Search results for: physical risk factors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 19157

Search results for: physical risk factors

18677 Effects, Causes, and Prevention of Teen Dating Violence

Authors: Isabel Jones

Abstract:

As adolescence is a formative time, experiences during adolescence often affect the rest of one’s life. Therefore, dating, specifically violence in dating, can have lasting effects on the rest of one’s life. In order to find sources, searches were conducted on PsycINFO, specifically EBSCO, and narrowed down under the criteria that the source contained information about adolescent dating violence rather than adult, and focused on causes, effects, or prevention methods. This literature review examines research regarding the effects and causes of TDV, and then what methods are effective in the prevention of TDV development. This will allow for a clear image of how these prevention methods are effective and why they are important. Effects of TDV extend beyond the physical, including psychological and sexual long-lasting effects. These are caused by a number of concepts, including learned behavior, inhibitory issues/substance abuse, and cultural factors. When both of these are taken into account, preventative measures such as school-based interventions, parental/adult monitoring, and the presence of positive family examples are more clear as to their effectiveness. This literature review may provide further awareness to this public health crisis and give the public a view of how adolescents are affected by TDV on their path from child to adult.

Keywords: adolescence, dating violence, risk factors, predictors, relationship

Procedia PDF Downloads 60
18676 Safety of Ports, Harbours, Marine Terminals: Application of Quantitative Risk Assessment

Authors: Dipak Sonawane, Sudarshan Daga, Somesh Gupta

Abstract:

Quantitative risk assessment (QRA) is a very precise and consistent approach to defining the likelihood, consequence and severity of a major incident/accident. A variety of hazardous cargoes in bulk, such as hydrocarbons and flammable/toxic chemicals, are handled at various ports. It is well known that most of the operations are hazardous, having the potential of damaging property, causing injury/loss of life and, in some cases, the threat of environmental damage. In order to ensure adequate safety towards life, environment and property, the application of scientific methods such as QRA is inevitable. By means of these methods, comprehensive hazard identification, risk assessment and appropriate implementation of Risk Control measures can be carried out. In this paper, the authors, based on their extensive experience in Risk Analysis for ports and harbors, have exhibited how QRA can be used in practice to minimize and contain risk to tolerable levels. A specific case involving the operation for unloading of hydrocarbon at a port is presented. The exercise provides confidence that the method of QRA, as proposed by the authors, can be used appropriately for the identification of hazards and risk assessment of Ports and Terminals.

Keywords: quantitative risk assessment, hazard assessment, consequence analysis, individual risk, societal risk

Procedia PDF Downloads 76
18675 Future Outlook and Current Situation for Security of Gas Supply in Eastern Baltic Region

Authors: Ando Leppiman, Kati Kõrbe Kaare, Ott Koppel

Abstract:

The growing demand for gas has rekindled a debate on gas security of supply due to supply interruptions, increasing gas prices, transportation and distribution bottlenecks and a growing reliance on imports over longer distances. Security of supply is defined mostly as an infrastructure package to satisfy N-1 criteria. In case of Estonia, Finland, Latvia, and Lithuania all the gas infrastructure is built to supply natural gas only from one single supplier, Russia. In 2012, almost 100% of natural gas to the Eastern Baltic Region was supplied by Gazprom. under such circumstances infrastructure N-1 criteria does not guarantee security of supply. In the Eastern Baltic Region, the assessment of risk of gas supply disruption has been worked out by applying the method of risk scenarios. There are various risks to be tackled in Eastern Baltic States in terms of improving security of supply, such as single supplier risk, physical infrastructure risk, regulatory gap, fair price, and competition. The objective of this paper is to evaluate the energy security of the Eastern Baltic Region within the framework of the European Union’s policies and to make recommendations on how to better guarantee the energy security of the region.

Keywords: security of supply, supply routes for natural gas, energy balance, diversified supply options, common regulative package

Procedia PDF Downloads 255
18674 Fuzzy Inference System for Risk Assessment Evaluation of Wheat Flour Product Manufacturing Systems

Authors: Atrin Barzegar, Yas Barzegar, Stefano Marrone, Francesco Bellini, Laura Verde

Abstract:

The aim of this research is to develop an intelligent system to analyze the risk level of wheat flour product manufacturing system. The model consists of five Fuzzy Inference Systems in two different layers to analyse the risk of a wheat flour product manufacturing system. The first layer of the model consists of four Fuzzy Inference Systems with three criteria. The output of each one of the Physical, Chemical, Biological and Environmental Failures will be the input of the final manufacturing systems. The proposed model based on Mamdani Fuzzy Inference Systems gives a performance ranking of wheat flour products manufacturing systems. The first step is obtaining data to identify the failure modes from expert’s opinions. The second step is the fuzzification process to convert crisp input to a fuzzy set., then the IF-then fuzzy rule applied through inference engine, and in the final step, the defuzzification process is applied to convert the fuzzy output into real numbers.

