Search results for: injury risk level

Authors: Rachel deCatanzaro, Madeline Austen, Ken Tuininga, Kathy St. Laurent, Christina Rohe

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In Canada, the federal Species at Risk Act (SARA) provides protection for wildlife species at risk and a national legislative framework for the conservation or recovery of species that are listed as endangered, threatened, or special concern under Schedule 1 of SARA. Key aspects of the federal species at risk program include the development of recovery documents (recovery strategies, action plans, and management plans) outlining threats, objectives, and broad strategies or measures for conservation or recovery of the species; the identification and protection of critical habitat for threatened and endangered species; and working with groups and organizations to implement on-the-ground recovery actions. Environment Canada’s progress on the development of recovery documents and on the identification and protection of critical habitat in Ontario will be presented, along with successes and challenges associated with on-the ground implementation of recovery actions. In Ontario, Environment Canada is currently involved in several recovery and monitoring programs for at-risk bird species such as the Loggerhead Shrike, Piping Plover, Golden-winged Warbler and Cerulean Warbler and has provided funding for a wide variety of recovery actions targeting priority species at risk and geographic areas each year through stewardship programs including the Habitat Stewardship Program, Aboriginal Fund for Species at Risk, and the Interdepartmental Recovery Fund. Key research needs relevant to the recovery of species at risk have been identified, and include: surveys and monitoring of population sizes and threats, population viability analyses, and addressing knowledge gaps identified for individual species (e.g., species biology and habitat needs). The engagement of all levels of government, the local and international conservation communities, and the scientific research community plays an important role in the conservation and recovery of species at risk in Ontario– through surveying and monitoring, filling knowledge gaps, conducting public outreach, and restoring, protecting, or managing habitat – and will be critical to the continued success of the federal species at risk program.

Keywords: conservation biology, habitat protection, species at risk, wildlife recovery

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Authors: Somchai Buaroong

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This research attempted to study information system success in dimensions of the user satisfaction level and to find the association between the independent factors of the user experiences, user knowledge, and user attitude. The study sample was selected using simple random sampling that comprised of 190 users who had used the Bangkok HIS. The data were reported from 165 questionnaires. The results found that the user satisfaction was at a moderate level, user satisfaction on the information quality and system quality was at a moderate level, while satisfaction on service quality was at a high level. The computer knowledge of the user was at a moderate level, and the user attitude was at a positive level. The participation of the user was at a low level and the participation in decision and in evaluation was at a low level; however participation in implementation and in benefit was at a moderate.

Keywords: information system success, hospital information system, user attitude, user satisfaction

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Authors: Lina Najafian, Hamidreza Vakilifard

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The present study focused on the relationship between the quality of accruals and non-systematic risk. The independent study variables included the ability of accruals, the information content of accruals, and amount of discretionary accruals considered as accruals quality measures. The dependent variable was non-systematic risk based on the Fama and French Three Factor model (FFTFM) and the capital asset pricing model (CAPM). The control variables were firm size, financial leverage, stock return, cash flow fluctuations, and book-to-market ratio. The data collection method was based on library research and document mining including financial statements. Multiple regression analysis was used to analyze the data. The study results showed that there is a significant direct relationship between financial leverage and discretionary accruals and non-systematic risk based on FFTFM and CAPM. There is also a significant direct relationship between the ability of accruals, information content of accruals, firm size, and stock return and non-systematic based on both models. It was also found that there is no relationship between book-to-market ratio and cash flow fluctuations and non-systematic risk.

Keywords: accruals quality, non-systematic risk, CAPM, FFTFM

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Authors: O. O. Olawusi-Peters, K. I. Adejugbagbe

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The concentration of heavy metal (Cd, Pb, Fe, Zn, Cu) in Clarias gariepinus collected from fish markets; Fanibi (Station I) and Fiwasaye (Station II) in Akure metropolis, Ondo state, Nigeria were investigated to ascertain the safety for the consumers. 60 samples were collected from the two markets in three batches (I, II, III) for a period of six months and analyzed for heavy metals in the gills and muscles of the fish. Also, the Health Risk Index (HRI) was used to determine the health risk of these metals to the consumer. The results showed that the investigated metal concentration was higher in station I than station II, except Pb having higher concentration in station II than station I. In both stations, the highest concentration of Fe was recorded in the gills (12.60 ± 1.51; 6.94 ± 1.38) and muscles (3.72 ± 0.09; 3.86 ± 0.33) of samples in batch I. Also, the HRI revealed that consumption of Clarias gariepinus from these study areas did not pose any health risk (HRI < 1). In addition, concentrations of the heavy metals were all below the permissible limits recommended by FAO/WHO.

