Search results for: health risk factors

Authors: Sajjad Baghernezhad

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Meta-heuristic and hybrid algorithms have high adeer in modeling medical problems. In this study, a neural network was used to predict covid-19 among high-risk and low-risk patients. This study was conducted to collect the applied method and its target population consisting of 550 high-risk and low-risk patients from the Kerman University of medical sciences medical center to predict the coronavirus. In this study, the memetic algorithm, which is a combination of a genetic algorithm and a local search algorithm, has been used to update the weights of the neural network and develop the accuracy of the neural network. The initial study showed that the accuracy of the neural network was 88%. After updating the weights, the memetic algorithm increased by 93%. For the proposed model, sensitivity, specificity, positive predictivity value, value/accuracy to 97.4, 92.3, 95.8, 96.2, and 0.918, respectively; for the genetic algorithm model, 87.05, 9.20 7, 89.45, 97.30 and 0.967 and for logistic regression model were 87.40, 95.20, 93.79, 0.87 and 0.916. Based on the findings of this study, neural network models have a lower error rate in the diagnosis of patients based on individual variables and vital signs compared to the regression model. The findings of this study can help planners and health care providers in signing programs and early diagnosis of COVID-19 or Corona.

Keywords: COVID-19, decision support technique, neural network, genetic algorithm, memetic algorithm

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Authors: Merab Mamuladze, Mixeil Lejava, Fadiko Abuselidze

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

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

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Authors: Ljiljana Seric, Vladimir Divic, Marin Bugaric

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This paper presents methodology for spatial analysis of GIS data that is used for assessing the microlocation risk index from potential damages of high winds. The analysis is performed on freely available GIS data comprising information about wind load, terrain cover and topography of the area. The methodology utilizes the legislation of Eurocode norms for determination of wind load of buildings and constructions. The core of the methodology is adoption of the wind load parameters related to location on geographical spatial grid. Presented work is a part of the Wind Risk Project, supported by the European Commission under the Civil Protection Financial Instrument of the European Union (ECHO). The partners involved in Wind Risk project performed Wind Risk assessment and proposed action plan for three European countries – Slovenia, Croatia and Germany. The proposed method is implemented in GRASS GIS open source GIS software and demonstrated for Case study area of wider area of Split, Croatia. Obtained Wind Risk Index is visualized and correlated with critical infrastructures like buildings, roads and power lines. The results show good correlation between high Wind Risk Index with recent incidents related to wind.

Keywords: Eurocode norms, GIS, spatial analysis, wind distribution, wind risk

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Authors: Nouira Mariem, Ennigrou Samir

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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Authors: Muhammad Tahir, Mushtaq Muhammad

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Capital structure is one of the key decisions taken by the financial managers. This study aims to investigate the factors influencing capital structure decision in Oil and Gas industry of Pakistan using secondary data from published annual reports of listed Oil and Gas Companies of Pakistan. This study covers the time-period from 2008-2014. Capital structure can be affected by profitability, firm size, growth opportunities, dividend payout, liquidity, business risk, and ownership structure. Panel data technique with Ordinary least square (OLS) regression model has been used to find the impact of set of explanatory variables on the capital structure using the Stata. OLS regression results suggest that dividend payout, firm size and government ownership have the most significant impact on financial leverage. Dividend payout and government ownership are found to have significant negative association with financial leverage however firm size indicated positive relationship with financial leverage. Other variables having significant link with financial leverage includes growth opportunities, liquidity and business risk. Results reveal significant positive association between growth opportunities and financial leverage whereas liquidity and business risk are negatively correlated with financial leverage. Profitability and managerial ownership exhibited insignificant relationship with financial leverage. This study contributes to existing Managerial Finance literature with certain managerial implications. Academically, this research study describes the factors affecting capital structure decision of Oil and Gas Companies in Pakistan and adds latest empirical evidence to existing financial literature in Pakistan. Researchers have studies capital structure in Pakistan in general and industry at specific, nevertheless still there is limited literature on this issue. This study will be an attempt to fill this gap in the academic literature. This study has practical implication on both firm level and individual investor/ lenders level. Results of this study can be useful for investors/ lenders in making investment and lending decisions. Further, results of this study can be useful for financial managers to frame optimal capital structure keeping in consideration the factors that can affect capital structure decision as revealed by this study. These results will help financial managers to decide whether to issue stock or issue debt for future investment projects.

