Search results for: suicidal risk

Authors: Greg Zimmerman

Abstract:

Background: Major depression is a common illness that affects millions of people globally. It is the leading cause of disability and is projected to become the number one cause of the global burden of disease by 2030. Many of those who suffer from depression also suffer from Irritable Bowel Syndrome (IBS). Acupuncture has been shown to help depression. The aim of this study was to investigate the effectiveness of acupuncture in reducing the risk of IBS in patients with depression. Methods: We enrolled patients diagnosed with depression through the Taiwanese National Health Insurance Research Database (NHIRD). Propensity score matching was used to match equal numbers (n=32971) of the acupuncture cohort and no-acupuncture cohort based on characteristics including sex, age, baseline comorbidity, and medication. The Cox regression model was used to compare the hazard ratios (HRs) of IBS in the two cohorts. Results: The basic characteristics of the two groups were similar. The cumulative incidence of IBS was significantly lower in the acupuncture cohort than in the no-acupuncture cohort (Log-rank test, p<0.001). Conclusion: The results provided real-world evidence that acupuncture may have a beneficial effect on IBS risk reduction in patients with depression.

Keywords: acupuncture, depression, irritable bowel syndrome, national health insurance research database, real-world evidence

Procedia PDF Downloads 90

Authors: C. L. Wu, W. W. Tseng

Abstract:

From the National Health Insurance (NHI) system was introduced in Taiwan in 2000, there have been some problems in transformed small-scale hospitals, such as mobility of patients, shortage of nursing staff, medical pipelines breaking fire compartments and insufficient fire protection systems. Due to shrinking of the funding scale and the aging society, fire safety in small-scale hospitals has recently given cause for concern. The aim of this study is to determine fire risk index for small-scale hospital through a systematic approach The selection of fire safety mitigation methods can be regarded as a multi-attribute decision making process which must be guaranteed by expert groups. First of all, identify and select safety related factors and identify evaluation criteria through literature reviews and experts group. Secondly, application of the Fuzzy Analytic Hierarchy Process method is used to ascertain a weighted value which enables rating of the importance each of the selected factors. Overall, Sprinkler type and Compartmentation are the most crucial indices in mitigating fire, that is to say, structural approach play an important role to decrease losses in fire events.

Keywords: Fuzzy Delphi Method, fuzzy analytic hierarchy, process risk assessment, fire events

Procedia PDF Downloads 429

Authors: Espinosa Carlos, Nobrega Doris

Abstract:

Children are at high risk for lead (Pb) exposure. The objective of this study was to identify risk factors that contribute to high blood lead (PbB) levels in Venezuelan children. The concentration of PbB was determined in 60 children (ages 4-9 years old), coming from the Michelena sector, Valencia District, Carabobo State. The relationship between these concentrations and socio-economical parameters (A: high quality life; B: fair quality life; C: critic poverty), Pb levels of faucet water (Pb-water) and dust Pb levels of floor (Pb-dust) of their houses, was established. Living areas were classified according to sectors and socio-economical status. Forty [40=66.7%] children resulted with PbB levels above the permissible concentration (LAPC). Average PbB was not significantly higher than the permissible levels. Odds ratio proved that children from status C are 7.28 times more likely to have LAPC of PbB than the ones coming from A or B. Thirty-four percent (34%) of the children with LAPC come from status C which could be considered the most critical status from the exposure risk point of view. The 76,3% of the sampled houses reported VSLP of Pb-water, being the Pb-water average in 35 ± 25.5 ug/L. This average significantly went superior to the permissible limit established by Venezuela and international organisms (10 ug/L). When grouping the results of PbB and Pb-water by sex, were that 50,8% of the children who presented/displayed VSLP of Pb-water and PbB. Was a significant relation (p ≤ 0.05), between masculine sex and the VSLP of PbB and Pb-water (x² = 3,672). In relation to the Pb-Dust analyses, were not statistically significant differences with respect to their permissible limit value (40 ug/pie²). This study shows that by correlating geographical and health data, we can identify 'high risk' areas, leading to a proactive public health action. The results of this study are excellent, in order to take preventive measures for the care from the health. Later studies are suggested predicting main to determine of more conclusive form of levels elevated of PbB in the investigated population.

Keywords: demographic, lead, risk, socio-economical status

Procedia PDF Downloads 116

Authors: Aly Kassem, Eman Sapet, Eman Abdelbaset, Hosam Mahmoud

Abstract:

Objective: Hypertension is an important public health challenge being one of the most common worldwide disease-affecting human. Our aim is to study the clinical characteristics, therapeutic regimens, treatment compliance, and risk factors in a sector of of hypertensive patients at Sohag City. Subject and Methods: A cross sectional study; conducted in Sohag city; it involved 520 patients; males (45.7 %) and females (54.3 %). Their ages ranged between 35-85 years. BP measurements, BMI, blood glucose, Serum creatinine, urine analysis, serum Lipids, blood picture and ECG were done all the studied patients. Results: Hypertension presented more between non-smokers (72.55%), females (54.3%), educated patients (50.99%) and patients with low SES (54.9%). CAD presented in (51.63%) of patients, while laboratory investigations showed hyperglycaemia in (28.7%), anemia in (18.3%), high serum creatinine level in (8.49%) and proteinuria in (10.45%) of patient. Adequate BP control was achieved in (49.67%); older patients had lower adequacy of BP control in spite of the extensive use of multiple-drug therapy. Most hypertensive patients had more than one coexistent CV risk factor. Aging, being a female (54.3%), DM (32.3%), family history of hypertension (28.7%), family history of CAD (25.4%), and obesity (10%) were the common contributing risk factors. ACE-inhibitors were prescribed in (58.16%), Beta-blockers in (34.64%) of the patients. Monotherapy was prescribed for (41.17%) of the patients. (75.81%) of patients had regular use of their drug regimens. (49.67%) only of patients had their condition under control, the number of drugs was inversely related to BP control. Conclusion: Hypertensive patients in Sohag city had a profile of high CV risks, and poor blood pressure control particularly in the elderly. A multidisciplinary approach for routine clinical check-up, follow-up, physicians and patients training, prescribing simple once-daily regimens and encouraging life style modifications are recommended. Anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance.

