Search results for: occupational risk factors

Authors: Jo Parsons, Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton

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The problem: Vaccinations are routinely offered to pregnant women in the UK for influenza (flu), pertussis (whooping cough), and COVID-19, yet the uptake of these vaccinations in pregnancy remains low. Pregnant women are at increased risk of hospitalisation, morbidity, and mortality from these preventable illnesses, which can also expose their unborn babies to an increased risk of serious complications, including in utero death. This research aims to explore how pregnant women feel about vaccinations offered during pregnancy (flu, whooping cough, and COVID-19), particularly following the COVID-19 pandemic. It also aims to examine factors influencing women’s decisions about vaccinations during pregnancy and how they feel about their health and vulnerabilities to illness arising from the COVID-19 pandemic. The approach: This is a qualitative study involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Pregnant women were recruited via participating hospitals and community groups. Midwives were recruited via participating hospitals and midwife-specific social media groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented will focus on data from pregnant women. Pregnant women reported a wide range of views and vaccination behaviour, and identified several factors influencing their decision whether to accept vaccinations or not. These included internal factors (comprised of beliefs about susceptibility to illness, perceptions of immunity, fear, and feelings of responsibility), other influences (including visibility of illness and external influences such as healthcare professional recommendations), vaccination-related factors (comprised of beliefs about effectiveness and safety of vaccinations, availability and accessibility of vaccinations and preferences for alternative forms of protection to vaccination) and COVID-19 specific factors (including COVID-19 vaccinations and COVID-19 specific influences). Implications: Findings identified some of the factors that affect pregnant women’s decisions when deciding to have a vaccination or not and how these decisions have been influenced by COVID-19. Findings highlight areas where healthcare professional advice needs to focus, such as the provision of information about the increased vulnerability to illnesses during pregnancy and consideration of opportunistic vaccination at hospital appointments to maximise uptake of vaccinations during pregnancy. Findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, COVID-19

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Authors: Prateep Wajeetongratana

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The objective of this research is to examine the effects of internal audit innovation on firm performance effectiveness influences of financial report reliability, organizational process improvement, and risk management effectiveness. This paper drew upon the survey data collected from 400 employees survey conducted at Nonthaburi province, Thailand. The statistics utilized in this paper included percentage, mean, standard deviation, and regression analysis. The findings revealed that the majority of samples were between 31-40 years old, married, held an undergraduate degree, and had an average income between 10,000-15,000 baht. And also the results show that auditing integration has only influence on financial report reliability. Moreover, corporate risk evaluation has effect on firm performance by risk management effectiveness and control self-assessment has effect influence on firm performance by organizational process improvement and risk management effectiveness as well.

Keywords: corporate risk evaluation, firm performance effectiveness, internal audit innovation, marketing management

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Authors: Man Kumar Tamang, Uday Narayan Yadav

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Background and objectives: Every country in the world is facing a demographic challenge due to drastic growth of population over 60 years. Adequate diet and nutritional status are important determinants of health in elderly populations. This study aimed to assess the nutritional status among the elderly population and factors associated with malnutrition at the community setting in rural Nepal. Methods: This is a community-based cross-sectional study among elderly of age 60 years or above in the three randomly selected VDCs of Morang district in eastern Nepal, between August and November, 2016. A multi stage cluster sampling was adopted with sample size of 345 of which 339 participated in the study. Nutritional status was assessed by MNA tool and associated socio-economic, demographic, psychological and nutritional factors were checked by binary logistic regression analysis. Results: Among 339 participants, 24.8% were found to be within normal nutritional status, 49.6% were at risk of malnutrition and 24.8% were malnourished. Independent factors associated with malnutrition status among the elderly people after controlling the cofounders in the bivariate analysis were: elderly who were malnourished were those who belonged to backward caste according to traditional Hindu caste system [OR=2.69, 95% CI: 1.17-6.21), being unemployed (OR=3.23, 95% CI: 1.63-6.41),who experienced any mistreatment from caregivers (OR=4.05, 95% CI: 1.90-8.60), being not involved in physical activity (OR=4.67, 95% CI: 1.87-11.66) and those taking medication for any co-morbidities. Conclusion: Many socio-economic, psychological and physiological factors affect nutritional status in our sample population and these issues need to be addressed for bringing improvement in elderly nutrition and health status.

Keywords: elderly, eastern Nepal, malnutrition, nutritional status

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Authors: A. Khan, I. Khan, M. Younus, S. E. Haque, U. Waheed, H. Neubauer, A. A. Anjum, S. A. Muhammad, A. Idrees T. Abbas, S. Raza, M. A. Ali, M. Farooq, M. Mahmood, A. Hussain, H. Danish, U. Tayyab, M. Zafar, M. Aslam.

