Search results for: risk factor

Authors: Alfred Kamate Siviri, Angelus Mafikiri Tsongo, Jean Robert Kala Kamdjoug

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Digitalization and information systems well organized have been selected as relevant measures to mitigate operational risks within organizations. Unfortunately, information system comes with new threats that can cause severe damage and quick organization lockout. This study aims to measure perceived information system risks and their effects on operational risks within the microfinance institution in D.R. Congo. Also, the factors influencing the operational risk are identified, and the link between operational risk with other risks and performance is to be assessed. The study proposes a research model drawn on the combination of Resources-Based-View, dynamic capabilities, the agency theory, the Information System Security Model, and social theories of risk. Therefore, we suggest adopting a mixed methods research with the sole aim of increasing the literature that already exists on perceived operational risk assessment and its link with other risk and performance, a focus on IT risk.

Keywords: Democratic Republic Congo, information system risk, microfinance performance, operational risk

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Authors: Alexander Kelíšek, Denisa Janasová, Veronika Mitašová

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Weak signals using is often associated with early warning. It is possible to find a link between early warning, respectively early problems detection and risk management. The idea of early warning is very important in the context of crisis management because of the risk prevention possibility. Weak signals are likened to risk symptoms. Nowadays, their usefulness as a tool of proactive problems solving is emphasized. Based on it, it is possible to use weak signals not only in strategic planning, project management, or early warning system, but also as a subsidiary element in risk management. The main question is how to effectively integrate weak signals into risk management. The main aim of the paper is to point out the possibilities of weak signals using in small and medium enterprises risk management.

Keywords: early warning system, weak signals, risk management, small and medium enterprises (SMEs)

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

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

Keywords: delirium, risk factors, outcome, intervention

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Authors: Berrin Şentürk

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In this study, due to the recurrence of bovine tuberculosis, in the same areas, the risk factors for the disease were determined and evaluated at the local level. This study was carried out in 32 farms where the disease was detected in the district and center of Samsun province in 2014. Predetermined risk factors, such as farm, environmental and economic risks, were investigated with the survey method. It was predetermined that risks in the three groups are similar to the risk variables of the disease on the global scale. These risk factors that increase the susceptibility of the infection must be understood by the herd owners. The risk-based contagious disease management system approach should be applied for bovine tuberculosis by farmers, animal health professionals and public and private sector decision makers.

Keywords: bovine tuberculosis, disease management, control, outbreak, risk analysis

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Authors: Etienne Sugewe

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Purpose: The establishment of a positive HIV serologic status of an individual could have been an inhibitory factor to prevent risk behaviours in people living with HIV/AIDS. We conducted a cross-sectional study in order to assess the prevalence and predictors of risk behaviors among HIV-positive people in Douala-Cameroon. Methods: We used pre-checked questionnaires to systematically collect data from four HIV treatment centers in Douala. This was done to some of them during the distribution of drugs and to others during their classical rendezvous between the months of May and July 2012. The Chi-Square and Student t-test were used for cross tabulation of variables; multiple regression analysis was performed to identify predictors of risky sexual behaviours. Results: Of the 330 persons interviewed, sixty percent were reported to have had sexual intercourse after the diagnosis of HIV. We obtained 37% HIV-positive partners, and 63% had HIV- negative partners or partners with unknown status. Among our patients, 45% of the subjects with regular partners reported to have had anal or vaginal sex. Those whose score on the knowledge about HIV/AIDS was < 50% and where 90% of them were less susceptible to the condom during intercourse (p: 0.01). About 74% of patients on ARV were less susceptible to the use of condoms during sexual intercourse (p: 0.03). Conclusion: Risk sexual behaviours among people living with HIV/AIDS are common and potentially expose their partners. For HIV-positive partners, these habits pose a real risk of suprainfection by other strains of HIV. The need to increase awareness and education among people living with HIV is therefore highly recommended.

