Search results for: risk factors for diabetic complications

Authors: Salima Smiti, Ines Gasmi, Makram Soui

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Credit risk is the most important issue for financial institutions. Its assessment becomes an important task used to predict defaulter customers and classify customers as good or bad payers. To this objective, numerous techniques have been applied for credit risk assessment. However, to our knowledge, several evaluation techniques are black-box models such as neural networks, SVM, etc. They generate applicants’ classes without any explanation. In this paper, we propose to assess credit risk using rules classification method. Our output is a set of rules which describe and explain the decision. To this end, we will compare seven classification algorithms (JRip, Decision Table, OneR, ZeroR, Fuzzy Rule, PART and Genetic programming (GP)) where the goal is to find the best rules satisfying many criteria: accuracy, sensitivity, and specificity. The obtained results confirm the efficiency of the GP algorithm for German and Australian datasets compared to other rule-based techniques to predict the credit risk.

Keywords: credit risk assessment, classification algorithms, data mining, rule extraction

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Authors: Pillay J. D., D. De Wit, J. F. Ducray

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Field hockey is a popular international sport which is played in more than 100 countries across the world. Due to the nature of hockey, players repeatedly perform a combination of forward flexion and rotational movements of the spine in order to strike the ball. These movements have been shown to increase the risk of pain and injury to the lumbar spine. The aim of this study was to determine the prevalence and incidence of low back pain (LBP) in male adolescent field hockey players and the characteristics of LBP in terms of location, chronicity, disability, and treatment sought, as well as its association with selected risk factors. A survey was conducted on 112 male adolescent field hockey players in the eThekwini Municipality of KwaZulu-Natal, South Africa. The questionnaire contained sections on the demographics of participants, general characteristics of participants, health and lifestyle characteristics, low back pain patterns, treatment of low back pain, and the level of disability associated with LBP. The data were statistically analysed using IBM SPSS version 25 with statistical significance set at p-value <0.05. Descriptive statistics such as mean and standard deviation were used to summarise responses to continuous variables as appropriate. Categorical variables were described using frequency tables. Associations between risk factors and low back pain were tested using Pearson’s chi-square test and t-tests as appropriate. A total of 68 questionnaires were completed for analysis (67% participation rate); the period prevalence of LBP was 63.2% (35.0%:beginning of the season, 32.4%:mid-season, 22.1%: end of season). Incidence was 38.2%. The most common location for LBP was the middle low back region (39.5%), and the most common duration of pain was a few hours (32.6%). Most participants (79.1%) did not classify their pain as a disability, and only 44.2% of participants received medical treatment for their LBP. An interesting finding was the association between hydration and LBP (p = 0.050), i.e., those individuals who did not hydrate frequently during matches and training were significantly more likely to experience LBP. The results of this study, although limited to a select group of adolescents, showed a higher prevalence of LBP than that of previous studies. More importantly, even though most participants did not experience LBP classified as a disability, LBP still had a large impact on participants, as nearly half of the participants consulted with a medical professional for treatment. Need for the application of further strategies in the prevention and management of LBP in field hockey, such as adequate warm-up and cool-down, stretching exercises, rest between sessions, etc., are recommended as simple strategies to reduce LBP prevalence.

Keywords: adolescents, field hockey players, incidence, low back pain, prevalence, risk factors

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Authors: Cindy Davis, Samantha Rayner

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Secondary traumatic stress (STS) is an indirect form of trauma affecting the psychological well-being of mental health workers; STS is found to be a prevalent risk in mental health occupations. Various factors impact the development of STS within the literature; including the level of trauma individuals are exposed to and their level of empathy. Research is limited on STS in mental health workers in Australia; therefore, this study examined STS and related factors of empathetic behavior and trauma caseload among mental health workers. The research utilized an online survey quantitative research design with a purposive sample of 190 mental health workers (176 females) recruited via professional websites and unofficial social media groups. Participants completed an online questionnaire comprising of demographics, the secondary traumatic stress scale and the empathy scale for social workers. A standard hierarchical regression analysis was conducted to examine the significance of covariates, traumatized clients, traumatic stress within workload and empathy in predicting STS. The current research found 29.5% of participants to meet the criteria for a diagnosis of STS. Age and past trauma within the covariates were significantly associated with STS. Amount of traumatized clients significantly predicted 4.7% of the variance in STS, traumatic stress within workload significantly predicted 4.8% of the variance in STS and empathy significantly predicted 4.9% of the variance in STS. These three independent variables and the covariates accounted for 18.5% of the variance in STS. Practical implications include a focus on developing risk strategies and treatment methods that can diminish the impact of STS.

