Search results for: uveal melanoma risk factors

Authors: Olakunle Felix Adekunle

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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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Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila

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Introduction: The risk factors for the chronicization of postoperative pain are numerous and often intricately intertwined. Among these, the severity of acute postoperative pain is currently recognized as one of the most determining factors. Mastectomy and thoracotomy are described as among the most painful surgeries and the most likely to lead to chronic post-surgical pain (CPSP). Objective: To examine the aspects of acute postoperative pain potentially involved in the development of chronic pain following breast and thoracic surgery. Patients and Methods: A prospective study involving 164 patients was conducted over a six-month period. Postoperative pain (during mobilization) was assessed using a Visual Analog Scale (VAS) at various time points after surgery: Day 0, 1st, 2nd, 5th days, 1st and 6th months. Moderate to severe pain was defined as a VAS score ≥ 4. A comparative analysis (univariate analysis) of postoperative pain intensities at different evaluation phases was performed on patients with and without CPSP to identify potential associations with the risk of chronicization six months after surgery. Results: At the 6th month post-surgery, the incidence of CPSP was 43.0%. Moderate to severe acute postoperative pain (in the first five days) was observed in 64% of patients. The highest pain scores were reported among thoracic surgery patients. Comparative measures revealed a highly significant association between the presence of moderate to severe acute pain, especially lasting for ≥ 48 hours, and the occurrence of CPSP (p-value <0.0001). Likewise, the persistence of subacute pain (up to 4 to 6 weeks after surgery), especially of moderate to severe intensity, was significantly associated with the risk of chronicization at six months (p-value <0.0001). Conclusion: CPSP after breast and thoracic surgery remains a fairly common morbidity that profoundly affects the quality of life. Severe acute postoperative pain, especially if it is prolonged and/or with a slow decline in intensity, can be an important predictive factor for the risk of chronicization. Therefore, more effective and intensive management of acute postoperative pain, as well as longitudinal monitoring of its trajectory over time, should be an essential component of strategies for preventing chronic pain after surgery.

Keywords: chronic post-surgical pain, acute postoperative pain, breast and thoracic surgery, subacute postoperative pain, pain trajectory, predictive factor

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Authors: Fouzia Khanam, Belal Hossain, Kaosar Afsana, Mahfuzar Rahman

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Aim: Although cardiovascular diseases (CVD) has already been recognized as a major cause of death in developed countries, its prevalence is rising in developing countries as well, and engendering a challenge for the health sector. Bangladesh has experienced an epidemiological transition from communicable to non-communicable diseases over the last few decades. So, the rising prevalence of CVD and its risk factors are imposing a major problem for the country. We aimed to examine the prevalence of CVDs and socioeconomic and lifestyle factors related to it from a population-based survey. Methods: The data used for this study were collected as a part of a large-scale cross-sectional study conducted to explore the overall health status of children, mothers and senior citizens of Bangladesh. Multistage cluster random sampling procedure was applied by considering unions as clusters and households as the primary sampling unit to select a total of 11,428 households for the base survey. Present analysis encompassed 12338 respondents of ≥ 35 years, selected from both rural areas and urban slums of the country. Socio-economic, demographic and lifestyle information were obtained through individual by a face-to-face interview which was noted in ODK platform. And height, weight, blood pressure and glycosuria were measured using standardized methods. Chi-square test, Univariate modified Poisson regression model, and multivariate modified Poisson regression model were done using STATA software (version 13.0) for analysis. Results: Overall, the prevalence of CVD was 4.51%, of which 1.78% had stroke and 3.17% suffered from heart diseases. Male had higher prevalence of stroke (2.20%) than their counterparts (1.37%). Notably, thirty percent of respondents had high blood pressure and 5% population had diabetes and more than half of the population was pre-hypertensive. Additionally, 20% were overweight, 77% were smoker or consumed smokeless tobacco and 28% of respondents were physically inactive. Eighty-two percent of respondents took extra salt while eating and 29% of respondents had deprived sleep. Furthermore, the prevalence of risk factor of CVD varied according to gender. Women had a higher prevalence of overweight, obesity and diabetes. Women were also less physically active compared to men and took more extra salt. Smoking was lower in women compared to men. Moreover, women slept less compared to their counterpart. After adjusting confounders in modified Poisson regression model, age, gender, occupation, wealth quintile, BMI, extra salt intake, daily sleep, tiredness, diabetes, and hypertension remained as risk factors for CVD. Conclusion: The prevalence of CVD is significant in Bangladesh, and there is an evidence of rising trend for its risk factors such as hypertension, diabetes especially in older population, women and high-income groups. Therefore, in this current epidemiological transition, immediate public health intervention is warranted to address the overwhelming CVD risk.

