Search results for: neonatal death risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6924

Search results for: neonatal death risk

6624 The Development and Validation of the Awareness to Disaster Risk Reduction Questionnaire for Teachers

Authors: Ian Phil Canlas, Mageswary Karpudewan, Joyce Magtolis, Rosario Canlas

Abstract:

This study reported the development and validation of the Awareness to Disaster Risk Reduction Questionnaire for Teachers (ADRRQT). The questionnaire is a combination of Likert scale and open-ended questions that were grouped into two parts. The first part included questions relating to the general awareness on disaster risk reduction. Whereas, the second part comprised questions regarding the integration of disaster risk reduction in the teaching process. The entire process of developing and validating of the ADRRQT was described in this study. Statistical and qualitative findings revealed that the ADRRQT is significantly valid and reliable and has the potential of measuring awareness to disaster risk reduction of stakeholders in the field of teaching. Moreover, it also shows the potential to be adopted in other fields.

Keywords: awareness, development, disaster risk reduction, questionnaire, validation

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6623 Memory and Matrilineage: Is the Siri Mass Possession Tradition of Tulunadu a Death Ritual?

Authors: Yogitha Shetty

Abstract:

Tulunadu, a Tulu-speaking ethno-linguistic minority region in the west coast of India is abundant with oral narratives and associated rituals very unique to this region. One such major worship tradition prevalent here is the mass possession cult of women called Siri Jatre. Deriving its referential script from the Siri epic or pāḍdana, Siri rituals are performed annually in many places of Tulunadu. During these rituals thousands of afflicted women gather at the temple premises and get possessed by the pantheon of seven Siri spirits. While mapping the existing corpus of literature on Siri Jatre – analyzing it as a mode of spirit possession, its psycho-therapeutic significance, its emancipatory potential, etc – this paper offers a paradigm shift by perceiving the entire Siri ritual as a death rite offered to Siri’s grandfather Berma Alva. It draws its arguments from the fieldworks conducted recently in some Siri shrines, interviews conducted among adept Siri women and by analyzing the death rites performed among Bunt caste of the region, and locating it within the historically matrilineal fabric. Thereby, it problematizes the existing analytical frames and raises the question of – if annual Siri ceremonies are a means to bemoan the end of a matrilineal family of Siri? It would delve on the gender configuration as manifested in the Siri cult, having its base in the Tuluva society’s matrilineage, and thereby add to the prevalent ethnographic investigative approaches.

Keywords: death rite, matrilineage, possession, women

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6622 Risk Assessment of Building Information Modelling Adoption in Construction Projects

Authors: Amirhossein Karamoozian, Desheng Wu, Behzad Abbasnejad

Abstract:

Building information modelling (BIM) is a new technology to enhance the efficiency of project management in the construction industry. In addition to the potential benefits of this useful technology, there are various risks and obstacles to applying it in construction projects. In this study, a decision making approach is presented for risk assessment in BIM adoption in construction projects. Various risk factors of exerting BIM during different phases of the project lifecycle are identified with the help of Delphi method, experts’ opinions and related literature. Afterward, Shannon’s entropy and Fuzzy TOPSIS (Technique for Order Preference by Similarity to Ideal Situation) are applied to derive priorities of the identified risk factors. Results indicated that lack of knowledge between professional engineers about workflows in BIM and conflict of opinions between different stakeholders are the risk factors with the highest priority.

Keywords: risk, BIM, fuzzy TOPSIS, construction projects

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6621 Polyvictimization and the Risk of Harm to Self and Others among Children and Youth

Authors: Shannon L. Stewart, Ashley Toohey, Natalia Lapshina

Abstract:

There is a well-established relationship between childhood maltreatment and negative outcomes (e.g., physical and mental health problems, social skill deficits, poor quality of life). The goal of this study was to examine the relationship between polyvictimization (multiple types of trauma) and risk of harm to self and others, taking into account possible age and sex differences. A total of 8980 children and youth were recruited from over 50 mental health facilities across Ontario, Canada. Among this sample, 29% of children and youth had experienced polyvictimization. Results showed that female children and youth who had experienced trauma were at greater risk of harm to themselves, while their male counterparts were at greater risk of harming others. Further, findings from this study highlight that experiencing polyvictimization, regardless of age or sex, increased the risk of harm to self and others. These findings add to extant literature as to the cumulative relationship between polyvictimization and risk in relation to harming oneself or others. Further, results from this study have significant implications for assessment and care-planning for those children and youth presenting with a trauma background.

