Foodborne Disease Risk Assessment of Foodservice Establishments in a Community

1982 ◽  
Vol 45 (1) ◽  
pp. 93-100 ◽  
Author(s):  
FRANK L. BRYAN
Keyword(s):  
Risk Assessment ◽  
Foodborne Pathogens ◽  
Relative Frequency ◽  
Disease Risk ◽  
Risk Index ◽  
Foodborne Disease ◽  
Administrative Procedure ◽  
Epidemiologic Data ◽  
Bacterial Contaminants ◽  
Composite Risk

An administrative procedure based upon epidemiologic data to estimate risk of foodborne disease from foods served in foodservice establishments is presented. The method utilizes food-property risk, food-operations risk, and average daily-patronage risk as coefficients to compute a composite risk index. The food-property risk is concerned with the characteristics of the foods prepared in an establishment in regard to the relative frequency that these foods have been, or because of their intrinsic qualities could become, vehicles of foodborne pathogens. The food-operations risk is concerned with the probability that foods are or will become contaminated, that contaminants survive or are likely to survive certain processes, and that if bacterial contaminants are present, they could multiply to sufficient quantities to cause disease. As the number of persons that eat an implicated or likely vehicle, the risk increases.

Refined Disease Risk Index (DRI) and Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) Predict Survival after Haploidentical Stem Cell Transplantation: A Comparative Study with EBMT Risk Score in 220 Consecutive Patients

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4400-4400 ◽  
Author(s):  
Maria Teresa Lupo-Stanghellini ◽  
Elisa Sala ◽  
Simona Piemontese ◽  
Mara Morelli ◽  
Raffaella Greco ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Stem Cell ◽  
Cell Transplantation ◽  
Risk Score ◽  
Hematopoietic Cell Transplantation ◽  
Disease Risk ◽  
Risk Index ◽  
Hematopoietic Cell ◽  
Comorbidity Index ◽  
Very High

Abstract Background Optimization of pre-transplant risk assessment is a crucial issue to improve the allo-HSCT decision making process. Actually 3 major algorithms are in use in clinical practice: the EBMT risk score, the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) score and - more recently introduced - the refined Disease Risk Index (DRI). DRI was defined to calibrate HSCT outcome across studies and centers. It was developed as a tool to assign patients into risk groups based on disease type and status at the time of transplantation. The aim of the DRI is to provide a robust tool that can be used for prognostication, for the analysis and interpretation of retrospective data, whether conducted in single-center, multicenter, or registry settings, or within the context of the federally mandated center outcome reporting. The DRI can also be used for the stratification of patients entering prospective HCT clinical trials. DRI is not a fixed tool but instead it was conceived to be refined by the transplant community as new information becomes available. Here we are presenting the results of a retrospective study designed to evaluate the 3 aforementioned score in stratification and prognostication of transplant outcome after a haploidentical HSCT (haplo-HSCT). Patients and Methods We included 220 adult patients (pts - 138 male, 82 female) who underwent a haplo-HSCT for hematologic malignancies, between 2006 and 2014 and were reported to our Institutional database. Risk assessment score and outcome analysis included all consecutive pts receiving an haplo-HSCT as 1st allogeneic transplantation. Pts receiving haplo-HSCT as 2nd or 3rd HSCT were excluded from the present analysis. Median age was 49 years (range, 15-77). The cohort included a broad representation of diseases (138/220 acute leukemia, 30 Hodgkin lymphoma); 62 pts were in complete remission at transplant, 158 were presenting active disease. Conditioning regimens mostly rely upon the combination of treosulfan plus fludarabine (201/220) and total body irradiation (range 200 - 400 cGy) was utilized in 52 patients. GVHD prophylaxis consisted mostly of an mTor inhibitor (rapamycin) combined with mycophenolate mofetil. The majority of patients received peripheral blood stem cells from a family haploidentical donor as stem cell source, while only 4 patients received bone marrow transplant. A written consent was given by pts allowing the use of medical records for research in accordance with the Declaration of Helsinki. Results The median follow-up for survivors was 37 months (r 6-107). The overall survival (OS) at 2-y was 35% and the transplant related mortality at 100-days 23%. The 2y OS according to EBMT / HCT-CI / DRI risk score are reported in table 1.a and figure 1. The evaluation of the HCT-CI impact after DRI stratification was able to show a significant difference in outcome showing better survival for pts with low DRI score and low HCT-CI score as expected (table 1.b). Discussion Refined DRI score and HCT-CI score predict survival after haplo-HSCT. The integrated application of refined DRI and HCT-CI may improve the definition of transplant eligibility for pts candidate to allogeneic HSCT form alternative donors including family haploidentical source. Table 1a. EBMT score 0-3 % pts 4-5 %pts > 5 %pts p 51% 17 34% 51 27% 32 0.07 HCT-CI score 0-2 3-4 >/= 5 48% 59 36% 31 0% 10 0.0001 DRI score Low-Intermediate High Very-High 61% 32 27% 51 5% 17 0.0001 Table 1b. HCT-CI 0-4 HCT-CI >/=5 p DRILow-Intermediate 64% 0% 0.0001 DRIHigh-Very High 29% 0% Figure 1. Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Drought Risk Assessment by Using Drought Hazard and Vulnerability Indexes

