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High-risk Areas (high-risk + area)

Distribution by Scientific Domains

Medical Sciences	58%
Life Sciences	41%

Selected Abstracts

Ecological niche modelling as a technique for assessing threats and setting conservation priorities for Asian slow lorises (Primates: Nycticebus)

DIVERSITY AND DISTRIBUTIONS, Issue 2 2009
J. S. Thorn
ABSTRACT Aim, Data on geographical ranges are essential when defining the conservation status of a species, and in evaluating levels of human disturbance. Where locality data are deficient, presence-only ecological niche modelling (ENM) can provide insights into a species' potential distribution, and can aid in conservation planning. Presence-only ENM is especially important for rare, cryptic and nocturnal species, where absence is difficult to define. Here we applied ENM to carry out an anthropogenic risk assessment and set conservation priorities for three threatened species of Asian slow loris (Primates: Nycticebus). Location, Borneo, Java and Sumatra, Southeast Asia. Methods, Distribution models were built using maximum entropy (MaxEnt) ENM. We input 20 environmental variables comprising temperature, precipitation and altitude, along with species locality data. We clipped predicted distributions to forest cover and altitudinal data to generate remnant distributions. These were then applied to protected area (PA) and human land-use data, using specific criteria to define low-, medium- or high-risk areas. These data were analysed to pinpoint priority study sites, suitable reintroduction zones and protected area extensions. Results, A jackknife validation method indicated highly significant models for all three species with small sample sizes (n = 10 to 23 occurrences). The distribution models represented high habitat suitability within each species' geographical range. High-risk areas were most prevalent for the Javan slow loris (Nycticebus javanicus) on Java, with the highest proportion of low-risk areas for the Bornean slow loris (N. menagensis) on Borneo. Eighteen PA extensions and 23 priority survey sites were identified across the study region. Main conclusions, Discriminating areas of high habitat suitability lays the foundations for planning field studies and conservation initiatives. This study highlights potential reintroduction zones that will minimize anthropogenic threats to animals that are released. These data reiterate the conclusion of previous research, showing MaxEnt is a viable technique for modelling species distributions with small sample sizes. [source]

Geographic Variation of Pediatric Burn Injuries in a Metropolitan Area

ACADEMIC EMERGENCY MEDICINE, Issue 7 2003
Kristine G. Williams MD
Objectives: To use a geographic information system (GIS) and spatial statistics to describe the geographic variation of burn injuries in children 0,14 years of age in a major metropolitan area. Methods: The authors reviewed patient records for burn injuries treated during 1995 at the two children's hospitals in St. Louis. Patient addresses were matched to block groups using a GIS, and block group burn injury rates were calculated. Mapping software and Bayesian analysis were used to create maps of burn injury rates and risks in the city of St. Louis. Results: Three hundred eleven children from the city of St. Louis were treated for burn injuries in 1995. The authors identified an area of high incidence for burn injuries in North St. Louis. The filtered rate contour was 6 per 1,000 children at risk, with block group rates within the area of 0 to 58.8 per 1,000 children at risk. Hierarchical Bayesian analysis of North St. Louis burn data revealed a relative risk range of 0.8771 to 1.182 for census tracts within North St. Louis, suggesting that there may be pockets of high risk within an already identified high-risk area. Conclusions: This study shows the utility of geographic mapping in providing information about injury patterns within a defined area. The combination of mapping injury rates and spatial statistical analysis provides a detailed level of injury surveillance, allowing for identification of small geographic areas with elevated rates of specific injuries. [source]

Etiology and prevention of gastric cancer: a population study in a high risk area of China

