Search results for: cardiovascular risk factors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14568

Search results for: cardiovascular risk factors

14268 From Intuitive to Constructive Audit Risk Assessment: A Complementary Approach to CAATTs Adoption

Authors: Alon Cohen, Jeffrey Kantor, Shalom Levy

Abstract:

The use of the audit risk model in auditing has faced limitations and difficulties, leading auditors to rely on a conceptual level of its application. The qualitative approach to assessing risks has resulted in different risk assessments, affecting the quality of audits and decision-making on the adoption of CAATTs. This study aims to investigate risk factors impacting the implementation of the audit risk model and propose a complementary risk-based instrument (KRIs) to form substance risk judgments and mitigate against heightened risk of material misstatement (RMM). The study addresses the question of how risk factors impact the implementation of the audit risk model, improve risk judgments, and aid in the adoption of CAATTs. The study uses a three-stage scale development procedure involving a pretest and subsequent study with two independent samples. The pretest involves an exploratory factor analysis, while the subsequent study employs confirmatory factor analysis for construct validation. Additionally, the authors test the ability of the KRIs to predict audit efforts needed to mitigate against heightened RMM. Data was collected through two independent samples involving 767 participants. The collected data was analyzed using exploratory factor analysis and confirmatory factor analysis to assess scale validity and construct validation. The suggested KRIs, comprising two risk components and seventeen risk items, are found to have high predictive power in determining audit efforts needed to reduce RMM. The study validates the suggested KRIs as an effective instrument for risk assessment and decision-making on the adoption of CAATTs. This study contributes to the existing literature by implementing a holistic approach to risk assessment and providing a quantitative expression of assessed risks. It bridges the gap between intuitive risk evaluation and the theoretical domain, clarifying the mechanism of risk assessments. It also helps improve the uniformity and quality of risk assessments, aiding audit standard-setters in issuing updated guidelines on CAATT adoption. A few limitations and recommendations for future research should be mentioned. First, the process of developing the scale was conducted in the Israeli auditing market, which follows the International Standards on Auditing (ISAs). Although ISAs are adopted in European countries, for greater generalization, future studies could focus on other countries that adopt additional or local auditing standards. Second, this study revealed risk factors that have a material impact on the assessed risk. However, there could be additional risk factors that influence the assessment of the RMM. Therefore, future research could investigate other risk segments, such as operational and financial risks, to bring a broader generalizability to our results. Third, although the sample size in this study fits acceptable scale development procedures and enables drawing conclusions from the body of research, future research may develop standardized measures based on larger samples to reduce the generation of equivocal results and suggest an extended risk model.

Keywords: audit risk model, audit efforts, CAATTs adoption, key risk indicators, sustainability

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14267 Development of Femoral Head Osteonecrosis Due to Corticosteroids Consumption; Probable Role of OCP: A Case Report

Authors: S. Alireza Mirghasemi, Shervin Rashidinia, Mohammad Saleh Sadeghi, Mohsen Talebizadeh, Narges Rahimi Gabaran, Seyed Shahin Eftekhari, Sara Shahmoradi

Abstract:

Avascular necrosis of femoral head is a pathologic condition that the main cause is decreased blood supply of femoral head. Among predisposing risk factors, chronic use of corticosteroids, alcoholism, smocking and hip traumas have more important role. Also we can mention OCP consumption as a risk factor among less common predisposing factors that lead to AVNF, in this study we introduce another cause of AVNF with a period of treatment with moderate dose of corticosteroids accompanied by OCP as a probable facilitating factor that leads to AVNF.

Keywords: AVN, corticosteroids consumption, femoral head osteonecrosis, OCP

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14266 A Risk-Based Modeling Approach for Successful Adoption of CAATTs in Audits: An Exploratory Study Applied to Israeli Accountancy Firms

Authors: Alon Cohen, Jeffrey Kantor, Shalom Levy

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Technology adoption models are extensively used in the literature to explore drivers and inhibitors affecting the adoption of Computer Assisted Audit Techniques and Tools (CAATTs). Further studies from recent years suggested additional factors that may affect technology adoption by CPA firms. However, the adoption of CAATTs by financial auditors differs from the adoption of technologies in other industries. This is a result of the unique characteristics of the auditing process, which are expressed in the audit risk elements and the risk-based auditing approach, as encoded in the auditing standards. Since these audit risk factors are not part of the existing models that are used to explain technology adoption, these models do not fully correspond to the specific needs and requirements of the auditing domain. The overarching objective of this qualitative research is to fill the gap in the literature, which exists as a result of using generic technology adoption models. Followed by a pretest and based on semi-structured in-depth interviews with 16 Israeli CPA firms of different sizes, this study aims to reveal determinants related to audit risk factors that influence the adoption of CAATTs in audits and proposes a new modeling approach for the successful adoption of CAATTs. The findings emphasize several important aspects: (1) while large CPA firms developed their own inner guidelines to assess the audit risk components, other CPA firms do not follow a formal and validated methodology to evaluate these risks; (2) large firms incorporate a variety of CAATTs, including self-developed advanced tools. On the other hand, small and mid-sized CPA firms incorporate standard CAATTs and still need to catch up to better understand what CAATTs can offer and how they can contribute to the quality of the audit; (3) the top management of mid-sized and small CPA firms should be more proactive and updated about CAATTs capabilities and contributions to audits; and (4) All CPA firms consider professionalism as a major challenge that must be constantly managed to ensure an optimal CAATTs operation. The study extends the existing knowledge of CAATTs adoption by looking at it from a risk-based auditing approach. It suggests a new model for CAATTs adoption by incorporating influencing audit risk factors that auditors should examine when considering CAATTs adoption. Since the model can be used in various audited scenarios and supports strategic, risk-based decisions, it maximizes the great potential of CAATTs on the quality of the audits. The results and insights can be useful to CPA firms, internal auditors, CAATTs developers and regulators. Moreover, it may motivate audit standard-setters to issue updated guidelines regarding CAATTs adoption in audits.