Keywords: children's mental health, polyvictimization, risk of harm, sex differences

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6620 Flood Planning Based on Risk Optimization: A Case Study in Phan-Calo River Basin in Vinh Phuc Province, Vietnam

Authors: Nguyen Quang Kim, Nguyen Thu Hien, Nguyen Thien Dung

Abstract:

Flood disasters are increasing worldwide in both frequency and magnitude. Every year in Vietnam, flood causes great damage to people, property, and environmental degradation. The flood risk management policy in Vietnam is currently updated. The planning of flood mitigation strategies is reviewed to make a decision how to reach sustainable flood risk reduction. This paper discusses the basic approach where the measures of flood protection are chosen based on minimizing the present value of expected monetary expenses, total residual risk and costs of flood control measures. This approach will be proposed and demonstrated in a case study for flood risk management in Vinh Phuc province of Vietnam. Research also proposed the framework to find a solution of optimal protection level and optimal measures of the flood. It provides an explicit economic basis for flood risk management plans and interactive effects of options for flood damage reduction. The results of the case study are demonstrated and discussed which would provide the processing of actions helped decision makers to choose flood risk reduction investment options.

Keywords: drainage plan, flood planning, flood risk, residual risk, risk optimization

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6619 Climate Related Financial Risk on Automobile Industry and the Impact to the Financial Institutions

Authors: Mahalakshmi Vivekanandan S.

Abstract:

As per the recent changes happening in the global policies, climate-related changes and the impact it causes across every sector are viewed as green swan events – in essence, climate-related changes can often happen and lead to risk and a lot of uncertainty, but needs to be mitigated instead of considering them as black swan events. This brings about a question on how this risk can be computed so that the financial institutions can plan to mitigate it. Climate-related changes impact all risk types – credit risk, market risk, operational risk, liquidity risk, reputational risk and other risk types. And the models required to compute this has to consider the different industrial needs of the counterparty, as well as the factors that are contributing to this – be it in the form of different risk drivers, or the different transmission channels or the different approaches and the granular form of data availability. This brings out the suggestion that the climate-related changes, though it affects Pillar I risks, will be a Pillar II risk. This has to be modeled specifically based on the financial institution’s actual exposure to different industries instead of generalizing the risk charge. And this will have to be considered as the additional capital to be met by the financial institution in addition to their Pillar I risks, as well as the existing Pillar II risks. In this paper, the author presents a risk assessment framework to model and assess climate change risks - for both credit and market risks. This framework helps in assessing the different scenarios and how the different transition risks affect the risk associated with the different parties. This research paper delves into the topic of the increase in the concentration of greenhouse gases that in turn cause global warming. It then considers the various scenarios of having the different risk drivers impacting the Credit and market risk of an institution by understanding the transmission channels and also considering the transition risk. The paper then focuses on the industry that’s fast seeing a disruption: the automobile industry. The paper uses the framework to show how the climate changes and the change to the relevant policies have impacted the entire financial institution. Appropriate statistical models for forecasting, anomaly detection and scenario modeling are built to demonstrate how the framework can be used by the relevant agencies to understand their financial risks. The paper also focuses on the climate risk calculation for the Pillar II Capital calculations and how it will make sense for the bank to maintain this in addition to their regular Pillar I and Pillar II capital.

Keywords: capital calculation, climate risk, credit risk, pillar ii risk, scenario modeling

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6618 Proposal of a Model Supporting Decision-Making Based on Multi-Objective Optimization Analysis on Information Security Risk Treatment

Authors: Ritsuko Kawasaki (Aiba), Takeshi Hiromatsu

Abstract:

Management is required to understand all information security risks within an organization, and to make decisions on which information security risks should be treated in what level by allocating how much amount of cost. However, such decision-making is not usually easy, because various measures for risk treatment must be selected with the suitable application levels. In addition, some measures may have objectives conflicting with each other. It also makes the selection difficult. Moreover, risks generally have trends and it also should be considered in risk treatment. Therefore, this paper provides the extension of the model proposed in the previous study. The original model supports the selection of measures by applying a combination of weighted average method and goal programming method for multi-objective analysis to find an optimal solution. The extended model includes the notion of weights to the risks, and the larger weight means the priority of the risk.