JOURNAL OF DIGESTIVE DISEASES, Issue 4 2005
Wei Cheng YOU
A series of studies has been carried out in Linqu County, Shandong Province, China, a high-risk area for gastric cancer, to investigate the risk factors associated with gastric cancer, precancerous lesions and the prevention of gastric cancer. Our studies showed that sour pancakes (a popular local food), salted foods, cigarette smoking, and family history of gastric cancer were risk factors, whereas fresh vegetables, and intake of vitamin C and calcium were inversely associated with the risk of gastric cancer. The prevalence of chronic atrophic gastritis was approximately 20% in an adult population in Linqu County, intestinal metaplasia was approximately 50%, and dysplasia was approximately 20%. A follow-up study showed that the relative risk of developing gastric cancer increased with the severity of gastric lesions, and was associated with dietary factors, cigarette smoking and H. pylori infection in this population. The findings strongly support the idea that gastric cancer is primarily determined by environmental factors and develops in a multistep progression of precancerous lesions. [source]

Neurocysticercosis and Human Immunodeficiency Virus Infection: A Case Report

JOURNAL OF TRAVEL MEDICINE, Issue 6 2006
DTM&H, Leonardo Chianura MD
Ecuador is considered a holoendemic high-risk area for the transmission of cysticercosis. Moreover, the progression of human immunodeficiency virus (HIV) occurs worldwide. We present a case of simultaneous diagnosis of cysticercosis and HIV infection in a 22-year-old Ecuadorian immigrant. We would postulate that with the increasing HIV incidence in endemic areas of cysticercosis, the simultaneous diagnosis of both diseases is an event to be expected. [source]

Ecological niche modelling as a technique for assessing threats and setting conservation priorities for Asian slow lorises (Primates: Nycticebus)

Surveillance of vivax malaria vectors and civilian patients for malaria high-risk areas in northern Gyeonggi and Gangwon Provinces near the demilitarized zone, Republic of Korea, 2003,2006

ENTOMOLOGICAL RESEARCH, Issue 4 2010
Jae Chul SHIM
Abstract After re-emergence of malaria in 1993, a continued increase in Plasmodium vivax cases was observed from 1993 to 2006 in northern Gyeonggi and Gangwon Provinces adjacent to the demilitarized zone separating North from South Korea. Annual parasite incidence per 1000 people ranged from 0.33 in 2004 to 0.89 in 2006. While malaria case rates declined (22.6%) in 2004, they increased 75.1% in 2005 and 51.7% in 2006 from the previous years. An initial incorrect diagnosis of 46.8% of malaria cases as common cold resulted in a mean delay of 1.3 days for the detection malarial parasites. Of the total cases, 10.2% from December to May were due to latent intrinsic incubation infections acquired the previous malaria season and the rest of the cases from June to November were either latent or short incubation infections. Overall, the peak anopheline population occurred from July to September, resulting in a similar peak in malaria cases. While malaria cases increased during 2005,2006, anopheline populations, based on trap indices, were not significantly different during 4 years of surveillance. To decrease the malaria patient infective period to mosquitoes, public health centers in Paju and Cheorwon in 2006 prescribed chloroquine + primaquine at days 0,3 after initial malaria diagnosis followed by an additional 11 days of primaquine (early primaquine treatment), rather than chloroquine on days 0,3 and primaquine on days 4,17 (delayed primaquine treatment). A reduction in the malaria parasite incidence during 2007 was recorded for the two locations offering the early primaquine treatment relative to other locations using the delayed primaquine treatment. [source]

Using a Geographic Information System to identify areas with potential for off-target pesticide exposure

ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 8 2006
Thomas G. Pfleeger
Abstract In many countries, numerous tests are required as part of the risk assessment process before chemical registration to protect human health and the environment from unintended effects of chemical releases. Most of these tests are not based on ecological or environmental relevance but, rather, on consistent performance in the laboratory. A conceptual approach based on Geographic Information System (GIS) technology has been developed to identify areas that are vulnerable to nontarget chemical exposure. This GIS-based approach uses wind speed, frequency of those winds, pesticide application rates, and spatial location of agricultural crops to identify areas with the highest potential for pesticide exposure. A test scenario based on an incident in Idaho (USA) was used to identify the relative magnitude of risk from off-target movement of herbicides to plants in the conterminous United States. This analysis indicated that the western portion of the Corn Belt, the central California valley, southeastern Washington, the Willamette Valley of Oregon, and agricultural areas bordering the Great Lakes are among those areas in the United States that appear to have the greatest potential for off-target movement of herbicides via drift. Agricultural areas, such as the Mississippi River Valley and the southeastern United States, appears to have less potential, possibly due to lower average wind speeds. Ecological risk assessments developed for pesticide registration would be improved by using response data from species common to high-risk areas instead of extrapolating test data from species unrelated to those areas with the highest potential for exposure. [source]