Keywords: health risk index, heavy metals, clarias gariepinus, akure metropolis, fish monger

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Authors: Genevieve Zingg

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Since the onset of the 2015 ‘refugee crisis’ in the European Union (EU), migrant deaths have overwhelmingly occurred in the Mediterranean Sea. However, far less attention has been paid to the startling number of injuries, deaths, and allegations of systematic human rights violations occurring within European refugee camps. Most troubling is the assertion that injuries and deaths in EU refugee camps have occurred as a result of negligent management and poor access to healthcare, food, water and sanitation, and other elements that comprise an adequate standard of living under international human rights law. Using available evidence and documentation, this paper will conduct a thorough examination of the causes of death and injury in EU refugee camps, with a specific focus on Greece, in order to identify instances of negligence or conditions that amount to potential breaches of human rights law. Based on its analysis, this paper will subsequently explore potential legal avenues to achieving justice and accountability under international human rights law in order to effectively address and remedy inadequate standards of living causing wrongful death or injury in European refugee camps.

Keywords: European Union, Greece, human rights, international human rights law, migration, refugees

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Authors: Eun-Chan Kim, Jeong-Hwan Oh, Seung-Guk Lee

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Billions of tones of ballast water including various aquatic organisms are being carried around the world by ships. When the ballast water is discharged into new environments, some aquatic organisms discharged with ballast water may become invasive and severely disrupt the native ecology. Thus, International Maritime Organization (IMO) adopted the Ballast Water Management Convention in 2004. Regulation A-4 of the convention states that a government in waters under their jurisdiction may grant exemptions to any requirements to ballast water management, but only when they are granted to a ship or ships on a voyage or voyages between specified ports or locations, or to a ship which operates exclusively between specified ports or locations. In order to grant exemptions, risk assessment should be conducted based on the guidelines for risk assessment developed by the IMO. For the risk assessment, it is essential to collect the relevant information and establish a database system. This paper studies the database system for ballast water risk assessment. This database consists of the shipping database, ballast water database, port environment database and species database. The shipping database has been established based on the data collected from the port management information system of Korea Government. For the ballast water database, ballast water discharge has only been estimated by the loading/unloading of the cargoes as the convention has not come into effect yet. The port environment database and species database are being established based on the reference documents, and existing and newly collected monitoring data. This database system has been approved to be a useful system, capable of appropriately analyzing the risk assessment in the all ports of Korea.

Keywords: ballast water, IMO, risk assessment, shipping, environment, species

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Authors: Heidi Ahonen

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Since antiquity, many cultures have seemingly known the power of low frequencies, incorporating them in healing practices through drumming, singing, humming, etc. Many music therapists recognize there is something in music that is transformative enough to make a difference in people’s lives. This paper summarizes the key findings of several low-frequency research with various client populations conducted by the author. Utilizing low-frequency sound (30 or 40 Hz) may have diverse therapeutic impacts: (1) Calming effect – decreased agitation (autism, brain injury, AD, dementia) (2) Muscle relaxation (CP & spasticity & pain/after surgery patients, MS, fibromyalgia) (3) Relaxation/stress release (anxiety, stress, PTSD, trauma, insomnia) (4) Muscular/motor functioning/ decrease of tremor (CP, MS, Parkinson) (5) Increase in alertness, cognitive awareness & short-term memory function (brain injury, severe global developmental delay, AD) (6) Increased focus (AD, PTSD, trauma). The paper will conclude by presenting ideas informing the clinical practice. Future studies need to investigate what frequencies are effective for particular client populations and why, what theories can explain the effect, and finally, something that has been long debated - is it auditive or kinaesthetic stimulation or the combination of both that is effective?