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Brucellosis is one of the major problems of milk producing animals in our country which deteriorate the health of livestock. It is a disease of zoonotic significance which is capable of producing disease in humans leading to infertility, orchitis, abortions, and synovitis. In this particular study, milk and serum samples of cattle and buffalo (n=402) were collected from different districts of Punjab including Narowal, Gujranwala and Gujrat. Milk samples were analyzed by Milk Ring Test (MRT), while serum samples were tested through Rose Bengal Plate agglutination Test (RBPT) and Indirect Enzyme Linked Immunosorbant Assay (i-ELISA). The sample tested with MRT were 9.5% positive, including cattle 9.6% and buffalo 9.3%. While using the RBPT test for the detection of serum samples and for screening purpose it was observed that 16.4% animals were seropositive, cattle were 18.8% and buffalo were 13.9% seropositive. The higher prevalence of brucellosis indicates the danger of the disease to human population. The serum samples positive by RBPT were further confirmed by the use of most specific and sensitive serological test known as i-ELISA. 11.4% animals were confirmed as seropositive by i-ELISA including cattle 13.5% seropositive and buffalo 9.3%. The results indicated high seroprevalence of brucellosis in cattle as compared to buffalos. Different risk factors were also studied to know the association between disease and their spread. Advanced age, larger herds, history of abortion and pregnancy of the animals is considered to be the important factors for the prevalence and spread of the hazardous zoonotic disease. It is a core issue of developing countries like Pakistan and has major public health impact.

Keywords: humans, bovines, infertility, orchitis, abortions, seroprevalence, brucellosis

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Authors: B.S. Roopa

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Objectives: To investigate the prevalence of concomitant use of GPDs in patients treated with NSAIDs and GPDs in recommended dose and frequency as prophylaxis. And also to know the association between risk factors and prescription of GPDs in patients treated with NSAIDs. Methods: Study was a prospective, observational, cross-sectional survey. Data from patients with prescription of NSAIDs at the out-patient departments of secondary care Hospital, Nilgiris, India were collected in a specially designed proforma for a period of 45 days. Analysis using χ2 tests for discrete variables. Factors that might be associated with prescription of GPD with NSIADs were assessed in multiple logistic regression models. Results: Three hundred and three patients were included in this study, and the rate of GPD prescription was 89.1%. Most of the patients received H2-receptor antagonist, and, to a lesser degree, antacid and proton pump inhibitor. Patients with history of GI ulcer/bleeding were much more likely to be co-prescribed GPD than those who had no history of GI disorders .Compared with patients who were managed in general outpatient clinic, those managed in Secondary care hospital in Nilgrisis, India were more likely to receive GPD. Conclusions: The prescription rate of GPD with NSAIDs is high. Patients were prescribed with H2RA with dose of 150mg twice daily, which are not effective in reducing the risk of NSAIDs induced gastric ulcer. Only the frequency of NSAIDs prescription was considered significant determinant for the co-prescription with GPAs in patients who are < 65 years and ≥ 65 years old.

Keywords: gastro protective agents, non steridol anti inlfammatory agents

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Authors: Ghada Soltane

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The objective of this study was to identify factors impacting supply chain collaboration. a quantitative study was carried out on a sample of 84 Tunisian industrial companies. To verify the research hypotheses and test the direct effect of these factors on supply chain collaboration a multiple regression method was used using SPSS 26 software. The results show that there are four factors direct effects that affect supply chain collaboration in a meaningful and positive way, including: trust, engagement, information sharing and information quality

Keywords: supply chain collaboration, factors of collaboration, principal component analysis, multiple regression

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Authors: Darynne Madison Dela Gente, Panayiota Courelli

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Similarities in behavior between perpetrators of school violence and those with a parent in prison raise concern when considering the root causes of a student’s violent behavior. Dealing with parental incarceration is highly consequential on a student’s emotional well-being and may cause aggressive behavior that can lead to them becoming a perpetrator of school violence. These students are more likely to have interpersonal issues, antisocial tendencies, and a hostile demeanor, which are factors that closely align with indicators of an offender of violence. Developmental risk factors of parental incarceration are heavily understudied and often overlooked. This literature review aims to analyze the correlation between having a parent in prison and exhibiting physical or verbal aggression in a school environment. Furthermore, it strives to bring awareness to the inconsistencies in existing research and encourage a greater depth of study of the behavioral impacts, specifically in an academic setting. Furthermore, it will elaborate on the effectiveness of current intervention programs, such as Project Avary, Hope House, Kids Mates Inc., and Girl Scouts Beyond Bars, which provide immense support, as well as proposed methods of implementation in a school environment. Creating a space for these students to cope ultimately aids in the prevention of violent behaviors and intergenerational incarceration. Access to intervention programs, especially in schools located in areas with high rates of incarceration, would greatly reduce the risk of these students becoming perpetrators of school violence.