Keywords: audit risk, CAATTs, financial auditing, information technology, technology adoption models

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14265 Risk of Fractures at Different Anatomic Sites in Patients with Irritable Bowel Syndrome: A Nationwide Population-Based Cohort Study

Authors: Herng-Sheng Lee, Chi-Yi Chen, Wan-Ting Huang, Li-Jen Chang, Solomon Chih-Cheng Chen, Hsin-Yi Yang

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A variety of gastrointestinal disorders, such as Crohn’s disease, ulcerative colitis, and coeliac disease, are recognized as risk factors for osteoporosis and osteoporotic fractures. One recent study suggests that individuals with irritable bowel syndrome (IBS) might also be at increased risk of osteoporosis and osteoporotic fractures. Up to now, the association between IBS and the risk of fractures at different anatomic sites occurrences is not completely clear. We conducted a population-based cohort analysis to investigate the fracture risk of IBS in comparison with non-IBS group. We identified 29,505 adults aged ≥ 20 years with newly diagnosed IBS using the Taiwan National Health Insurance Research Database in 2000-2012. A comparison group was constructed of patients without IBS who were matched according to gender and age. The occurrence of fracture was monitored until the end of 2013. We analyzed the risk of fracture events to occur in IBS by using Cox proportional hazards regression models. Patients with IBS had a higher incidence of osteoporotic fractures compared with non-IBS group (12.34 versus 9.45 per 1,000 person-years) and an increased risk of osteoporotic fractures (adjusted hazard ratio [aHR] = 1.27, 95 % confidence interval [CI] = 1.20 – 1.35). Site specific analysis showed that the IBS group had a higher risk of fractures for spine, forearm, hip and hand than did the non-IBS group. With further stratification for gender and age, a higher aHR value for osteoporotic fractures in IBS group was seen across all age groups in males, but seen in elderly females. In addition, female, elderly, low income, hypertension, coronary artery disease, cerebrovascular disease, and depressive disorders as independent osteoporotic fracture risk factors in IBS patients. The IBS is considered as a risk factor for osteoporotic fractures, particularly in female individuals and fracture sites located at the spine, forearm, hip and hand.

Keywords: irritable bowel syndrome, fracture, gender difference, longitudinal health insurance database, public health

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14264 Research on Measuring Operational Risk in Commercial Banks Based on Internal Control

Authors: Baobao Li

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Operational risk covers all operations of commercial banks and has a close relationship with the bank’s internal control. But in the commercial banks' management practice, internal control is always separated from the operational risk measurement. With the increasing of operational risk events in recent years, operational risk is paid more and more attention by regulators and banks’ managements. The paper first discussed the relationship between internal control and operational risk management and used CVaR-POT model to measure operational risk, and then put forward a modified measurement method (to use operational risk assessment results to modify the measurement results of the CVaR-POT model). The paper also analyzed the necessity and rationality of this method. The method takes into consideration the influence of internal control, improves the accuracy and effectiveness of operational risk measurement and save the economic capital for commercial banks, avoiding the drawbacks of using some mainstream models one-sidedly.

Keywords: commercial banks, internal control, operational risk, risk measurement

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14263 Socio-Demographic Factors and Testing Practices Are Associated with Spatial Patterns of Clostridium difficile Infection in the Australian Capital Territory, 2004-2014

Authors: Aparna Lal, Ashwin Swaminathan, Teisa Holani

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Background: Clostridium difficile infections (CDIs) have been on the rise globally. In Australia, rates of CDI in all States and Territories have increased significantly since mid-2011. Identifying risk factors for CDI in the community can help inform targeted interventions to reduce infection. Methods: We examine the role of neighbourhood socio-economic status, demography, testing practices and the number of residential aged care facilities on spatial patterns in CDI incidence in the Australian Capital Territory. Data on all tests conducted for CDI were obtained from ACT Pathology by postcode for the period 1st January 2004 through 31 December 2014. Distribution of age groups and the neighbourhood Index of Relative Socio-economic Advantage Disadvantage (IRSAD) were obtained from the Australian Bureau of Statistics 2011 National Census data. A Bayesian spatial conditional autoregressive model was fitted at the postcode level to quantify the relationship between CDI and socio-demographic factors. To identify CDI hotspots, exceedance probabilities were set at a threshold of twice the estimated relative risk. Results: CDI showed a positive spatial association with the number of tests (RR=1.01, 95% CI 1.00, 1.02) and the resident population over 65 years (RR=1.00, 95% CI 1.00, 1.01). The standardized index of relative socio-economic advantage disadvantage (IRSAD) was significantly negatively associated with CDI (RR=0.74, 95% CI 0.56, 0.94). We identified three postcodes with high probability (0.8-1.0) of excess risk. Conclusions: Here, we demonstrate geographic variations in CDI in the ACT with a positive association of CDI with socioeconomic disadvantage and identify areas with a high probability of elevated risk compared with surrounding communities. These findings highlight community-based risk factors for CDI.