Keywords: low frequency, 40 Hz, sound, neuro disability

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Authors: Siti Juryiah Mohd Khalid, Norazlina Dol

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Academic libraries in Malaysia are still not prepared for disaster even though several occasions have been reported. The study sets out to assess the current status of preparedness in disaster management among Malaysian academic libraries in the State of Selangor and the Federal Territory of Kuala Lumpur. To obtain a base level of knowledge on disaster preparedness of current practices, a questionnaire was distributed to chief librarians or their assignees in charge of disaster or emergency preparedness at 40 academic libraries and 34 responses were received. The study revolved around the current status of preparedness, on various issues including existence of disaster preparedness plan among academic libraries in Malaysia, disaster experiences by the academic libraries, funding, risk assessment activities and involvement of library staff in disaster management. Frequency and percentage tables were used in the analysis of the data collected. Some of the academic libraries under study have experienced one form of disaster or the other. Most of the academic libraries do not have a written disaster preparedness plan. The risk assessments and staff involvement in disaster preparedness by these libraries were generally adequate.

Keywords: academic libraries, disaster preparedness plan, disaster management, emergency plan

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Authors: Raj Chandran, Saul Datwyler, Jaime Marino, Daniel West, Karla Grasso, Adam Buss, Hina Syed, Zina Al Sahouri, Jennifer Yen, Krista Caudle, Beth McQuiston

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The Alinity i TBI test is Therapeutic Goods Administration (TGA) registered and is a panel of in vitro diagnostic chemiluminescent microparticle immunoassays for the measurement of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) in plasma and serum. The Alinity i TBI performance was evaluated in a multi-center pivotal study to demonstrate the capability to assist in determining the need for a CT scan of the head in adult subjects (age 18+) presenting with suspected mild TBI (traumatic brain injury) with a Glasgow Coma Scale score of 13 to 15. TBI has been recognized as an important cause of death and disability and is a growing public health problem. An estimated 69 million people globally experience a TBI annually1. Blood-based biomarkers such as glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have shown utility to predict acute traumatic intracranial injury on head CT scans after TBI. A pivotal study using prospectively collected archived (frozen) plasma specimens was conducted to establish the clinical performance of the TBI test on the Alinity i system. The specimens were originally collected in a prospective, multi-center clinical study. Testing of the specimens was performed at three clinical sites in the United States. Performance characteristics such as detection limits, imprecision, linearity, measuring interval, expected values, and interferences were established following Clinical and Laboratory Standards Institute (CLSI) guidance. Of the 1899 mild TBI subjects, 120 had positive head CT scan results; 116 of the 120 specimens had a positive TBI interpretation (Sensitivity 96.7%; 95% CI: 91.7%, 98.7%). Of the 1779 subjects with negative CT scan results, 713 had a negative TBI interpretation (Specificity 40.1%; 95% CI: 37.8, 42.4). The negative predictive value (NPV) of the test was 99.4% (713/717, 95% CI: 98.6%, 99.8%). The analytical measuring interval (AMI) extends from the limit of quantitation (LoQ) to the upper LoQ and is determined by the range that demonstrates acceptable performance for linearity, imprecision, and bias. The AMI is 6.1 to 42,000 pg/mL for GFAP and 26.3 to 25,000 pg/mL for UCH-L1. Overall, within-laboratory imprecision (20 day) ranged from 3.7 to 5.9% CV for GFAP and 3.0 to 6.0% CV for UCH-L1, when including lot and instrument variances. The Alinity i TBI clinical performance results demonstrated high sensitivity and high NPV, supporting the utility to assist in determining the need for a head CT scan in subjects presenting to the emergency department with suspected mild TBI. The GFAP and UCH-L1 assays show robust analytical performance across a broad concentration range of GFAP and UCH-L1 and may serve as a valuable tool to help evaluate TBI patients across the spectrum of mild to severe injury.

Keywords: biomarker, diagnostic, neurology, TBI

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Authors: Chao Sima, Shanaz Ghandhi, Sally A. Amundson, Michael L. Bittner, David J. Brenner

