climate change in South-East Asia, if population health is to be protected and strengthened while addressing changing weather and climate patterns. Enhancing the resilience of health systems is key to ensuring a sustainable path to improved planetary and population health.

  6. Outpatient Management of Children With World Health Organization Chest Indrawing Pneumonia: Implementation Risks and Proposed Solutions.

    Science.gov (United States)

    McCollum, Eric D; Ginsburg, Amy Sarah

    2017-10-16

    This Viewpoints article details our recommendation for the World Health Organization Integrated Management of Childhood Illness guidelines to consider additional referral or daily monitoring criteria for children with chest indrawing pneumonia in low-resource settings. We review chest indrawing physiology in children and relate this to the risk of adverse pneumonia outcomes. We believe there is sufficient evidence to support referring or daily monitoring of children with chest indrawing pneumonia and signs of severe respiratory distress, oxygen saturation <93% (when not at high altitude), moderate malnutrition, or an unknown human immunodeficiency virus (HIV) status in an HIV-endemic setting. Pulse oximetry screening should be routine and performed at the earliest point in the patient care pathway as possible. If outpatient clinics lack capacity to conduct pulse oximetry, nutritional assessment, or HIV testing, then we recommend considering referral to complete the evaluation. When referral is not possible, careful daily monitoring should be performed. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  7. Real-World Assessment of Clinical Outcomes in Patients with Lower-Risk Myelofibrosis Receiving Treatment with Ruxolitinib

    Directory of Open Access Journals (Sweden)

    Keith L. Davis

    2015-01-01

    Full Text Available Few trial-based assessments of ruxolitinib in patients with lower-risk myelofibrosis (MF have been conducted, and no studies have made such assessments in a real-world population. We assessed changes in spleen size and constitutional symptoms during ruxolitinib treatment using a retrospective, observational review of anonymized US medical record data of patients diagnosed with IPSS low-risk (n=25 or intermediate-1-risk (n=83 MF. The majority of patients were male (low risk, 60%; intermediate-1 risk, 69%. Most patients (92% and 77% were still receiving ruxolitinib at the medical record abstraction date (median observation/exposure time, 8 months. The proportion of patients with moderate or severe palpable splenomegaly (≥10 cm decreased from diagnosis (56% to best response (12%. Fatigue was reported in 47% of patients and was the most common constitutional symptom. For most symptoms in both risk groups, shifts in the distribution of severity from more to less severe from diagnosis to best response were observed. Both patients with low-risk and intermediate-1-risk MF experienced a substantial decrease in spleen size with ruxolitinib treatment in real-world settings. For most symptoms examined, there were distinct improvements in the distribution of severity during ruxolitinib treatment. These findings suggest that patients with lower-risk MF may benefit clinically from ruxolitinib treatment.

  8. Combating stress risks with the job stress self diagnostic method: paper XV World Congress of Sociology 2002

    OpenAIRE

    Oeij, P.R.A.

    2002-01-01

    In this paper of the World Congress of Sociology 2002 of ISA (International Sociological Association), the content and uses of the Job Stress Self Diagnostic Method (JSSDM) are described. The JSSDM aim is (a) to diagnose work processes to determine the presence of conditions for control problems and stress risks, and (b) to develop solutions to combat stress risks on organisational level. The method is based on three theories of job and organisation design and on the insight to combine viewpo...

  9. Index-Based Insurance Contracts to FOSTER Cooperation Between Agents Exposed to Uncorrelated Drought and Flooding Risks

    Science.gov (United States)

    Denaro, S.; Giuliani, M.; Castelletti, A.; Characklis, G. W.

    2017-12-01

    Worldwide, conflict over shared water resources is exacerbated by population growth, economic development and climate change. In multi-purpose water systems, stakeholders can face higher financial risks as a consequence of increased hydrological uncertainty and recurrent extreme events. In this context, a financial hedging tool able to bundle together the uncorrelated risks faced by different stakeholders may be an efficient solution to both foster cooperation and manage the financial losses associated with extreme events. In this work we explore the potential of risk diversification strategies involving index-based insurance joint contract solutions, to manage financial risk in a multi-purpose water system prone to both drought and flood risk. Risk diversification can allow for reduced insurance premiums in situations in which the bundled risks are entirely, or mostly, uncorrelated. Jointly covering flood and drought related risks from competing users in the same geographic area represents a novel application. The approach is demonstrated using a case study on Lake Maggiore, a regulated lake whose management is highly controversial due to numerous and competing human activities. In particular we focus on the ongoing conflict among the lakeshore population, affected by flood risk, and the downstream farmers' districts, facing drought related losses. Results are promising and indicate that bundling uncorrelated risks from competing users is beneficial to both promoting insurance premium affordability and facilitating collaboration schemes at the catchment scale.

  10. A Comparison of Microplastic Ecological Risk in Sediments of Shanghai and Hong Kong Based on the Ecological Risk Index and Plastic Hazard Classes

    Science.gov (United States)

    Xu, P.; Li, D.

    2017-12-01

    Microplastic which refers to the plastic fragments and particles with diameters less than 5 mm has potential threatening impacts on various ambient medium. The shortage of knowledge of ecological risks from microplastics inhibits the scientific research process. Based on the research of the literature widely, this paper analyzed potential ecological risk of microplastic in sediment of Shanghai and Hong Kong by means of ecological risk index and hazard classes developed by UN Globally Harmonized System. Combining of the two assessment method, results showed that the order of microplastic pollution extents in sediments was Changjiang Estuary

  11. Systemic Immune-Inflammation Index and Circulating T-Cell Immune Index Predict Outcomes in High-Risk Acral Melanoma Patients Treated with High-Dose Interferon

    Directory of Open Access Journals (Sweden)

    Jiayi Yu

    2017-10-01

    Full Text Available High-dose interferon alfa-2b (IFN-α-2b improves the survival of patients with high-risk melanoma. We aimed to identify baseline peripheral blood biomarkers to predict the outcome of acral melanoma patients treated with IFN-α-2b. Pretreatment baseline parameters and clinical data were assessed in 226 patients with acral melanoma. Relapse-free survival (RFS and overall survival (OS were assessed using the Kaplan-Meier method, and multivariate Cox regression analyses were applied after adjusting for stage, lactate dehydrogenase (LDH, and ulceration. Univariate analysis showed that neutrophil-to-lymphocyte ratio ≥2.35, platelet-to-lymphocyte ratio ≥129, systemic immune-inflammation index (SII ≥615 × 109/l, and elevated LDH were significantly associated with poor RFS and OS. The SII is calculated as follows: platelet count × neutrophil count/lymphocyte count. On multivariate analysis, the SII was associated with RFS [hazard ratio (HR=1.661, 95% confidence interval (CI: 1.066-2.586, P=.025] and OS (HR=2.071, 95% CI: 1.204-3.564, P=.009. Additionally, we developed a novel circulating T-cell immune index (CTII calculated as follows: cytotoxic T lymphocytes/(CD4+ regulatory T cells × CD8+ regulatory T cells. On univariate analysis, the CTII was associated with OS (HR=1.73, 95% CI: 1.01-2.94, P=.044. The SII and CTII might serve as prognostic indicators in acral melanoma patients treated with IFN-α-2b. The indexes are easily obtainable via routine tests in clinical practice.

  12. Index-based dietary patterns and risk of lung cancer in the NIH-AARP diet and health study.

    Science.gov (United States)

    Anic, G M; Park, Y; Subar, A F; Schap, T E; Reedy, J

    2016-01-01

    Dietary pattern analysis considers combinations of food intake and may offer a better measure to assess diet-cancer associations than examining individual foods or nutrients. Although tobacco exposure is the major risk factor for lung cancer, few studies have examined whether dietary patterns, based on preexisting dietary guidelines, influence lung cancer risk. After controlling for smoking, we examined associations between four diet quality indices-Healthy Eating Index-2010 (HEI-2010), Alternate Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet score (aMED) and Dietary Approaches to Stop Hypertension (DASH)-and lung cancer risk in the NIH-AARP (National Institutes of Health-American Association of Retired Persons) Diet and Health study. Baseline dietary intake was assessed in 460 770 participants. Over a median of 10.5 years of follow-up, 9272 incident lung cancer cases occurred. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and confidence intervals (CIs). Comparing highest to lowest quintiles, HRs (95% CIs) for lung cancer were as follows: HEI-2010=0.83 (0.77-0.89), AHEI-2010=0.86 (0.80-0.92), aMED=0.85 (0.79-0.91) and DASH=0.84 (0.78-0.90). Among the individual components of the dietary indices, higher consumption of whole grains and fruits was significantly inversely associated with lung cancer risk for several of the diet indices. Total index score analyses stratified by smoking status showed inverse associations with lung cancer for former smokers; however, only HEI-2010 was inversely associated in current smokers and no index score was inversely associated among never smokers. Although smoking is the factor most strongly associated with lung cancer, this study adds to a growing body of evidence that diet may have a modest role in reducing lung cancer risk, especially among former smokers.

  13. Evaluation of dyslipidemia, lipid ratios, and atherogenic index as cardiovascular risk factors among semi-urban dwellers in Nigeria

    Science.gov (United States)

    Olamoyegun, Michael Adeyemi; Oluyombo, Rotimi; Asaolu, Stephen Olabode

    2016-01-01

    Background and Objectives: The increasing frequency of cardiovascular disease (CVD) rests on the presence of major cardiovascular risk factors including dyslipidemia. This dyslipidemia is also a target for the prevention and treatment of many cardiovascular diseases. Hence, identification of individuals at risk of CVD is needed for early identification and prevention. The study was carried out to evaluate dyslipidemia using the lipid ratios and indices instead of just the conventional lipid profile. Methodology: It was a cross-sectional study with 699 participants recruited from semi-urban communities in Nigeria. Anthropometric indices, blood pressure, and fasting lipid profiles were determined. Abnormalities in lipid indices and lipid ratios with atherogenic index were also determined. SPSS software version 17.0 were used for analysis, P < 0.05 was considered statistically significant. Results: There were 699 participants with a mean age of 64.45 ± 15.53 years. Elevated total cholesterol, high low-density lipoprotein-cholesterol, elevated triglyceride, and low high-density lipoprotein were seen in 5.3%, 19.3%, 4.4%, and 76.3% of the participants, respectively. The Castelli's risk index-I (CRI-I) predicted the highest prevalence of predisposition to cardiovascular risk (47.8%) with females being at significantly higher risk (55.2% vs. 29.3%, P < 0.001). Atherogenic coefficient, CRI-II, CHOLIndex, atherogenic index of plasma (AIP) predicted a cardiovascular risk prevalence of 22.5%, 15.9%, 11.2%, and 11.0%, respectively, with no significant difference in between the sexes. Conclusions: Serum lipid ratios and AIP may be used in addition to lipid parameters in clinical practice to assess cardiovascular risks even when lipid profiles are apparently normal. AIP was more gender specific amidst the lipid ratios. PMID:27853034

  14. Automated Assessment of Existing Patient's Revised Cardiac Risk Index Using Algorithmic Software.

    Science.gov (United States)

    Hofer, Ira S; Cheng, Drew; Grogan, Tristan; Fujimoto, Yohei; Yamada, Takashige; Beck, Lauren; Cannesson, Maxime; Mahajan, Aman

    2018-05-25

    Previous work in the field of medical informatics has shown that rules-based algorithms can be created to identify patients with various medical conditions; however, these techniques have not been compared to actual clinician notes nor has the ability to predict complications been tested. We hypothesize that a rules-based algorithm can successfully identify patients with the diseases in the Revised Cardiac Risk Index (RCRI). Patients undergoing surgery at the University of California, Los Angeles Health System between April 1, 2013 and July 1, 2016 and who had at least 2 previous office visits were included. For each disease in the RCRI except renal failure-congestive heart failure, ischemic heart disease, cerebrovascular disease, and diabetes mellitus-diagnosis algorithms were created based on diagnostic and standard clinical treatment criteria. For each disease state, the prevalence of the disease as determined by the algorithm, International Classification of Disease (ICD) code, and anesthesiologist's preoperative note were determined. Additionally, 400 American Society of Anesthesiologists classes III and IV cases were randomly chosen for manual review by an anesthesiologist. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve were determined using the manual review as a gold standard. Last, the ability of the RCRI as calculated by each of the methods to predict in-hospital mortality was determined, and the time necessary to run the algorithms was calculated. A total of 64,151 patients met inclusion criteria for the study. In general, the incidence of definite or likely disease determined by the algorithms was higher than that detected by the anesthesiologist. Additionally, in all disease states, the prevalence of disease was always lowest for the ICD codes, followed by the preoperative note, followed by the algorithms. In the subset of patients for whom the

  15. Health care index score and risk of death following tuberculosis diagnosis in HIV-positive patients

    DEFF Research Database (Denmark)

    Podlekareva, D N; Grint, D; Post, F A

    2013-01-01

    To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome.......To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome....

  16. The World Charity Index 2014

    NARCIS (Netherlands)

    Schuyt, T.N.M.; Verkaik, D.J.

    2014-01-01

    City A.M., a London based business newspaper publishes an article on Giving, in particular on giving by foundations, at the end of every calendar year. This year, we contributed to this newspaper article by delivering 3 top 20 lists: One for Europe's largest foundations in terms of giving, one for

  17. WORLD PORT INDEX Nineteenth Edition

    Science.gov (United States)

    2009-01-01

    SABLE US 4424N 08319W CP06 14863 V RN E N N Y Y Y Q N Q M Y N 4460 OSCODA US 4425N 08319W CP06 14863 V RN E N N Y Y Y Q N Q M Y N 4470 ALPENA US 4504N... ALPENA US CP06 04470 ALSEA 16810 * ALTA NO 182 21130 ALTAMIRA MX 148 09355 ALTATA MX 153 15820 ALUMINA MARINE TERM 10772 * ALUSHTA UP BA24 43810

  18. Nutrition-related risk indexes and long-term mortality in noncritically ill inpatients who receive total parenteral nutrition (prospective multicenter study).

    Science.gov (United States)

    Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Ma Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Cabrerizo, Lucio; Rubio, Miguel A; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; del Olmo, Dolores; Pereira, José Luis; Tous, María C; Olveira, Gabriel

    2015-10-01

    Malnutrition in hospitalized patients is associated with an increased risk of death, in both the short and the long term. The purpose of this study was to determine which nutrition-related risk index predicts long-term mortality better (three years) in patients who receive total parenteral nutrition (TPN). This prospective, multicenter study involved noncritically ill patients who were prescribed TPN during hospitalization. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), body mass index, albumin and prealbumin, as well as long-term mortality. Over the 1- and 3-year follow-up periods, 174 and 244 study subjects (28.8% and 40.3%) respectively, died. Based on the Cox proportional hazards survival model, the nutrition-related risk indexes most strongly associated with mortality were SGA and albumin (Nutrition and Metabolism. All rights reserved.

  19. Association of body mass index with amnestic and non-amnestic mild cognitive impairment risk in elderly.

    Science.gov (United States)

    Wang, Feng; Zhao, Minghui; Han, Zhaoli; Li, Dai; Zhang, Shishuang; Zhang, Yongqiang; Kong, Xiaodong; Sun, Ning; Zhang, Qiang; Lei, Ping

    2017-09-15

    Previous studies focused on the relationship between body mass index and cognitive disorder and obtained many conflicting results. This study explored the potential effects of body mass index on the risk of mild cognitive impairment (amnestic and non-amnestic) in the elderly. The study enrolled 240 amnestic mild cognitive impairment patients, 240 non-amnestic mild cognitive impairment patients and 480 normal cognitive function controls. Data on admission and retrospective data at baseline (6 years ago) were collected from their medical records. Cognitive function was evaluated using Mini-Mental State Examination and Montreal Cognitive Assessment. Being underweight, overweight or obese at baseline was associated with an increased risk of amnestic mild cognitive impairment (OR: 2.30, 95%CI: 1.50 ~ 3.52; OR: 1.74, 95%CI: 1.36 ~ 2.20; OR: 1.71, 95%CI: 1.32 ~ 2.22, respectively). Being overweight or obese at baseline was also associated with an increased risk of non-amnestic mild cognitive impairment (OR: 1.51, 95%CI: 1.20 ~ 1.92; OR: 1.52, 95%CI: 1.21 ~ 1.97, respectively). In subjects with normal weights at baseline, an increased or decreased body mass index at follow-up was associated with an elevated risk of amnestic mild cognitive impairment (OR: 1.80, 95%CI: 1.10 ~ 3.05; OR: 3.96, 95%CI: 2.88 ~ 5.49, respectively), but only an increased body mass index was associated with an elevated risk of non-amnestic mild cognitive impairment (OR: 1.71, 95%CI: 1.16 ~ 2.59). Unhealthy body mass index levels at baseline and follow-up might impact the risk of both types of mild cognitive impairment (amnestic and non-amnestic).

  20. A novel prognostic indicator for in-hospital and 4-year outcomes in patients with pulmonary embolism: TIMI risk index.

    Science.gov (United States)

    Keskin, Muhammed; Güvenç, Tolga Sinan; Hayıroğlu, Mert İlker; Kaya, Adnan; Tatlısu, Mustafa Adem; Avşar, Şahin; Öz, Ahmet; Keskin, Taha; Uzun, Ahmet Okan; Kozan, Ömer

    2017-10-01

    Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) was recently evaluated in patients with acute myocardial infarction and found as an important prognostic index. In the current study, we evaluated the prognostic value of TRI in patients with moderate-high and high risk pulmonary embolism (PE) who were treated with thrombolytic agents. We retrospectively evaluated the in-hospital and long-term (4-year) prognostic impact of TRI in a total number of 456 patients with moderate-high and high risk PE. Patients were stratified by quartiles (Q) of admission TRI. In-hospital analysis revealed significantly higher rates of in-hospital death for patients with TRI in Q4. After adjustment for confounding baseline variables, TRI in Q4 was associated with 2.8-fold hazard of in-hospital death. Upon multivariate analysis, admission TRI in Q4 vs. Q1-3 was associated with 3.1 fold hazard of 4-year mortality rate. TRI in Q4, as compared to Q1-3, was significantly predictive of short term and long-term outcomes in PE patients who treated with thrombolytic agents. Our data suggest TRI to be an independent, feasible, and cost-effective tool for rapid risk stratification in moderate-high and high risk PE patients who treated with thrombolytic agents. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Sex hormone-binding globulin levels predict insulin sensitivity, disposition index, and cardiovascular risk during puberty

    DEFF Research Database (Denmark)

    Sørensen, Kaspar; Aksglaede, Lise; Munch-Andersen, Thor

    2009-01-01

    Early puberty is associated with increased risk of subsequent cardiovascular disease. Low sex hormone-binding globulin (SHBG) levels are a feature of early puberty and of conditions associated with increased cardiovascular risk. The aim of the present study was to evaluate SHBG as a predictor...... of glucose metabolism and metabolic risk during puberty....

  2. Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes

    DEFF Research Database (Denmark)

    Gunge, V B; Andersen, I; Kyrø, C

    2017-01-01

    BACKGROUND/OBJECTIVES: For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether...... adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes. SUBJECTS/METHODS: Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50 − 64 years recruited between 1993 and 1997. The healthy.......55, 95% CI = 0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR = 0.95, 95% CI = 0.92, 0.99) and women (HR = 0.93, 95% CI = 0.88, 0.98). CONCLUSIONS: A healthy Nordic diet is associated...

  3. Measuring cervical cancer risk: development and validation of the CARE Risky Sexual Behavior Index.

    Science.gov (United States)

    Reiter, Paul L; Katz, Mira L; Ferketich, Amy K; Ruffin, Mack T; Paskett, Electra D

    2009-12-01

    To develop and validate a risky sexual behavior index specific to cervical cancer research. Sexual behavior data on 428 women from the Community Awareness Resources and Education (CARE) study were utilized. A weighting scheme for eight risky sexual behaviors was generated and validated in creating the CARE Risky Sexual Behavior Index. Cutpoints were then identified to classify women as having a low, medium, or high level of risky sexual behavior. Index scores ranged from 0 to 35, with women considered to have a low level of risky sexual behavior if their score was less than six (31.3% of sample), a medium level if their score was 6–10 (30.6%), or a high level if their score was 11 or greater (38.1%). A strong association was observed between the created categories and having a previous abnormal Pap smear test (p Sexual Behavior Index provides a tool for measuring risky sexual behavior level for cervical cancer research. Future studies are needed to validate this index in varied populations and test its use in the clinical setting.

  4. Childhood body mass index and the risk of prostate cancer in adult men

    DEFF Research Database (Denmark)

    Aarestrup, J; Gamborg, M; Cook, M B

    2014-01-01

    BACKGROUND: Prostate cancer aetiology is poorly understood. It may have origins early in life; previously we found a positive association with childhood height. The effects of early life body mass index (BMI; kg m(-2)) on prostate cancer remain equivocal. We investigated if childhood BMI...... to the Danish Cancer Registry. Cox proportional hazards regressions were performed. RESULTS: Overall, 3355 men were diagnosed with prostate cancer. Body mass index during childhood was positively associated with adult prostate cancer. The hazard ratio of prostate cancer was 1.06 (95% confidence interval (CI): 1...

  5. Redefining high-risk patients with stage II colon cancer by risk index and microRNA-21: results from a population-based cohort

    DEFF Research Database (Denmark)

    Hansen, T F; Kjær-Frifeldt, S; Christensen, R D

    2014-01-01

    Background:The aim of the present study was to analyse the prognostic value of microRNA-21 (miRNA-21) in patients with stage II colon cancer aiming at a risk index for this group of patients.Methods:A population-based cohort of 554 patients was included. MicroRNA-21 was analysed by qPCR based...... on tumour tissue. An index was created using the coefficients obtained from a collective multiple Cox regression. The entire procedure was cross-validated (10-fold). The performance of the index was quantified by time-dependent receiver operating characteristics curves.Results:High miRNA-21 expression...... was associated with an unfavourable recurrence-free cancer-specific survival (RF-CSS), hazard ratio 1.35 (95% confidence interval, 1.03-1.76) (P=0.028). The generated RF-CSS index divided the traditional high-risk patients into subgroups with 5-year RF-CSS rates of 87% and 73%, respectively (P...

  6. A dynamic process of health risk assessment for business continuity management during the World Exposition Shanghai, China, 2010.