Keywords: HIV/AIDS, behaviours, HIV positive, Douala, 2012

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Authors: Wee Tong Liaw, Elaine Wong Yee Sing

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The main objective and focus of this study are to establish the significance of a sustained health promoting workplace on stock and portfolio returns focusing on companies listed on the Singapore stock exchange, using a two-factor model comprising of the single factor CAPM and a 'health promoting workplace' factor. The 'health promoting workplace' factor represents the excess returns derived between two portfolios of component stocks that, when combined, would represent a top tier stock market index in Singapore, namely the STI index. The first portfolio represents companies that are independently assessed by the Singapore’s Health Award, SHA, to have a sustained and comprehensive health promoting workplace (SHA-STI portfolio) and the second portfolio represents companies that had not been independently assessed (Non-SHA STI portfolio). Since 2001, many companies in Singapore have voluntarily participated in the bi-annual Singapore HEALTH Award initiated by the Health Promotion Board of Singapore (HPB). The Singapore HEALTH Award (SHA), is an industry-wide award and assessment process. SHA assesses and recognizes employers in Singapore for implementing a comprehensive and sustainable health promotion programme at their workplaces. When using a ten year holding period instead of a one year holding period, excess returns in the SHA-STI portfolio over Non-SHA STI portfolio were consistently being observed over all test periods, during 2001 to 2013. In addition, when applied to the SHA-STI portfolio, results from the Two Factor Model consistently revealed higher explanatory powers across all test periods for the portfolio as well as all the individual component stocks in SHA-STI portfolio, than the single factor CAPM model. However, with respect to attaining higher level of achievement in the Singapore Health Award, this study did not show any incentive for selecting listed companies that have achieved a higher level of award. Results from this study would give further insights to investors and fund managers alike who intend to consider health promoting workplace as a risk factor in their stock or portfolio selection process, in particular for investors who have a preference for STI’s component stocks and with a longer investment horizon. Key micro factors like management abilities, business development strategies and production capabilities that meet the needs of market would create the demand for a company’s product(s) or service(s) and consequently contribute to its top line and profitability. Thereafter, the existence of a sustainable health promoting workplace would be a key catalytic factor in sustaining a productive workforce needed to support the continued success of a profitable business.

Keywords: asset pricing model, company's performance, stock returns, financial risk factor, sustained health promoting workplace

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Authors: Fidelis E. Uwumiro, Chimaobi O. Nwevo, Favour O. Osemwota, Victory O. Okpujie, Emeka S. Obi, Omamuyovbi F. Nwoagbe, Ejiroghene Tejere, Joycelyn Adjei-Mensah, Christopher N. Ekeh, Charles T. Ogbodo