Keywords: capital structure, multicollinearity, ordinary least square (OLS), panel data

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Authors: André Luis Messias Dos Santos Duque, Daniela Polessa Paula, Rosane Harter Griep

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The intensity of physical activity (PA) over time is essential for health promotion. However, there are few studies that have analyzed the practice of different intensities of PA longitudinally. The objective was to identify PA intensity trajectories in men and women from a Brazilian multicentric cohort and their associated factors. Data from 10,367 participants (5,777 women and 4,590 men) aged 35 to 74 years from the baseline and two follow-up visits (2012-2014 and 2017-2019) of the Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. PA intensity (low, moderate, or high) was assessed using the leisure-time PA module of the International Physical Activity Questionnaire (IPAQ), and sociodemographic, behavioral, and clinical variables were included. Chi-square and T-student tests were used, considering a significant level of 5%. Four intensity trajectories were identified: low, moderate, high, and no pattern. Most participants (82.5% of women and 75.7% of men) had low PA intensity trajectories, and only 2% of women and 4.8% of men had high PA intensity trajectories. For both sexes, a significant difference (p<0.05) was found for age group, education level, income, smoking, type 2 diabetes, obesity, hypertriglyceridemia, and hypertension. Actions that promote the practice of high-intensity PA over time and consider sociodemographic, clinical, and behavioral factors are necessary.

Keywords: lifestyle, longterm effects, physical activity, socioeconomic factors

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Authors: Dolhadi Bin Zainudin

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The study attempts to predict the relationship between influencing factors in the adoption of ISO 9000:2008 and to identify which how these factors play the main role in achieving ISO 9000 standard. A survey using structured questionnaire was employed. A total of 255 respondents from 255 small and medium enterprises participated in this study. With regards to influencing factors, a discriminant analysis was conducted and the results showed that three out of nine critical success factors is statistically significant between ISO 9000:2008 and non-ISO 9000 certified companies which are communication for quality, information and analysis and organizational culture.

Keywords: ISO 9000, quality management, factors, small and medium enterprise, Malaysia, influencing factors

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Authors: George Mariano Soriano

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In this study, a Rapid Earthquake Risk Ranking Criteria was formulated by integrating various existing maps and databases by the Department of Public Works and Highways (DPWH) and Philippine Institute of Volcanology and Seismology (PHIVOLCS). Utilizing Geographic Information System (GIS) software, the above-mentioned maps and databases were used in extracting seismic hazard parameters and bridge vulnerability characteristics in order to rank the seismic damage risk rating of bridges in the National Capital Region.

Keywords: bridge, earthquake, GIS, hazard, risk, vulnerability

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Authors: Wafa Al Jabri

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Background: In Middle Eastern Islamic Countries (MEICs), there is a high prevalence of genetic blood disorders (GBDs), particularly sickle cell disease and thalassemia. The GBDs are considered a major public health concern, especially with the increase in affected populations along with the associated psychological, social, and financial cost of management. Despite the availability of premarital screening services (PSS) that aim to identify the asymptomatic carriers of GBDs and provide genetic counseling to couples in order toreduce the prevalence of these diseases; yet, the success rate of PSS is very low due to religious and socio-cultural concerns. Purpose: This paper aims to highlight the factors that affect the success of PSS in MEICs. Methods: A literature review of articles located in CINAHL, PubMed, SCOPUS, and MedLinewas carried out using the following terms: “premarital screening,” “success,” “effectiveness,” and “ genetic blood disorders.” Second, a hand search of the reference lists and Google searches were conducted to find studies that did not exist in the primary database searches. Only studies which are conducted in MEICs countries and published in the last five years were included. Studies that were not published in English were excluded. Results: Fourteen articles were included in the review. The results showed that PSS in most of the MEICs was successful in achieving its objective of identifying high-risk marriages; however, the service failed to meetitsultimate goal of reducing the prevalence of GBDs. Various factors seem to hinder the success of PSS, including poor public awareness, late timing of the screening, culture and social stigma, religious beliefs, availability of prenatal diagnosis and therapeutic abortion, emotional factors, and availability of genetic counseling services. However, poor public awareness, late timing of the screening, and unavailability of adequate counseling services were the most common barriers identified. Conclusion: Overcoming the identified barriers by providing effective health education programs, offering the screening test to young adults at an earlier stage, and tailoring the genetic counseling would be crucial steps to provide a framework for an effective PSS in MEICs.