Keywords: failure modes, fuzzy rules, fuzzy inference system, risk assessment

Procedia PDF Downloads 69
18673 Comparison of the Common Factors of the Top Academic Elementary Schools to the Average Elementary Schools in California: Looking beyond School Leadership

Authors: Lindy Valdez, Daryl Parker

Abstract:

Introduction: There has been much research on academic achievement in elementary schools. Most of the research has been on school leadership. While research has focused on the role of leadership on school improvement, little research has examined what variables the top elementary schools have in common. To undertake school improvement, it is important to understand what factors the best schools share. The purpose of this study was to examine data of the “Best Elementary Schools in California,” based on academic achievement as rated by three prominent websites and determine if these schools had any common factors which were different than the statewide averages. The variables examined included access to subject matter specialists (physical education, art, and music), librarians, after school programs, class size, socioeconomic status, and diversity. The participants consisted of the top public elementary schools in California based on the websites i)https://www.niche.com/k12/search/best-schools/, ii)https://www.finder.com/best-schools-california,and iii)https://www.schooldigger.com/go/CA/schoolrank.aspx. The data for subject matter specialists (physical education, art, and music), librarians, after school programs, class size, socioeconomic status, and diversity were collected from these top schools and compared to California statewide averages. Results indicate that top public elementary schools in California have a high number of subject matter specialists that teach physical education, art, and music. These positions are on the decline in the average public elementary school in California, but the top schools have abundant access to these specialists. The physical education specialist has the highest statistically significant difference between the nationwide average and the top schools—librarians, and after school programs are also most commonly high in top public elementary schools in California. The high presence of these programs may be aiding academic achievement in less visible ways. Class size is small, socio-economic status is high, and diversity is low among top public elementary schools in California when compared to the statewide average public elementary schools in California. The single largest area of discrepancy was between physical education specialists in a top school and their state and nationwide averages. The socioeconomic status of schools and parents may be an underlining factor affecting several other variables. This affluence could explain how these schools were able to have access to subject matter specialists, after-school activities, and, therefore, more opportunities for physical activity and greater learning opportunities affecting academic achievement.

Keywords: academic achievement, elementary education, factors, schools

Procedia PDF Downloads 128
18672 To Access the Knowledge, Awareness and Factors Associated With Diabetes Mellitus in Buea, Cameroon

Authors: Franck Acho

Abstract:

This is a chronic metabolic disorder which is a fast-growing global problem with a huge social, health, and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Diabetes mellitus is a chronic heterogeneous metabolic disorder with a complex pathogenesis. It is characterized by elevated blood glucose levels or hyperglycemia, which results from abnormalities in either insulin secretion or insulin action or both. Hyperglycemia manifests in various forms with a varied presentation and results in carbohydrate, fat, and protein metabolic dysfunctions. Long-term hyperglycemia often leads to various microvascular and macrovascular diabetic complications, which are mainly responsible for diabetes-associated morbidity and mortality. Hyperglycemia serves as the primary biomarker for the diagnosis of diabetes as well. Furthermore, it has been shown that almost 50% of the putative diabetics are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. This study was conducted in a locality to access the level of knowledge, awareness and risk factors associated with people leaving with diabetes mellitus. A month before the screening was to be conducted, a health screening in some selected churches and on the local community radio as well as on relevant WhatsApp groups were advertised. A general health talk was delivered by the head of the screening unit to all attendees who were all educated on the procedure to be carried out with benefits and any possible discomforts after which the attendee’s consent was obtained. Evaluation of the participants for any leads to the diabetes selected for the screening was done by taking adequate history and physical examinations such as excessive thirst, increased urination, tiredness, hunger, unexplained weight loss, feeling irritable or having other mood changes, having blurry vision, having slow-healing sores, getting a lot of infections, such as gum, skin and vaginal infections. Out of the 94 participants the finding show that 78 were females and 16 were males, 70.21% of participants with diabetes were between the ages of 60-69yrs.The study found that only 10.63% of respondents declared a good level of knowledge of diabetes. Out of 3 symptoms of diabetes analyzed in this study, high blood sugar (58.5%) and chronic fatigue (36.17%) were the most recognized. Out of 4 diabetes risk factors analyzed in this study, obesity (21.27%) and unhealthy diet (60.63%) were the most recognized diabetes risk factors, while only 10.6% of respondents indicated tobacco use. The diabetic foot was the most recognized diabetes complication (50.57%), but some the participants indicated vision problems (30.8%),or cardiovascular diseases (20.21%) as diabetes complications.

Keywords: diabetes mellitus, non comunicable disease, general health talk, hyperglycemia

Procedia PDF Downloads 50
18671 The Relationship of Depression Risk and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Authors: Yu Chen Su

Abstract:

Introduction: Gestational diabetes mellitus (GDM) refers to impaired glucose tolerance in pregnant women, impacting both the mother and newborn with short and long-term effects. It increases risks of preeclampsia, hypertension, type 2 diabetes, cesarean section, and preterm birth. GDM is associated with fetal macrosomia, shoulder dystocia, neonatal hypoglycemia, and future type 2 diabetes risk. A study on 6,421 pregnant women found 12% experienced high stress, linked to maladaptive coping and depressive emotions. Women with high-risk pregnancies may experience greater stress and depression. Research suggests GDM increases depression prevalence. A study on 632 Hispanic women with GDM showed severe stress and depression tendencies. Involving 95 women with GDM, 33.4% exhibited depression symptoms. Another study compared 180 GDM women to 186 with normal glucose levels, revealing higher depression levels in GDM women. They found GDM women were 1.85 times more likely to receive antidepressants during pregnancy and 1.69 times more likely to experience postpartum depression. Maternal stress and depressive symptoms during pregnancy are significant factors. Early identification by healthcare professionals can greatly benefit GDM women, their infants, and their families. Objectives: The purpose of this study was to investigate the association between gestational diabetes mellitus (GDM) and the risk of depression. Methods: This study reviewed and analyzed relevant literature on gestational diabetes mellitus (GDM) and depression in 6,876 patients. The literature search followed PRISMA guidelines and included databases like Embase, PubMed, MEDLINE, CINAHL, and Cochrane Library. Prospective or retrospective studies with relevant risk ratios and estimates were included, using a random-effects model for the analysis of depression risk correlation. Studies without depression data or relevant risks were excluded. The search period extended until October 2022. Results: Systematic review of 7 studies (6,876 participants) found a significant association (OR = 8.77, CI: 7.98-9.64, p < 0.05) between gestational diabetes mellitus (GDM) and higher depression risk compared to healthy pregnant women. Conclusions: Pregnancy is a significant life transition involving physiological, psychological, and social changes. Gestational diabetes poses challenges to women's physical and mental well-being. Sensitive healthcare professionals identifying issues early can greatly benefit women, babies, and the family.