    Science.gov (United States)

    Sun, Xiaodong; Keim, Mark; Dong, Chen; Mahany, Mollie; Guo, Xiang

    2014-01-01

    Reports of health issues related to mass gatherings around the world have indicated a potential for public health and medical emergencies to occur on a scale that could place a significant impact on business continuity for national and international organisations. This paper describes a risk assessment process for business continuity management that was performed as part of the planning efforts related to the World Expo 2010 Shanghai China (Expo), the world's largest mass gathering to date. Altogether, 73 million visitors attended the Expo, generating over US$2bn of revenue. During 2008 to 2010, the Shanghai Municipal Center for Disease Control and Prevention performed a dynamic series of four disaster risk assessments before and during the Expo. The purpose of this assessment process was to identify, analyse and evaluate risks for public health security during different stages of the Expo. This paper describes an overview of the novel approach for this multiple and dynamic process of assessment of health security risk for ensuring business continuity.

  7. The Risk Return Relationship: Evidence from Index Return and Realised Variance Series

    OpenAIRE

    Minxian Yang

    2014-01-01

    The risk return relationship is analysed in bivariate models for return and realised variance(RV) series. Based on daily time series from 21 international market indices for more than 13 years (January 2000 to February 2013), the empirical findings support the arguments of risk return tradeoff, volatility feedback and statistical balance. It is reasoned that the empirical risk return relationship is primarily shaped by two important data features: the negative contemporaneous correlation betw...

  8. Interaction of a genetic risk score with physical activity, physical inactivity, and body mass index in relation to venous thromboembolism risk.

    Science.gov (United States)

    Kim, Jihye; Kraft, Peter; Hagan, Kaitlin A; Harrington, Laura B; Lindstroem, Sara; Kabrhel, Christopher

    2018-06-01

    Venous thromboembolism (VTE) is highly heritable. Physical activity, physical inactivity and body mass index (BMI) are also risk factors, but evidence of interaction between genetic and environmental risk factors is limited. Data on 2,134 VTE cases and 3,890 matched controls were obtained from the Nurses' Health Study (NHS), Nurses' Health Study II (NHS II), and Health Professionals Follow-up Study (HPFS). We calculated a weighted genetic risk score (wGRS) using 16 single nucleotide polymorphisms associated with VTE risk in published genome-wide association studies (GWAS). Data on three risk factors, physical activity (metabolic equivalent [MET] hours per week), physical inactivity (sitting hours per week) and BMI, were obtained from biennial questionnaires. VTE cases were incident since cohort inception; controls were matched to cases on age, cohort, and genotype array. Using conditional logistic regression, we assessed joint effects and interaction effects on both additive and multiplicative scales. We also ran models using continuous wGRS stratified by risk-factor categories. We observed a supra-additive interaction between wGRS and BMI. Having both high wGRS and high BMI was associated with a 3.4-fold greater risk of VTE (relative excess risk due to interaction = 0.69, p = 0.046). However, we did not find evidence for a multiplicative interaction with BMI. No interactions were observed for physical activity or inactivity. We found a synergetic effect between a genetic risk score and high BMI on the risk of VTE. Intervention efforts lowering BMI to decrease VTE risk may have particularly large beneficial effects among individuals with high genetic risk. © 2018 WILEY PERIODICALS, INC.

  9. [Systemic candidiasis in medical intensive care unit: analysis of risk factors and the contribution of colonization index].

    Science.gov (United States)

    Massou, S; Ahid, S; Azendour, H; Bensghir, M; Mounir, K; Iken, M; Lmimouni, B E; Balkhi, H; Drissi Kamili, N; Haimeur, C

    2013-06-01

    Description of the epidemiological and clinical characteristics of the patients introducing risk factors of invasive candidiasis. Analysis of risk factors for candidiasis invasive and evaluation of the contribution of colonization index (CI) in the diagnosis of the systematic candidiasis in medical intensive care. Prospective observational study (October 2007 to October 2009). The selected patients present risk factors of system IC candidiasis with an infectious syndrome or clinical signs suggestive of Candida infection and hospitalized more than 48 hours in medical intensive care unit. Pittet's colonization index was calculated at admission and then once a week added to a blood culture. Patients were classified according to level of evidence of Candida infection and the degree of colonization (CIcandidiasis. In multivariate analysis, the corticosteroid therapy was associated with a high colonisation (IC ≥ 0.5) and neutropenia with a high risk of systemic candidiasis. The positive predictive value of CI was 26%. The negative predictive value was 98%, the sensitivity and specificity was 93% and 48% respectively. CI has the advantage to provide a quantified data of the patient's situation in relation to the colonization. But, it isn't helpful with patients having an invasive candidiasis in medical intensive care unit. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  10. The Compression Intensity Index: a practical anatomical estimate of the biomechanical risk for a deep tissue injury.

    Science.gov (United States)

    Gefen, Amit

    2008-01-01

    Pressure-related deep tissue injury (DTI) is a severe form of pressure ulcer that initiates in compressed muscle tissues under bony prominences, and progresses superficially towards the skin. Patients with impaired motosensory capacities are at high risk of developing DTI. There is a critical medical need for developing risk assessment tools for DTI. A new anatomical index, the Compression Intensity Index: CII=(BW/Rt);[1/2], which depends on the body weight (BW), radius of curvature of the ischial tuberosities (R) and thickness of the underlying gluteus muscles (t), is suggested for approximating the loading intensity in muscle tissue during sitting in permanent wheelchair users, as part of a clinically-oriented risk assessment for DTI. Preliminary CII data were calculated for 6 healthy and 4 paraplegic subjects following MRI scans, and data were compared between the groups and with respect to a gold standard, being a previously developed subject-specific MRI-finite-element (MRI-FE) method of calculating muscle tissue stresses (Linder-Ganz et al., J. Biomech. 2007). Marked differences between the R and t parameters of the two groups caused the CII values of the paraplegics to be approximately 1.6-fold higher than for the healthy (pbedridden patients. Hence, CII measurements can be integrated into DTI-risk-assessment tools, the need of which is now being discussed intensively in the American and European Pressure Ulcer Advisory Panel meetings.

  11. Posttraumatic stress symptoms and body mass index among World Trade Center disaster-exposed smokers: A preliminary examination of the role of anxiety sensitivity.

    Science.gov (United States)

    Farris, Samantha G; Paulus, Daniel J; Gonzalez, Adam; Mahaffey, Brittain L; Bromet, Evelyn J; Luft, Benjamin J; Kotov, Roman; Zvolensky, Michael J

    2016-07-30

    Among individuals exposed to the World Trade Center (WTC) disaster on September 11, 2001, posttraumatic stress disorder (PTSD) and symptoms are both common and associated with increased cigarette smoking and body mass. However, there is little information on the specific processes underlying the relationship of PTSD symptoms with body mass. The current study is an initial exploratory test of anxiety sensitivity, the fear of internal bodily sensations, as a possible mechanism linking PTSD symptom severity and body mass index (BMI). Participants were 147 adult daily smokers (34.0% female) exposed to the WTC disaster (via rescue/recovery work or direct witness). The direct and indirect associations between PTSD symptom severity and BMI via anxiety sensitivity (total score and subscales of physical, cognitive, and social concerns) were examined. PTSD symptom severity was related to BMI indirectly via anxiety sensitivity; this effect was specific to physical concerns about the meaning of bodily sensations. Interventions focusing on anxiety sensitivity reduction (specifically addressing physical concerns about bodily sensations) may be useful in addressing elevated BMI among trauma-exposed persons. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Humans vs Hardware: The Unique World of NASA Human System Risk Assessment

    Science.gov (United States)

    Anton, W.; Havenhill, M.; Overton, Eric

    2016-01-01

    Understanding spaceflight risks to crew health and performance is a crucial aspect of preparing for exploration missions in the future. The research activities of the Human Research Program (HRP) provide substantial evidence to support most risk reduction work. The Human System Risk Board (HSRB), acting on behalf of the Office of Chief Health and Medical Officer (OCHMO), assesses these risks and assigns likelihood and consequence ratings to track progress. Unfortunately, many traditional approaches in risk assessment such as those used in the engineering aspects of spaceflight are difficult to apply to human system risks. This presentation discusses the unique aspects of risk assessment from the human system risk perspective and how these limitations are accommodated and addressed in order to ensure that reasonable inputs are provided to support the OCHMO's overall risk posture for manned exploration missions.

  13. Natural gas projects in the developing world: An empirical evaluation of merits, obstacles, and risks

    Science.gov (United States)

    Mor, Amit

    Significant amounts of natural gas have been discovered in developing countries throughout the years during the course of oil exploration. The vast majority of these resources have not been utilized. Some developing countries may benefit from a carefully planned utilization of their indigenous resources, which can either be exported or used domestically to substitute imported or exportable fuels or feedstock. Governments, potential private sector investors, and financiers have been searching for strategies to promote natural gas schemes, some of which have been in the pipeline for more than two decades. The purpose of this thesis is to identify the crucial factors determining the success or failure of launching natural gas projects in the developing world. The methodology used to evaluate these questions included: (1) establishing a representative sample of natural gas projects in developing countries that were either implemented or failed to materialize during the 1980-1995 period, (2) utilizing a Probit limited dependent variable econometric model in which the explained variable is project success or failure, and (3) choosing representing indicators to reflect the assumed factors affecting project success. The study identified two conditions for project success: (1) the economic viability of the project and (2) securing financing for the investment. The factors that explain the ability or inability of the sponsors to secure financing were: (1) the volume of investment that represented the large capital costs of gas transportation, distribution, and storage, (2) the level of foreign exchange constraint in the host country, and (3) the level of development of the country. The conditions for private sector participation in natural gas projects in developing countries were identified in the study by a Probit model in which the explained variable was private sector participation. The results showed that a critical condition for private sector participation is the

  14. Association of Classic Cardiovascular Risk Factors and Lifestyles With the Cardio-ankle Vascular Index in a General Mediterranean Population.

    Science.gov (United States)

    Elosua-Bayés, Marc; Martí-Lluch, Ruth; García-Gil, María Del Mar; Camós, Lourdes; Comas-Cufí, Marc; Blanch, Jordi; Ponjoan, Anna; Alves-Cabratosa, Lia; Elosua, Roberto; Grau, María; Marrugat, Jaume; Ramos, Rafel

    2018-06-01

    The cardio-ankle vascular index (CAVI) assesses arterial stiffness. We aimed to describe the distribution of CAVI in a Mediterranean population, to determine the proportion of CAVI ≥ 9 by sex and coronary risk level, and to assess the association of CAVI with classic cardiovascular risk factors and lifestyle patterns. This cross-sectional study was based on the population of Girona province. The CAVI was measured using the VaSera VS-1500. Of 2613 individuals included in this study, the prevalence of CAVI ≥ 9 was 46.8% in men and 36.0% in women and significantly increased with coronary risk: from 21.1% and 24.8%, respectively to 76.7%, in the low-risk group, and 61.9% in the high-risk group. The CAVI increased with age in both sexes, being higher in men across all age groups. In men, CAVI ≥ 9 was associated with hypertension (OR, 2.70; 95%CI, 1.90-3.87) and diabetes (OR, 2.38; 95%CI, 1.52-3.78), body mass index (BMI) ≤ 25 to < 30 (OR, 0.44; 95%CI, 0.27-0.72) and BMI ≥ 30 (OR, 0.28; 95%CI, 0.14-0.58), and physical activity (OR, 0.66; 95%CI, 0.47-0.92). In women, CAVI ≥ 9 was associated with hypertension (OR, 2.22; 95%CI, 1.59-3.09), hypercholesterolemia (OR, 1.40; 95%CI, 1.01-1.94), and BMI ≥ 30 (OR, 0.38; 95%CI, 0.20-0.71). The CAVI increases with age and is higher in men than in women. This index is associated with classic risk factors and coronary risk. It could be a good predictive biomarker, but further follow-up studies are required to assess its added value to cardiovascular risk stratification. Copyright © 2017. Published by Elsevier España, S.L.U.

  15. Applying the Flood Vulnerability Index as a Knowledge base for flood risk assessment

    NARCIS (Netherlands)

    Balica, S-F.

    2012-01-01

    Floods are one of the most common and widely distributed natural risks to life and property worldwide. An important part of modern flood risk management is to evaluate vulnerability to floods. This evaluation can be done only by using a parametric approach. Worldwide there is a need to enhance our

  16. Weight, height, body mass index and risk of breast cancer in postmenopausal women: a case-control study

    Directory of Open Access Journals (Sweden)

    Vahdaninia Mariam

    2008-09-01

    Full Text Available Abstract Background Many women in Iran have a relatively high body mass index. To investigate whether the condition contributes to excess breast cancer cases, a case-control study was conducted to assess the relationships between anthropometric variables and breast cancer risk in Tehran, Iran. Methods All incident cases of breast cancer in the Iranian Centre for Breast Cancer (ICBC were identified through the case records. Eligible cases were all postmenopausal women with histological confirmed diagnosis of breast cancer during 1996 to year 2000. Controls were randomly selected postmenopausal women attending the ICBC for clinical breast examination during the same period. The body mass index (BMI was calculated based on weights and heights as measured by the ICBC nursing staff. Both tests for trend and logistic regression analysis were performed to calculate odds ratios and 95% confidence intervals as measures of relative risk. Results In all, 116 breast cancer cases and 116 controls were studied. There were no significant differences between cases and control with regard to most independent variables studied. However, a significant difference was observed between cases and controls indicating that the mean BMI was higher in cases as compared to controls (P = 0.004. Performing logistic regression analysis while controlling for age, age at menopause, family history of breast cancer and parity, the results showed that women with a BMI in the obese range had a three fold increased risk of breast cancer [odds ratio (OR = 3.21, 95% confidence interval (CI: 1.15–8.47]. Conclusion The results suggest that obesity in postmenopausal women could increase risk of breast cancer and it merits further investigation in populations such as Iran where it seems that many women are short in height, and have a relatively high body mass index.

  17. Evaluating perspectives for PRRS virus elimination from pig dense areas with a risk factor based herd index.

    Science.gov (United States)

    Fahrion, A S; Beilage, E grosse; Nathues, H; Dürr, S; Doherr, M G

    2014-06-01

    Porcine reproductive and respiratory syndrome virus (PRRSV) is wide-spread in pig populations globally. In many regions of Europe with intensive pig production and high herd densities, the virus is endemic and can cause disease and production losses. This fuels discussion about the feasibility and sustainability of virus elimination from larger geographic regions. The implementation of a program aiming at virus elimination for areas with high pig density is unprecedented and its potential success is unknown. The objective of this work was to approach pig population data with a simple method that could support assessing the feasibility of a sustainable regional PRRSV elimination. Based on known risk factors such as pig herd structure and neighborhood conditions, an index characterizing individual herds' potential for endemic virus circulation and reinfection was designed. This index was subsequently used to compare data of all pig herds in two regions with different pig- and herd-densities in Lower Saxony (North-West Germany) where PRRSV is endemic. Distribution of the indexed herds was displayed using GIS. Clusters of high herd index densities forming potential risk hot spots were identified which could represent key target areas for surveillance and biosecurity measures under a control program aimed at virus elimination. In an additional step, for the study region with the higher pig density (2463 pigs/km(2) farmland), the potential distribution of PRRSV-free and non-free herds during the implementation of a national control program aiming at national virus elimination was modeled. Complex herd and trade network structures suggest that PRRSV elimination in regions with intensive pig farming like that of middle Europe would have to involve legal regulation and be accompanied by important trade and animal movement restrictions. The proposed methodology of risk index mapping could be adapted to areas varying in size, herd structure and density. Interpreted in the

  18. Wealth index and risk of childhood overweight and obesity: evidence from four prospective cohorts in Peru and Vietnam.

    Science.gov (United States)

    Carrillo-Larco, Rodrigo M; Miranda, J Jaime; Bernabé-Ortiz, Antonio

    2016-05-01

    To estimate the incidence and risk of childhood overweight and obesity according to socioeconomic status in Peruvian and Vietnamese school-aged children. Longitudinal data from the Young Lives study were analyzed. Exposure was wealth index in tertiles. Outcome was overweight and obesity. Cumulative incidence per 100 children-years, relative risks (RR), and 95 % confidence intervals (95 % CI) were calculated. A hierarchical approach, including child- and family-related variables, was followed to construct multivariable models. The cumulative incidence of overweight and obesity was 4.8 (95 % CI 4.1-5.5) and 1.7 (95 % CI 1.3-2.2) in the younger and older Peruvian cohort, respectively; and in Vietnam 1.5 (95 % CI 1.2-1.8) and 0.3 (95 % CI 0.2-0.5), respectively. The incidence of overweight and obesity was higher at the top wealth index tertile in all samples. In the older cohorts, comparing highest versus bottom wealth index tertile, RR of overweight and obesity was four to nine times higher: 4.25 in Peru (95 % CI 2.21-8.18) and 9.11 in Vietnam (95 % CI 1.07-77.42). The results provide important information for childhood obesity prevention in countries moving ahead with economic, epidemiological and nutritional transitions.

  19. Cardiovascular Risk Factors and Distributions of the Ankle-Brachial Index among Type 2 Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Badaruddoza Doza

    2012-01-01

    Full Text Available Background. The aim of present study is to observe the association between the levels of ankle-brachial index (ABI and cardiovascular risk factors among people with type 2 diabetes mellitus in north India. A cross-sectional study was carried out at a centre for heart and diabetic clinic in the state of Punjab on 1121 subjects (671 males and 450 females with type 2 diabetes mellitus. History of symptoms related to cardiovascular diseases was noted, and blood pressure and anthropometric measurements were recorded. Ankle-brachial index (ABI was measured using ultrasonic Doppler flow detector. Subjects with ABI ≤0.9 and ≥1.30 were classified as having low and high ABI, respectively. Females had a higher BMI and brachial-ankle pulse wave velocity (<0.001. Whereas, males had higher diastolic blood pressure and duration of type 2 diabetes mellitus. The differences of systolic blood pressure and ankle-brachial index were not found significant between the sexes. The prevalence of low ABI (<0.9 was 4.47% in men and 4.67% in women and high ABI (≥1.30 was prevalent in 14% of men and 10.45% of women. Age, BMI, baPWV, and blood pressures were significantly associated with ABI value in both sexes. The results suggested that the ABI might be used as a strong indicator for cardiovascular risk factors in type 2 diabetic subjects.

  20. Bridging Two Worlds: Reconciling Practical Risk Assessment Methodologies with Theory of Attack Trees

    NARCIS (Netherlands)

    Gadyatskaya, Olga; Harpes, Carlo; Mauw, Sjouke; Muller, Cedric; Muller, Steve

    2016-01-01

    Security risk treatment often requires a complex cost-benefit analysis to be carried out in order to select countermeasures that optimally reduce risks while having minimal costs. According to ISO/IEC 27001, risk treatment relies on catalogues of countermeasures, and the analysts are expected to

  1. Education and inequalities in risk scores for coronary heart disease and body mass index: evidence for a population strategy.

    Science.gov (United States)

    Liu, Sze Yan; Kawachi, Ichiro; Glymour, M Maria

    2012-09-01

    Concerns have been raised that education may have greater benefits for persons at high risk of coronary heart disease (CHD) than for those at low risk. We estimated the association of education (less than high school, high school, or college graduates) with 10-year CHD risk and body mass index (BMI), using linear and quantile regression models, in the following two nationally representative datasets: the 2006 wave of the Health and Retirement Survey and the 2003-2008 National Health and Nutrition Examination Survey (NHANES). Higher educational attainment was associated with lower 10-year CHD risk for all groups. However, the magnitude of this association varied considerably across quantiles for some subgroups. For example, among women in NHANES, a high school degree was associated with 4% (95% confidence interval = -9% to 1%) and 17% (-24% to -8%) lower CHD risk in the 10th and 90th percentiles, respectively. For BMI, a college degree was associated with uniform decreases across the distribution for women, but with varying increases for men. Compared with those who had not completed high school, male college graduates in the NHANES sample had a BMI that was 6% greater (2% to 11%) at the 10th percentile of the BMI distribution and 7% lower (-10% to -3%) at the 90th percentile (ie, overweight/obese). Estimates from the Health and Retirement Survey sample and the marginal quantile regression models showed similar patterns. Conventional regression methods may mask important variations in the associations between education and CHD risk.

  2. The influence of body mass index, age and sex on inflammatory disease risk in semi-captive Chimpanzees.

    Directory of Open Access Journals (Sweden)

    Vincent Obanda

    Full Text Available Obesity and ageing are emerging issues in the management of captive primates, including Chimpanzees, Pan troglodytes. Studies on humans show that obesity and old age can independently increase the risk of inflammatory-associated diseases indicated by elevated levels of pro-inflammatory cells and proteins in the blood of older or obese compared to levels in younger or non-obese individuals. In humans, sex can influence the outcomes of these risks. Health management of these problems in chimpanzee populations requires an understanding of similarities and differences of factors influencing inflammatory disease risks in humans and in chimpanzees. We examined the relationship between age, sex and Body Mass Index (BMI with hematological biomarkers of inflammatory disease risk established for humans which include the neutrophil to lymphocyte ratio (NLR, and neutrophil, white blood cell (WBC, platelet microparticle and platelet counts. We found that higher values of NLR, neutrophil count and platelet microparticle count were associated with higher BMI values and older age indicating increased inflammation risk in these groups; a similar pattern to humans. There was a strong sex by age interaction on inflammation risk, with older males more at risk than older females. In contrast to human studies, total WBC count was not influenced by BMI, but like humans, WBC and platelet counts were lower in older individuals compared to younger individuals. Our findings are similar to those of humans and suggest that further insight on managing chimpanzees can be gained from extensive studies of ageing and obesity in humans. We suggest that managing BMI should be an integral part of health management in captive chimpanzee populations in order to partially reduce the risk of diseases associated with inflammation. These results also highlight parallels in inflammation risk between humans and chimpanzees and have implications for understanding the evolution of

  3. Use of Segregation Indices, Townsend Index, and Air Toxics Data to Assess Lifetime Cancer Risk Disparities in Metropolitan Charleston, South Carolina, USA

    Directory of Open Access Journals (Sweden)

    LaShanta J. Rice

    2014-05-01

    Full Text Available Background: Studies have demonstrated a relationship between segregation and level of education, occupational opportunities, and risk behaviors, yet a paucity of research has elucidated the association between racial residential segregation, socioeconomic deprivation, and lifetime cancer risk. Objectives: We examined estimated lifetime cancer risk from air toxics by racial composition, segregation, and deprivation in census tracts in Metropolitan Charleston. Methods: Segregation indices were used to measure the distribution of groups of people from different races within neighborhoods. The Townsend Index was used to measure economic deprivation in the study area. Poisson multivariate regressions were applied to assess the association of lifetime cancer risk with segregation indices and Townsend Index along with several sociodemographic measures. Results: Lifetime cancer risk from all pollution sources was 28 persons/million for half of the census tracts in Metropolitan Charleston. Isolation Index and Townsend Index both showed significant correlation with lifetime cancer risk from different sources. This significance still holds after adjusting for other sociodemographic measures in a Poisson regression, and these two indices have stronger effect on lifetime cancer risk compared to the effects of sociodemographic measures. Conclusions: We found that material deprivation, measured by the Townsend Index and segregation measured by the Isolation index, introduced high impact on lifetime cancer risk by air toxics at the census tract level.