Keywords: mental health, PTSD, social work, trauma

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Authors: Nadia Obaed, Lexi Frankel, Amalia Ardeljan, Denis Nigel, Anniki Witter, Omar Rashid

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Breast cancer is the most common cancer among women, with a lifetime risk of one in eight of all women in the United States. Although breast cancer is prevalent throughout the world, the uneven distribution in incidence and mortality rates is shaped by the variation in population structure, environment, genetics and known lifestyle risk factors. Furthermore, the bacterial profile in healthy and cancerous breast tissue differs with a higher relative abundance of bacteria capable of causing DNA damage in breast cancer patients. Previous bacterial infections may change the composition of the microbiome and partially account for the environmental factors promoting breast cancer. One study found that higher amounts of Staphylococcus, Bacillus, and Enterobacteriaceae, of which Escherichia coli (E. coli) is a part, were present in breast tumor tissue. Based on E. coli’s ability to damage DNA, it is hypothesized that there is an increased risk of breast cancer associated with previous E. coli infection. Therefore, the purpose of this study was to evaluate the correlation between E. coli infection and the incidence of breast cancer. Holy Cross Health, Fort Lauderdale, provided access to the Health Insurance Portability and Accountability (HIPAA) compliant national database for the purpose of academic research. International Classification of Disease 9th and 10th Codes (ICD-9, ICD-10) was then used to conduct a retrospective analysis using data from January 2010 to December 2019. All breast cancer diagnoses and all patients infected versus not infected with E. coli that underwent typical E. coli treatment were investigated. The obtained data were matched for age, Charlson Comorbidity Score (CCI score), and antibiotic treatment. Standard statistical methods were applied to determine statistical significance and an odds ratio was used to estimate the relative risk. A total of 81286 patients were identified and analyzed from the initial query and then reduced to 31894 antibiotic-specific treated patients in both the infected and control group, respectively. The incidence of breast cancer was 2.51% and present in 2043 patients in the E. coli group compared to 5.996% and present in 4874 patients in the control group. The incidence of breast cancer was 3.84% and present in 1223 patients in the treated E. coli group compared to 6.38% and present in 2034 patients in the treated control group. The decreased incidence of breast cancer in the E. coli and treated E. coli groups was statistically significant with a p-value of 2.2x10-16 and 2.264x10-16, respectively. The odds ratio in the E. coli and treated E. coli groups was 0.784 and 0.787 with a 95% confidence interval, respectively (0.756-0.813; 0.743-0.833). The current study shows a statistically significant decrease in breast cancer incidence in association with previous Escherichia coli infection. Researching the relationship between single bacterial species is important as only up to 10% of breast cancer risk is attributable to genetics, while the contribution of environmental factors including previous infections potentially accounts for a majority of the preventable risk. Further evaluation is recommended to assess the potential and mechanism of E. coli in decreasing the risk of breast cancer.

Keywords: breast cancer, escherichia coli, incidence, infection, microbiome, risk

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Authors: Elena M. Capitanul, Carlos A. Nunes Cosenza, Walid El Moudani, Felix Mora Camino

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The construction of a new airport or the extension of an existing one requires massive investments and many times public private partnerships were considered in order to make feasible such projects. One characteristic of these projects is uncertainty with respect to financial and environmental impacts on the medium to long term. Another one is the multistage nature of these types of projects. While many airport development projects have been a success, some others have turned into a nightmare for their promoters. This communication puts forward a new approach for airport investment risk assessment. The approach takes explicitly into account the degree of uncertainty in activity levels prediction and proposes milestones for the different stages of the project for minimizing risk. Uncertainty is represented through fuzzy dual theory and risk management is performed using dynamic programming. An illustration of the proposed approach is provided.

Keywords: airports, fuzzy logic, risk, uncertainty

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Authors: Silvia Di Giacomo, Marcello Locatelli, Simone Carradori, Francesco Cacciagrano, Chiara Toniolo, Gabriela Mazzanti, Luisa Mannina, Stefania Cesa, Antonella Di Sotto

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Hyperglycemia represents the main pathogenic factor in the development of diabetes complications and has been found associated with mitochondrial dysfunction and oxidative stress, which in turn increase cell dysfunction. Therefore, counteract oxidative species appears to be a suitable strategy for preventing the hyperglycemia-induce cell damage and support the pharmacotherapy of diabetes and metabolic diseases. Antidiabetic potential of many food sources has been linked to the presence of polyphenolic metabolites, particularly flavonoids such as quercetin and its glycosylated form rutin. In line with this evidence, in the present study, we assayed the potential anti-hyperglycemic activity of an ethyl acetate extract from the peel of Punica granatum L. var. Dente di Cavallo (PGE), a fruit well known to traditional medicine for the beneficial properties of its edible juice. The effect of the extract on the glucidic metabolism has been evaluated by assessing its ability to inhibit α-amylase and α-glucosidase, two digestive enzymes responsible for the hydrolysis of dietary carbohydrates: their inhibition can delay the carbohydrate digestion and reduce glucose absorption, thus representing an important strategy for the management of hyperglycemia. Also, the PGE ability to block the release of advanced glycated end-products (AGEs), whose accumulation is known to be responsible for diabetic vascular complications, was studied. The iron-reducing and chelating activities, which are the primary mechanisms by which AGE inhibitors stop their metal-catalyzed formation, were evaluated as possible antioxidant mechanisms. At last, the phenolic content of PGE was characterized by chromatographic and spectrophotometric methods. Our results displayed the ability of PGE to inhibit α-amylase enzyme with a similar potency to the positive control: the IC₅₀ values were 52.2 (CL 27.7 - 101.2) µg/ml and 35.6 (CL 22.8 - 55.5) µg/ml for acarbose and PGE, respectively. PGE also inhibited the α-glucosidase enzyme with about a 25 higher potency than the positive controls of acarbose and quercetin. Furthermore, the extract exhibited ferrous and ferric ion chelating ability, with a maximum effect of 82.1% and 80.6% at a concentration of 250 µg/ml respectively, and reducing properties, reaching the maximum effect of 80.5% at a concentration of 10 µg/ml. At last, PGE was found able to inhibit the AGE production (maximum inhibition of 82.2% at the concentration of 1000 µg/ml), although with lower potency with respect to the positive control rutin. The phytochemical analysis of PGE displayed the presence of high levels of total polyphenols, tannins, and flavonoids, among which ellagic acid, gallic acid and catechin were identified. Altogether these data highlight the ability of PGE to control the carbohydrate metabolism at different levels, both by inhibiting the metabolic enzymes and by affecting the AGE formation likely by chelating mechanisms. It is also noteworthy that peel from pomegranate, although being a waste of juice production, can be reviewed as a nutraceutical source. In conclusion, present results suggest the possible role of PGE as a remedy for preventing hyperglycemia complications and encourage further in vivo studies.