Keywords: gestational diabetes, depression, systematic review, neta-analysis

Procedia PDF Downloads 68
18670 Association of Xeroderma pigmentosum Group D Gene Polymorphism with Colorectal Cancer Risk in Kashmiri Population

Authors: Syed Sameer Aga, Saniya Nissar

Abstract:

The Xeroderma pigmentosum group D gene (XPD) plays a key role in nucleotide excision repair (NER) pathway of the damaged DNA. Genetic polymorphisms in the coding region of the XPD gene may alter DNA repair capacity of the protein and hence can modulate the risk of colorectal cancer (CRC) risk. The aim of the study was to determine the genetic association of XPD Lys751Gln polymorphism with the risk of colorectal cancer (CRC) development. 120 CRC patients and 160 normal controls were assessed for genotype frequencies of XPD Lys751Gln polymorphism using PCR-RFLP technique. We observed a significant association (p < 0.05) between the XPD Lys751Gln polymorphism and the risk of developing CRC (p < 0.05). Additionally, Gln/Gln genotype of the XPD gene doubled the risk for the development of CRC [p < 0.05; OR=2.25 95% CI (1.07-4.7)]. Our results suggest that there is a significant association between the XPD Lys751Gln polymorphism and the risk of CRC.

Keywords: colorectal cancer, polymorphism, RFLP, DNA Repair, NER, XPD

Procedia PDF Downloads 208
18669 A Holistic Analysis of the Emergency Call: From in Situ Negotiation to Policy Frameworks and Back

Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

Abstract:

Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

Procedia PDF Downloads 94
18668 The Determinants of Enterprise Risk Management: Literature Review, and Future Research

Authors: Sylvester S. Horvey, Jones Mensah

Abstract:

The growing complexities and dynamics in the business environment have led to a new approach to risk management, known as enterprise risk management (ERM). ERM is a system and an approach to managing the risks of an organization in an integrated manner to achieve the corporate goals and strategic objectives. Regardless of the diversities in the business environment, ERM has become an essential factor in managing individual and business risks because ERM is believed to enhance shareholder value and firm growth. Despite the growing number of literature on ERM, the question about what factors drives ERM remains limited. This study provides a comprehensive literature review of the main factors that contribute to ERM implementation. Google Scholar was the leading search engine used to identify empirical literature, and the review spanned between 2000 and 2020. Articles published in Scimago journal ranking and Scopus were examined. Thirteen firm characteristics and sixteen articles were considered for the empirical review. Most empirical studies agreed that firm size, institutional ownership, industry type, auditor type, industrial diversification, earnings volatility, stock price volatility, and internal auditor had a positive relationship with ERM adoption, whereas firm size, institutional ownership, auditor type, and type of industry were mostly seen be statistically significant. Other factors such as financial leverage, profitability, asset opacity, international diversification, and firm complexity revealed an inconclusive result. The growing literature on ERM is not without limitations; hence, this study suggests that further research should examine ERM determinants within a new geographical context while considering a new and robust way of measuring ERM rather than relying on a simple proxy (dummy) for ERM measurement. Other firm characteristics such as organizational culture and context, corporate scandals and losses, and governance could be considered determinants of ERM adoption.

Keywords: enterprise risk management, determinants, ERM adoption, literature review

Procedia PDF Downloads 167
18667 Personal and Social Factors as Barriers to Leisure Walking in Residential Neighborhoods

Authors: Zeinab Aliyas, Diba Mahboubi

Abstract:

Leisure walking is known as one of the most common types of physical activity that perform in purpose of recreation or health, which in turn may affect resident’s health. In the recent years, promoting leisure walking activity in neighborhood areas become as one of the important issues regarding promoting mental and physical health, however; the level of physical inactivity is rising in many societies including Iran. As it was proven that the tendency to walk out of choice is not encouraging among Iranian people. Hence; understanding the main concern of residents regarding walking activity in their neighborhoods can help in increasing the tendency to do leisure activity among residents. Built environment, social and individual factors are known as the main factors that affect decision to walk, in this regard, the study aimed to investigate the influence of personal and social factors that prevent residents to walk for recreation or exercise in their neighborhoods. Hence the fear of crime and personal barriers were examined in the current research as social and personal factors respectively. To collect the required data, 500 questionnaires by using systematic sampling were distributed from March to May 2016 in four residential neighborhoods of Bandar Abbas in Iran out which 411 questionnaire turned out to be qualified to be used in the study. The Smart-PLS was used to analyze the data. The findings of the study revealed that personal and fear of crime both have significant influence on the level of recreation and exercise walking in the neighborhood areas. The study found that fear of crime has the higher influence on exercise and recreational walking behavior in comparison to individual factors. It was revealed that social factors such as fear of crime in the neighborhoods might be more important than the personal reason for walking optionally in the surrounding environment. The finding of this study can help urban and health researcher to know the significant influence of fear of crime and individual attitudes on the level of leisure walking activity, in addition, the findings of the study suggest that urban planners and designers, as well as public health promoters, need to highly consider the contribution of neighborhoods' social environment variables as well as individual variables to promote walking behavior changes among adult population.

