Age At Menarche And Risk Of Cancer Cervix

Research Problem: What is the role of early mcnarche as a risk factor in the outcome of cancer cervix? Objective: To investigate the role of early menarche as a risk factor for cancer cervix. Study Design: Hospital based, group matched, case control study. Setting: Gynaecology Clinic, Govt. Medical College Hospital, Nagpur. Participants: The study was carried out on 230 incident cases of cancer cervix confirmed by histopathology and equal number of controls selected from female patients admitted to the study hospital for conditions other than gynaecological cancers and showing pap smear within normal limits. The controls were group matched for 5 years class interval. Study Variable: Age at  menarche. Statistical Analysis: Univariate  analysis  was  done using Pearson's chi - square test and Odds Ratio while Adjusted Odds Ratio was calculated by using Unconditional Multiple Logistic Regression. Attributable and Population-Attributable Risk Proportion were also calculated. Result: A significant trend was observed towards increasing cancer cervix risk with decreasing age at menarche. Study subjects who had menarche before 13 years of age were at a significantly higher risk of cancer cervix. Various statistical characteristics endorsed this findings. Conclusion: The study identified a significant association of early menarche with cervical cancer. Recommendation: Independent and interactive role of early menarche in the outcome of cancer cervix needs further exploration by conducting studies involving multiple factors and using multivariate analysis

Group Rekeying Protocol for Secure communication

Group communication is one of the approaches to impart the messages effectively. Yet, security is the issue for this, and thus keys are utilized to secure the information. In this paper, the key management in group communication, an advanced rekeying approach based on the Logical Key Hierarchy (LKH) and One way Function Tree (OFT) schemes are explained. The AES crypto scheme is used to rekey the keys and the performance of the approach is better than LKH and OFT. Forward and backward security is provided by the proposed rekeying scheme. It is a novel rekeying scheme for large-scale dynamic groups that levers on logical sub-grouping and join history. On contrary other schemes, subgroups only support efficient group key management, have no application meaning and are transparent to the application layer. It misuses the historical backdrop of joining events to build up an aggregate requesting among subgroups and among nodes in every subgroup, so as to effectively recoup from collusion attacks

Human factors and missed solutions to Enigma design weaknesses

The German World War II Enigma suffered from design weaknesses that facilitated its large-scale decryption by the British throughout the war. The author shows that the main technical weaknesses (self-coding and reciprocal coding) could have been avoided using simple contemporary technology, and therefore the true cause of the weaknesses is not technological but must be sought elsewhere. Specifically, human factors issues resulted in the persistent failure to seek out more effective designs. Similar limitations seem to beset the literature on the period, which misunderstands the Enigma weaknesses and therefore inhibits broader thinking about design or realising the critical role of human factors engineering in cryptography

Integrated diagnostics: proceedings from the 9th biennial symposium of the International Society for Strategic Studies in Radiology

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Effects on incident reporting after educating residents in patient safety: a controlled study

<p>Abstract</p> <p>Background</p> <p>Medical residents are key figures in delivering health care and an important target group for patient safety education. Reporting incidents is an important patient safety domain, as awareness of vulnerabilities could be a starting point for improvements. This study examined effects of patient safety education for residents on knowledge, skills, attitudes, intentions and behavior concerning incident reporting.</p> <p>Methods</p> <p>A controlled study with follow-up measurements was conducted. In 2007 and 2008 two patient safety courses for residents were organized. Residents from a comparable hospital acted as external controls. Data were collected in three ways: 1] questionnaires distributed before, immediately after and three months after the course, 2] incident reporting cards filled out by course participants during the course, and 3] residents' reporting data gathered from hospital incident reporting systems.</p> <p>Results</p> <p>Forty-four residents attended the course and 32 were external controls. Positive changes in knowledge, skills and attitudes were found after the course. Residents' intentions to report incidents were positive at all measurements. Participants filled out 165 incident reporting cards, demonstrating the skills to notice incidents. Residents who had reported incidents before, reported more incidents after the course. However, the number of residents reporting incidents did not increase. An increase in reported incidents was registered by the reporting system of the intervention hospital.</p> <p>Conclusions</p> <p>Patient safety education can have immediate and long-term positive effects on knowledge, skills and attitudes, and modestly influence the reporting behavior of residents.</p

Do specialty registrars change their attitudes, intentions and behaviour towards reporting incidents following a patient safety course?