Keywords: anti-hyperglycemic activity, antioxidant properties, nutraceuticals, polyphenols, pomegranate

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Authors: Maithem Al-Saadi, Min An

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During airport planning and design stages, the major issues of capacity and safety in construction and operation of an airport need to be taken into consideration. The airside of an airport is a major and critical infrastructure that usually consists of runway(s), taxiway system, and apron(s) etc., which have to be designed according to the international standards and recommendations, and local limitations to accommodate the forecasted demands. However, in many cases, airport airsides are suffering from unexpected risks that occurred during airport operations. Therefore, safety risk assessment should be applied in the planning and design of airsides to cope with the probability of risks and their consequences, and to make decisions to reduce the risks to as low as reasonably practicable (ALARP) based on safety risk assessment. This paper presents a combination approach of Failure Modes, Effect, and Criticality Analysis (FMECA), Fuzzy Reasoning Approach (FRA), and Fuzzy Analytic Hierarchy Process (FAHP) to develop a risk analysis model for safety risk assessment. An illustrated example is used to the demonstrate risk assessment process on how the design of an airside in an airport can be analysed by using the proposed safety design risk assessment model.

Keywords: airport airside planning and design, design for safety, fuzzy reasoning approach, fuzzy AHP, risk assessment

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Authors: Mohamed Hamada Abdelkader Fayed

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Background: To evaluate the diagnostic accuracy of (ADD-RS) with D-dimer as a screening test to exclude AAS. Methods: We conducted research for the studies examining the diagnostic accuracy of (ADD- RS)+ D-dimer to exclude the diagnosis of AAS, We searched MEDLINE, Embase, and Cochrane of Trials up to 31 December 2020. Results: We identified 3 studies using (ADD-RS) with D-dimer as a diagnostic tool for AAS, involving 3261 patients were AAS was diagnosed in 559(17.14%) patients. Overall results showed that the pooled sensitivities were 97.6 (95% CI 0.95.6, 99.6) at (ADD-RS)≤1(low risk group) with D-dimer and 97.4(95% CI 0.95.4,, 99.4) at (ADD-RS)>1(High risk group) with D-dimer., the failure rate was 0.48% at low risk group and 4.3% at high risk group respectively. Conclusions: (ADD-RS) with D-dimer was a useful screening test with high sensitivity to exclude Acute Aortic Syndrome.

Keywords: aortic dissection detection risk score, D-dimer, acute aortic syndrome, diagnostic accuracy

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Authors: Atia Alam

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Growing liberalisation and intense market competition increase firm’s risk exposure and induce corporations to use derivatives extensively as a risk management instrument, which results in decrease in firm’s risk, and increase in value. Present study contributes towards existing literature by providing an in-depth analysis regarding the effect of extent of derivative usage on firm’s risk and value by using panel data models and seemingly unrelated regression technique. New evidence is established in current literature by dividing the sample data based on firm’s Exchange Rate (ER) and Interest Rate (IR) exposure. Analysis is performed for the effect of extent of derivative usage on firm’s risk and value and its variation with respect to the ER and IR exposure. Sample data consists of 166 Pakistani firms listed on Pakistan stock exchange for the period of 2004-2010. Results show that extensive usage of derivative instruments significantly increases firm value and reduces firm’s risk. Furthermore, comprehensive analysis depicts that Pakistani corporations having higher exchange rate exposure, with respect to foreign sales, and higher interest rate exposure, on the basis of industry adjusted leverage, have higher firm value and lower risk. Findings from seemingly unrelated regression also provide robustness to results obtained through panel data analysis. Study also highlights the role of derivative usage as a risk management instrument in high and low ER and IR risk and helps practitioners in understanding how value increasing effect of extent of derivative usage varies with the intensity of firm’s risk exposure.

Keywords: extent of derivative usage, firm value, risk, Pakistan, non-financial firms

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Authors: Samia Jamshed Nauman Majeed

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Purpose: Globally, the pandemic of COVID -19 has created a massive distraction for educational reforms influencing learning options, education access, and outcomes of students in more than 190 countries which has carved marks in history. To explore the challenges and complications confronted by students and faculty members while ensuring access to online education, qualitative research was conducted. Methodology: For this purpose, a series of focus group discussions were conducted in different regions of Pakistan, which revealed interesting findings shared by Panelists, which include Vice-Chancellors, Rectors, and Deans of different private and public sector universities of Pakistan. The qualitative research aims to explore the challenges and success factors of online educations by students with diverse backgrounds of higher education institutions to maximize student educational outcomes. Findings: The findings revealed several challenges and opportunities when it comes to online education for students of higher education institutions. Simultaneously, the researchers discovered the key success factors necessary for online education. Lastly, the paper presents the research limitations and future research recommendations to streamline online education in a better way ensuring the students' success. Originality: The pandemic has forced the closure of social, business, and educational activities, which has drastically influence the quality of education with its subsequent impact on the economy. In response, numerous universities across the globe are forced to suspend their educational activities by closing the universities. Though online education has been adopted worldwide by the universities, which brought numerous issues for academia, particularly for underdeveloped countries, and Pakistani higher education reforms are no exception to this.