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In a large-scale radiologic emergency, potentially affected population need to be triaged efficiently using various biomarkers where personal dosimeters are not likely worn by the individuals. It has long been established that radiation injury can be estimated effectively using panels of genetic biomarkers. Furthermore, the rate of radiation, in addition to dose of radiation, plays a major role in determining biological responses. Therefore, a better and more accurate triage involves estimating both the dose level of the exposure and the length of time of that exposure. To that end, a large in vivo study was carried out on mice with internal emitter caesium-137 (¹³⁷Cs). Four different injection doses of ¹³⁷Cs were used: 157.5 μCi, 191 μCi, 214.5μCi, and 259 μCi. Cohorts of 6~7 mice from the control arm and each of the dose levels were sacrificed, and blood was collected 2, 3, 5, 7 and 14 days after injection for microarray RNA gene expression analysis. Using a generalized linear model with penalized maximum likelihood, a panel of 244 genes was established and both the doses of injection and the number of days after injection were accurately predicted for all 155 subjects using this panel. This has proven that microarray gene expression can be used effectively in radiation biodosimetry in predicting both the dose levels and the length of exposure time, which provides a more holistic view on radiation exposure and helps improving radiation damage assessment and treatment.

Keywords: caesium-137, gene expression microarray, multivariate responses prediction, radiation biodosimetry

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Authors: Lowanika Victor Tibane, David Mamba

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Human body, animals, and plants depend on certain essential metals in permissible quantities for their survival. Excessive metal concentration may cause severe malfunctioning of the organisms and even fatal in extreme cases. Because of gold mining in the Witwatersrand basin in South Africa, enormous untreated mine dumps comprise elevated concentration of essential trace elements. Elevated quantities of trace metal have direct negative impact on the quality of soil for different land use types, reduce soil efficiency for plant growth, and affect the health human and animals. A total of 21 subsoil samples were examined using inductively coupled plasma optical emission spectrometry and X-ray fluorescence methods and the results elevated men concentration of Fe (36,433.39) > S (5,071.83) > Cu (1,717,28) > Mn (612.81) > Cr (74.52) > Zn (68.67) > Ni (40.44) > Co (9.63) > P (3.49) > Mo > (2.74), reported in mg/kg. Using various contamination indices, it was discovered that the sites surveyed are on average moderately contaminated with Co, Cr, Cu, Mn, Ni, S, and Zn. The ecological risk assessment revealed a low ecological risk for Cr, Ni and Zn, whereas Cu poses a very high ecological risk.

Keywords: essential trace elements, soil contamination, contamination indices, toxicity, descriptive statistics, ecological risk evaluation

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Authors: Naveed Ul Hassan, Bilal Aziz, Maryam Mushtaq, Imran Ameen Khan

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Equity risk premium (ERP) is the stock return in excess of risk free return. Even though it is an essential topic of finance but still there is no common consensus upon its forecasting. For forecasting ERP, apart from the macroeconomic variables attention is devoted to technical indicators as well. For this purpose, set of 14 technical and 14 macro-economic variables is selected and all forecasts are generated based on a standard predictive regression framework, where ERP is regressed on a constant and a lag of a macroeconomic variable or technical indicator. The comparative results showed that technical indicators provide better indications about ERP estimates as compared to macro-economic variables. The relative strength of ERP predictability is also investigated by using National Bureau of Economic Research (NBER) data of business cycle expansion and recessions and found that ERP predictability is more than twice for recessions as compared to expansions.

Keywords: equity risk premium, forecasting, macroeconomic indicators, technical indicators

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Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda

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Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.

Keywords: delirium, risk factors, outcome, intervention

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Authors: Sayyed Mostafa Ahmadi, Neda Raeesi