2018 ◽  
Author(s):  
Ismail Dabanli
Keyword(s):  
Risk Assessment ◽  
Risk Index ◽  
Standardized Precipitation Index ◽  
Hazard Index ◽  
Vulnerability Index ◽  
Drought Risk ◽  
Drought Vulnerability ◽  
Drought Hazard ◽  
Hazard Vulnerability ◽  
Composite Risk

Abstract. Drought has multiple impacts on socioeconomic sectors and it is expected to increase in the coming years due to non-stationary nature of climate variability and change. Here, we investigated drought hazard, vulnerability, and risk based on hydro-meteorological and actual socio-economic data for provinces of Turkey. Although, drought vulnerability and risk assessment are essential parts of drought phenomenon, so far, lack of proper integrated drought risk assessment in Turkey (and elsewhere) has led to higher socio-economic impacts. Firstly, the Drought Hazard Index (DHI) is derived based on the probability occurrences of drought using Standardized Precipitation Index (SPI) to facilitate the understanding of drought phenomenon. Secondly, the Drought Vulnerability Index (DVI) is calculated by utilizing four socio-economic indicators to quantify drought impact on society. Finally, the Drought Risk Index (DRI) is obtained by multiplying DHI and DVI for provinces of Turkey to highlight the relative importance of hazard and vulnerability assessment for drought risk management. A set of drought hazard, vulnerability, and composite risk maps were then developed. The outputs of analysis reveal that among 81 administrative provinces in Turkey, 73 provinces are exposed to the low drought risk (0 

scholarly journals Alzheimer’s environmental and genetic risk scores are differentially associated with ‘g’ and δ

2018 ◽  
Author(s):  
Shea J. Andrews ◽  
G. Peggy McFall ◽  
Roger A. Dixon ◽  
Nicolas Cherbuin ◽  
Ranmalee Eramudugolla ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Risk Score ◽  
Genetic Risk ◽  
Disease Risk ◽  
Genetic Risk Score ◽  
Risk Index ◽  
Dementia Risk ◽  
National University

AbstractIntroductionWe investigated the association of the Australian National University Alzheimer’s Disease Risk Index (ANU-ADRI) and an AD genetic risk score (GRS) with cognitive performance.MethodsThe ANU-ADRI (composed of 11 risk factors for AD) and GRS (composed of 25 AD risk loci) were computed in 1,061 community-dwelling older adults. Participants were assessed on 11 cognitive tests and activities of daily living. Structural equation modelling was used to evaluate the association of the ANU-ADRI and GRS with: 1) general cognitive ability (g) 2) dementia related variance in cognitive performance (δ) and 3) verbal ability, episodic memory, executive function and processing speed.ResultsA worse ANU-ADRI score was associated with poorer performance in ‘g’, δ, and each cognitive domain. A worse GRS was associated with poorer performance in δ and episodic memory.DiscussionThe ANU-ADRI was broadly associated with worse cognitive performance, validating its further use in early dementia risk assessment.HighlightsAn environmental/lifestyle dementia risk index is broadly associated with cognitive performanceAn Alzheimer’s genetic risk score is associated with dementia severity and episodic memoryThe environmental risk index is more strongly associated with dementia severity than genetic riskResearch in ContextSystematic ReviewThe authors reviewed the literature using online databases (e.g. PubMed). Previous research has highlighted the need for dementia risk assessment tools to be evaluated on outcomes prior to dementia onset, such as cognitive performance. The relevant citations have been appropriately cited.InterpretationThe Australian National University Alzheimer’s Disease Risk Index (ANU-ADRI) was more broadly associated with cognitive performance than Alzheimer’s genetic risk. For the ANU-ADRI, stronger effects were observed for dementia-related variance in cognitive task performance that for variance in general cognitive function. This suggests that ANU-ADRI is more specifically associated with dementia-related processes and further validates its use in early risk assessment for dementia.Future DirectionsAccordingly, future studies should seek to evaluate the association of the ANU-ADRI and genetic risk with AD biomarkers and longitudinal cognitive performance to evaluate differential trajectories in ‘g’ and δ.

scholarly journals Disease Risk Index (DRI) and Age but Not HCT Comorbidity Index (HCT-CI) Are Predictive of Overall Survival after Cord Blood Transplantation Supported By Haplo-CD34+ progenitor Cells