Keywords: online education, higher education institutions, COVID-19, challenges, key success factors

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Authors: Abderrahmen Aloulou, Younes Boujelbene

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The current paper displays a new method of extracting information content from options prices by eliminating biases caused by daily variation of contract maturity. Based on Kernel regression tool, this non-parametric technique serves to obtain a spectrum of interpolated options with constant maturity horizons from negotiated optional contracts on the S&P TSX 60 index. This method makes it plausible to compare daily risk neutral densities from which extracting time continuous indicators allows the detection traders attitudes’ evolution, such as, belief homogeneity, asymmetry and extreme Risk Perception. Our findings indicate that the applied method contribute to develop effective trading strategies and to adjust monetary policies through controlling trader’s reactions to economic and monetary news.

Keywords: risk neutral densities, kernel, constant maturity horizons, homogeneity, asymmetry and extreme risk perception

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Authors: Ali Mortazavi

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The main objective of this research project is to delve into a multitude of geomechanical risks associated with various mining methods employed within the underground mining industry. Controlling geotechnical design parameters and operational factors affecting the selection of suitable mining techniques for a given underground mining condition will be considered from a risk assessment point of view. Important geomechanical challenges will be investigated as appropriate and relevant to the commonly used underground mining methods. Given the complicated nature of rock mass in-situ and complicated boundary conditions and operational complexities associated with various underground mining methods, the selection of a safe and economic mining operation is of paramount significance. Rock failure at varying scales within the underground mining openings is always a threat to mining operations and causes human and capital losses worldwide. Geotechnical design is a major design component of all underground mines and basically dominates the safety of an underground mine. With regard to uncertainties that exist in rock characterization prior to mine development, there are always risks associated with inappropriate design as a function of mining conditions and the selected mining method. Uncertainty often results from the inherent variability of rock masse, which in turn is a function of both geological materials and rock mass in-situ conditions. The focus of this research is on developing a methodology which enables a geomechanical risk assessment of given underground mining conditions. The outcome of this research is a geotechnical risk analysis algorithm, which can be used as an aid in selecting the appropriate mining method as a function of mine design parameters (e.g., rock in-situ properties, design method, governing boundary conditions such as in-situ stress and groundwater, etc.).

Keywords: geomechanical risk assessment, rock mechanics, underground mining, rock engineering

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Authors: Winnie Kung, Xinhua Liu, Debbie Huang, Patricia Kim, Keon Kim, Xiaoran Wang, Lawrence Yang

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Considerable Asian Americans were exposed to the World Trade Center attack due to the proximity of the site to Chinatown and a sizeable number of South Asians working in the collapsed and damaged buildings nearby. Few studies focused on Asians in examining the disaster’s mental health impact, and even less longitudinal studies were reported beyond the first couple of years after the event. Based on the World Trade Center Health Registry, this study examined the trajectory of PTSD of individuals directly exposed to the attack from 2-3 to 5-6 years after the attack, comparing Asians against the non-Hispanic White group. Participants included 2,431 Asians and 31,455 Whites. Trajectories were delineated into the resilient, chronic, delayed-onset and remitted groups using PTSD checklist cut-off score at 44 at the 2 waves. Logistic regression analyses were conducted to compare the poorer trajectories against the resilient as a reference group, using predictors of baseline sociodemographic, exposure to the disaster, lower respiratory symptoms and previous depression/anxiety disorder diagnosis, and recruitment source as the control variable. Asians had significant lower socioeconomic status in terms of income, education and employment status compared to Whites. Over 3/4 of participants from both races were resilient, though slightly less for Asians than Whites (76.5% vs 79.8%). Asians had a higher proportion with chronic PTSD (8.6% vs 7.4%) and remission (5.9% vs 3.4%) than Whites. A considerable proportion of participants had delayed-onset in both races (9.1% Asians vs 9.4% Whites). The distribution of trajectories differed significantly by race (p<0.0001) with Asians faring poorer. For Asians, in the chronic vs resilient group, significant protective factors included age >65, annual household income >$50,000, and never married vs married/cohabiting; risk factors were direct disaster exposure, job loss due to 9/11, lost someone, and tangible loss; lower respiratory symptoms and previous mental disorder diagnoses. Similar protective and risk factors were noted for the delayed-onset group, except education being protective; and being an immigrant a risk. Between the 2 comparisons, the chronic group was more vulnerable than the delayed-onset as expected. It should also be noted that in both comparisons, Asians’ current employment status had no significant impact on their PTSD trajectory. Comparing between Asians against Whites, the direction of the relationships between the predictors and the PTSD trajectories were mostly the same, although more factors were significant for Whites than for Asians. A few factors showed significant racial difference: Higher risk for lower respiratory symptoms for Whites than Asians, higher risk for pre-9/11 mental disorder diagnosis for Asians than Whites, and immigrant a risk factor for the remitted vs resilient groups for Whites but not for Asians. Over 17% Asians still suffered from PTSD 5-6 years after the WTC attack signified its persistent impact which incurred substantial human, social and economic costs. The more disadvantaged socioeconomic status of Asians rendered them more vulnerable in their mental health trajectories relative to Whites. Together with their well-documented low tendency to seek mental health help, outreach effort to this population is needed to ensure follow-up treatment and prevention.

