Search results for: health risk

Authors: Segen Asayehegn

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Introduction: In Tigray, Ethiopia, next to cervical cancer, breast cancer is one of the most common cancer health problems for women. Objectives: This article is proposed to identify the prospective and potential risk factors affecting the time-to-first-recurrence of breast cancer patients in Tigray, Ethiopia. Methods: The data were taken from the patient’s medical record that registered from January 2010 to January 2020. The study considered a sample size of 1842 breast cancer patients. Powerful non-parametric and parametric shared frailty survival regression models (FSRM) were applied, and model comparisons were performed. Results: Out of 1842 breast cancer patients, about 1290 (70.02%) recovered/cured the disease. The median cure time from breast cancer is found at 12.8 months. The model comparison suggested that the lognormal parametric shared a frailty survival regression model predicted that treatment, stage of breast cancer, smoking habit, and marital status significantly affects the first recurrence of breast cancer. Conclusion: Factors like treatment, stages of cancer, and marital status were improved while smoking habits worsened the time to cure breast cancer. Recommendation: Thus, the authors recommend reducing breast cancer health problems, the regional health sector facilities need to be improved. More importantly, concerned bodies and medical doctors should emphasize the identified factors during treatment. Furthermore, general awareness programs should be given to the community on the identified factors.

Keywords: acceleration factor, breast cancer, Ethiopia, shared frailty survival models, Tigray

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Authors: Catelyn Coyle, Helena Kwakwa

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Objective: As novel and better tolerated therapies become available, effective HCV testing and care models become increasingly necessary to not only identify individuals with active infection but also link them to HCV providers for medical evaluation and treatment. Our aim is to describe an effective HCV testing and linkage to care model piloted in a network of five community health centers located in Philadelphia, PA. Methods: In October 2012, National Nursing Centers Consortium piloted a routine opt-out HCV testing model in a network of community health centers, one of which treats HCV, HIV, and co-infected patients. Key aspects of the model were medical assistant initiated testing, the use of laboratory-based reflex test technology, and electronic medical record modifications to prompt, track, report and facilitate payment of test costs. Universal testing on all adult patients was implemented at health centers serving patients at high-risk for HCV. The other sites integrated high-risk based testing, where patients meeting one or more of the CDC testing recommendation risk factors or had a history of homelessness were eligible for HCV testing. Mid-course adjustments included the integration of dual HIV testing, development of a linkage to care coordinator position to facilitate the transition of HIV and/or HCV-positive patients from primary to specialist care, and the transition to universal HCV testing across all testing sites. Results: From October 2012 to June 2015, the health centers performed 7,730 HCV tests and identified 886 (11.5%) patients with a positive HCV-antibody test. Of those with positive HCV-antibody tests, 838 (94.6%) had an HCV-RNA confirmatory test and 590 (70.4%) progressed to current HCV infection (overall prevalence=7.6%); 524 (88.8%) received their RNA-positive test result; 429 (72.7%) were referred to an HCV care specialist and 271 (45.9%) were seen by the HCV care specialist. The best linkage to care results were seen at the test and treat the site, where of the 333 patients were current HCV infection, 175 (52.6%) were seen by an HCV care specialist. Of the patients with active HCV infection, 349 (59.2%) were unaware of their HCV-positive status at the time of diagnosis. Since the integration of dual HCV/HIV testing in September 2013, 9,506 HIV tests were performed, 85 (0.9%) patients had positive HIV tests, 81 (95.3%) received their confirmed HIV test result and 77 (90.6%) were linked to HIV care. Dual HCV/HIV testing increased the number of HCV tests performed by 362 between the 9 months preceding dual testing and first 9 months after dual testing integration, representing a 23.7% increment. Conclusion: Our HCV testing model shows that integrated routine testing and linkage to care is feasible and improved detection and linkage to care in a primary care setting. We found that prevalence of current HCV infection was higher than that seen in locally in Philadelphia and nationwide. Intensive linkage services can increase the number of patients who successfully navigate the HCV treatment cascade. The linkage to care coordinator position is an important position that acts as a trusted intermediary for patients being linked to care.

Keywords: HCV, routine testing, linkage to care, community health centers

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Authors: Destriyanti Sugiarti, Ririn A Wulandari

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Background: Malaria disease was widespread in many countries, both tropical and sub-tropical. Tasikmalaya is a region that experienced an increase in malaria cases over the last 5 years and highest in 2013, a total of 168 positive cases of malaria. Tasikmalaya region consists of coastal and mountain areas, it has a potential place for Anopheles mosquito breeding, i.e swamp, lagoon, andrice fields.The purpose of this study was to determine the correlation of environmental risk factors with the incidence of malaria in Tasikmalaya. Methods: The design of the study is case control study with 140 samples in 5 sub-district (Cineam, Cikatomas, Cipatujah, Salopa, and Jatiwaras). This study examines the environmental factors that influence the incidence of malaria in Tasikmalaya District in 2013. The research used 14 variables: individual characteristics (education, knowledge, occupation) and environmental risk factors (mobility to endemic areas, use mosquito nets, use of wire gauze at home, use mosquito repellent, repellent use, the presence of a large animal in a cage, breeding place, the presence of larvae, temperature and humidity chamber). Results: Results demonstrated an association between occupation (0.22; 0.10-0.47), the mobility of the population to the endemic areas (37.4; 14.29-98.18) ,the presence of larvae (5.26; 1.41-19.74), and the room temperature with optimum temperature for mosquito breeding is 25-30oC (3.25; 1.62- 6.50). Conclusion: The dominant factor affecting the spread of malaria in Tasikmalaya is the mobility of the population to endemic areas. The results of the study suggest migration survey conducted activity and health promotion for preventive efforts against malaria in malaria-endemic areas, and to encourage people to behave healthy life by freeing environment of mosquito larvae and protect themselves from mosquito bites.