  4. Predictive performance of the visceral adiposity index for a visceral adiposity-related risk: Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Azizi Fereidoun

    2011-05-01

    Full Text Available Abstract Background Visceral adiposity index (VAI has recently been developed based on waist circumference, body mass index (BMI, triglycerides (TGs, and high-density lipoprotein cholesterol (HDL-C. We examined predictive performances for incident diabetes of the VAI per se and as compared to the metabolic syndrome (MetS and waist-to-height-ratio (WHtR. Methods Participants free of diabetes at baseline with at least one follow-up examination (5,964 were included for the current study. Weibull regression models were developed for interval-censored survival data. Absolute and relative integrated discriminatory improvement index (IDI and cut-point-based and cut-point-free net reclassification improvement index (NRI were used as measures of predictive ability for incident diabetes added by VAI, as compared to the MetS and WHtR. Results The annual incidence rate of diabetes was 0.85 per 1000 person. Mean VAI was 3.06 (95%CIs 2.99-3.13. Diabetes risk factors levels increased in stepwise fashion across VAI quintiles. Risk gradient between the highest and lowest quintile of VAI was 4.5 (95%CIs 3.0-6.9. VAI significantly improved predictive ability of the MetS. The relative IDI and cut-point free NRI for predictive ability added to MetS by VAI were 30.3% (95%CIs 18.8-41.8% and 30.7% (95%CIs 20.8-40.7%, respectively. WHtR, outperformed VAI with cut-point-free NRI of 24.6% (95%CIs 14.1-35.2%. Conclusions In conclusion, although VAI could be a prognostic tool for incident diabetes events, gathering information on its components (WC, BMI, TGs, and HDL-C is unlikely to improve the prediction ability beyond what could be achieved by the simply assessable and commonly available information on WHtR.

  5. a case s ation of heavy metals' health risk index in vegetable unflower

    African Journals Online (AJOL)

    userpc

    ntrol of pollution produce from industries affects both air and soil table Amaranth and Sunflower ... ls, Health risk, Sunflower, and Vegetable Amaranth. ign material into a .... were homogenized by grinding using ceramic coated grinder. All the ...

  6. Cumulative risk assessment of phthalate exposure of Danish children and adolescents using the hazard index approach

    DEFF Research Database (Denmark)

    Søeborg, T; Frederiksen, H; Andersson, Anna-Maria

    2012-01-01

    Human risk assessment of chemicals is traditionally presented as the ratio between the actual level of exposure and an acceptable level of exposure, with the acceptable level of exposure most often being estimated by appropriate authorities. This approach is generally sound when assessing the risk...... of individual chemicals. However, several chemicals may concurrently target the same receptor, work through the same mechanism or in other ways induce the same effect(s) in the body. In these cases, cumulative risk assessment should be applied. The present study uses biomonitoring data from 129 Danish children...... and adolescents and resulting estimated daily intakes of four different phthalates. These daily intake estimates are used for a cumulative risk assessment with anti-androgenic effects as the endpoint using Tolerable Daily Intake (TDI) values determined by the European Food Safety Authorities (EFSA) or Reference...

  7. Can the Air Pollution Index be used to communicate the health risks of air pollution?

    International Nuclear Information System (INIS)

    Li, Li; Lin, Guo-Zhen; Liu, Hua-Zhang; Guo, Yuming; Ou, Chun-Quan; Chen, Ping-Yan

    2015-01-01

    The validity of using the Air Pollution Index (API) to assess health impacts of air pollution and potential modification by individual characteristics on air pollution effects remain uncertain. We applied distributed lag non-linear models (DLNMs) to assess associations of daily API, specific pollution indices for PM 10 , SO 2 , NO 2 and the weighted combined API (APIw) with mortality during 2003–2011 in Guangzhou, China. An increase of 10 in API was associated with a 0.88% (95% confidence interval (CI): 0.50, 1.27%) increase of non-accidental mortality at lag 0–2 days. Harvesting effects appeared after 2 days’ exposure. The effect estimate of API over lag 0–15 days was statistically significant and similar with those of pollutant-specific indices and APIw. Stronger associations between API and mortality were observed in the elderly, females and residents with low educational attainment. In conclusion, the API can be used to communicate health risks of air pollution. - Highlights: • The cumulative effects of API on mortality over lag 0–15 days remained significant. • The indices for three specific pollutants had similar associations with mortality. • The effects of API were modified by age, gender and educational attainment. • Our findings can help to communicate health risks of air pollution to the public. - The Air Pollution Index communicates health risks of air pollution

  8. "RISK ASSESSMENT OF DEVELOPING DISTAL UPPER EXTREMITY DISORDERS BY STRAIN INDEX METHOD IN AN ASSEMBLING ELECTRONIC INDUSTRY"

    Directory of Open Access Journals (Sweden)

    M. Pourmahabadian

    2005-08-01

    Full Text Available The strain index (SI is a substantial advancement and has been devised to analyze ergonomic risks for distal upper extremity (DUE disorders. This semi-quantitative tool allows for the measurement of hazards and does not require unduly lengthy training to begin to use it accurately. Uses of the strain index include analysis of a current job to assess whether it is safe or hazardous, quantification of the risks, and assistance in the initial design of a job or in the redesign of a job. The aim of this study was to assess and analyze risk of developing DUE disorders in different jobs as well as hazard classification in an assembling electronic industry through SI method. Also, DUE disorders prevalence, work-related absenteeism and turnover extracted from SI results were compared and assessed by those obtained by Nordic musculoskeletal questionnaire (NMQ. The findings of this study showed that more than 50% of investigated jobs are categorized as "hazardous" and there is a significant difference between SI mean in hazardous and safe jobs (P < 0.0001. In addition, significant difference was found between prevalence of DUE disorders in "safe" and "hazardous" jobs (P < 0.049. But, no significant difference (P = 0.3 was obtained between mean absenteeism in "safe" and hazardous jobs. Also, no significant difference statistically was found between turnover in "safe" and hazardous jobs (X2 = 0.133, P = 1 and high prevalence of DUE disorders is due to low turnover rate of workers.

  9. Difficult mask ventilation in general surgical population: observation of risk factors and predictors [v1; ref status: indexed, http://f1000r.es/47z

    Directory of Open Access Journals (Sweden)

    Davide Cattano

    2014-08-01

    Full Text Available Background: There are few predictors of difficult mask ventilation and a simple, objective, predictive system to identify patients at risk of difficult mask ventilation does not currently exist. We present a retrospective - subgroup analysis aimed at identifying predictive factors for difficult mask ventilation (DMV in patients undergoing pre-operative airway assessment before elective surgery at a major teaching hospital. Methods: Data for this retrospective analysis were derived from a database of airway assessments, management plans, and outcomes that were collected prospectively from August 2008 to May 2010 at a Level 1 academic trauma center. Patients were stratified into two groups based on the difficulty of mask ventilation and the cohorts were analyzed using univariate analysis and stepwise selection method. Results: A total of 1399 pre-operative assessments were completed with documentation stating that mask ventilation was attempted. Of those 1399, 124 (8.9% patients were found to be difficult to mask ventilate. A comparison of patients with and without difficult mask ventilation identified seven risk factors for DMV: age, body mass index (BMI, neck circumference, history of difficult intubation, presence of facial hair, perceived short neck and obstructive sleep apnea. Although seven risk factors were identified, no individual subject had more than four risk factors. Conclusion: The results of this study confirm that in a real world clinical setting, the incidence of DMV is not negligible and suggest the use of a simple bedside predictive score to improve the accuracy of DMV prediction, thereby improving patient safety. Further prospective studies to validate this score would be useful.

  10. Body mass index during adolescence, rather than childhood, is critical in determining MS risk.

    Science.gov (United States)

    Hedström, A K; Olsson, T; Alfredsson, L

    2016-06-01

    Obesity in childhood and during adolescence has repeatedly been associated with increased risk of developing multiple sclerosis (MS). We aimed to investigate whether the most critical period occurs during childhood or later, during adolescence. Using a population-based case-control study (1586 cases and 2800 controls), individuals with different body sizes at age 10 and different body mass indices at age 20 were compared regarding MS risk, by calculating odds ratios with 95% confidence intervals. Potential interactions between HLA-DRB1*15 and absence of HLA-A*02, respectively, and both childhood and adolescent obesity were evaluated by calculating the attributable proportion due to interaction. Regardless of body size at age 10, individuals with adolescent obesity had a 90% increased risk of MS. Among participants who were not obese at age 20, no association was observed between body size at age 10 and subsequent MS risk. An interaction was observed between the HLA MS risk genes and adolescent, but not childhood, obesity. Our results suggest that BMI during adolescence, rather than childhood, is critical in determining MS risk. © The Author(s), 2015.

  11. Validation of the Hong Kong Cantonese Version of World Health Organization Five Well-Being Index for People with Severe Mental Illness.

    Science.gov (United States)

    Kong, C L; Lee, C C; Ip, Y C; Chow, L P; Leung, C H; Lam, Y C

    2016-03-01

    The World Health Organization Five Well-Being Index (WHO-5) has been developed to measure psychological wellbeing. Translation and linguistic validation of the WHO-5 into a Cantonese version has been accomplished for local use but it is not yet validated in people with severe mental illness in Hong Kong. This study aimed to examine the applicability of WHO-5 in measuring the psychological wellbeing dimension of people with severe mental illness. A brief and easily administrated tool to measure psychological wellbeing of people with severe mental illness can be used to provide an outcome measure in research studies and clinical trials. Subjects were randomly recruited from the Extended-Care Patient Intensive Treatment, Early Diversion and Rehabilitation Stepping-Stone Project (EXITERS) and the Rehabilitation Activity Centre (RAC) of Kwai Chung Hospital in Hong Kong. They were invited to complete the abbreviated version of Hong Kong Chinese World Health Organization Quality of Life (WHOQOL-BREF [HK]) and WHO-5 (Cantonese version) separately and concurrent validity was examined. A total of 84 subjects were recruited, 42 each from EXITERS and RAC. In all, 49 (58%) were male and 35 (42%) were female. The mean ± standard deviation age was 43.2 ± 9.7 years. Their mean duration of mental illness was 16.4 ± 10.5 years and the mean years of education was 10.17 ± 2.5 years, i.e. about junior secondary school level in Hong Kong. The internal consistency of the WHO-5 was satisfactory (0.86) and was comparable with previous reports. Regarding validity, 1-factor structure with an eigenvalue of 3.24 explained 64.8% of total variance of WHO-5 for people with severe mental illness. Concurrent validity was established with moderate correlation (0.41-0.51) between WHO-5 and 4 domains of the WHOQOL-BREF (HK). The WHO-5 (Cantonese version) is a reliable and valid tool to assess the psychological wellbeing of people with severe mental illness in Hong Kong. It can be used to monitor

  12. The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison

    Directory of Open Access Journals (Sweden)

    Kahn Henry S

    2005-09-01

    Full Text Available Abstract Background Body mass index (BMI, kg/m2 may not be the best marker for estimating the risk of obesity-related disease. Consistent with physiologic observations, an alternative index uses waist circumference (WC and fasting triglycerides (TG concentration to describe lipid overaccumulation. Methods The WC (estimated population minimum 65 cm for men and 58 cm for women and TG concentration from the third National Health and Nutrition Examination Survey (N = 9,180, statistically weighted to represent 100.05 million US adults were used to compute a "lipid accumulation product" [LAP = (WC-65 × TG for men and (WC-58 × TG for women] and to describe the population distribution of LAP. LAP and BMI were compared as categorical variables and as log-transformed continuous variables for their ability to identify adverse levels of 11 cardiovascular risk factors. Results Nearly half of the represented population was discordant for their quartile assignments to LAP and BMI. When 23.54 million with ordinal LAP quartile > BMI quartile were compared with 25.36 million with ordinal BMI quartile > LAP quartile (regression models adjusted for race-ethnicity and sex the former had more adverse risk levels than the latter (p 0.1. As continuous variables, LAP provided a consistently more adverse beta coefficient (slope than BMI for nine cardiovascular risk variables (p 0.2. Conclusion LAP (describing lipid overaccumulation performed better than BMI (describing weight overaccumulation for identifying US adults at cardiovascular risk. Compared to BMI, LAP might better predict the incidence of cardiovascular disease, but this hypothesis needs prospective testing.

  13. Estimation of the Cardiovascular Risk Using World Health Organization/International Society of Hypertension (WHO/ISH Risk Prediction Charts in a Rural Population of South India

    Directory of Open Access Journals (Sweden)

    Arun Gangadhar Ghorpade

    2015-08-01

    Full Text Available Background World Health Organization/International Society of Hypertension (WHO/ISH charts have been employed to predict the risk of cardiovascular outcome in heterogeneous settings. The aim of this research is to assess the prevalence of Cardiovascular Disease (CVD risk factors and to estimate the cardiovascular risk among adults aged >40 years, utilizing the risk charts alone, and by the addition of other parameters. Methods A cross-sectional study was performed in two of the villages availing health services of a medical college. Overall 570 subjects completed the assessment. The desired information was obtained using a pretested questionnaire and participants were also subjected to anthropometric measurements and laboratory investigations. The WHO/ISH risk prediction charts for the South-East Asian region was used to assess the cardiovascular risk among the study participants. Results The study covered 570 adults aged above 40 years. The mean age of the subjects was 54.2 (±11.1 years and 53.3% subjects were women. Seventeen percent of the participants had moderate to high risk for the occurrence of cardiovascular events by using WHO/ISH risk prediction charts. In addition, CVD risk factors like smoking, alcohol, low High-Density Lipoprotein (HDL cholesterol were found in 32%, 53%, 56.3%, and 61.5% study participants, respectively. Conclusion Categorizing people as low (20% risk is one of the crucial steps to mitigate the magnitude of cardiovascular fatal/non-fatal outcome. This cross-sectional study indicates that there is a high burden of CVD risk in the rural Pondicherry as assessed by WHO/ISH risk prediction charts. Use of WHO/ISH charts is easy and inexpensive screening tool in predicting the cardiovascular event.

  14. Carbohydrate, dietary glycaemic index and glycaemic load, and colorectal cancer risk: a case-control study in China.

    Science.gov (United States)

    Huang, Jing; Fang, Yu-Jing; Xu, Ming; Luo, Hong; Zhang, Nai-Qi; Huang, Wu-Qing; Pan, Zhi-Zhong; Chen, Yu-Ming; Zhang, Cai-Xia

    2018-04-01

    A carbohydrate-rich diet results in hyperglycaemia and hyperinsulinaemia; it may further induce the carcinogenesis of colorectal cancer. However, epidemiological evidence among Chinese population is quite limited. The aim of this study was to investigate total carbohydrate, non-fibre carbohydrate, total fibre, starch, dietary glycaemic index (GI) and glycaemic load (GL) in relation to colorectal cancer risk in Chinese population. A case-control study was conducted from July 2010 to April 2017, recruiting 1944 eligible colorectal cancer cases and 2027 age (5-year interval) and sex frequency-matched controls. Dietary information was collected by using a validated FFQ. The OR and 95 % CI of colorectal cancer risk were assessed by multivariable logistic regression models. There was no clear association between total carbohydrate intake and colorectal cancer risk. The adjusted OR was 0·85 (95 % CI 0·70, 1·03, P trend=0·08) comparing the highest with the lowest quartile. Total fibre was related to a 53 % reduction in colorectal cancer risk (adjusted ORquartile 4 v. 1 0·47; 95 % CI 0·39, 0·58). However, dietary GI was positively associated with colorectal cancer risk, with an adjusted ORquartile 4 v. 1 of 3·10 (95 % CI 2·51, 3·85). No significant association was found between the intakes of non-fibre carbohydrate, starch and dietary GL and colorectal cancer risk. This study indicated that dietary GI was positively associated with colorectal cancer risk, but no evidence supported that total carbohydrate, non-fibre carbohydrate, starch or high dietary GL intake were related to an increased risk of colorectal cancer in a Chinese population.

  15. Body Mass Index and Risk of Infections Among Women in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Harpsøe, Maria C; Nielsen, Nete M; Friis-Møller, Nina

    2016-01-01

    baseline BMI and later hospitalization for 1) any infectious disease and 2) infections of the respiratory tract, whereas a dose-response relationship was seen for skin infections. The most pronounced associations were seen for acute upper respiratory infections at multiple and unspecified sites...... was observed among overweight (BMI 25-infections of the upper respiratory tract and skin.......We investigated the possible association between body mass index (BMI; weight (kg)/height (m)(2)) and hospitalization or treatment for acute infection in a prospective cohort study. We linked 75,001 women enrolled in the Danish National Birth Cohort from 1996 to 2002, who had information on BMI...

  16. Injury risk is low among world-class volleyball players: 4-year data from the FIVB Injury Surveillance System.

    Science.gov (United States)

    Bere, Tone; Kruczynski, Jacek; Veintimilla, Nadège; Hamu, Yuichiro; Bahr, Roald

    2015-09-01

    Little is known about the rate and pattern of injuries in international volleyball competition. To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation (FIVB) Injury Surveillance System (ISS) (junior and senior, male and female). The FIVB ISS is based on prospective registration of injuries by team medical staff during all major FIVB tournaments (World Championships, World Cup, World Grand Prix, World League, Olympic Games). This paper is based on 4-year data (September 2010 to November 2014) obtained through the FIVB ISS during 32 major FIVB events (23 senior and 9 junior). The incidence of time-loss injuries during match play was 3.8/1000 player hours (95% CI 3.0 to 4.5); this was greater for senior players than for junior players (relative risk: 2.04, 1.29 to 3.21), while there was no difference between males and females (1.04, 0.70 to 1.55). Across all age and sex groups, the ankle was the most commonly injured body part (25.9%), followed by the knee (15.2%), fingers/thumb (10.7%) and lower back (8.9%). Injury incidence was greater for centre players and lower for liberos than for other player functions; injury patterns also differed between player functions. Volleyball is a very safe sport, even at the highest levels of play. Preventive measures should focus on acute ankle and finger sprains, and overuse injuries in the knee, lower back and shoulder. 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.

  17. Age-specific performance of the revised cardiac risk index for predicting cardiovascular risk in elective noncardiac surgery

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Wissenberg, Mads; Jørgensen, Mads Emil

    2015-01-01

    , II, III, and IV. Multivariable odds ratio estimates were as follows: ischemic heart disease 3.30 (95% confidence interval, 2.96-3.69), high-risk surgery 2.70 (2.46-2.96), congestive heart failure 2.65 (2.29-3.06), cerebrovascular disease 10.02 (9.08-11.05), insulin therapy 1.62 (1.......37-1.93), and kidney disease 1.45 (1.33-1.59). Modeling RCRI classes as a continuous variable, C statistic was highest among age group 56 to 65 years (0.772) and lowest for those aged >85 years (0.683). Sensitivity of RCRI class >I (ie, having ≥ 1 risk factor) for capturing major adverse cardiovascular events was 59...

  18. The Volcanic Hazards Assessment Support System for the Online Hazard Assessment and Risk Mitigation of Quaternary Volcanoes in the World

    Directory of Open Access Journals (Sweden)

    Shinji Takarada

    2017-12-01

    Full Text Available Volcanic hazards assessment tools are essential for risk mitigation of volcanic activities. A number of offline volcanic hazard assessment tools have been provided, but in most cases, they require relatively complex installation procedure and usage. This situation causes limited usage of volcanic hazard assessment tools among volcanologists and volcanic hazards communities. In addition, volcanic eruption chronology and detailed database of each volcano in the world are essential key information for volcanic hazard assessment, but most of them are isolated and not connected to and with each other. The Volcanic Hazard Assessment Support System aims to implement a user-friendly, WebGIS-based, open-access online system for potential hazards assessment and risk-mitigation of Quaternary volcanoes in the world. The users can get up-to-date information such as eruption chronology and geophysical monitoring data of a specific volcano using the direct link system to major volcano databases on the system. Currently, the system provides 3 simple, powerful and notable deterministic modeling simulation codes of volcanic processes, such as Energy Cone, Titan2D and Tephra2. The system provides deterministic tools because probabilistic assessment tools are normally much more computationally demanding. By using the volcano hazard assessment system, the area that would be affected by volcanic eruptions in any location near the volcano can be estimated using numerical simulations. The system is being implemented using the ASTER Global DEM covering 2790 Quaternary volcanoes in the world. The system can be used to evaluate volcanic hazards and move this toward risk-potential by overlaying the estimated distribution of volcanic gravity flows or tephra falls on major roads, houses and evacuation areas using the GIS-enabled systems. The system is developed for all users in the world who need volcanic hazards assessment tools.

  19. Body mass index in childhood and adult risk of primary liver cancer

    DEFF Research Database (Denmark)

    Berentzen, Tina Landsvig; Gamborg, Michael; Holst, Claus

    2014-01-01

    BACKGROUND & AIMS: Childhood overweight increases the risk of early development of non-alcoholic fatty liver disease, which may predispose to carcinogenesis. We investigated if childhood body size during school ages was associated with the risk of primary liver cancer in adults. METHODS: A cohort......-specific reference. Information on liver cancer was obtained from the National Cancer Registry. Hazard ratios and 95% confidence intervals (95% CI) of liver cancer were estimated by Cox regression. RESULTS: During 6,963,105 person-years of follow-up, 438 cases of primary liver cancer were recorded. The hazard ratio...... hepatitis, alcohol-related disorders, and biliary cirrhosis. CONCLUSIONS: Higher BMI in childhood increases the risk of primary liver cancer in adults. In view of the high case fatality of primary liver cancer, this result adds to the future negative health outcomes of the epidemic of childhood overweight...

  20. Strong influence of El Niño Southern Oscillation on flood risk around the world

    NARCIS (Netherlands)

    Ward, P.J.; Jongman, B.; Kummu, M.S.; Dettinger, M.D.; Sperna Weiland, F.C.; Winsemius, H.C.