Keywords: PTSD, Asian Americans, World Trade Center Attack, racial differences

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Authors: M. Ndaw, G. Mendy, S. Ouya

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Information system risk management helps to reduce or eliminate risk by implementing appropriate controls. In this paper, we propose a quantification model of controls impact on information system risks by automatizing the residual criticality estimation step of FMECA which is based on a inductive reasoning. For this, we defined three equations based on type and maturity of controls. For testing, the values obtained with the model were compared to estimated values given by interlocutors during different working sessions and the result is satisfactory. This model allows an optimal assessment of controls maturity and facilitates risk analysis of information system.

Keywords: information system, risk, control, FMECA method

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Authors: Wid Kattan, Rahaf Albarraq

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Background: Tokophobia is a pathological fear of pregnancy that can lead to the avoidance of childbirth. It is classified as primary or secondary. This report describes a patient with tokophobia, as well as her presentation, risk factors, comorbidities, and treatment. Case Presentation: A 43-year-old Saudi woman experienced tokophobia upon becoming pregnant for the fifth time. She was assessed in two clinical interviews by a consultant psychiatrist specializing in women’s mental health. In addition, she completed several questionnaires for assessment of different aspects of her mental health: overall depression, perinatal depression, generalized anxiety, maternal functioning, and fear of childbirth (FOC). Several risk factors and comorbidities that may have contributed to the development of tokophobia in this patient were discussed, including traumatic experiences in previous deliveries, the unplanned nature of the pregnancy, perinatal depression, and pronounced symptoms of anxiety. A collaborative decision to perform a C-section was made, in line with obstetric guidelines and good mental health practice. Full symptomatic recovery was achieved immediately after delivery. Conclusions: We hope to increase clinical awareness of the assessment and management of tokophobia, which is a relatively new concept and, as yet, understudied.

Keywords: tokophobia, fear of childbirth, mental health, anxiety, case report, depression, fear of delivery, psychiatry, cesarean section, perinatal depression

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Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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Authors: Jie Liu, Wei Wei, Chun-Ping Chang

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Using a sample of 110 countries over the period 1984-2013, this paper examines the impacts of country risks on choosing a specific exchange rate regime (first by utilizing the Levy-Yeyati and Sturzenegger de facto classification and then robusting it by the IMF de jure measurement) relative to other regimes via the panel multinomial logit approach. Empirical findings are as follows. First, in the full samples case we provide evidence that government is more likely to implement a flexible regime, but less likely to adopt a fixed regime, under a low level of composite and financial risk. Second, we find that Eurozone countries are more likely to choose a fixed exchange rate regime with a decrease in the level of country risk and favor a flexible regime in response to a shock from an increase of risk, which is opposite to non-Eurozone countries. Third, we note that high-risk countries are more likely to choose a fixed regime with a low level of composite and political risk in the government, but do not adjust the exchange rate regime as a shock absorber when facing economic and financial risks. It is interesting to see that those countries with relatively low risk display almost opposite results versus high-risk economies. Overall, we believe that it is critically important to account for political economy variables in a government’s exchange rate policy decisions, especially for country risks. All results are robust to the panel ordered probit model.

Keywords: country risk, political economy, exchange rate regimes, shock absorber

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Authors: Jadwiga Królikowska, Andrzej Królikowski, Jarosław Bajer

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The work delineates the threats of maladjustment of the capacity of rain canals, designed and built in the early 20th century, in connection to heavy rainfall, especially in summer. This is the cause of the so called 'urban floods.' It directly relates to fierce raise of paving in the cities. Resolving this problem requires a change in philosophy of draining the rainfall by wider use of retention, infiltration and usage of rainwater. In systemic approach to managing the safety of urban drainage systems the risk, which is directly connected to safety failures, has been accepted as a measure. The risk level defines the probability of occurrence of losses greater than the ones forecast for a given time frame. The procedure of risk modelling, enabling its numeric analysis by using appropriate weights, is a significant issue in this paper.

Keywords: risk management, drainage system, urban areas, urban floods

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Authors: Magda Milleyde de Sousa Lima, Letícia Lima Aguiar, Marina Guerra Martins, Erika Veríssimo Dias Sousa, Lizandra Sampaio de Oliveira, Lívia Moreira Barros, Joselany Áfio Caetano