Keywords: Environmental risk factors, malaria, correlation, Anopheles

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Authors: Lana Singleton

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Achieving a sufficient global solution to climate change seems elusive through disappointing climate agreements and lack of cooperation. However, is this reluctance of coordination deep rooted on a more individual, societal level within countries due to a fundamental lack of social and institutional trust? The risks of climate change are illustrious and widely accepted, yet responses on an individual level are also largely inadequate. This research looks to further investigate types of trust, risk perception of climate change, and their interaction to build a greater understanding of whether a social trap (Rothstein, 2005) – where an absence of trust can overwhelm an individuals’ risk perception and result in minimal action despite knowing the dangers of no action – exists and where it is more prevalent. Presence of the social trap will be analysed for willingness to act in favour of climate change mitigation as well as attitude (acceptance) of different types of renewable energy forms. Using probit models with cross-sectional survey data on four developed European countries (UK, France, Germany, and Norway), we find evidence of the social trap in the aggregated data model, which highlights the importance of social trust regarding willingness to act in favour of climate mitigation as there is a high probability of action regardless of risk perception of climate change when social trust is high. In contrast, the same is not true for renewables, as interactions were mainly insignificant, although there were interesting findings involving institutional trust, gender, and country specific results for particular renewables.

Keywords: climate risk, renewables, risk perception, social trap, trust, willingness to act

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Authors: Lavanya Dharmendran, Shenuka Singh, Sona Baburathanam

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The aim of the study is to understand the level of awareness in a community of a specific region of Kuwait regarding oral cancer and its screening methods so as to enhance the uptake of oral cancer screening methods. This is a cross-sectional study comprising 100 adult participants residing in the governate of Farwaniya, Kuwait. Participants of above 18 years of both genders will be selected using convenience sampling. Data collection includes the administration of a self-administered questionnaire. The questionnaire comprises three sections, each section assessing the knowledge, attitudes and practices of the participants’ opinions about oral cancer and screening methods. Data will be analyzed using Humphris Oral Cancer Knowledge Scale. Inferential statistics will be done using Chi-Square or Fisher’s exact test for categorical data. A level of p<.05 will be established as being significant. All ethical considerations, such as respect for personal confidentiality and informed consent, will be applied in this study. This study revealed that although respondents were aware of the term oral cancer, more than half of the study participants were unaware of the symptoms associated with this condition. Smoking and alcohol were identified as risk factors for oral cancer, but the majority of participants did not identify the Human Papilloma Virus (HPV) as an added risk factor. This suggests a greater need for dental practitioners to include educational strategies in routine dental visits to ensure greater awareness of oral cancer.

Keywords: oral cancer, oral screening, oral public health, oral health

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Authors: Ankit Tyagi, Reet Kamal Tiwari, Naveen James

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In India, landslides are the most frequently occurring disaster in the regions of the Himalayas and the Western Ghats. The steep slopes and land use in these areas are quite apprehensive. In the recent past, many landslide hazard zonation (LHZ) works have been carried out in the Himalayas. However, the preparation of LHZ maps considering temporal factors such as seismic ground shaking, seismic amplification at surface level, and rainfall are limited. Hence this study presents a comprehensive use of the multi-criteria decision-making (MCDM) method in landslide risk assessment. In this research, we conducted both geospatial and geotechnical analysis to minimize the danger of landslides. Geospatial analysis is performed using high-resolution satellite data to produce landslide causative factors which were given weightage using the MCDM method. The geotechnical analysis includes a slope stability check, which was done to determine the potential landslide slope. The landslide risk map can provide useful information which helps people to understand the risk of living in an area.

Keywords: landslide hazard zonation, PHA, AHP, GIS

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Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Fathers are at risk of depression during the postpartum period. Some studies have been reported maternal depression is the key predictor of paternal postpartum depression (PPD). This study aimed to estimate the prevalence and predictors of parental PPD and its association with maternal PPD. In a cross-sectional study, via a stratified random and convenience sampling method, participants referring to health centers during 2-8 weeks postpartum were recruited from March to October 2017. Paternal PPD and its relation to maternal PPD and other related factors were assessed using multiple logistic regression. Participants were 591 literate couples who referred to Mazandaran province primary health centers during to study period. Couples were screened for depression using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ) as well. Data on mothers ‘demographic characteristics and obstetrics factors was also gathered. Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age [OR=1.20, (95%CI: 1.05- 1.36)], maternal depressive symptoms [OR=1.15, (95%CI: 1.04-1.27)], higher GHQ scores [OR=1.21, (95%CI: 1.11-1.33)] and increased recent life events [OR=1.42, (95%CI: 1.01-1.2.00)] were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD [OR=0.20, (95%CI: 0.07-0.53)]. Depressive symptoms, especially in first-time fathers following the birth of a child, are not uncommon. Maternal depressive symptoms and paternal well-being were strong predictors of parental PPD. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease the suffering of depression for both depressed parents are recommended.