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Background and Objectives: Cervical spondylosis is a common problem that affects the adult spine and is the most common cause of radiculopathy and myelopathy in older patients. Anterior discectomy and fusion is a well-known technique in degenerative cervical disc disease. However, one of the late undesirable complications is adjacent disc degeneration, which affects about 91% of patients in ten years. Many factors can be effective in causing this complication, but some are still debatable. Discovering these risk factors and eliminating them can improve the quality of life. Methods: This is a retrospective cohort study. All patients who underwent anterior discectomy and fusion surgery in the neurosurgery ward of Imam Khomeini Hospital between 2013 and 2016 were evaluated. Their demographic information was collected. All patients were visited and examined for radiculopathy, myelopathy, and muscular force. At the same visit, all patients were asked to have a facelift, and neck profile, as well as a neck MRI(General Tesla 3). Preoperative graphs were used to measure the diameter of the cervical canal(Pavlov ratio) and to evaluate sagittal alignment(Cobb Angle). Preoperative MRI of patients was reviewed for anterior and posterior longitudinal ligament calcification. Result: In this study, 57 patients were studied. The mean age of patients was 50.63 years, and 49.1% were male. Only 3.5% of patients had anterior and posterior longitudinal ligament calcification. Symptomatic ASD was observed in 26.6%. The X-rays and MRIs showed evidence of 80.7% radiological ASD. Among patients who underwent one-level surgery, 20% had symptomatic ASD, but among patients who underwent two-level surgery, the rate of ASD was 50%.In other words, the higher the number of surfaces that are operated and fused, the higher the probability of symptomatic ASD(P-value <0.05). The X-rays and MRIs showed 80.7% of radiological ASD. Among patients who underwent surgery at one level, 78% had radiological ASD, and this number was 92% among patients who underwent two-level surgery(P-value> 0.05). Demographic variables such as age, sex, height, weight, and BMI did not have a significant effect on the incidence of radiological ASD(P-value> 0.05), but sex and height were two influential factors on symptomatic ASD(P-value <0.05). Other related variables such as family history, smoking and exercise also have no significant effect(P-value> 0.05). Radiographic variables such as Pavlov ratio and sagittal alignment were also unaffected by the incidence of radiological and symptomatic ASD(P-value> 0.05). The number of surgical surfaces and the incidence of anterior and posterior longitudinal ligament calcification before surgery also had no statistically significant effect(P-value> 0.05). In the study of the ability of the neck to move in different directions, none of these variables are statistically significant in the two groups with radiological and symptomatic ASD and the non-affected group(P-value> 0.05). Conclusion: According to the findings of this study, this disease is considered to be a multifactorial disease. The incidence of radiological ASD is much higher than symptomatic ASD (80.7% vs. 26.3%) and sex, height and number of fused surfaces are the only factors influencing the incidence of symptomatic ASD and no variable influences radiological ASD.

Keywords: risk factors, anterior neck disectomy and fusion, adjucent segment degeneration, complication

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Authors: Ryan Adams

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Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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Authors: Erwin L. Descallar

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Food safety is crucial in protecting the health of consumers, maintaining integrity in the entire food industry, and ensuring regulatory compliance. Food is a universal need for survival, and everyone is at risk of engaging in improper food handling, which increases vulnerability to foodborne illnesses. The level of knowledge or awareness and meat storage practices of students are behaviors influenced by various demographic factors. The Health Belief Model examines the relationship of such demographic factors towards the attitude, perception, and actions of individuals on perceived risk. This study aims to analyze and understand the correlation of said behaviors with course programs, prior food poisoning experience, and food handling of university students. The study employed randomized responses from 89 university students (n=89) under the College of Science at the Polytechnic University of the Philippines–Sta. Mesa (Manila). The results were subjected to measures of central tendency for score ranking and inferential statistics. The statistics were compared using Pearson ‘r’ Product Moment Correlation to determine the degree of relationship between the knowledge and practices on meat storage and safety. No statistically significant differences were found between the course program of students, food poisoning experiences, level of knowledge, and awareness regarding proper meat storage practices. However, increased frequency and involvement in meat handling have shown a positive correlation, indicating that there is a correlation between food handling and proper meat storage practices of university students.

Keywords: meat storage practices, food handling, food safety, meat science and technology

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Authors: Olor Obi, Ishiekwen Bridget, Ekpeyong Edom

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Even though gout is becoming more common, the role of dietary risk factors in the development and management of this condition remains unclear. Therefore, this review work will aim at clarifying the role of dietary factors in the risk and management of gout. An extensive search of literature published between 1960 and 2018 will be performed on the databases of PubMed, CINAHL, Science Direct, Cochrane, BMJ, Ann Rheum Dis, and BioMed to identify relevant cohort, prospective, population-based, or cross-sectional studies that examined the effect of diet on gout. About 19 studies will be included in this review work. The methodological quality of these studies will be evaluated using the quality assessment tool for observational and cross-sectional studies developed by the National Heart, Lungs, and Blood Institute. This work intends to reveal that a positive association exists between the intake of sugary, sweetened beverages and the risk of gout. It will also reveal the relationship between the increase in coffee consumption and the risk of gout.