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Patients with chronic kidney disease are vulnerable to episodes which make the safety of their health vulnerable, mainly due to the treatment process that exposes them to high rates of interventions during hemodialysis sessions. Some factors associated with health care contribute to the risk of death and complications. However, there are a small number of scientific studies evaluating the level of safety of hemodialysis clinics, and the sociodemographic characteristics of patients and professionals associated with this safety. Therefore, the present study aims to examine the level of patient safety in hemodialysis clinics in the Brazilian capital, to identify the sociodemographic and clinical factors of patients and nursing staff associated with the level of safety. This is an observational, descriptive and quantitative research conducted in three hemodialysis clinics placed in the city of Fortaleza-CE, Brazil, from September to November 2019. The sample was formed after a sample calculation for finite inhabitants of correlation with 200 chronic renal patients, 30 nursing technicians and seven nurses. Conventional sampling was used based on the inclusion criteria: being present at the hemodialysis session on the day the researcher performed the data collection and being 18 years of age or older. Participants who presented communication difficulties to listen to and/or answer the sociodemographic and clinical questionnaire were excluded. Two instruments were applied: sociodemographic and clinical characterization form and Chronic Renal Patient Safety Assessment Scale on Hemodialysis (EASPRCH). The data were analyzed using the Kruskal Walls Test for categorical variables and Spearman correlation coefficient for non-categorical variables, using the Statistical Package SPSS version 20.0. The present study respected the ethical and legal principles determined by resolution 466/2012 of the National Health Council, under the approval of the Ethics and Research Committee with an opinion number: 3,255,635. The results showed that a hemodialysis clinic presented unsafe care practices of 32 points in the EASPRCH (p=0.001). A statistical association was identified between the level of safety and the variables of the patients: level of education (p=0.018), family income (p=0.049), type of employment (p=0.012), venous access site (p=0.009), use of medication during the session (p=0.008) and time of hemodialysis (p=0.002). When evaluating the profile of nurses, a statistical association was evidenced between the level of safety with the variables: marital status (p=0.000), race (p=0.017), schooling (p= 0.000), income (p=0.013), age (p=0.000), clinic workload (p=0.000), time working with hemodialysis (p=0.000), time working in the clinic (p= 0.007) and clinic sizing (p=0.000). In order, the sociodemographic factors of nursing technicians associated with the level of patient safety were: race (p= 0.001) and weekly workload at (p=0.010). Therefore, it is concluded that there is a non-conformity in the level of patient safety in one of the clinics studied and, that sociodemographic and clinical factors of patients and health professionals corroborate the level of safety of the health unit.

Keywords: hemodialysis, nursing, patient safety, quality improvement

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Authors: Adebusoye Michael, Anthony Gloria, Fasan Temitope, Jacob Anayo

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Background: The culture of fast food consumption has gradually become a common lifestyle in Nigeria especially among young people in urban areas, in spite of the associated adverse health consequences. The adolescent pattern of fast foods consumption and their perception of this practice, as a risk factor for Non-Communicable Diseases (NCDs), have not been fully explored. This study was designed to assess fast food consumption pattern and the perception of it as a risk factor for NCDs among undergraduates of Federal Polytechnic, Bauchi. Methodology: The study was descriptive cross-sectional in design. One hundred and eighty-five students were recruited using systematic random sampling method from the two halls of residence. A structured questionnaire was used to assess the consumption pattern of fast foods. Data collected from the questionnaires were analysed using statistical package for the social sciences (SPSS) version 16. Simple descriptive statistics, such as frequency counts and percentages were used to interpret the data. Results: The age range of respondents was 18-34 years, 58.4% were males, 93.5% singles and 51.4% of their parents were employed. The majority (100%) were aware of fast foods and (75%) agreed to its implications as NCD. Fast foods consumption distribution included meat pie (4.9%), beef roll/ sausage (2.7%), egg roll (13.5%), doughnut (16.2%), noodles(18%) and carbonated drinks (3.8%). 30.3% consumed thrice in a week and 71% attached workload to high consumption of fast food. Conclusion: It was revealed that a higher social pressure from peers, time constraints, class pressure and school programme had the strong influence on high percentages of higher institutions’ students consume fast foods and therefore nutrition educational campaigns for campus food outlets or vendors and behavioural change communication on healthy nutrition and lifestyles among young people are hereby advocated.

Keywords: fast food consumption, Nigerian polytechnic, risk factors, undergraduate

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Authors: Karolina Siejka, Monika Piekarska, Monika Zbroja, Weronika Cyranka, Maryla Kuczynska, Magdalena Grzegorczyk, Malgorzata Nowakowska, Agnieszka Brodzisz, Magdalena Maria Wozniak

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Crohn’s disease is one of chronic inflammatory bowel diseases. It is increasing in prevalence worldwide, especially with young people. The disease usually occurs in the second to the fourth decade of life. Traditionally is diagnosed by clinical indicates, endoscopic, and histological findings. Magnetic Resonance Enterography (MRE) can demonstrate mural and extramural inflammatory signs and complications, which make it a valuable diagnostic modality. The study included 76 adults and 36 children diagnosed with Crohn’s disease. Each patient underwent MRE with intravenous administration of a contrast agent. All the studies were performed using Siemens Aera 1.5T scanner according to a local study protocol. Whenever applicable, MR Enterography findings were verified with endoscopy. Forty adults and all 36 children had an active phase of Crohn’s disease; five adults had a chronic phase of the disease; one adult had both chronic and active inflammatory features. Thirty adults have no sings of pathology. In both adult and pediatric groups the most commonly observed manifestation of active disease was thickened edematous ileum wall (26 adults and 36 children). Adults had Bauhin’s valve edema in 58% cases (n=23) and mesenteric changes in 34% cases (n=9). To compare, 32 children had Bauhin’s valve edema (89%) and, in 23 cases, was found inflammatory infiltration of the peri-intestinal fat (64%). The involvement of the large intestine was more common among children (100%). Complications of Crohn’s disease were found commonly in adults (40% of adults, 22% of children). There were observed 18 fistulas (14 adults, four children) and six abscesses (2 adults, four children). MRE is a reliable method in the evaluation of Crohn’s disease activity, especially of its complications. The lack of radiations makes MRE well-tolerated modality, which can be often repeated, particularly in young patients. The disease had different medical sings depending on age – children often had a more active inflammatory process, but there were more complications in the adult group.