Keywords: cardiovascular diseases, diabetes, hypertension, stroke

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Authors: S. B. D. Samarasinghe, Malini Herath

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Participatory planning is a very important process for decision making and choosing the best alternative options for community welfare, development of the society and its interactions among community and professionals. People’s involvement is considered as the key guidance in participatory planning. Presently, Participatory planning is being used in many fields. It's not only limited to planning but also to disaster management, poverty, housing, etc. In the past, Disaster management practice was a top-down approach, but it raised many issues as it was converted to a bottom-up approach. There are several approaches that can aid disaster management. Community-Based Disaster Risk Management (CBDRM) is a very successful participatory approach to risk management that is often successfully applied by other disaster-prone countries. In the local context, CBDRM has been applied to prevent Diseases as well as to prevent disasters such as landslides, tsunamis and floods. From three years before, Sri Lanka has initiated the CBDRM approach to minimize landslide vulnerability. Hence, this study mainly focuses on the impact of CBDRM approaches on landslide hazards. Also to identify their successes and failures from both implementing parties and community. This research is carried out based on a qualitative method combined with a descriptive research approach. A successful framework was prepared via a literature review. Case studies were selected considering landslide CBDRM programs which were implemented by Disaster Management Center and National Building Research Organization in Badulla. Their processes were evaluated. Data collection is done through interviews and informal discussions. Then their ideas were quantified by using the Relative Effectiveness index. The resulting numerical value was used to rank the program effectiveness and their success, failures and impacting factors. Results show that there are several failures among implementing parties and the community. Overcoming those factors can make way for better conduction of future CBDRM programs.

Keywords: community-based disaster risk management, disaster management, preparedness, landslide

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Authors: Alba Ballester Ciuró, Marc Pares Franzi

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While coming decades are likely to see a higher flood risk in Europe and greater socio-economic damages, traditional flood risk management has become inefficient. In response to that, new approaches such as capacity building and public participation have recently been incorporated in natural hazards mitigation policy (i.e. Sendai Framework for Action, Intergovernmental Panel on Climate Change reports and EU Floods Directive). By integrating capacity building and public participation, we present a research concerning the promotion of participatory social capacity building actions for flood risk mitigation at the local level. Social capacities have been defined as the resources and abilities available at individual and collective level that can be used to anticipate, respond to, cope with, recover from and adapt to external stressors. Social capacity building is understood as a process of identifying communities’ social capacities and of applying collaborative strategies to improve them. This paper presents a proposal of systematization of participatory social capacity building process for flood risk mitigation, and its implementation in a high risk of flooding area in the Ebro river basin: Ribera Alta del Ebro. To develop this process, we designed and tested a tool that allows measuring and building five types of social capacities: knowledge, motivation, networks, participation and finance. The tool implementation has allowed us to assess social capacities in the area. Upon the results of the assessment we have developed a co-decision process with stakeholders and flood risk management authorities on which participatory activities could be employed to improve social capacities for flood risk mitigation. Based on the results of this process, and focused on the weaker social capacities, we developed a set of participatory actions in the area oriented to general public and stakeholders: informative sessions on flood risk management plan and flood insurances, interpretative river descents on flood risk management (with journalists, teachers, and general public), interpretative visit to the floodplain, workshop on agricultural insurance, deliberative workshop on project funding, deliberative workshops in schools on flood risk management (playing with a flood risk model). The combination of obtaining data through a mixed-methods approach of qualitative inquiry and quantitative surveys, as well as action research through co-decision processes and pilot participatory activities, show us the significant impact of public participation on social capacity building for flood risk mitigation and contributes to the understanding of which main factors intervene in this process.

Keywords: flood risk management, public participation, risk reduction, social capacities, vulnerability assessment

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Authors: Yuli Paola Cifuentes Sanabria, Lina Paola Beltrán Beltrán, Leonardo Juan Ramírez López

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The availability to deploy mobile applications for healthcare is increasing daily thru different mobile app stores. But within these capabilities the number of hacking attacks has also increased, in particular into medical mobile applications. The security vulnerabilities in medical mobile apps can be triggered by errors in code, incorrect logic, poor design, among other parameters. This is usually used by malicious attackers to steal or modify the users’ information. The aim of this research is to analyze the vulnerabilities detected in mobile medical apps according to risk factor standards defined by OWASP in 2014.