Keywords: information security risk treatment, selection of risk measures, risk acceptance, multi-objective optimization

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6617 A New Criterion Using Pose and Shape of Objects for Collision Risk Estimation

Authors: DoHyeung Kim, DaeHee Seo, ByungDoo Kim, ByungGil Lee

Abstract:

As many recent researches being implemented in aviation and maritime aspects, strong doubts have been raised concerning the reliability of the estimation of collision risk. It is shown that using position and velocity of objects can lead to imprecise results. In this paper, therefore, a new approach to the estimation of collision risks using pose and shape of objects is proposed. Simulation results are presented validating the accuracy of the new criterion to adapt to collision risk algorithm based on fuzzy logic.

Keywords: collision risk, pose, shape, fuzzy logic

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6616 Evaluation of Transfusion-Related Acute Lung Injury

Authors: Hossein Barri Ghazani

Abstract:

Transfusion-related acute lung injury is the main reason of transfusion-related death, and it’s assigned to white blood cell reactive antibodies present in the blood product (anti-HLA class I and class II or anti granulocyte antibodies). TRALI may occur in the COVID-19 patients who are treated by convalescent plasma. The rate of TRALI’s reactions is the same in both males and females and can happen in all age groups. TRALI’s occurrence is higher for people who receive plasma from female donors because the parous female donors have multiple HLA antibodies in their plasma. Patients with chronic liver disease have an augmented risk of transfusion-related acute lung injuries from plasma containing blood products like FFP and PRP. The condition of TRALI suddenly starts with a non‐cardiogenic pulmonary Edema, often accompanied by marked systemic hypovolemic and hypotension. The conditions occur during or within a few hours of transfusion. Chest X-ray shows a nodular penetration or bats’ wing pattern of Edema which can be seen in acute respiratory distress syndrome as well. TRALI can occur with any type of blood products and can occur with as little as one unit. The blood donor center should be informed of the suspected TRALI reactions when the symptoms of TRALI are observed. After a review of the clinical data, the donors must be screened for granulocyte and HLA antibodies. The diagnosis and management of TRALI is not simple and is best done with a professional team and a specialty skilled nurse experienced with the upkeep of these patients.

Keywords: TRALI, transfusion-related death, anti-granulocyte antibodies, anti-HLA antibodies, COVID-19

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6615 Bereavement Risk Assessment of Family Caregivers of Patients with Cancer: Relationship between Bereavement Risk and Post-Loss Psychological Distress

Authors: Tomohiro Uchida, Noriaki Satake, Toshimichi Nakaho, Akira Inoue, Hidemitsu Saito

Abstract:

In this study, we assessed the bereavement risk of family caregivers of patients with cancer. In the palliative care unit of Tohoku University Hospital, we conducted a family psychoeducation session to support the family caregivers of patients with cancer. A total of 50 participants (8 males and 42 females; mean age = 62.98 years, SD = 11.10) were assessed after the session for bereavement risk using the Japanese version of the Bereavement Risk Assessment Tool (BRAT-J). According to the BRAT-J scores, eight participants were considered to be having no known risk (Level 1), seventeen had minimal risk (Level 2), twenty had a low risk (Level 3), four had a moderate risk (Level 4), and one had a high risk (Level 5). Of these participants, seven participants had completed the follow-up postal survey that assessed their psychological distress (the Kessler Psychological Distress Scale: K6) to compare the bereavement risk. According to the K6 scores, three-fourth of the individuals, who were considered to be at Level 3 on the BRAT-J, scored higher than the cutoff point (>10) for the detection of depressive disorder. On the other hand, one-third of the individuals, who were considered to be at Level 2 on the BRAT-J, scored higher than the cutoff point. Therefore, it appears that the BRAT-J can predict the likelihood of difficulties or complications in bereaved family caregivers. This research was approved by the Ethics Committee of Tohoku University Graduate School of Medicine and Tohoku University Hospital.

Keywords: palliative care, family caregivers, bereavement risk, BRAT, post-loss psychological distress

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6614 Measures for Earthquake Risk Reduction in Algeria

Authors: Farah Lazzali, Yamina Ait Meziane

Abstract:

Recent earthquakes in Algeria have demonstrated the need for seismic risk reduction. In fact, the latest major earthquake that affected the Algiers-Boumerdes region in 2003 caused excessive levels of loss of life and property. Economic, social and environmental damage were also experienced. During the three days following the event, a relatively weak coordination of public authority was noted. Many localities did not receive any relief due to lack of information from concerned authorities and delay in connecting damaged roads. Following this event, Algerian government and civil society has recognized the urgent need for an appropriate and immediate seismic risk mitigation strategy. This paper describes procedures for emergency response following past earthquakes in Algeria and provides a brief review of risk mitigation activities since 1980. The paper also aims to provide measures to reduce earthquake risk through general strategy and practical implementation of the mitigation actions.