Keywords: adolescent behavior, adolescent mental health, parental incarceration, school violence prevention

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Authors: Risna Wijayanti, Sumiati, Hanif Iswari

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This study aims to analyze the role of financial risk attitude as a mediation between financial knowledge and business growth. The ability of human resources in managing capital (financial literacy) can be a major milestone for a company's business to grow and build its competitive advantage. This study analyzed the important role of financial risk attitude in bringing about financial knowledge on corporate growth. There have been many discussions arguing that financial knowledge is one of the main abilities of corporate managers in determining the success of managing a company. However, a contrary argument of other scholars also enlightened that financial knowledge did not have a significant influence on corporate growth. This study used literatures' review to analyze whether there is another variable that can mediate the effect of financial knowledge toward corporate growth. Research mapping was conducted to analyze the concept of risk tolerance. This concept was related to people's risk aversion effects when making a decision under risk and the role of financial knowledge on changes in financial income. Understanding and managing risks and investments are complicated, in particular for corporate managers, who are always demanded to maintain their corporate growth. Substantial financial knowledge is extremely needed to identify and take accurate information for corporate financial decision-making. By reviewing several literature, this study hypothesized that financial knowledge of corporate managers would be meaningless without manager's courage to bear risks for taking favorable business opportunities. Therefore, the level of risk aversion from corporate managers will determine corporate action, which is a reflection of corporate-level investment behavior leading to attain corporate success or failure for achieving the company's expected growth rate.

Keywords: financial knowledge, financial risk attitude, corporate growth, risk tolerance

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Authors: Irni Rahmayani Johan, Ira Kamelia

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One of the impacts of the rapid advancement of technology is the rise of digital finance, including peer-to-peer lending (P2P). P2P lending has been widely marketed, including an online student loan that used the P2P platform. This study aims to analyze the effect of financial literacy, perception of debt, and perception of risk toward student willingness to use the online student loan (P2P lending). Using a cross-sectional study design, in collecting the data this study employed an online survey method, with a total sample of 280 undergraduate students of IPB university, Indonesia. This study found that financial literacy, perception of debt, perception of risk, and interest in using online student loans are categorized as low level. While the level of knowledge is found to be the lowest, the first-year students showed a higher level in terms of willingness to use the online student loan. In addition, the second year students recorded a positive perception toward debt. This study showed that level of study, attendance in personal finance course, and student’ GPA is positively related to financial knowledge. While debt perception is negatively related to financial attitudes. Similarly, the negative relationship is found between risk perception and the willingness to use the online student loan. The determinant factor of the willingness to use online student loans is the level of study, debt perception, financial risk perception, and time risk perception. Students with a higher level of study are more likely to have a lower interest in using online student loans. Moreover, students who perceived debt as a financial stimulator, as well as those with higher level of financial risk perceptions and time risk perceptions, tend to show more interest to use the loan.

Keywords: financial literacy, willingness to use, online student loan, perception of risk, perception of debt

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Authors: Karl Bryant Buan, Owaida Macadadaya Jr., Mon Eleazar Nonato, Zeke Andrew Palabrica, Charistabelle Mae Santiago

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This study explored the occupational health risks faced by employees in the Business Process Outsourcing (BPO) industry, particularly in the Telco Account department of Alorica. The study used a stratified sampling method and a diagnostic tool called Workplace Integrated Safety and Health (WISH) Assessment to measure and evaluate the employees' perception of workplace health and safety. The results showed that more than 50% of call center workers reported feeling emotionally drained, sleep deprived, burnt out, and in need of anxiety or stress medication due to their work. Additionally, there was a significant difference in the perception of employee diversity, specifically in terms of leadership commitment, participation, policies, programs, and practices. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) results revealed that most employees complained of discomfort in their lower back, shoulder, upper back, neck, and hip. The researchers recommended an implementation plan for alternative work set-up, a satisfaction survey for employees, team-building activities or programs, and motivational approaches through benefits, incentives, and rewards.