Keywords: premarital screening, success, effectiveness, and genetic blood disorders

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Authors: Maryam Rafraf, Aida Ghaffari

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

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

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Authors: Seyed Fakhroddin Hejazi, Mohammad Saleh Sadeghi, Leili Iranirad

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Silent myocardial infarction is defined as the appearance of pathological Q waves in the electrocardiogram, without objective signs of myocardial infarction and any minimal or atypical symptoms. Although this condition has been known for a long time, but little is known about its phenomenon and the mechanisms of it remain unclear. Its coincidence with stroke is also still controversial. This case report introduces a middle-aged man with silent myocardial infarction presented with homonymous hemianopia, which except stage 1 hypertension, had no other major cardiovascular risk factors including diabetes mellitus, hypercholesterolemia, family history of cardiac diseases and smoking. In conclusion, this case report indicated that existence of only one cardiovascular risk factor would lead to the development of MI or stroke.

Keywords: silent myocardial infarction, homonymous hemianopia, stroke, hypertension

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Authors: Wisit Wichitkosoom

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

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

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Authors: Mohamed Fairooz Abdul Khir

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The linkage between liability for risk and legitimacy of reward is a governing principle that must be fully observed in financial transactions. It is the cornerstone of any Islamic business or financial deal. The absence of risk taking principle may give rise to numerous prohibited elements such as ribā, gharar and gambling that violate the objectives of financial transactions. However, fiqhī domains from which it emanates have not been clearly spelled out by the scholars. In addition, the concept of risk taking in relation to contemporary risks associated with financial contracts, such as credit risk, liquidity risk, reputational risk and market risk, needs further scrutiny as regard their Sharīʿah bases. Hence, this study is imperatively significant to prove that absence of risk taking concept in Islamic financial instruments give rise to prohibited elements particularly ribā. This study is primarily intended to clarify the concept of risk in Islamic financial transactions from the fiqhī perspective and evaluate analytically the selected issues involving risk taking based on the established concept of risk taking from fiqhī viewpoint. The selected issues are amongst others charging cost of fund on defaulting customers, holding the lessee liable for total loss of leased asset under ijārah thumma al-bayʿ and capital guarantee under mushārakah based instruments. This is a library research in which data has been collected from various materials such as classical fiqh books, regulators’ policy guidelines and journal articles. This study employed deductive and inductive methods to analyze the data critically in search for conclusive findings. It suggests that business risks have to be evaluated based on their subjects namely (i) property (māl) and (ii) work (ʿamal) to ensure that Islamic financial instruments structured based on certain Sharīʿah principles are not diverted from the risk taking concept embedded in them. Analysis of the above selected cases substantiates that when risk taking principle is breached, the prohibited elements such as ribā, gharar and maysir do arise and that they impede the realization of the maqāṣid al-Sharīʿah intended from Islamic financial contracts.

Keywords: Islamic finance, ownership risk, ribā, risk taking

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Authors: Ezri Coda, Kris Justine Miparanum, Relvin Jay Sale

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The study dealt on suicide risk level of college students in UM Tagum College. The primary goal of the study was to assess the level of suicide risk among students at the UM Tagum College in terms of perceived burdensomeness, low belongingness/social alienation and acquired ability to enact lethal self-injury utilizing quantitative non- experimental study with 380 students in UM Tagum College as respondents of the study. Mean was the statistical tools used for the data treatment. Moreover, the study aims to determine the mean of the level of the suicide risk assessment in terms of program, type of student, age, year level, civil status and gender, and lastly, to design an intervention program for those identified students with high suicide risk. Results showed a low level of suicide risk in terms of perceived burdensomeness, low belongingness/social alienation and acquired ability to enact lethal self-injury.

Keywords: suicide risk, perceived burdensomeness, low belongingness/social alienation, acquired ability to enact lethal self-injury, UM Tagum College, Philippines

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Authors: Samaneh serraj

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Listening anxiety has a detrimental effect on language learners. Through a qualitative study on Iranian EFL learners several factors were identified as having influence on their listening anxiety. These factors were divided into three categories, i.e. individual factors (nerves and emotionality, using inappropriate strategies and lack of practice), input factors (lack of time to process, lack of visual support, nature of speech and level of difficulty) and environmental factors (instructors, peers and class environment).