Keywords: spatial, socio-demographic, infection, Clostridium difficile

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14262 Prevalence and Associated Factors of Overweight and Obesity in Children with Intellectual Disability: A Cross-Sectional Study among Chinese Children

Authors: Jing-Jing Wang, Yang Gao, Heather H. M. Kwok, Wendy Y. J. Huang

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Objectives: Intellectual disability (ID) ranks among the top 20 most costly disorders. A child with ID creates a wide set of challenges to the individual, family, and society, and overweight and obesity aggravate those challenges. People with ID have the right to attain optimal health like the rest of the population. They should be given priority to eliminate existing health inequities. Childhood obesity epidemic and associated factors among children, in general, has been well documented, while knowledge about overweight and obesity in children with ID is scarce. Methods: A cross-sectional study was conducted among 524 Chinese children with ID (males: 68.9%, mean age: 12.2 years) in Hong Kong in 2015. Children’s height and weight were measured at school. Parents, in the presence of their children, completed a self-administered questionnaire at home about the children’s physical activity (PA), eating habits, and sleep duration in a typical week as well as parenting practices regarding children’s eating and PA, and their socio-demographic characteristics. Multivariate logistic regression estimated the potential risk factors for children being overweight. Results: The prevalence of overweight and obesity in children with ID was 31.3%, which was higher than their general counterparts (18.7%-19.9%). Multivariate analyses revealed that the risk factors of overweight and obese in children with ID included: comorbidity with autism, the maternal side being overweight or obese, parenting practices with less pressure to eat more, children having shorter sleep duration, longer periods of sedentary behavior, and higher intake frequencies of sweetened food, fried food, and meats, fish, and eggs. Children born in other places, having snacks more frequently, and having irregular meals were also more likely to be overweight or obese, with marginal significance. Conclusions: Children with ID are more vulnerable to being overweight or obese than their typically developing counterparts. Identified risk factors in this study highlight a multifaceted approach to the involvement of parents as well as the modification of some children’s questionable behaviors to help them achieve a healthy weight.

Keywords: prevalence, risk factors, obesity, children with disability

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14261 Risk Factors for Postoperative Fever in Patients Undergoing Lumbar Fusion

Authors: Bang Haeyong

Abstract:

Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

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14260 Prevalence and Risk Factors of Musculoskeletal Disorders among Physical Therapist's Seniors versus Internship Students

Authors: A. H. Bekhet, N. Helmy

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Background: Physical therapists are knowledgeable in treatment and prevention of musculoskeletal injuries; however, they have occupational musculoskeletal injuries because Physical therapy profession requires effort that may lead to work-related musculoskeletal disorders. No previous studies among physical therapists have been reported in Egypt. We aim to assess the prevalence and risk factors of musculoskeletal disorders among physical therapist’s seniors versus internship students. Method: We conducted a cross-sectional study in faculty of physical therapy Cairo university Prevalence and risk factors of musculoskeletal injuries were assessed using self-administered questionnaire with closed-ended questions. Seniors therapist was defined as a physical therapist with more than 5 years of work experience. Data were analyzed using SPSS 22.0 for Windows. Results: The study included 106 physical therapists (Junior = 72; senior = 34), the mean age of senior therapists was 30.1 (SD 6.3) years and junior therapists were 22.8 (SD 2.4). Female subjects constituted 83.9% of the studied sample. The mean hours of contact with patients was higher among junior therapists 6.4 (SD 2.6) vs. 5.7 (SD 2.1) among senior therapists. The prevalence of a musculoskeletal injury, once or more in their lifetime, was significantly higher among senior therapists (86% vs. 66.7%; p = 0.04). The highest risk factor in increasing the symptoms of the injury among junior therapists was maintaining a position for a prolonged period of time at 28% while performing manual therapy techniques was the highest risk factor among senior therapists at 32%. 53% of senior therapists have limited their patient contact time as a result of their injury in comparison to 25% of junior therapists (p = 0.09). Conclusion: the presented study shows that the prevalence of musculoskeletal injuries, once or more in their lifetime, is significantly higher among senior therapists.

Keywords: musculoskeletal injuries, occupational injuries, physical therapists, work related disorders

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14259 Static Balance in the Elderly: Comparison Between Elderly Performing Physical Activity and Fine Motor Coordination Activity

Authors: Andreia Guimaraes Farnese, Mateus Fernandes Reu Urban, Leandro Procopio, Renato Zangaro, Regiane Albertini

Abstract:

Senescence changes include postural balance, inferring the risk of falls, and can lead to fractures, bedridden, and the risk of death. Physical activity, e.g., cardiovascular exercises, is notable for improving balance due to brain cell stimulations, but fine coordination exercises also elevate cell brain metabolism. This study aimed to verify whether the elderly person who performs fine motor activity has a balance similar to that of those who practice physical activity. The subjects were divided into three groups according to the activity practice: control group (CG) with seven participants for the sedentary individuals, motor coordination group (MCG) with six participants, and activity practitioner group (PAG) with eight participants. Data comparisons were from the Berg balance scale, Time up and Go test, and stabilometric analysis. Descriptive statistical and ANOVA analyses were performed for data analysis. The results reveal that including fine motor activities can improve the balance of the elderly and indirectly decrease the risk of falls.