Keywords: WISH assessment, CMDQ, ANOVA, diverse SOGIESC

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Authors: Ahmed Abdallatif

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Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour

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Purposes: The activation of coagulation in patients with cancer contributes significantly to morbidity and mortality rates and may play a fundamental role in the host response to growing tumor’s. Patients with cancer are clearly at high risk for the development of venous thromboembolism (VTE), particularly during chemotherapy and surgery. This situation is aggravated by the use of venous access catheters and possibly growth factors. Methods: Data derived from large, randomized, controlled trials have been used to determine the true incidence of this complication of cancer and its treatment. The incidence based on the analyses of these randomized controlled trials varies from 1% for limited stage patients with breast cancer treated with tamoxifen to 60% for patients with any type of cancer who are subjected to orthopedic surgery and do not receive prophylactic therapy. Results: In view of the morbidity and mortality attributable to VTE in cancer, widespread utilization of prophylactic anticoagulation therapy, which has proven safe and effective in a variety of situations, should be considered. While migratory thrombophlebitis is a clear indicator of an underlying neoplasm, the risk of cancer in patients with the more typical form of VTE has been the subject of intense debate over recent years. Conclusion: Some investigators have suggested that the relative risk of being diagnosed with occult cancer within six months of an episode of VTE (particularly recurrent VTE) could be up to 10-fold. However, the cost-effectiveness of aggressive screening for cancer in patients with VTE has not yet been defined adequately.

Keywords: venous thromboembolism, malignancy, cancer, tumor, heparin

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Authors: M. Marsadek, A. Mohamed

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Power system security analysis is the most time demanding process due to large number of possible contingencies that need to be analyzed.  In a power system, any contingency resulting in security violation such as line overload or low voltage may occur for a number of reasons at any time.  To efficiently rank a contingency, both probability and the extent of security violation must be considered so as not to underestimate the risk associated with the contingency. This paper proposed a contingency ranking method that take into account the probabilistic nature of power system and the severity of contingency by using a newly developed method based on risk factor.  The proposed technique is implemented on IEEE 24-bus system.

Keywords: line overload, low voltage, probability, risk factor, severity

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Authors: Michael Scott Evans, Andrew Smith

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The feeling of fatigue at work could potentially have devastating consequences. The aim of this study was to investigate whether the well-established objective indicator of fatigue – the Fatigue Risk Index (FRI) calculator used by the rail industry is an effective indicator to the number of safety incidents, in which fatigue could have been a contributing factor. The study received ethics approval from Cardiff University’s Ethics Committee (EC.16.06.14.4547). A total of 901 safety incidents were recorded from a single British rail franchise between 1st June 2010 – 31st December 2016, into the Safety Management Information System (SMIS). The safety incident types identified that fatigue could have been a contributing factor were: Signal Passed at Danger (SPAD), Train Protection & Warning System (TPWS) activation, Automatic Warning System (AWS) slow to cancel, failed to call, and station overrun. From the 901 recorded safety incidents, the scheduling system CrewPlan was used to extract the Fatigue Index (FI) score and Risk Index (RI) score of all train drivers on the day of the safety incident. Only the working rosters of 64.2% (N = 578) (550 men and 28 female) ranging in age from 24 – 65 years old (M = 47.13, SD = 7.30) were accessible for analyses. Analysis from all 578 train drivers who were involved in safety incidents revealed that 99.8% (N = 577) of Fatigue Index (FI) scores fell within or below the identified guideline threshold of 45 as well as 97.9% (N = 566) of Risk Index (RI) scores falling below the 1.6 threshold range. Their scores represent good practice within the rail industry. These findings seem to indicate that the current objective indicator, i.e. the FRI calculator used in this study by the British rail franchise was not an effective predictor of train driver’s FI scores and RI scores, as safety incidents in which fatigue could have been a contributing factor represented only 0.2% of FI scores and 2.1% of RI scores. Further research is needed to determine whether there are other contributing factors that could provide a better indication as to why there is such a significantly large proportion of train drivers who are involved in safety incidents, in which fatigue could have been a contributing factor have such low FI and RI scores.

Keywords: fatigue risk index calculator, objective indicator of fatigue, rail industry, safety incident

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Authors: Tero Huhtala, Minna Pikkarainen, Saila Saraniemi

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Information technology has long been used as an enabler of exchange for goods and services. Services are evolving from generic to personalized, and the reverse use of customer data has been discussed in both academia and industry for the past few years. This article presents the results of an empirical case study in the area of preventive health care services. The primary data were gathered in workshops, in which future personal data-based services were conceptualized by analyzing future scenarios from a business perspective. The aim of this study is to understand business model transformation in emerging personal data ecosystems. The work was done as a case study in the context of occupational healthcare. The results have implications to theory and practice, indicating that adopting personal data management principles requires transformation of the business model, which, if successfully managed, may provide access to more resources, potential to offer better value, and additional customer channels. These advantages correlate with the broadening of the business ecosystem. Expanding the scope of this study to include more actors would improve the validity of the research. The results draw from existing literature and are based on findings from a case study and the economic properties of the healthcare industry in Finland.