Keywords: exercise walking, fear of crime, neighborhood, personal barriers, recreation walking

Procedia PDF Downloads 186
18666 Spatial Planning Model on Landslide Risk Disaster at West Java Geothermal Field, Indonesia

Authors: Herawanti Kumalasari, Raldi Hendro Koestoer, Hayati Sari Hasibuan

Abstract:

Geographically, Indonesia is located in the arc of volcanoes that cause disaster prone one of them is landslide disaster. One of the causes of the landslide is the conversion of land from forest to agricultural land in upland areas and river border that has a steep slope. The study area is located in the highlands with fertile soil conditions, so most of the land is used as agricultural land and plantations. Land use transfer also occurs around the geothermal field in Pangalengan District, West Java Province which will threaten the sustainability of geothermal energy utilization and the safety of the community. The purpose of this research is to arrange the concept of spatial pattern arrangement in the geothermal area based on disaster mitigation. This research method using superimpose analysis. Superimpose analysis to know the basic physical condition of the planned area through the overlay of disaster risk map with the map of the plan of spatial plan pattern of Bandung Regency Spatial Plan. The results of the analysis will then be analyzed spatially. The results have shown that most of the study areas were at moderate risk level. Planning of spatial pattern of existing study area has not fully considering the spread of disaster risk that there are settlement area and the agricultural area which is in high landslide risk area. The concept of the arrangement of the spatial pattern of the study area will use zoning system which is divided into three zones namely core zone, buffer zone and development zone.

Keywords: spatial planning, geothermal, disaster risk, zoning

Procedia PDF Downloads 267
18665 Understanding Risky Borrowing Behavior among Young Consumers: An Empirical Study

Authors: T. Hansen

Abstract:

Many consumers are uncertain of what financial borrowing behavior may serve their interests in the best way. This is important since consumers’ risky financial decisions may not only negatively affect their short-term liquidity but may haunt them for years after they are made. Obviously, this is especially critical for young adults who often carry large amounts of student loans or credit card debt, which in turn may hinder their future ability to obtain financial healthiness. Even though factors such as financial knowledge, attitudes towards risk, gender, and motivations of borrowing, among others, are known to influence consumer borrowing behavior, no existing model comprehensibly describes the mechanisms behind young adults’ risky borrowing behavior. This is unfortunate since a better understanding of the relationships between such factors and young adults’ risky borrowing behavior may be of value to financial service providers and financial authorities aiming to improve young adults’ borrowing behavior. This research extends prior research by developing a conceptual framework for the purpose of understanding young adults’ risky borrowing behavior. The study is based on two survey samples comprising 488 young adults aged 18-25 who have not obtained a risky loan (sample 1) and 214 young adults aged 18-25 who already have obtained a risky loan (sample 2), respectively. The results suggest several psychological, sociological, and behavioral factors that may influence young adults’ intentional risky borrowing behavior, which in turn is shown to affect actualized risky borrowing behavior. We also found that the relationship between intentional risky borrowing behavior and actualized risky borrowing behavior is negatively moderated by perceived risk – but not by perceived complexity. In particular, the results of this study indicate that public policy makers, banks and financial educators should seek to eliminate less desirable social norms on how to behave financially. In addition, they should seek to enhance young adults’ risky borrowing perceived risk, thereby preventing that intentional risky borrowing behavior translates into actualized risky behavior.

Keywords: financial services, risky borrowing behavior, young adults, financial knowledge, social norms, perceived risk, financial trust, public financial policy

Procedia PDF Downloads 258
18664 Comparative Analyses of Prevalence of Intimate Partner Violence in Ten Developing Countries: Evidence from Nationally Representative Surveys

Authors: Elena Chernyak, Ryan Ceresola

Abstract:

Intimate partner violence is a serious social problem that affects a million women worldwide and impacts their health and wellbeing. Some risk factors for intimate partner violence against women (e.g., disobeying or arguing with a partner, women’s age, education, and employment) are similar in many countries, both developed and developing. However, one of the principal and most significant contributors to women’s vulnerability to violence perpetrated by their intimate partners is the witnessing of interparental aggression in the family of origin. Witnessing interparental violence may lead to acceptance of intimate partner violence as a normal way to resolve conflicts. Thus, utilization of violence becomes the behavioral model: men who witnessed the parental violence are more likely to employ physical violence against their female partners whereas women who observed their fathers beating their mothers learn to tolerate aggressive behavior and become victims of domestic violence themselves. Taking into consideration the importance of this subject matter, the association between witnessing intimate partner violence in family-of-origin and experience of intimate partner violence in adulthood requires further attention. The objective of this research is to analyze and compare the prevalence of intimate partner violence in ten developing countries in different regions, namely: Mali, Haiti, Jordan, Peru, the Philippines, Pakistan, Cambodia, Egypt, the Dominican Republic and Nigeria. Specifically, this research asks whether witnessing interparental violence in a family of origin is associated with the woman’s experience of intimate partner violence during adulthood and to what extent this factor varies among the countries under investigation. This study contributes to the literature on domestic violence against women, prevalence and experience of intimate partner violence against women in developing countries, and the risk factors, using recently collected, nationally representative population-based data from above-mentioned countries. The data used in this research are derived from the demographic and health surveys conducted in the ten mentioned above countries from 2013-2016. These surveys are cross-sectional, nationally representative surveys of ever-married or cohabitating women of reproductive age and the good source of high quality and comprehensive information about women, their children, partners, and households. To complete this analysis, multivariate logistic regression was run for each of the countries, and the results are presented with odds ratios, in order to highlight the effect of witnessing intimate partner violence controlling for other factors. The results of this study indicated that having witnessed partner violence in a family of origin significantly (by 50-500%) increases the likelihood of experiencing later abuse for respondents in all countries. This finding provides robust support for the intergenerational transmission of violence theory that explains the link between interparental aggression and intimate partner violence in subsequent relationships in adulthood as a result of a learned model of behavior observed in childhood. Furthermore, it was found that some of the control variables (e.g., education, number of children, and wealth) are associated with intimate partner violence in some countries under investigation while are not associated with male partner’s abusive behavior in some other, which may be explained by specific cultural and economic factors.