The feasibility of developing a risk assessment for the impact of climate change on the emergence of Crimean-Congo haemorrhagic fever in livestock in Europe: a Review

JOURNAL OF APPLIED MICROBIOLOGY, Issue 6 2010
P. Gale
Summary Crimean-Congo haemorrhagic fever virus (CCHFV) is one of the most widespread of all medically important arboviruses with ticks of the Hyalomma spp. serving as the main vectors. Infection of livestock by CCHFV serves as a route of exposure to humans, as a reservoir of disease and as a route of importation. This study discusses the pathways and data requirements for a qualitative risk assessment for the emergence of CCHFV in livestock in Europe. A risk map approach is proposed based on layers that include the potential routes of release (e.g. by migrating birds carrying infected ticks) together with the main components for exposure, namely the distributions of the tick vectors, the small vertebrate host reservoirs and the livestock. A layer on landscape fragmentation serves as a surrogate for proximity of livestock to the tick cycle. Although the impact of climate change on the emergence of CCHF is not clear, comparing the distribution of risk factors in each layer currently with those predicted in the 2080s with climate change can be used to speculate how potential high-risk areas may shift. According to the risk pathway, transstadial and/or transovarial transmission in the tick vector are crucial for CCHFV spread. Vector competence and tick vector switching, however, remain critical factors for CCHFV colonization of new regions in Europe. The species of migratory bird is also an important consideration in the release assessment with greater abundance and biodiversity of ground-dwelling birds in southern Europe than in northern Europe. [source]

Diarrhea A to Z: America to Zimbabwe

JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2009
Lori A. Spies RN NP-C
Abstract Purpose: To review international statistics on the morbidity and mortality of diarrhea, pathophysiology, global incidence, and implications for the clinical practice of nurse practitioners (NPs). Data sources: Selective review of literature. Conclusions: Because of ever-increasing international travel, immigration, and rising awareness of global health issues, NPs must be current on the prevention, diagnosis, and treatment of diarrhea. Implications for Practice: Increased awareness of diarrhea as a significant international health issue mandates that NPs counsel clients who travel to high-risk areas about preventive measures to avoid exposure or manage symptoms while traveling. Guidelines for evidence-based treatments of diarrheal illness are widely available and should be followed. [source]

The Efficacy of Chemoprophylaxis against Malaria with Chloroquine plus Proguanil, Mefloquine, and Atovaquone plus Proguanil in Travelers from Denmark

JOURNAL OF TRAVEL MEDICINE, Issue 3 2003
Kristian Kofoed
Background The risk of malaria infection in travelers is seldom known in detail and neither is the efficacy of different prophylactic regimens, due to a lack of controlled trials. Surveillance of malaria diagnosed after return can provide data on risk and efficacy. Methods An open case-control study was initiated. Imported cases were notified to our department and were studied in 320 permanent residents in Denmark, returning from abroad with malaria from 1997 to 1999. These were compared with a group of 600 travelers who were not infected with malaria and matched by age, sex, and destination. Information on the use of chemoprophylaxis and the length of stay in malarious areas were obtained by questionnaire. Results Two hundred cases of Plasmodium falciparum malaria were notified of which 103 had used chloroquine and proguanil, 16 mefloquine, and 3 atovaquone and proguanil as prophylaxis, whereas the rest had taken other drugs or no prophylaxis. This study showed that the risk increased with increasing exposure and that compliance was lower especially for mefloquine users in malaria cases compared with controls. The study provided the first comprehensive data on the use of atovaquone/proguanil to travelers. The estimated efficacy of chloroquine and proguanil, mefloquine, and atovaquone and proguanil in fully compliant users was 1:599, 1:2,232, and 1:1,943, respectively, P. falciparum cases per prescription. The country specific risk data showed that the risk of getting malaria varied from 1 per 140 travelers to Ghana to almost 1 per 40,000 to Thailand, providing data that allow the use of prophylaxis to be restricted to high-risk areas. Conclusion There was a considerable variation in risk between the countries with the highest risk in tropical Africa. Chloroquine and proguanil was less efficient compared with mefloquine. Atovaquone/proguanil (Malarone) was at least as efficient as mefloquine, but breakthroughs were observed. [source]