Keywords: ecosystem, business model, personal data, preventive healthcare

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Authors: Kristina Gordon

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One in three children in the United States is a victim of a maltreatment investigation, and about one in nine children has a substantiated investigation. Home visiting is one of several preventative strategies rooted in an early childhood approach that fosters maternal, infant, and early childhood health, protection, and growth. In the United States, 88% of states report administering home visiting programs or state-designed models. The purpose of this study was to conduct a systematic review on home visiting programs in the United States focused on the prevention of child abuse and neglect. This systematic review included 17 articles which found that most of the studies reported optimistic results. Common across studies was program content related to (1) typical child development, (2) parenting education, and (3) child physical health. Although several factors common to home visiting and parenting interventions have been identified, no research has examined the common components of manualized home visiting programs to prevent child maltreatment. Child maltreatment can be addressed with home visiting programs with evidence-based components and cultural adaptations that increase prevention by assisting families in tackling the risk factors they face. An innovative approach to child maltreatment prevention is bringing together at-risk families with the aging community. This innovative approach was prompted due to existing home visitation programs only focusing on improving skillsets and providing temporary relationships. This innovative approach can provide the opportunity for families to build a relationship with an aging individual who can share their wisdom, skills, compassion, love, and guidance, to support families in their well-being and decrease child maltreatment occurrence. Families would be identified if they experience any of the risk factors, including parental substance abuse, parental mental illness, domestic violence, and poverty. Families would also be identified as at risk if they lack supportive relationships such as grandparents or relatives. Families would be referred by local agencies such as medical clinics, hospitals, schools, etc., that have interactions with families regularly. The aging community would be recruited at local housing communities and community centers. An aging individual would be identified by the elderly community when there is a need or interest in a relationship by or for the individual. Cultural considerations would be made when assessing for compatibility between the families and aging individuals. The pilot program will consist of a small group of participants to allow manageable results to evaluate the efficacy of the program. The pilot will include pre-and post-surveys to evaluate the impact of the program. From the results, data would be created to determine the efficacy as well as the sufficiency of the details of the pilot. The pilot would also be evaluated on whether families were referred to Child Protective Services during the pilot as it relates to the goal of decreasing child maltreatment. The ideal findings will display a decrease in child maltreatment and an increase in family well-being for participants.

Keywords: child maltreatment, home visiting, neglect, preventative, abuse

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Authors: Espinosa Carlos, Nobrega Doris

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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

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Authors: Kasirga Yildirak, Ismail Gur

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We propose a model to measure hail risk of an Agricultural Insurance portfolio. Hail is one of the major catastrophic event that causes big amount of loss to an insurer. Moreover, it is very hard to predict due to its strange atmospheric characteristics. We make use of parcel based claims data on apricot damage collected by the Turkish Agricultural Insurance Pool (TARSIM). As our ultimate aim is to compute the loadings assigned to specific parcels, we build a portfolio risk model that makes use of PD and the severity of the exposures. PD is computed by Spherical-Linear and Circular –Linear regression models as the data carries coordinate information and seasonality. Severity is mapped into integer brackets so that Probability Generation Function could be employed. Individual regressions are run on each clusters estimated on different criteria. Loss distribution is constructed by Panjer Recursion technique. We also show that one risk-one crop model can easily be extended to the multi risk–multi crop model by assuming conditional independency.

Keywords: hail insurance, spherical regression, circular regression, spherical clustering

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Authors: Swathi Sampath, V. Kalaichelvi

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The assessment of the risk posed by a borrower to a lender is one of the common problems that financial institutions have to deal with. Consumers vying for a mortgage are generally compared to each other by the use of a number called the Credit Score, which is generated by applying a mathematical algorithm to information in the applicant’s credit report. The higher the credit score, the lower the risk posed by the candidate, and the better he is to be taken on by the lender. The objective of the present work is to use fuzzy logic and linguistic rules to create a model that generates Credit Scores.

Keywords: credit scoring, fuzzy logic, mortgage, risk assessment

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Authors: Francisco Toledo-Castillo, María Josefa Sospedra-Baeza, Sergio Hidalgo-Fuentes

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Motorcycles constitute about 9% of all motorized vehicles in Spain and are generally overrepresented in traffic accidents, accounting for 21% of total accidents. Six years of motorcycle accident data were obtained through the national accident database of Spain (Dirección General de Tráfico). Some of the studied factors are age, gender, helmet wearing, alcohol consumption, speeding, subject’s driving license and for how long it has been held, the trip purpose, and the presence of a passenger on the vehicle. Key findings show helmet use, unsafe speed, the trip purpose, weather, distraction, collision type and other variables play significant roles in crash-injury outcomes. Finally, we examine evolution of mortality and severity from 2006 to 2011.