Keywords: listening Comprehension, Listening Anxiety, Foreign language learners

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Authors: Yin-Hsuan Wu, Perng-Jy Tsai, Ying-Fang Wang, Shun-Hui Chung

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The present study was conducted to characterize exposure concentrations, concentrations deposited on the different respiratory regions, and resultant health risks associated with heavy metal exposures for road marking workers. Road marking workers of three similar exposure groups (SEGs) were selected, including the paint pouring worker, marking worker, and preparing worker. Personal exposure samples were collected using an inhalable dust sampler (IOM), and the involved particle size distribution samples were estimated using an eight-stage Marple personal cascade impactor during five working days. In total, 25 IOM samples and 20 Marple samples were collected. All collected samples were analyzed for their heavy metal contents using the ICP/MS. The resultant heavy metal particle size distributions were also used to estimate the fractions of particle deposited on the head airways (Chead), tracheobronchial (Cthorac) and alveolar regions (Cresp) of the exposed workers. In addition, Pb and Cr were selected to estimate the incremental cancer risk, and Zn, Ti, and Mo were selected to estimate the corresponding non-cancer risk in the present study. Results show that three heavy metals, including Pb, Cr, and Ti, were found with the highest concentrations for the SEG of the paint pouring worker (=0.585±2.98, 0.307±1.71, 0.902±2.99 μg/m³, respectively). For the fraction of heavy metal particle deposited on the respiratory tract, both alveolar and head regions were found with the highest values (=23-43% and 39-61%, respectively). For both SEGs of the paint pouring and marking, 51% of Cr, 59-61% of Zn, and 48-51% of Ti were found to be deposited on the alveolar region, and 41-43% of Pb was deposited on the head region. Finally, the incremental cancer risk for the SEGs of the paint pouring, marking, and preparing were found as 1.08×10⁻⁵, 2.78×10⁻⁶, and 2.20×10⁻⁶, respectively. In addition, the estimated non-cancer risk for the above three SEGs was found to be consistently less than unity. In conclusion, though the estimated non-cancer risk was less than unity, all resultant incremental cancer risk was greater than 10⁻⁶ indicating the abatement of workers’ exposure is necessary. It is suggested that strategies, including placing on the molten kettle, substitution the currently used paints for less heavy metal containing paints, and wearing fume protecting personal protective equipment can be considered in the future from reducing the worker’s exposure aspect.

Keywords: health risk assessment, heavy metal, respiratory track deposition, road marking

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Authors: Hossein Rassi, Marjan Moradi Fard, Masoud Houshmand

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Background: Cervical cancer is multistep disease that is thought to result from an interaction between genetic background and environmental factors. Human papillomavirus (HPV) infection is the leading risk factor for cervical intraepithelial neoplasia (CIN) and cervical cancer. In other hand, some of p53 and miRNA polymorphism may plays an important role in carcinogenesis. This study attempts to clarify the relation of p53 genotypes and miR-146a rs2910164 polymorphism in cervical lesions. Method: Forty two archival samples with cervical lesion retired from Khatam hospital and 40 sample from healthy persons used as control group. A simple and rapid method was used to detect the simultaneous amplification of the HPV consensus L1 region and HPV-16,-18, -11, -31, 33 and -35 along with the b-globin gene as an internal control. We use Multiplex PCR for detection of P53 and miR-146a rs2910164 genotypes in our lab. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Cervix lesions were collected from 42 patients with Squamous metaplasia, cervical intraepithelial neoplasia, and cervical carcinoma. Successful DNA extraction was assessed by PCR amplification of b-actin gene (99bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of cervical lesions in the study population. In this study, we detected 13 HPV 18 from 42 cervical cancer. Conclusion: The connection between several SNP polymorphism and human virus papilloma in rare researches were seen. The reason of these differences in researches' findings can result in different kinds of races and geographic situations and also differences in life grooves in every region. The present study provided preliminary evidence that a p53 GG genotype and miR-146a rs2910164 CC genotype may effect cervical cancer risk in the study population, interacting synergistically with HPV 18 genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with HPV18 can serve as major risk factors in the early identification of cervical cancers. Furthermore, the results indicate the possibility of primary prevention of cervical cancer by vaccination against HPV18 in Iran.