Keywords: anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance

Procedia PDF Downloads 282

Authors: Kevin T. Inks

Abstract:

India’s Brahmaputra River Valley has, since independence, experienced consistent low-intensity guerrilla warfare between ethnic and religious groups. These groups are often organized around perceived ethnic territoriality, and target civilians, communities, and especially migrants belonging to other ethnic and religious groups. Intense flooding and erosion have led to widespread displacement, and disaster relief funds are largely tied to legal land tenure. Displaced residents of informal settlements receive little or no resettlement aid, and their subsequent migration strategies and risk from guerrilla violence are poorly understood. Semi-structured interviews and comprehensive surveys focused on perceptions of risk, efficacy of disaster relief, and migration and adaptation strategies were conducted with households identified as being ‘at-risk’ of catastrophic flooding and erosion in Majuli District, Assam. Interviews with policymakers and government workers were conducted to assess disaster relief efforts in informal settlements, and remote sensing methods were used to identify informal settlement and hydrogeomorphic change. The results show that various ethnic and religious groups have differential strategies and preferences for resettlement. However, these varying strategies are likely to lead to differential levels of risk from guerrilla violence. Members of certain ethnic groups residing in informal settlements, in the absence of resettlement assistance, are more likely to seek out unofficial settlement on land far from the protection of the state and experience greater risk of becoming victims of political violence. As climate change and deforestation are likely to increase the severity of the displacement crisis in the Brahmaputra River Valley, more comprehensive disaster relief and surveying efforts are vital for limiting migration and informal settlement in potential sites of guerrilla warfare.

Keywords: climate, displacement, flooding, India, violence

Procedia PDF Downloads 86

Authors: Merab Mamuladze, Mixeil Lejava, Fadiko Abuselidze

Abstract:

At present, where most of the soils of Georgia have a small contour, the demand for small-capacity technical means, in particular motoblocks, has increased. Motoblocks perform agricultural work for various purposes, where the work process is performed by the operator, who experiences various magnitudes of vibration, impact, noise, and in general, as a result of long-term work production, causes body damage, dynamic load, and respiratory diseases in people. In the scientific paper, the dependence on the vibration of different types of diesel fuel is investigated in the case of five different revolutions in the internal combustion engine. Studies have shown that fuel and engine speed are the only risk factors that contradict the ISO 5349-2(2004) international standard. The experience of four years of work studies showed that 10% of operators received various types of injuries as a result of working with motoblocks. Experiments also showed that the amount of vibration decreases when the number of revolutions of the engine increases, and in the case of using biodiesel fuel, the damage risk factor is 5-10%, and in the case of using conventional diesel, this indicator has gone up to 20%.

Keywords: engine, vibration, biodiesel, high risk factor, working conditions

Procedia PDF Downloads 66

Authors: Zohreh Mohammadi, Jan Kaspar, Peter Lohmander, Robert Marusak, Harald Vacik, Ljusk Ola Eriksson

Abstract:

Storms are important damaging agents in European forest ecosystems. In the latest decades, significant economic losses in European forestry occurred due to storms. This study investigates the problem of optimal harvest planning when forest stands risk to be felled by storms. One of the most applicable mathematical methods which are being used to optimize forest management is stochastic dynamic programming (SDP). This method belongs to the adaptive optimization class. Sequential decisions, such as harvest decisions, can be optimized based on sequential information about events that cannot be perfectly predicted, such as the future storms and the future states of wind protection from other forest stands. In this paper, stochastic dynamic programming is used to maximize the expected present value of the profits from an area consisting of several forest stands. The region of analysis is the Czech Republic. The harvest decisions, in a particular time period, should be simultaneously taken in all neighbor stands. The reason is that different stands protect each other from possible winds. The optimal harvest age of a particular stand is a function of wind speed and different wind protection effects. The optimal harvest age often decreases with wind speed, but it cannot be determined for one stand at a time. When we consider a particular stand, this stand also protects other stands. Furthermore, the particular stand is protected by neighbor stands. In some forest stands, it may even be rational to increase the harvest age under the influence of stronger winds, in order to protect more valuable stands in the neighborhood. It is important to integrate wind risk in forestry decision-making.

Keywords: Czech republic, forest stands, stochastic dynamic programming, wind risk

Procedia PDF Downloads 124

Authors: Tamas Madl

Abstract:

Sudden cardiac death (SCD) constitutes a large proportion of cardiovascular mortalities, provides little advance warning, and the risk is difficult to recognize based on ubiquitous, low cost medical equipment such as the standard, 12-lead, ten second ECG. Autonomic abnormalities have been shown to be strongly predictive of SCD risk; yet current methods are not trivially applicable to the brevity and low temporal and electrical resolution of standard ECGs. Here, we build horizontal visibility graph representations of very short inter-beat interval time series, and perform unsuper- vised representation learning in order to convert these variable size objects into fixed-length vectors preserving similarity rela- tions. We show that such representations facilitate classification into healthy vs. at-risk patients on two different datasets, the Mul- tiparameter Intelligent Monitoring in Intensive Care II and the PhysioNet Sudden Cardiac Death Holter Database. Our results suggest that graph representation learning of heartbeat interval time series facilitates robust classification even in sequences as short as ten seconds.