Keywords: intimate partner violence, domestic violence against women, developing countries, demographic and health surveys, risk factors

Procedia PDF Downloads 137
18663 Prevalence of Physical Activity Levels and Perceived Benefits of and Barriers to Physical Activity among Jordanian Patients with Coronary Heart Disease: A Cross-Sectional Study

Authors: Eman Ahmed Alsaleh

Abstract:

Background: Many studies published in other countries identified certain perceived benefits and barriers to physical activity among patients with coronary heart disease. Nevertheless, there is no data about the issue relating to Jordanian patients with coronary heart disease. Objective: This study aimed to describe the prevalence of level of physical activity, benefits of and barriers to physical activity as perceived by Jordanian patients with coronary heart disease, and the relationship between physical activity and perceived benefits of and barriers to physical activity. In addition, it focused on examining the influence of selected sociodemographic and health characteristics on physical activity and the perceived benefits of and barriers to physical activity. Methods: A cross-sectional design was performed on a sample of 400 patients with coronary heart disease. They were given a list of perceived benefits and barriers to physical activity and asked to what extent they disagreed or agreed with each. Results: Jordanian patients with coronary heart disease perceived various benefits and barriers to physical activity. Most of these benefits were physiologically related (average mean = 5.7, SD = .7). The most substantial barriers to physical activity as perceived by the patients were: feeling anxiety, not having enough time, lack of interest, bad weather, and feeling of being uncomfortable. Sociodemographic and health characteristics that significantly influenced perceived barriers to physical activity were age, gender, health perception, chest pain frequency, education, job, caring responsibilities, ability to travel alone, smoking, and previous and current physical activity behaviour. Conclusion: This research demonstrates that patients with coronary heart disease have perceived physiological benefits of physical activity, and they have perceived motivational, physical health, and environmental barriers to physical activity, which is significant in developing intervention strategies that aim to maximize patients' participation in physical activity and overcome barriers to physical activity.

Keywords: prevalence, coronary heart disease, physical activity, perceived barriers

Procedia PDF Downloads 106
18662 Understanding Surface Failures in Thick Asphalt Pavement: A 3-D Finite Element Model Analysis

Authors: Hana Gebremariam Liliso

Abstract:

This study investigates the factors contributing to the deterioration of thick asphalt pavements, such as rutting and cracking. We focus on the combined influence of traffic loads and pavement structure. This study uses a three-dimensional finite element model with a Mohr-Coulomb failure criterion to analyze the stress levels near the pavement's surface under realistic conditions. Our model considers various factors, including tire-pavement contact stresses, asphalt properties, moving loads, and dynamic analysis. This research suggests that cracking tends to occur between dual tires. Some key discoveries include the risk of cracking increases as temperatures rise; surface cracking at high temperatures is associated with distortional deformation; using a uniform contact stress distribution underestimates the risk of failure compared to realistic three-dimensional tire contact stress, particularly at high temperatures; the risk of failure is higher near the surface when there is a negative temperature gradient in the asphalt layer; and debonding beneath the surface layer leads to increased shear stress and premature failure around the interface.

Keywords: asphalt pavement, surface failure, 3d finite element model, multiaxial stress states, Mohr-Coulomb failure criterion

Procedia PDF Downloads 49
18661 Competition between Regression Technique and Statistical Learning Models for Predicting Credit Risk Management

Authors: Chokri Slim

Abstract:

The objective of this research is attempting to respond to this question: Is there a significant difference between the regression model and statistical learning models in predicting credit risk management? A Multiple Linear Regression (MLR) model was compared with neural networks including Multi-Layer Perceptron (MLP), and a Support vector regression (SVR). The population of this study includes 50 listed Banks in Tunis Stock Exchange (TSE) market from 2000 to 2016. Firstly, we show the factors that have significant effect on the quality of loan portfolios of banks in Tunisia. Secondly, it attempts to establish that the systematic use of objective techniques and methods designed to apprehend and assess risk when considering applications for granting credit, has a positive effect on the quality of loan portfolios of banks and their future collectability. Finally, we will try to show that the bank governance has an impact on the choice of methods and techniques for analyzing and measuring the risks inherent in the banking business, including the risk of non-repayment. The results of empirical tests confirm our claims.

Keywords: credit risk management, multiple linear regression, principal components analysis, artificial neural networks, support vector machines

Procedia PDF Downloads 146
18660 A Causal Model for Environmental Design of Residential Community for Elderly Well-Being in Thailand

Authors: Porntip Ruengtam

Abstract:

This article is an extension of previous research presenting the relevant factors related to environmental perceptions, residential community, and the design of a healing environment, which have effects on the well-being and requirements of Thai elderly. Research methodology began with observations and interviews in three case studies in terms of the management processes and environment design of similar existing projects in Thailand. The interview results were taken to summarize with related theories and literature. A questionnaire survey was designed for data collection to confirm the factors of requirements in a residential community intended for the Thai elderly. A structural equation model (SEM) was formulated to explain the cause-effect factors for the requirements of a residential community for Thai elderly. The research revealed that the requirements of a residential community for Thai elderly were classified into three groups when utilizing a technique for exploratory factor analysis. The factors were comprised of (1) requirements for general facilities and activities, (2) requirements for facilities related to health and security, and (3) requirements for facilities related to physical exercise in the residential community. The results from the SEM showed the background of elderly people had a direct effect on their requirements for a residential community from various aspects. The results should lead to the formulation of policies for design and management of residential communities for the elderly in order to enhance quality of life as well as both the physical and mental health of the Thai elderly.