Keywords: earthquake, hazard, prevention, strategy, risk reduction

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6613 Level of Grief, Emotional Impact and Coping Strategies of Internal Medicine Residents in Response to a Patient’s Death

Authors: Florge Francis A. Sy

Abstract:

Physicians develop emotional and psychological distress after facing a patient’s death. This can result in stress or burnout. Coping mechanisms in dealing with these deaths may be maladaptive. Determining grief, emotional impact, and coping strategies in physicians is necessary to identify those needing intervention. This can be done by employing validated assessment tools such as the Texas Revised Inventory of Grief (TRIG) scale, Impact of Events Scale (IES), and BriefCOPE tool, respectively. This prospective, observational study was done in a private hospital in Cebu City. Fifty-five internal medicine residents were included and tasked to answer a survey based on their most memorable patient death encounter. The TRIG, IES, and BriefCOPE scores were determined. Participants were divided into severe grief and non-severe grief based on TRIG scores, low-impact, moderate-impact, and high-impact based on IES, and low-use, moderate-use, and high-use based on the BriefCOPE. The differences in the groups’ characteristics were statistically determined, and a p-value of < 0.05 was significant. The participants’ average age was 28.45 years. Most were female and single. Most belonged to the non-severe group based on TRIG, a moderate-impact group based on the IES, and high-use group based on the BriefCOPE. However, 21.8% reported severe grief, 27.3% reported high-impact, and 10.9% had low use of coping strategies. The proportion of residents who encountered CPR prior to the patient’s death was greater in the severe group. Proportions of both high-impact and non-high impact groups were comparable. The proportion of female residents was higher in the high-use group. There were a number of residents who reported severe grief, high emotional impact, and low coping strategies. This highlights the need for interventions such as debriefing after CPR or formal training in residency programs in dealing with emotional burden to counteract maladaptive coping behaviors and prevent negative outcomes.

Keywords: residents, grief, emotional impact, coping, patient death

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6612 Monitoring Systemic Risk in the Hedge Fund Sector

Authors: Frank Hespeler, Giuseppe Loiacono

Abstract:

We propose measures for systemic risk generated through intra-sectorial interdependencies in the hedge fund sector. These measures are based on variations in the average cross-effects of funds showing significant interdependency between their individual returns and the moments of the sector’s return distribution. The proposed measures display a high ability to identify periods of financial distress, are robust to modifications in the underlying econometric model and are consistent with intuitive interpretation of the results.

Keywords: hedge funds, systemic risk, vector autoregressive model, risk monitoring

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6611 Integrated Risk Management as a Framework for Organisational Success

Authors: Olakunle Felix Adekunle

Abstract:

Risk management is recognised as an essential tool to tackle the inevitable uncertainty associated with business and projects at all levels. But it frequently fails to meet expectations, with projects continuing to run late, over budget or under performing, and business is not gaining the expected benefits. The evident disconnect which often occurs between strategic vision and tactical project delivery typically arises from poorly defined project objectives and inadequate attention to the proactive management of risks that could affect those objectives. One of the main failings in the traditional approach to risk management arises from a narrow focus on the downside, restricted to the technical or operational field, addressing tactical threats to processes, performance or people. This shortcoming can be overcome by widening the scope of risk management to encompass both strategic risks and upside opportunities, creating an integrated approach which can bridge the gap between strategy and tactics. Integrated risk management addresses risk across a variety of levels in the organisation, including strategy and tactics, and covering both opportunity and threat. Effective implementation of integrated risk management can produce a number of benefits to the organisation which are not available from the typical limited-scope risk process. This paper explores how to expand risk management to deliver strategic advantage while retaining its use as a tactical tool.

Keywords: risk management, success, organization, strategy, project, tactis, vision

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6610 A Risk Pathway of Distal and Proximal Factors for Self-Injury among Adolescents

Authors: Sarit Gideoni Cohen

Abstract:

The aim of the study was to examine possible risk pathway which initiated by the distal risk factors of insecure attachment to the mother, the father and peers and then developed by means of proximal risk factors: stressful life events and emotional distress. 275 participants (aged 13-26) from high-schools, youth groups and university were requited. Twenty-two percent participants reported at least one episode of self-injury. The relationship between paternal and peer attachment were partly mediated by stressful life events and depressive symptoms. Paternal and peer attachment influences during adolescence as contributing to risk pathway for self-injury were acknowledged.