Keywords: mHealth apps, OWASP, protocols, security vulnerabilities, risk factors

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Authors: Nicholas Agyepong, Paul Gyan

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Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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Authors: Nicholas Agyepong, Paul Gyan

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Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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Authors: Marko Živanović, Jovana Bjekić, Maša Vukčević Marković

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Professionals and volunteers involved in refugee protection and support are on a daily basis faced with people who have experienced numerous traumatic experiences and, as such, are subjected to secondary traumatization (ST). The aim of this study was to provide insight into risk factors for ST in helpers working with refugees in Serbia. A total of 175 participants working with refugees fulfilled: Secondary Traumatization Questionnaire, checklist of refugees’ traumatic experiences, Hopkins Symptoms Checklist (HSCL) assessing depression and anxiety symptoms, quality of life questionnaire (MANSA), HEXACO personality inventory, and COPE assessing coping mechanisms. In addition, participants provided information on work-related problems. Qualitative analysis of answers to the question about most difficult part of their job has shown that burnout-related issues are clustered around three recurrent topics that can be considered as the most prominent generators of stress, namely: ‘lack of organization and cooperation’, ‘not been able to do enough’, and ‘hard to take it and to process it’. Factor analysis (Maximum likelihood extraction, Promax rotation) have shown that ST comprises of two correlated factors (r = .533, p < .01), namely Psychological deficits and Intrusions. Results have shown that risk factor for ST could be find in three interrelated sources: 1) work-related problems; 2) personality-related risk factors and 3) clients’ traumatic experiences. Among personality related factors, it was shown that risk factor for Intrusions could be find in – high Emotionality (β = .221, p < .05), and Altruism (β = .322, p < .01), while low Extraversion (β = -.365, p < .01) represents risk factor for Psychological deficits. In addition, usage of maladaptive coping mechanisms –mental disengagement (r = .253, p < .01), behavioral disengagement (r = .274, p < .01), focusing on distress and venting of emotions (r = .220, p < .05), denial (r = .164, p < .05), and substance use (r = .232, p < .01) correlate with Psychological deficits while Intrusions corelate with Mental disengagement (r = .251, p < .01) and denial (r = .183, p < .05). Regarding clients’ traumatic experiences it was shown that both quantity of traumatic events in country of origin (for Deficits r = .226, p < .01; for Intrusions r = .174, p < .05) and in transit (for Deficits r = .288, p < .01), as well as certain content-related features of such experiences (especially experiences which are severely dislocated from ‘everyday reality’) are related to ST. In addition, Psychological deficits and Intrusions have shown to be accompanied by symptoms of depression (r = .760, p < .01; r = .552, p < .01) and anxiety (r = .740, p < .01; r = .447, p < .01) and overall lower life quality (r = -.454, p < .01; r = .256, p < .01). Results indicate that psychological vulnerability of persons who are working with traumatized individuals can be found in certain personality traits, and usage of maladaptive coping mechanisms, which disable one to deal with work-related issues, and to cope with quantity and quality of traumatic experiences they were faced with, affecting ones’ psychological well-being. Acknowledgement: This research was funded by IRC Serbia.

Keywords: mental health, refugees, secondary traumatization, traumatic experiences

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Authors: Farrin Nayebzadeh, Mohammadreza Eslami Amirabadi

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According to technological progress and urban development, the cities of the world are growing to become metropolitans, living in which can be enthusiastic, entertaining and accessibility to the facilities like education, economic factors, hygiene and welfare is high. On the other hand, there are some problems that have been ignored in planning for such high quality of life, most important of which, is human health. Two aspects of human health are physical health and mental health, that are closely associated. Human mental health depends on two important factors: Biological factor and environmental factor. Air pollution is one of the most important environmental risk factors that affects mental health. Psychological and toxic effects of air pollution can lead to psychiatric symptoms, including anxiety and changes in mood, cognition, and behavior, depression and also children's mental disorders like hyperactivity, aggression and agitation. Increased levels of some air pollutants are accompanied by an increase in psychiatric admissions and emergency calls and, in some studies, by changes in behavior and a reduction in psychological well-being. Numerous toxic pollutants interfere with the development and adult functioning of the nervous system. Psychosocial stress can cause symptoms similar to those of organic mental disorders. These factors can cause resonance of psychiatric disorders. So, in cities of developing countries, people challenge with mental health problems due to environmental factors especially air pollution that have not been forecasted in urban planning.