Keywords: depression, men, postpartum, risk factors, women

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Authors: Noel Busch-Armendariz, Caitlin Sulley

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Introduction: This study investigated the development of college experiences, COVID-19 pandemic experiences, alcohol use, and sexual violence. The longitudinal study includes 656 college students living in the same dormitory. Students' alcohol use and social network structure were investigated to better understand the relationship with sexual violence risk. Basic Methodologies: Over two years, students repeated five web-based surveys, including a pre-college survey and surveys during four consecutive semesters. Questions were added in the fourth wave to assess students’ experiences of the COVID-19 pandemic, administered from November-January 2021, including mental and behavioral health. Analyses include the impact of COVID on living arrangements, drinking behaviors, and daily life; experiences of COVID symptoms, testing, and diagnosis, responses to COVID such as social distancing, quarantining, not working, increased health care needs; experience of fear, worry, stigma, emotional well-being, loneliness, and mental health; experiences of financial loss, lack of basic supplies, receiving emotional and financial support, and comparison with academic disengagement. Concluding Statement: Findings and discussion will include strategies to strengthen mental and behavioral health programs and policies.

Keywords: COVID, mental health, substance abuse, college students, sexual misconducts

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Authors: Rajendra Kanojia

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Femoral components with inbuilt rotation require thicker flexion resection of the lateral femoral condyle and could potential risk to damage the popliteus tendon especially in the smaller Asian knees. We prospectively evaluated 10 patients with bilateral varus osteoarthritis knee to size the cuts and their location in relation to the popliteus tendon. Two different types of implant were used on either side, one side requires resection in 3° external rotation (group A) and other side femoral component with inbuilt external roation (group B). We had popliteus tendon injury in 3 knees all from group B. Risk of damaging the popliteus tendon was found higher in group B.

Keywords: popliteaus tendon injury, TKA, orthopaedic surgery, biomechanics and clinical applications

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Authors: Christopher G. Harris, Guy D. Eslick

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Purpose: Lobular carcinoma in situ (LCIS) is a known risk factor for breast cancer of unclear significance when detected in association with invasive carcinoma. This meta-analysis aims to determine the impact of LCIS on local recurrence risk for individuals with breast cancer treated with breast conservation therapy to help guide appropriate treatment strategies. Methods: We identified relevant studies from five electronic databases. Studies were deemed suitable for inclusion where they compared patients with invasive breast cancer and concurrent LCIS to those with breast cancer alone, all patients underwent breast conservation therapy (lumpectomy with adjuvant radiation therapy), and local recurrence was evaluated. Recurrence data were pooled by use of a random effects model. Results: From 1488 citations screened by our search, 8 studies were deemed suitable for inclusion. These studies comprised of 908 cases and 10638 controls. Median follow-up time was 90 months. There was a significantly increased overall risk of local breast cancer recurrence for individuals with LCIS in association with breast cancer following breast conservation therapy [pOR 1.87; 95% CI 1.14-3.04; p = 0.012]. The risk of local recurrence was non-significantly increased at 5 [pOR 1.09; 95% CI 0.48-2.48; p = 0.828] and 10 years [pOR 1.90; 95% CI 0.89-4.06; p = 0.096]. Conclusions: Individuals with LCIS in association with invasive breast cancer have an increased risk of local recurrence following breast conservation therapy. This supports consideration of aggressive local control of LCIS by way of completion mastectomy or re-excision for certain high-risk patients.

Keywords: breast cancer, breast conservation therapy, lobular carcinoma in situ, lobular neoplasia, local recurrence, meta-analysis

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Authors: Herlena Hayati, Diyan Reni Jayathi, Hairida Anggun, Citra Amelia

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This systematic review research is aimed to find out anemia maternal during pregnancy as a risk factor of low birth weight. This research was done by searching some journals which have associated to maternal anemia during pregnancy with low birth weight that had been published in journal accreditation and scopus index. Study literature that researcher had been done by March – April 2016 through online library of UI. The journals that had been selected according to inclusive criteria and exclusive criteria had been through the critial appraisal process. This systematic review towards 4 journals that had been selected and published showed the significant result statistically that anemia maternal is one of the risk factors which causes low birth weight. Anemia maternal on the first-trimester pregnancy showed significant association with low birth weight. Moderate anemia and severe anemia also showed significant association with low birth weight. Meanwhile, mild anemia doesn’t have an association with low birth weight. The conclusion of this study is anemia maternal (as an independent risk factor) have an influence towards low birth weight.