Keywords: self-injury, attachment, depression, stressful life-events, adolescence

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6609 Is Brain Death Reversal Possible in Near Future: Intrathecal Sodium Nitroprusside (SNP) Superfusion in Brain Death Patients=The 10,000 Fold Effect

Authors: Vinod Kumar Tewari, Mazhar Husain, Hari Kishan Das Gupta

Abstract:

Background: Primary or secondary brain death is also accompanied with vasospasm of the perforators other than tissue disruption & further exaggerates the anoxic damage, in the form of neuropraxia. In normal conditions the excitatory impulse propagates as anterograde neurotransmission (ANT) and at the level of synapse, glutamate activates NMDA receptors on postsynaptic membrane. Nitric oxide (NO) is produced by Nitric oxide Synthetase (NOS) in postsynaptic dendride or cell body and travels backwards across a chemical synapse to bind to the axon terminal of a presynaptic neuron for regulation of ANT this process is called as the retrograde neurotransmission (RNT). Thus the primary function of NO is RNT and the purpose of RNT is regulation of chemical neurotransmission at synapse. For this reason, RNT allows neural circuits to create feedback loops. The haem is the ligand binding site of NO receptor (sGC) at presynaptic membrane. The affinity of haem exhibits > 10,000-fold excess for NO than Oxygen (THE 10,000 FOLD EFFECT). In pathological conditions ANT, normal synaptic activity including RNT is absent. NO donors like sodium nitroprusside (SNP) releases NO by activating NOS at the level of postsynaptic area. NO now travels backwards across a chemical synapse to bind to the haem of NO receptor at axon terminal of a presynaptic neuron as in normal condition. NO now acts as impulse generator (at presynaptic membrane) thus bypasses the normal ANT. Also the arteriolar perforators are having Nitric Oxide Synthetase (NOS) at the adventitial side (outer border) on which sodium nitroprusside (SNP) acts; causing release of Nitric Oxide (NO) which vasodilates the perforators causing gush of blood in brain’s tissue and reversal of brain death. Objective: In brain death cases we only think for various transplantations but this study being a pilot study reverses some criteria of brain death by vasodilating the arteriolar perforators. To study the effect of intrathecal sodium nitroprusside (IT SNP) in cases of brain death in which: 1. Retrograde transmission = assessed by the hyperacute timings of reversal 2. The arteriolar perforator vasodilatation caused by NO and the maintenance of reversal of brain death reversal. Methods: 35 year old male, who became brain death after head injury and has not shown any signs of improvement after every maneuver for 6 hours, a single superfusion done by SNP via transoptic canal route for quadrigeminal cistern and cisternal puncture for IV ventricular with SNP done. Results: He showed spontaneous respiration (7 bouts) with TCD studies showing start of pulsations of various branches of common carotid arteries. Conclusions: In future we can give this SNP via transoptic canal route and in IV ventricle before declaring the body to be utilized for transplantations or dead or in broader way we can say that in near future it is possible to revert back from brain death or we have to modify our criterion.

Keywords: brain death, intrathecal sodium nitroprusside, TCD studies, perforators, vasodilatations, retrograde transmission, 10, 000 fold effect

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6608 An Investigation of the Compliance of Kermanian College Students' Diet with Who/Fao Nutrition Targets

Authors: Farideh Doostan, Sahar Mohseni Taklloo, Mohammad Nosrati

Abstract:

Chronic diseases are non-communicable and largely preventable by lifestyle changes including healthy diet consumption. They are the most common cause of death in the world and projected to increase by 15% globally between 2010 and 2020.The hazardous effects of behavioral and dietary risk factors on chronic disease have been established in prospective cohort studies and randomized trials. Because of some changes occur in college students’ lifestyle, assessment of dietary risk factors is important in these populations. Objective: This research was the first study that conducted to evaluate dietary intakes of Kermanian college students with WHO/FAO nutritional objectives. Material and Methods: In this descriptive cross-sectional study, 229 healthy college students of health faculty in Kerman University of Medical Sciences that do not intake any medical drugs were recruited using multistage sampling in 2013.Usual dietary intake was collected using a valid Food Frequency Questionnaire (FFQ) and diet quality was calculated based on WHO nutrient goals. To analysis of data between two groups, independent sample t. test and man whitney were applied. Results: Two hundred and twenty-nine college students; 151 females (65.9%) and 78 males (34.1%), the mean age of 21.9 years were studied. The mean of the Body Mass Index (Kg/m2) and Waist Circumference (cm) in males were 22.34 ±3.52 and 80.76±11.16 and in females were 21.19±2.62 and 73.67±7.65 respectively. Mean of daily cholesterol intake in males was significantly more than females (305±101 VS 268±98; P=0.008) and more than WHO/FAO recommendation (less than 300 mg/day). The mean of daily sodium intake in men and women were 10.4±1 and 10.9±5.3 respectively. These amounts were more than WHO/FAO recommendation (less than 2g/day). In addition, women were consumed fruit and vegetables more than men (839±336 VS 638±281; p ‹ 0.001) and these amounts were more than WHO/FAO recommendation (more than 400g/day) in both groups. Other intake indices were in the range of WHO/FAO recommendations, So that Percent of calories intake from total fat, saturated fatty acids, polyunsaturated fatty acids and added sugar were in compliance with WHO/FAO recommendations. Conclusion: Cholesterol intake in men and sodium intake in all participants were more than WHO/FAO recommendation. These dietary components are the most important causes of cardiovascular disease (one of the main causes of death in our population). These results indicated that proper nutritional education and interventions are needed in this population.

Keywords: college students, food intake, WHO /FAO nutrient intake goals, Kerman

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6607 Effects of Alpha Lipoic Acid on Limb Lengths in Neonatal Rats Exposed to Maternal Tobacco Smoke

Authors: Ramazan F. Akkoc, Elif Erdem, Nalan Kaya, Gonca Ozan, D. Özlem Dabak, Enver Ozan

Abstract:

Maternal tobacco smoke exposure is known to cause growth retardation in the neonatal skeletal system. Alpha lipoic acid, a natural antioxidant found in some foods, limits the activities of osteoclasts and supports the osteoblast's bone formation mechanism. In this study, it was aimed to investigate the effects of alpha lipoic acid (ALA) on the height, long bones and tail lengths of pups exposed to maternal tobacco smoke. The rats were divided into four groups: 1) control group, 2) tobacco smoke group, 3) tobacco smoke + ALA group, and 4) ALA group. Rats in the group 2 (tobacco smoke), group 3 (tobacco smoke + ALA) were exposed to tobacco smoke twice a day for one hour starting from eight weeks before mating and during pregnancy. In addition to tobacco smoke, 20 mg/kg of alpha lipoic acid was administered via oral gavage to the rats in the group 3 (tobacco smoke + ALA). Only alpha lipoic acid was administered to the rats in the group 4. On day 21 postpartum, the height and tail lengths of the pups in all groups were measured, and the length of the extremity long bones was measured after decapitation. All morphometric measurements performed in group 2 (tobacco smoke) showed a significant decrease compared to group 1 (control), while all measurements in group 3 (tobacco smoke + ALA) showed a significant increase compared to group 2 (tobacco smoke). It has been shown that ALA has a protective effect against the regression of height, long bones and tail lengths of pups exposed to maternal tobacco smoke.

Keywords: alpha lipoic acid, bone, morphometry, rat, tobacco smoke

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6606 Preventive Effects of Motorcycle Helmets on Clinical Outcomes in Motorcycle Crashes

Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

Abstract:

Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

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6605 The Impact of Corporate Governance on Risk Taking in European Insurance Industry

Authors: Francesco Venuti, Simona Alfiero

Abstract:

The aim of this paper is to develop an empirical research on the nature and consequences of corporate governance on Eurozone Insurance Industry risk taking attitude. More particularly, we analyzed the effect of public ownership on risk taking with respect to privately held Insurance Companies. We also analyzed the effects on risk taking attitude of different degrees of ownership concentration, directors compensation, and the dimension/diversity of the Board of Directors. Our results provide quite strong evidence that, coherently with the Agency Theory, publicly traded insurance companies with more concentrated ownership are less risky than the corresponding privately held.

