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Analyses of the association between external radiation dose and prostate cancer risk were carried out both for workers with probable exposure to blood glucose 68 fasting buy 25mg cozaar amex these radionuclides and for those who had no such exposure diabetes test pancreas buy cheap cozaar 25mg. The association between external dose and prostate cancer was restricted to diabetes test calgary order cozaar 25mg those with radionuclide exposure jamaica diabetes diet cozaar 25 mg visa. A positive association was seen in both groups of workers, although it was statistically significant only among those who had been monitored for internal contamination. Adjustment for these potential exposures had little effect on the radiation risk estimates. The interpretation of these results is limited by the absence of individual exposure estimates for the chemicals considered. Rinsky and colleagues (1981) considered exposure to a number of workplace carcinogens in a case-control study of lung cancer among civilian employees of the Portsmouth naval shipyard. Asbestos and welding by-products were found to confound the association between radiation exposure and lung cancer risk in this population, where radiation workers appear to be more heavily exposed to asbestos and welding fumes than other workers. The unadjusted lung cancer odds ratio for workers with a cumulative dose of 10­ 49. Modifiers of Radiation Risk Several authors have reported an association between age at exposure and/or attained age and the risk of radiationinduced cancer. Although the estimates are lower than the linear estimates obtained from studies of atomic bomb survivors, as seen in Table 8-7, they are compatible with a range of possibilities, from a reduction of risk at low doses, to risks twice those on which current radiation Copyright National Academy of Sciences. Lung, liver, and bone are the organs that receive the largest doses from plutonium, and excess cancers in all three organs have been linked clearly to plutonium exposure among Mayak workers (Gilbert and others 2000; Koshurnikova and others 2000; Kreisheimer and others 2000). Analyses were adjusted for internal exposure to plutonium by using the estimated body burden for workers who had plutonium-monitoring data and by using a plutonium surrogate variable for workers who were not monitored for plutonium. The plutonium surrogate variable was developed recently from detailed work histories. There was no statistically significant departure from linearity and no evidence of modification by sex or age at hire. Estimates and confidence intervals for the solid cancer end points are shown in Table 8-8. For these end points, linear-quadratic functions provided significantly better fits than linear functions with a "downturn" in the dose-response at high doses. This may have resulted from overestimation of doses of certain workers in early years due to inadequacies in early film dosimeters. If this is the case, estimates of the linear term from the fitted linear-quadratic function may be more reliable. The estimates for cancers of the lung, liver, and bone were higher than those for other organs, possibly because the adjustment for plutonium exposure was less adequate for these cancers. There was no evidence of modification of the dose-response by sex, age at hire, or time since exposure. Overall, they do not suggest that current radiation risk estimates for cancer at low levels of exposure are appreciably in error. Uncertainty concerning the exact size of this risk, remains, however, as indicated by the width of the confidence intervals presented. The Mayak complex, which is located in the Chelyabinsk region of the Russian Federation, includes three main plants: a reactor complex, a radiochemical separation plant, and a plutonium production plant. Workers at all three plants had the potential for exposure to external radiation, and workers at the radiochemical and plutonium production plants also had the potential for exposure to plutonium. Recently, data on workers at two auxiliary plants, who had much less potential for exposure, have been added to the cohort under study to expand the comparison group. As for other nuclear worker cohorts, estimates of annual external doses are available from individual film badge monitoring data. Some workers were also monitored for plutonium exposure; however, since routine testing based on large urine samples did not begin until about 1970, only about 40% of workers with the potential for such exposure have been monitored. External exposures and exposures of Mayak workers to plutonium far exceed those of other nuclear worker cohorts discussed previously in this chapter. For example, for the nearly 11,000 monitored workers hired before 1959, the mean cumulative external dose was 1. Thus, the Mayak cohort offers a unique opportunity to obtain reasonably precise estimates of risks from medium- to high-dose protracted external exposure that can then be compared to estimates based on acute exposure, such as those obtained from A-bomb survivors.