Keywords: anemia maternal, low birth weight, pregnancy, systematic review

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Authors: Sadia Munir

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The aim of this study is to investigate changes in placental development and vascular dysfunction which subsequently affect feto-maternal health in pregnancies complicated by gestational diabetes mellitus (GDM). Fetal and postnatal adverse health outcomes of GDM are shown to be associated with disturbances in placental structure and function. Children of women with GDM are more likely to be obese and diabetic in childhood and adulthood. GDM also increases the risk of adverse pregnancy outcomes, including preeclampsia, birth injuries, macrosomia and neonatal hypoglycemia, respiratory distress syndrome, neonatal cardiac dysfunction and stillbirth. Incidences of type 2 diabetes in the MENA region are growing at an alarming rate which is estimated to become more than double by 2030. Five of the top 10 countries for diabetes prevalence in 2010 were in the Gulf region. GDM also increases the risk of development of type 2 diabetes. Interestingly, more than half of the women with GDM develop diabetes later in their life. The human placenta is a temporary organ located at the interface between mother and fetal blood circulation. Placenta has a central role as both a producer as well as a target of several molecules that are involved in placental development and function. We have investigated performed a Pubmed search with key words placenta, GDM, placental villi, vascularization, cytokines, growth factors, inflammation, hypoxia, oxidative stress and pathophysiology. We have investigated differences in the development and vascularization of placenta, their underlying causes and impact on feto-maternal health through literature review. We have also identified gaps in the literature and research questions that need to be answered to completely understand the central role of placenta in the GDM. This study is important in understanding the pathophysiology of placenta due to changes in the vascularization of villi, surface area and diameter of villous capillaries in pregnancies complicated by GDM. It is necessary to understand these mechanisms in order to develop treatments to reverse their effects on placental malfunctioning, which in turn, will result in improved mother and child health.

Keywords: gestational diabetes mellitus, placenta, vasculature, villi

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Authors: Joseph Paul Chunga

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The investment universe is awash with a myriad of financial choices that investors have to opt for, which principally culminates into a duality between aggressive or conservative approaches. Howbeit, it is pertinent to emphasize that the investment vehicles with an aggressive approach tend to take on more risk than the latter group in an effort to generate higher future returns for their respective investors. This study examines the conditionality effect that such partiality in financing has on the High-Tech and Public Utility companies listed on the Shenzhen Stock Exchange (SSE). Specifically, it examines the significance of the relationship between capitalization ratios of Total Debt Ratio (TDR), Degree of Financial Leverage (DFL) and profitability ratios of Earnings per Share (EPS) and Returns on Equity (ROE) on the Financial Risk of the two industries. We employ a modified version of the Panel Regression Model used by Rahman (2017) to estimate the relationship. The study finds that there is a significant positive relationship between the capitalization ratios on the financial risk of Public Utility companies more than High-Tech companies and a substantial negative relationship between the profitability ratios and the financial risk of the former than the latter companies. This then spells an important insight for prospective investors with regards to the volatility of earnings of such companies.

Keywords: financial leverage, debt financing, conservative firms, aggressive firms

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Authors: Wan-Ling Jiang, Hsin Chi, Jia-Lu Cheng, Ming-Fang Cheng

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Background: Investigating the risk factors for the fecal carriage of third-generation cephalosporin-resistant E.coli could contribute to further disease prevention. Previous research on third-generation cephalosporin-resistant prevalence in children in different regions of Taiwan is limited. This project aims to explore the risk factors and regional differences in the prevalence of third-generation cephalosporin-resistant and other antibiotic-resistant E. coli in the northern, southern, and eastern regions of Taiwan. Methods: We collected data from children aged 0 to 18 from community or outpatient clinics from July 2022 to May 2023 in southern, northern, and eastern Taiwan. The questionnaire was designed to survey the characteristics of participants and possible risk factors, such as clinical information, household environment, drinking water, and food habits. After collecting fecal samples and isolating stool culture with E.coli, antibiotic sensitivity tests and MLST typing were performed. Questionnaires were used to analyze the risk factors of third-generation cephalosporin-resistant E. coli in the three different regions of Taiwan. Results: In the total 246 stool samples, third-generation cephalosporin-resistant E.coli accounted for 37.4% (97/246) of all isolates. Among the three different regions of Taiwan, the highest prevalence of fecal carriage with third-generation cephalosporin-resistant E.coli was observed in southern Taiwan (42.7%), followed by northern Taiwan (35.5%) and eastern Taiwan (28.4%). Multi-drug resistant E. coli had prevalence rates of 51.9%, 66.3%, and 37.1% in the northern, southern, and eastern regions, respectively. MLST typing revealed that ST131 was the most prevalent type (11.8%). The prevalence of ST131 in northern, southern, and eastern Taiwan was 10.1%, 12.3%, and 13.2%, respectively. Risk factors analysis identified lower paternal education, overweight status, and non-vegetarian diet as statistical significance risk factors for third-generation cephalosporin-resistant E.coli. Conclusion: The fecal carriage rates of antibiotic-resistant E. coli among Taiwanese children were on the rise. This study found regional disparities in the prevalence of third-generation cephalosporin-resistant and multi-drug-resistant E. coli, with southern Taiwan having the highest prevalence. Lower paternal education, overweight, and non-vegetarian diet were the potential risk factors of third-generation cephalosporin-resistant E. coli in this study.