Keywords: sudden cardiac death, heart rate variability, ECG analysis, time series classification

Procedia PDF Downloads 215

Authors: Shu-Han Hsu, Jiho Yoon, Chwen Sheu

Abstract:

With the rapidly growing of blockchain technology and cryptocurrency, various industries which include tourism has added in cryptocurrency as the payment method of their transaction. More and more tourism companies accept payments in digital currency for flights, hotel reservations, transportation, and more. For travellers and tourists, using cryptocurrency as a payment method has become a way to circumvent costs and prevent risks. Understanding volatility dynamics and interdependencies between standard currency and cryptocurrency is important for appropriate financial risk management to assist policy-makers and investors in marking more informed decisions. The purpose of this paper has been to understand and explain the risk spillover effects between six major cryptocurrencies and the top ten most traded standard currencies. Using data for the daily closing price of cryptocurrencies and currency exchange rates from 7 August 2015 to 10 December 2019, with 1,133 observations. The diagonal BEKK model was used to analyze the co-volatility spillover effects between cryptocurrency returns and exchange rate returns, which are measures of how the shocks to returns in different assets affect each other’s subsequent volatility. The empirical results show there are co-volatility spillover effects between the cryptocurrency returns and GBP/USD, CNY/USD and MXN/USD exchange rate returns. Therefore, currencies (British Pound, Chinese Yuan and Mexican Peso) and cryptocurrencies (Bitcoin, Ethereum, Ripple, Tether, Litecoin and Stellar) are suitable for constructing a financial portfolio from an optimal risk management perspective and also for dynamic hedging purposes.

Keywords: blockchain, co-volatility effects, cryptocurrencies, diagonal BEKK model, exchange rates, risk spillovers

Procedia PDF Downloads 128

Authors: Xiaohong Xu, Tianchu Zhang, Yangfan Chen, Rongtai Tan

Abstract:

In Canada, Air Quality Health Index (AQHI) is a scale designed to help residences understand the impact of air quality on human health. In Ontario, Canada, AQHI was implemented in June 2015. This study investigated temporal variability of daily AQHI and impact of regional transport on AQHI in Windsor, Ontario, Canada from 2016 to 2019. During 2016–2019, 1428 daily AQHIs were recorded in Windsor Downtown Station. Among those, the AQHIs were at the low health risk level (AQHI = 1, 2 or 3) in 82% of days, only a few days at high risk level (AQHI = 7), the rest were at moderate health risk level (AQHI = 4, 5, 6), indicating air quality in Windsor was fairly good with relatively low health risk. The annual mean AQHI value decreased from 2.95 in 2016 to 2.81 in 2019, demonstrating the improvement of air quality. Half of the days, AQHI were 3 regardless of season. AQHI was higher in the warm season (3.1) than in the cold season (2.6) due to more frequent moderate risk days (27%, AQHI = 4) in warm season and more frequent low risk days (42%, AQHI = 2) in the cold season. Among the three pollutants considered in AQHI calculation, O3 was the most frequently reported dominant contributor to daily AQHI (88% of days), followed by NO2 (12%), especially in the cold season, with small contribution from PM2.5 (<1%). In the past two decades, NO2 concentrations had decreased significantly and O3 concentrations had increased, resulting in daily AQHI being less reliance on NO2 (from 51% of days being the primary contributor during 2003–2010 to 12% during 2016–2019) and more on O3 concentrations (49% to 88%). Trajectory analysis found that AQHI ≤ 3 days were closely associated with air masses from the north and northwest, whereas AQHI > 3 days were closely associated with air masses from the west and southwest. This is because northerly flows brought in clear air mass owing to less industrial facilities, while polluted air masses were transported from the south of Windsor, where several industrial states of the US were located. Overall, O3 concentrations dictate the daily AQHI values, the seasonal variability of AQHI, and the impact of regional transport on AQHI in Windsor. This makes further reductions of AQHI challenging because O3 concentrations are likely to continue increasing due to weakened consumption of O3 by NO owing to decreasing NO emissions and more hot days because of climate change. The predominant and increasing contribution of O3 to AQHI calls for more effective control measures to mitigate O3 pollution and its impact on human health and the environment.

Keywords: air quality, Air Quality Health Index (AQHI), hysplit, regional transport, windsor

Procedia PDF Downloads 54

Authors: Maryam Rafraf, Aida Ghaffari

Abstract:

Objectives: Nonalcoholic fatty liver disease (NAFLD) is considered as an independent risk factor for cardiovascular disease (CVD). Dyslipidemia contributes to the enhanced risk of CVD in persons with NAFLD. This study aimed to investigate the effects of turmeric supplementation on serum lipids levels in patients with NAFLD. Methods: In this double-blind, randomized, controlled clinical trial, 46 NAFLD patients (21 males and 25 females; age range, 20 – 60 years) were randomly assigned in the two groups. The intervention and control groups received 3g of turmeric (n = 23) and placebo (n = 23), daily for 12 weeks. Fasting blood samples were collected at baseline and at the end of the trial. Results: Turmeric supplementation significantly increased serum levels of HDL-C compared with the placebo group at the end of the study (by 12.73%, P < 0.05). Serum levels of triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly reduced within turmeric group at the end of the study (P < 0.05). Conclusions: Turmeric consumption had beneficial effects on serum lipids levels of subjects and may be useful in controlling of CVD risk factors in NAFLD patients.