<p>Abstract</p> <p>Background</p> <p>Reporting incidents can contribute to safer health care, as an awareness of the weaknesses of a system could be considered as a starting point for improvements. It is believed that patient safety education for specialty registrars could improve their attitudes, intentions and behaviour towards incident reporting. The objective of this study was to examine the effect of a two-day patient safety course on the attitudes, intentions and behaviour concerning the voluntary reporting of incidents by specialty registrars.</p> <p>Methods</p> <p>A patient safety course was designed to increase specialty registrars' knowledge, attitudes and skills in order to recognize and cope with unintended events and unsafe situations at an early stage. Data were collected through an 11-item questionnaire before, immediately after and six months after the course was given.</p> <p>Results</p> <p>The response rate at all three points in time assessed was 100% (n = 33). There were significant changes in incident reporting attitudes and intentions immediately after the course, as well as during follow-up. However, no significant changes were found in incident reporting behaviour.</p> <p>Conclusions</p> <p>It is shown that patient safety education can have long-term positive effects on attitudes towards reporting incidents and the intentions of registrars. However, further efforts need to be undertaken to induce a real change in behaviour.</p

Support Vector Machines and Kernels for Computational Biology

ISSN:1553-734XISSN:1553-735

Golden Rule of Forecasting: Be Conservative

This article proposes a unifying theory, or the Golden Rule, or forecasting. The Golden Rule of Forecasting is to be conservative. A conservative forecast is consistent with cumulative knowledge about the present and the past. To be conservative, forecasters must seek out and use all knowledge relevant to the problem, including knowledge of methods validated for the situation. Twenty-eight guidelines are logically deduced from the Golden Rule. A review of evidence identified 105 papers with experimental comparisons; 102 support the guidelines. Ignoring a single guideline increased forecast error by more than two-fifths on average. Ignoring the Golden Rule is likely to harm accuracy most when the situation is uncertain and complex, and when bias is likely. Non-experts who use the Golden Rule can identify dubious forecasts quickly and inexpensively. To date, ignorance of research findings, bias, sophisticated statistical procedures, and the proliferation of big data, have led forecasters to violate the Golden Rule. As a result, despite major advances in evidence-based forecasting methods, forecasting practice in many fields has failed to improve over the past half-century

Dying well with reduced agency: a scoping review and thematic synthesis of the decision-making process in dementia, traumatic brain injury and frailty

Background In most Anglophone nations, policy and law increasingly foster an autonomy-based model, raising issues for large numbers of people who fail to fit the paradigm, and indicating problems in translating practical and theoretical understandings of ‘good death’ to policy. Three exemplar populations are frail older people, people with dementia and people with severe traumatic brain injury. We hypothesise that these groups face some over-lapping challenges in securing good end-of-life care linked to their limited agency. To better understand these challenges, we conducted a scoping review and thematic synthesis. Methods To capture a range of literature, we followed established scoping review methods. We then used thematic synthesis to describe the broad themes emerging from this literature. Results Initial searches generated 22,375 references, and screening yielded 49, highly heterogeneous, studies that met inclusion criteria, encompassing 12 countries and a variety of settings. The thematic synthesis identified three themes: the first concerned the processes of end-of-life decision-making, highlighting the ambiguity of the dominant shared decision-making process, wherein decisions are determined by families or doctors, sometimes explicitly marginalising the antecedent decisions of patients. Despite this marginalisation, however, the patient does play a role both as a social presence and as an active agent, by whose actions the decisions of those with authority are influenced. The second theme examined the tension between predominant notions of a good death as ‘natural’ and the drive to medicalise death through the lens of the experiences and actions of those faced with the actuality of death. The final theme considered the concept of antecedent end-of-life decision-making (in all its forms), its influence on policy and decision-making, and some caveats that arise from the studies. Conclusions Together these three themes indicate a number of directions for future research, which are likely to be applicable to other conditions that result in reduced agency. Above all, this review emphasises the need for new concepts and fresh approaches to end of life decision-making that address the needs of the growing population of frail older people, people with dementia and those with severe traumatic brain injury