Keywords: gout, dietary factors, management of gout, gouty arthritis

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Authors: Azizah Nurdin, Trika Irianta, Mardiah Tahir, Maisuri T. Chalid

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Background: Studies of anal incontinence in the general population are rare however its financial healthcare cost is significant. Women attended Hasanuddin University Teaching Hospital and its networking in Makassar, Indonesia was surveyed between February to April 2015 about their obstetrical and gynecological history. Aims: To establish obstetrical risk factor of anal incontinence among women in Makassar. Methods: In a cross sectional face to face interview study, 135 women aged 30 years or more were selected randomly. Participants were asked to complete an anal incontinence questionnaire. Results: From a total sample of 135 respondents, 42,2 % reported has flatulence incontinence. Parity, history of anal sphincter laceration, history of having large baby, history of assisted vaginal delivery were shown have no significant association with anal incontinence, while history of episiotomy was shown have a significant association with anal incontinence (p value < 0.05). The risk of flatulence incontinence was higher among women with history of episiotomy (OR : 2,85, 95 % CI = 1,58- 5,13) Conclusions: This study has confirmed that fecal incontinence is a fairly common symptom. Flatulence incontinence is the most frequent even. An obstetrical factor like episiotomy is one of risk factor that could be avoided in order to prevent anal incontinence.

Keywords: anal incontinence, flatulence incontinence, obstetrical risk factor, women

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Authors: Sandipika Gupta

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Objective: Due to admirably low 30-day mortality rates for paediatric cardiac surgery, it is now pertinent to turn towards more intermediate-length outcomes such as morbidities closely associated with these surgeries. One such morbidity, major adverse events (MAE) comprises a group of adverse outcomes associated with paediatric cardiac surgery (e.g. cardiac arrest, major haemorrhage). Methods: This is a retrospective study that analysed the incidence and impact of MAE which was the primary outcome in the UK population. The data was collected in 5 centres between October 2015 and June 2017, amassing 3090 surgical episodes. The incidence and risk factors for MAE, were assessed through descriptive statistical analyses and multivariate logistic regression. The secondary outcomes of life status at 6 months and the length of hospital stay were also evaluated to understand the impact of MAE on patients. Results: Out of 3090 episodes, 134 (4.3%) had a postoperative MAE. The majority of the episodes were in: neonates (47%, P<0.001), high-risk cardiac diagnosis groups (20.1%, P<0.001), episodes with longer 5mes on the bypass (72.4%, P<0.001) and urgent surgeries (57.9%, P<0.001). Episodes reporting MAE also reported longer lengths of stay in hospital (29 days vs 9 days, P<0.001). Furthermore, patients experiencing MAE were at a higher risk of mortality at the 6-month life status check (mortality rates: 29.2% vs 2%, P<0.001).Conclusions: Key risk factors were identified. An important negative impact of MAE was found for patients. The identified risk factors could be used to profile and flag at-risk patients. Monitoring of MAE rates and closer investigation into the care pathway before and after individual MAEs in children’s heart units may lead to a reduction in these terrible events.

Keywords:

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Authors: Milton Montejano Castillo, Tarsicio Pastrana Salcedo

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Based on the hypothesis that disaster risk is constructed socially and historically, this article shows the importance of keeping alive the historical memory of disaster by means of architectural and urban heritage conservation. This is illustrated with three examples of Latin American World Heritage cities where disasters like floods and earthquakes have shaped urban form. Therefore, the study of urban form or ‘Urban Morphology’ is proposed as a tool to understand and analyze urban transformations with the documentation of the occurrence of disasters. Lessons learned from such cities may be useful to reduce disasters risk in contemporary built environments.

Keywords: conservation, disaster risk reduction, urban morphology, World Heritage

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Authors: Yusuf Garba Baba

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The construction industry and housing subsector are fraught with risks that have the potential of negatively impacting on the achievement of project objectives. The success or otherwise of most construction projects depends to large extent on how well these risks have been managed. The recent paradigm shift by the subsector to use of formal risk management approach in contrast to hitherto developed rules of thumb means that risks must not only be identified but also properly assessed and responded to in a systematic manner. The study focused on identifying risks associated with housing development projects and prioritisation assessment of the identified risks in order to provide basis for informed decision. The study used a three-step identification framework: review of literature for similar projects, expert consultation and questionnaire based survey to identify potential risk factors. Delphi survey method was employed in carrying out the relative prioritization assessment of the risks factors using computer-based Analytical Hierarchical Process (AHP) software. The results show that 19 out of the 50 risks significantly impact on housing development projects. The study concludes that although significant numbers of risk factors have been identified as having relevance and impacting to housing construction projects, economic risk group and, in particular, ‘changes in demand for houses’ is prioritised by most developers as posing a threat to the achievement of their housing development objectives. Unless these risks are carefully managed, their effects will continue to impede success in these projects. The study recommends the adoption and use of the combination of multi-technique identification framework and AHP prioritization assessment methodology as a suitable model for the assessment of risks in housing development projects.