Keywords: Escherichia coli, fecal carriage, antimicrobial resistance, risk factors, prevalence

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Authors: C. A. Bradley, D. Patsios, D. Berridge

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This paper presents evidence to better understand the risk and protective factors related to sibling conflict and the patterns of association between sibling conflict and negative adjustment outcomes by incorporating additional familial and societal factors within statistical models of risk and adjustment. It was conducted through the secondary analysis of a large representative cross-sectional dataset of children in the UK. The original study includes proxy interviews for young children and self-report interviews for adolescents. The study applies an ecological systems framework for the analyses. Hierarchical regression models assess risk and protective factors and adjustment outcomes associated with sibling conflict. Interactions reveal differential effect between contextual risk factors and the social context of influence. The general pattern of findings suggested that, although factors affecting likelihood of experiencing sibling conflict were often determined by child age, some remained consistent across childhood. These factors were often conditional on each other, reinforcing the importance of an ecological framework. Across both age-groups, sibling conflict was associated with siblings closer in age; male sibling groups; most advantaged socio-economic group; and exposure to community violence, such as witnessing violent assault or robbery. The study develops the evidence base on the influence of ethnicity and socio-economic group on sibling conflict by exploring interactions between social context. It also identifies key new areas of influence – such as family structure, disability, and community violence in exacerbating or reducing risk of conflict. The study found negative associations between sibling conflict and young children’s mental well-being and adolescents' mental well-being and anti-social behaviour, but also more context specific associations – such as sibling conflict moderating the negative impact of adversity and high risk experiences for young children such as parental violence toward the child.

Keywords: adjustment, conflict, ecological systems, family systems, risk and protective factors, sibling

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Authors: J. Milton, C. Uzoigwe, O. Ayeko, B. Offorha, K. Anderson, R. G. Middleton

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Background: We used the UK National Hip Fracture database to determine the effect of institution hip fracture case volume on hip fracture healthcare outcomes in 2019. Using logistic regression for each healthcare outcome, we compared the best performing 50 units with the poorest performing 50 units in order to determine if the unit volume was associated with performance for each particular outcome. Method: We analysed 175 institutions treating a total of 67,673 patients over the course of a year. Results: The number of hip fractures seen per unit ranged between 86 and 952. Larger units tendered to perform health assessments more consistently and mobilise patients more expeditiously post-operatively. Patients treated at large institutions had shorter lengths of stay. With regard to most other outcomes, there was no association between unit case volume and performance, notably compliance with the Best Practice Tariff, time to surgery, proportion of eligible patients undergoing total hip arthroplasty, length of stay, delirium risk, and pressure sore risk assessments. Conclusion: There is no relationship between unit volume and the majority of health care outcomes. It would seem that larger institutions tend to perform better at parameters that are dependent upon personnel numbers. However, where the outcome is contingent, even partially, on physical infrastructure capacity, there was no difference between larger and smaller units.

Keywords: institution volume, mortality, neck of femur fractures, osteoporosis

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Authors: Karl-Erich Lindenschmidt, Apurba Das, Joel Trudell, Keanne Russell

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In this presentation, we explore options for mitigating ice-jam flooding along the Athabasca River in western Canada. Not only flood hazard, expressed in this case as the probability of flood depths and extents being exceeded, but also flood risk, in which annual expected damages are calculated. Flood risk is calculated, which allows a cost-benefit analysis to be made so that decisions on the best mitigation options are not based solely on flood hazard but also on the costs related to flood damages and the benefits of mitigation. The river ice model is used to simulate extreme ice-jam flood events with which scenarios are run to determine flood exposure and damages in flood-prone areas along the river. We will concentrate on three mitigation options – the placement of a dike, artificial breakage of the ice cover along the river, the installation of an ice-control structure, and the construction of a reservoir. However, any mitigation option is not totally failsafe. For example, dikes can still be overtopped and breached, and ice jams may still occur in areas of the river where ice covers have been artificially broken up. Hence, for all options, it is recommended that zoning of building developments away from greater flood hazard areas be upheld. Flood mitigation can have a negative effect of giving inhabitants a false sense of security that flooding may not happen again, leading to zoning policies being relaxed. (Text adapted from Lindenschmidt [2022] "Ice Destabilization Study - Phase 2", submitted to the Regional Municipality of Wood Buffalo, Alberta, Canada)

Keywords: ice jam, flood hazard, flood risk river ice modelling, flood risk

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Authors: Yas Barzegaar, Atrin Barzegar

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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

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Authors: C. Sridawruang

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Young people today has sexual activities differing from those of earlier generations, in that teenagers are likely to have multiple partners, and are frequently in short-term relationships or with partners that are not well known to them. The proportion of teenage mothers in Thailand has increased. Young people were not specifically addressed during the overall very successful HIV-prevention campaigns. Because of this missed opportunity, they are still unaware of the risk of unsafe sexual behavior. Aims: To describe the reproductive health care services in perspectives of rural Thai teenagers Methods: This survey was one part of a mixed method approach taken using survey and focus groups with 439 teenagers aged 12-18 years in 5 villages, Udon Thani, Thailand. The standard questionnaire survey had been used for collecting data. The numeric data was checked and analyzed by using descriptive statistics. Results: Most teenager respondents stated that they do not know where sexual reproductive health services provided for them. Most teenagers felt difficult to access and talk with health staff about sexual related issues. They stated that discussing, or consulting with health providers might not be safe. Teenagers might lose opportunities to access and get advice from health care services. The mean knowledge score of contraception and condom reproductive was 6.34 from a total score 11. Most teenagers especially girls expressed a need for counseling services and reported a need for telephone services. Conclusions: The need of appropriate information focusing on sexual relationships and contraception should be designed to help young people make wise decisions and there should be set health care services for Thai teenagers to make sure that teenagers could access easily. Health care providers need to be trained to improve their knowledge, attitudes and skills in reproductive health care practices for Thai teenagers.