Keywords: elderly, environmental design, residential community, structural equation modeling

Procedia PDF Downloads 307
18659 Risk Assessment of Oil Spill Pollution by Integration of Gnome, Aloha and Gis in Bandar Abbas Coast, Iran

Authors: Mehrnaz Farzingohar, Mehran Yasemi, Ahmad Savari

Abstract:

The oil products are imported and exported via Rajaee’s tanker terminal. Within loading and discharging in several cases the oil is released into the berths and made oil spills. The spills are distributed within short time and seriously affected Rajaee port’s environment and even extended areas. The trajectory and fate of oil spills investigated by modeling and parted by three risk levels base on the modeling results. First GNOME (General NOAA Operational Modeling Environment) applied to trajectory the liquid oil. Second, ALOHA (Areal Location Of Hazardous Atmosphere) air quality model, is integrated to predict the oil evaporation path within the air. Base on the identified zones the high risk areas are signed by colored dots which their densities calculated and clarified on a map which displayed the harm places. Wind and water circulation moved the pollution to the East of Rajaee Port that accumulated about 12 km of coastline. Approximately 20 km of north east of Qeshm Island shore is covered by the three levels of risky areas. Since the main wind direction is SSW the pollution pushed to the east and the highest risk zones formed on the crests edges hence the low risk appeared on the concavities. This assessment help the management and emergency systems to monitor the exposure places base on the priority factors and find the best approaches to protect the environment.

Keywords: oil spill, modeling, pollution, risk assessment

Procedia PDF Downloads 383
18658 Determinants of Risk Perceptions and Risk Attitude among Flue-Cured Virginia Tobacco Growers: A Case Study of Pakistan

Authors: Wencong Lu, Abdul Latif, Raza Ullah, Subhan Ullah

Abstract:

Agricultural production is subject to risk and the attitudes of producers toward risk, in turn, may be affected by certain socioeconomic characteristics of producers. Although, it is important to assess the risk attitude of farmers and their perception towards different calamitous risk sources for better understanding of their risk management adoption decisions, to the best of our knowledge no studies have been carried out to analyze the risk attitude and risk perceptions in the context of tobacco production in Pakistan. Therefore the study in hand is conducted with an attempt to overcome the gap in existing literature by analyzing different catastrophic risk sources faced by tobacco growers, their attitude towards risk and the effect of socioeconomic and demographic characteristics, farmers’ participation in contract farming and off-farm diversification on their risk attitude and risk perception. Around 78% of Pakistan’s entire tobacco crop and nearly all of the country’s Flue-Cured Virginia (FCV) tobacco is produced in Khyber Pakhtunkhwa (KPK) province alone. The yield/hectare of tobacco produced in KPK province is 14% higher than the global average and 22 % higher than national average. Khyber Pakhtunkhwa province was selected as main study area as nearly all of the country’s Flue-Cured Virginia (FCV) tobacco is produced in Khyber Pakhtunkhwa (KPK) province alone. Six districts were purposely selected based on their contribution in overall production for the last five years which accounts for more than 94.84% of the tobacco production in KPK province. Specific objectives taken into considerations for this study are the risk attitude of the farmers for growing FCV tobacco crop, farmers’ risk perception for different risk sources related to tobacco production (as far as the incidence and severity of each risk source is concerned) and the effect of socioeconomic characteristics, contract farming participation and off-farm diversification (income) on the risk attitude and risk perception of FCV tobacco growers.

Keywords: risk attitude, risk perception, contract farming, off-farm diversification, probit model

Procedia PDF Downloads 357
18657 Feasibility of Risk Assessment for Type 2 Diabetes in Community Pharmacies Using Two Different Approaches: A Pilot Study in Thailand

Authors: Thitaporn Thoopputra, Tipaporn Pongmesa, Shuchuen Li

Abstract:

Aims: To evaluate the application of non-invasive diabetes risk assessment tool in community pharmacy setting. Methods: Thai diabetes risk score was applied to assess individuals at risk of developing type 2 diabetes. Interactive computer-based risk screening (IT) and paper-based risk screening (PT) tools were applied. Participants aged over 25 years with no known diabetes were recruited in six participating pharmacies. Results: A total of 187 clients, mean aged (+SD) was 48.6 (+10.9) years. 35% were at high risk. The mean value of willingness-to-pay for the service fee in IT group was significantly higher than PT group (p=0.013). No significant difference observed for the satisfaction between groups. Conclusions: Non-invasive risk assessment tool, whether paper-based or computerized-based can be applied in community pharmacy to support the enhancing role of pharmacists in chronic disease management. Long term follow up is needed to determine the impact of its application in clinical, humanistic and economic outcomes.