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2040-2040
Author(s):  
Alexandra Gomez-Arteaga ◽  
Nina Orfali ◽  
Danielle Guarneri ◽  
Usama Gergis ◽  
Sebastian A. Mayer ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cord Blood ◽  
Progenitor Cells ◽  
Disease Risk ◽  
Risk Index ◽  
Cord Blood Transplantation ◽  
Blood Transplantation ◽  
Alternative Donor ◽  
Comorbidity Index ◽  
Very High

Introduction: Predictors routinely used to assess long-term survival after allogeneic hematopoietic cell transplantation (alloHCT) have not been specifically validated for pre-transplant risk assessment of patients getting cord blood transplantation supported by Haplo-CD34+ Progenitor cells as a myeloid bridge (haplo-cord). Methods: All consecutive adult patients with hematological malignancies who received an alternative donor alloHCT with a haplo-cord at Weill Cornell Medicine were included. Data was collected from an ongoing haplo-cord protocol (clinicaltrials.gov identifier 01810588). Plasma cell disorders were excluded. Age, CIBMTR Disease Risk Index (DRI), Karnofsky performance score (KPS), and HCT comorbidity index (HCT-CI) (routinely calculated since 06/2014), were assessed before alloHCT. The Kaplan-Meier method was used to estimate OS probabilities. Comparisons of OS were evaluated by the log-rank test. Significant predictors were considered in a Cox proportional hazards regression model using forward stepwise selection. A cumulative incidence function (CI) for relapse was calculated using a competing risk model for non-relapse mortality (NRM). We further validated our findings in the subgroup of patients with AML. Results: Between 06/2012 and 12/2018, 217 patients underwent haplo-cord transplantation. Indications for alloHCT included: 66% leukemia, 19% MDS/MPN, 15% Lymphoma. Median age was 58 yr (22% ≤ 40yrs, 33% between 41-59yrs, and 45% ≥ 60 yrs). 43% of patients were women. KPS score was ≥ 90 in 56%. DRI was high/very-high in 43% and low/intermediate in 56%. HCT-CI for 154 patients was 0 in 14%, 1-2 in 21%, 3-5 in 45% and ≥ 6 in 20%. Conditioning regimens included fludarabine with melphalan 45%, plus TBI 51%, other 4%. Median follow-up was 30 months. 2yr OS was 38% (95%CI 31-44%). 2yr CI of NRM was 35% and relapse 36%. Age (p=0.001), DRI (p<0.001), and KPS (p=0.003) were associated with OS in univariate analysis(Figure 1). HCT-CI did not correlate with OS (p=0.53). In a multivariable model, only age ≥60 (HR 1.86, p=0.01) and high/very high DRI (HR 1.86, p<0.001) remained predictive of OS. (Figure 2). Age ≥ 60 was associated with increased NRM at 2 yrs (45% vs 27%, p=0.01). High/very high DRI was associated with relapse at 2 years (51% vs 24%, p<0.001). A subgroup analysis of 123 patients with AML showed consistent findings; age ≥ 60 (HR 2.11, p=0.04) and high/very high DRI (HR 2.51, p<0.001) remained predictive for OS in multivariable analysis. Conclusion: DRI and age are highly predictive of OS for patients undergoing haplo-cord transplantation. Our finding that HCT-CI is not predictive of OS when applied to haplo-cord alloHCT is supported by previous findings investigating the role of HCT-CI in cohorts with cord blood donors (Adachi Y et al BBMT 2018 and Majhail N et al BBMT 2008). To this end, our findings demonstrate that a high HCT-CI score should not preclude patients from evaluation for alternative donor transplantation using cord blood supported by Haplo-CD34+ progenitor cells. Other prognostic tools to assess specific comorbidities impacting this transplant platform are needed for accurate pre-transplant risk assessment in order to improve decision making and clinical trial assignments. Disclosures Van Besien: Miltenyi Biotec: Research Funding.

Educated Guesses: Health Risk Assessment in Environmental Impact Statements

1990 ◽  
Vol 16 (3) ◽  
pp. 399-427
Author(s):  
Pamela D. Harvey
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Environmental Impact ◽  
Disease Risk ◽  
National Environmental Policy Act ◽  
The Public ◽  
Environmental Impact Statements ◽  
National Environmental ◽  
Scientific Tool ◽  
Predicted Risk

Environmental pollution threatens public health. The search for solutions has advanced the frontiers of science and law. Efforts to protect the environment and public health begin with describing potential adverse consequences of human activities and characterizing the predicted risk. The National Environmental Policy Act requires the preparation of environmental impact statements to describe the effects of proposed federal projects and provide information for agency decisionmakers and the public.Risks to public health are particularly difficult to quantify because of uncertainty about the relation between exposure to environmental contamination and disease. Risk assessment is the current scientific tool to present estimates of risk. The methodology has created controversy, however, when underlying assumptions and uncertainties are not clearly presented. Critics caution that the methodology is vulnerable to bias. This Note evaluates the use of risk assessment in the environmental impact statement process and offers recommendations to ensure informed decisions.

