The purpose of this study was to retrospectively identify risk factors of elderly nursing home residents that may predict the hospitalization of recently admitted elderly nursing home residents. Two groups of randomly chosen residents were studied. The non-hospitalized group (n = 100) were admitted to a nursing home and remained in the facility for at least 90 days. The hospitalized group (n = 100) were discharged to a hospital within 30 days of admission to the nursing home. The presence of HCFA irregularities increased the odds for hospitalization of an elderly nursing home resident by 1.67. Regular medication orders on discharge increased the odds of hospitalization by 1.25. This study showed that the use of the 33 HCFA indicators are useful in identifying elderly nursing home residents that may be at an increased risk of hospitalization.

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No description available.

Temos aktualumas. Atlikta integruoto rizikos žemės ūkyje vertinimo krypties mokslinės literatūros analizė, leidžia teigti, kad pavienių rizikos rūšių vertinimas yra plačiai analizuojamas. Galima būtų išskirti tokias problemas: kaip verslo subjektai vertina ir valdo skirtingas rizikos rūšis; kaip įvertinti riziką stichinių nelaimių metu; kokios yra rizikos valdymo ypatybės bankų sektoriuje; su kokiomis problemomis susiduria mažos įmonės vertindamos riziką; kaip rizikos valdymas įtakoja pinigų srautus įmonėse; kokie yra rizikos integruoto vertinimo privalumai ir kokia jų įtaka sprendimų priėmimo kokybei; kokios rizikos rūšys yra būdingos žemės ūkio sektoriui; kaip galima įvertinti diversifikuotą riziką ir išskirti integruoto vertinimo privalumus. Minėtuose tyrimuose nebuvo analizuota rizikos rūšių tarpusavio sąveikos ir nebandyta jų vertinti integruotai. Integruotas vertinimas padeda vienu metu identifikuoti net keleto rizikos rūšių sukeliamas grėsmes, to pasekoje padidėja priimamų ekonominių sprendimų efektyvumas. Siekiant integruotai vertinti kelias rizikos rūšis žemės ūkyje būtina į vertinimo metodiką įtraukti aspektus, kurie yra neatsiejami nuo žemės ūkio sektoriaus specifikos ir yra nebūdingi kitoms verslo sritims. Integruotas rizikos žemės ūkyje vertinimas ir tinkamas jo interpretavimas padeda pasiekti norimus veiklos rezultatus ir minimalizuoti nesėkmių galimybes. Mokslinėje literatūroje atkreipiamas dėmesys dažniausiai į dviejų rizikos rūšių integruotą vertinimą... [toliau žr. visą tekstą] / Relevance of the topic.The completed analysis of scientific literature on integrated risk assessment in agriculture leads to a conclusion that the assessment of separate risk types is extensively analysed. The problems to be addressed include: how business entities assess and manage different risk types; how to assess natural disaster risks; what risk management characteristics are typical to the banking sector; what problems small enterprises face in risk assessment; how risk management affects cash flows in organisations; what integrated risk assessment advantages are and what their impact on decision-making quality is; what types of risk are typical of the agricultural sector; how to assess diversified risks and to expose the advantages of integrated assessment. The research did not address the interrelation between different risk types neither sought their integrated assessment. Integrated assessment enables to identify several types of risks at a time and therefore improves the efficiency of economic decisions. For the purpose of an integrated assessment of several types of risk in agriculture, the assessment methodology must include aspects that are inherent in agricultural sector and not typical of other business areas. Integrated risk assessment in agriculture and its relevant interpretation contribute to the achievement of desired performance results and minimisation of potential failures. Typically scientific literature focuses on integrated assessment of two risk... [to full text]

Hazardous Materials (HazMat) are transported throughout Canada in a great number of road shipments. The transportation of HazMat poses special risks for neighboring population and environment. While HazMat accidents are rare events, they could be catastrophic in nature and could result in substantial damage to nearby communities. Effective emergency response plays an important role in the safe transportation of HazMat. Transportation of HazMat involves different parties, including shippers, regulators, and surrounding communities. While the shipping party is responsible for safe delivery of HazMat shipments, it is the responsibility of local emergency service agencies to respond to accidents occurring within their jurisdictions. In this research, the emergency response to HazMat transport accidents is assumed to be delegated exclusively to specially trained and equipped HazMat teams. This research proposes a new comprehensive systematic approach to determine the best location of HazMat teams on regional bases utilizing HazMat transport risk as a location criterion. The proposed model is the first to consider emergency response roles in HazMat transport risk analysis, and was intended as an optimization tool to be used by practitioners for HazMat emergency response planning. Additionally, the proposed model can be used to assess risk implications in regards to current locations of HazMat teams in a region, and to develop effective strategies for locating HazMat teams, such as closing and/or relocating teams in the region. The model investigates how HazMat team locations can be tailored to recognize the risk of transporting HazMat and would provide a more objective set of input alternatives into the multi-criteria decision making process of regionally locating HazMat teams. The proposed model was applied to the region of southwestern Ontario in effort to illustrate its features and capabilities in the HazMat emergency response planning and decision making process. Accordingly, the model provided very useful insights while reviewing several HazMat team location strategies for the southwestern Ontario region and investigating tradeoff among different factors. This research contributes to a better understanding of emergency response roles by reducing HazMat transport risks, and will greatly benefit both researchers and practitioners in the field of HazMat transport and emergency response.