Keywords: cervical cancer, HPV18, p53 codon 72 polymorphism, miR-146a rs2910164 polymorphism

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Authors: Mai Ashraf Talaat

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

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

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Authors: Sandra Soca Lozano, Teresa Isabel Lozano Pérez, Germain Weber

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Cancer is a chronic disease of high prevalence in children and adolescents. Medical care in Cuba is carried out by a multidisciplinary team and family is the mediator between this team and the patient. Around this disease, there are interwoven many stereotypes and taboos by its relation to death. In this research report, we describe the work paradigm of psychological care to patients suffering from these diseases in the University Pediatric Hospital Juan Manuel Márquez of Havana, Cuba. We present the psychosocial factors that must be taken into account to provide comprehensive care and ensuring the quality of life of patients and their families. We also present the factors related to the health team and the management of information done with the patient. This is a descriptive proposal from the working experience accumulated in the named institution and in the review of the literature. As a result of this report we make a proposal of teamwork and the aspects in which psychological intervention should be continue performing in terms of increasing the quality of the care made by the health team. We conclude that it is necessary to continue improving the information management of children and adolescents with theses health problems and took into account their right to autonomy.

Keywords: comprehensive care, management of information, psychosocial factors, right to autonomy

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Authors: Alaa Ashraf Khaleel Abdallah

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Background: The global landscape has witnessed an alarming rise in armed conflicts, further devastating populations through enforced displacement, compromised infrastructure, and strained healthcare systems. In Sudan, the situation is particularly dire, with conflict exacerbating shortages in medical supplies and personnel, pushing the already fragile healthcare system into crisis, especially affecting surgical care. Initially, war impacts were significant in conflict zones like Khartoum, but since mid-April 2023, the entire country has descended into chaos. Weak monitoring and health information systems hinder accurate assessment of surgical care in conflict zones, leading to inadequate resource allocation, suboptimal care, and missed opportunities for global learning. This study investigates the impact of the Sudanese conflict on postoperative complications, exploring prevalence, types, outcomes, and psychological effects in conflict and safe areas. Methods: Conducted across 10 Sudanese states—5 in conflict zones such as Khartoum and West Darfur, and 5 in safer regions like River Nile and Kassala—this study analyzed data from 1,457 patients who underwent surgery post-April 2023. Data were collected using a pretested, mixed-mode questionnaire that incorporated elements from validated frameworks and tailored questions specific to the study's context. Hospital records and surgical logs were also used, with data analyzed via SPSS. Results: The overall prevalence of postoperative complications was 35.89%, with a higher rate in conflict zones (57.5%) compared to safe areas (26.4%). Surgical site infections predominated in conflict zones (24.7%) and higher than its prevalence in safe areas, and while fever was prevalent in safer regions even though much less compared to conflict areas, bleeding from surgical site was very frequent in conflict areas. Most patients recovered within two months at a rate higher in safe areas, but most of them required further medical or surgical management within the first month, but psychological impacts were more pronounced in conflict zones with 22.22% reported anxiety among injuries patients, and 20.6% experienced depression, 13.5% and 16.9% respectively, in those had surgeries for other medical conditions, compared to 0.22%anxiety rates and 8.1%for depression in safer regions. Risk factors included age, travel to conflict zones, access to care, delays, and comorbidities. Conclusion: Strengthening healthcare systems and ensuring accessible surgical care are critical in both conflict and safe areas. Specific attention must be given to addressing patient suffering and demographic shifts caused by armed conflict. Further research is needed to refine the predictive model for postoperative complications in conflict zones.

Keywords: postoperative complications, conflict zones, risk factors, surgical outcomes, Sudan

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Authors: Oyuntsetseg Sandag, Lkhagvadorj Khosbayar, Naidansuren Tsendeekhuu, Densenbal Dansran, Bandi Solongo