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Several risk factors associated with cardiovascular events have been identified as specific to Chronic Kidney Disease (CKD). This study endeavors to validate these CKD-specific risk factors using up-to-date national-level data, thereby highlighting the crucial significance of confirming the validity and generalizability of findings obtained from previous studies conducted on smaller patient populations. The study utilized the nationwide inpatient sample database to identify adult hospitalizations for CKD from 2016 to 2020, employing validated ICD-10-CM/PCS codes. A comprehensive literature review was conducted to identify both traditional and CKD-specific risk factors associated with cardiovascular events. Risk factors and cardiovascular events were defined using a combination of ICD-10-CM/PCS codes and statistical commands. Only risk factors with specific ICD-10 codes and hospitalizations with complete data were included in the study. Cardiovascular events of interest included cardiac arrhythmias, sudden cardiac death, acute heart failure, and acute coronary syndromes. Univariate and multivariate regression models were employed to evaluate the association between chronic kidney disease-specific risk factors and cardiovascular events while adjusting for the impact of traditional CV risk factors such as old age, hypertension, diabetes, hypercholesterolemia, inactivity, and smoking. A total of 690,375 hospitalizations for CKD were included in the analysis. The study population was predominantly male (375,564, 54.4%) and primarily received care at urban teaching hospitals (512,258, 74.2%). The mean age of the study population was 61 years (SD 0.1), and 86.7% (598,555) had a CCI of 3 or more. At least one traditional risk factor for CV events was present in 84.1% of all hospitalizations (580,605), while 65.4% (451,505) included at least one CKD-specific risk factor for CV events. The incidence of CV events in the study was as follows: acute coronary syndromes (41,422; 6%), sudden cardiac death (13,807; 2%), heart failure (404,560; 58.6%), and cardiac arrhythmias (124,267; 18%). 91.7% (113,912) of all cardiac arrhythmias were atrial fibrillations. Significant odds of cardiovascular events on multivariate analyses included: malnutrition (aOR: 1.09; 95% CI: 1.06–1.13; p<0.001), post-dialytic hypotension (aOR: 1.34; 95% CI: 1.26–1.42; p<0.001), thrombophilia (aOR: 1.46; 95% CI: 1.29–1.65; p<0.001), sleep disorder (aOR: 1.17; 95% CI: 1.09–1.25; p<0.001), and post-renal transplant immunosuppressive therapy (aOR: 1.39; 95% CI: 1.26–1.53; p<0.001). The study validated malnutrition, post-dialytic hypotension, thrombophilia, sleep disorders, and post-renal transplant immunosuppressive therapy, highlighting their association with increased risk for cardiovascular events in CKD patients. No significant association was observed between uremic syndrome, hyperhomocysteinemia, hyperuricemia, hypertriglyceridemia, leptin levels, carnitine deficiency, anemia, and the odds of experiencing cardiovascular events.

Keywords: cardiovascular events, cardiovascular risk factors in CKD, chronic kidney disease, nationwide inpatient sample

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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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Authors: Fawad Ali

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Toxic heavy metal contamination has a negative impact on soil quality which ultimately pollutes the agriculture system. In the current work, we analyzed uptake of various heavy metals by dietary vegetables grown in wastewater irrigated areas of Swabi city. The samples of soil and vegetables were analyzed for heavy metals viz Cd, Cr, Mn, Fe, Ni, Cu, Zn and Pb using Atomic Absorption Spectrophotometer. High levels of metals were found in wastewater irrigated soil and vegetables in the study area. Especially the concentrations of Pb and Cd in the dietary vegetable crossed the permissible level of World Health Organization. Substantial positive correlation was found among the soil and vegetable contamination. Transfer factor for some metals including Cr, Zn, Mn, Ni, Cd and Cu was greater than 0.5 which shows enhanced accumulation of these metals due to contamination by domestic discharges and industrial effluents. Linear regression analysis indicated significant correlation of heavy metals viz Pb, Cr, Cd, Ni, Zn, Cu, Fe and Mn in vegetables with concentration in soil of 0.964 at P≤0.001. Abelmoschus esculentus indicated Health Risk Index (HRI) of Pb >1 in adults and children. The source identification analysis carried out by Principal Component Analysis (PCA) and Cluster Analysis (CA) showed that ground water and soil were being polluted by the trace metals coming out from industries and domestic wastes. Hierarchical cluster analysis (HCA) divided metals into two clusters for wastewater and soil but into five clusters for soil of control area. PCA extracted two factors for wastewater, each contributing 61.086 % and 16.229 % of the total 77.315 % variance. PCA extracted two factors, for soil samples, having total variance of 79.912 % factor 1 and factor 2 contributed 63.889 % and 16.023 % of the total variance. PCA for sub soil extracted two factors with a total variance of 76.136 % factor 1 being 61.768 % and factor 2 being 14.368 %of the total variance. High pollution load index for vegetables in the study area due to metal polluted soil has opened a study area for proper legislation to protect further contamination of vegetables. This work would further reveal serious health risks to human population of the study area.