Keywords: nonalcoholic fatty liver, serum lipids, supplementation, turmeric

Procedia PDF Downloads 137

Authors: Jeffrey Tzu-Hao Tsai, Yi-Shan Wong

Abstract:

This article proposes a cohort-age-period (CAP) model to characterize multi-population mortality processes using cohort, age, and period variables. Distinct from the factor-based Lee-Carter-type decomposition mortality model, this approach is empirically based and includes the age, period, and cohort variables into the equation system. The model not only provides a fruitful intuition for explaining multivariate mortality change rates but also has a better performance in forecasting future patterns. Using the US and the UK mortality data and performing ten-year out-of-sample tests, our approach shows smaller mean square errors in both countries compared to the models in the literature.

Keywords: longevity risk, stochastic mortality model, multivariate mortality rate, risk management

Procedia PDF Downloads 32

Authors: David A. Scott, Michelle G. Scott

Abstract:

The problem of juvenile crime, school suspensions and oppositional behaviors indicates a need for a wide range of intervention programs for at-risk youth. Juvenile court systems and mental health agencies are examining alternative ways to deal with at-risk youth that will allow the adolescent to live within their home community. The previous trend that treatment away from home is more effective than treatment near one's community has shifted. Research now suggests that treatment be close to home for several reasons, such as increased treatment success, parental involvement, and reduced costs. Treatment options consist of a wide range of interventions, including outpatient, inpatient, and community-based services (therapeutic group homes, foster care and in-home preservation services). The juvenile justice system, families and other mental health agencies continue to seek the most effective treatment for at-risk youth in their communities. This research examines two possible treatment modalities, a multi-systemic outpatient program and a residential program. Research examining effective, evidence- based counseling will be discussed during this presentation. The presenter recently completed a three-year research grant examining effective treatment modalities for at-risk youth participating in a multi-systemic program. The presenter has also been involved in several research activities gathering data on effective techniques used in residential programs. The data and discussion will be broken down into two parts, each discussing one of the treatment modalities mentioned above. Data on the residential programs was collected on both a sample of 740 at- risk youth over a five-year period and also a sample of 63 participants during a one-year period residing in a residential programs. The effectiveness of these residential services was measured in three ways: services are evaluated by primary referral sources; follow-up data is obtained at various intervals after program participation to measure recidivism (what percentage got back into trouble with the Department of Juvenile Justice); and a more sensitive, "Offense Seriousness Score", has been computed and analyzed prior to, during and after treatment in the residential program. Data on the multi-systemic program was gathered over the past three years on 190 participants. Research will discuss pre and post test results, recidivism rates, academic performance, parental involvement, and effective counseling treatment modalities.

Keywords: at-risk youth, group homes, therapeutic group homes, recidivism rates

Procedia PDF Downloads 56

Authors: J. B. Frisch, D. Evandiloff, P. Martin, N. Ouizille, F. Pires

Abstract:

Smart Beta strategies intend to be an asset management revolution with reference to classical cap-weighted indices. Indeed, these strategies allow a better control on portfolios risk factors and an optimized asset allocation by taking into account specific risks or wishes to generate alpha by outperforming indices called 'Beta'. Among many strategies independently used, this paper focuses on four of them: Minimum Variance Portfolio, Equal Risk Contribution Portfolio, Maximum Diversification Portfolio, and Equal-Weighted Portfolio. Their efficiency has been proven under constraints like momentum or market phenomenon, suggesting a reconsideration of cap-weighting.
 To further increase strategy return efficiency, it is proposed here to compare their strengths and weaknesses inside time intervals corresponding to specific identifiable market phases, in order to define adapted strategies depending on pre-specified situations. 
Results are presented as performance curves from different combinations compared to a benchmark. If a combination outperforms the applicable benchmark in well-defined actual market conditions, it will be preferred. It is mainly shown that such investment 'rules', based on both historical data and evolution of Smart Beta strategies, and implemented according to available specific market data, are providing very interesting optimal results with higher return performance and lower risk.
 Such combinations have not been fully exploited yet and justify present approach aimed at identifying relevant elements characterizing them.

Keywords: smart beta, minimum variance portfolio, equal risk contribution portfolio, maximum diversification portfolio, equal weighted portfolio, combinations

Procedia PDF Downloads 324

Authors: Thimira Pasas P, Nirmala Priyadarshani M, Ishani R

Abstract:

Obesity is a global health issue. Early identification is essential to plan interventions and intervene than to reduce the worsening of obesity and its consequences on the health issues of the individual. Childhood obesity is multifactorial, with both modifiable and unmodifiable risk factors. A genetically susceptible individual (unmodifiable), when placed in an obesogenic environment (modifiable), is likely to become obese in onset and progression. The present study was conducted to identify the age of onset of childhood obesity and the influence of modifiable risk factors for childhood obesity among school children living in a suburban area of Sri Lanka. The study population was aged 11-12 years of Piliyandala Educational Zone. Data were collected from 11–12-year-old school children attending government schools in the Piliyandala Educational Zone. They were using a validated, pre-tested self-administered questionnaire. A stratified random sampling method was performed to select schools and to select a representative sample to include all 3 types of government schools of students due to the prevailing pandemic situation, information from the last school medical inspection on data from 2020used for this purpose. For each obese child identified, 2 non-obese children were selected as controls. A single representative from the area was selected by using a systematic random sampling method with a sampling interval of 3. Data was collected using a validated, pre-tested self-administered questionnaire and the Child Health Development Record of the child. An introduction, which included explanations and instructions for filing the questionnaire, was carried out as a group activity prior to distributing the questionnaire among the sample. The results of the present study aligned with the hypothesis that the age of onset of childhood obesity and prediction must be within the first two years of child life. A total of 130 children (66 males: 64 females) participated in the study. The age of onset of obesity was seen to be within the first two years of life. The risk of obesity at 11-12 years of age was Obesity risk was identified at 3-time s higher among females who underwent rapid weight gain within their infancy period. Consuming milk prior to breakfast emerged as a risk factor that increases the risk of obesity by three times. The current study found that the drink before breakfast tends to increase the obesity risk by 3-folds, especially among obese females. Proper monitoring must be carried out to identify the rapid weight gain, especially within the first 2 years of life. Consumption of mug milk before breakfast tends to increase the obesity risk by 3 times. Identification of the confounding factors, proper awareness of the mothers/guardians and effective proper interventions need to be carried out to reduce the obesity risk among school children in the future.