Keywords: youth friendly health services, rural, Thai, teenagers

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Authors: Zina Benouaret, Djamil Aissani

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In this work, we introduce the qualitative and quantitative concept of the strong stability method in the risk process modeling two lines of business of the same insurance company or an insurance and re-insurance companies that divide between them both claims and premiums with a certain proportion. The approach proposed is based on the identification of the ruin probability associate to the model considered, with a stationary distribution of a Markov random process called a reversed process. Our objective, after clarifying the condition and the perturbation domain of parameters, is to obtain the stability inequality of the ruin probability which is applied to estimate the approximation error of a model with disturbance parameters by the considered model. In the stability bound obtained, all constants are explicitly written.

Keywords: Markov chain, risk models, ruin probabilities, strong stability analysis

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Authors: Abdullah Almilaibary, Jeremy Jolley, Mark Hayter

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Background: Despite recent progress in enhancing the accessibility of HIV-related health services worldwide, opportunities to diagnose patients are often missed due to genuine barriers at different levels. The aim of the study is to explore the factors that affect the utilization of HIV testing services by young people aged 17-25 in Saudi Arabia. Methods: A non-experimental descriptive cross-sectional design was used to predict factors that influenced HIV testing among Umm- Al Qura University students aged 17-25 years. A newly developed self-completed online questionnaire was used and the study sample was drawn using a convenience sampling technique. The questionnaire consisted of 52 items divided into three scales: 12 items for HIV/AIDS-related knowledge, 3 items for risk perception, and 37 items for attitudes toward HIV testing. Five experts in the field of HIV/AIDS validated the contents of the questionnaire and agreed that the items included were related to the construct being measured. The reliability of the questionnaire was also assessed using a test/re-test strategy with 27 participants recruited from the population under study. The reliability assessment revealed that the questionnaire was consistent as Cronbach’s Alpha was 0.80 for HIV/ADS knowledge, 0.88 for risk perception and 0.78 for attitudes towards HIV testing. The data were collected between 14th of July and 14th of October 2014. Results: 394 participants completed the questionnaires: 116 (29.4%) male and 278 (70%) female. 50.5% of the participants were aged 20 to 22 years, 34.8% were 17-19 years and 14.7% were aged between 23-25 years; about 93% of the participants were single. Only 20 (6%) participants had previously been tested for HIV. The main reasons for not being tested for HIV were: exposure to HIV was considered unlikely (48%), HIV test was not offered (36%) and unawareness of HIV testing centres (16%). On HIV/AIDS-related knowledge, the male participants scored higher than the females as the mean score for males was (M = 6.4, SD = 2.4) while for females it was (M 5.7, SD 2.5). In terms of risk perception, female participants appeared to have lower levels of risk perception than male participants, with the mean score for males being (M 11.7, SD 2.5) and (M 10.5, SD 2.4) for females. The female participants showed slightly more positive attitudes towards HIV testing than male participants: the mean score for males was (M = 108.14, SD = 17.9) and was (M = 111.32, SD = 17.3) for females. Conclusions: The data reveal that misconceptions about HIV/AIDS in Saudi Arabia are still a challenge. Although the attitudes towards HIV testing were reasonably positive, the utilization of the HIV test was low. Thus, tailoring HIV/AIDS preventive strategies in Saudi Arabia should focus on the needs of young people and other high risk groups in the country.

Keywords: attitude toward hiv testing, hiv testing, hiv/aids related knowledge, risk perception

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Authors: Zena F. Mushtaq, Iqbal M. Abbas

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Background: Diabetes mellitus during pregnancy is one of the major medical and social problems with increasing prevalence in last decades and may lead to more vulnerable to dental problems and increased risk for periodontal diseases. Objectives: To assess oral hygiene behaviors among pregnant women with diabetes who attended primary health care centers and find out the relationship between oral hygiene behaviors and studied variables. Methodology: A cross sectional design was conducted from 7 July to 30 September 2014 on non probability (convenient sample) of 150 pregnant women with diabetes was selected from twelve Primary Health Care Centers at Baghdad city. Questionnaire format is tool for data collection which had designed and consisted of three main parts including: socio demographic, reproductive characteristics and items of oral hygiene behaviors among pregnant women with diabetes. Reliability of the questionnaire was determined through internal consistency of correlation coefficient (R= 0.940) and validity of content was determined through reviewing it by (12) experts in different specialties and was determined through pilot study. Descriptive and inferential statistics were used to analyze collected data. Result: Result of study revealed that (35.3%) of study sample was (35-39) years old with mean and SD is (X & SD = 33.57 ± 5.54) years, and (34.7%) of the study sample was graduated from primary school and less, half of the study sample was government employment and self employed, (42.7%) of the study sample had moderate socioeconomic status, the highest percentage (70.0%) of the study sample was nonsmokers, The result indicates that oral hygiene behaviors have moderate mean score in all items. There are no statistical significant association between oral hygiene domain and studied variables. Conclusions: All items related to health behavior concerning oral hygiene is in moderate mean of score, which may expose pregnant women with diabetes to high risk of periodontal diseases. Recommendations: Dental care provider should perform a dental examination at least every three months for each pregnant woman with diabetes, explanation of the effect of DM on periodontal health, oral hygiene instruction, oral prophylaxis, professional cleaning and treatment of periodontal diseases(scaling and root planing) when needed.