    2014-01-01

    El Niño Southern Oscillation (ENSO) is the most dominant interannual signal of climate variability and has a strong influence on climate over large parts of the world. In turn, it strongly influences many natural hazards (such as hurricanes and droughts) and their resulting socioeconomic impacts,

  1. The Swiss "Willensnation" at Risk: Teachers in the Cultural Gap during the First World War

    Science.gov (United States)

    Brühwiler, Ingrid

    2015-01-01

    As a neutral and multilingual country, Switzerland struggled with major domestic political conflicts during the First World War due to the two cultures of the French-speaking and German-speaking parts of the country. The divided cultural loyalties ("fossé moral", "Röstigraben"), consisting of Swiss-Germans supporting Germany…

  2. FACTORS OF FOREIGN MILITARY INTERVENTION RISK ASSESSMENT IN THE MODERN WORLD

    Directory of Open Access Journals (Sweden)

    A. A. Ivanov

    2016-01-01

    Full Text Available The starting point of the conclusions of politicians and experts was the recognition of the changed nature of threats to the New World Order. In post-Westfalia system of international relations the main actors are not sovereigns, but transnational actors of world politics, including transnational terrorist and criminal networks. In this situation, the support of global security threat serves the underground world – terrorists, shady business structures, failed states. The unconventional nature of the threat to peace and stability of the New World Order requires an equally innovative response which transcends the formal constraints of international law and the traditional doctrine of deterrence. An analysis of the U.S. foreign policy concepts suggests that today’s academic and political community has promoted consensus of neoliberals and neoconservatives, supporters of the institutional functionalism and representatives of the school of Realpolitik. This consensus was based on the recognition of the admissibility of pre-emptive strikes on the territory of failed states, sponsoring international terrorism, or the implementation of open interference in the internal affairs of “rogue states” for human rights and democratic freedoms guarantee.

  3. Self-reported symptoms and risk factors for digital ischaemia among international world-class beach volleyball players.

    Science.gov (United States)

    Van De Pol, Daan; Alaeikhanehshir, Sena; Maas, Mario; Kuijer, P Paul F M

    2016-01-01

    The prevalence of ischaemia-related symptoms is remarkably high among elite indoor volleyball players. Since the exposure to sport-specific demands may be higher in beach volleyball compared to indoor volleyball, the aim of this study was to assess the prevalence of ischaemia-related symptoms and associated risk factors among world-class beach volleyball players. Therefore, a questionnaire survey was performed among beach volleyball players active during the 2013 Grand Slam Beach Volleyball in the Netherlands. In total, 60 of the 128 beach volleyball players (47%) participated: 26 males and 34 females from 17 countries. The self-reported prevalence of cold or blue or pale digits in the dominant hand during or immediately after practice or competition was 38% (n = 23). Two risk factors were independently associated with symptoms of blue or pale digits: more than 14 years playing volleyball (odds ratio (OR) 4.42, 90% confidence interval (90% CI) 1.30-15.07) and sex (female) (OR 4.62, 90% CI 1.15-18.57). In conclusion, the prevalence of symptoms associated with digital ischaemia is high among international world-class beach volleyball players. Female sex and the length of the volleyball career were independently associated with an increased risk of ischaemia-related symptoms. The high prevalence of these seemingly innocuous symptoms and possible associated risk factors warrant regular monitoring since early detection can potentially prevent thromboembolic complications and irreversible tissue damage.

  4. [Study on building index system of risk assessment of post-marketing Chinese patent medicine based on AHP-fuzzy neural network].

    Science.gov (United States)

    Li, Yuanyuan; Xie, Yanming; Fu, Yingkun

    2011-10-01

    Currently massive researches have been launched about the safety, efficiency and economy of post-marketing Chinese patent medicine (CPM) proprietary Chinese medicine, but it was lack of a comprehensive interpretation. Establishing the risk evaluation index system and risk assessment model of CPM is the key to solve drug safety problems and protect people's health. The clinical risk factors of CPM exist similarities with the Western medicine, can draw lessons from foreign experience, but also have itself multi-factor multivariate multi-level complex features. Drug safety risk assessment for the uncertainty and complexity, using analytic hierarchy process (AHP) to empower the index weights, AHP-based fuzzy neural network to build post-marketing CPM risk evaluation index system and risk assessment model and constantly improving the application of traditional Chinese medicine characteristic is accord with the road and feasible beneficial exploration.

  5. Trajectories of body mass index among Canadian seniors and associated mortality risk.

    Science.gov (United States)

    Wang, Meng; Yi, Yanqing; Roebothan, Barbara; Colbourne, Jennifer; Maddalena, Victor; Sun, Guang; Wang, Peizhong Peter

    2017-12-04

    This study aims to characterize the heterogeneity in BMI trajectories and evaluate how different BMI trajectories predict mortality risk in Canadian seniors. Data came from the Canadian National Population Health Survey (NPHS, 1994-2011) and 1480 individuals aged 65-79 years with at least four BMI records were included in this study. Group-based trajectory model was used to identify distinct subgroups of longitudinal trajectories of BMI measured over 19 years for men and women. Cox proportional hazards models were used to examine the association between BMI trajectories and mortality risks. Distinct trajectory patterns were found for men and women: 'Normal Weight-Down'(N-D), 'Overweight-Normal weight' (OV-N), 'Obese I-Down' (OB I-D), and 'Obese II- Down' (OB II-D) for women; and 'Normal Weight-Down' (N-D), 'Overweight-Normal weight' (OV-N), 'Overweight-Stable' (OV-S), and 'Obese-Stable' (OB-S) for men. Comparing with OV-N, men in the OV-S group had the lowest mortality risk followed by the N-D (HR = 1.66) and OB-S (HR = 1.98) groups, after adjusting for covariates. Compared with OV-N, women in the OB II-D group with three or more chronic health conditions had higher mortality risk (HR = 1.61); however, women in OB II-D had lower risk (HR = 0.56) if they had less than three conditions. The course of BMI over time in Canadian seniors appears to follow one of four different patterns depending on gender. The findings suggest that men who were overweight at age 65 and lost weight over time had the lowest mortality risk. Interestingly, obese women with decreasing BMI have different mortality risks, depending on their chronic health conditions. The findings provide new insights concerning the associations between BMI and mortality risk.

  6. Flood risk in a changing world - a coupled transdisciplinary modelling framework for flood risk assessment in an Alpine study area

    Science.gov (United States)

    Huttenlau, Matthias; Schneeberger, Klaus; Winter, Benjamin; Pazur, Robert; Förster, Kristian; Achleitner, Stefan; Bolliger, Janine

    2017-04-01

    Devastating flood events have caused substantial economic damage across Europe during past decades. Flood risk management has therefore become a topic of crucial interest across state agencies, research communities and the public sector including insurances. There is consensus that mitigating flood risk relies on impact assessments which quantitatively account for a broad range of aspects in a (changing) environment. Flood risk assessments which take into account the interaction between the drivers climate change, land-use change and socio-economic change might bring new insights to the understanding of the magnitude and spatial characteristic of flood risks. Furthermore, the comparative assessment of different adaptation measures can give valuable information for decision-making. With this contribution we present an inter- and transdisciplinary research project aiming at developing and applying such an impact assessment relying on a coupled modelling framework for the Province of Vorarlberg in Austria. Stakeholder engagement ensures that the final outcomes of our study are accepted and successfully implemented in flood management practice. The study addresses three key questions: (i) What are scenarios of land- use and climate change for the study area? (ii) How will the magnitude and spatial characteristic of future flood risk change as a result of changes in climate and land use? (iii) Are there spatial planning and building-protection measures which effectively reduce future flood risk? The modelling framework has a modular structure comprising modules (i) climate change, (ii) land-use change, (iii) hydrologic modelling, (iv) flood risk analysis, and (v) adaptation measures. Meteorological time series are coupled with spatially explicit scenarios of land-use change to model runoff time series. The runoff time series are combined with impact indicators such as building damages and results are statistically assessed to analyse flood risk scenarios. Thus, the

  7. Assessing and managing multiple risks in a changing world — The Roskilde recommendations

    DEFF Research Database (Denmark)

    Selck, Henriette; Adamsen, Peter B.; Backhaus, Thomas

    2017-01-01

    -management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological context for assessments in human...

  8. Risk factors for renal disease and urinary abnormalities in men and women: data from the World Kidney Day in the province of Ferrara, Italy.

    Science.gov (United States)

    Fabbian, Fabio; Bedani, Pier Luigi; Rizzioli, Emanuela; Molino, Christian; Pala, Marco; De Giorgi, Alfredo; Menegatti, Alessandra Mallozzi; Bagnaresi, Isabella; Portaluppi, Francesco; Manfredini, Roberto

    2013-01-01

    Chronic kidney disease (CKD) is a worldwide health problem due to its morbidity and mortality, and cost. World Kidney Day (WKD) has been planned to improve disease prevention. The aim of this study was to evaluate CKD risk factors and urinary abnormalities, collected on WKD along several years, in men and women. Between 2006 and 2012, 1980 subjects, of whom 1012 women, from general population living in Ferrara area, a town in the north-east of Italy, were investigated. For each participant age, sex, smoking, hypertensive and diabetic status, body mass index (BMI), waist circumference (WC), and blood pressure (BP) were obtained. Moreover, body shape index (BSI) was calculated. All subjects underwent dipstick urinalysis. Men had higher BMI, WC, and BP than women. Women had higher prevalence of abdominal obesity and higher BSI (0.0951 ± 0.0105 vs. 0.0920 ± 0.0071 m(11/6)kg(-2/3)), while men had higher prevalence of overweight. In women, hematuria and leukocyturia were more prevalent (16.9% vs. 12.8%; OR 95%CI 1.161 (1.042-1.294); p = 0.012; 18.5% vs. 7% OR 95%CI 1.538 (1.403-1.676); p < 0.001, respectively), while glycosuria was less frequent (4.2% vs. 8.8% OR 95%CI 0.642 (0.501-0.822); p < 0.001) than in men. Frequency of proteinuria was similar in the two sexes. Venn diagrams indicate a different overlap of urinary abnormalities in the two sexes. Risk factors for CKD collected during the WKD appear to be different in the two sexes, and urinary abnormalities overlap differently. Data collected during the WKD are related to sex, and women deserve greater attention.

  9. The prediction of the incidence rate of upper limb musculoskeletal disorders, with CTD risk index method on potters of Meybod city

    Directory of Open Access Journals (Sweden)

    Reza Khani Jazani

    2012-02-01

    Full Text Available Background: The objective of this study was to predict the incidence of musculoskeletal disorders in potters of Meybod city by performing CTD risk index method.Materials and Method: This is a descriptive cross-sectional study. Target society was all workers in pottery workshops which were located in the Meybod. Information related to musculoskeletal disorders was obtained by the Nordic questionnaire and we used CTD risk index method to predict the incidence of musculoskeletal disorders.Results: We observed in this study that 59.3% of the potters had symptoms of musculoskeletal disorders in at least in one of their upper extremities. Also significant differences between mean CTD risk index on potters with and without symptoms of the upper limb musculoskeletal disorders, respectively (p=0.038.Conclusion: CTD risk index method can be as a suitable method for predicting the incidence of musculoskeletal disorders used in the potters

  10. Screening manual and office workers for risk of long-term sickness absence: cut-off points for the Work Ability Index

    NARCIS (Netherlands)

    Schouten, L.S.; Joling, C.I.; van der Gulden, J.W.J.; Heymans, M.W.; Bultmann, U.; Roelen, C.A.M.

    2015-01-01

    OBJECTIVES: The aim of this study was to investigate the Work Ability Index (WAI) as a tool to screen for risk of different durations of long-term sickness absence (LTSA) among manual and office workers.

  11. Pathway index models for construction of patient-specific risk profiles.

    Science.gov (United States)

    Eng, Kevin H; Wang, Sijian; Bradley, William H; Rader, Janet S; Kendziorski, Christina

    2013-04-30

    Statistical methods for variable selection, prediction, and classification have proven extremely useful in moving personalized genomics medicine forward, in particular, leading to a number of genomic-based assays now in clinical use for predicting cancer recurrence. Although invaluable in individual cases, the information provided by these assays is limited. Most often, a patient is classified into one of very few groups (e.g., recur or not), limiting the potential for truly personalized treatment. Furthermore, although these assays provide information on which individuals are at most risk (e.g., those for which recurrence is predicted), they provide no information on the aberrant biological pathways that give rise to the increased risk. We have developed an approach to address these limitations. The approach models a time-to-event outcome as a function of known biological pathways, identifies important genomic aberrations, and provides pathway-based patient-specific assessments of risk. As we demonstrate in a study of ovarian cancer from The Cancer Genome Atlas project, the patient-specific risk profiles are powerful and efficient characterizations useful in addressing a number of questions related to identifying informative patient subtypes and predicting survival. Copyright © 2012 John Wiley & Sons, Ltd.

  12. The impact of house price index specification levels on the risk profile of housing corporations

    NARCIS (Netherlands)

    Kramer, B.; Kuijl, T.; Francke, M.

    2009-01-01

    Asset Liability Management (ALM) for housing corporations is based on stochastic scenario models for important risk and return drivers such as interest and inflation rates, construction costs and sales prices of houses. Given the situation of the housing corporation (current real estate portfolio,

  13. Tail risk analysis of the S&P/OIC COMCEC 50 index

    Directory of Open Access Journals (Sweden)

    Mahmoud Bekri

    2015-03-01

    We show how the use of the stable distributions achieves a great amelioration of the modelling of the S&P/OIC COMCEC 50, considering the different statistical tests and in terms of the assessment of the value of tail risk.

  14. Body Mass Index and Risk of Gallbladder Cancer: Systematic Review and Meta-Analysis of Observational Studies

    Directory of Open Access Journals (Sweden)

    Wenbin Tan

    2015-09-01

    Full Text Available OBJECTIVES: To provide a quantitative assessment of the association between excess body weight, interpreted as increased body mass index (BMI, and the risk of gallbladder cancer (GBC. METHODS: We identified eligible studies in Medline and EMBASE up to 1 February 2015, and reference lists of retrieved articles. Summary relative risks with their 95% confidence intervals were calculated in a random-effects model. Subgroup analyses were performed according to study design, gender, geographic location, ascertainment of exposure and adjustment for confounders. RESUITS: A total of 12 cohort studies and 8 case-control studies were included in the meta-analysis. Overall, compared with “normal” weight, the summary relative risks of GBC were 1.14 (95% CI, 1.04–1.25 for overweight individuals (BMI 25–30 kg/m2 and 1.56 (95% CI, 1.41–1.73 for obese individuals (BMI > 30 kg/m2. Obese women had a higher risk of GBC than men did (women: SRRs 1.67, 95% CI 1.38–2.02; men: SRRs 1.42, 95% CI 1.21–1.66, and there was significant association between overweight and GBC risk in women (SRRs 1.26, 95% CI 1.13–1.40, but not in men (SRRs 1.06, 95% CI 0.94–1.20. CONCLUSIONS: Findings from this meta-analysis indicate that obesity is associated with an increased risk of GBC, especially in women. Overweight is associated with GBC risk only in women.

  15. Sarcopenia is a risk factor for elevated aminotransferase in men independently of body mass index, dietary habits, and physical activity.

    Science.gov (United States)

    Yoo, Ki Deok; Jun, Dae Won; Lee, Kang Nyeong; Lee, Hang Lak; Lee, Oh Young; Yoon, Byung Chul; Choi, Ho Soon

    2015-04-01

    Aminotransferase activity is a surrogate marker of liver injury showing strong correlations with obesity and metabolic syndrome. However, elevated aminotransferase activity is not uncommon in non-obese and non-alcoholic patients in clinical practice. To examine the relationship between sarcopenia and aminotransferase activity in a large population-based cohort. Data from the Korean National Health and Nutrition Examinations were used. A total of 13,431 subjects were included. A whole-body dual X-ray absorptiometry scan was performed on each patient to measure total and regional muscle mass. Appendicular skeletal muscle mass indices were also obtained. The prevalence of sarcopenia was significantly higher in the group with elevated aminotransferase levels than in the normal liver enzyme group (males: 26.5% vs. 16.9%; females: 38.3% vs. 22.1%, plevels. The frequency of elevated aminotransferase increased in male patients with sarcopenia after adjusting for potential confounding factors including age, body mass index, fasting glucose level, dietary, and exercise habits. However, the correlation was no longer observed in women after adjusting for body mass index. Sarcopenia is a risk factor for elevated aminotransferase in men, independently of body mass index, dietary habits, and physical activity. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  16. Advanced Atherogenic Index for the Assessment of Consolidated Lipid Risk in Premature Coronary Artery Disease Patients in India.

    Science.gov (United States)

    Bansal, Sanjiv Kumar; Agarwal, Sarita; Daga, Mridul Kumar

    2016-01-01

    The high prevalence, severity, and prematurity of coronary artery disease (CAD) in the Indian population cannot be completely explained by the conventional lipid parameters and the existing lipid indices. To calculate newly defined advanced atherogenic index (AAI) in premature CAD patients and compare it between cases and controls and Correlate its values with the existing indices. One hundred and twenty premature CAD patients and an equal number of age and sex matched healthy individuals were included in this study. Lipid profile and nonconventional lipid parameters like oxidized Low density lipoprotein (OX LDL), small dense LDL (SD LDL), lipoprotein (a) apolipoprotein B (Apo B), and apolipoprotein A1 (Apo A1) were estimated and their values were used to define AAI and existing lipid indices like AI, lipid tetrad index (LTI) and lipid pentad index (LPI). The mean age of cases and controls was 37.29 + 4.50 and 36.13 + 3.53 years, respectively. The value of AAI was highly significant in cases (3461.22 ± 45.20) as compared to controls (305.84 ± 21.80). AAI has shown better statistical significance and correlation (P statistic and cumulative distribution function plot has shown that AAI can discriminate cases and controls more accurately as compared to the earlier indices. Statistically AAI appears to be a better marker of consolidated lipid risk in premature CAD patients as compared to the earlier indices.

  17. Maternal body mass index before pregnancy as a risk factor for ADHD and autism in children.

    Science.gov (United States)

    Andersen, Christina Hebsgaard; Thomsen, Per Hove; Nohr, Ellen Aagaard; Lemcke, Sanne

    2018-02-01

    The risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) may be influenced by environmental factors such as maternal obesity before pregnancy. Previous studies investigating those associations have found divergent results. We aim to investigate in a large birth cohort this association further in children with ADHD, ASD and comorbid ADHD and ASD. Our study population consisted of 81,892 mother-child pairs participating in the Danish National Birth Cohort (DNBC). Information about pre-pregnancy weight and height was collected in week 16 of pregnancy; the analysis was divided into groups based on BMI. Children with a clinical diagnosis of ADHD and/or ASD were identified in the Danish health registries at an average age of 13.3 years. Hazard ratios (HRs) were estimated using time-to-event analysis. Compared to normal weight mothers, the risk of having a child with ADHD was significantly increased if the mother was overweight (HR = 1.28 [95% CI 1.15;1.48]), obese (HR = 1.47 [95% CI 1.26;1.71]) or severely obese (HR = 1.95 [95% CI 1.58;2.40]). The same pattern was seen for the combined ADHD and ASD group. Regarding ASD, an increased risk was observed in underweight (HR = 1.30 [95% CI 1.01;1.69]) and obese (HR = 1.39 [95% CI 1.11;1.75]) mothers. Subgroup analysis revealed that the association in the ADHD group could mostly be attributable to the hyperactive group. Maternal obesity before pregnancy is a risk factor for ADHD in children. Maternal obesity as well as underweight may also be associated with an increased risk for ASD.

  18. Low skeletal muscle mass outperforms the Charlson Comorbidity Index in risk prediction in patients undergoing pancreatic resections.

    Science.gov (United States)

    Wagner, D; Marsoner, K; Tomberger, A; Haybaeck, J; Haas, J; Werkgartner, G; Cerwenka, H; Bacher, H; Mischinger, H J; Kornprat, P

    2018-05-01

    Low skeletal muscle mass is a known predictor of morbidity and mortality in patients undergoing major pancreatic surgeries. We sought to combine low skeletal muscle mass with established risk predictors to improve their prognostic capacity for postoperative outcome and morbidity. As established parameters to predict preoperative mortality risk for patients, the ASA classification and the Charlson Comorbidity Index (CCI) were used. The Hounsfield Units Average Calculation (HUAC) was measured to define low skeletal muscle mass in 424 patients undergoing pancreatic resections for malignancies. Patients in the lowest sex-adjusted quartile for HUAC were defined as having low skeletal muscle mass (muscle wasting). Multivariable Cox regression analysis was utilized to identify preoperative risk factors associated with postoperative morbidity. Median patient age was 63 years (19-87), 47.9% patients were male, and half the cohort had multiple comorbidities (Charlson Comorbidity Index [CCI]>6, 63.2%), 30-day mortality was 5.8% (n = 25). Median HUAC was 19.78 HU (IQR: 15.94-23.54) with 145 patients (34.2%) having low skeletal muscle mass. Preoperative frailty defined by low skeletal muscle mass was associated with an increased risk for postoperative complications (OR 1.55, CI 95% 0.98-2.45, p = 0.014), and a higher 30-day mortality (HR 5.17, CI 95% 1.57-16.69, p = 0.004). With an AUC of 0.85 HUAC showed the highest predictability for 30-day mortality (CI 95% 0.78-0.91, p = 0.0001). Patients with CCI ≥6 and low skeletal muscle mass defined by the HUAC had a 9.78 higher risk of dying in the immediate postoperative phase (HR 9.78, CI 95% 2.98-12.2, p = 0.0001). Low skeletal muscle mass predicts postoperative mortality and complications best and it should be incorporated to conventional risk scores to identify high risk patients. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights

  19. Effects of weight loss and long-term weight maintenance with diets varying in protein and glycemic index on cardiovascular risk factors

    DEFF Research Database (Denmark)

    Gögebakan, Özlem; Kohl, Angela; Osterhoff, Martin A.

    2011-01-01

    We sought to separately examine the effects of either weight loss or diets varying in protein content and glycemic index without further changes in body weight on cardiovascular risk factors within the Diet, Obesity, and Genes study (DiOGenes).......We sought to separately examine the effects of either weight loss or diets varying in protein content and glycemic index without further changes in body weight on cardiovascular risk factors within the Diet, Obesity, and Genes study (DiOGenes)....

  20. Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults.