Keywords: childhood obesity, school children, age of onset, weight gain, feeding pattern, activity level

Procedia PDF Downloads 122

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

Abstract:

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

Procedia PDF Downloads 495

Authors: Sammy Xiaoyan Ying

Abstract:

Professional skepticism remains one of the most important and controversial topics in auditing. This study examines the influence of client cooperativeness and fraud risk on judgments of professional skepticism among Chinese entry-level auditors in the context of evaluation of client-provided audit evidence. Given that the essence of auditors’ PS rests on distrust of clients, this study invokes trust-related theories from psychological and cultural perspectives. Specifically, invoking psychology theories of trust concerning positive relationship between risk and distrust, this study hypothesizes that professional skepticism is likely to be positively associated with client fraud risk. The results support the hypothesis and show that lower (higher) levels of client fraud risk lead to lower (higher) levels of professional skepticism. Furthermore, drawing on analysis of relationship between cooperation and trust, with particular reference to guanxi dynamics in the Chinese culture, this study hypothesizes that professional skepticism is likely to be negatively associated with client cooperativeness. The results support the hypothesis and show that higher (lower) levels of client cooperativeness lead to lower (higher) levels of professional skepticism. The findings may assist audit firms and auditing educators in improving training and education programs and enhancing entry-level auditors’ abilities to maintain professional skepticism. Also, practitioners and regulators may benefit from increasing awareness of psychological factors in influencing professional skepticism.

Keywords: audit judgment, Chinese culture, entry-level auditor, professional skepticism

Procedia PDF Downloads 276

Authors: Wisit Wichitkosoom

Abstract:

Objective:The majority of the hisk-risk patients (ST-elevation myocardial infarction (STEMI), Acute cerebrovascular accident, Sepsis, Acute Traumatic patient ) are admitted to district or lacal hospitals (average 1-1.30 hr. from Udonthani general hospital, Northeastern province, Thailand) without proper facilities. The referral system was support to early care and early management at pre-hospital stage and prepare for the patient data to higher hospital. This study assessed the reduction in treatment delay achieved by pre-hospital diagnosis and referral directly to Udonthani General Hospital. Methods and results: Four district or local hospitals without proper facilities for treatment the very high-risk patient were serving the study region. Pre-hospital diagnoses were established with the simple technology such as LINE, SMS, telephone and Fax for concept of LEAN process and then the telemedicine, by ambulance monitoring (ECG, SpO2, BT, BP) in both real time and snapshot mode was administrated during the period of transfer for safety transfer concept (inter-hospital stage). The standard treatment for patients with STEMI, Intracranial injury and acute cerebrovascular accident were done. From 1 October 2012 to 30 September 2013, the 892 high-risk patients transported by ambulance and transferred to Udonthani general hospital were registered. Patients with STEMI diagnosed pre-hospitally and referred directly to the Udonthani general hospital with telemedicine closed monitor (n=248). The mortality rate decreased from 11.69% in 2011 to 6.92 in 2012. The 34 patients were arrested on the way and successful to CPR during transfer with the telemedicine consultation were 79.41%. Conclusion: The proper innovation could apply for health care system. The very high-risk patients must had the closed monitoring with two-way communication for the “safety transfer period”. It could modified to another high-risk group too.

Keywords: safety transfer, telemedicine, critical patients, medical and health sciences

Procedia PDF Downloads 290

Authors: Shorena Sadzaglishvili, Teona Gotsiridze, Ketevan Lekishvili, Darejan Javakhishvili, Alida Bouris

Abstract:

Globally, adolescents and young people experience high levels of HIV vulnerability and risk. Estimates suggest that AIDS-related deaths among young people are increasing, suggesting poor prioritization of adolescents in national plans for HIV testing and treatment services. HIV/AIDS is currently the sixth leading cause of death in people aged 10-24 years. Among young people, street connected youth are clearly distinguished as being among the most at risk for HIV infection. The present study recognizes the urgent need to scale up effective HIV responses that are tailored to the unique needs of street connected youth for the global HIV agenda and especially, the former Soviet country - Georgia, where 'street kids' are a new phenomenon and estimated to be about 2,500. During two months trained interviewers conducted individual semi-structured qualitative interviews with 22 key informants from the local governmental and nongovernmental service organizations, including psychologists, social workers, peer educators, mobile health workers, and managers. Informants discussed social network characteristics influencing street connected youth’s sexual risk behaviors. Data were analyzed using Dedoose. It was revealed that there are three types of homogeneous networks of street-connected youth aged 10-19 based on ethnical background: (1) Georgians; (2) migrant kids of Azeri-Kurdish origin, and (3) local Roma-Moldavian kids. These networks are distinguished with various HIV risk through both risky sexual and drug-related behaviors. In addition, there are several cases of HIV infection identified through reactive social services. Street connected youth do not have basic information about the HIV related sexual, alcohol and drug behaviors nor there are any systematic programs providing HIV testing and consultation for reducing the vulnerability of HIV infection. There is a need to systematically examine street-connected youth risk-taking behaviors by applying an integrated, multilevel framework to a population at great risk of HIV. Acknowledgment: This work was supported by Shota Rustaveli National Science Foundation of Georgia (SRNSFG) [#FR 17_31], Ilia State University.