Keywords: motorcycle accidents, risk factors, statistics, Spain

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Authors: Mustafa Dogru, Ruveyda Komurlu

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Companies and professionals in the construction sector face various risks in every project depending on the characteristics, size, complexity, the location of the projects and the techniques used. Some risks’ effects may increase as the project progresses whereas new risks may emerge. Because of the ever-changing nature of the risks, risk management is a cyclical process that needs to be repeated throughout the project. Since the risks threaten the success of the project, risk management is an important part of the entire project management process. The aims of this study are to emphasize the importance of risk management in construction projects, summarize the risk identification process, and introduce a number of methods for preventing risks such as alternative design, checklists, prototyping and test-analysis-correction technique etc. Following the literature review conducted to list the techniques for preventing risks, case studies has been performed to compare and evaluate the success of the techniques in a number of completed projects with the same typology, performed domestic and international. Findings of the study suggest that controlling and minimizing the level of the risks in construction projects, taking optimal precautions for different risks, and mitigating or eliminating the effects of risks are important in order to prevent additional costs for the project. Additionally, focusing on the risks that have highest impact is the most rational way to minimize the effects of the risks on projects.

Keywords: construction projects, construction management, project management, risk management

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Authors: Ainura Tursunalieva, Irene Hudson

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

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

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Authors: Lesa A. Thompson, Yoshinori Ikenaka, Victor Wepener, Mayumi Ishizuka

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One method for controlling malaria in endemic regions is the killing of vector mosquitoes using pesticides such as DDT in indoor residual spraying (IRS). This study was carried out to investigate the presence of and human health risk due to DDT and its metabolites (collectively, DDTs) contaminating human food sources in areas where DDT is used for IRS. Free-range chicken products (meat and eggs) were collected from homesteads in KwaZulu-Natal Province in the northeast of South Africa, and fish meat samples from Maputo Bay in neighbouring Mozambique. Samples were analysed for DDTs (o,p’-DDT, p,p’-DDT, o,p’-DDD, p,p’-DDD, o,p’-DDE and p,p’-DDE) using a gas chromatograph with electron capture detector (GC-ECD). DDTs were detected in all food types, with the predominant congener being p,p’-DDE. The presence of p,p’-DDT confirmed recent release of DDT into the environment. By using concentration levels detected in foods and national consumption levels, the risk to human health through consumption of such food products was calculated. In order of risk level, these were: chicken eggs > chicken meat > fish meat. Human risk (carcinogenic) values greater than one suggest there is an increased health risk through consumption of these foods.

Keywords: DDT, food contamination, human health risk, Mozambique, South Africa

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Authors: Emma Avoyan

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The safety standards for flood protection in the Netherlands have been revised recently. It is expected that all major flood-protection structures will have to be reinforced to meet the new standards. The Dutch Flood Protection Programme aims at accomplishing this task through innovative integrated projects such as construction of multi-functional flood defenses. In these projects, flood safety purposes will be combined with spatial planning, nature development, emergency management or other sectoral objectives. Therefore, implementation of dike reinforcement projects requires early involvement and collaboration between public and private sectors, different governmental actors and agencies. The development and implementation of such integrated projects has been an issue in Dutch flood risk management since long. Therefore, this article analyses how cross-sector collaboration within flood risk governance in the Netherlands has evolved over time, and how this development can be explained. The integrative framework for collaborative governance is applied as an analytical tool to map external factors framing possibilities as well as constraints for cross-sector collaboration in Dutch flood risk domain. Supported by an extensive document and literature analysis, the paper offers insights on how the system context and different drivers changing over time either promoted or hindered cross-sector collaboration between flood protection sector, urban development, nature conservation or any other sector involved in flood risk governance. The system context refers to the multi-layered and interrelated suite of conditions that influence the formation and performance of complex governance systems, such as collaborative governance regimes, whereas the drivers initiate and enable the overall process of collaboration. In addition, by applying a method of process tracing we identify a causal and chronological chain of events shaping cross-sectoral interaction in Dutch flood risk management. Our results indicate that in order to evaluate the performance of complex governance systems, it is important to firstly study the system context that shapes it. Clear understanding of the system conditions and drivers for collaboration gives insight into the possibilities of and constraints for effective performance of complex governance systems. The performance of the governance system is affected by the system conditions, while at the same time the governance system can also change the system conditions. Our results show that the sequence of changes within the system conditions and drivers over time affect how cross-sector interaction in Dutch flood risk governance system happens now. Moreover, we have traced the potential of this governance system to shape and change the system context.