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Introduction: Obstructive sleep apnea (OSA) is a common disorder affecting at least 2% to 4% of the adult population. It is estimated that nearly 80% of men and 93% of women with moderate to severe sleep apnea are undiagnosed. A number of screening questionnaires and clinical screening models have been developed to help identify patients with OSA, also it’s indeed to clinical practice. Purpose of study: Determine dependence of obstructive sleep apnea between for severe risk and risk factor. Material and Methods: A cross-sectional study included 114 patients presenting from theCentral state 3th hospital and Central state 1th hospital. Patients who had obstructive sleep apnea (OSA)selected in this study. Standard StopBang questionnaire was obtained from all patients.According to the patients’ response to the StopBang questionnaire was divided into low risk, intermediate risk, and high risk.Descriptive statistics were presented mean ± standard deviation (SD). Each questionnaire was compared on the likelihood ratio for a positive result, the likelihood ratio for a negative test result of regression. Statistical analyses were performed utilizing SPSS 16. Results: 114 patients were obtained (mean age 48 ± 16, male 57)that divided to low risk 54 (47.4%), intermediate risk 33 (28.9%), high risk 27 (23.7%). Result of risk factor showed significantly increasing that mean age (38 ± 13vs. 54 ± 14 vs. 59 ± 10, p<0.05), blood pressure (115 ± 18vs. 133 ± 19vs. 142 ± 21, p<0.05), BMI(24 IQR 22; 26 vs. 24 IQR 22; 29 vs. 28 IQR 25; 34, p<0.001), neck circumference (35 ± 3.4 vs. 38 ± 4.7 vs. 41 ± 4.4, p<0.05)were increased. Results from multiple logistic regressions showed that age is significantly independently factor for OSA (odds ratio 1.07, 95% CI 1.02-1.23, p<0.01). Predictive value of age was significantly higher factor for OSA (AUC=0.833, 95% CI 0.758-0.909, p<0.001). Our study showing that risk of OSA is beginning 47 years old (sensitivity 78.3%, specifity74.1%). Conclusions: According to most of all patients’ response had intermediate risk and high risk. Also, age, blood pressure, neck circumference and BMI were increased such as risk factor was increased for OSA. Especially age is independently factor and highest significance for OSA. Patients’ age one year is increased likelihood risk factor 1.1 times is increased.

Keywords: obstructive sleep apnea, Stop-Bang, BMI (Body Mass Index), blood pressure

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Authors: Vidhya Venugopal, Rekha S.

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Introduction: Climate change and the growing frequency of higher average temperatures and heat waves have detrimental health effects, especially for certain vulnerable groups with limited socioeconomic status (SES) or physiological capacity to adapt to or endure high temperatures. Little research has been conducted on the effects of heat stress on pregnant women and fetuses in tropical regions such as India. Very high ambient temperatures may worsen Adverse Pregnancy Outcomes (APOs) and are a major worry in the scenario of climate change. The relationship between rising temperatures and APO must be better understood in order to design more effective interventions. Methodology: We conducted an observational cohort study involving 865 pregnant women in various districts of Tamil Nadu districts between 2014 and 2021. Physiological Heat Strain Indicators (HSI) such as morning and evening Core Body Temperature (CBT) and Urine Specific Gravity (USG) were monitored using an infrared thermometer and refractometer, respectively. A validated, modified version of the HOTHAPS questionnaire was utilised to collect self-reported health symptoms. A follow-up was undertaken with the mothers to collect information regarding birth outcomes and APOs, such as spontaneous abortions, stillbirths, Preterm Birth (PTB), birth abnormalities, and Low Birth Weight (LBW). Major findings of the study: According to the findings of our study, ambient temperatures (mean WBGT°C) were substantially higher (>28°C) for approximately 46% of women performing moderate daily life activities. 82% versus 43% of these women experienced dehydration and heat-related complaints. 34% of women had USG >1.020, which is symptomatic of dehydration. APOs, which include spontaneous abortions, were prevalent at 2.2%, stillbirth/preterm birth/birth abnormalities were prevalent at 2.2%, and low birth weight was prevalent at 16.3%. With exposures to WBGT>28°C, the incidence of miscarriage or unexpected abortion rose by approximately 2.7 times (95% CI: 1.1-6.9). In addition, higher WBGT exposures were associated with a 1.4-fold increased risk of unfavorable birth outcomes (95% Confidence Interval [CI]: 1.02-1.09). The risk of spontaneous abortions was 2.8 times higher among women who conceived during the hotter months (February – September) compared to those women who conceived in the cooler months (October – January) (95% CI: 1.04-7.4). Positive relationships between ambient heat and APOs found in this study necessitate further exploration into the underlying factors for extensive cohort studies to generate information to enable the formulation of policies that can effectively protect these women against excessive heat stress for enhanced maternal and fetal health.