Keywords: air pollution, environmental factors, mental health, psychiatric disorder

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Authors: Funmilayo Juliana Afolabi, Joke Haafkens, Paul De Beer

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Globally, there is a growing concern on reducing workplace accidents in the informal sector. However, there is a dearth of study on the perception of the informal workers on occupational risks they are exposed to. The way a worker perceives the workplace risk will influence his/her risk tolerance and risk behavior. The aim of this paper, therefore, is to have an in-depth understanding of the way the artisans perceive the risks at their workplace and how it influences their risk tolerance and risk behavior. This will help in designing meaningful intervention for the artisans and it will assist the policy makers in formulating a policy that will help them. Methods: Forty-three artisans were purposely selected for the study; data were generated through observation of the workplace and work practices of the artisans and in-depth interview from automobile artisans (Panel beater, Mechanic, Vulcanizer, and Painters) in Osun State, Nigeria. The transcriptions were coded and analyzed using MAXQDA software. Results: The perceived occupational risks among the study groups are a danger of being run over by oncoming vehicles while working by the roadside, a risk of vehicle falling on workers while working under the vehicle, cuts, and burns, fire explosion, falls from height and injuries from bursting of tires. The identified risk factors are carelessness of the workers, pressure from customers, inadequate tools, preternatural forces, God’s will and lack of apprentices that will assist them in the workplace. Furthermore, the study revealed that artisans engage in risky behavior like siphoning fuel with mouth because of perception that fuel is good for expelling worms and will make them free from any stomach upset. Conclusions: The study concluded that risky behaviors are influenced by culture, beliefs, and perception of the artisans. The study, therefore, suggested proper health and safety education for the artisans.

Keywords: automobile artisans, informal, occupational risks, Nigeria, sociological enquiry

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Authors: Johnson Adafin, James O. B. Rotimi, Suzanne Wilkinson, Abimbola O. Windapo

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An aspect of client expenditure management that requires attention is the level of accuracy achievable in design-stage elemental cost planning. This has been a major concern for construction clients and practitioners in New Zealand (NZ). Pre-tender estimating inaccuracies are significantly influenced by the level of risk information available to estimators. Proper cost planning activities should ensure the production of a project’s likely construction costs (initial and final), and subsequent cost control activities should prevent unpleasant consequences of cost overruns, disputes and project abandonment. If risks were properly identified and priced at the design stage, observed variance between design-stage elemental cost plans (ECPs) and final tender sums (FTS) (initial contract sums) could be reduced. This study investigates the variations between design-stage ECPs and FTS of construction projects, with a view to identifying risk factors that are responsible for the observed variance. Data were sourced through interviews, and risk factors were identified by using thematic analysis. Access was obtained to project files from the records of study participants (consultant quantity surveyors), and document analysis was employed in complementing the responses from the interviews. Study findings revealed the discrepancies between ECPs and FTS in the region of -14% and +16%. It is opined in this study that the identified risk factors were responsible for the variability observed. The values obtained from the analysis would enable greater accuracy in the forecast of FTS by Quantity Surveyors. Further, whilst inherent risks in construction project developments are observed globally, these findings have important ramifications for construction projects by expanding existing knowledge on what is needed for reasonable budgetary performance and successful delivery of construction projects. The findings contribute significantly to the study by providing quantitative confirmation to justify the theoretical conclusions generated in the literature from around the world. This therefore adds to and consolidates existing knowledge.

Keywords: accuracy, design-stage, elemental cost plan, final tender sum

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Authors: Beng Yew Low, Cher Liang Cha, Cheng Yong Teoh

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Due to a lack of continual assessment or grade related data, identifying first-year engineering students in a polytechnic education at risk of failing is challenging. Our experience over the years tells us that there is no strong correlation between having good entry grades in Mathematics and the Sciences and excelling in hardcore engineering subjects. Hence, identifying students at risk of failure cannot be on the basis of entry grades in Mathematics and the Sciences alone. These factors compound the difficulty of early identification and intervention. This paper describes the development of a predictive analytics model in the early detection of students at risk of failing and evaluates its effectiveness. Data from continual assessments conducted in term one, supplemented by data of student psychological profiles such as interests and study habits, were used. Three classification techniques, namely Logistic Regression, K Nearest Neighbour, and Random Forest, were used in our predictive model. Based on our findings, Random Forest was determined to be the strongest predictor with an Area Under the Curve (AUC) value of 0.994. Correspondingly, the Accuracy, Precision, Recall, and F-Score were also highest among these three classifiers. Using this Random Forest Classification technique, students at risk of failure could be identified at the end of term one. They could then be assigned to a Learning Support Programme at the beginning of term two. This paper gathers the results of our findings. It also proposes further improvements that can be made to the model.