    Science.gov (United States)

    Knowles, K M; Paiva, L L; Sanchez, S E; Revilla, L; Lopez, T; Yasuda, M B; Yanez, N D; Gelaye, B; Williams, M A

    2011-01-24

    Objectives. To examine the extent to which measures of adiposity can be used to predict selected components of metabolic syndrome (MetS) and elevated C-reactive protein (CRP). Methods. A total of 1,518 Peruvian adults were included in this study. Waist circumference (WC), body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHtR), and visceral adiposity index (VAI) were examined. The prevalence of each MetS component was determined according to tertiles of each anthropometric measure. ROC curves were used to evaluate the extent to which measures of adiposity can predict cardiovascular risk. Results. All measures of adiposity had the strongest correlation with triglyceride concentrations (TG). For both genders, as adiposity increased, the prevalence of Mets components increased. Compared to individuals with low-BMI and low-WC, men and women with high-BMI and high- WC had higher odds of elevated fasting glucose, blood pressure, TG, and reduced HDL, while only men in this category had higher odds of elevated CRP. Overall, the ROCs showed VAI, WC, and WHtR to be the best predictors for individual MetS components. Conclusions. The results of our study showed that measures of adiposity are correlated with cardiovascular risk although no single adiposity measure was identified as the best predictor for MetS.

  1. Waist Circumference, Body Mass Index, and Other Measures of Adiposity in Predicting Cardiovascular Disease Risk Factors among Peruvian Adults

    Directory of Open Access Journals (Sweden)

    K. M. Knowles

    2011-01-01

    Full Text Available Objectives. To examine the extent to which measures of adiposity can be used to predict selected components of metabolic syndrome (MetS and elevated C-reactive protein (CRP. Methods. A total of 1,518 Peruvian adults were included in this study. Waist circumference (WC, body mass index (BMI, waist-hip ratio (WHR, waist-height ratio (WHtR, and visceral adiposity index (VAI were examined. The prevalence of each MetS component was determined according to tertiles of each anthropometric measure. ROC curves were used to evaluate the extent to which measures of adiposity can predict cardiovascular risk. Results. All measures of adiposity had the strongest correlation with triglyceride concentrations (TG. For both genders, as adiposity increased, the prevalence of Mets components increased. Compared to individuals with low-BMI and low-WC, men and women with high-BMI and high- WC had higher odds of elevated fasting glucose, blood pressure, TG, and reduced HDL, while only men in this category had higher odds of elevated CRP. Overall, the ROCs showed VAI, WC, and WHtR to be the best predictors for individual MetS components. Conclusions. The results of our study showed that measures of adiposity are correlated with cardiovascular risk although no single adiposity measure was identified as the best predictor for MetS.

  2. U.S. Civil Air Show Crashes, 1993 to 2013: Burden, Fatal Risk Factors, and Evaluation of a Risk Index for Aviation Crashes.

    Science.gov (United States)

    Ballard, Sarah-Blythe; Osorio, Victor B

    2015-01-01

    This study provides new public health data about U.S. civil air shows. Risk factors for fatalities in civil air show crashes were analyzed. The value of the FIA score in predicting fatal outcomes was evaluated. With the use of the FAA's General Aviation and Air Taxi Survey and the National Transportation Safety Board's data, the incidence of civil air show crashes from 1993 to 2013 was calculated. Fatality risk factors for crashes were analyzed by means of regression methods. The FIA index was validated to predict fatal outcomes by using the factors of fire, instrument conditions, and away-from-airport location, and was evaluated through receiver operating characteristic (ROC) curves. The civil air show crash rate was 31 crashes per 1,000 civil air events. Of the 174 civil air show crashes that occurred during the study period, 91 (52%) involved at least one fatality; on average, 1.1 people died per fatal crash. Fatalities were associated with four major risk factors: fire [adjusted odds ratio (AOR) = 7.1, 95% confidence interval (CI) = 2.4 to 20.6, P Civil air show crashes were marked by a high risk of fatal outcomes to pilots in aerobatic performances but rare mass casualties. The FIA score was not a valid measurement of fatal risk in civil air show crashes.

  3. World food markets into the 21st century: commodity risk management policies

    OpenAIRE

    Duncan, Ronald C.

    1997-01-01

    Recent concerns about future global food production seem poorly based. The rapid phase of growth in food consumption is over for most of the world's population because of increased incomes and, besides, population growth rates continue to slow. Thus, the rate of growth of food production needed in the future is much lower than it has been for the past 40 years. Production and price instability will continue, perhaps with lessened intensity because of reduced government intervention. With priv...

  4. Arsenic and other elements in drinking water and dietary components from the middle Gangetic plain of Bihar, India: Health risk index.

    Science.gov (United States)

    Kumar, Manoj; Rahman, Mohammad Mahmudur; Ramanathan, A L; Naidu, Ravi

    2016-01-01

    This study investigates the level of contamination and health risk assessment for arsenic (As) and other elements in drinking water, vegetables and other food components in two blocks (Mohiuddinagar and Mohanpur) from the Samastipur district, Bihar, India. Groundwater (80%) samples exceeded the World Health Organization (WHO) guideline value (10μg/L) of As while Mn exceeded the previous WHO limit of 400μg/L in 28% samples. The estimated daily intake of As, Cd, Co, Cr, Cu, Mn, Ni, Pb and Zn from drinking water and food components were 169, 19, 26, 882, 4645, 14582, 474, 1449 and 12,955μg, respectively (estimated exposure 3.70, 0.41, 0.57, 19.61, 103.22, 324.05, 10.53, 32.21 and 287.90μg per kg bw, respectively). Twelve of 15 cooked rice contained high As concentration compared to uncooked rice. Water contributes (67%) considerable As to daily exposure followed by rice and vegetables. Whereas food is the major contributor of other elements to the dietary exposure. Correlation and principal component analysis (PCA) indicated natural source for As but for other elements, presence of diffused anthropogenic activities were responsible. The chronic daily intake (CDI) and health risk index (HRI) were also estimated from the generated data. The HRI were >1 for As in drinking water, vegetables and rice, for Mn in drinking water, vegetables, rice and wheat, for Pb in rice and wheat indicated the potential health risk to the local population. An assessment of As and other elements of other food components should be conducted to understand the actual health hazards caused by ingestion of food in people residing in the middle Gangetic plain. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Comparing 3 dietary pattern methods--cluster analysis, factor analysis, and index analysis--With colorectal cancer risk: The NIH-AARP Diet and Health Study.

    Science.gov (United States)

    Reedy, Jill; Wirfält, Elisabet; Flood, Andrew; Mitrou, Panagiota N; Krebs-Smith, Susan M; Kipnis, Victor; Midthune, Douglas; Leitzmann, Michael; Hollenbeck, Albert; Schatzkin, Arthur; Subar, Amy F

    2010-02-15

    The authors compared dietary pattern methods-cluster analysis, factor analysis, and index analysis-with colorectal cancer risk in the National Institutes of Health (NIH)-AARP Diet and Health Study (n = 492,306). Data from a 124-item food frequency questionnaire (1995-1996) were used to identify 4 clusters for men (3 clusters for women), 3 factors, and 4 indexes. Comparisons were made with adjusted relative risks and 95% confidence intervals, distributions of individuals in clusters by quintile of factor and index scores, and health behavior characteristics. During 5 years of follow-up through 2000, 3,110 colorectal cancer cases were ascertained. In men, the vegetables and fruits cluster, the fruits and vegetables factor, the fat-reduced/diet foods factor, and all indexes were associated with reduced risk; the meat and potatoes factor was associated with increased risk. In women, reduced risk was found with the Healthy Eating Index-2005 and increased risk with the meat and potatoes factor. For men, beneficial health characteristics were seen with all fruit/vegetable patterns, diet foods patterns, and indexes, while poorer health characteristics were found with meat patterns. For women, findings were similar except that poorer health characteristics were seen with diet foods patterns. Similarities were found across methods, suggesting basic qualities of healthy diets. Nonetheless, findings vary because each method answers a different question.

  6. Maternal body mass index before pregnancy as a risk factor for ADHD and autism in children

    DEFF Research Database (Denmark)

    Andersen, Christina Hebsgaard; Thomsen, Per Hove; Nohr, Ellen Aagaard

    2018-01-01

    The risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) may be influenced by environmental factors such as maternal obesity before pregnancy. Previous studies investigating those associations have found divergent results. We aim to investigate in a large...... birth cohort this association further in children with ADHD, ASD and comorbid ADHD and ASD. Our study population consisted of 81,892 mother-child pairs participating in the Danish National Birth Cohort (DNBC). Information about pre-pregnancy weight and height was collected in week 16 of pregnancy......; the analysis was divided into groups based on BMI. Children with a clinical diagnosis of ADHD and/or ASD were identified in the Danish health registries at an average age of 13.3 years. Hazard ratios (HRs) were estimated using time-to-event analysis. Compared to normal weight mothers, the risk of having...

  7. Height, weight and body mass index in early adulthood and risk of schizophrenia

    DEFF Research Database (Denmark)

    Sørensen, Holger Jelling; Mortensen, E L; Reinisch, J M

    2006-01-01

    individuals born between 1959 and 1961. In 1999, cases of schizophrenia were identified in the Danish Psychiatric Central Register, and the cases were compared with the cohort pool of controls with respect to height, weight, and BMI from draft records. The effect of low BMI was adjusted for parental social...... status when the cohort members were 1 year old, birth weight, birth length, and maternal pre-pregnancy BMI. RESULTS: Forty-five cases of schizophrenia had a lower young adult mean body weight and BMI than controls. A significant inverse relationship between BMI and risk of later schizophrenia was found....... No significant differences between cases and controls were observed with respect to adult height. CONCLUSION: Independent of several possible confounders, an inverse relationship between young adult BMI and risk of later development of schizophrenia was demonstrated in this all-male sample....

  8. A risk-based approach to flood management decisions in a nonstationary world

    Science.gov (United States)

    Rosner, Ana; Vogel, Richard M.; Kirshen, Paul H.

    2014-03-01

    Traditional approaches to flood management in a nonstationary world begin with a null hypothesis test of "no trend" and its likelihood, with little or no attention given to the likelihood that we might ignore a trend if it really existed. Concluding a trend exists when it does not, or rejecting a trend when it exists are known as type I and type II errors, respectively. Decision-makers are poorly served by statistical and/or decision methods that do not carefully consider both over- and under-preparation errors, respectively. Similarly, little attention is given to how to integrate uncertainty in our ability to detect trends into a flood management decision context. We show how trend hypothesis test results can be combined with an adaptation's infrastructure costs and damages avoided to provide a rational decision approach in a nonstationary world. The criterion of expected regret is shown to be a useful metric that integrates the statistical, economic, and hydrological aspects of the flood management problem in a nonstationary world.

  9. Occupational coke oven emissions exposure and risk of abnormal liver function: modifications of body mass index and hepatitis virus infection

    Energy Technology Data Exchange (ETDEWEB)

    Y. Hu; B. Chen; J. Qian; L. Jin; T. Jin; D. Lu [Fudan University, Shanghai (China). Department of Occupational and Environmental Health

    2010-03-15

    Occupational coke oven emissions (COEs) have been considered an important health issue. However, there are no conclusive data on human hepatic injury due to COE exposure. The association of COE exposure with liver function was explored and the effects of modification of potential non-occupational factors were assessed. 705 coke oven workers and 247 referents were investigated. Individual cumulative COE exposure was quantitatively estimated. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), {gamma}-glutamyl transferase, alkaline phosphatase, hepatitis B surface antigen and anti-hepatitis C antibody were measured. Among those with high COE exposure, the adjusted ORs of abnormal ALT and AST were 5.23 (95% CI 2.66 to 10.27) and 1.95 (95% CI 1.18 to 3.52), respectively. Overweight individuals (body mass index (BMI) {>=}25 kg/m{sup 2}) with high COE exposure had elevated risks of abnormal ALT (adjusted OR 23.93, 95% CI 8.73 to 65.62) and AST (adjusted OR 5.18, 95% CI 2.32 to 11.58). Risk of liver damage in hepatitis B virus- or hepatitis C virus-positive individuals with COE exposure was also elevated. Long-term exposure to COE increases the risk of liver dysfunction, which is more prominent among those with higher BMI and hepatitis virus infection. The risk assessment of liver damage associated with COE exposure should take BMI and hepatitis virus infection into consideration.

  10. Histological evaluation of patients with gastritis at high risk of developing gastric cancer using a conventional index.

    Science.gov (United States)

    Tanaka, Aki; Kamada, Tomoari; Inoue, Kazuhiko; Shiotani, Akiko; Kusunoki, Hiroaki; Manabe, Noriaki; Ito, Masanori; Hata, Jiro; Haruma, Ken

    2011-06-15

    Although gastric cancer (GCa) is strongly associated with Helicobacter pylori infection, only some H. pylori-positive subjects develop gastric cancer. The aim of this study is to identify H. pylori-positive subjects at high risk of developing GCa by assessment of the histopathological findings in the non-cancer-containing mucosa of patients with and without GCa. The subjects were 35 patients with diffuse-type gastric cancer (D-GCa), 55 with intestinal-type gastric cancer (I-GCa), and 99 H. pylori-positive controls without GCa. Two specimens were taken from the greater curvature of the antrum and the middle body. Histopathological gradings were evaluated using the updated Sydney System, and the risk of GCa was evaluated using a modified Meining's gastric cancer risk index (GCRI). Among the H. pylori-positive controls, corpus gastritis was seen in 98.0% (97/99) and corpus atrophic gastritis in 78.8% (78/99). The mean GCRI for the D-GCa (5.514±2.03) and I-GCa (6.836±2.08) groups was significantly greater than that for the H. pylori-positive controls (4.071±2.07; p=0.0005, pcancer. However, H. pylori-positive patients at high risk of developing GCa (not only intestinal-type but also diffuse-type) may be detected using a simple GCRI. Copyright © 2011 Elsevier GmbH. All rights reserved.

  11. Associations of Body Mass Index with Sexual Risk-Taking and Injection Drug Use among US High School Students

    Directory of Open Access Journals (Sweden)

    Richard Lowry

    2014-01-01

    Full Text Available The purpose of this study was to determine if body mass index (BMI is associated with behaviors that may increase risk for HIV and other sexually transmitted diseases (STDs among US high school students. We analyzed nationally representative data from the 2005–2011 national Youth Risk Behavior Surveys (YRBS to examine associations of BMI categories with sexual risk behaviors and injection drug use among sexually active high school students, using sex-stratified logistic regression models. Controlling for race/ethnicity and grade, among female and male students, both underweight (BMI < 5th percentile and obesity (BMI ≥ 95th percentile were associated with decreased odds of being currently sexually active (i.e., having had sexual intercourse during the past 3 months. However, among sexually active female students, obese females were more likely than normal weight females to have had 4 or more sex partners (odds ratio, OR = 1.59, not used a condom at last sexual intercourse (OR = 1.30, and injected illegal drugs (OR = 1.98. Among sexually active male students, overweight (85th percentile ≤ BMI < 95th percentile was associated with not using a condom at last sexual intercourse (OR = 1.19 and obesity was associated with injection drug use (OR = 1.42. Among sexually active students, overweight and obesity may be indicators of increased risk for HIV and other STDs.

  12. Body Mass Index below Obesity Threshold Implies Similar Cardiovascular Risk among Various Polycystic Ovary Syndrome Phenotypes.

    Science.gov (United States)

    Bagir, Gulay Simsek; Bakiner, Okan S; Bozkirli, Emre; Cavlak, Gulhan; Serinsoz, Hulya; Ertorer, M Eda

    2016-01-01

    The aim of this study was to determine the cardiometabolic risk factors in different polycystic ovary syndrome (PCOS) phenotypes. This cross-sectional study was performed between 2010 and 2011. Eighty-nine patients with PCOS and 25 age- and weight-matched healthy controls were included in the study. Patients were grouped using the Rotterdam 2003 criteria as: group 1, oligomenorrhea and/or anovulation (ANOV) and hyperandrogenemia (HA) and/or hyperandrogenism (n = 23); group 2, ANOV and polycystic ovaries (PCO; n = 22); group 3, HA and PCO (n = 22); group 4, ANOV, HA and PCO (n = 22); group 5, controls (n = 25). Laboratory blood tests for diagnosis and cardiometabolic risk assessments were performed. Insulin resistance (IR) was calculated in all patients with the homeostasis model assessment of IR (HOMA-IR) formula. An euglycemic hyperinsulinemic clamp test was performed on 5 randomly selected cases in each subgroup, making 25 cases in total, and indicated as the 'M' value (mg/kg/min), which is the total body glucose disposal rate. The mean BMl values of the groups were: group 1, 26.1 ± 5.3; group 2, 27.9 ± 5.2; group 3, 24.3 ± 4.2; group 4, 27.9 ± 7.5; group 5, 24.7 ± 5.2 (p > 0.05). There were no differences in the lipid profile, plasma glucose, HOMA-IR, insulin and M values between the groups (p > 0.05). Phenotypes with oligomenorrhea/anovulation (groups 1, 2 and 4) were more obese than group 3 (p = 0.039). The cardiometabolic risk profile was similar among the PCOS subgroups. This finding could be attributed to the mean BMl values, which, being below 30, were not within the obesity range. Obesity appeared to be an important determinant of high cardiovascular risk in PCOS. © 2015 S. Karger AG, Basel.

  13. Body mass index, cognitive deficit and depressive symptoms in high cardiovascular risk patients

    Directory of Open Access Journals (Sweden)

    Amanda Lucas da Costa

    Full Text Available Abstract To evaluate the relationship of obesity, cognitive impairment and depressive symptoms in patients with high cardiovascular risk. Methods: A sample of 93 patients aged 50 years or older was selected from the Center of Dyslipidemia and High Cardiovascular Risk from Hospital de Clínicas de Porto Alegre (HCPA. Patients with stroke were excluded. For cognitive evaluation, the MMSE (Mini Mental State Examination was used. A score of 24 or less was considered as cognitive impairment, and for those who had 4 years or less of education, the cutoff point was 17. The GDS-15 (Geriatric Depression Scale was also used, with the cutoff of 6 for presence of depressive symptoms. Results: Obese patients showed lower mean MMSE scores compared to non-obese patients (p=0.0012. Additionally, for every one point increase in BMI above 30 there was a 27% increase in the chances of the patient having cognitive impairment. The obese patients presented 31% chance of having cognitive impairment compared with overweight subjects. Conclusions: Our findings corroborated the association between obesity and cognitive impairment in high cardiovascular risk patients. This association however, was not observed for depressive symptoms.

  14. Hazard Quotients, Hazard Indexes, and Cancer Risks of Toxic Metals in PM10 during Firework Displays

    Directory of Open Access Journals (Sweden)

    Siwatt Pongpiachan

    2018-04-01

    Full Text Available Bonfire night is a worldwide phenomenon given to numerous annual celebrations characterised by bonfires and fireworks. Since Thailand has no national ambient air quality standards for metal particulates, it is important to investigate the impacts of particulate injections on elevations of air pollutants and the ecological health impacts resulting from firework displays. In this investigation, Pb and Ba were considered potential firework tracers because their concentrations were significantly higher during the episode, and lower than/comparable with minimum detection limits during other periods, indicating that their elevated concentrations were principally due to pyrotechnic displays. Pb/Ca, Pb/Al, Pb/Mg, and Pb/Cu can be used to pin-point emissions from firework displays. Air mass backward trajectories (72 h from the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT model indicated that areas east and north-east of the study site were the main sources of the airborne particles. Although the combined risk associated with levels of Pb, Cr, Co., Ni, Zn, As, Cd, V, and Mn was far below the standards mentioned in international guidelines, the lifetime cancer risks associated with As and Cr levels exceeded US-EPA guidelines, and may expose inhabitants of surrounding areas of Bangkok to an elevated cancer risk.

  15. Height, waist circumference, body mass index, and body somatotype across the life course and risk of glioma.

    Science.gov (United States)

    Cote, David J; Downer, Mary K; Smith, Timothy R; Smith-Warner, Stephanie A; Egan, Kathleen M; Stampfer, Meir J

    2018-06-26

    Recent studies have suggested height as a risk factor for glioma, but less is known regarding body mass index (BMI) or other anthropomorphic measures. We evaluated the association between body habitus and risk of glioma. We evaluated the association of measures of height, BMI, waist circumference, and somatotypes with risk of glioma in two prospective cohorts, the Nurses' Health Study and the Health Professionals Follow-Up Study. We documented 508 incident cases of glioma (321 glioblastoma [GBM]). In both cohorts, we found no significant association between adult BMI or waist circumference and risk of glioma, with pooled HR for BMI of 1.08 (95% CI 0.85-1.38 comparing ≥ 30 to < 25 kg/m 2 ) and for waist circumference of 1.05 (95% CI 0.80-1.37 highest vs. lowest quintile). Higher young adult BMI (at age 18 in NHS and 21 in HPFS) was associated with modestly increased risk of glioma in the pooled cohorts (pooled HR 1.35, 95% CI 1.06-1.72 comparing ≥ 25 kg/m 2 vs. less; HR 1.34 for women and 1.37 for men). Analysis of body somatotypes suggested reduced risk of glioma among women with heavier body types at all ages this measure was assessed (HRs ranging from 0.52 to 0.65 comparing highest tertile to lowest tertile), but no significant association among men. Height was associated with increased risk of glioma among women (HR 1.09, 95% CI 1.04-1.14 per inch), but not significantly among men. Within the 8 years prior to diagnosis, cases had no material weight loss compared to non-cases. All results were similar when limited to GBM. Adult BMI and waist circumference were not associated with glioma. Higher BMI at age 21 for men and at age 18 for women was modestly associated with risk in the pooled cohort. Based on body somatotypes, however, women with heavier body types during childhood and young adulthood may be at lower risk of glioma, although this association was not observed later in life with measurements of BMI. Greater height was associated with

  16. Índice de riesgo para el intento suicida en México Risk index for attempted suicide in Mexico

    Directory of Open Access Journals (Sweden)

    Guilherme Borges

    2012-12-01

    Full Text Available OBJETIVO: Desarrollar un índice de riesgo de los intentos de suicidio en los últimos 12 meses dentro de un grupo de personas con ideación suicida. MATERIAL Y MÉTODOS: Estudio de prevalencia. Se analizaron los datos de la Encuesta Nacional de Adicciones de 2008. El índice de riesgo estuvo conformado por la edad, estado civil, religión, ocupación, tipo de población, migración a Estados Unidos, consumo de alcohol y drogas, síntomas de depresión, conducta problemática y abuso sexual. RESULTADOS: Se observó un incremento monotónico con el aumento de los factores de riesgo y la ausencia o presencia de un plan y el riesgo, con razones de momios desde 2.07 hasta 152.19. El área bajo la curva fue elevada, con un valor de 0.844, cercano a 1. CONCLUSIÓN: El uso de este índice puede ayudar a prevenir que los pacientes sigan desarrollando ideación suicida e intento suicida de consecuencias inciertas, incluyendo la muerte.OBJECTIVE: To develop a risk index of suicide attempts in the last 12 months among people with suicide ideation. MATERIALS AND METHODS: Cross-sectional study. Data came from the National Addictions Survey 2008. The risk index was made up by age, marital status, religion, occupation, area of the country in which they live, immigrant to the United States, alcohol and drug consumption, depression symptoms, behavioral problems and a history of sexual abuse. RESULTS: We found a monotonic relationship between the increase in risk factors and the existence of a plan and the risk, with an odds ratio over 2.07 up to 152.19. The area under the curve is quite high, with a value of 0.844, very close to 1. CONCLUSION: The use of this index may help prevent patients from further developing their suicide ideation process and may prevent a suicide attempt of uncertain consequences, including death.