Keywords: community pharmacy, intervention, prevention, risk assessment, type 2 diabetes

Procedia PDF Downloads 507
18656 Factors Predicting Symptom Cluster Functional Status and Quality of Life of Chronic Obstructive Pulmonary Disease Patients

Authors: D. Supaporn, B. Julaluk

Abstract:

The purposes of this study were to study symptom cluster, functional status and quality of life of patients with chronic obstructive pulmonary disease (COPD), and to examine factors related to and predicting symptom cluster, functional status and quality of life of COPD patients. The sample was 180 COPD patients multi-stage random sampling from 4 hospitals in the eastern region, Thailand. The research instruments were 8 questionnaires and recorded forms measuring personal and illness data, co-morbidity, physical and psychological symptom, health status perception, social support, and regimen adherence, functional status and quality of life. Spearman rank and Pearson correlation coefficient, exploratory factors analysis and standard multiple regression were used to analyzed data. The findings revealed that two symptom clusters were generated: physical symptom cluster including dyspnea, fatigue and insomnia; and, psychological symptom cluster including anxiety and depression. Scores of physical symptom cluster was at moderate level while that of psychological symptom cluster was at low level. Scores on functional status, social support and overall regimen adherence were at good level whereas scores on quality of life and health status perception were at moderate level. Disease severity was positively related to physical symptom cluster, psychological symptom cluster and quality of life, and was negatively related to functional status at a moderate level (rs = .512, .509, .588 and -.611, respectively). Co-morbidity was positively related to physical symptom cluster and psychological symptom cluster at a low level (r = .179 and .176, respectively). Regimen adherence was negatively related to quality of life and psychological symptom cluster at a low level (r=-.277 and -.309, respectively), and was positively related to functional status at a moderate level (r=.331). Health status perception was negatively related to physical symptom cluster, psychological symptom cluster and quality of life at a moderate to high level (r = -.567, -.640 and -.721, respectively) and was positively related to functional status at a high level (r = .732). Social support was positively related to functional status (r=.235) and was negatively related to quality of life at a low level (r=-.178). Physical symptom cluster was negatively related to functional status (r= -.490) and was positively related to quality of life at a moderate level (r=.566). Psychological symptom cluster was negatively related to functional status and was positively related to quality of life at a moderate level (r= -.566 and .559, respectively). Disease severity, co-morbidity and health status perception could predict 40.2% of the variance of physical symptom cluster. Disease severity, co-morbidity, regimen adherence and health status perception could predict 49.8% of the variance of psychological symptom cluster. Co-morbidity, regimen adherence and health status perception could predict 65.0% of the variance of functional status. Disease severity, health status perception and physical symptom cluster could predict 60.0% of the variance of quality of life in COPD patients. The results of this study can be used for enhancing quality of life of COPD patients.

Keywords: chronic obstructive pulmonary disease, functional status, quality of life, symptom cluster

Procedia PDF Downloads 551
18655 Healthcare Associated Infections in an Intensive Care Unit in Tunisia: Incidence and Risk Factors

Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

Abstract:

Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

Procedia PDF Downloads 363
18654 Evaluation of Associated Risk Factors and Determinants of near Miss Obstetric Cases at B.P. Koirala Institute of Health Sciences, Dharan

Authors: Madan Khadka, Dhruba Uprety, Rubina Rai

Abstract:

Background and objective: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of the level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near-miss obstetric cases and maternal death. Material and Methods A Prospective Observational Study was done from August 1, 2014, to June 30, 2015, in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by the 5-factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, and a complication of abortion, ruptured uterus, medical/surgical condition and sepsis. Results: A total of 9,727 delivery were attended during the study period from August 2014 to June 2014. There were 6307 (71.5%) vaginal delivery and 2777(28.5%) caesarean section and 181 perinatal death with a total of 9,546 live birth. A total of 162 near miss was identified, and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions (WLTC) of 172, Severe maternal outcome ratio of 18.64 per 1000 live birth, Maternal near-miss mortality ratio (MNM: 1 MD) 10.1:1, Mortality index (MI) of 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9%. 19.75% were prim gravidae, with mean age 25.66 yrs, and cardiovascular and coagulation dysfunction as a major life threatening condition and sepsis (25%) was the major cause of mortality. Conclusion: Hemorrhage and hypertensive disorders are the leading causes of near miss event and sepsis as a leading cause of mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.

Keywords: abortion, eclampsia, hemorrhage, maternal mortility, near miss

Procedia PDF Downloads 194
18653 Modifying Cardiometabolic Disease Risk Factors in Urban Primary School Children: Three Different Exercise Interventions

Authors: Anneke Van Biljon

Abstract:

Background: Exercise is a primary form of preventing and improving cardiometabolic disease risk factors; however specific exercise variables and their associated health benefits in children are inconclusive. A preliminary study revealed that different exercise variables may improve particular cardiometabolic health benefits. Objectives: This study further investigated the specific cardiometabolic health benefits associated with three isocaloric exercise interventions set at different intensities. Methods: Hundred-and-twenty (n = 120) participants between the ages of 10 – 14 years old were assigned to four different study groups 1. High intensity interval training (HIIT) at > 80% MHR 2. Moderate intensity continuous training (MICT) at 65% – 70% MHR 3. Alternative intensities (ALT) of HIIT and MICT 4. Control group. Exercise interventions were designed to generate isocaloric workloads of ~154.77 kcal per session, three times per week for five weeks. The one-way ANOVA test established comparisons between group means. Post hoc tests were calculated to determine specific group differences. Results: Although, all exercise groups improved cardiometabolic health, the MICT group showed greater improvements in fasting glucose (-9.30%), whereas cardiorespiratory fitness increased most by 31.33% (p = 0.000) within the HIIT group. Finally, ALT group recorded overall superior and additional cardiometabolic health benefits compared with both MICT and HIIT groups. Conclusion: The findings of this study indicate that superior benefits may be elicited when combining and alternating MICT and HIIT. These results provide specific exercise recommendations for achieving optimal and substantial cardiometabolic health benefits in children which will contribute towards achieving the health-related Sustainable Development Goals for 2030.