Keywords: continual assessment, predictive analytics, random forest, student psychological profile

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Authors: Navah Z. Ratzon, Talia Glick, Iris Manor

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Attention Deficit Hyperactivity Disorder (ADHD) is a chronic disorder that affects the sufferer’s functioning throughout life and in various spheres of activity, including driving. Difficulties in cognitive functioning and executive functions are often part and parcel of the ADHD diagnosis, and thus form a risk factor in driving. Studies examining the effectiveness of intervention programs for improving and rehabilitating driving in typical teenagers have been conducted in relatively small numbers; while studies on similar programs for teenagers with ADHD have been especially scarce. The aim of the present study has been to examine the effectiveness of a metacognitive occupational therapy intervention program for reducing risk factors in driving among teenagers with ADHD. The present study included 37 teenagers aged 17 to 19. They included 23 teenagers with ADHD divided into experimental (11) and control (12) groups; as well as 14 non-ADHD teenagers forming a second control group. All teenagers taking part in the study were examined in the Tel Aviv University driving lab, and underwent cognitive diagnoses and a driving simulator test. Every subject in the intervention group took part in 3 assessment meetings, and two metacognitive treatment meetings. The control groups took part in two assessment meetings with a follow-up meeting 3 months later. In all the study’s groups, the treatment’s effectiveness was tested by comparing monitoring results on the driving simulator at the first and second evaluations. In addition, the driving of 5 subjects from the intervention group was monitored continuously from a month prior to the start of the intervention, a month during the phase of the intervention and another month until the end of the intervention. In the ADHD control group, the driving of 4 subjects was monitored from the end of the first evaluation for a period of 3 months. The study’s findings were affected by the fact that the ADHD control group was different from the two other groups, and exhibited ADHD characteristics manifested by impaired executive functions and lower metacognitive abilities relative to their peers. The study found partial, moderate, non-significant correlations between driving skills and cognitive functions, executive functions, and perceptions and attitudes towards driving. According to the driving simulator test results and the limited sampling results of actual driving, it was found that a metacognitive occupational therapy intervention may be effective in reducing risk factors in driving among teenagers with ADHD relative to their peers with and without ADHD. In summary, the results of the present study indicate a positive direction that speaks to the viability of using a metacognitive occupational therapy intervention program for reducing risk factors in driving. A further study is required that will include a bigger number of subjects, add actual driving monitoring hours, and assign subjects randomly to the various groups.

Keywords: ADHD, driving, driving monitoring, metacognitive intervention, occupational therapy, simulator, teenagers

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Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji

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Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.

Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: Alina Svechkina, Boris A. Portnov

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In line with a rapid increase in pollution sources and enforcement of stricter air pollution regulation, which lowers pollution levels, it becomes more difficult to identify actual risk sources behind the observed morbidity patterns, and new approaches are required to identify potential risks and take preventive actions. In the present study, we discuss a probabilistic approach to the spatial identification of a priori unidentified environmental health hazards. The underlying assumption behind the tested approach is that the observed adverse health patterns (morbidity, mortality) can become a source of information on the geographic location of environmental risk factors that stand behind them. Using this approach, we analyzed sources of environmental exposure using data on mortality rates available for the year 2015 for NUTS 3 (Nomenclature of Territorial Units for Statistics) subdivisions of the European Union. We identified several areas in the southwestern part of Europe as primary risk sources for the observed mortality patterns. Multivariate regressions, controlled by geographical location, climate conditions, GDP (gross domestic product) per capita, dependency ratios, population density, and the level of road freight revealed that mortality rates decline as a function of distance from the identified hazard location. We recommend the proposed approach an exploratory analysis tool for initial investigation of regional patterns of population morbidity patterns and factors behind it.

Keywords: mortality, environmental hazards, air pollution, distance decay gradient, multi regression analysis, Europe, NUTS3

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Authors: Chi-Jung Chung, Chao-Hsiang Chang, Chiu-Shong Liu, Sheng-Wei Li, Mu-Chi Chung, Ting-Jie Wen, Hui-Ling Lee

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Cigarette smoke contains volatile organic compounds (VOCs), such as acrylamide, 1,3-butadiene, and benzene. This study aimed to explore the associations between the urinary levels of cotinine and VOC metabolites and the risk of urothelial carcinoma (UC). A hospital-based case–control study involving two groups matched on the basis of age ( ± 3 years) and gender was designed. UC was clinically diagnosed through urological examinations and pathologically verified. Smoking-related information was collected through questionnaires and face-to-face interviews with all study participants. Urine samples were collected for the analysis of the urinary levels of VOC metabolites, cotinine, and 8-hydroxydeoxygua- nosine (8-OHdG), which was selected as a proxy of oxidative stress. Multiple logistic regressions were applied to estimate the risk of UC. The urinary cotinine and 8-OHdG levels of the UC group were higher than those of the control group. The urinary levels of VOC metabolites, including N-acetyl-S-(2-carbamoylethyl)-L-cysteine (AAMA), N- acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine, N-acetyl-S- (4- hydroxy-2-buten-1-yl)-Lcysteine-3, trans, trans-muconic acid (t,t- MA), and S-phenylmercapturic acid (SPMA) increased as the urinary levels of cotinine increased. Relevant dose-response relationships between the risk of UC risk and the urinary levels of AAMA , t,t-MA, SPMA, and 8-OHdG were found after adjusting for potential risk factors. The UC risk of participants with high urinary levels of cotinine, AAMA, t,t-MA, SPMA, and 8-OHdG were 3.5–6-fold higher than those of other participants. Increased urinary levels of VOC metabolites were associated with smoking-related UC risk. The development of UC should be explored in large-scale in vitro or in vivo studies with the repeated measurement of VOC metabolites.