Keywords: collaborative governance, cross-sector interaction, flood risk management, the Netherlands

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Authors: Elijah Cavan

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In Major League Sports (MLB, NBA, NHL, NFL), it is the Front Office Staff (FOS) who make decisions about who plays for their respective team. The FOS bear the brunt of the responsibility for acquiring players through drafting, trading and signing players in free agency while typically contesting with maximum roster salary constraints. The players themselves are volatile assets of these teams- their value fluctuates with age and performance. A simple comparison can be made when viewing players as assets. The problem here is similar to that of optimizing your investment portfolio. The The goal is ultimately to maximize your periodic returns while tolerating a fixed risk (degree of uncertainty/ potential loss). Each franchise may value assets differently, and some may only tolerate lower risk levels- these are examples of factors that introduce additional constraints into the model. In this talk, we will detail the mathematical formulation of this problem as a constrained optimization problem- which can be solved with classical machine learning methods but is also well posed as a problem to be solved on quantum computers

Keywords: optimization, financial mathematics, sports analytics, simulated annealing

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Authors: P. Serpytis, K. Azukaitis, U. Gargalskaite, R. Navickas, J. Badariene, V. Dzenkeviciute

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Purpose: Total longitudinal displacement (tLoD) of the common carotid artery (CCA) wall is a novel ultrasound marker of vascular function that can be evaluated using modified speckle tracking techniques. Decreased CCA tLoD has already been shown to be associated with diabetes and was shown to predict one year cardiovascular outcome in patients with suspected coronary artery disease (CAD) . The aim of our study was to evaluate if CCA tLoD differ between patients with moderate or high cardiovascular (CV) risk and patients after recent acute myocardial infarction (AMI). Methods: 49 patients (54±6 years) with moderate or high CV risk and 42 patients (58±7 years) after recent AMI were included. All patients were non-diabetic. CCA tLoD was evaluated using GE EchoPAC speckle tracking software and expressed as mean of both sides. Data on systolic blood pressure, total and high density lipoprotein (HDL) cholesterol levels, high sensitivity C-reactive protein (hsCRP) level, smoking status and family history of early CV events was evaluated and assessed for association with CCA tLoD. Results: tLoD of CCA did not differ between patients with moderate or high CV risk and patients with very high CV risk after MI (0.265±0.128 mm vs. 0.237±0.103 mm, p>0.05). Lower tLoD was associated with lower HDL cholesterol levels (r=0.211, p=0.04) and male sex (0.228±0.1 vs. 0.297±0.134, p=0.01). Conclusions: tLoD of CCA did not differ between patients with moderate or high CV risk and patients with very high CV risk after AMI. However, lower CCA tLoD was significantly associated with low HDL cholesterol levels and male sex.

Keywords: total longitudinal displacement, carotid artery, cardiovascular risk, acute myocardial infarction

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Authors: Z. A. Ahmad, R. C. Omar, I. Z. Baharuddin, R. Roslan

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Assessments of social vulnerability, carried out holistically, can provide an important guide to the planning process and to decisions on resource allocation at various levels, and can help to raise public awareness of geo-hazard risks. The assessments can help to provide answers for basic questions such as the human vulnerability at the geo-hazard prone or disaster areas causing health damage, economic loss, loss of natural heritage and vulnerability impact of extreme natural hazard event. To overcome these issues, integrated framework for assessing the increasing human vulnerability to environmental changes caused by geo-hazards will be introduced using an indicator from landslide risk map that is related to agent based modeling platform. The indicators represent the underlying factors, which influence a community’s ability to deal with and recover from the damage associated with geo-hazards. Scope of this paper is particularly limited to landslides.

Keywords: social, vulnerability, geo-hazard, methodology, indicators

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Authors: Kirsty Biggs, Peter Larsen-Disney