Keywords: balance, barapodometer, coordination, elderly

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14258 Assessment of Acute Cardiovascular Responses to Moderate and Vigorous Intensity Aerobic Exercises in Sedentary Adults and Amateur Athletes

Authors: Caner Yilmaz, Zuhal Didem Takinaci

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Introduction: Today, our knowledge about the effects of physical activity performed at the different intensity of the cardiovascular system are still not clear. Therefore, to contribute to the literature, in our study, sedentary individuals and amateur athletes were assessed in a single session with the aim of evaluating the cardiovascular effects of the moderate and severe exercise. Methods: 80 participants (40 amateur athletes and 40 sedentary, young adults) participated in our study. Participants were divided into two groups: amateur athletes (mean age: 25.0 ± 3.6 yrs) and sedentary in group II (mean age: 23.8 ± 3.7 yrs). Participants in both groups were assessed twice, namely, firstly, at moderate intensity (5km/h 30 min. walking) and secondly at the vigorous intensity (8km/h 20 min. jogging). Participants’ SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), HR (Heart Rate), SpO₂ (Oxygen Saturation), BT (Body Temperature) and RR (Respiratory Rate) were measured. Results: In our study, the findings showed that after moderate-intensity aerobic exercise, change in SBP, DBP, and SpO₂ were significantly higher in Group II (p < 0.05). After the severe intensity aerobic exercises, change in SBP, SpO₂, HR, and RR was significantly higher in Group II (p < 0.05). The BORG score of Group II was significantly higher after both moderate and severe intensity aerobic exercise (p < 0.05). Conclusion: The cardiovascular responses of amateur athletes were closer to initial values, and the differences between the two groups were increased in direct proportion to the intensity of the exercise. Both exercise intensities could be adequate.

Keywords: aerobic, exercise, sedantary, cardi̇ovascular

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14257 Provisions for Risk in Islamic Banking and Finance in Comparison to the Conventional Banks in Malaysia

Authors: Rashid Masoud Ali Al-Mazrui, Ramadhani Mashaka Shabani

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Islamic banks and financial institutions are exposed to the same risks as conventional banking. These risks include the rate return risk, credit or market risk, liquidity risk, and operational risk among others. However, being a financial institution that operates Islamic banking and finance operations, there is additional risk associated with its operations different from conventional finance, such as displacing commercial risk. They face Shari'ah compliance risks because of their failure to follow Shari'ah principles. To have proper mitigation and risk management, banks should have proper risk management policies to mitigate risks. This paper aims to study the risk management taken by Islamic banks in comparison with conventional banks. Also, the study evaluates the provisions for risk management taken by selected Islamic banks and conventional banks. The study employs qualitative analysis using secondary data by applying a content analysis approach with a sample size of 4 Islamic banks and four conventional banks ranging from 2010 to 2020. We find that these banks all use the same technique, except for the associated risk. The extra ways are used, but only for additional risks that are available to Islamic banking and finance.

Keywords: emerging risk, risk management, Islamic banking, conventional bank

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14256 The Correlation between Musculoskeletal Disorders and Body Postures during Playing among Guitarists

Authors: Navah Z. Ratzon, Shlomit Cohen, Sigal Portnoy

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This work focuses on posture and risk factors for the musculoskeletal disorder in guitarists, which constitutes the largest group of musicians today. The source of the problems experienced by these musicians is linked to physical, psychosocial and personal risk factors. These muscular problems are referred to as Playing Related Musculoskeletal Disorder (PRMD). There is not enough research that specifically studies guitar players, and to the extent of our knowledge, there is almost no reference to the characteristics of their movement patterns while they play. This is in spite of the high prevalence of PRMD in this population. Kinematic research may provide a basis for the development of a prevention plan for this population and their unique characteristics of playing patterns. The aim of the study was to investigate the correlation between risk factors for PRMD among guitar players and self-reporting of pain in the skeletal muscles, and specifically to test whether there are differences in the kinematics of the upper body while playing in a sitting or standing posture. Twenty-five guitarists, aged 18-35, participated in the study. The methods included a motion analysis using a motion capture system, anthropometric measurements and questionnaires relating to risk factors. The questionnaires used were the Standardized Nordic Questionnaire for the Analysis of Musculoskeletal Symptoms and the Demand Control Support Questionnaire, as well as a questionnaire of personal details. All of the study participants complained of musculoskeletal pain in the past year; the most frequent complaints being in the left wrist. Statistically significant correlations were found between biodemographic indices and reports of pain in the past year and the previous week. No significant correlations were found between the physical posture while playing and reports of pain among professional guitarists. However, a difference was found in several kinematic parameters between seated and standing playing postures. In a majority of the joints, the joint angles while playing in a seated position were more extreme than those during standing. This finding may suggest a higher risk for musculoskeletal disorder while playing in a seated position. In conclusion, the results of the present research highlight the prevalence of musculoskeletal problems in guitar players and its correlation with various risk factors. The finding supports the need for intervention in the form of prevention through identifying the risk factors and addressing them. Relating to the person, to their occupation and environment, which are the basis of proper occupational therapy, can help meet this need.