Defense of Breast Cancer Malpractice Claims

THE BREAST JOURNAL, Issue 2 2001
FACOG, Samuel Zylstra MD
Abstract: The goal of this study was to determine whether factors associated with the successful defense and cost of malpractice cases involving the failure to diagnose breast cancer could be identified in medical and legal records. Secondary goals were to develop a multidisciplinary clinical algorithm utilizing National Comprehensive Cancer Network (NCCN) practice guidelines with practitioner risk management strategies. Physician deviations from these guidelines were tracked to identify high-risk areas in the diagnosis of breast cancer. A multidisciplinary clinical algorithm was introduced and practitioner risk management issues were addressed. In this study specific medical, legal, and cost factors were retrospectively abstracted and analyzed to identify associations between medical and legal factors and medicolegal outcome. ProMutual handled 156 malpractice cases involving breast cancer between January 22, 1986, and November 20, 1997. Of the total, 124 cases involving 212 defendants were closed. The closed cases were analyzed, using multivariable stepwise logistic and linear regression, to identify associations between clinical factors and case outcome. Women's health practitioners (WHPs), including obstetrician-gynecologists (OB-GYNs), family medicine, and internal medicine clinicians, were the largest group of defendants (97). Others included radiologists (43), surgeons (33), and pathologists (3). OB-GYNs accounted for 31% of these defendants, with a cost of more than $16 million. The greatest number of specialists represented in the open cases were radiologists, with 38% of the total. The defense model predicts that the probability of successful defense is lessened with inadequate record keeping, a patient that has metastasis and is alive, and a delay in diagnosis of 12 months or more. The overall indemnity model predicts a higher indemnity with the spread of disease at the time of evaluation, a patient who has metastasis and is alive, and a date of occurence closer to the present. Indemnity is less in patients who have had a lymph node dissection, who have died, or who are alive without metastasis. The WHP model predicts an increased overall indemnity with the spread of disease at the time of evaluation and the presence of a mass without pain. Indemnity decreases with a history of pregnancy, absence of presenting symptoms, or presentation with pain with or without a mass, and the performance of a lymph node dissection. [source]

Blood lead levels in Egyptian children from high and low lead-polluted areas: impact on cognitive function

ACTA NEUROLOGICA SCANDINAVICA, Issue 1 2009
G. A. Mostafa
Objectives,,, Many children are harmed by low-level lead exposure which impairs cognitive development with subsequent poor scholastic achievement. We investigated blood lead levels in children in relation to cognitive function. Materials and methods,,, Blood lead levels were measured in 100 children recruited from high (n = 50) and low (n = 50) lead-polluted areas. Results,,, Blood lead levels ranged between 3 and 28 ,g/dl (median 9, interquartile range 6 ,g/dl). In addition, 43% of children had levels ,10 ,g/dl, of whom 90.1% were living in high-risk areas for lead pollution. Cognitive dysfunction was found in 37% of children. Children with cognitive dysfunction had significantly higher blood lead and lower hemoglobin than those without (P < 0.001). Conclusions,,, Increased blood lead level in many children is one of the health problems in Egypt which may be the reason, at least in part, for cognitive dysfunction with subsequent poor scholastic achievement. Thus, interventions to control lead exposure are mandatory. [source]