Home About us Contact
|
Home About us Contact | ||
|
|
||
Reducing Risk (reducing + risk)
Selected AbstractsBleeding Complications in Acute Coronary Syndromes and Percutaneous Coronary Intervention: Predictors, Prognostic Significance, and Paradigms for Reducing RiskCLINICAL CARDIOLOGY, Issue S2 2007Steven V. Manoukian M.D. Abstract In clinical trials up to 30% of patients with acute coronary syndromes (ACS) or undergoing percutaneous coronary intervention (PCI) experience bleeding complications, and even higher rates have been reported in contemporary practice. A growing body of data suggests a strong correlation between bleeding and both short- and long-term adverse outcomes, including mortality, which is independent of baseline characteristics and remains evident in most trials, despite variations in the definition of major bleeding. Although the value of antithrombin and antiplatelet therapy in reducing the risk of ischemic events is well established, the mechanisms of action that confer the benefits of these therapies have an inherent tendency to increase the risk of bleeding complications. As a result, characterization of baseline hemorrhagic risk is critical and must be accomplished before selecting an antithrombotic therapy. Risk factors for bleeding may be divided into two categories: nonmodifiable (including age, gender, race, weight, renal insufficiency, anemia, and acuity of presentation) and modifiable (including choice of antithrombotic therapy and PCI procedural characteristics). Of these predictive factors, the choice, dosage, and duration of the antithrombin and/or antiplatelet regimen are perhaps the most readily modifiable, especially in patients with an increased risk of bleeding. This review explores the nature of the association between bleeding and adverse outcomes, including mortality; evaluates risk factors for bleeding; and examines mechanisms for reducing bleeding complications through the selection of appropriate antithrombotic therapy. Copyright © 2007 Wiley Periodicals, Inc. [source] Diverting with Benevolent Military Force: Reducing Risks and Rising above Strategic BehaviorINTERNATIONAL STUDIES QUARTERLY, Issue 2 2007EMIZET F. KISANGANI Research on the diversionary use of force has burgeoned in recent years, but the literature remains divided. This paper attempts to reconcile extant findings by advancing a new theoretical framework for diversionary force centered on the agenda-setting literature. It expands the conventional conception of diversionary behavior and distinguishes the benevolent use of force over low politics issues (which we term socioeconomic interventions, SEI) from belligerent force used over high politics issues (which we term politico-strategic interventions, PSI). This expansion also refines our understanding of strategic conflict avoidance (SCA). Using Zero-Inflated Poisson (ZIP) regression on 140 countries from 1950 to 1996, we find that democracies and mixed regimes tend to use SEI for diversion even though strategic conflict avoidance does not prevent them from using PSI. We further find that autocracies do not externalize their internal problems with either type of armed force and that, surprisingly, strategic conflict avoidance may constrain autocracies suffering economic decline. These outcomes suggest that our theory has utility and that research on both diversion and SCA would benefit from further theoretical refinement. [source] Quitting Still Best Strategy for Reducing Risks of SmokingCA: A CANCER JOURNAL FOR CLINICIANS, Issue 1 2006Article first published online: 31 DEC 200 No abstract is available for this article. [source] Reducing risk of shortages due to drought in water supply systems using genetic algorithms,IRRIGATION AND DRAINAGE, Issue 2 2009V. Nicolosi évaluation des risques; gestion de l'eau; sécheresse; éléments déclenchant pour les plans sécheresse Abstract The evaluation of risk of shortages due to drought in water supply systems is a necessary step both in the planning and in the operation stage. A methodology for unconditional (planning) and conditional (operation) risk evaluation is presented in this study. The risk evaluation is carried out by means of an optimisation model based on genetic algorithms aimed to define thresholds for the implementation of mitigation measures tested through Monte Carlo simulation that makes use of a stochastic generation of streamflows. The GA enables the optimisation of reservoir storages which identify monthly thresholds for shifting three states of the system (normal, alert and alarm) to which correspond different mitigation measures such as water demand rationing, additional supplies from alternative sources or reduction of release for