Keywords: street connected youth, social networks, HIV/AIDS, HIV testing

Procedia PDF Downloads 145

Authors: Mikhail V. Khachaturyan

Abstract:

The article analyzes problems of improving the management systems of the ownership risks in the conditions of the transformation of the Russian economy. Among the main sources of threats business owners should highlight is the inefficiency of the implementation of business models and interaction with hired managers. In this context, it is particularly important to analyze the relationship of business models and ownership risks. The analysis of this problem appears to be relevant for a number of reasons: Firstly, the increased risk appetite of the owner directly affects the business model and the composition of his holdings; secondly, owners with significant stakes in the company are factors in the formation of particular types of risks for owners, for which relations have a significant influence on a firm's competitiveness and ultimately determines its survival; and thirdly, inefficient system of management ownership of risk is one of the main causes of mass bankruptcies, which significantly affects the stable operation of the economy as a whole. The separation of the processes of possession, disposal and use in modern organizations is the cause of not only problems in the process of interaction between the owner and managers in managing the organization as a whole, but also the asymmetric information about the kinds and forms of the main risks. Managers tend to avoid risky projects, inhibit the diversification of the organization's assets, while owners can insist on the development of such projects, with the aim not only of creating new values for themselves and consumers, but also increasing the value of the company as a result of increasing capital. In terms of separating ownership and management, evaluation of projects by the ratio of risk-yield requires preservation of the influence of the owner on the process of development and making management decisions. It is obvious that without a clearly structured system of participation of the owner in managing the risks of their business, further development is hopeless. In modern conditions of forming a risk management system, owners are compelled to compromise between the desire to increase the organization's ability to produce new value, and, consequently, increase its cost due to the implementation of risky projects and the need to tolerate the cost of lost opportunities of risk diversification. Improving the effectiveness of the management of ownership risks may also contribute to the revitalization of creditors on implementation claims to inefficient owners, which ultimately will contribute to the efficiency models of ownership control to exclude variants of insolvency. It is obvious that in modern conditions, the success of the model of the ownership of risk management and audit is largely determined by the ability and willingness of the owner to find a compromise between potential opportunities for expanding the firm's ability to create new value through risk and maintaining the current level of new value creation and an acceptable level of risk through the use of models of diversification.

Keywords: improving, ownership risks, problem, Russia

Procedia PDF Downloads 334

Authors: Eleni Stefania Kalapoda

Abstract:

Recurring heat waves due to the global climate change emergency pose continuous risks to human health and urban resources. Local and state decision-makers incorporate Heat Vulnerability Indices (HVIs) to quantify and map the relative impact on human health in emergencies. These maps enable government officials to identify the highest-risk districts and to concentrate emergency planning efforts and available resources accordingly (e.g., to reevaluate the location and the number of heat-relief centers). Even though the framework of conducting an HVI is unique per municipality, its accuracy in assessing the heat risk is limited. To resolve this issue, varied housing-related metrics should be included. This paper quantifies and classifies NYC’s single detached housing typology within high-vulnerable NYC districts using detailed energy simulations and post-processing calculations. The results show that the variation in indoor heat risk depends significantly on the dwelling’s design/operation characteristics, concluding that low-ventilated dwellings are the most vulnerable ones. Also, it confirmed that when building-level determinants of exposure are excluded from the assessment, HVI fails to capture important components of heat vulnerability. Lastly, the overall vulnerability ratio of the housing units was calculated between 0.11 to 1.6 indoor heat degrees in terms of ventilation and shading capacity, insulation degree, and other building attributes.

Keywords: heat vulnerability index, energy efficiency, urban heat, resiliency to heat, climate adaptation, climate mitigation, building energy

Procedia PDF Downloads 61

Authors: Yu Chen Su

Abstract:

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

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

Procedia PDF Downloads 57

Authors: Ellis Kofi Akwaa-Sekyi, Jordi Moreno Gené

Abstract:

Managerial actions which negatively profile banks and impair corporate reputation are addressed through effective internal control systems. Disregard for acceptable standards and procedures for granting credit have affected bank loan portfolios and could be cited for the crises in some European countries. The study intends to determine the effectiveness of internal control systems, investigate whether perceived agency problems exist on the part of board members and to establish the relationship between internal controls and credit risk among listed banks in the European Union. Drawing theoretical support from the behavioural compliance and agency theories, about seventeen internal control variables (drawn from the revised COSO framework), bank-specific, country, stock market and macro-economic variables will be involved in the study. A purely quantitative approach will be employed to model internal control variables covering the control environment, risk management, control activities, information and communication and monitoring. Panel data from 2005-2014 on listed banks from 28 European Union countries will be used for the study. Hypotheses will be tested and the Generalized Least Squares (GLS) regression will be run to establish the relationship between dependent and independent variables. The Hausman test will be used to select whether random or fixed effect model will be used. It is expected that listed banks will have sound internal control systems but their effectiveness cannot be confirmed. A perceived agency problem on the part of the board of directors is expected to be confirmed. The study expects significant effect of internal controls on credit risk. The study will uncover another perspective of internal controls as not only an operational risk issue but credit risk too. Banks will be cautious that observing effective internal control systems is an ethical and socially responsible act since the collapse (crisis) of financial institutions as a result of excessive default is a major contagion. This study deviates from the usual primary data approach to measuring internal control variables and rather models internal control variables in a quantitative approach for the panel data. Thus a grey area in approaching the revised COSO framework for internal controls is opened for further research. Most bank failures and crises could be averted if effective internal control systems are religiously adhered to.