Keywords: volatile organic compound, urothelial carcinoma, cotinine, 8-hydroxydeoxyguanosine

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Authors: Krzysztof J. Czarnocki, F. Silveira, E. Czarnocka, K. Szaniawska

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Research background: Problems related to the occupational health and decreasing level of safety occur commonly in the construction industry. Important factor in the occupational safety in construction industry is scaffold use. All scaffolds used in construction, renovation, and demolition shall be erected, dismantled and maintained in accordance with safety procedure. Increasing demand for new construction projects unfortunately still is linked to high level of occupational accidents. Therefore, it is crucial to implement concrete actions while dealing with scaffolds and risk assessment in construction industry, the way on doing assessment and liability of assessment is critical for both construction workers and regulatory framework. Unfortunately, professionals, who tend to rely heavily on their own experience and knowledge when taking decisions regarding risk assessment, may show lack of reliability in checking the results of decisions taken. Purpose of the article: The aim was to indicate crucial parameters that could be modeling with Risk Assessment Model (RAM) use for improving both building enterprise productivity and/or developing potential and safety climate. The developed RAM could be a benefit for predicting high-risk construction activities and thus preventing accidents occurred based on a set of historical accident data. Methodology/Methods: A RAM has been developed for assessing risk levels as various construction process stages with various work trades impacting different spheres of enterprise activity. This project includes research carried out by teams of researchers on over 60 construction sites in Poland and Portugal, under which over 450 individual research cycles were carried out. The conducted research trials included variable conditions of employee exposure to harmful physical and chemical factors, variable levels of stress of employees and differences in behaviors and habits of staff. Genetic modeling tool has been used for developing the RAM. Findings and value added: Common types of trades, accidents, and accident causes have been explored, in addition to suitable risk assessment methods and criteria. We have found that the initial worker stress level is more direct predictor for developing the unsafe chain leading to the accident rather than the workload, or concentration of harmful factors at the workplace or even training frequency and management involvement.

Keywords: safety climate, occupational health, civil engineering, productivity

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Authors: Francesco Venuti, Simona Alfiero

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

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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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Authors: Rebecca M. Dagger, Katy Hadgraft, Matthew Teggart, Peter Angell

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Background: There is a growing body of evidence that demonstrates the association between sedentary behaviour, cardiometabolic risk and all-cause mortality. Since full time working adults spend approximately 8 hours per day in the workplace, interventions to reduce sedentary behaviour at work may alleviate some of the negative health outcomes associated with sedentary behaviour. The aims of this pilot study were to assess the impacts of using a Sit-Stand workstation on markers of cardiometabolic health in a cohort of desk workers. Methods: Twenty eight participants were recruited and randomly assigned to a control (n=5 males, 9 females, mean age 37 years ± 9.4 years) or intervention group (n= 5 males, 9 females, mean age 42 years ± 12.7 years). All participants attended the labs on 2 occasion’s pre and post intervention, following baseline measurements the intervention participants had the Sit Stand Workstations (Ergotron, USA) installed for a 10 week intervention period. The Sit Stand workstations allow participants to stand or sit at their usual workstation and participants were encouraged to the use the desk in a standing position at regular intervals throughout the working day. Cardiometabolic risk markers assessed were body mass, body composition (using bio impedance analysis; Tanita, Tokyo), fasting blood Total Cholesterol (TC), lipid profiles (HDL-C, LDL-C, TC: HDL-C ratio), triglycerides and fasting glucose (Cholestech LDX), resting systolic and diastolic blood pressure and resting heart rate. ANCOVA controlling for baseline values was used to assess the group difference in changes in risk markers between pre and post intervention. Results: The 10 week intervention was associated with significant reductions in some cardiometabolic risk factors. There were significant group effects on change in body mass (F (1,25)=5.915, p<0.05), total body fat percentage (F(1,25)=12.615, p<0.01), total fat mass (F (1,25)=6.954, p<0.05), and systolic blood pressure (F (1,25)=5.012, p<0.05). There were no other significant group effects on changes in other cardiometabolic risk markers. Conclusion: This pilot study highlights the importance of reducing sedentary behaviour in the workplace for reduction in cardiometabolic risk markers. Further research is required to support these findings.