  17. Interactive effect of genetic susceptibility with height, body mass index, and hormone replacement therapy on the risk of breast cancer

    Directory of Open Access Journals (Sweden)

    Harlid Sophia

    2012-06-01

    Full Text Available Abstract Background Breast cancer today has many established risk factors, both genetic and environmental, but these risk factors by themselves explain only part of the total cancer incidence. We have investigated potential interactions between certain known genetic and phenotypic risk factors, specifically nine single nucleotide polymorphisms (SNPs and height, body mass index (BMI and hormone replacement therapy (HRT. Methods We analyzed samples from three different study populations: two prospectively followed Swedish cohorts and one Icelandic case–control study. Totally 2884 invasive breast cancer cases and 4508 controls were analysed in the study. Genotypes were determined using Mass spectrometry-Maldi-TOF and phenotypic variables were derived from measurements and/or questionnaires. Odds Ratios and 95% confidence intervals were calculated using unconditional logistic regression with the inclusion of an interaction term in the logistic regression model. Results One SNP (rs851987 in ESR1 tended to interact with height, with an increasingly protective effect of the major allele in taller women (p = 0.007 and rs13281615 (on 8q24 tended to confer risk only in non users of HRT (p-for interaction = 0.03. There were no significant interactions after correction for multiple testing. Conclusions We conclude that much larger sample sets would be necessary to demonstrate interactions between low-risk genetic polymorphisms and the phenotypic variables height, BMI and HRT on the risk for breast cancer. However the present hypothesis-generating study has identified tendencies that would be of interest to evaluate for gene-environment interactions in independent materials.

  18. Shortened version of the work ability index to identify workers at risk of long-term sickness absence.

    Science.gov (United States)

    Schouten, Lianne S; Bültmann, Ute; Heymans, Martijn W; Joling, Catelijne I; Twisk, Jos W R; Roelen, Corné A M

    2016-04-01

    The Work Ability Index (WAI) identifies non-sicklisted workers at risk of future long-term sickness absence (LTSA). The WAI is a complicated instrument and inconvenient for use in large-scale surveys. We investigated whether shortened versions of the WAI identify non-sicklisted workers at risk of LTSA. Prospective study including two samples of non-sicklisted workers participating in occupational health checks between 2010 and 2012. A heterogeneous development sample (N= 2899) was used to estimate logistic regression coefficients for the complete WAI, a shortened WAI version without the list of diseases, and single-item Work Ability Score (WAS). These three instruments were calibrated for predictions of different (≥2, ≥4 and ≥6 weeks) LTSA durations in a validation sample of non-sicklisted workers (N= 3049) employed at a steel mill, differentiating between manual (N= 1710) and non-manual (N= 1339) workers. The discriminative ability was investigated by receiver operating characteristic analysis. All three instruments under-predicted the LTSA risks in both manual and non-manual workers. The complete WAI discriminated between individuals at high and low risk of LTSA ≥2, ≥4 and ≥6 weeks in manual and non-manual workers. Risk predictions and discrimination by the shortened WAI without the list of diseases were as good as the complete WAI. The WAS showed poorer discrimination in manual and non-manual workers. The WAI without the list of diseases is a good alternative to the complete WAI to identify non-sicklisted workers at risk of future LTSA durations ≥2, ≥4 and ≥6 weeks. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  19. Body mass index, waist circumference, type 2 diabetes mellitus and risk of liver cancer for U.S. adults

    Science.gov (United States)

    Campbell, Peter T.; Newton, Christina C.; Freedman, Neal D.; Koshiol, Jill; Alavanja, Michael C.; Beane Freeman, Laura E.; Buring, Julie E.; Chan, Andrew T.; Chong, Dawn Q.; Datta, Mridul; Gaudet, Mia M.; Gaziano, J. Michael; Giovannucci, Edward; Graubard, Barry; Hollenbeck, Albert R.; King, Lindsey; Lee, I-Min; Linet, Martha; Palmer, Julie; Petrick, Jessica L.; Poynter, Jenny N.; Purdue, Mark; Robien, Kim; Rosenberg, Lynn; Sahasrabuddhe, Vikrant; Schairer, Catherine; Sesso, Howard D.; Sigurdson, Alice; Stevens, Victoria L.; Wactowski-Wende, Jean; Zeleniuch-Jacquotte, Anne; Renehan, Andrew G.; McGlynn, Katherine A.

    2016-01-01

    Incidence rates for liver cancer have increased threefold since the mid-1970s in the United States in parallel with increasing trends for obesity and type 2 diabetes mellitus (T2DM). We conducted an analysis of baseline body mass index (BMI), waist circumference (WC), and T2DM with risk of liver cancer. The Liver Cancer Pooling Project maintains harmonized data from 1.57 million adults enrolled in 14 U.S.-based prospective studies. Cox regression estimated hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, sex, study center, alcohol, smoking, race, and BMI (for WC and T2DM). Stratified analyses assessed whether the BMI-liver cancer associations differed by hepatitis sera-positivity in nested analyses for a subset of cases (n=220) and controls (n=547). After enrollment, 2,162 incident liver cancer diagnoses were identified. BMI, per 5 kg/m2, was associated with higher risks of liver cancer, more so for men (HR: 1.38; 95% CI: 1.30 to 1.46) than women (HR: 1.25; 95% CI: 1.17 to 1.35; p-interaction: 0.02). WC, per 5 cm, was associated with higher risks of liver cancer, approximately equally by sex (overall, HR: 1.08; 95% CI: 1.04 to 1.13). T2DM was associated with higher risk of liver cancer (HR: 2.61; 95% CI: 2.34 to 2.91). In stratified analyses, there was a null association between BMI and liver cancer risk for participants who were sera-positive for hepatitis. This study suggests that high BMI, high WC, and T2DM are associated with higher risks of liver cancer and that the association may differ by status of viral hepatitis infection. PMID:27742674

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

    Science.gov (United States)

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

    2014-04-01

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

  1. [Relationship between the risk of emergency cesarean section for nullipara with the prepregnancy body mass index or gestational weight gain].

    Science.gov (United States)

    Zhao, R F; Zhang, W Y; Zhou, L

    2017-11-25

    Objective: To investigate the risk of emergency cesarean section during labor with the pre-pregnancy body mass index or gestational weight gain. Methods: A total of 6 908 healthy nullipara with singleton pregnancy and cephalic presentation who was in term labor in Beijing Obstetrics and Gynecology Hospital from August 1(st), 2014 to September 30(th), 2015 were recruited. They were divided into two groups, the vaginal delivery group (92.88%, 6 416/6 908) and the emergency cesarean section group (7.12%, 492/6 908). According to WHO body mass index (BMI) classification criteria and the pre-pregnancy BMI, the 6 908 women were divided into three groups, the underweight group(BMIgain (GWG) group (16.72%, 1 155/6 908), the appropriate GWG group (43.11%, 2 978/6 908), the excessive GWG group (40.17%, 2 775/6 908). Unadjusted and adjusted odds ratio ( OR ) and confidence interval ( CI ) of the risk of emergency cesarean section were calculated by bivariate logistic regression. Results: (1) Comparing to the vaginal delivery group, women in the emergency cesarean section group were older, with a lower education level. Their prepregnancy BMI was higer and had more gestational weight gain. They had higher morbidity of pregnancy induced hypertension and gestational diabetes mellitus. Comparing to the vaginal delivery group, the neonates in the emergency cesarean section group were elder in gestational week, with higher birth weight. More male infants and large for gestation age infants were seen in the emergency cesarean section group (all P gain was associated with the increased risk of emergency cesarean section, (a OR= 1.03, 95% CI : 1.01-1.05). GWG above IOM giudelines did not independently affect the risk of emergency cesarean section ( OR= 1.30, 95% CI : 1.07-1.58; a OR= 1.01, 95% CI : 0.82-1.24). In the underweight group, the normal weight group and the overweight or obese group, the excessive GWG women and the appropriate GWG women had no significant difference in the

  2. Managing water utility financial risks through third-party index insurance contracts

    Science.gov (United States)

    Zeff, Harrison B.; Characklis, Gregory W.

    2013-08-01

    As developing new supply capacity has become increasingly expensive and difficult to permit (i.e., regulatory approval), utilities have become more reliant on temporary demand management programs, such as outdoor water use restrictions, for ensuring reliability during drought. However, a significant fraction of water utility income is often derived from the volumetric sale of water, and such restrictions can lead to substantial revenue losses. Given that many utilities set prices at levels commensurate with recovering costs, these revenue losses can leave them financially vulnerable to budgetary shortfalls. This work explores approaches for mitigating drought-related revenue losses through the use of third-party financial insurance contracts based on streamflow indices. Two different types of contracts are developed, and their efficacy is compared against two more traditional forms of financial hedging used by water utilities: Drought surcharges and contingency funds (i.e., self-insurance). Strategies involving each of these approaches, as well as their use in combination, are applied under conditions facing the water utility serving Durham, North Carolina. A multireservoir model provides information on the scale and timing of droughts, and the financial effects of these events are simulated using detailed data derived from utility billing records. Results suggest that third-party index insurance contracts, either independently or in combination with more traditional hedging tools, can provide an effective means of reducing a utility's financial vulnerability to drought.

  3. The Cumulative Lifting Index (CULI) for the Revised NIOSH Lifting Equation: Quantifying Risk for Workers With Job Rotation.

    Science.gov (United States)

    Garg, Arun; Kapellusch, Jay M

    2016-08-01

    The objectives were to: (a) develop a continuous frequency multiplier (FM) for the Revised NIOSH Lifting Equation (RNLE) as a function of lifting frequency and duration of a lifting task, and (b) describe the Cumulative Lifting Index (CULI), a methodology for estimating physical exposure to workers with job rotation. The existing FM for the RNLE (FME) does not differentiate between task duration >2 hr and <8 hr, which makes quantifying physical exposure to workers with job rotation difficult and presents challenges to job designers. Using the existing FMs for 1, 2, and 8 hr of task durations, we developed a continuous FM (FMP) that extends to 12 hr per day. We simulated 157,500 jobs consisting of two tasks each and, using different combinations of Frequency Independent Lifting Index, lifting frequency and duration of lifting. Biomechanical stresses were estimated using the CULI, time-weighted average (TWA), and peak exposure. The median difference between FME and FMP was ±1% (range: 0%-15%). Compared to CULI, TWA underestimated risk of low-back pain (LBP) for 18% to 30% of jobs, and peak exposure for an assumed 8-hr work shift overestimated risk of LBP for 20% to 25% of jobs. Peak task exposure showed 90% agreement with CULI but ignored one of two tasks. The CULI partially addressed the underestimation of physical exposure using the TWA approach and overestimation of exposure using the peak-exposure approach. The proposed FM and CULI may provide more accurate physical exposure estimates, and therefore estimated risk of LBP, for workers with job rotation. © 2016, Human Factors and Ergonomics Society.

  4. Exploring the Potential of WorldView-2 Red-Edge Band-Based Vegetation Indices for Estimation of Mangrove Leaf Area Index with Machine Learning Algorithms

    Directory of Open Access Journals (Sweden)

    Yuanhui Zhu

    2017-10-01

    Full Text Available To accurately estimate leaf area index (LAI in mangrove areas, the selection of appropriate models and predictor variables is critical. However, there is a major challenge in quantifying and mapping LAI using multi-spectral sensors due to the saturation effects of traditional vegetation indices (VIs for mangrove forests. WorldView-2 (WV2 imagery has proven to be effective to estimate LAI of grasslands and forests, but the sensitivity of its vegetation indices (VIs has been uncertain for mangrove forests. Furthermore, the single model may exhibit certain randomness and instability in model calibration and estimation accuracy. Therefore, this study aims to explore the sensitivity of WV2 VIs for estimating mangrove LAI by comparing artificial neural network regression (ANNR, support vector regression (SVR and random forest regression (RFR. The results suggest that the RFR algorithm yields the best results (RMSE = 0.45, 14.55% of the average LAI, followed by ANNR (RMSE = 0.49, 16.04% of the average LAI, and then SVR (RMSE = 0.51, 16.56% of the average LAI algorithms using 5-fold cross validation (CV using all VIs. Quantification of the variable importance shows that the VIs derived from the red-edge band consistently remain the most important contributor to LAI estimation. When the red-edge band-derived VIs are removed from the models, estimation accuracies measured in relative RMSE (RMSEr decrease by 3.79%, 2.70% and 4.47% for ANNR, SVR and RFR models respectively. VIs derived from red-edge band also yield better accuracy compared with other traditional bands of WV2, such as near-infrared-1 and near-infrared-2 band. Furthermore, the estimated LAI values vary significantly across different mangrove species. The study demonstrates the utility of VIs of WV2 imagery and the selected machine-learning algorithms in developing LAI models in mangrove forests. The results indicate that the red-edge band of WV2 imagery can help alleviate the saturation

  5. Dealing with public perceptions of health risks in a nuclear world

    International Nuclear Information System (INIS)

    Friedman, R.S.

    1988-01-01

    An enormous gap exists between the perceptions within the scientific and technical community and the general public regarding health and safety risks associated with many technologies, especially nuclear power. Closing the gap in risk perception is not an easy matter. Studies demonstrate that disagreements about risks will not simply evaporate in the face of expert testimony. Problem resolution demands education and public information programs that clarify scientific and policy dimensions of the problem. Emphasis must be placed on identification of the knowledgeable experts as well as on explanation of their findings. Attention, in particular, must be paid to expanding public understanding of the meaning of risk probabilities. Encouragement must be given to the development of a sophisticated cadre of media personnel to serve as a liaison between the scientific community and the public. Additionally, increased use should be made by public utilities in the nuclear business of scientific and lay advisory committees to serve as a bridge to a skeptical public. And finally, outreach programs should be established with schools, church groups, and civic organizations designed to upgrade knowledge and understanding of health risks in the generation of nuclear energy

  6. Leveraging the World Cup: Mega Sporting Events, Human Rights Risk, and Worker Welfare Reform in Qatar

    OpenAIRE

    Sarath Ganji

    2016-01-01

    Qatar will realize its decades-long drive to host a mega sporting event when, in 2022, the opening ceremony of the Fédération Internationale de Football Association (FIFA) World Cup commences. By that time, the Qatari government will have invested at least $200 billion in real estate and development projects, employing anywhere between 500,000 and 1.5 million foreign workers to do so. The scale of these preparations is staggering — and not necessarily positive. Between 2010 and 2013, more tha...

  7. Adjustments of the Pesticide Risk Index Used in Environmental Policy in Flanders.

    Science.gov (United States)

    Fevery, Davina; Peeters, Bob; Lenders, Sonia; Spanoghe, Pieter

    2015-01-01

    Indicators are used to quantify the pressure of pesticides on the environment. Pesticide risk indicators typically require weighting environmental exposure by a no effect concentration. An indicator based on spread equivalents (ΣSeq) is used in environmental policy in Flanders (Belgium). The pesticide risk for aquatic life is estimated by weighting active ingredient usage by the ratio of their maximum allowable concentration and their soil halflife. Accurate estimates of total pesticide usage in the region are essential in such calculations. Up to 2012, the environmental impact of pesticides was estimated on sales figures provided by the Federal Government. Since 2013, pesticide use is calculated based on results from the Farm Accountancy Data Network (FADN). The estimation of pesticide use was supplemented with data for non-agricultural use based on sales figures of amateur use provided by industry and data obtained from public services. The Seq-indicator was modified to better reflect reality. This method was applied for the period 2009-2012 and showed differences between estimated use and sales figures of pesticides. The estimated use of pesticides based on accountancy data is more accurate compared to sales figures. This approach resulted in a better view on pesticide use and its respective environmental impact in Flanders.

  8. Adjustments of the Pesticide Risk Index Used in Environmental Policy in Flanders.

    Directory of Open Access Journals (Sweden)

    Davina Fevery

    Full Text Available Indicators are used to quantify the pressure of pesticides on the environment. Pesticide risk indicators typically require weighting environmental exposure by a no effect concentration. An indicator based on spread equivalents (ΣSeq is used in environmental policy in Flanders (Belgium. The pesticide risk for aquatic life is estimated by weighting active ingredient usage by the ratio of their maximum allowable concentration and their soil halflife. Accurate estimates of total pesticide usage in the region are essential in such calculations. Up to 2012, the environmental impact of pesticides was estimated on sales figures provided by the Federal Government. Since 2013, pesticide use is calculated based on results from the Farm Accountancy Data Network (FADN. The estimation of pesticide use was supplemented with data for non-agricultural use based on sales figures of amateur use provided by industry and data obtained from public services. The Seq-indicator was modified to better reflect reality. This method was applied for the period 2009-2012 and showed differences between estimated use and sales figures of pesticides. The estimated use of pesticides based on accountancy data is more accurate compared to sales figures. This approach resulted in a better view on pesticide use and its respective environmental impact in Flanders.

  9. Predictors of public climate change awareness and risk perception around the world

    Science.gov (United States)

    Lee, Tien Ming; Markowitz, Ezra M.; Howe, Peter D.; Ko, Chia-Ying; Leiserowitz, Anthony A.

    2015-11-01

    Climate change is a threat to human societies and natural ecosystems, yet public opinion research finds that public awareness and concern vary greatly. Here, using an unprecedented survey of 119 countries, we determine the relative influence of socio-demographic characteristics, geography, perceived well-being, and beliefs on public climate change awareness and risk perceptions at national scales. Worldwide, educational attainment is the single strongest predictor of climate change awareness. Understanding the anthropogenic cause of climate change is the strongest predictor of climate change risk perceptions, particularly in Latin America and Europe, whereas perception of local temperature change is the strongest predictor in many African and Asian countries. However, other key factors associated with public awareness and risk perceptions highlight the need to develop tailored climate communication strategies for individual nations. The results suggest that improving basic education, climate literacy, and public understanding of the local dimensions of climate change are vital to public engagement and support for climate action.

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

    Science.gov (United States)

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

    2011-01-01

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

  11. Association of a body mass index genetic risk score with growth throughout childhood and adolescence.

    Directory of Open Access Journals (Sweden)

    Nicole M Warrington

    Full Text Available While the number of established genetic variants associated with adult body mass index (BMI is growing, the relationships between these variants and growth during childhood are yet to be fully characterised. We examined the association between validated adult BMI associated single nucleotide polymorphisms (SNPs and growth trajectories across childhood. We investigated the timing of onset of the genetic effect and whether it was sex specific.Children from the ALSPAC and Raine birth cohorts were used for analysis (n = 9,328. Genotype data from 32 adult BMI associated SNPs were investigated individually and as an allelic score. Linear mixed effects models with smoothing splines were used for longitudinal modelling of the growth parameters and measures of adiposity peak and rebound were derived.The allelic score was associated with BMI growth throughout childhood, explaining 0.58% of the total variance in BMI in females and 0.44% in males. The allelic score was associated with higher BMI at the adiposity peak (females  =  0.0163 kg/m(2 per allele, males  =  0.0123 kg/m(2 per allele and earlier age (-0.0362 years per allele in males and females and higher BMI (0.0332 kg/m(2 per allele in females and 0.0364 kg/m(2 per allele in males at the adiposity rebound. No gene:sex interactions were detected for BMI growth.This study suggests that known adult genetic determinants of BMI have observable effects on growth from early childhood, and is consistent with the hypothesis that genetic determinants of adult susceptibility to obesity act from early childhood and develop over the life course.

  12. Piloting a 'spatial isolation' index: the built environment and sexual and drug use risks to sex workers.

    Science.gov (United States)

    Deering, Kathleen N; Rusch, Melanie; Amram, Ofer; Chettiar, Jill; Nguyen, Paul; Feng, Cindy X; Shannon, Kate

    2014-05-01

    Employing innovative mapping and spatial analyses of individual and neighbourhood environment data, we examined the social, physical and structural features of overlapping street-based sex work and drug scenes and explored the utility of a 'spatial isolation index' in explaining exchanging sex for drugs and exchanging sex while high. Analyses drew on baseline interview and geographic data (January 2010-October 2011) from a large prospective cohort of street and off-street sex workers (SWs) in Metropolitan Vancouver and external publically-available, neighbourhood environment data. An index measuring 'spatial isolation' was developed from seven indicators measuring features of the built environment within 50m buffers (e.g., industrial or commercial zoning, lighting) surrounding sex work environments. Bivariate and multivariable logistic regression was used to examine associations between the two outcomes (exchanged sex for drugs; exchanged sex while high) and the index, as well as each individual indicator. Of 510 SWs, 328 worked in street-based/outdoor environments (e.g., streets, parks, alleys) and were included in the analyses. In multivariable analysis, increased spatial isolation surrounding street-based/outdoor SWs' main places of servicing clients as measured with the index was significantly associated with exchanging sex for drugs. Exchanging sex for drugs was also significantly positively associated with an indicator of the built environment suggesting greater spatial isolation (increased percent of parks) and negatively associated with those suggesting decreased spatial isolation (increased percent commercial areas, increased count of lighting, increased building footprint). Exchanging sex while high was negatively associated with increased percent of commercial zones but this association was removed when adjusting for police harassment. The results from our exploratory study highlight how built environment shapes risks within overlapping street-based sex

  13. SU-E-T-316: The Design of a Risk Index Method for 3D Patient Specific QA

    Energy Technology Data Exchange (ETDEWEB)

    Cho, W; Wu, H [Seoul National University Hospital, Seoul (Korea, Republic of); Xing, L [Stanford University, Stanford, CA (United States); Suh, T [Catholic UniversityMedical College, Seoul (Korea, Republic of)

    2014-06-01

    Purpose: To suggest a new guidance for the evaluation of 3D patient specific QA, a structure-specific risk-index (RI) method was designed and implemented. Methods: A new algorithm was designed to assign the score of Pass, Fail or Pass with Risk to all 3D voxels in each structure by improving a conventional Gamma Index (GI) algorithm, which implied the degree of the risk of under-dose to the treatment target or over-dose to the organ at risks (OAR). Structure-specific distance to agreement (DTOA), dose difference and minimum checkable dose were applied to the GI algorithm, and additional parameters such as dose gradient factor and dose limit of structures were used to the RI method. Maximum passing rate (PR) and minimum PR were designed and calculated for each structure with the RI method. 3D doses were acquired from a spine SBRT plan by simulating the shift of beam iso-center, and tested to show the feasibility of the suggested method. Results: When the iso-center was shifted by 1 mm, 2 mm, and 3 mm, the PR of conventional GI method between shifted and non-shifted 3D doses were 99.9%, 97.4%, and 89.7% for PTV, 99.8%, 84.8%, and 63.2% for spinal cord, and 100%, 99.5%, 91.7% for right lung. The minimum PRs from the RI method were 98.9%, 96.9%, and 89.5% for PTV, and 96.1%, 79.3%, 57.5% for spinal cord, and 92.5%, 92.0%, 84.4% for right lung, respectively. The maximum PRs from the RI method were equal or less than the PRs from the conventional GI evaluation. Conclusion: Designed 3D RI method showed more strict acceptance level than the conventional GI method, especially for OARs. The RI method is expected to give the degrees of risks in the delivered doses, as well as the degrees of agreements between calculated 3D doses and measured (or simulated) 3D doses.