Keywords: diabetes, health behavior, pregnant women, oral hygiene

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Authors: Joelle Fong

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Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.

Keywords: actuarial modeling, cohort analysis, frail elderly, health

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Authors: Ainura Tursunalieva, Irene Hudson

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Continuous improvement of both the quality and safety of health care is an important goal in Australia and internationally. The intensive care unit (ICU) receives patients with a wide variety of and severity of illnesses. Accurately identifying patients at risk of developing complications or dying is crucial to increasing healthcare efficiency. Thus, it is essential for clinicians and researchers to have a robust framework capable of evaluating the risk profile of a patient. ICU scoring systems provide such a framework. The Acute Physiology and Chronic Health Evaluation III and the Simplified Acute Physiology Score II are ICU scoring systems frequently used for assessing the severity of acute illness. These scoring systems collect multiple risk factors for each patient including physiological measurements then render the assessment outcomes of individual risk factors into a single numerical value. A higher score is related to a more severe patient condition. Furthermore, the Mortality Probability Model II uses logistic regression based on independent risk factors to predict a patient’s probability of mortality. An important overlooked limitation of SAPS II and MPM II is that they do not, to date, include interaction terms between a patient’s vital signs. This is a prominent oversight as it is likely there is an interplay among vital signs. The co-existence of certain conditions may pose a greater health risk than when these conditions exist independently. One barrier to including such interaction terms in predictive models is the dimensionality issue as it becomes difficult to use variable selection. We propose an innovative scoring system which takes into account a dependence structure among patient’s vital signs, such as systolic and diastolic blood pressures, heart rate, pulse interval, and peripheral oxygen saturation. Copulas will capture the dependence among normally distributed and skewed variables as some of the vital sign distributions are skewed. The estimated dependence parameter will then be incorporated into the traditional scoring systems to adjust the points allocated for the individual vital sign measurements. The same dependence parameter will also be used to create an alternative copula-based model for predicting a patient’s probability of mortality. The new copula-based approach will accommodate not only a patient’s trajectories of vital signs but also the joint dependence probabilities among the vital signs. We hypothesise that this approach will produce more stable assessments and lead to more time efficient and accurate predictions. We will use two data sets: (1) 250 ICU patients admitted once to the Chui Regional Hospital (Kyrgyzstan) and (2) 37 ICU patients’ agitation-sedation profiles collected by the Hunter Medical Research Institute (Australia). Both the traditional scoring approach and our copula-based approach will be evaluated using the Brier score to indicate overall model performance, the concordance (or c) statistic to indicate the discriminative ability (or area under the receiver operating characteristic (ROC) curve), and goodness-of-fit statistics for calibration. We will also report discrimination and calibration values and establish visualization of the copulas and high dimensional regions of risk interrelating two or three vital signs in so-called higher dimensional ROCs.

Keywords: copula, intensive unit scoring system, ROC curves, vital sign dependence

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Authors: Quang Dung Le, Kentaro Tanaka, Viet Dung Luu, Kotaro Shirai

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Mercury pollutant is great concerns in globe due to its toxicity and biomagnification through the food web. Recently increasing approaches of stable isotope analyses which have applied in food-web structure are enabled to elucidate more insight trophic transfer of pollutants in ecosystems. In this study, the integration of total mercury (Hg) and stable isotopic analyses (δ13C and δ15N) were measured from basal food sources to invertebrates and fishes in order to determine Hg transfer in Setiu lagoon food webs. The average Hg concentrations showed the increasing trend from low to high trophic levels. The result also indicated that potential Hg exposure from inside mangrove could be higher than that from the tidal flat of mangrove creek. Fish Hg concentrations are highly variable, and many factors driving this variability need further examinations. A positive correlation found between Hg concentrations and δ15N values (the trophic magnification factor was 3.02), suggesting Hg biomagnification through the lagoon food web. Almost all Hg concentrations in fishes and mud crabs did not present a risk for human consumption, however, the Hg concentrations of Caranx ignobilis exceed the permitted level could raise a concern of the potential risk for the marine system. Further investigations should be done to elucidate whether trophic relay relates to high Hg concentrations of some fish species in coastal systems.

Keywords: mercury, transfer, stable isotopes, health risk, mangrove, food web

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Authors: Choppala Pratheek, Vineet Ahuja

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Background: Crohn's disease (CD) recurrence following surgery is a common challenge, and current detection methods rely on risk factors identified in Western populations. This study aimed to investigate the risk factors and rates of postoperative CD recurrence in a tuberculosis-endemic region like India. Retrospective data was collected from a structured database from a specialty IBD clinic by reviewing case files from January 2005 to December 2021. Inclusion criteria involved CD patients diagnosed based on the ECCO-ESGAR consensus guidelines, who had undergone at least one intestinal resection and had a minimum follow-up period of one year at the IBD clinic. Results: A total of 90 patients were followed up for a median period of 45 months (IQR, 20.75 - 72.00). Out of the 90 patients, 61 received ATT prior to surgery, with a mean delay in diagnosis of 2.5 years, although statistically non-significant (P=0.078). Clinical recurrence occurred in 50% of patients, with the cumulative rate increasing from 13.3% at one year to 40% at three years. Among 63 patients who underwent endoscopy, 65.7% showed evidence of endoscopic recurrence, with the cumulative rate increasing from 31.7% at one year to 55.5% at four years. Smoking was identified as a significant risk factor for early endoscopic recurrence (P=0.001) by Cox regression analysis, but no other risk factors were identified. Initiating post-operative medications prior to clinical recurrence delayed its onset (P=0.004). Subgroup analysis indicated that endoscopic monitoring aided in the early identification of recurrence (P=0.001). The findings contribute to enhancing post-operative CD management strategies in such regions where the disease burden is escalating.