Keywords: sedentary behaviour, caridometabolic risk, evidence, risk makers

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Authors: Ritsuko Kawasaki, Takeshi Hiromatsu

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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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Authors: A. O. Ogunkeyede, D. Amuchi, A. A. Adebayo

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Heavy metal contaminations in soil have received great attention. Anthropogenic activities such as vehicular emission, industrial activities and constructions have resulted in elevated concentration of heavy metals in the surface soils. The metal particles can be free from the surface soil when they are disturbed and re-entrained in air, which necessitated the need to investigate surface soil at market environment where adults and children are present on daily basis. This study assesses concentration of heavy metal pollution, ecological and health risk factors in surface soil at Effurun market. 8 samples were collected at household material (EMH), fish (EMFs), fish and commodities (EMF-C), Abattoir (EMA 1 & 2), fruit sections (EMF 1 & 2) and lastly main road (EMMR). The samples were digested and analyzed in triplicate for contents of Lead (Pb), Nickel (Ni), Cadmium (Cd) and Copper (Cu). The mean concentration of the Pb mg/kg (112.27 ± 1.12) and Cu mg/kg (156.14 ± 1.10) were highest in the abattoir section (EMA 1). The mean concentrations of the heavy metal were then used to calculate the ecological and health risk for people within the market. Pb contamination at EMMR, EMF 2, EMFs were moderately while Pb shows considerable contamination at EMH, EMA 1, EMA 2 and EMF-C sections of the Effurun market. The ecological risk factor varies between low to moderate pollution for Pb and EMA 1 has the highest potential ecological risk that falls within moderate pollution. The hazard quotient results show that dermal exposure pathway is the possible means of heavy metal exposure to the traders while ingestion is the least sources of exposure to adult. The ingestion suggested that children around the EMA 1 have the highest possible exposure to children due to hand-to-mouth and object-to-mouth behaviour. The results further show that adults at the EMA1 will have the highest exposure to Pb due to inhalation during burning of cow with tyre that contained Pb and Cu. The carcinogenic risk values of most sections were higher than acceptable values, while Ni at EMMR, EMF 1 & 2, EMFs and EMF-C sections that were below the acceptable values. The cancer risk for inhalation exposure pathway for Pb (1.01E+17) shows a significant level of contamination than all the other sections of the market. It suggested that the people working at the Abattoir were very prone to cancer risk.

Keywords: carcinogenic, ecological, heavy metal, risk

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Authors: Michael Ajide Oyinloye

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The natural environment is made up of air, water and soil. The release of emission of industrial waste into anyone of the components of the environment causes pollution. Industrial pollution significantly threatens the inherent right of people, to the enjoyment of a safe and secure environment. The aim of this paper is to assess the effect of environmental pollution and health risks of residents living near Ewekoro Cement factory. The research made use of IKONOS imagery for Geographical Information System (GIS) to buffer and extract buildings that are less than 1 km to the plant, within 1 km to 5 km and above 5 km to the factory. Also, a questionnaire was used to elicit information on the socio-economic factors, the effect of environmental pollution on residents and measures adopted to control industrial pollution on the residents. Findings show that most buildings that between less than 1 km and 1 km to 5 km to the factory have high health risk in the study area. The study recommended total relocation for the residents of the study area to reduce risk health problems.

Keywords: environmental pollution, health risk, GIS, satellite imagery, ewekoro

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Authors: S. Behnam Asl, H. Sadeghi Naeini, L. Sadat Ensaniat, R. Khorshidian, S. Alipour, S. Behnam Asl

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Nowadays, the construction industry is growing, especially among developing countries. Iran also has a critical role in these industries in terms of workers disorders. Work-related musculoskeletal disorders (WMSDs) account for 7% of the whole diseases in the society, which makes some limitations. One of the main factors which causes WMSDs is awkward posture. Steel bar bending is considered as one of the prominent performance among construction workers. In this case study, we aimed to find the major tasks of bar benders and the most important risk factors related to it. This study was carried out among twenty workers (18-45 years) as our volunteer samples in some construction sites with less than 6 floors in two regions of Tehran municipality. The data was gathered through in depth observation, interview and questionnaire. Also postural analysis was done by OWAS method. In another part of study we used NMQ for gathering some data about psychosocial effects of work related disorders. Our findings show that 64% of workers were not aware of work risks, about 59% of workers had troubles in their wrists, hands, especially workers who worked in steel bar bending. In 46% cases lower back pain was in prevalence. Considering gathered data and results, awkward postures and long term tasks and their duration are known as the main risk factors of WMSDs among construction workers, meaning that work-rest schedule and tools design should be reconsidered to make an ergonomic condition for the mentioned workers.