  14. SU-E-T-316: The Design of a Risk Index Method for 3D Patient Specific QA

    International Nuclear Information System (INIS)

    Cho, W; Wu, H; Xing, L; Suh, T

    2014-01-01

    Purpose: To suggest a new guidance for the evaluation of 3D patient specific QA, a structure-specific risk-index (RI) method was designed and implemented. Methods: A new algorithm was designed to assign the score of Pass, Fail or Pass with Risk to all 3D voxels in each structure by improving a conventional Gamma Index (GI) algorithm, which implied the degree of the risk of under-dose to the treatment target or over-dose to the organ at risks (OAR). Structure-specific distance to agreement (DTOA), dose difference and minimum checkable dose were applied to the GI algorithm, and additional parameters such as dose gradient factor and dose limit of structures were used to the RI method. Maximum passing rate (PR) and minimum PR were designed and calculated for each structure with the RI method. 3D doses were acquired from a spine SBRT plan by simulating the shift of beam iso-center, and tested to show the feasibility of the suggested method. Results: When the iso-center was shifted by 1 mm, 2 mm, and 3 mm, the PR of conventional GI method between shifted and non-shifted 3D doses were 99.9%, 97.4%, and 89.7% for PTV, 99.8%, 84.8%, and 63.2% for spinal cord, and 100%, 99.5%, 91.7% for right lung. The minimum PRs from the RI method were 98.9%, 96.9%, and 89.5% for PTV, and 96.1%, 79.3%, 57.5% for spinal cord, and 92.5%, 92.0%, 84.4% for right lung, respectively. The maximum PRs from the RI method were equal or less than the PRs from the conventional GI evaluation. Conclusion: Designed 3D RI method showed more strict acceptance level than the conventional GI method, especially for OARs. The RI method is expected to give the degrees of risks in the delivered doses, as well as the degrees of agreements between calculated 3D doses and measured (or simulated) 3D doses

  15. The Role of Age and Excess Body Mass Index in Progression to Type 1 Diabetes in At-Risk Adults.

    Science.gov (United States)

    Ferrara, Christine T; Geyer, Susan M; Evans-Molina, Carmella; Libman, Ingrid M; Becker, Dorothy J; Wentworth, John M; Moran, Antoinette; Gitelman, Stephen E; Redondo, Maria J

    2017-12-01

    Given the global rise in both type 1 diabetes incidence and obesity, the role of body mass index (BMI) on type 1 diabetes pathophysiology has gained great interest. Sustained excess BMI in pediatric participants of the TrialNet Pathway to Prevention (PTP) cohort increased risk for progression to type 1 diabetes, but the effects of age and obesity in adults remain largely unknown. To determine the effect of age and sustained obesity on the risk for type 1 diabetes in adult participants in the TrialNet PTP cohort (i.e., nondiabetic autoantibody-positive relatives of patients with type 1 diabetes). Longitudinally accumulated BMI >25 kg/m2 was calculated to generate a cumulative excess BMI (ceBMI) for each participant, with ceBMI values ≥0 kg/m2 and ≥5 kg/m2 representing sustained overweight or obese status, respectively. Recursive partitioning analysis yielded sex- and age-specific thresholds for ceBMI that confer the greatest risk for type 1 diabetes progression. In this cohort of 665 adults (age 20 to 50 years; median follow-up, 3.9 years), 49 participants developed type 1 diabetes. Age was an independent protective factor for type 1 diabetes progression (hazard ratio, 0.95; P = 0.008), with a threshold of >35 years that reduced risk for type 1 diabetes. In men age >35 years and women age <35 years, sustained obesity (ceBMI ≥5 kg/m2) increased the risk for type 1 diabetes. Age is an important factor for type 1 diabetes progression in adults and influences the impact of elevated BMI, indicating an interplay of excess weight, age, and sex in adult type 1 diabetes pathophysiology. Copyright © 2017 Endocrine Society

  16. The Strain Index and ACGIH TLV for HAL: risk of trigger digit in the WISTAH prospective cohort.

    Science.gov (United States)

    Kapellusch, Jay M; Garg, Arun; Hegmann, Kurt T; Thiese, Matthew S; Malloy, Elizabeth J

    2014-02-01

    The objective of this study was to investigate the association between job physical exposure (JPE) and incidence of flexor tendon entrapment of the digits (FTED). FTED, commonly known as trigger digit, is associated with age, gender, and certain health disorders. Although JPE has been suggested as a risk factor for FTED, there are no prospective cohort studies. A cohort of 516 workers was enrolled from 10 diverse manufacturing facilities and followed monthly for 6 years. Worker demographics, medical history, and symptoms of FTED were assessed. JPE was individually measured using the Strain Index (SI) and American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV for HAL). Changes in JPE (assessed quarterly) and symptoms (assessed monthly) were recorded during follow-up. FTED was defined as demonstrated triggering on examination. Point prevalence of FTED at baseline was 3.6%. During follow-up there were 23 incident FTED cases (left and/or right hands). The incident rate for first occurrence of FTED from enrollment was 1.38 per 100 person-years. Risk factors were JPE, age, gender, diabetes mellitus, carpometacarpal osteoarthrosis, and rheumatoid arthritis. In multivariate models, the SI showed strong association with risk of FTED when treated as a continuous variable and marginal association when dichotomized (SI > 6.1). TLV for HAL showed a statistical trend of increasing risk of FTED using the ACGIH limits, but no association as a continuous variable. Both JPE and personal risk factors are associated with FTED development. The SI and TLV for HAL are useful tools for estimating JPE.

  17. The relation between ankle-brachial index (ABI and coronary artery disease severity and risk factors: an angiographic study

    Directory of Open Access Journals (Sweden)

    Masoumeh Sadeghi

    2011-07-01

    .Keywords: Ankle–Brachial Index, Angiography, Atherosclerotic Risk Factors.

  18. Risk estimates of stochastic effects due to exposure to radiation - a stochastic harm index

    International Nuclear Information System (INIS)

    Gonen, Y.G.

    1980-01-01

    The effects of exposure to low level radiation on the survival probability and life expectancy were investigated. The 1977 vital statistics of Jewish males in Israel were used as a baseline, mainly the data on normalized survival probability and life expectation as functions of age. Assumed effects of exposure were superposed on these data and the net differences calculated. It was found that the realistic rate effects of exposure to radiation are generally less than calculated by multiplying the collective dose by the risk factor. The effects are strongly age-dependent, decreasing sharply with age at exposure. The assumed harm due to exposure can be more than offset by improvements in medical care and safety. (H.K.)

  19. Trends in flood risk management in deltas around the world: Are we going ‘soft’?

    NARCIS (Netherlands)

    Wesselink, A.; Warner, J.F.; Syed, M.A.; Chan, F.; Tran, D.D.; Huq, H.; Huthoff, F.; Thuy, Le N.; Pinter, N.; Staveren, van M.F.; Wester, P.; Zegwaard, A.

    2015-01-01

    Flood-risk management (FRM) is shaped by context: a society’s cultural background; physical possibilities and constraints; and the historical development of that society’s economy, politi- cal system, education, etc. These provide different drivers for change, in interaction with more global

  20. An index-based method to assess risks of climate-related hazards in coastal zones: The case of Tetouan

    Science.gov (United States)

    Satta, Alessio; Snoussi, Maria; Puddu, Manuela; Flayou, Latifa; Hout, Radouane

    2016-06-01

    The regional risk assessment carried out within the ClimVar & ICZM Project identified the coastal zone of Tetouan as a hotspot of the Mediterranean Moroccan coast and so it was chosen for the application of the Multi-Scale Coastal Risk Index for Local Scale (CRI-LS). The local scale approach provides a useful tool for local coastal planning and management by exploring the effects and the extensions of the hazards and combining hazard, vulnerability and exposure variables in order to identify areas where the risk is relatively high. The coast of Tetouan is one of the coastal areas that have been most rapidly and densely urbanized in Morocco and it is characterized by an erosive shoreline. Local authorities are facing the complex task of balancing development and managing coastal risks, especially coastal erosion and flooding, and then be prepared to the unavoidable impacts of climate change. The first phase of the application of the CRI-LS methodology to Tetouan consisted of defining the coastal hazard zone, which results from the overlaying of the erosion hazard zone and the flooding hazard zone. Nineteen variables were chosen to describe the Hazards, Vulnerability and Exposure factors. The scores corresponding to each variable were calculated and the weights assigned through an expert judgement elicitation. The resulting values are hosted in a geographic information system (GIS) platform that enables the individual variables and aggregated risk scores to be color-coded and mapped across the coastal hazard zone. The results indicated that 10% and 27% of investigated littoral fall under respectively very high and high vulnerability because of combination of high erosion rates with high capital land use. The risk map showed that some areas, especially the flood plains of Restinga, Smir and Martil-Alila, with distances over 5 km from the coast, are characterized by high levels of risk due to the low topography of the flood plains and to the high values of exposure

  1. Childhood body mass index in relation to subsequent risk of type 1 diabetes-A Danish cohort study

    DEFF Research Database (Denmark)

    Antvorskov, Julie C; Aunsholt, Lise; Buschard, Karsten

    2018-01-01

    . The study included 238 cases and 10 147 controls selected from the Copenhagen School Health Record Register (CSHRR). Cases of T1D were identified in the Danish Registry of Childhood and Adolescent Diabetes and 2 regional studies and linked to CSHRR. Using conditional logistic regression models......The incidence of type 1 diabetes (T1D) is increasing, and obesity may be a contributing factor by increasing the risk and accelerating the onset. We investigated the relation between childhood body mass index z-scores (BMIz) and the later risk of T1D, including association with age at onset of T1D...... BMIz at 7 and 13 years of age and the age of onset (P = .34 and P = .42, respectively). Increased BMIz is associated with a moderate increase in risk of T1D, but with no relation to age at onset within the analyzed age range. Increased BMIz over time is unlikely to explain the rising incidence of T1D....

  2. An empirical evaluation of Value-at-Risk: The case of the Belgrade Stock Exchange index - BELEX15

    Directory of Open Access Journals (Sweden)

    Đaković Vladimir

    2012-03-01

    Full Text Available The subject of the research is to test and analyze VaR (Value-at-Risk methods of market risk management on the financial market of the Republic of Serbia. Thus, concrete research is conducted in the period 2005 - 2011, with the goal of VaR methods performance assessment on the Serbian financial market. The tested VaR methods are Historical simulation (HS and Delta normal VaR with 95% and 99% confidence level for 50, 100, 200 and 250 days. BELEX15 stock index of the Belgrade Stock Exchange, which comprises of 15 most liquid securities of the Serbian financial market, is used as a benchmark indicator of the conditions on the Serbian financial market. The goals which are intended for achieving in the research are focused to Historical simulation (HS and Delta normal VaR performance assessment on, according to many criteria, 'specific'-transitory financial market of the Republic of Serbia. The basic goal of the research is to come to concrete, practically tested, knowledge about the possibility and performance of VaR methods application on the financial market of the Republic of Serbia in function of investment decisions optimizing. Research results point to the necessity of VaR methods application in market risk management on the financial market of the Republic of Serbia.

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

    Science.gov (United States)

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

    2015-04-01

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

  4. Genetically Predicted Body Mass Index and Breast Cancer Risk : Mendelian Randomization Analyses of Data from 145,000 Women of European Descent

    NARCIS (Netherlands)

    Guo, Yan; Warren Andersen, Shaneda; Shu, Xiao-Ou; Michailidou, Kyriaki; Bolla, Manjeet K; Wang, Qin; Garcia-Closas, Montserrat; Milne, Roger L; Schmidt, Marjanka K; Chang-Claude, Jenny; Dunning, Allison; Bojesen, Stig E; Ahsan, Habibul; Aittomäki, Kristiina; Andrulis, Irene L; Anton-Culver, Hoda; Arndt, Volker; Beckmann, Matthias W; Beeghly-Fadiel, Alicia; Benitez, Javier; Bogdanova, Natalia V; Bonanni, Bernardo; Børresen-Dale, Anne-Lise; Brand, Judith; Brauch, Hiltrud; Brenner, Hermann; Brüning, Thomas; Burwinkel, Barbara; Casey, Graham; Chenevix-Trench, Georgia; Couch, Fergus J; Cox, Angela; Cross, Simon S; Czene, Kamila; Devilee, Peter; Dörk, Thilo; Dumont, Martine; Fasching, Peter A; Figueroa, Jonine; Flesch-Janys, Dieter; Fletcher, Olivia; Flyger, Henrik; Fostira, Florentia; Gammon, Marilie; Giles, Graham G; Guénel, Pascal; Haiman, Christopher A; Hamann, Ute; Hooning, Maartje J; Hopper, John L; Jakubowska, Anna; Jasmine, Farzana; Jenkins, Mark; John, Esther M; Johnson, Nichola; Jones, Michael E; Kabisch, Maria; Kibriya, Muhammad; Knight, Julia A; Koppert, Linetta B; Kosma, Veli-Matti; Kristensen, Vessela; Le Marchand, Loic; Lee, Eunjung; Li, Jingmei; Lindblom, Annika; Luben, Robert; Lubinski, Jan; Malone, Kathi E; Mannermaa, Arto; Margolin, Sara; Marme, Frederik; McLean, Catriona; Meijers-Heijboer, Hanne; Meindl, Alfons; Neuhausen, Susan L; Nevanlinna, Heli; Neven, Patrick; Olson, Janet E; Perez, Jose I A; Perkins, Barbara; Peterlongo, Paolo; Phillips, Kelly-Anne; Pylkäs, Katri; Rudolph, Anja; Santella, Regina; Sawyer, Elinor J; Schmutzler, Rita K; Seynaeve, Caroline; Shah, Mitul; Shrubsole, Martha J; Southey, Melissa C; Swerdlow, Anthony J; Toland, Amanda E; Tomlinson, Ian; Torres, Diana; Truong, Thérèse; Ursin, Giske; Van Der Luijt, Rob B; Verhoef, Senno; Whittemore, Alice S; Winqvist, Robert; Zhao, Hui; Zhao, Shilin; Hall, Per; Simard, Jacques; Kraft, Peter; Pharoah, Paul; Hunter, David; Easton, Douglas F; Zheng, Wei

    BACKGROUND: Observational epidemiological studies have shown that high body mass index (BMI) is associated with a reduced risk of breast cancer in premenopausal women but an increased risk in postmenopausal women. It is unclear whether this association is mediated through shared genetic or

  5. Effects of a general practice-based intervention on diet, body mass index and blood lipids in patients at cardiovascular risk

    NARCIS (Netherlands)

    Woollard, J.; Burke, V.; Beilin, L.J.; Verheijden, M.W.; Bulsara, M.K.

    2003-01-01

    Background General practice-based health-promotion programmes implemented by nurse-counsellors may reduce cardiovascular risk factors, particularly in patients at increased risk. Neither change in fat intake nor serum cholesterol differed significantly between groups. Body mass index increased in

  6. GRI Index 2017

    OpenAIRE

    World Bank

    2017-01-01

    This World Bank GRI Index 2017 provides an overview of sustainability considerations within the World Bank’s lending and analytical services as well as its corporate activities. This index of sustainability indicators has been prepared in accordance with the internationally recognized standard for sustainability reporting, the GRI Standards: Core option (https://www.globalreporting.org). T...

  7. 2016 GRI Index

    OpenAIRE

    World Bank

    2016-01-01

    This 2016 World Bank Global Reporting Initiative (GRI) Index provides an overview of sustainability considerations within the World Bank’s lending and analytical services as well as its corporate activities. This index of sustainability indicators has been prepared in accordance with the internationally recognized standard for sustainability reporting GRI guidelines (https://www.globalrepo...

  8. Long-term bleeding risk prediction in 'real world' patients with atrial fibrillation: Comparison of the HAS-BLED and ABC-Bleeding risk scores. The Murcia Atrial Fibrillation Project.

    Science.gov (United States)

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

    2017-10-05

    Risk scores in patients with atrial fibrillation (AF) based on clinical factors alone generally have only modest predictive value for predicting high risk patients that sustain events. Biomarkers might be an attractive prognostic tool to improve bleeding risk prediction. The new ABC-Bleeding score performed better than HAS-BLED score in a clinical trial cohort but has not been externally validated. The aim of this study was to analyze the predictive performance of the ABC-Bleeding score compared to HAS-BLED score in an independent "real-world" anticoagulated AF patients with long-term follow-up. We enrolled 1,120 patients stable on vitamin K antagonist treatment. The HAS-BLED and ABC-Bleeding scores were quantified. Predictive values were compared by c-indexes, IDI, NRI, as well as decision curve analysis (DCA). Median HAS-BLED score was 2 (IQR 2-3) and median ABC-Bleeding was 16.5 (IQR 14.3-18.6). After 6.5 years of follow-up, 207 (2.84 %/year) patients had major bleeding events, of which 65 (0.89 %/year) had intracranial haemorrhage (ICH) and 85 (1.17 %/year) had gastrointestinal bleeding events (GIB). The c-index of HAS-BLED was significantly higher than ABC-Bleeding for major bleeding (0.583 vs 0.518; p=0.025), GIB (0.596 vs 0.519; p=0.017) and for the composite of ICH-GIB (0.593 vs 0.527; p=0.030). NRI showed a significant negative reclassification for major bleeding and for the composite of ICH-GIB with the ABC-Bleeding score compared to HAS-BLED. Using DCAs, the use of HAS-BLED score gave an approximate net benefit of 4 % over the ABC-Bleeding score. In conclusion, in the first "real-world" validation of the ABC-Bleeding score, HAS-BLED performed significantly better than the ABC-Bleeding score in predicting major bleeding, GIB and the composite of GIB and ICH.

  9. Advanced atherogenic index for the assessment of consolidated lipid risk in premature coronary artery disease patients in India

    Directory of Open Access Journals (Sweden)

    Sanjiv Kumar Bansal

    2016-01-01

    Full Text Available Introduction: The high prevalence, severity, and prematurity of coronary artery disease (CAD in the Indian population cannot be completely explained by the conventional lipid parameters and the existing lipid indices. Aims and Objectives: To calculate newly defined advanced atherogenic index (AAI in premature CAD patients and compare it between cases and controls and Correlate its values with the existing indices. Material and Methods: One hundred and twenty premature CAD patients and an equal number of age and sex matched healthy individuals were included in this study. Lipid profile and nonconventional lipid parameters like oxidized Low density lipoprotein (OX LDL, small dense LDL (SD LDL, lipoprotein (a apolipoprotein B (Apo B, and apolipoprotein A1 (Apo A1 were estimated and their values were used to define AAI and existing lipid indices like AI, lipid tetrad index (LTI and lipid pentad index (LPI. Results: The mean age of cases and controls was 37.29 + 4.50 and 36.13 + 3.53 years, respectively. The value of AAI was highly significant in cases (3461.22 ± 45.20 as compared to controls (305.84 ± 21.80. AAI has shown better statistical significance and correlation (P < 0.0001, r = 0.737 as compared to the earlier indices such as AI (P < 0.01, r = 0.52, LTI (P < 0.001, r = 0.677 and LPI (P < 0.001, r = 0.622 in premature CAD. Kolmogorov D statistic and cumulative distribution function plot has shown that AAI can discriminate cases and controls more accurately as compared to the earlier indices. Conclusion: Statistically AAI appears to be a better marker of consolidated lipid risk in premature CAD patients as compared to the earlier indices.

  10. Leveraging the World Cup: Mega Sporting Events, Human Rights Risk, and Worker Welfare Reform in Qatar

    Directory of Open Access Journals (Sweden)

    Sarath Ganji

    2016-12-01

    Full Text Available Qatar will realize its decades-long drive to host a mega sporting event when, in 2022, the opening ceremony of the Fédération Internationale de Football Association (FIFA World Cup commences. By that time, the Qatari government will have invested at least $200 billion in real estate and development projects, employing anywhere between 500,000 and 1.5 million foreign workers to do so. The scale of these preparations is staggering — and not necessarily positive. Between 2010 and 2013, more than 1,200 labor migrants working in Qatar’s construction sector died, with another 4,000 deaths projected by the start of the event. Foreign workers are subject to conditions of forced labor, human trafficking, and indefinite detention. Advocacy groups cite deplorable living and working conditions, coupled with lax legal protections for workers, as the main culprits. Absent significant improvements in worker welfare, Qatar’s World Cup will be remembered as a human rights tragedy.This article examines whether it is possible for Qatar’s World Cup to forge a different legacy, as an agent of change on behalf of worker welfare reform. In examining the issue, the article takes a two-fold approach. First, it locates the policy problem of worker welfare abuses in the context of the migration life cycle. The migration life cycle represents the range of activities that mediate the relationship between an individual migrant and the labor migration system — from the time the migrant first considers working overseas to his employment abroad to his eventual return to the home country. An understanding of worker welfare abuses in Qatar does not begin or end with reports of migrant deaths. A much broader pattern of abuse exists that, if ignored, will undermine effective policy responses.Second, the article frames worker welfare as a matter that lies at the intersection of business and human rights. Mega events are large-scale, internationally recognized activities

  11. The Use of Remotely Sensed Rainfall for Managing Drought Risk: A Case Study of Weather Index Insurance in Zambia

    Directory of Open Access Journals (Sweden)

    Emily Black

    2016-04-01

    Full Text Available Remotely sensed rainfall is increasingly being used to manage climate-related risk in gauge sparse regions. Applications based on such data must make maximal use of the skill of the methodology in order to avoid doing harm by providing misleading information. This is especially challenging in regions, such as Africa, which lack gauge data for validation. In this study, we show how calibrated ensembles of equally likely rainfall can be used to infer uncertainty in remotely sensed rainfall estimates, and subsequently in assessment of drought. We illustrate the methodology through a case study of weather index insurance (WII in Zambia. Unlike traditional insurance, which compensates proven agricultural losses, WII pays out in the event that a weather index is breached. As remotely sensed rainfall is used to extend WII schemes to large numbers of farmers, it is crucial to ensure that the indices being insured are skillful representations of local environmental conditions. In our study we drive a land surface model with rainfall ensembles, in order to demonstrate how aggregation of rainfall estimates in space and time results in a clearer link with soil moisture, and hence a truer representation of agricultural drought. Although our study focuses on agricultural insurance, the methodological principles for application design are widely applicable in Africa and elsewhere.