Keywords: body posture, motion tracking, PRMD, guitarists

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14255 Holistic Risk Assessment Based on Continuous Data from the User’s Behavior and Environment

Authors: Cinzia Carrodano, Dimitri Konstantas

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Risk is part of our lives. In today’s society risk is connected to our safety and safety has become a major priority in our life. Each person lives his/her life based on the evaluation of the risk he/she is ready to accept and sustain, and the level of safety he/she wishes to reach, based on highly personal criteria. The assessment of risk a person takes in a complex environment and the impact of actions of other people’actions and events on our perception of risk are alements to be considered. The concept of Holistic Risk Assessment (HRA) aims in developing a methodology and a model that will allow us to take into account elements outside the direct influence of the individual, and provide a personalized risk assessment. The concept is based on the fact that in the near future, we will be able to gather and process extremely large amounts of data about an individual and his/her environment in real time. The interaction and correlation of these data is the key element of the holistic risk assessment. In this paper, we present the HRA concept and describe the most important elements and considerations.

Keywords: continuous data, dynamic risk, holistic risk assessment, risk concept

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14254 Assessment of Predictive Confounders for the Prevalence of Breast Cancer among Iraqi Population: A Retrospective Study from Baghdad, Iraq

Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

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Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m2. 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal Breast Cancer, Hormone Sensitivity, Iraq, Risk Factors

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14253 Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Tunisia: Risk and Protective Factor

Authors: Ahmed Sami Hammami, Mohamed Jellazi

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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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14252 Risk Factors Associated with Ectoprotozoa Infestation of Wild and Farmed Cyprinids

Authors: M. A. Peribanez, G. Illan, I. De Blas, A. Muniesa, I. Ruiz-Zarzuela

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Intensive aquaculture is commonly associated with increased incidence of parasites. However, in Spain, the recent intensification of cyprinid production has not led to knowledge of the parasites that develop in the aquaculture facilities, the factors that affect their development and spread and the transmission between wild and cultivated fish species. The present study focuses on the knowledge of environmental factors, as well as host dependent factors, and their possible influence as risk factors in the incidence and intensity of parasitic infections. This work was conducted in the Duero River Basin, NW Spain. A total of 114 tenches (Tinca tinca) were caught in a fish farm and 667 specimens belonging to six species of cyprinid, not tench, in five rivers. An exhaustive search and microscopic identification of protozoa on skin and gills were carried out. Physical, chemical, and biological parameters of water samples from the capture points were determined. Only two ectoprotozoa were identified, Ichthyophthirius multifiliis and Tripartiella sp. In I. multifiliis, a high intensity of infection (more than 40 parasites on the body surface and more than 80 on gills) was determined in farmed tench (14%) and in Iberian barbel (Luciobarbus bocagei) (91%) and Duero nase (Pseudochondrostoma duriense) (71%) of middle stretches of rivers. The prevalence was similar between farmed tenches and cyprinids of middle courses. Tripartiella sp. was only found in barbels (prevalence in middle stretches, 0.7%) and in farmed tenches (63%), this species resulting in a high risk factor (odds ratio, OR= 1143) in the presence of the ciliate. There were no differences between the two species relative to the intensity of parasitization. Some of the physical, chemical and microbiological water quality parameters appear to be risk factors in the presence of I. multifiliis, with maximum OR of 8. Nevertheless, in Tripartiella sp., the risk is multiplied by 720 when the pH value exceeds 8.4, if we consider the total of the data, and it is increased more than 500 times if we only consider the values recorded in the fish farm (529 by nitrates > 3 mg/l; 530 by total coliforms > 100 CFU/100 ml). However, the high prevalence and risk of infection by I. multifiliis and Tripartiella sp. in fish farms should be related to environmental factors that dependent upon sampling point rather than in direct influence of the physical-chemical and biological parameters of the water. The high pH value recorded in the fish farm (9.62 ± 0.76) is the only parameter that we consider may have a substantial direct influence. Chronic exposure to alkaline pH levels can be a chronic stress generator, predisposing to parasitization by Tripartiella sp. In conclusion, often minor changes in ecosystem conditions, both natural and man-made, can modify the host-parasite relationship, resulting in an increase in the prevalence and intensity of parasitic infections in populations of cyprinids, sometimes causing disease outbreaks.

Keywords: cyprinids, fish, parasites, protozoa, risk factors

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14251 Risk Management in Islamic Banks: A Case Study of the Faisal Islamic Bank of Egypt

Authors: Mohamed Saad Ahmed Hussien

Abstract:

This paper discusses the risk management in Islamic banks and aims to determine the difference in the practices and methods of risk management in those banks compared to the conventional banks, and to make a case study of the biggest Islamic bank in Egypt (Faisal Islamic Bank of Egypt) to identify the most important financial risks faced and how to manage those risks. It was found that Islamic banks face two types of risks. The first type is similar to the risks in conventional banks; the second type is the additional risks which facing the Islamic banks only as a result of some Islamic modes of financing. With regard to the risk management, Islamic banks such as conventional banks applied the regulatory rules issued by the Central Banks and the Basel Committee; Islamic banks also applied the instructions and procedures issued by the Islamic Financial Services Board (IFSB). Also, Islamic banks are similar to the conventional banks in the practices and methods which they use to manage the risks. And there are some factors that may affect the risk management in Islamic banks, such as the size of the bank and the efficiency of the administration and the staff of the bank.

