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31.
Charuhas V. Thakar Orfeas Liangos JeanPierre Yared David A. Nelson Srinivas Hariachar Emil P. Paganini 《Hemodialysis international. International Symposium on Home Hemodialysis》2003,7(2):143-147
Background: Acute renal failure (ARF) after cardiac surgery is associated with significant morbidity and mortality, irrespective of the need for dialysis. Previous studies have attempted to identify predictors of ARF and develop risk stratification algorithms. This study aims to validate the algorithm in an independent cohort of patients that includes a significant proportion of female and black patients and compares two different definitions of renal outcome.
Methods: A large single center cardiac surgery database was examined (n, 24,660; 1993–2000) which included 29.9% females and 3.7% black patients. Post‐operative ARF was defined as: a) ARF requiring dialysis, b) > 50% reduction in creatinine clearance relative to baseline or requiring dialysis. Clinical variables related to baseline renal function and cardiovascular disease were used in recursive partitioning analysis for both outcome definitions. Chi‐square goodness of fit analysis was performed to validate the algorithm.
Results: The frequency of post‐operative ARF requiring dialysis ranged between 0.5 and 15.5% based on the risk categories with the area under the receiver operating characteristic (ROC) curve of 0.78. Using the more inclusive definition of ARF, the frequency was significantly higher ranging from 2.6 to 25%(P < 0.001) with an area under ROC curve of 0.65.
Conclusions: The renal risk stratification algorithm is valid in predicting post‐operative ARF in an independent cohort of patients, well represented by differences in gender and race. Since the need for dialysis remains subjective, a more objective and inclusive definition of ARF may help in identifying a larger number of patients 'at‐risk'. 相似文献
Methods: A large single center cardiac surgery database was examined (n, 24,660; 1993–2000) which included 29.9% females and 3.7% black patients. Post‐operative ARF was defined as: a) ARF requiring dialysis, b) > 50% reduction in creatinine clearance relative to baseline or requiring dialysis. Clinical variables related to baseline renal function and cardiovascular disease were used in recursive partitioning analysis for both outcome definitions. Chi‐square goodness of fit analysis was performed to validate the algorithm.
Results: The frequency of post‐operative ARF requiring dialysis ranged between 0.5 and 15.5% based on the risk categories with the area under the receiver operating characteristic (ROC) curve of 0.78. Using the more inclusive definition of ARF, the frequency was significantly higher ranging from 2.6 to 25%(P < 0.001) with an area under ROC curve of 0.65.
Conclusions: The renal risk stratification algorithm is valid in predicting post‐operative ARF in an independent cohort of patients, well represented by differences in gender and race. Since the need for dialysis remains subjective, a more objective and inclusive definition of ARF may help in identifying a larger number of patients 'at‐risk'. 相似文献
32.
Rudolf Habison 《International Journal of Project Management》1985,3(3):178-181
Meeting time and cost objectives in complex projects involves specific problems and risks. An attempt is made to analyse the components of total cost increase of a project caused by time delay. An outline is given as to how these considerations can be used to estimate cost increases in investors' decision situations as well as to ascertain fair contractual penalties and claims for compensation and for the evaluation of justified project acceleration costs. 相似文献
33.
Lussier Isabelle; Derevensky Jeffrey L.; Gupta Rina; Bergevin Tanya; Ellenbogen Stephen 《Canadian Metallurgical Quarterly》2007,21(2):165
The study of resilient children has overturned many deficit-focused models concerning the ontogenesis of children raised in adversity. This study explored the relationship between risk and protective factors, resilience, and youth gambling behavior. More specifically, this study examined the relative contribution of various risk and protective domains in relation to problem gambling behavior and examined whether youth identified as resilient (high risk exposure- high internalized protection) were as likely as those identified as vulnerable (high risk exposure-low internalized protection) to engage in excessive gambling behavior. The sample consisted of 1,273 students ages 12 to 19. The findings demonstrated that risk and protective factors each provide a unique contribution to the prediction model of gambling problems. Resilient and vulnerable youth differed significantly in their self-reported gambling severity. As well, resilient youth were not statistically distinguishable from low-risk exposure groups in terms of their gambling severity. Findings are interpreted with respect to resilience and prevention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
34.
Jules Sadefo Kamdem 《Computing and Visualization in Science》2007,10(4):197-210
In this paper, we generalize the Linear VaR method from portfolios with normally distributed risk factors to portfolios with
mixture of elliptically distributed ones. We treat both the Expected Shortfall and the Value-at-Risk of such portfolios. Special
attention is given to the particular case of a mixture of multivariate t-distributions.