scholarly journals Environmental Risk Assessment of Petroleum Activities in Surface Sediments, Suez Gulf, Egypt

2021 ◽  
Vol 9 (5) ◽  
pp. 473
Author(s):  
Magda M. Abou El-Safa ◽  
Mohamed Gad ◽  
Ebrahem M. Eid ◽  
Ashwaq M. Alnemari ◽  
Mohammed H. Almarshadi ◽  
...  
Keyword(s):  
Heavy Metals ◽  
Risk Assessment ◽  
Heavy Metal ◽  
Surface Sediment ◽  
Surface Sediments ◽  
Surf Zone ◽  
Risk Index ◽  
Negative Relationship ◽  
Anthropogenic Sources ◽  
Suez Gulf

The present study focuses on the risk assessment of heavy metal contamination in aquatic ecosystems by evaluating the current situation of heavy metals in seven locations (North Amer El Bahry, Amer, Bakr, Ras Gharib, July Water Floud, Ras Shokeir, and El Marageen) along the Suez Gulf coast that are well-known representative sites for petroleum activities in Egypt. One hundred and forty-six samples of surface sediments were carefully collected from twenty-seven profiles in the intertidal and surf zone. The hydrochemical parameters, such as pH and salinity (S‰), were measured during sample collection. The mineralogy study was carried out by an X-ray diffractometer (XRD), and the concentrations of Al, Mn, Fe, Cr, Cu, Co, Zn, Cd, and Pb were determined using inductively coupled plasma mass spectra (ICP-MS). The ecological risks of heavy metals were assessed by applying the contamination factor (CF), enrichment factor (EF), geoaccumulation index (Igeo), pollution load index (PLI), and potential ecological risk index (RI). The mineralogical composition mainly comprised quartz, dolomites, calcite, and feldspars. The average concentrations of the detected heavy metals, in descending order, were Al > Fe > Mn > Cr > Pb > Cu > Zn > Ni > Co > Cd. A non-significant or negative relationship between the heavy metal concentration in the samples and their textural grain size characteristics was observed. The coastal surface sediment samples of the Suez Gulf contained lower concentrations of heavy metals than those published for other regions in the world with petroleum activities, except for Al, Mn, and Cr. The results for the CF, EF, and Igeo showed that Cd and Pb have severe enrichment in surface sediment and are derived from anthropogenic sources, while Al, Mn, Fe, Cr, Co, Ni, Cu, and Zn originate from natural sources. By comparison, the PLI and RI results indicate that the North Amer El Bahry and July Water Floud are considered polluted areas due to their petroleum activities. The continuous monitoring and assessment of pollutants in the Suez Gulf will aid in the protection of the environment and the sustainability of resources.

scholarly journals Reforestation Impacted Soil Heavy Metal Fractionation and Related Risk Assessment in the Karst Area, Southwest China

Forests ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 891
Author(s):  
Qian Zhang ◽  
Guilin Han ◽  
Xingliang Xu
Keyword(s):  
Heavy Metals ◽  
Risk Assessment ◽  
Ecological Risk ◽  
Southwest China ◽  
Risk Index ◽  
Contamination Factor ◽  
Karst Area ◽  
Risk Assessment Code ◽  
Bcr Sequential Extraction ◽  
Soil Heavy Metals

Human agricultural activities have resulted in widespread land degradation and soil contamination in the karst areas. However, the effects of reforestation after agricultural abandonment on the mobility risks and contamination of heavy metals have been rarely reported. In the present study, six soil profiles were selected from cropland and abandoned cropland with reforestation in the Puding karst regions of Southwest China. The Community Bureau of Reference (BCR) sequential extraction method was used to evaluate the compositions of different chemical fractions of soil heavy metals, including Fe, Mn, Cr, Zn, Ni, and Cd. The total contents of Cr, Ni, Zn, Cd, and Mn in the croplands were significantly higher than those in the abandoned croplands. For all soils, Cr, Ni, Zn, and Fe were mainly concentrated in the residual fractions (>85%), whereas Mn and Cd were mostly observed in the non-residual fractions (>65%). The non-residual fractions of Cd, Cr, Ni, and Zn in the croplands were higher than those in the abandoned croplands. These results indicated that the content and mobility of soil heavy metals decreased after reforestation. The individual contamination factor (ICF) and risk assessment code (RAC) showed that Cd contributed to considerable contamination of karst soils. The global contamination factor (GCF) and potential ecological risk index (RI) suggested low contamination and ecological risk of the investigated heavy metals in the croplands, moreover they can be further reduced after reforestation.

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