Keywords: risk management, risk identification, risk analysis, analytic hierarchical process

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Authors: Mustapha Achibane, Imane Allam

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Since the nineties, all Moroccan banking institutions have to respect an arsenal of prudential ratios. The respect of these prudential measures aims to ensure the financial system stability. In order to do so, regulatory authorities tried to reduce the financial and operational risks incurred by the banking entities. Meanwhile, regulatory authorities demanded a balance sheet management work from banks. They also asked them to establish a management control system to manage operational risk, as well as an effort in terms of incurred risk-based commitments. Therefore, the prudential approach has a macroeconomic nature and it is presented as a determinant of the operational, microeconomic approach. This operational approach takes the form of a strategy that each banking entity must develop to manage the different banking risks. This study seeks to analyze the problem of risk management between the prudential and the operational approaches. It was processed through a literature review followed by an analysis of the Moroccan banking sector’s performance. At first, we will reconcile the inductive logic and then, the analytical one. The first approach consists of analyzing the phenomenon from a normative and conceptual perspective, while the second one will consist of considering the Moroccan banking system and analyzing the behavior of Moroccan banking entities in terms of risk management and performance. The results identified a favorable growth in terms of performance, despite the huge provisioning effort made to meet the international standards and the harmonization of the regulations.

Keywords: banking performance, financial intermediation, operational approach, prudential standards, risk management

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Authors: Safia Hocine, Zina Benouaret, Djamil A¨ıssani

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In this paper, we study the performance of the strong stability method of the univariate classical risk model. We interest to the stability bounds established using two approaches. The first based on the strong stability method developed for a general Markov chains. The second approach based on the regenerative processes theory . By adopting an algorithmic procedure, we study the performance of the stability method in the case of exponential distribution claim amounts. After presenting numerically and graphically the stability bounds, an interpretation and comparison of the results have been done.

Keywords: Marcov chain, regenerative process, risk model, ruin probability, strong stability

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Authors: Malvina Hoxha, Valerie Capra, Carola Buccellati, Angelo Sala, Clara Cena, Roberta Fruttero, Massimo Bertinaria, G. Enrico Rovati

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Today COXIBs are used in the treatment of arthritis and many other painful conditions in selected patients with high gastrointestinal risk and low CV risk. Previously we found a new mechanism of action of a traditional NSAID (diclofenac) and a COXIB (lumiracoxib) that possess weak competitive antagonism at the TP receptor. We hypothesize that modifying the structure of a known specific inhibitor of cyclooxygenase-2 (COXIB), so that it becomes also a more potent thromboxane antagonist will preserve the anti-inflammatory and gastrointestinal safety typical of COXIBs and prevent the cardiovascular risk associated with long term therapy.

Keywords: cyclooxygenase, inflammation, lumiracoxib, thromboxane A2

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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

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Authors: Christian Perrin, Nicholas Blagden, Louise Allen, Sarah Impey

Abstract:

Social workers in the UK and professionals globally are faced with a particular challenge when dealing with allegations of child sexual abuse (CSA) in the community. In the absence of a conviction or incontestable evidence, staff can often find themselves unable to take decisive action to remove a child from harm, even though there may be a credible threat to their welfare. Conversely, practitioners may over-calculate risk through fear of being accountable for harm. This is, in part, due to the absence of a structured and evidence-based risk assessment tool which can predict the likelihood of a person committing child sexual abuse. Such assessments are often conducted by forensic professionals who utilise offence-specific data and personal history information to calculate risk. In situations where only allegations underpin a case, this mode of assessment is not viable. There are further ethical issues surrounding the assessment of risk in this area which require expert consideration and sensitive planning. This paper explores this entangled problem extant in the wider call to prevent sexual and child sexual abuse in the community. To this end, 32 qualitative interviews were undertaken with social workers dealing with CSA cases. Results were analysed using thematic analysis and operationalised to formulate a risk and protection protocol for use in case management. This paper reports on the early findings associated with the initial indications of protocol reliability. Implications for further research and practice are discussed.