Keywords: cardiometabolic disease risk factors, exercise, pediatrics, interventions

Procedia PDF Downloads 241
18652 Real Activities Manipulation vs. Accrual Earnings Management: The Effect of Political Risk

Authors: Heba Abdelmotaal, Magdy Abdel-Kader

Abstract:

Purpose: This study explores whether a firm’s effective political risk management is preventing real and accrual earnings management . Design/methodology/approach: Based on a sample of 130 firms operating in Egypt during the period 2008-2013, two hypotheses are tested using the panel data regression models. Findings: The empirical findings indicate a significant relation between real and accrual earnings management and political risk. Originality/value: This paper provides a statistically evidence on the effects of the political risk management failure on the mangers’ engagement in the real and accrual earnings management practices, and its impact on the firm’s performance.

Keywords: political risk, risk management failure, real activities manipulation, accrual earnings management

Procedia PDF Downloads 430
18651 Study of Congenital Malformations in Newborns in the Pediatrics and Neonatology Department of the Maternity of the Wilaya of Batna, Algeria

Authors: Belhadi Kamilia, Bendaoud Fadhila, Zidani Abla

Abstract:

Birth defects are morphological abnormalities and functionally represent the main causes of morbidity and neonatal mortality. Was to analyze a number of maternal and newborn traits, assess the main causes and risk factors of her abnormalities and describe the clinical aspects and different types of birth defects. At maternity of Batna, our rate of congenital malformations is 19% of hospitalized new-borns Mono malformations are the most common, mainly 28% neurological malformations predominated by Spina Bifida and hydrocephalus, Poly malformations and accounted for only 15% of our study. 39,61% of newborns are premature. We found a male predominance, the sex ratio of 1.33 males to one girl, most by mothers over 35; the analysis of the pathological history has shown that the diseases encountered in mothers are pregnant HTA and diabetes. These are the most common diseases, with a percentage of ( 19% and 21%) Taking medication exists with a percentage of 28%. Concerning the diagnosis, the realization that antenatal ultrasound is carried out in 12% of cases, and the mortality rate is very high; most cases die at 45%. Congenital malformations remain a problem in terms of treatment and prognosis; this will allow investigators to investigate other factors, better understand the causes of congenital malformations and develop effective prevention and treatment strategies.

Keywords: malformation, congenital, newborn, risk factors, Wilaya of Batna, Algeria.

Procedia PDF Downloads 32
18650 Effect of Physical and Breathing Exercises on Quality of Life and Psychophysical Status among Haemodialysis Patients: A Scoping Review

Authors: Noof Eid Al Shammari

Abstract:

Background: Living with haemodialysis (HD) can impose several physical and social restrictions on the lives of individuals. Usually, the patient has three dialysis sessions per week that each run for three to four hours. This limits the social life of patients and causes a lower quality of life, in conjunction with the fact that people with chronic kidney disease must follow strict fluid and food regimens and use multiple medications. Given these factors, patients undergoing HD generally need psychological support. Objective: This scoping review study aims to evaluate the effectiveness of physical and breathing exercises on quality of life (QOL) and psychophysical status in patients undergoing HD. Methodology: Searches for relevant studies were performed in four databases (MEDLINE, CINAHL, Google Scholar, and PubMed) for articles published between 2011 and 2021. Out of all the searched literature, ten studies met the inclusion criteria (8 randomised controlled trials, one quasi-experimental study, and one pilot study), with a total of 588 patients. Different types of physical and breathing exercises were used (breathing, cardiopulmonary, and physical exercises). Results: All included studies in this scoping review revealed that most of the aerobic or anaerobic exercises, as well as breathing exercises, had a positive effect and significantly improved patients’ QOL, physical functioning, and psychological status. Conclusions: In this review, most of the articles demonstrated a positive effect of physical and breathing exercises on the QOL and psychophysical status of HD patients. Based on the findings of these studies, physical and breathing exercises were shown to improve muscle strength and other health-related aspects of QOL, including sexual, social, cognitive, and physical functions. However, more studies will need to be conducted with a larger sample to determine the best intervention that could be implemented and standardised in nursing care for patients undergoing HD.

Keywords: physical exercise, breathing exercises, quality of life, depression, hemodialysis

Procedia PDF Downloads 104
18649 Risk Screening in Digital Insurance Distribution: Evidence and Explanations

Authors: Finbarr Murphy, Wei Xu, Xian Xu

Abstract:

The embedding of digital technologies in the global economy has attracted increasing attention from economists. With a large and detailed dataset, this study examines the specific case where consumers have a choice between offline and digital channels in the context of insurance purchases. We find that digital channels screen consumers with lower unobserved risk. For the term life, endowment, and disease insurance products, the average risk of the policies purchased through digital channels was 75%, 21%, and 31%, respectively, lower than those purchased offline. As a consequence, the lower unobserved risk leads to weaker information asymmetry and higher profitability of digital channels. We highlight three mechanisms of the risk screening effect: heterogeneous marginal influence of channel features on insurance demand, the channel features directly related to risk control, and the link between the digital divide and risk. We also find that the risk screening effect mainly comes from the extensive margin, i.e., from new consumers. This paper contributes to three connected areas in the insurance context: the heterogeneous economic impacts of digital technology adoption, insurer-side risk selection, and insurance marketing.

Keywords: digital economy, information asymmetry, insurance, mobile application, risk screening

Procedia PDF Downloads 68
18648 Morphology and Risk Factors for Blunt Aortic Trauma in Car Accidents: An Autopsy Study

Authors: Ticijana Prijon, Branko Ermenc

Abstract:

Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall.An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: aorta, blunt trauma, car accidents, morphology, risk factors

Procedia PDF Downloads 503