The aim of my research has been to explore, in the area of probation, the influence of the shift away from traditional social work values towards an emphasis on punishment, enforcement and the management of risk. In particular my focus has been on how this shift has influenced the methods by which practitioners undertake their role, with an increasing focus on risk assessment removing them from the principles engendered within their professional disciplines and further away from an empathetic and meaningful relationship with their clients. I examine the consequences of this shift through the ways in which criminal justice legislation, policy and practice have developed and impacted upon particular categories of offenders. The theoretical orientation of my work involves a dual focus on the deconstruction of the client and the practitioner. The former is redefined from welfare citizen to carrier of risk and criminogenic needs, while the latter is fragmented and deskilled into an operator of routine risk assessment and prediction techniques. I argue that an important outcome of these procedures is the deployment of a concept of 'pre-emptive criminalisation'. My research work, which is the basis of this submission, comprised three components: a comparative study of three mental health White Papers, a research study of the working of OASys (the Offender Assessment System) and a study of the effectiveness of risk assessment in the parole process. The research techniques involved mainly the reading of policy documents and the content analysis of OASys reports. My findings, detailed in my various publications, include an argument that the effectiveness of risk predictions involve precisely the type of high level practitioner skills now being undermined by deskilling and also illustrate the role of such risk predictors in the pre-emptive criminalisation of clients. The thesis concludes with an acknowledgement of the limitations of the type of research I have conducted and suggestions for directions in which it might be further developed.

Abandoned metal mines in the Tamar catchment, south west England, represent a significant threat to surface water quality via generation of acid mine waters. Currently the River Tamar fails environmental quality standards (EQS) established under the Water Framework Directive (2000/60/EC) for dissolved Cu (x ̅ = 0.19 ± 0.05 μmol L-1) and Zn (x ̅ = 0.19 ± 0.06 μmol L-1, both 1997-2007) downstream of historic mining area of Gunnislake. The aim of this study was to quantify the risk to surface water quality by diffuse drainage generated by mine waste tips. For the first time, a GIS model was compiled and used to generate a priority list of known areas of mine waste, based on physical and environmental factors. The methodology was consistent with European guidance documentation published to meet the requirements of the Mining Waste Directive (2001/21/EC) and has since been applied, in a modified form, to other catchments in south west England. Two study sites, with contrasting mineralogy and hydrology, scored highly in the model and were the subject of field investigations from 2007-2009. These were Devon Great Consols (DGC), an abandoned Cu-As mine near Gunnislake and Wheal Betsy (WB), an abandoned Pb-Ag mine, near Mary Tavy. At each site, surface waters and shallow groundwaters were sampled and analysed for dissolved metals (including Al, Cu, Zn, Mn, Pb, Ni, and Cd), metalloids (As, Sb), major ions and anions. Samples of four selected mine waste tips were also gathered and subjected to a range of laboratory leaching experiments including the novel application of a dynamic upflow percolation test, based on an existing European method (CEN TS 14405). Leachates generated by the waste tips in the field were highly variable and elevated with respect to EQS for Al (up to 1850 μmol L-1), Cu (570 μmol L-1), Zn (34 μmol L-1), Ni (3.8 μmol L-1), Cd (0.17 μmol L-1), Mn (216 μmol L-1), Fe(537 μmol L-1) , As (380 μmol L-1) and Sb (5.4 μmol L-1). Estimated annual fluxes of dissolved metals were predicted using average rainfall data and catchment areas calculated in ArcHydro9 to estimate the annual discharge of waters from the tip. These calculations showed annual contaminant flux from the tips to exceed, or be of the same order of magnitude to, major adit discharges in the catchment (e.g. Cu 50900-66900 mol y-1 at DGC and 470 mol y-1 Cd at WB) and represented a significant contributor to metal flux in the Tamar catchment. Primary sulphide minerals in the waste were generally highly altered and metals (Pb, Cu, Zn, and Mn) and As were found to be strongly associated with secondary iron minerals, precipitated under oxic conditions. In finer wastes, sorption to clay minerals was also found to be very important for the retention of dissolved metals, particularly Pb. Concentrations of contaminants in column field leachates were similar for most metals (Cu, Zn, Mn, Ni and Cd) and may provide a useful tool for prediction of leachate composition. However, sorption and release of metals and As to the secondary phases and clays were highly sensitive to pH change and where laboratory experiments did not replicate field pH, discrepancies between in situ and laboratory results were observed up to two orders of magnitude in scale (particularly for As and Pb).