Keywords: heat exposures, community, pregnant women, physiological strain, adverse outcome, interventions

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Authors: Piotr Prewysz-Kwinto

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The market of financial instruments with high risk is developing very dynamically in recent years and attracts more and more interest of investors. It consists essentially of two groups of instruments, i.e. derivatives and exchange traded product (ETP), and each year new types are introduced and offered to investors. The aim of this paper is to present the principles concerning financial instruments with high investment risk available on the Warsaw Stock Exchange (WSE), because they have quite complex constructions, and to evaluate the development of this market. In order to achieve this aim, statistical data from 2014-2016 was analyzed. The results confirm that the financial instruments with high investment risk available on the WSE constitute a diversified and the most numerous group of financial instruments and attract the most interest of investors. Responsible investing requires, however, a good knowledge of how they work and how they can generate profit to not expose oneself to unexpected losses.

Keywords: derivatives, exchange traded products (ETP), financial instruments, financial market, risk, stock exchange

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Authors: Sabina Garayeva

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To determine the significant risk factors for intrauterine growth restriction (IUGR), we carried out a thorough study of the social status of the parents of children with IUGR. We observed 315 mothers who gave birth to children with (IUGR), of which 172 mothers with asymmetric type and 143 mothers with symmetric type of IUGR. Through a detailed survey was gathered detailed information about education of parents. The results show that the majority of mothers with IUGR had secondary education (44,8 ± 2,8%), and fathers - higher education (35,2 ± 2,7%). Whereas in the control group, the largest number of parents had higher education (mother 35,3 ± 4,4%, fathers 42,9 ± 4,5%). Number of mothers with secondary education with IUGR was significantly (p1 <0,01; χ2 = 22,67) differs from the number of mothers with physiological pregnancy with the same level of education. Meanwhile, in the group with a symmetrical embodiment of IUGR mothers with secondary formation of significantly greater 53,1 ± 4,2%, than the asymmetric embodiment IUGR 37,8 ± 3,7% (p2 <0,05; χ2 = 8 06). Among fathers with secondary education significant difference was noted in the symmetric version of IUGR 37,8 ± 4,1% more than in the control group (p1 <0,05), and among parents of children with asymmetric IUGR option prevailed fathers with higher education - 37 2 ± 3,7%. Thus, our results revealed a low educational level of the mother as a risk factor for IUGR, which further help to develop preventive and therapeutic measures to eliminate the severity of its consequences. As seen from the data presented, mothers of children with asymmetric IUGR had a school education and fathers - higher education, while in the symmetric type of both parents had secondary education. It is found that frequency of children, born with IUGR, of mothers - housewives and fathers, engage in physical labor, was high. Thus, the analysis conducted by the social status of the parents with IUGR revealed a low level of education and unemployed mothers as risk factors for this disease, which in the future will help to develop preventive and therapeutic measures to eliminate the severity of its.

Keywords: intrauterine growth restriction, education of mothers, education influence, IUGR

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Authors: Nihayatul Munaa, Nyoman A. Damayanti

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This study seeks to understand what factors might influence a patient’s perception of health care under national health insurance in early implementation. In Indonesia, National Health Insurance was first implemented in 2014 and planned to achieve universal health coverage by 2019. However, the little understanding of this new policy lead to increase of complaint in hospital as a health care provider. This is a observational descriptive study with cross sectional design method. Data was collected through in-depth interview with 96 patient from Jemursari Islamic Hospital of Surabaya (Rumah Sakit Islam Jemursari Surabaya) who participate in National Health Insurance. Subject was selected by simple random sampling. The findings demonstrated that from five categories, 82,3% patient was satisfied in reliability aspect and 85,4% in assurance aspect, while in tangible, responsiveness and empathy aspect > 90% patient was satisfied. Meanwhile, in Indonesia, the minimum service standard of healthcare of patient satisfaction is 90%.