Keywords: agency theory, credit risk, internal controls, revised COSO framework

Procedia PDF Downloads 291

Authors: Tea Poklepović, Zdravka Aljinović, Mario Matković

Abstract:

Modern Portfolio Theory (MPT) according to Markowitz states that investors form mean-variance efficient portfolios which maximizes their utility. Markowitz proposed the standard deviation as a simple measure for portfolio risk and the lower semi-variance as the only risk measure of interest to rational investors. This paper uses a third volatility estimator based on intraday data and compares three efficient frontiers on the Croatian Stock Market. The results show that range-based volatility estimator outperforms both mean-variance and lower semi-variance model.

Keywords: variance, lower semi-variance, range-based volatility, MPT

Procedia PDF Downloads 497

Authors: Mohd Izzat Md. Nor, Norfazlina Jaffar, Noor Zaitulakma Md. Zain, Nur Izyanti Mohd Suppian, Subhashini Balakrishnan, Geetha Kandavello

Abstract:

During the Coronavirus (COVID-19) pandemic, Malaysia has been focusing on building herd immunity by introducing vaccination programs into the community. Hospital Standard Operating Procedures (SOP) were developed to prevent inpatient transmission. Objective: In this study, we focus on the positivity rate of inpatient Person Under Surveillance (PUS) becoming COVID-19 positive and compare this to the National rate in order to see the outcomes of the patient who becomes COVID-19 positive in relation to their vaccination status. Methodology: This is a retrospective observational study carried out from 1 January until 30 March 2022 in Institut Jantung Negara (IJN). There were 5,255 patients admitted during the time of this study. Pre-admission Polymerase Chain Reaction (PCR) swab was done for all patients. Patients with positive PCR on pre-admission screening were excluded. The patient who had exposure to COVID-19-positive staff or patients during hospitalization was defined as PUS and were quarantined and monitored for potential COVID-19 infection. Their frequency and risk of exposure (WHO definition) were recorded. A repeat PCR swab was done for PUS patients that have clinical deterioration with or without COVID symptoms and on their last day of quarantine. The severity of COVID-19 infection was defined as category 1-5A. All patients' vaccination status was recorded, and they were divided into three groups: fully immunised, partially immunised, and unvaccinated. We analyzed the positivity rate of PUS patients becoming COVID-positive, outcomes, and correlation with the vaccination status. Result: Total inpatient PUS to patients and staff was 492; only 13 became positive, giving a positivity rate of 2.6%. Eight (62%) had multiple exposures. The majority, 8/13(72.7%), had a high-risk exposure, and the remaining 5 had medium-risk exposure. Four (30.8%) were boostered, 7(53.8%) were fully vaccinated, and 2(15.4%) were partial/unvaccinated. Eight patients were in categories 1-2, whilst 38% were in categories 3-5. Vaccination status did not correlate with COVID-19 Category (P=0.641). One (7.7%) patient died due to COVID-19 complications and sepsis. Conclusion: Within the first quarter of 2022, our institution's positivity rate (2.6%) is significantly lower than the country's (14.4%). High-risk exposure and multiple exposures to positive COVID-19 cases increased the risk of PUS becoming COVID-19 positive despite their underlying vaccination status.

Keywords: COVID-19, boostered, high risk, Malaysia, quarantine, vaccination status

Procedia PDF Downloads 76

Authors: Mai Ashraf Talaat

Abstract:

Objectives: The aim of this review article is to assess the success of dental implants in breast cancer patients receiving bisphosphonate therapy and to evaluate the risk of developing bisphosphonate-related osteonecrosis of the jaw following dental implant surgery. Materials and Methods: A thorough search was conducted, with no time or language restriction, using: PubMed, PubMed Central, Web of Science, and ResearchGate electronic databases. Medical Subject Headings (MeSH) terms such as “bisphosphonate”, “dental implant”, “bisphosphonate-related osteonecrosis of the jaw (BRONJ)”, “osteonecrosis”, “breast cancer, MRONJ”, and their related entry terms were used. Eligibility criteria included studies and clinical trials that evaluated the impact of bisphosphonates on dental implants. Conclusion: Breast cancer patients undergoing bisphosphonate therapy may receive dental implants. However, the risk of developing BRONJ and implant failure is high. Risk factors such as the type of BP received, the route of administration, and the length of treatment prior to surgery should be considered. More randomized controlled trials with long-term follow-ups are needed to draw more evidence-based conclusions.

Keywords: dental implants, breast cancer, bisphosphonates, osteonecrosis, bisphosphonate-related osteonecrosis of the jaw

Procedia PDF Downloads 99

Authors: Pooja Pandey

Abstract:

The role of communication plays an integral part in the management of any disaster, whether natural or human-induced, both require effective and strategic delivery of information. The way any information is conveyed carries the most weight while dealing with the disaster. Hence, integrating communication strategies in disaster risk management (DRM) are extensively acknowledged however, these integration and planning are missing from the practical books. Researchers are continuously exploring integrated DRM and have established substantial vents between research and implementation of the strategies (gaps between science and policy). For this reason, this paper reviews the communication barriers that obstruct effective management of the disaster. Communication between first responders (government agencies, police, medical services) and the public (people directly affected by the disaster) is most critical and lacks proper delivery during a disaster. And these challenges can only be resolved if the foundation of the problem is properly dealt with, which is resolving the issues within the organizations. Through this study, it was found that it is necessary to build the communication gap between the organizations themselves as most of the hindrances occur during the mitigation, preparedness, response and recovery phase of the disaster. The study is concluded with the main aim to review the communication barriers within and at the organizational, technological, and social levels that impact effective DRM. In the end, some suggestions are made to strengthen the knowledge for future improvement in communication between the responders and their organizations.