Keywords: agency theory, corporate governance, insurance companies, risk taking

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6604 The Application of Article 111 of the Constitution of Bangladesh in the Criminal Justice System as a Sentencing Guideline

Authors: Sadiya S. Silvee

Abstract:

Generally, the decision of the higher court is binding on its subordinate courts. As provided in Article 111 of the Constitution, 'the law declared by the Appellate Division (AD) shall be binding on the High Court Division (HCD) and the law declared by either division of the Supreme Court shall be binding on all courts subordinate to it.' This means the judicial discipline requires the HCD to follow the decision of the AD and that it is necessary for the lower tiers of courts to accept the decision of the higher tiers as a binding precedent. Analyzing the application of Article 111 of the Constitution in the criminal justice system as a sentencing guideline, the paper, by examining whether there is any consistency in decision between one HC Bench and another HC Bench, explores whether HCD can per incuriam its previous decision. In doing so, the Death Reference (DR) Cases are contemplated. Furthermore, the paper shall examine whether the Court of Session follows the decision of the HCD while using their discretion to make the choice between death and imprisonment for life under section 302 of PC. The paper argues due to the absence of any specific direction for sentencing and inconsistency in jurisprudence among the HCD; the subordinate courts are in a dilemma.

Keywords: death reference, sentencing factor, sentencing guideline, criminal justice system and constitution

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6603 Development of Risk Management System for Urban Railroad Underground Structures and Surrounding Ground

Authors: Y. K. Park, B. K. Kim, J. W. Lee, S. J. Lee

Abstract:

To assess the risk of the underground structures and surrounding ground, we collect basic data by the engineering method of measurement, exploration and surveys and, derive the risk through proper analysis and each assessment for urban railroad underground structures and surrounding ground including station inflow. Basic data are obtained by the fiber-optic sensors, MEMS sensors, water quantity/quality sensors, tunnel scanner, ground penetrating radar, light weight deflectometer, and are evaluated if they are more than the proper value or not. Based on these data, we analyze the risk level of urban railroad underground structures and surrounding ground. And we develop the risk management system to manage efficiently these data and to support a convenient interface environment at input/output of data.

Keywords: urban railroad, underground structures, ground subsidence, station inflow, risk

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6602 Outcomes of Using Guidelines for Caring and Referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department of Songkhla Hospital, Thailand

Authors: Thanom Kaeniam

Abstract:

ST-Elevation Myocardial Infarction (STEMI) is a state of sudden death of the heart muscle due to sudden blockage of the artery. STEMI patients are usually in critical condition and with a potential opportunity for sudden death. Therefore, management guidelines for safety in caring and referring STEMI patients are needed. The objective of this developmental research was to assess the effectiveness of using the guidelines for caring and referring STEMI patients at the Accident and Emergency Department of Songkhla Hospital. The subjects of the study were 22 nurses in the emergency room, and doctors on duty in the accident and emergency room selected using purposive sampling with inclusion criteria. The research instruments were the guidelines for caring and referring STEMI patients, and record forms for the effectiveness of using the guidelines for caring and referring STEMI patients (a general record form for STEMI patients, a record form for SK administering, a referring record form for PCI, and a record form for dead patient in the accident and emergency room and during referring). The instruments were tested for content validity by three experts, and the reliability was tested using Kuder-Richardson 20 (KR20). The descriptive statistic employed was the percentage. The outcomes of using the guidelines for caring and referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department revealed that before using the guidelines in 2009, 2010, and 2011, there were 84, 73, and 138 STEMI patients receiving services at the accident and emergency room, of which, only 9, 32, and 48 patients were referred for PCI/SK medications, or 10.74; 43.84; and 34.78 percent, and the death rates were 10.71; 10.95; and 11.59 percent, respectively. However, after the use of the guidelines in 2012, 2013, and 2014, there were 97, 77, and 57 patients, of which, the increases to 77, 72, and 55 patients were referred for PCI /SK medications or 79.37; 93.51; and 96.49 percent, and the death rates were reduced to 10.30; 6.49; and 1.76 percent, respectively. The results of the study revealed that the use of the guidelines for caring and referring STEMI patients at the Accident and Emergency Department increased the effectiveness and quality of nursing, especially in terms of SK medication, caring and referring patients for PCI to reduce the death rate.

Keywords: outcomes, guidelines for caring, referring, myocardial infarction, STEMI

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6601 Clustering for Detection of the Population at Risk of Anticholinergic Medication

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

Abstract:

Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

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6600 Proposal of a Model Supporting Decision-Making on Information Security Risk Treatment

Authors: Ritsuko Kawasaki, Takeshi Hiromatsu

Abstract:

Management is required to understand all information security risks within an organization, and to make decisions on which information security risks should be treated in what level by allocating how much amount of cost. However, such decision-making is not usually easy, because various measures for risk treatment must be selected with the suitable application levels. In addition, some measures may have objectives conflicting with each other. It also makes the selection difficult. Therefore, this paper provides a model which supports the selection of measures by applying multi-objective analysis to find an optimal solution. Additionally, a list of measures is also provided to make the selection easier and more effective without any leakage of measures.