ecological use. For unconditional risk evaluation a long time horizon has been considered (40 years), while the conditional risk evaluation is performed on a short time horizon (2,3 months). Results of simulations have been studied by means of consolidated indices of performance and frequency analysis of shortages of a given entity corresponding to different planning/management policies. A multi-use water system has been used as a case study including competing irrigation and industrial demands. Copyright © 2008 John Wiley & Sons, Ltd. L'évaluation du risque de manques d'eau dus à la sécheresse dans les systèmes d'approvisionnement en eau est une étape nécessaire à la fois pour la planification et l'exploitation. Une méthodologie pour l'évaluation du risque inconditionnel (planification) et conditionnel (exploitation) est présentée dans cette étude. L'évaluation du risque est effectuée au moyen d'un modèle d'optimisation basé sur des algorithmes génétiques visant à définir des seuils pour la mise en ,uvre des mesures d'atténuation testés par une méthode de Monte Carlo générant les débits des rivières. L'algorithme génétique permet d'optimiser les stockages de réservoir avec des seuils mensuels pour identifier trois états du système (normal, alerte et alarme) auxquels correspondent différentes mesures d'atténuation telles que rationnement de la demande en eau, approvisionnements complémentaires par des sources alternatives ou réduction des lâchures pour l'usage écologique. Pour l'évaluation des risques inconditionnels un horizon à long terme a été considéré (40 ans) tandis que l'évaluation conditionnelle est faite sur un horizon à court terme (2 ou 3 mois). Les résultats des simulations ont été étudiés au moyen d'indices de performance consolidés et de l'analyse de la fréquence des manques d'eau pour une entité donnée correspondant à différentes politiques de planification et gestion. L'étude de cas porte sur un système multi-usage comportant une demande d'irrigation en concurrence avec les demandes industrielles. Copyright © 2008 John Wiley & Sons, Ltd. [source] Probiotics and their fermented food products are beneficial for healthJOURNAL OF APPLIED MICROBIOLOGY, Issue 6 2006S. Parvez Abstract Probiotics are usually defined as microbial food supplements with beneficial effects on the consumers. Most probiotics fall into the group of organisms' known as lactic acid-producing bacteria and are normally consumed in the form of yogurt, fermented milks or other fermented foods. Some of the beneficial effect of lactic acid bacteria consumption include: (i) improving intestinal tract health; (ii) enhancing the immune system, synthesizing and enhancing the bioavailability of nutrients; (iii) reducing symptoms of lactose intolerance, decreasing the prevalence of allergy in susceptible individuals; and (iv) reducing risk of certain cancers. The mechanisms by which probiotics exert their effects are largely unknown, but may involve modifying gut pH, antagonizing pathogens through production of antimicrobial compounds, competing for pathogen binding and receptor sites as well as for available nutrients and growth factors, stimulating immunomodulatory cells, and producing lactase. Selection criteria, efficacy, food and supplement sources and safety issues around probiotics are reviewed. Recent scientific investigation has supported the important role of probiotics as a part of a healthy diet for human as well as for animals and may be an avenue to provide a safe, cost effective, and ,natural' approach that adds a barrier against microbial infection. This paper presents a review of probiotics in health maintenance and disease prevention. [source] Factors associated with safe patient handling behaviors among critical care nursesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2010Soo-Jeong Lee RN Abstract Background Patient handling is a major risk factor for musculoskeletal (MS) injury among nurses. The aims of the study were to describe nurses' work behaviors related to safe patient handling and identify factors influencing their safe work behaviors, including the use of lifting equipment. Methods A cross-sectional study using a mailed questionnaire with a nationwide random sample of 361 critical care nurses. Nurses reported on the physical, psychosocial, and organizational characteristics of their jobs and on their MS symptoms, risk perception, work behaviors, and demographics. Hierarchical multiple linear regression analyses were used to identify significant factors. Results More than half of participants had no lifting equipment on their unit, and 74% reported that they performed all patient lift or transfer tasks manually. Significant factors for safer work