Keywords: communication, organization, barriers, first responders, disaster risk management

Procedia PDF Downloads 278

Authors: Renaud Gaucher

Abstract:

Research on happiness has developed significantly in the past fifty years and economics and the political science are starting to be influenced by advances in the field. Until recently, finance has stayed outside this movement. The goal of our research is to integrate finance into this movement conceptually. We explain the why, the what and the how of the finance of happiness. We then study the relationship between corporate finance and happiness. We discuss the optimization of the relationship between the financial performance of a firm and the happiness at work of its employees, and the reduction of financial risk by developing goods that foster the happiness of their users. Finally we look at the development of happiness investment funds, that is investment funds founded on happiness research, and the best ways to share risks and earnings to build a happier society.

Keywords: finance, happiness, investment fund, risk

Procedia PDF Downloads 169

Authors: Mulugeta Shegaze, Mekitie Wondafrash, Alemayehu A. Alemayehu, Shikur Mohammed, Zewdu Shewangezaw, Mukerem Abdo, Gebresilasea Gendisha

Abstract:

Background: The 2004 World Health Assembly called for specific actions to halt the overweight and obesity epidemic that is currently penetrating urban populations in the developing world. Adolescents require particular attention due to their vulnerability to develop obesity and the fact that adolescent weight tracks strongly into adulthood. However, there is scarcity of information on the modifiable risk factors to be targeted for primary intervention among urban adolescents in Ethiopia. This study was aimed at determining the magnitude and risk factors of overweight and obesity among high school adolescents in Addis Ababa. Methods: An institution-based cross-sectional study was conducted in February and March 2014 on 456 randomly selected adolescents from 20 high schools in Addis Ababa city.  Demographic data and other risk factors of overweight and obesity were collected using self-administered structured questionnaire, whereas anthropometric measurements of weight and height were taken using calibrated equipment and standardized techniques. The WHO STEPS instrument for chronic disease risk was applied to assess dietary habit and physical activity. Overweight and obesity status was determined based on BMI-for-age percentiles of WHO 2007 reference population. Results: The prevalence rates of overweight, obesity, and overall overweight/ obesity among high school adolescents in Addis Ababa were 9.7% (95%CI = 6.9-12.4%), 4.2% (95%CI = 2.3-6.0%), and 13.9% (95%CI = 10.6-17.1%), respectively. Overweight/obesity prevalence was highest among female adolescents, in private schools, and in the higher wealth category. In multivariable regression model, being female [AOR(95%CI) = 5.4(2.5,12.1)], being from private school [AOR(95%CI) = 3.0(1.4,6.2)], having >3 regular meals [AOR(95%CI) = 4.0(1.3,13.0)], consumption of sweet foods [AOR(95%CI) = 5.0(2.4,10.3)] and spending >3 hours/day sitting [AOR(95%CI) = 3.5(1.7,7.2)] were found to increase overweight/ obesity risk, whereas high Total Physical Activity level [AOR(95%CI) = 0.21(0.08,0.57)] and better nutrition knowledge [AOR(95%CI) = 0.160.07,0.37)] were found protective. Conclusions: More than one in ten of the high school adolescents were affected by overweight/obesity with dietary habit and physical activity are important modifiable risk factors. Well-tailored nutrition education program targeting lifestyle change should be initiated with more emphasis to female adolescents and students in private schools.

Keywords: adolescents, NCDs, overweight, obesity

Procedia PDF Downloads 286

Authors: Singh Baljinder, Sharma Navneet

Abstract:

Microalbuminuria is the earliest detectable marker of diabetic nephropathy. We planned to evaluate the prevalence of microalbuminuria in type 1 diabetics and correlate with various risk factor. We randomly selected 100 type 1 diabetic patients after inclusion and exclusion criteria from DCRC, S. P. Medical College, Bikaner. Clinical examinations for anthropometeric parameters, hypertension, retinopathy, glycaemic status, lipid profile were done and microalbuminuria was estimated by micral test. Microalbuminuria was seen in 38% patients. The mean urinary albumin concentration was 96.61 mg/l in microalbuminuria positive cases, 134 mg/L in hypertensive patients while 74.5 mg/L in normal patients. Mean diabetic duration was 6.43 years in microalbuminurics. Albumin excretion increased significantly with age at onset of 10-18 years and declined thereafter. Microalbuminuria cases exhibited mean cholesterol 181.63 mg%, TG 130.94 mg%, LDL 109.87 mg%, HDL 57.5 mg% and VLDL 30.64 mg%. Mean urinary albumin concentration in patients with retinopathy was 160.52 mg/L while 78.66 mg/L without retinopathy. In multiple stepwise logistic regression analysis, a strong positive association was seen between microalbuminuria and hypertension (OR=5.087, CI=2.1319-12.101), fasting blood sugar (OR=3. 491, CI=1.138-10.70), duration of diabetes (OR=3.41, CI=1.360-8.55) and HbA1c (OR=2.381, CI-=1.1-5.64). The present study indicates that microalbuminuria is a common complication of type 1 diabetes mellitus and can be prevented by careful management of risk factors.

Keywords: type 1 diabetes, microalbuminuria, diabetic nephropathy, retinopathy, hypertension

Procedia PDF Downloads 432