Keywords: crohns, post operative, tuberculosis-endemic, risk factors

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Authors: Moise A.E., State G., Tudorache M., Custură I., Enea D.N., Osman (Defta) A., Drăgotoiu D.

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This scientific paper explores risk management strategies in the food supply chain, with a focus on chicken raw materials, in the context of a company sourcing from the EU and non-EU. The aim of the paper is to adapt the requirements of international standards (IFS, BRC, QS, ITW, FSSC, ISO), proposing efficient methods to identify and remediate non-conformities and corrective and preventive actions. Defining the supply flow and acceptance steps promotes collaboration with suppliers to ensure the quality and safety of raw materials. To assess the risks of suppliers and raw materials, objective criteria are developed and vulnerabilities in the supply chain are analyzed, including the risk of fraud. Active monitoring of international alerts through RASFF helps to identify emerging risks quickly, and regular analysis of international trends and company performance enables continuous adaptation of risk management strategies. Implementing these measures strengthens food safety and consumer confidence in the final products supplied.

Keywords: food supply chain, international standards, quality and safety of raw materials, RASFF

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Authors: Sergey Podluzhnyy

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One of the most important tasks of investment and pension fund management is building decision support system which helps to make right decision on corporate bond portfolio formation. Today there are several basic methods of bond portfolio management. They are duration management, immunization and convexity management. Identified methods have serious disadvantage: they do not take into account credit risk or insolvency risk of issuer. So, identified methods can be applied only for management and evaluation of high-quality sovereign bonds. Applying article proposes mathematical model for building an optimal in case of risk and yield corporate bond portfolio. Proposed model takes into account the default probability in formula of assessment of bonds which results to more correct evaluation of bonds prices. Moreover, applied model provides tools for visualization of the efficient frontier of corporate bonds portfolio taking into account the exposure to credit risk, which will increase the quality of the investment decisions of portfolio managers.

Keywords: corporate bond portfolio, default probability, effective boundary, portfolio optimization task

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Authors: Abdul Kadir, L. Meily Kurniawidjaja

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Batik Madura workers are exposed to many Musculoskeletal Disorders risk factors, particularly Low Back Pain (LBP). This study was conducted as an early detection of ergonomic risk level on Workers Industrial Sentra Batik Madura in Dusun Banyumas, Klampar Subdistrict, Proppo Pamekasan, Madura, East Java. This study includes 12 workers who 11 workers had pain in the upper and lower part of the neck, back, wrist right hand, also 10 workers had pain in the right shoulder. This is a descriptive observational study with cross-sectional approach. Qualitative research by observing workers activity such as draw and putting the wax motif, fabric dyeing, fabric painting, discoloration, washing, and drying. The results are workers have identified ergonomic hazards such as awkward postures, twisting movements, repetitive, and static work postures. Using the method of REBA and QEC, the results get a very high-risk level of activity in each of Madura batik making process is the draw and putting the wax motif, coloring, painting, discoloration, washing, and drying. The level of risk can be reduced by improvement of work equipment include the provision of seats, strut fabric, high settings furnaces, drums, coloring basin, and washing tub.

Keywords: activities of Madura's batik, ergonomic risk level, equipment, QEC (Quick Exposure Checklist), REBA (Rapid Entire Body Assessment)

Procedia PDF Downloads 172

Authors: Bremmy Laksono, Nurul Qomarilla, Riksa Parikrama, Dyan K. Nugrahaeni, Willyanti Soewondo, Dadang S. H. Effendi, Eriska Rianti, Arlette S. Setiawan, Ine Sasmita, Risti S. Primanti, Erna Kurnikasari, Yunia Sribudiani

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Down syndrome is a chromosomal abnormality of chromosome 21 which can appear in man or woman. Maternal age and paternal age, history of radiation are the common risk factors. This study was conducted to observe risk factors which related as causes of Down syndrome. In this case control study using purposive sampling technique, 84 respondents were chosen from Cell Culture and Cytogenetics Laboratory patients in Faculty of Medicine, Universitas Padjadjaran, Indonesia. They were used as study samples and divided into 42 Down syndrome cases and 42 control respondents. This study used univariate and bivariate analysis (chi-square). Samples population were West Java residents, the biggest province in Indonesia in number of population. The results showed maternal age, paternal age, history of radiation exposure and family history were not significantly related to Down syndrome baby. Moreover, all of those factors also did not contribute to the risk of having a child with Down syndrome in patients at Cell Culture and Cytogenetics Laboratory, Faculty of Medicine, Universitas Padjadjaran. Therefore, we should investigate other risk factors of Down syndrome in West Java population.

Keywords: down syndrome, family history, maternal age, paternal age, risk factor

Procedia PDF Downloads 388