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There are numerous benefits to blood glucose of 102 50 mg cozaar visa the trap haul-out provision what can you eat on a diabetes diet discount cozaar 25 mg on line, including benefits to diabetic lifestyle discount 50mg cozaar with visa lobster and marine mammals if trap gear is limited signs diabetes 1 year old 25mg cozaar visa, as well as enforcement benefits. These benefits are discussed in greater detail in the response to Comment 22 in the Comment and Responses Section later in this proposed rule. The choice of the dates is reasonable because fishing effort is typically minimal during that time period. Failure to implement a similar trap restriction in the Federal Outer Cape zone could have deleterious effects because the restriction already exists in state waters. Accordingly, there would be great incentive for state-Federal dually permitted fishers to transfer their traps into Federal Outer Cape Area waters during the restricted season, thus greatly increasing effort there, absent similar Federal restrictions. The closure would apply only to traps set in the Outer Cape Area; those authorized to set traps in other areas would not be affected. The Board became so concerned about the poor condition of the lobster stock that it took emergency action in February 2003 (a gauge increase) as an immediate stopgap measure while it developed a more thorough plan to respond to the situation. For more than 7 years, the Lobster Board and its sub-committees publicly deliberated over its Area 2 plan. The choice of the 2001­2003 time period reflects an effort to cap fishing effort in Area 2 as it existed while the Commission was developing its Area 2 Limited Access Plan. The dates also reflect an attempt to capture the attrition that occurred in the fishery during the downturn years in 2001­2003. The Commission chose landings as the appropriate metric because landings better reflected actual effort than the reported maximum number of traps fished. This figure represents only 15 percent of the 170 permit holders who designated the Outer Cape Area as a potential fishing area on their permits in 2007. Of those 170 permit holders, however, only 38 purchased trap tags, which suggests that the vast majority (132 permits) designated the Outer Cape Area, but did not actively fish. Additionally, 12 of the 38 trap tag purchasers hailed from ports so distant from the Outer Cape Area that it seems unlikely that those 12 actively fished in the Outer Cape Area. Specifically, the Commission recommended qualifying permit holders into Area 2 if they could document Area 2 landings history from 2001 to 2003. This landings history would be fed into a scientifically-reviewed regression formula to determine the number of traps allocated to the individual. This figure represents approximately 48 percent of the 431 permit holders who designated Area 2 on their permits in 2007. Of those 431 permit holders, however, only 182 purchased trap tags, which suggests that the majority (249 permits) designated Area 2 but did not actively fish there (or anywhere else). This cap would limit the number of Federal lobster permits that an Area 2 participant could own at any one time. At this time the Commission does not appear to have reached a definitive policy on ownership caps. The Commission followed its Outer Cape Transferability Plan with new trap transfer plans in two other areas: One for Area 3; another for Area 2. All recommendations, however, contain the following three basic elements: (1) Individuals could buy and sell traps up to a set trap cap during a designated time period; (2) only individuals with qualified area allocations could sell traps; and (3) each trap transfer would be taxed by 10 percent, payable in traps. Each area trap transfer plan was crafted after considerable public debate and comment. Industry-based Lobster Conservation Management Teams in Areas 2, 3, and Outer Cape Area were the original proponents and architects of their respective area plans. The plans were further refined in public meetings and hearings by the Lobster Board. The program would allow qualified permit holders to sell portions of their trap allocation to other Federal permit holders. The initial recommendation was overly simplistic, which hampered its implementation. In short, the Commission sought to allow qualified Outer Cape permit holders to buy and sell their trap allocations during a who qualify, but only for a small allocation. In other words, individuals could increase their allocation by purchasing additional traps through this program. As a result, the proposed trap transfer program will allow buyers and sellers to scale their businesses to optimum efficiency.