This is a part of J. SADEFO-KAMDEM PhD Thesis[12] of the Université de Reims, France . It has been presented at the workshop
on modelling and computation in Financial Engineering at Bad Herrenalb, Germany May 6-8, 2003. The author is an associate
professor at the Department of mathematics, université d’Evry Val d’Essonne. 相似文献
35.
Hispanic children are the fastest growing segment of the population. Numerous factors place them at-risk for school success. This study examined the effects of Child-Centered Play Therapy (CCPT) compared to a curriculum-based small group intervention with 29 Hispanic children referred for school counseling due to behavior problems. Children were assigned to treatment groups by random drawing within grade levels. Treatment was provided by Hispanic bilingual counselors. Statistical analysis revealed that, according to parent report, children receiving CCPT showed statistically significant decreases in externalizing behavior problems, compared to the curriculum-based treatment group. Effect size calculations revealed that CCPT demonstrated a large treatment effect on externalizing behavior problems and a moderate treatment effect on internalizing behavior problems. Cultural considerations and recommendations for practice and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
36.
农业重组微生物生物安全研究进展 总被引:2,自引:2,他引:0
综述了近年来农业重组微生物的研究现状和进展 ,详细介绍农业重组微生物环境释放的监控方法以及对环境的冲击作用 ,对一些有关生物安全研究的热点问题进行了探讨 相似文献
37.
Objective: Guided by the extended parallel process model (EPPM), the objective was to assess control processes dominant in influenza behavior decisions. Design: Cross-sectional survey. Results: Response rate was 31% (n=968). Regarding influenza risk, 59% were in danger control. Those in fear control were more likely to report influenza infection (p=.000). In the nonvaccinated, those in fear control were more likely to indicate not knowing where to get the vaccine (p=.016) and that it was unavailable (p=.027), and those in danger control believed they did not need it (p=.023). Zero critical values were more likely to indicate that no health provider recommended the shot (p=.002). Conclusions: Most perceived efficacy to be stronger than threat related to influenza; according to the EPPM, they are aware of their risk but recognize their ability to avert it. For those in danger control, messages should focus on increasing perceptions of severity and susceptibility to positively affect behavior change. For those in fear control, messages should focus on efficacy only. With a critical value of zero, no threat is induced, and a high-threat/high-efficacy approach should be taken. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
38.
The authors present a theory for understanding risk for problem drinking among reservation-dwelling American Indians. The theory offers an overall framework for understanding the risk process for this group. It considers the distinction between factors that influence mean levels of American Indian problem drinking and factors that influence individual differences in American Indian drinking. It proposes important contextual differences between reservation-dwelling American Indians and Caucasians that may help explain the higher mean levels of American Indian problem drinking. The theory further holds that, within the high mean level of problem drinking characteristic of many American Indian reservations, individual differences in problem drinking can be explained by very similar personality and learning factors as those that influence problem-drinking levels for other ethnic groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
39.
Cooper M. Lynne; Wood Phillip K.; Orcutt Holly K.; Albino Austin 《Canadian Metallurgical Quarterly》2003,84(2):390
Longitudinal data from a representative sample of 1,978 Black and White adolescents were used to examine the role of personality in multiple risk or problem behaviors. Results indicate that covariation among diverse behaviors (educational underachievement, delinquent behavior, substance use, sexual behavior) can be adequately modeled by a single higher order factor, and that impulsivity and avoidance coping serve as generalized risk factors for involvement in these behaviors. Whereas none of the personality variables examined explained change in problem behaviors once established, avoidance coping prospectively predicted involvement among a subgroup of adolescents with little or no prior involvement. Results suggest that dysfunctional styles of regulating emotions and emotionally driven behaviors are core features of risky or problem behaviors during adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
40.
Community violence has emerged as a major risk factor for the development of mental health problems in children and adolescents. If mental health providers are to meet the needs of children and communities dealing with community violence, then they will need to integrate principles from various subdisciplines in psychology (e.g., developmental psychology, school psychology, developmental psychopathology) as well as disciplines outside of psychology (e.g., sociology, public health, medicine) to understand fully the developmental impact of exposure to community violence. The development of such a model is necessary to identify the pathways, risk, and protective factors on which prevention and intervention programs can be built. The goal of this article is to present an ecological-transactional model of community violence as a conceptual framework for understanding the existing literature and for guiding future research on community violence exposure and child development. (PsycINFO Database Record (c) 2011 APA, all rights reserved) 相似文献