  12. Risk of malignancy index used as a diagnostic tool in a tertiary centre for patients with a pelvic mass

    DEFF Research Database (Denmark)

    Håkansson, Fanny; Høgdall, Estrid V S; Nedergaard, Lotte

    2012-01-01

    Abstract Objective. Risk of malignancy index (RMI), based on a serum cancer antigen 125 level, ultrasound findings and menopausal status, is used to discriminate ovarian cancer from benign pelvic mass. In Denmark, patients with pelvic mass and RMI =200 are referred to tertiary gynecologic oncology...... the use of RMI =200 as a tool for preoperative identification of ovarian cancer at a tertiary center. Design. Prospective observational study. Setting. A tertiary center in Copenhagen, Denmark. Population. One thousand one hundred and fifty-nine women with pelvic mass. Methods. The RMI was calculated...... pelvic mass. Results. There were 778 women diagnosed with benign pelvic mass, while 251 had ovarian cancer and 74 had borderline ovarian tumor. Fifty-six women were diagnosed with other forms of cancer. Sensitivity and specificity for ovarian cancer vs. benign pelvic mass for RMI =200 were 92 and 82...

  13. Constructing the Suicide Risk Index (SRI): does it work in predicting suicidal behavior in young adults mediated by proximal factors?

    Science.gov (United States)

    O'Connor, Maebh; Dooley, Barbara; Fitzgerald, Amanda

    2015-01-01

    Suicide is a key concern among young adults. The aim of the study was to (1) construct a suicide risk index (SRI) based on demographic, situational, and behavioral factors known to be linked to suicidal behavior and (2) investigate whether the association between the SRI and suicidal behavior was mediated by proximal processes (personal factors, coping strategies, and emotional states). Participants consisted of 7,558 individuals aged 17-25 years (M = 20.35, SD = 1.91). Nearly 22% (n = 1,542) reported self-harm and 7% (n = 499) had attempted suicide. Mediation analysis revealed both a direct effect (ß = .299, 95% CI = [.281, .317], p suicidal behavior. The strongest mediators were levels of self-esteem, depression, and avoidant coping. Interventions to increase self-esteem, reduce depression, and encourage adaptive coping strategies may prevent suicidal behavior in young people.

  14. Banding the World Together; The Global Growth of Control Banding and Qualitative Occupational Risk Management

    OpenAIRE

    Zalk, David M; Heussen, Ga Henri

    2011-01-01

    Control Banding (CB) strategies to prevent work-related illness and injury for 2.5 billion workers without access to health and safety professionals has grown exponentially this last decade. CB originates from the pharmaceutical industry to control active pharmaceutical ingredients without a complete toxicological basis and therefore no occupational exposure limits. CB applications have broadened into chemicals in general - including new emerging risks like nanomaterials and recently into erg...

  15. [The real-world effectiveness of personal protective equipment and additional risks for workers' health].

    Science.gov (United States)

    Denisov, É I; Morozova, T V; Adeninskaia, E E; Kur'erov, N N

    2013-01-01

    The effectiveness of personal protective equipment (PPE) of hearing, respiratory organs and hands is considered. It is shown that real effect of PPE is twice lower than declared by supplier; this presumes some derating system. The aspects of discomfort and additional risks are analyzed. The hygienic and physiologic evaluation of PPE is required along with elaboration of an official document (OSH standard or sanitary regulation) on selection, personal fit, organization of use and individual training of workers and their motivation.

  16. A World at Risk: Aggregating Development Trends to Forecast Global Habitat Conversion

    Science.gov (United States)

    Oakleaf, James R.; Kennedy, Christina M.; Baruch-Mordo, Sharon; West, Paul C.; Gerber, James S.; Jarvis, Larissa; Kiesecker, Joseph

    2015-01-01

    A growing and more affluent human population is expected to increase the demand for resources and to accelerate habitat modification, but by how much and where remains unknown. Here we project and aggregate global spatial patterns of expected urban and agricultural expansion, conventional and unconventional oil and gas, coal, solar, wind, biofuels and mining development. Cumulatively, these threats place at risk 20% of the remaining global natural lands (19.68 million km2) and could result in half of the world’s biomes becoming >50% converted while doubling and tripling the extent of land converted in South America and Africa, respectively. Regionally, substantial shifts in land conversion could occur in Southern and Western South America, Central and Eastern Africa, and the Central Rocky Mountains of North America. With only 5% of the Earth’s at-risk natural lands under strict legal protection, estimating and proactively mitigating multi-sector development risk is critical for curtailing the further substantial loss of nature. PMID:26445282

  17. A Real-World Community Health Worker Care Coordination Model for High-Risk Children.

    Science.gov (United States)

    Martin, Molly A; Perry-Bell, Kenita; Minier, Mark; Glassgow, Anne Elizabeth; Van Voorhees, Benjamin W

    2018-04-01

    Health care systems across the United States are considering community health worker (CHW) services for high-risk patients, despite limited data on how to build and sustain effective CHW programs. We describe the process of providing CHW services to 5,289 at-risk patients within a state-run health system. The program includes 30 CHWs, six care coordinators, the Director of Care Coordination, the Medical Director, a registered nurse, mental health specialists, and legal specialists. CHWs are organized into geographic and specialized teams. All CHWs receive basic training that includes oral and mental health; some receive additional disease-specific training. CHWs develop individualized care coordination plans with patients. The implementation of these plans involves delivery of a wide range of social service and coordination support. The number of CHW contacts is determined by patient risk. CHWs spend about 60% of their time in an office setting. To deliver the program optimally, we had to develop multiple CHW job categories that allow for CHW specialization. We created new technology systems to manage operations. Field issues resulted in program changes to improve service delivery and ensure safety. Our experience serves as a model for how to integrate CHWs into clinical and community systems.

  18. [Risk factors of venous thromboembolism recurrence and the predictive value of simplified pulmonary embolism severity index in medical inpatients].

    Science.gov (United States)

    Shi, C L; Zhou, H X; Tang, Y J; Wang, L; Yi, Q; Liang, Z A

    2016-04-12

    To explore the risk factors of venous thromboembolism (VTE) recurrence and the predictive value of simplified pulmonary embolism severity index (sPESI) in medical inpatients. A total of 149 consecutive patients with first diagnosed VTE from the medical departments of West China Hospital of Sichuan University from January 2011 and December 2012 were enrolled and followed-up for 24 months. The VTE recurrence rate was calculated and univariate and multivariate cox proportional hazards regression analysis were performed to identify the risk factors associated with VTE recurrence. All the patients were evaluated by sPESI, and survival analysis was used to explore its value in predicting VTE recurrence in these medical patients. Out of the included 149 patients, 23(15.4%) patients had VTE recurrence during the 2 years' follow-up and median recurrence time was 167 days. The univariate analysis showed bed rest, severe lung disease, nephrotic syndrome, inappropriate anticoagulant therapy, smoking, diabetes, and malignant neoplasm might be associated with VTE recurrence (P=0.043, 0.006, 0.009, 0.032, 0.098, 0.048, 0.021). Among these risk factors, the multivariate analysis revealed severe lung disease, nephrotic syndrome, and malignant neoplasm were the independent risk factors (HR=3.45, 5.67, 3.60; P=0.020, 0.020, 0.047); while for inappropriate anticoagulant therapy, the P value was marginal (HR=3.94, 95% CI: 0.99-15.63, P=0.051). The median sPESI scores of the patients with VTE recurrence was higher than that of the patients without VTE recurrence[1(1, 2) vs 0(0, 1), P=0.001], and patients with sPESI≥1 were associated with 5.57-fold increased risk of VTE recurrence compared with patients with sPESI=0 (95%CI: 1.79-17.30, P=0.001). Survival analysis also showed that the 2-year cumulative VTE recurrence rate of patients with sPESI≥1 was significant higher than that of patients with sPESI=0 (38.4% vs 5.7%, P=0.001). The medical VTE patients have high VTE recurrence risk

  19. Evaluating the effectiveness of risk minimisation measures: the application of a conceptual framework to Danish real-world dabigatran data.

    Science.gov (United States)

    Nyeland, Martin Erik; Laursen, Mona Vestergaard; Callréus, Torbjörn

    2017-06-01

    For both marketing authorization holders and regulatory authorities, evaluating the effectiveness of risk minimization measures is now an integral part of pharmacovigilance in the European Union. The overall aim of activities in this area is to assess the performance of risk minimization measures implemented in order to ensure a positive benefit-risk balance in patients treated with a medicinal product. Following a review of the relevant literature, we developed a conceptual framework consisting of four domains (data, knowledge, behaviour and outcomes) intended for the evaluation of risk minimization measures put into practice in the Danish health-care system. For the implementation of the framework, four classes of monitoring variables can be named and defined: patient descriptors, performance-related indicators of knowledge, behaviour and outcomes. We reviewed the features of the framework when applied to historical, real-world data following the introduction of dabigatran in Denmark for the prophylactic treatment of patients with non-valvular atrial fibrillation. The application of the framework provided useful graphical displays and an opportunity for a statistical evaluation (interrupted time series analysis) of a regulatory intervention. © 2017 Commonwealth of Australia. Pharmacoepidemiology & Drug Safety © 2017 John Wiley & Sons, Ltd. © 2017 Commonwealth of Australia. Pharmacoepidemiology & Drug Safety © 2017 John Wiley & Sons, Ltd.

  20. Prevalence of Borrelia burgdorferi sensu lato in Ixodes ricinus ticks and assessment of entomological risk index at localities in Belgrade

    Directory of Open Access Journals (Sweden)

    Krstić Milena

    2016-01-01

    Full Text Available Background/Aim. The first case of human Lyme borreliosis (LB in Serbia was recorded in 1987. The number of reported LB cases has increased in the past decade. The aim of this study was to estimate the density of Ixodes ricinus (I. ricinus ticks, the prevalence of Borrelia burgdorferi sensu lato (B. burgdorferi in them, and entomological risk index (ERI at 19 Belgrade localities which were grouped into three categories (forests, parkforests, parks. The values of ERI were compared with the number of tick bites in humans. Methods. Ticks were collected monthly by using the flag hours method and the infection rate was determined by using dark field microscopy. The ERI value was calculated for each locality where the ticks were collected. The related data about tick bites was obtained from the patient protocol of the Institute of Epidemiology, Military Medical Academy, Belgrade. Results. The total number of collected ticks, the number of nymphs and the infection rates of the nymphs were significantly higher in forests (p < 0.05 than park-forests and parks. Statistically, the ERI value was significantly higher in forests than parks of Belgrade (χ2 = 7.78, p < 0.01. In March and July, the ERI value was also significantly higher in forests, than park-forests (p < 0.01 and parks (p < 0.01. May was the month with the highest ERI value in each ecological category (forests p < 0.05; park-forests p < 0.01; parks p < 0.001. However, the number of tick bites in humans did not correlate with ERI values. Conclusion. The obtained results indicate that the risk of tick bite and human exposure to B. burgdorferi sensu lato is present at all selected localities in Belgrade. For a more comprehensive Lyme disease risk assessment the method of entomological risk index assessment should be combined with other methods, taking into consideration all tick stages and the behaviour and habits of people who may get infected B. burgdorferi sensu lato.

  1. Risks, prices, and positions: A social network analysis of illegal drug trafficking in the world-economy.

    Science.gov (United States)

    Boivin, Rémi

    2014-03-01

    Illegal drug prices are extremely high, compared to similar goods. There is, however, considerable variation in value depending on place, market level and type of drugs. A prominent framework for the study of illegal drugs is the "risks and prices" model (Reuter & Kleiman, 1986). Enforcement is seen as a "tax" added to the regular price. In this paper, it is argued that such economic models are not sufficient to explain price variations at country-level. Drug markets are analysed as global trade networks in which a country's position has an impact on various features, including illegal drug prices. This paper uses social network analysis (SNA) to explain price markups between pairs of countries involved in the trafficking of illegal drugs between 1998 and 2007. It aims to explore a simple question: why do prices increase between two countries? Using relational data from various international organizations, separate trade networks were built for cocaine, heroin and cannabis. Wholesale price markups are predicted with measures of supply, demand, risks of seizures, geographic distance and global positioning within the networks. Reported prices (in $US) and purchasing power parity-adjusted values are analysed. Drug prices increase more sharply when drugs are headed to countries where law enforcement imposes higher costs on traffickers. The position and role of a country in global drug markets are also closely associated with the value of drugs. Price markups are lower if the destination country is a transit to large potential markets. Furthermore, price markups for cocaine and heroin are more pronounced when drugs are exported to countries that are better positioned in the legitimate world-economy, suggesting that relations in legal and illegal markets are directed in opposite directions. Consistent with the world-system perspective, evidence is found of coherent world drug markets driven by both local realities and international relations. Copyright © 2013 Elsevier B

  2. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study.

    Science.gov (United States)

    Zhang, Ming; Wang, Bingyuan; Liu, Yu; Sun, Xizhuo; Luo, Xinping; Wang, Chongjian; Li, Linlin; Zhang, Lu; Ren, Yongcheng; Zhao, Yang; Zhou, Junmei; Han, Chengyi; Zhao, Jingzhi; Hu, Dongsheng

    2017-03-01

    Risk of type 2 diabetes mellitus (T2DM) is increased in metabolically obese but normal-weight people. However, we have limited knowledge of how to prevent T2DM in normal-weight people. We aimed to evaluate the association between triglyceride glucose (TyG) index and incident T2DM among normal-weight people in rural China. We included data from 5706 people with normal body mass index (BMI) (18.5-23.9 kg/m 2 ) without baseline T2DM in a rural Chinese cohort followed for a median of 6.0 years. A Cox proportional-hazard model was used to assess the risk of incident T2DM by quartiles of TyG index and difference in TyG index between follow-up and baseline (TyG-D), estimating hazard ratios (HRs) and 95% confidence intervals (CIs). A generalized additive plot was used to show the nonparametric smoothed exposure-response association between risk of T2DM and TyG index as a continuous variable. TyG was calculated as ln [fasting triglyceride level (mg/dl) × fasting plasma glucose level (mg/dl)/2]. Risk of incident T2DM was increased with quartiles 2, 3 and 4 versus quartile 1 of TyG index (adjusted HR [aHR] 2.48 [95% CI 1.20-5.11], 3.77 [1.83-7.79], and 5.30 [2.21-12.71], P trend  index). Risk of incident T2DM was increased with quartile 4 versus quartile 1 of TyG-D (aHR 3.91 [2.22-6.87]). The results were consistent when analyses were restricted to participants without baseline metabolic syndrome and impaired fasting glucose level. The generalized additive plot showed cumulative increased risk of T2DM with increasing TyG index. Risk of incident T2DM is increased with increasing TyG index among rural Chinese people, so the index might be an important indicator for identifying people at high risk of T2DM.

  3. Prevalence of cardiovascular risk factors in youth with type 1 diabetes and elevated body mass index.

    Science.gov (United States)

    Redondo, Maria J; Foster, Nicole C; Libman, Ingrid M; Mehta, Sanjeev N; Hathway, Joanne M; Bethin, Kathleen E; Nathan, Brandon M; Ecker, Michelle A; Shah, Avni C; DuBose, Stephanie N; Tamborlane, William V; Hoffman, Robert P; Wong, Jenise C; Maahs, David M; Beck, Roy W; DiMeglio, Linda A

    2016-04-01

    The prevalence of cardiovascular risk factors in children with type 1 diabetes and elevated BMI in the USA is poorly defined. We aimed to test the hypothesis that children with type 1 diabetes who are overweight or obese have increased frequencies of hypertension, dyslipidemia, and micro-/macroalbuminuria compared to their healthy weight peers. We studied 11,348 children 2 to 18 years of age enrolled in T1D Exchange between September 2010 and August 2012 with type 1 diabetes for ≥1 year and BMI ≥ 5th age-/sex-adjusted percentile (mean age 12 years, 49 % female, 78 % non-Hispanic White). Overweight and obesity were defined based on Centers for Disease Control and Prevention criteria. Diagnoses of hypertension, dyslipidemia, and micro-/macroalbuminuria were obtained from medical records. Logistic and linear regression models were used to assess factors associated with weight status. Of the 11,348 participants, 22 % were overweight and 14 % obese. Hypertension and dyslipidemia were diagnosed in 1.0 % and 3.8 % of participants, respectively; micro-/macroalbuminuria was diagnosed in 3.8 % of participants with available data (n = 7,401). The odds of either hypertension or dyslipidemia were higher in obese than healthy weight participants [OR 3.5, 99 % confidence interval (CI) 2.0-6.1 and 2.2, 99 % CI 1.6-3.1, respectively]. Obese participants tended to be diagnosed with micro-/macroalbuminuria less often than healthy weight participants (OR 0.6, 99 % CI 0.4-1.0). Obese children with type 1 diabetes have a higher prevalence of hypertension and dyslipidemia than healthy weight children with type 1 diabetes. The possible association of obesity with lower micro-/macroalbuminuria rates warrants further investigation.

  4. Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors.

    Science.gov (United States)

    Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

    2016-01-01

    Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years ( P fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76-19.49; P falls (OR =2.55; 95% CI =1.05-6.19; P =0.039), age (OR =1.14; 95% CI =1.05-1.23; P =0.001), and BMI (OR =0.91; 95% CI =0.83-0.99; P =0.034). Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls.

  5. Documentation of body mass index and control of associated risk factors in a large primary care network

    Directory of Open Access Journals (Sweden)

    Grant Richard W

    2009-12-01

    Full Text Available Abstract Background Body mass index (BMI will be a reportable health measure in the United States (US through implementation of Healthcare Effectiveness Data and Information Set (HEDIS guidelines. We evaluated current documentation of BMI, and documentation and control of associated risk factors by BMI category, based on electronic health records from a 12-clinic primary care network. Methods We conducted a cross-sectional analysis of 79,947 active network patients greater than 18 years of age seen between 7/05 - 12/06. We defined BMI category as normal weight (NW, 18-24.9 kg/m2, overweight (OW, 25-29.9, and obese (OB, ≥ 30. We measured documentation (yes/no and control (above/below of the following three risk factors: blood pressure (BP ≤130/≤85 mmHg, low-density lipoprotein (LDL ≤130 mg/dL (3.367 mmol/L, and fasting glucose Results BMI was documented in 48,376 patients (61%, range 34-94%, distributed as 30% OB, 34% OW, and 36% NW. Documentation of all three risk factors was higher in obesity (OB = 58%, OW = 54%, NW = 41%, p for trend Conclusions In a large primary care network BMI documentation has been incomplete and for patients with BMI measured, risk factor control has been poorer in obese patients compared with NW, even in those with obesity and CVD or diabetes. Better knowledge of BMI could provide an opportunity for improved quality in obesity care.

  6. Piloting a ‘Spatial Isolation’ Index: The Built Environment and Sexual and Drug Use Risks to Sex Workers

    Science.gov (United States)

    Deering, Kathleen N; Rusch, Melanie; Amram, Ofer; Chettiar, Jill; Nguyen, Paul; Feng, Cindy X; Shannon, Kate

    2014-01-01

    Background Employing innovative mapping and spatial analyses of individual and neighborhood environment data, we examined the social, physical and structural features of overlapping street-based sex work and drug scenes and explored the utility of a ‘spatial isolation index’ in explaining exchanging sex for drugs and exchanging sex while high. Methods Analyses drew on baseline interview and geographic data (Jan/10-Oct/11) from a large prospective cohort of street and off-street sex workers (SWs) in Metropolitan Vancouver and external publically-available, neighborhood environment data. An index measuring ‘spatial isolation’ was developed from seven indicators measuring features of the built environment within 50m buffers (e.g. industrial or commercial zoning, lighting) surrounding sex work environments. Bivariate and multivariable logistic regression was used to examine associations between the two outcomes (exchanged sex for drugs; exchanged sex while high) and the index, as well as each individual indicator. Results Of 510 SWs, 328 worked in street-based/outdoor environments (e.g. streets, parks, alleys) and were included in the analyses. In multivariable analysis, increased spatial isolation surrounding street-based/outdoor SWs’ main places of servicing clients as measured with the index was significantly associated with exchanging sex for drugs. Exchanging sex for drugs was also significantly positively associated with an indicator of the built environment suggesting greater spatial isolation (increased percent of parks) and negatively associated with those suggesting decreased spatial isolation (increased percent commercial areas, increased count of lighting, increased building footprint). Exchanging sex while high was negatively associated with increased percent of commercial zones but this association was removed when adjusting for police harassment. Conclusions The results from our exploratory study highlight how built environment shapes risks

  7. The role of the dorsal anterior insula in sexual risk: Evidence from an erotic Go/NoGo task and real-world risk-taking.

    Science.gov (United States)

    Xue, Feng; Droutman, Vita; Barkley-Levenson, Emily E; Smith, Benjamin J; Xue, Gui; Miller, Lynn C; Bechara, Antoine; Lu, Zhong-Lin; Read, Stephen J

    2018-04-01

    The insula plays an important role in response inhibition. Most relevant here, it has been proposed that the dorsal anterior insular cortex (dAIC) plays a central role in a salience network that is responsible for switching between the default mode network and the executive control network. However, the insula's role in sexually motivated response inhibition has not yet been studied. In this study, eighty-five 18- to 30-year-old sexually active men who have sex with men (MSM) performed an erotic Go/NoGo task while in an MRI scanner. Participants' real-world sexual risk-taking (frequency of condomless anal intercourse over the past 90 days) was then correlated with their neural activity during the task. We found greater activity in bilateral anterior insular cortex (both dorsal and ventral) on contrasts with stronger motivational information (attractive naked male pictures versus pictures of clothed, middle-aged females) and on contrasts requiring greater response inhibition (NoGo versus Go). We also found that activity in the right dAIC was negatively correlated with participants' real-world sexual risk-taking. Our results confirmed the involvement of the insular cortex in motivated response inhibition. Especially, the decreased right dAIC activity may reduce the likelihood that the executive control net