Keywords: sexual offending, child sexual offence, offender rehabilitation, risk assessment, offence prevention

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Authors: Giriraj Achari, Malay Bhattacharyya

Abstract:

In this paper, the effectiveness of Copula Markov Switching Multifractal (MSM) models at forecasting Value-at-Risk of a two-stock portfolio is studied. The innovations are allowed to be drawn from distributions that can capture skewness and leptokurtosis, which are well documented empirical characteristics observed in financial returns. The candidate distributions considered for this purpose are Johnson-SU, Pearson Type-IV and α-Stable distributions. The two univariate marginal distributions are combined using the Student-t copula. The estimation of all parameters is performed by Maximum Likelihood Estimation. Finally, the models are compared in terms of accurate Value-at-Risk (VaR) forecasts using tests of unconditional coverage and independence. It is found that Copula-MSM-models with leptokurtic innovation distributions perform slightly better than Copula-MSM model with Normal innovations. Copula-MSM models, in general, produce better VaR forecasts as compared to traditional methods like Historical Simulation method, Variance-Covariance approach and Copula-Generalized Autoregressive Conditional Heteroscedasticity (Copula-GARCH) models.

Keywords: Copula, Markov Switching, multifractal, value-at-risk

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Authors: Nam Chol Yu, GyongIl Chu, HoJong Ri

Abstract:

Using DLTS (Deep-level transient spectroscopy) measurement techniques, we determined the dominant recombination center levels (defects of both A and B) in gold and platinum doped n-type silicon. Also, the injection and temperature dependence of the Shockley-Read-Hall (SRH) carrier lifetime was studied under low-level injection and high-level injection. Here measurements show that the dominant level under low-level injection located at EC-0.25 eV (A) correlated to the Pt+G1 and the dominant level under high-level injection located at EC-0.54 eV (B) correlated to the Au+G4. Finally, A and B are the same dominant levels for controlling the lifetime in gold-platinum doped n-silicon.

Keywords: recombination center level, lifetime, carrier lifetime control, Gold, Platinum, Silicon

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Authors: Nurul Noraziemah Mohd Pauzi, Muhammad Fauzi Mohd Zain

Abstract:

The rapid advance in the electronic industry has led to the increase amount of the waste cathode ray tube (CRT) devices. The management of CRT waste upon disposal haves become a major issue of environmental concern as it contains toxic elements (i.e. lead, barium, zinc, etc.) which has a risk of leaching if it is not managed appropriately. Past studies have reported regarding the possible use of CRT glass as a part of aggregate in concrete production. However, incorporating waste CRT glass may present an environmental risk via leachability of toxic elements. Accordingly, the preventive measures for reducing the risk was proposed. The current work presented the experimental results regarding potential leaching of toxic elements from four types of concrete mixed, each compromising waste CRT glass as coarse aggregate with different shape and properties. Concentrations of detected elements are measure in the leachates by using atomic absorption spectrometry (AAS). Results indicate that the concentration of detected elements were found to be below applicable risk, despite the higher content of toxic elements in CRT glass. Therefore, the used of waste CRT glass as coarse aggregate in hardened concrete does not pose any risk of leachate of heavy metals to the environment.

Keywords: recycled CRT glass, coarse aggregate, physical properties, leaching, toxic elements

Procedia PDF Downloads 356

Authors: Aida Alemany, Laura Ballester, Ana González-Urteaga

Abstract:

From 2007 subprime crisis to the recent Eurozone debt crisis the European banking industry has experienced a terrible financial instability situation with increasing levels of CDS spreads (used as a proxy of credit risk). This paper investigates whether volatility transmission channels in European banking markets have changed after three significant crises’ events during the period January 2006 to March 2013. The global financial crisis is characterized by a unidirectional volatility shocks spillovers effect in credit risk from inside to outside the Eurozone. By contrast, the Eurozone debt crisis is revealed to be local in nature with the euro as the key element suggesting a market fragmentation between distressed peripheral and non-distressed core Eurozone countries, whereas retaining the local currency have acted as a firewall. With these findings we are able to shed light on the impact of the different crises on the European banking credit risk dynamics.

Keywords: CDS spreads, credit risk, volatility spillovers, financial crisis

Procedia PDF Downloads 466