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Background: The UK cervical screening programme significantly reduces cancer mortality through the early detection of abnormal cells. Despite this, over a quarter of eligible women choose not to attend their appointment. Objective: To qualitatively explore patients’ barriers to attending cervical smear appointments and identify key trends of cervical screening behaviour, knowledge, and attitudes in primary and secondary care. Methods: A cross-sectional study was conducted to evaluate smear services in Brighton and Hove using questionnaires in general practice and colposcopy. 226 patients participated in the voluntary questionnaire between 10/11/2017 and 02/02/2018. 118 patients were recruited from general practice surgeries and 108 from the colposcopy department. Women were asked about their smear knowledge, self-perceived risks factors, prior experiences and reasons for non-attendance. Demographic data was also collected. Results: Approximately a third of women did not engage in smear testing services. This was consistent across primary and secondary care groups. Over 90% were aware of the role of the screening process in relation to cervical cancer; however, over two thirds believed the smear was also a tool to screen for other pathologies. The most commonly cited reasons for non-attendance were negative emotions or previous experiences. Inconvenient appointment times were also commonly described. In a comparison of attenders versus non-attenders previous negative experiences (p < 0.01) and number of identified risk factors (p = 0.02) were statistically significant with non-attenders describing more prior negative smears and identifying more risk factors. Smear knowledge, risk perception and perceived importance of screening were not significant. Negative previous experiences were described in relation to poor bedside manner, pain, embarrassment and staff competency. Conclusions: In contrary to the literature, our white Caucasian cohort experienced significant barriers to accessing smear services. Women’s prior negative experiences are overriding their perceived importance to attend the screening programme; therefore, efforts need to focus on improving clinical experiences through auditing tools, training and providing a supportive appointment setting. Positive changes can also be expected by improving appointment availabilities with extended hours and self-booking systems.

Keywords: barriers, cervical, Papanicolaou, screening, smear

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Authors: Petcharat  Kerdonfag, Surasak Taneepanichskul, Winai Wadwongtham

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Industrial noise is usually considered as the main impact of the environmental health and safety because its exposure can cause permanently serious hearing damage. Despite providing strictly hearing protection standards and campaigning extensively encouraging public health awareness among industrial workers in Thailand, hazard noise-induced hearing loss has dramatically been massive obstacles for workers’ health. The aims of the study were to explore and specify the hearing threshold levels among steel industrial workers responsible in which higher noise levels of work zone and to examine the relationships of hearing loss and workers’ age and the length of employment in Samut Prakan province, Thailand. Cross-sectional study design was done. Ninety-three steel industrial workers in the designated zone of higher noise (> 85dBA) with more than 1 year of employment from two factories by simple random sampling and available to participate in were assessed by the audiometric screening at regional Samut Prakan hospital. Data of doing screening were collected from October to December, 2016 by the occupational medicine physician and a qualified occupational nurse. All participants were examined by the same examiners for the validity. An Audiometric testing was performed at least 14 hours after the last noise exposure from the workplace. Workers’ age and the length of employment were gathered by the developed occupational record form. Results: The range of workers’ age was from 23 to 59 years, (Mean = 41.67, SD = 9.69) and the length of employment was from 1 to 39 years, (Mean = 13.99, SD = 9.88). Fifty three (60.0%) out of all participants have been exposing to the hazard of noise in the workplace for more than 10 years. Twenty-three (24.7%) of them have been exposing to the hazard of noise less than or equal to 5 years. Seventeen (18.3%) of them have been exposing to the hazard of noise for 5 to 10 years. Using the cut point of less than or equal to 25 dBA of hearing thresholds, the average means of hearing thresholds for participants at 4, 6, and 8 kHz were 31.34, 29.62, and 25.64 dB, respectively for the right ear and 40.15, 32.20, and 25.48 dB for the left ear, respectively. The more developing age of workers in the work zone with hazard of noise, the more the hearing thresholds would be increasing at frequencies of 4, 6, and 8 kHz (p =.012, p =.026, p =.024) for the right ear, respectively and for the left ear only at the frequency 4 kHz (p =.009). Conclusion: The participants’ age in the hazard of noise work zone was significantly associated with the hearing loss in different levels while the length of participants’ employment was not significantly associated with the hearing loss. Thus hearing threshold levels among industrial workers would be regularly assessed and needed to be protected at the beginning of working.

Keywords: hearing threshold levels, hazard of noise, hearing loss, audiometric testing

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Authors: Nabil Mekaoui, Nacer Jabour, Abdelhamid Allaoui, Abderahim Oulidi

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The reliability of several insurance indexes of the seismic risk is evaluated and compared for an efficient seismic risk coverage of buildings in Morocco, thus, reducing the basic risk. A large database of earthquake ground motions is established from recent seismic events in Morocco and synthetic ground motions compatible with the design spectrum in order to conduct nonlinear time history analyses on three building models representative of the building stock in Morocco. The uninhabitability index is evaluated based on the simulated damage index, then correlated with preselected insurance indexes. Interestingly, the commonly used peak ground acceleration index showed poor correlation when compared with other indexes, such as spectral accelerations at low periods. Recommendations on the choice of suitable insurance indexes are formulated for efficient seismic risk coverage in Morocco.

Keywords: catastrophe modeling, damage, earthquake, reinsurance, seismic hazard, trigger index, vulnerability

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