Keywords: bar benders, construction workers, musculoskeletal disorders (WMSDs), OWAS method

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

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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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Authors: Muhammad Ali, Aamir Sohail, Umair Malik

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Research in entrepreneurship has gained much attention in current academic environment. Youngsters are taking interest to start their own business in spite of risk matter. The objective of the study is to explain how various personality traits (personal attitude, locus of control, instrumental readiness and perceived behavioral control) are affecting entrepreneurial intention of students. The theory of planned behavior supports out study which explains that personal attractiveness, social norms and feasibility are the main factors that affect intentions of an individual. The sample data of 120 is collected from graduating batch of three reputed universities of Islamabad through questionnaires. Our results support the hypothesis that personality traits positively influence the entrepreneurial intention. We conclude from the study that many graduating students are willing to start a new venture, but most of them are likely to do a job in their respective fields. Risk factor also exists in their minds because in our country most people are risk-averse and they do not want to lose their money in case of loss.

Keywords: entrepreneurship, instrumental readiness, locus of control, personal attitude

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Authors: Rahaf Mandura, Fatmah Abusharkh, Layan Kurdi, Rahaf Shigdar, Khadijah Alattas

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Introduction: Age-related macular degeneration (AMD) in older individuals are serious health issues that severely impact the quality of life of millions globally. In 2020, the fourth leading cause of blindness worldwide was AMD. The global prevalence of AMD is estimated to be around 8.7%. AMD is a progressive disease involving the macular region of the retina, and it has a complex pathophysiology. RPE cell dysfunction plays a crucial step in the pathway leading to irreversible degeneration of photoreceptors with yellowish lipid-rich, protein-containing drusen deposits accumulating between Bruch's membrane and the RPE. Furthermore, lipofuscinogenesis, drusogenesis, inflammation, and neovascularization are four main processes responsible for the formation of the two types of AMD: the wet (exudative, neovascular) and dry (non-exudative, geographic atrophy) types. We retrospectively evaluated the prevalence of AMD among patients visiting the retina clinic at King Abdulaziz University Hospital (Jeddah, Makkah Province, Saudi Arabia) to identify the commonly associated risk factors of AMD. Methods: The records of 3,067 individuals from 2017 to 2021 were reviewed. Of these, 1,935 satisfied the inclusion criteria and were included in this study. We excluded all patient below 18 years, and those who did not undergo fundus imaging or attend their booked appointments, follow-ups, treatments, and referrals were excluded. Results: The prevalence of AMD among the patients was 4%. The age of patients with AMD was significantly greater than those without AMD (72.4 ± 9.8 years vs. 57.2 ± 15.5 years; p < 0.001). Participants with a family history of AMD tended to have the disease more than those without such a history (85.7% vs. 45%; p = 0.043). Ex- and current smokers were more likely to have AMD than non-smokers (34% and 18.6% vs. 7.2%; p < 0.001). Patients with hypertension and those without type 1 diabetes were at a higher risk of developing AMD than those without hypertension (5.5% vs. 2.8%; p = 0.002) and those with type 1 diabetes (4.2% vs. 0.8%; p = 0.040). In contrast, sex, nationality, type 2 diabetes, and abnormal lipid profile were not significantly associated with AMD. Regarding the clinical characteristics of AMD cases, most cases (70.4%) were of the dry type and affected both eyes (77.2%). The disease duration was ≥5 years in 43.1% of the patients. The most frequent chronic diseases associated with AMD were type 2 diabetes (69.1%), hypertension (61.7%), and dyslipidemia (18.5%). Conclusion: In summary, our single tertiary center study showed that AMD is widely prevalent in Jeddah, Saudi Arabia (4%) and linked to a wide range of risk factors. Some of these are modifiable risk factors that can be adjusted to help reduce AMD occurrence. Furthermore, this study has shown the importance of screening and follow-up of family members of patients with AMD to promote early detection and intervention of AMD. We recommend conducting further research on AMD in Saudi Arabia. Concerning the study design, a community-based cross-sectional study would be more helpful for assessing the disease's prevalence. Finally, recruiting a larger sample size is required for more accurate estimation.

Keywords: age related macular degeneration, prevelence, risk factor, dry AMD

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Authors: Qing Cao

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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

Procedia PDF Downloads 537