Keywords: Crohn's disease, diagnostics, inflammatory bowel disease, magnetic resonance enterography, MRE

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Authors: Jadwiga Królikowska, Andrzej Królikowski, Jarosław Bajer

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The work delineates the threats of maladjustment of the capacity of rain canals, designed and built in the early 20th century, in connection to heavy rainfall, especially in summer. This is the cause of the so called 'urban floods.' It directly relates to fierce raise of paving in the cities. Resolving this problem requires a change in philosophy of draining the rainfall by wider use of retention, infiltration and usage of rainwater. In systemic approach to managing the safety of urban drainage systems the risk, which is directly connected to safety failures, has been accepted as a measure. The risk level defines the probability of occurrence of losses grater than the ones forecast for a given time frame. The procedure of risk modelling, enabling its numeric analysis by using appropriate weights, is a significant issue in this paper.

Keywords: drainage system, urban areas, risk measurement, systemic approach

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Authors: Hyeon-Kyo Lim, Tong-Il Jang, Yong-Hee Lee

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For an operator in a nuclear power plant, human error is one of the most dreaded factors that may result in unexpected accidents. The possibility of human errors may be low, but the risk of them would be unimaginably enormous. Thus, for accident prevention, it is quite indispensable to analyze the influence of any factors which may raise the possibility of human errors. During the past decades, not a few research results showed that performance of human operators may vary over time due to lots of factors. Among them, stress is known to be an indirect factor that may cause human errors and result in mental illness. Until now, not a few assessment tools have been developed to assess stress level of human workers. However, it still is questionable to utilize them for human performance anticipation which is related with human error possibility, because they were mainly developed from the viewpoint of mental health rather than industrial safety. Stress level of a person may go up or down with work time. In that sense, if they would be applicable in the safety aspect, they should be able to assess the variation resulted from work time at least. Therefore, this study aimed to compare their applicability for safety purpose. More than 10 kinds of work stress tools were analyzed with reference to assessment items, assessment and analysis methods, and follow-up measures which are known to close related factors with work stress. The results showed that most tools mainly focused their weights on some common organizational factors such as demands, supports, and relationships, in sequence. Their weights were broadly similar. However, they failed to recommend practical solutions. Instead, they merely advised to set up overall counterplans in PDCA cycle or risk management activities which would be far from practical human error prevention. Thus, it was concluded that application of stress assessment tools mainly developed for mental health seemed to be impractical for safety purpose with respect to human performance anticipation, and that development of a new assessment tools would be inevitable if anyone wants to assess stress level in the aspect of human performance variation and accident prevention. As a consequence, as practical counterplans, this study proposed a new scheme for assessment of work stress level of a human operator that may vary over work time which is closely related with the possibility of human errors.

Keywords: human error, human performance, work stress, assessment tool, time-variant, accident prevention

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Authors: Maryam Bordbar, Yaser Mokhayeri, Sajjad Roosta, Fatemeh Ghasemi, Saeed Choobkar, Hamidreza Nikbakht, Ebrahim Falahi

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Objective: Diabetes mellitus type 2 is the most common metabolic disorder that is growing exponentially worldwide. Satureja Khuzestanica Jamzad is a native plant of Iran that grows widely in the south of Iran. Its antimicrobial, antioxidant, anti-inflammatory and pain-relieving effects have been documented in animal studies. The purpose of this study is to investigate the effect of consumption daily S. khuzestanica on inflammatory and antioxidant indicators in type 2 diabetic patients. Methods and Materials: In a double-blind, placebo-controlled clinical trial, 67 patients with type 2 diabetes were included and divided into two groups. One group received S. khuzestanica (capsule containing 500 mg) and the other group received placebo (500 mg talcum powder) once a day for 12 weeks. After the intervention, the inflammatory and antioxidant indicators of the two groups were compared. Results: In comparison to placebo groups, there was a significant difference in levels of total antioxidant capacity, superoxide dismutase, catalase, glutathione reductase, and glutathione peroxidase; these antioxidant indicators were higher in the intervention group (P<0.05). Moreover, a considerable decrease in weight, CRP and IL-6 levels were observed in patients in the S.Khuzestanica group. Conclusion: Our findings may provide novel complementary treatments without adverse effects for diabetes complications.