Keywords: patient’s satisfaction, national health insurance, hospital, complaint

Procedia PDF Downloads 198

Authors: Shakila Singh

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This research was conducted at a selected South African university campus with women students who drink alcohol. The purpose of the study was to examine their perspectives on the role of alcohol in their lives, their understandings about women’s vulnerability to alcohol-related sexual risk and their strategies against these. The study draws on feminist principles and practices to challenge gendered inequalities that legitimate and facilitate violence against women. Recognising the danger of focusing on risk management in ways that place the burden of responsibility entirely on young women to prevent their violation, this article focuses on women students’ agency in managing risk while taking up opportunities for self-discovery. Participation was voluntary, and a student-researcher administered an open-ended questionnaire to 55 participants. The findings suggest that young women position alcohol- use as a common activity at university, and that it gives them much pleasure. They recognise that it is riskier for women and articulate valuable strategies to manage the risk to their sexual safety when drinking. These include drinking within supportive networks, avoiding financial dependence, and managing their alcohol intake. This article argues that alcohol at university is an integral part of expressions of gender and sexuality and that risk-taking is a normal part of university students’ lives. Consequently, arguments about equality need to consider risk-taking as part of young people’s lives and promote ways of managing alcohol-related risks, rather than imagining that alcohol can be avoided entirely.

Keywords: alcohol-related sexual risk, drinking at university, managing risk, women students

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Authors: Natalia Kalinowska

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The adoption of the General Data Protection Regulation, (GDPR) finished the four-year work of the European Commission in this area in the European Union. Considering far-reaching changes, which will be applied by GDPR, the European legislator envisaged two-year transitional period. Member states and companies have to prepare for a new regulation until 25 of May 2018. The idea, which becomes a new look at an attitude to data protection in the European Union is risk-based approach. So far, as a result of implementation of Directive 95/46/WE, in many European countries (including Poland) there have been adopted very particular regulations, specifying technical and organisational security measures e.g. Polish implementing rules indicate even how long password should be. According to the new approach from May 2018, controllers and processors will be obliged to apply security measures adequate to level of risk associated with specific data processing. The risk in GDPR should be interpreted as the likelihood of a breach of the rights and freedoms of the data subject. According to Recital 76, the likelihood and severity of the risk to the rights and freedoms of the data subject should be determined by reference to the nature, scope, context and purposes of the processing. GDPR does not indicate security measures which should be applied – in recitals there are only examples such as anonymization or encryption. It depends on a controller’s decision what type of security measures controller considered as sufficient and he will be responsible if these measures are not sufficient or if his identification of risk level is incorrect. Data protection regulation indicates few levels of risk. Recital 76 indicates risk and high risk, but some lawyers think, that there is one more category – low risk/now risk. Low risk/now risk data processing is a situation when it is unlikely to result in a risk to the rights and freedoms of natural persons. GDPR mentions types of data processing when a controller does not have to evaluate level of risk because it has been classified as „high risk” processing e.g. processing on a large scale of special categories of data, processing with using new technologies. The methodology will include analysis of legal regulations e.g. GDPR, the Polish Act on the Protection of personal data. Moreover: ICO Guidelines and articles concerning risk based approach in GDPR. The main conclusion is that an appropriate risk assessment is a key to keeping data safe and avoiding financial penalties. On the one hand, this approach seems to be more equitable, not only for controllers or processors but also for data subjects, but on the other hand, it increases controllers’ uncertainties in the assessment which could have a direct impact on incorrect data protection and potential responsibility for infringement of regulation.

Keywords: general data protection regulation, personal data protection, privacy protection, risk based approach

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Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Niya Chen, Jennifer Chan

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In the financial market, risk management helps to minimize potential loss and maximize profit. There are two ways to assess risks; the first way is to calculate the risk directly based on the volatility. The most common risk measurements are Value at Risk (VaR), sharp ratio, and beta. Alternatively, we could look at the quantile of the return to assess the risk. Popular return models such as GARCH and stochastic volatility (SV) focus on modeling the mean of the return distribution via capturing the volatility dynamics; however, the quantile/expectile method will give us an idea of the distribution with the extreme return value. It will allow us to forecast VaR using return which is direct information. The advantage of using these non-parametric methods is that it is not bounded by the distribution assumptions from the parametric method. But the difference between them is that expectile uses a second-order loss function while quantile regression uses a first-order loss function. We consider several quantile functions, different volatility measures, and estimates from some volatility models. To estimate the expectile of the model, we use Realized Conditional Autoregressive Expectile (CARE) model with the bayesian method to achieve this. We would like to see if our proposed models outperform existing models in cryptocurrency, and we will test it by using Bitcoin mainly as well as Ethereum.

Keywords: expectile, CARE Model, CARR Model, quantile, cryptocurrency, Value at Risk

Procedia PDF Downloads 115