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Risk Assessment Programs (risk + assessment_program)
Selected AbstractsEvaluation of the Prostate Cancer Prevention Trial Risk calculator in a high-risk screening populationBJU INTERNATIONAL, Issue 3 2010David J. Kaplan Study Type , Diagnostic (exploratory cohort) Level of Evidence 2b OBJECTIVE To evaluate the Prostate Cancer Prevention Trial (PCPT) risk calculator in a screening cohort of young, racially diverse, high-risk men with a low baseline prostate-specific antigen (PSA) level and enrolled in the Prostate Cancer Risk Assessment Program (PRAP). The PCPT calculator provides an assessment of prostate cancer risk based on age, PSA level, race, previous biopsy, and family history. PATIENTS AND METHODS Eligibility for PRAP includes men aged 35,69 years who are African-American, have a family history of prostate cancer, or have a known BRCA1/2 mutation. PCPT risk scores were determined for PRAP participants, and were compared to observed prostate cancer rates. RESULTS In all, 624 participants were evaluated, including 382 (61.2%) African-American men and 242 (38.7%) men with a family history of prostate cancer; the median (range) age was 49.0 (34.0,69.0) years and the median PSA level 0.9 (0.1,27.2) ng/mL. The PCPT risk score correlated with prostate cancer diagnosis, as the median baseline risk score in patients diagnosed with prostate cancer was 31.3%, vs 14.2% in patients not diagnosed with prostate cancer (P < 0.001). The PCPT calculator similarly stratified the risk of diagnosis of Gleason score ,7 disease, as the median risk score was 36.2% in patients diagnosed with Gleason ,7 prostate cancer vs 15.2% in all other participants (P < 0.001). CONCLUSION The PCPT risk calculator score was found to stratify prostate cancer risk in a cohort of young, primarily African-American men with a low baseline PSA level. These results support further evaluation of this predictive tool for assessing the risk of prostate cancer in high-risk men. [source] Pre- and posttest evaluation of a breast cancer risk assessment program for nurse practitionersJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 7 2010FAANP (Associate Professor), FNP-C, Quannetta T. Edwards BSN, WHCNP-C Abstract Purpose: Numerous studies have shown that healthcare providers, including nurse practitioners (NPs) fail to provide breast cancer risk assessment (BrCRA) in primary care settings. A potential barrier to the use of BrCRA is insufficient knowledge or training of risk assessment. The purpose of this study was to analyze the outcome of a BrCRA program developed to enhance NPs' knowledge of risk assessment and use of empiric risk assessment models. Data sources: Thirty-five NPs participated in a before-after (pretest,posttest design) study evaluating the effectiveness of a BrCRA education program conducted at a national NP conference. Demographics, pre/post knowledge, and course satisfaction measures were all examined as a part of this pilot study. Conclusion: Continuing education through the implementation of a BrCRA program significantly increased NPs knowledge in assessing breast cancer risk and the use of empiric risk assessment models. Implications for practice: Many healthcare providers, including NPs, are inadequately prepared to assess a woman's risk for breast cancer. Understanding breast cancer risk assessment is essential if NPs are to provide appropriate counseling, management, and referral strategies needed to reduce a woman's risk for developing the disease. Continuing education provides one means to enhance NP's knowledge of BrCRA. [source] Polychlorinated naphthalenes and other dioxin-like compounds in Elbe River sedimentsENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 3 2008Werner Brack Abstract Contamination of Elbe River (Germany) sediments with dioxin-like toxicants was investigated following the 500-year flood (flood that statistically occurs once in 500 years) of 2002. It was hypothesized that large amounts of particulate matter from river beds and associated dioxin-like toxicants were mobilized and transported during this flood event. The investigation focused on polychlorinated naphthalenes (PCNs) that have not been determined previously in the Elbe River. The in vitro H4IIE- luc assay was used as an overall measure for toxicants capable of binding to the aryl hydrocarbon receptor (AhR). The assay was combined with congener-specific instrumental analyses and fractionation to quantify PCN contributions to total AhR-mediated activity relative to polychlorinated dibenzo- p -dioxins and dibenzofurans (PCDD/Fs) and polychlorinated biphenyls (PCBs). Penta- to octachloron-aphthalene concentrations of 30 ng/kg dry weight up to 13 ,g/kg dry weight were found in Elbe River sediments downstream of Bitterfeld. Concentrations of penta- to octachloronaphthalenes, however, were only approximately 3 ,g/kg dry weight at a site in the vicinity of Bitterfeld, where a level of approximately 3 mg/kg dry weight was reported before the flood. Also, the congener pattern of PCNs at this site changed after the flood, and PCN patterns reported previously for Bitterfeld and assigned to chlor-alkali electrolysis with graphite electrodes could now be observed at the sites from downstream of Bitterfeld and Magdeburg. Whereas PCDD/Fs dominated the dioxin-like activity in the middle and lower Elbe River, PCNs contributed as much as 10% of the total AhR-mediated activity. The contribution of PCBs was less significant (maximum, 0.2%). Thus, in Elbe River sediments, PCNs should be considered as relevant contaminants and be included in future monitoring and risk assessment programs. [source] Rapid evolution in crop-weed hybrids under artificial selection for divergent life historiesEVOLUTIONARY APPLICATIONS (ELECTRONIC), Issue 2 2009Lesley G. Campbell Abstract When species hybridize, offspring typically exhibit reduced fitness and maladapted phenotypes. This situation has biosafety implications regarding the unintended spread of novel transgenes, and risk assessments of crop-wild hybrids often assume that poorly adapted hybrid progeny will not evolve adaptive phenotypes. We explored the evolutionary potential of early generation hybrids using nontransgenic wild and cultivated radish (Raphanus raphanistrum, Raphanus sativus) as a model system. We imposed four generations of selection for two weedy traits , early flowering or large size , and measured responses in a common garden in Michigan, USA. Under selection for early flowering, hybrids evolved to flower as early as wild lineages, which changed little. These early-flowering hybrids also recovered wild-type pollen fertility, suggesting a genetic correlation that could accelerate the loss of crop traits when a short life cycle is advantageous. Under selection for large size at reproduction, hybrids evolved longer leaves faster than wild lineages, a potentially advantageous phenotype under longer growing seasons. Although early generation hybrid offspring have reduced fitness, our findings provide novel support for rapid adaptation in crop-wild hybrid populations. Biosafety risk assessment programs should consider the possibility of rapid evolution of weedy traits from early generations of seemingly unfit crop-wild hybrids. [source] | ||||||||||