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They provide opportunities for parents and caregivers to blood sugar normal range chart discount cozaar 25 mg amex be actively involved type 1 diabetes quick facts discount 50 mg cozaar overnight delivery, share information diabetes type 1 impotence discount 25mg cozaar amex, provide input and guidance test your diabetes order cozaar 50 mg without a prescription, and increase their own selfconfidence to protect and care for children. To offer children opportunities to develop, learn, play, and build/strengthen resiliency after an emergency or crisis, or during a protracted emergency. To identify and find ways to respond to particular threats to all children and/or specific groups of children, such as those with particular vulnerabilities, after the emergency/crisis, or during a protracted emergency. Other objectives may be relevant, depending on the needs and constraints of the context and the situation on the ground. In some situations, for example, Save the Children might seek to link Child Friendly Spaces to education or health and/or social service systems, have an objective that is advocacyoriented, focuses on inclusion of especially vulnerable groups of children, or facilitates family tracing. Resilience is the ability to "bounce back" from adversity and return to normal levels of functioning, even in the often unpredictable and changing environment of an emergency. While all children are different, resilient children do share some common characteristics. These include: Strong attachment to caring adults and/or peers; An ability to seek out positive, encouraging role models; Easy interaction with adults and peers; A level of independence and an ability to request help when necessary; Regular engagement in active play; An ability to adapt to change; A tendency to think before acting; Confidence to act or control aspects of his or her life or circumstances; and An active interest in hobbies or activities. Just as adults need structure, children also need to feel a structure, purpose and meaning in their lives. Experience from the field suggests that children are able to cope psychologically better in and after an emergency if structure and routine can be created (the more familiar, the better) that allows them to return to a sense of normalcy despite ongoing disruption and changes around them. They can help children continue some of the basic learning tasks of childhood and learn additional positive coping strategies through socializing activities with other children that further assist a return to a sense of normalcy. Child Rights Programming: How to Apply Rights Based Approaches to Programming, A Handbook for International Save the Children Alliance Members, p. The five priorities are right to protection from physical harm, right to protection from psychosocial distress, right to protection from family separation, right to protection from recruitment into armed forces or armed groups, right to protection from exploitation and gender-based violence. Child Centered Spaces: Safe Places for Healing: An Account by the Program Director. Concerns should be addressed in the best way possible, for example, through direct referral to health or other life-saving facilities or advocacy activities. Children at particular risk may include: Children who do not play and/or show psychosocial distress; Children who are separated, or at risk of being separated, from their primary caregivers; Children who are at risk of being recruited into armed forces or armed groups; Children who are heads of households, who are young mothers, or who take care of other children; Children who are at risk of physical harm; Children who are involved in exploitative child labor; Children with disabilities; Children who are otherwise marginalized and lack access to support and services; Children who are at risk of sexual exploitation or other gender-based violence, or who are at risk of early marriage. Implementation Tools and Resources For more information about how Child Friendly Spaces can help identify and address protection threats to children, please see section 3 ­ Protection Aspects of Child Friendly Spaces. Building on the Strengths of the Community and Child Participation Children, parents, caregivers, community leaders, service providers (such as education, health, and social welfare professionals) and the local community are essential to create positive relationships and environments to mitigate the impact of an emergency situation on children. The community­based approach used by Save the Children in Child Friendly Spaces works to build and strengthen community structures and capacities. Successful work with communities builds on the individual and group strengths that are already there, includes an understanding of how existing routines can be supported, and perhaps better routines identified, created, and sustained, through effective planning and design. Not everyone in a community will be equally involved, but a core group of actively involved people can be the key to project sustainability and/or transition to longer-term activities. Implementation Tools and Resources For additional information regarding talking with children, please see Annex 4 ­ Talking with Children: A Quick Introduction to Principles and Techniques. For additional information on working with communities, please see Annex 5 ­ Working with Communities. Inclusive/targeted approach Child Friendly Space activities are designed to reach large numbers of affected children as opposed to a distinctive group. At the same time, it is important to be aware of particularly vulnerable or marginal groups who may need special consideration in order to participate (young mothers, children who head households, children who take care of other children, disabled children, poor children, adolescents, etc. It is important to consult with children who are particularly vulnerable or who may be marginalized to make suitable programs and activities available. This support might include activities at the Child Friendly Space or the Child Friendly Space helping children in these groups link with other available support and services. Experience shows that most children who initially attend a Child Friendly Space are the most well-off in the community. You should investigate ways to identify and encourage children not attending Child Friendly Spaces to participate or design alternative activities with them.



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