Keywords: conventional banks, Faisal Islamic Bank of Egypt, Islamic banks, risk management

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14250 Study of Hypertension at Sohag City: Upper Egypt Experience

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

Abstract:

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

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

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14249 Effect of Methanol Root Extracts of Moringa Oleifera on Lipid Profile Parameters, Atherogenic Indices and HMG – CoA Reductase Activities of Poloxamer 407-Induced Hyperlipidemic Rats

Authors: Matthew Ocheleka Itodo, Ogo Agbo Ogo, Agnes Ogbene Abutu, Bawa Inalegwu

Abstract:

Hyperlipidemia is characterised by elevated serum total cholesterol and low density and very low-density lipoprotein cholesterol and decreased high-density lipoprotein are the risk factor for coronary heart diseases. There are claims by traditional medicine practitioners in Nigeria that Moringa oleifera plants are used for the treatment of cardiovascular diseases, but it appears there is no scientific research and, publication or documented work to verify these claims. This study aimed to determine the effect of methanol root extracts of Moringa oleifera on Lipid profile, Atherogenic indices and 3 hydroxyl 3 methylglutaryl Coenzyme A reductase activity of poloxamer 407-induced hyperlipidemic rats. The animals were grouped into 8; Group 1: Normal control, Group 2: Hyperlipidemic control. Groups 2 to 8 were induced with Poloxamer 407 1000 mg/Kg body weight. However, group 3 were treated with standard drugs (atorvastatin). Group 4 was treated with crude extract, and groups 5 to 8 were treated with purified fractions from column chromatography. The preliminary antihyperlipidemic study showed Methanol root extract at 200 mg/kg body weight significantly (p≤0.05) decreased total cholesterol, low-density lipoprotein, triacylglyceride, 3 hydroxyls 3 methylglutaryl Coenzyme A reductase, and increase high-density lipoprotein of hyperlipidemic treated groups. Screening the extracts for the most potent anti-hyperlipidemic activity reveals that fraction 1 of Total Cholesterol and Fraction 3 of Triacylglyceride have the highest percentage reduction of 56% and 51%, respectively. The atherogenic risk factor of all induced treated rats shows a significant (p<0.05) decrease in levels of Castelli’s risk index II, atherogenic index of plasma and a significant (p<0.05) higher level of Castelli’s risk index I ratio. The study shows that the methanol extract of root possesses antihyperlipidemic effects and may explain why it has been found to be useful in the management of cardiovascular diseases by traditional medicine practitioners.

Keywords: hyperlipidemia, moringa oleifera, poloxamer 407, lipid profile

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14248 A Risk Management Approach for Nigeria Manufacturing Industries

Authors: Olaniyi O. Omoyajowo

Abstract:

To be successful in today’s competitive global environment, manufacturing industry must be able to respond quickly to changes in technology. These changes in technology introduce new risks and hazards. The management of risk/hazard in a manufacturing process recommends method through which the success rate of an organization can be increased. Thus, there is a continual need for manufacturing industries to invest significant amount of resources in risk management, which in turn optimizes the production output and profitability of any manufacturing industry (if implemented properly). To help improve the existing risk prevention and mitigation practices in Small and Medium Enterprise (SME) in Nigeria Manufacturing Industries (NMI), the researcher embarks on this research to develop a systematic Risk Management process.

Keywords: manufacturing management, risk, risk management, SMEs

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14247 Environmental Safety and Occupational Health Risk Assessment for Rocket Static Test

Authors: Phontip Kanlahasuth

Abstract:

This paper presents the environmental safety and occupational health risk assessment of rocket static test by assessing risk level from probability and severity and then appropriately applying the risk control measures. Before the environmental safety and occupational health measures are applied, the serious hazards level is 31%, medium level is 24% and low level is 45%. Once risk control measures are practically implemented, the serious hazard level can be diminished, medium level is 38%, low level is 45% and eliminated level is 17%. It is clearly shown that the environmental safety and occupational health measures can significantly reduce the risk level.

Keywords: rocket static test, hazard, risk, risk assessment, risk analysis, environment, safety, occupational health, acceptable risk, probability, severity, risk level

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14246 An Evaluation of the Efficacy of School-Based Suicide Prevention Programs

Authors: S. Wietrzychowski

Abstract:

The following review has identified specific programs, as well as the elements of these programs, that have been shown to be most effective in preventing suicide in schools. Suicide is an issue that affects many students each year. Although this is a prominent issue, there are few prevention programs used within schools. The primary objective of most prevention programs is to reduce risk factors such as depression and hopelessness, and increase protective factors like support systems and help-seeking behaviors. Most programs include a gatekeeper training model, education component, peer support group, and/or counseling/treatment. Research shows that some of these programs, like the Signs of Suicide and Youth Aware of Mental Health Programme, are effective in reducing suicide behaviors and increasing protective factors. These programs have been implemented in many countries across the world and have shown promising results. Since schools can provide easy access to adolescents, implement education programs, and train staff members and students how to identify and to report suicide behaviors, school-based programs seem to be the best way to prevent suicide among adolescents. Early intervention may be an effective way to prevent suicide. Although, since early intervention is not always an option, school-based programs in high schools have also been shown to decrease suicide attempts by up to 50%. As a result of this presentation, participants will be able to 1.) list at least 2 evidence-based suicide prevention programs, 2.) identify at least 3 factors which protect against suicide, and 3.) describe at least 3 risk factors for suicide.