behavior included better safety climate, higher effort,reward imbalance, less overcommitment, greater social support, and day shift work. Physical workload, personal risk perception, or MS symptom experiences were not associated with safe work behavior. Conclusions Safe work behaviors are best understood as socio-cultural phenomena influenced by organizational, psychosocial, and job factors but, counter to extant theories of health behaviors, do not appear to be related to personal risk perception. Management efforts to improve working conditions and enhance safety culture in hospitals could prove to be crucial in promoting nurses' safe work behavior and reducing risk of MS injury. Am. J. Ind. Med. 53:886,897, 2010. © 2010 Wiley-Liss, Inc. [source] ORIGINAL RESEARCH,ED PHARMACOTHERAPY: Do Phosphodiesterase Type 5 Inhibitors Protect Against Condom-Associated Erection Loss and Condom Slippage?THE JOURNAL OF SEXUAL MEDICINE, Issue 5 2009Stephanie A. Sanders PhD ABSTRACT Introduction., Some physicians prescribe phosphodiesterase type 5 inhibitors (PDE5i) for men who experience condom-associated erection difficulties with a view to increasing condom use and reducing risk of sexually transmitted infections. Aim., To examine whether the prevalence of erection-related condom problems differs between men using and not using PDE5i at the last condom-protected penile,vaginal (PVI) or penile,anal intercourse. Methods., Seven hundred-five men who had used a male condom during the past 3 months for PVI were selected from a sample recruited through advertisement to an electronic mailing list for a large, internet-based, sexual-enhancement product company. An internet-based questionnaire posted in 2006 assessed condom-use errors and problems. Main Outcome Measures., Men who did and did not use PDE5i during the last time a condom was used were compared on: (i) erection loss while applying a condom; (ii) erection loss during sex while using a condom; (iii) condom slipped off during sex; (iv) delayed condom application (penetration of the vagina or anus prior to application of the male condom); (v) early condom removal (condom taken off and intercourse continued without it); (vi) "problem with the way the condom fit"; (vii) "problem with the way the condom felt"; and (viii) condom breakage. Results., Controlling for age, marital status (yes/no), and having children (yes/no), PDE5i users, compared with nonusers, were: (i) three times more likely to report erection loss during sex while using a condom (adjusted odds ratio [AOR] = 3.21, 95% confidence interval [CI] = 1.40,7.39, P = 0.006); (ii) almost five times more likely to report the condom slipped off during sex (AOR = 4.75, 95% CI = 1.68,13.44, P = 0.003); and (iii) more than twice as likely to remove condoms before sex was over (AOR = 2.46, 95% CI = 1.09,5.56, P = 0.03). Conclusions., Physicians prescribing PDE5i may want to evaluate whether men are experiencing condom-associated erection difficulties and, if they are, consider titrating dosages and/or making referrals for psychosexual therapy and/or condom skills education. Sanders SA, Milhausen RR, Crosby RA, Graham CA, and Yarber WL. Do phosphodiesterase type 5 inhibitors protect against condom-associated erection loss and condom slippage? J Sex Med 2009;6:1451,1456. [source] Prenatal Stretching Exercise and Autonomic Responses: Preliminary Data and a Model for Reducing PreeclampsiaJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2010SeonAe Yeo RNC Abstract Purpose: Preeclampsia is a leading cause of perinatal mortality and morbidity, and it increases maternal risk for future cardiovascular disease. The purpose of the study was to explore the relationships among stretching exercise, autonomic cardiac response, and the development of preeclampsia. Design: Secondary data analysis. Methods: Heart rate and pulse pressure were longitudinally examined in this secondary data analysis among women who engaged in stretching exercise daily from 18 weeks of gestation to the end of pregnancy compared with women who did walking exercise daily during the same time period. A total of 124 women were randomized to either stretching (n=60) or walking (n=64) in the parent study. Findings: Heart rates in the stretching group were consistently lower than those in the walking group. Conclusions: Based on the results of this secondary data analyses, a physiologic framework for possible beneficial effects of stretching exercise by enhancing autonomic responses on reducing risks for preeclampsia is proposed and discussed. Clinical Relevance: If the protective effect is established, stretching exercise can be translated into nursing intervention for prenatal care. [source] | ||||||||||