There is a growing demand for safe and convenient meat products. The effect of natural spice extracts incorporated with other hurdles for controlling pathogenic bacteria and extending the shelf life of RTE doner kebab were investigated. A comprehensive literature review was undertaken to establish the status of microbial risk, use of additives, knowledge on oxidative deterioration and HACCP associated with meat products. The in vitro antioxidant and antibacterial activities of spice extracts were screened and compared. Cinnamon, clove, and sumac alcoholic extracts demonstrated strong antimicrobial effect, however, rosemary proved effective as antioxidant in a lamb fat model. An accelerated shelf life study on a model system indicated that storage temperature was the most critical factor affecting lipid oxidation, which was effectively delayed by vacuum packaging and rosemary extracts. The effects of spice extracts, packaging and storage time on physiochemical, microbiological, and sensory attributes of doner kebab were evaluated. Application of rosemary and cinnamon extracts significantly reduced TVC, inhibited LAB, and retarded lipid oxidation rate. Sensory evaluation by a consumer panel indicated that only taste and spiciness perception was significantly different between treatments. A challenge test against Listeria monocytogenes showed significant differences between control and spice treatments at day 28. Strong inhibitory effects were associated to high levels of cinnamon particularly when applied after cooking. The effect of heat treatment and sumac (Rhus coriaria) on Bacillus cereus and Clostridium perfringens inactivation was evaluated on a doner kebab prototype. Addition of sumac significantly reduced D-values and z-values for both organisms in comparison to the control. The investigation of the effect of spice extracts, and environmental conditions on changes in growth kinetic parameters for L. monocytogenes and Salmonella Typhimurium showed that spice extracts are highly significant. For both microorganisms, Mumax was reduced as salt and spice concentrations increased, and pH levels decreased. This study shows that spice extracts incorporated with other hurdles can help to maintain safe and good quality RTE doner kebab.

Land is a finite natural resource that is increasingly getting exhausted as a result of land contamination. Land is made up of soil and groundwater, both of which have many functions for which we depend on, including provision of food and water, supporting shelter, natural flood defence, carbon sequestration, etc. Contaminants in land also pose a number of threats to public health and the environment; other natural resources; and have detrimental effects on property such as buildings, crops and livestock. The most effective method of dealing with these contaminants is to cleanup and return the sites to beneficial use. The cleanup process involves making a choice from amongst competing remediation technologies, where the wrong choice may have disastrous economic, environmental and/or social impacts. Contaminated land management is therefore much broader than the selection and implementation of remedial solutions, and requires extensive data collection and analysis at huge costs and effort. The need for decision support in contaminated land management decision-making has long been widely recognised, and in recent years a large number of Decision Support Systems (DSS) have been developed. This thesis presents the development of a Web-based knowledge-based DSS as an integrated management framework for the risk assessment of human health from, and sustainable management of, contaminated land. The developed DSS is based on the current UK contaminated land regime, published guidelines and technical reports from the UK Environment Agency (EA) and Department for Environment, Food and Rural Affairs (DEFRA) and other Government agencies and departments. The decision-making process of the developed DSS comprises of key stages in the risk assessment and management of contaminated land: (i) preliminary qualitative risk assessment; (ii) generic quantitative risk assessment; and (iii) options appraisal of remediation technologies and remediation design. The developed DSS requires site specific details and measured contaminant concentrations from site samples as input and produces a site specific report as output. The DSS output is intended to be used as information to support with contaminated land management decision-making.

CHDS State/Local / Accidental or intentional release of radiation may result in catastrophic consequences to urban and suburban populations. Any emergency response is compromised by insufficiently detailed protocols, and qualitative or quantitative wants in equipment and training. These challenges are no less acute for Sacramento County which is an archetype of at-risk suburban and urban settings. Recognized standards in critical patient care illustrate the need for specific considerations for radiological contaminated patients in a response protocol. Current practices in Sacramento require patient decontamination prior to treatment or transport. This may adversely affect survival profiles, despite national and international standards which specifically provide for consideration of alternate procedures. Radiation responses require a systems approach, whereby all work collaboratively toward a common goal. Incident commanders must appreciate their role in a radiation response, and how to incorporate the response into a unified multi-jurisdictional, unified command. Additionally, an essential component of any radiation response protocol is to decrease the associated "fear" of radiation in the general public as well as emergency responders. Best practices research, and recommendations at local, state, national and international levels are compiled into a usable radiation response protocol which can be utilized in formulating protocols in radiation emergency response. / Captain, Sacramento Metropolitan Fire District