Keywords: information security risk treatment, selection of risk measures, risk acceptance, multi-objective optimization

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6599 A Financial Analysis of the Current State of IKEA: A Case Study

Authors: Isabela Vieira, Leonor Carvalho Garcez, Adalmiro Pereira, Tânia Teixeira

Abstract:

In the present work, we aim to analyse IKEA as a company, by focusing on its development, financial analysis and future benchmarks, as well as applying some of the knowledge learned in class, namely hedging and other financial risk mitigation solutions, to understand how IKEA navigates and protects itself from risk. The decision that led us to choose IKEA for our casework has to do with the long history of the company since the 1940s and its high internationalization in 63 different markets. The company also has clear financial reports which aided us in the making of the present essay and naturally, was a factor that contributed to our decision.

Keywords: Ikea, financial risk, risk management, hedge

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6598 Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor

Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease

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6597 Intellectual Property Risk Assessment in Planning Market Entry to China

Authors: Qing Cao

Abstract:

Generally speaking, China has a relatively high level of intellectual property (IP) infringement. Risk assessment is indispensable in the strategic planning process. To complement the current literature in international business, the paper sheds the light on how to assess IP risk for foreign companies in planning market entry to China. Evaluating internal and external IP environment, proposed in the paper, consists of external analysis, internal analysis and further internal analysis. Through position the company’s IP environment, the risk assessment approach enables the foreign companies to either build the corresponding IP strategies or abort the entry plan beforehand to minimize the IP risks.

Keywords: intellectual property, IP environment, risk assessment

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6596 Sex Education Training Program Effect on Junior Secondary School Students Knowledge and Practice of Sexual Risk Behavior

Authors: Diyaolu Babajide Olufemi, Oyerinde Oyewole Olusesan

Abstract:

This study examined the effect of sex education training programs on the knowledge and practice of sexual risk behavior among secondary school adolescents in Ibadan North Local Government area of Oyo State. A total of 105 students were sampled from two schools in the Local Government area. Seventy students (70) constituted the experimental group while thirty-five (35) constituted the control group. Pretest-Posttest control group quasi-experimental design was adopted. A self-developed questionnaire was used to test participants’ knowledge and practice of sexual risk behavior before and after the training (α=.62, .82 and .74). Analysis indicated a significant effect of sex education training on participants’ knowledge and practice of sexual risk behavior, a significant gender difference in knowledge of sexual risk behavior but no significant age and gender difference in the practice of sexual risk behavior. It was thus concluded that sex education should be taught in schools and emphasized at homes with no age or gender restrictions.

Keywords: early adolescent, health risk, sexual risk behavior, sex education

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6595 Environmental Governance and Opportunities for Disaster Risk Reduction in Nigeria

Authors: Willie Eselebor

Abstract:

Environmental governance is not new, but may consist of a series of actions taken to establish sanity and ensure sustainable environment. While there is a growing accord linking disaster risk reduction with the management of environment and natural resources, little is known about failure to act which constitute vulnerability and how improved governance reduces risk globally. The paper reviews emerging trends in the field of application of governance tools and approaches for reducing disaster risk. The Hyogo Framework for Action (HFA) enjoin all stakeholders to stimulate the sustainable use and management of ecosystems, which promote the implementation of integrated environmental and natural resource planning that incorporate disaster risk reduction, including structural and non-structural measures, such as integrated management of fragile ecosystems. The methodology adopted is a case study of disaster-prone sites, prompting guided analysis on which hazards are traceable to environmental degradation, why a degraded environment reduces community resilience; how healthy ecosystems provide natural defense, and which opportunities exist to address gaps in reduction of disasters in Nigeria. The paper further analyses the interaction between disaster risk and environmental change. It is established that environmental governance remains a challenge; which implies that there is the need for a shift in traditional approaches to disaster risk management; exploring new initiatives and allowing environmental managers to be docketed as disaster risk managers in context, potentially opening up a window of dialogue on disaster risk management.

Keywords: disaster, ecosystem, environment, risk

Procedia PDF Downloads 328