Keywords: school, suicide, prevention, programs

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14245 Risk Factors and Biomarkers for the Recurrence of Ovarian Endometrioma: About the Immunoreactivity of Progesterone Receptor Isoform B and Nuclear Factor Kappa B.

Authors: Ae Ra Han, Taek Hoo Lee, Sun Zoo Kim, Hwa Young Lee

Abstract:

Introduction: Ovarian endometrioma is one of the important causes of poor ovarian reserve and up to half of them have recurred. However, the treatment for recurrence prevention has limited efficiency and repeated surgical management makes worsen the ovarian reserve. To find better management for recurrence prevention, we investigated risk factors and biomarkers for the recurrence of ovarian endometrioma. Methods: The medical records of women with the history of surgical dissection for ovarian endometrioma were collected. After exclusion of the cases with concurrent hysterectomy, been menopaused during follow-up, incomplete medical record, and loss of follow-up, a total of 134 women were enrolled. Immunohistochemical staining for progesterone receptor isoform B (PR-B) and nuclear factor kappa B (NFκB) was done with the fixed tissue blocks of their endometriomas which were collected at the time of surgery. Results: Severity of dysmenorrhea and co-existence of adenomyosis had significant correlation with recurrence of endometrioma. Increased PR-B (P = .041) and decreased NFκB (P = .036) immunoreactivity were found in recurrent group. Serum CA-125 level at the time of recurrence was higher than the highest level of CA-125 during follow-up in unrecurred group (55.6 vs. 21.3 U/mL, P = .014). Conclusion: We found that the severity of dysmenorrhea and coexistence of adenomyosis are risk factors for recurrence of ovarian endometrioma, and serial follow-up of CA-125 is effective to detect and prevent the recurrence. However, to determine the possibility of immunoreactivity of PR-B and NFκB as biomarkers for ovarian endometrioma, further studies of various races and large numbers with prospective design are needed.

Keywords: endometriosis, recurrence, biomarker, risk factor

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14244 Determinants of Smallholder Farmers' Intention to Adopt Jatropha as Raw Material for Biodiesel Production: A Proposed Model for Nigeria

Authors: Abdulsalam Mas’ud

Abstract:

Though Nigerian Biofuel Policy and Incentive was introduced in 2007, however, little if any is known about the impact of such policy for biodiesel development in Nigeria. It can be argued that lack of raw materials is one of the important factors that hinder the proper implementation of the policy. In line with this argument, this study aims to explore the determinants of smallholder farmers’ intention to adopt Jatropha as raw materials for biodiesel development in northern Nigeria, with Jigawa State as area of study. The determinants proposed for investigation covers personal factors, physical factors, institutional factors, economic factors, risk and uncertainty factors as well as social factors. The validation of the proposed model will have the implication of guiding policymakers towards enhancement of farmers’ participation in the Jatropha project for biodiesel raw materials production. The eventual byproducts of the proposed model validation and implementation will be employment generation, poverty reduction, combating dessert encroachment, economic diversification to renewable energy sources and electricity generation.

Keywords: adoption, biodiesel, factors, jatropha

Procedia PDF Downloads 275
14243 Toward a Risk Assessment Model Based on Multi-Agent System for Cloud Consumer

Authors: Saadia Drissi

Abstract:

The cloud computing is an innovative paradigm that introduces several changes in technology that have resulted a new ways for cloud providers to deliver their services to cloud consumers mainly in term of security risk assessment, thus, adapting a current risk assessment tools to cloud computing is a very difficult task due to its several characteristics that challenge the effectiveness of risk assessment approaches. As consequence, there is a need of risk assessment model adapted to cloud computing. This paper requires a new risk assessment model based on multi-agent system and AHP model as fundamental steps towards the development of flexible risk assessment approach regarding cloud consumers.

Keywords: cloud computing, risk assessment model, multi-agent system, AHP model, cloud consumer

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14242 Developing Measurement Instruments for Enterprise Resources Planning (ERP) Post-Implementation Failure Model

Authors: Malihe Motiei, Nor Hidayati Zakaria, Davide Aloini

Abstract:

This study aims to present a method to develop the failure measurement model for ERP post-implementation. To achieve this outcome, the study firstly evaluates the suitability of Technology-Organization-Environment framework for the proposed conceptual model. This study explains how to discover the constructs and subsequently to design and evaluate the constructs as formative or reflective. Constructs are used including reflective and purely formative. Then, the risk dimensions are investigated to determine the instruments to examine the impact of risk on ERP failure after implementation. Two construct as formative constructs consist inadequate implementation and poor organizational decision making. Subsequently six construct as reflective construct include technical risks, operational risks, managerial risks, top management risks, lack of external risks, and user’s inefficiency risks. A survey was conducted among Iranian industries to collect data. 69 data were collected from manufacturing sectors and the data were analyzed by Smart PLS software. The results indicated that all measurements included 39 critical risk factors were acceptable for the ERP post-implementation failure model.