Keywords: Satureja khuzestanica Jamzad, diabetes mellitus, antioxidant indicators, IL-6, C-reactive protein

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Authors: Nasib Zaman, Maneesha Kour, Muhammad Rizwan, Fazal Akbar

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Abstract: Chikungunya fever is a re-emerging rapidly spreading mosquito-borne disease cause by Aedes albopictus and Aedes aegypti mosquito vectors. Currently, it is affecting millions of people globally. Objective: This study's main objective was to find the incidence of chikungunya fever in the Swat region and the factors associated with the spread of this infection. Method: This study was carried out in different areas of Swat. Blood samples and data were collected from selected patients, and a questionnaire was filled for each patient. 3-5ml of the specimen was taken from the patient's vein and serum, or plasma was separated by centrifugation. Chikungunya tests were performed for IgG and IgM antibodies. The data was analyzed by SPSS and Graph Paid Prism 5. Results: A total of 169 patients were included in this study, out of which 103 (60.9%) having age less than 30 years were positive for chikungunya infection and 66 (39.1%) having more than 30 years were negative for this infection. Only 1 (0.6%) were positive for both IgG and IgM antibody. About 15 (8.9%) patients have diagnosed with positive IgG antibodies, and 25 (26.6%) patients were positive for IgM positive antibodies. The infection rate was significantly higher in males compared to females 71 (59.6%) vs. 14 (38%) P value=0.088, OR=1.7. Conclusion: This study concludes clinical knowledge and awareness that are necessary for a diagnosis of chikungunya infection properly. Therefore it is important to educate people for the eradication of this infection. Recommendation: This study also recommends investigating the other risk factors associated with this infection.

Keywords: Chikungunya, risk factor, Incidence, antibodies, mosquito

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Authors: N. W. Paul, M. Banerjee

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Discussing the nexus between global health policy and local practices, this article addresses the recent Ebola outbreak as a role model for narrative co-constructions of epidemic risk. We will demonstrate in how far a theory-driven and methodologically rooted analysis of narrativity can help to improve mechanisms of prevention and intervention whenever epidemic risk needs to be addressed locally in order to contribute to global health. Analyzing the narrative transformation of Ebola, we will also address issues of transcultural problem-solving and of normative questions at stake. In this regard, we seek to contribute to a better understanding of a key question of global health and justice as well as to the underlying ethical questions. By highlighting and analyzing the functions of narratives, this paper provides a translational approach to refine our practices by which we address epidemic risk, be it on the national, the transnational or the global scale.

Keywords: ebola, epidemic risk, medical ethics, medical humanities

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Authors: Zahra khaksari, Mahboobeh Mehrabi

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One of the biggest health problems in communities, suicide is now one of the top ten causes of death in the world. This study aimed to investigate the risk factors of suicide attempt in Minab city over two years. This was a descriptive and cross-sectional study. Subjects of this study were cases who admitted in Hazrat Abolfazl hospital of minab city over two years Since the beginning of 1389 to end of 1390. During this period,their cases were reviewed. To analyze data, descriptive statistics was applied. During this two-year period, 275 patients who had attempted suicide, of which 65 percent are female and most of them were 15-24 years. 60% of them were single and 70 % of rural areas. 51% of suicides in 1390 and most of the suicide attempts occurred at a rate of 37 percent in summer. and the most common way of attempting suicide was medication poisoning (74%). The suicide rate leading to death was 1.5% The chi-square test showes that there were significant relationship between suicide by gender and residence status. This means that more women are committing suicide of rural areas.based on The chi-square test there were significant relation between the gender and method, gender and the result of suicide and means that more women than men commit suicide with the use of drugs. Males were more successful suicide. who had attempted with organophosphates and hanging were more successful in suicide. The finding of the current study showed that most of the suicide victims were female ,rural deweller,14-24 years old,single, serious attention must be paid to the problems of this group. It also extends the field of education professionals and health centers, and psychological therapy that focuses specifically on this topic.

Keywords: attempt to suicide, minab, risk factors, suicide

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Authors: Mawuli M. Sedegah, Emmanuel O. Sarpong, Ernest Y. Acheampong

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Sports injuries among student-athletes in high schools have become prevalent in most developing countries. The study explores the risk factors influencing sports injuries and identify those sustained among high schools’ competitions in the Akuapem Municipality. Drawing on literature from sports injuries, 610 student-athletes were used to understand how they sustained various injuries during schools’ sports and games. Using a cross-sectional survey, the study reveals how wounds, knee injury, muscle cramps, and thigh injury are common injuries in the municipality. The physiological factor was rampant, resulting from the number of games played by student-athletes, which significantly influenced sprain, strain, dislocation, and nose bleeding injuries among them. Results recorded a low correlation accounting for 9% occurrence of sports injuries in the Akuapem Municipality. Further study can be done in the other districts to have a general approach to remedy some of these sports injuries.

Keywords: common injuries, physiological factors, sports injuries, student-athletes

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Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

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Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

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Authors: Magid Maatallah

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The problem is, investment management in modern conditions boils down to risk management which is very underdeveloped in Islamic financial theory and practice. Add to this the fact that, in Islamic perception, this is one of the areas of conventional finance in need of drastic reforms. This need was recently underlined by the story of Long Term Capital Management (LTCM ), ( told by Roger Lowenstein in his book, When Genius Failed, Random House, 2000 ). So we face a double challenge, to develop Islamic techniques of risk management and to see that these new techniques are free from the ills with which conventional methods are suffering. This is different from the challenge faced in the middle of twentieth century, to develop a method of financial intermediation free of interest.Risk was always there, especially in business. But industrialization brought risks unknown in trade and agriculture. Industrial production often involves long periods of time .The longer the period of production the more the uncertainty. The scope of the market has expanded to cover the whole world, introducing new kinds of risk. More than a thousand years ago, when Islamic laws were being written, the nature and scope of risk and uncertainty was different. However, something can still be learnt which, in combination with the modern experience, should enable us to realize the Shariah objectives of justice, fairness and efficiency.

Keywords: financial markets, Islamic framework, risk management, investment

Procedia PDF Downloads 541