Keywords: critical risk factors (CRFs), ERP projects, ERP post-implementation, measurement instruments, ERP system failure measurement model

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14241 Association between Physical Inactivity and Sedentary Behaviours with Risk of Hypertension among Sedentary Occupation Workers: A Cross-Sectional Study

Authors: Hanan Badr, Fahad Manee, Rao Shashidhar, Omar Bayoumy

Abstract:

Introduction: Hypertension is the major risk factor for cardiovascular diseases and stroke and a universe leading cause of disability-adjusted life years and mortality. Adopting an unhealthy lifestyle is thought to be associated with developing hypertension regardless of predisposing genetic factors. This study aimed to examine the association between recreational physical activity (RPA), and sedentary behaviors with a risk of hypertension among ministry employees, where there is no role for occupational physical activity (PA), and to scrutinize participants’ time spent in RPA and sedentary behaviors on the working and weekend days. Methods: A cross-sectional study was conducted among randomly selected 2562 employees working at ten randomly selected ministries in Kuwait. To have a representative sample, the proportional allocation technique was used to define the number of participants in each ministry. A self-administered questionnaire was used to collect data about participants' socio-demographic characteristics, health status, and their 24 hours’ time use during a regular working day and a weekend day. The time use covered a list of 20 different activities practiced by a person daily. The New Zealand Physical Activity Questionnaire-Short Form (NZPAQ-SF) was used to assess the level of RPA. The scale generates three categories according to the number of hours spent in RPA/week: relatively inactive, relatively active, and highly active. Gender-matched trained nurses performed anthropometric measurements (weight and height) and measuring blood pressure (two readings) using an automatic blood pressure monitor (95% accuracy level compared to a calibrated mercury sphygmomanometer). Results: Participants’ mean age was 35.3±8.4 years, with almost equal gender distribution. About 13% of the participants were smokers, and 75% were overweight. Almost 10% reported doctor-diagnosed hypertension. Among those who did not, the mean systolic blood pressure was 119.9±14.2 and the mean diastolic blood pressure was 80.9±7.3. Moreover, 73.9% of participants were relatively physically inactive and 18% were highly active. Mean systolic and diastolic blood pressure showed a significant inverse association with the level of RPA (means of blood pressure measures were: 123.3/82.8 among relatively inactive, 119.7/80.4 among relatively active, and 116.6/79.6 among highly active). Furthermore, RPA occupied 1.6% and 1.8% of working and weekend days, respectively, while sedentary behaviors (watching TV, using electronics for social media or entertaining, etc.) occupied 11.2% and 13.1%, respectively. Sedentary behaviors were significantly associated with high levels of systolic and diastolic blood pressure. Binary logistic regression revealed that physical inactivity (OR=3.13, 95% CI: 2.25-4.35) and sedentary behaviors (OR=2.25, CI: 1.45-3.17) were independent risk factors for high systolic and diastolic blood pressure after adjustment for other covariates. Conclusions: Physical inactivity and sedentary lifestyle were associated with a high risk of hypertension. Further research to examine the independent role of RPA in improving blood pressure levels and cultural and occupational barriers for practicing RPA are recommended. Policies should be enacted in promoting PA in the workplace that might help in decreasing the risk of hypertension among sedentary occupation workers.

Keywords: physical activity, sedentary behaviors, hypertension, workplace

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14240 Governance, Risk Management, and Compliance Factors Influencing the Adoption of Cloud Computing in Australia

Authors: Tim Nedyalkov

Abstract:

A business decision to move to the cloud brings fundamental changes in how an organization develops and delivers its Information Technology solutions. The accelerated pace of digital transformation across businesses and government agencies increases the reliance on cloud-based services. They are collecting, managing, and retaining large amounts of data in cloud environments makes information security and data privacy protection essential. It becomes even more important to understand what key factors drive successful cloud adoption following the commencement of the Privacy Amendment Notifiable Data Breaches (NDB) Act 2017 in Australia as the regulatory changes impact many organizations and industries. This quantitative correlational research investigated the governance, risk management, and compliance factors contributing to cloud security success. The factors influence the adoption of cloud computing within an organizational context after the commencement of the NDB scheme. The results and findings demonstrated that corporate information security policies, data storage location, management understanding of data governance responsibilities, and regular compliance assessments are the factors influencing cloud computing adoption. The research has implications for organizations, future researchers, practitioners, policymakers, and cloud computing providers to meet the rapidly changing regulatory and compliance requirements.

Keywords: cloud compliance, cloud security, data governance, privacy protection

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14239 The Anti-Inflammatory Effects of Nanodiamond Particles and Lipoic Acid on Rats' Cardiovascular System

Authors: Beata Skibska, Andrzej Stanczak, Agnieszka Skibska

Abstract:

Nanodiamond (ND) is a carbon nanomaterial that has high biocompatibility, and it has a very positive effect on a number of biochemical processes. NDs have great potential in treating multiple inflammation-associated diseases. The purpose of this study was to investigate the anti-inflammatory effect of nanodiamonds and lipoic acid (LA) (as antioxidants) on rats' cardiovascular systems after lipopolysaccharide (LPS) administration. Animal experiments enabled the determination of how nanodiamonds act when applied independently or in combination with lipoic acid. The effect of NDs and LA on C-reactive protein (CRP) levels and heart edema was evaluated. NDs and LA administered after LPS administration attenuated heart edema and significantly decreased the CRP level. The results suggest that NDs and LA play an important role in LPS-induced inflammation in the heart. NDs find new applications in modern biomedical science and biotechnologies.

Keywords: nanodiamonds, lipoic acid, inflammation, cardiovascular system

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