Keywords: health risk, vegetables, wastewater, atomic absorption sepctrophotometer

Procedia PDF Downloads 27

Authors: G. R. Constantine, M.C.K. Thilakasiri, V.S. Mohottala, T.V. Soundaram, D.S. Rathnayake, E.G.H.E. De Silva, A.L.S. Mohamed, V.R. Weerasekara

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Orthostatic hypotension is prevalent in the elderly population, and it is an important risk factor contributing to falls in the elderly. This study aims to evaluate the prevalence of orthostatic hypotension in hospitalized elderly patients, changes in blood pressure during the hospital stay, morbidities associated with it and its association with falls in the elderly. A cross-sectional descriptive study was conducted in the National Hospital of Sri Lanka (NHSL) in a sample of 120 patients of age 65 years or above who were admitted to the medical wards. The demographic, clinical data was obtained by an interviewer-administered questionnaire. Two validated questionnaires were used to assess symptoms and effects of orthostatic hypotension and risk factors associated with falls. Orthostatic hypotension on admission and after 3 days of hospital stay was measured by bed-side mercury sphygmomanometer. Prevalence of orthostatic hypotension among the study population was 63.3%(76 patients). But no significant change in the orthostatic hypotension noted after 3 days of hospital admission (SND 0.61, SE= 5.59, p=0.27). There was no significant association found between orthostatic hypotension and its symptoms (dizziness and vertigo, vision problems, malaise, fatigue, poor concentration, neck stiffness), impact on standing or walking and non-communicable diseases. Falls were experienced by 27.5 % (33 patients) of the study population and prevalence of patients with orthostatic hypotension who had experienced falls was 25.9% (28 patients). In conclusions, orthostatic hypotension is more prevalent among elderly patients, but It wasn’t associated with symptoms, and non-communicable diseases, or as a risk factor for falls in elderly.

Keywords: orthostatic hypotension, elderly falls, emergency geriatric, Sri Lanka

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Authors: Saud Al Mahdi

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Traditionally,portfolio managers have been discouraged from timing the market. This means, for example, that equity managers have been forced to adhere strictly to a benchmark with static or relatively stable components, such as the SP 500 or the Russell 3000. This means that the portfolio’s exposures to all risk factors should mimic as closely as possible the corresponding exposures of the benchmark. The main risk factor, of course, is the market itself. Effectively, a long-only portfolio would be constrained to have a beta 1. More recently, however, managers have been given greater discretion to adjust their portfolio’s risk exposures (in particular, the beta of their portfolio) dynamically to match the manager’s beliefs about future performance of the risk factors themselves. This freedom translates into the manager’s ability to adjust the portfolio’s beta dynamically. These strategies have come to be known as smart beta strategies. Adjusting beta dynamically amounts to attempting to "time" the market; that is, to increase exposure when one anticipates that the market will rise, and to decrease it when one anticipates that the market will fall. Traditionally, market timing has been believed to be impossible to perform effectively and consistently. Moreover, if a majority of market participants do it, their combined actions could destabilize the market. The aim of this project is to investigate so-called smart beta strategies to determine if they really can add value, or if they are merely marketing gimmicks used to sell dubious investment strategies.

Keywords: beta, alpha, active portfolio management, trading strategies

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Authors: Marko Živanović, Jovana Bjekić, Maša Vukčević Marković

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Professionals and volunteers involved in refugee protection and support are on a daily basis faced with people who have experienced numerous traumatic experiences and, as such, are subjected to secondary traumatization (ST). The aim of this study was to provide insight into risk factors for ST in helpers working with refugees in Serbia. A total of 175 participants working with refugees fulfilled: Secondary Traumatization Questionnaire, checklist of refugees’ traumatic experiences, Hopkins Symptoms Checklist (HSCL) assessing depression and anxiety symptoms, quality of life questionnaire (MANSA), HEXACO personality inventory, and COPE assessing coping mechanisms. In addition, participants provided information on work-related problems. Qualitative analysis of answers to the question about most difficult part of their job has shown that burnout-related issues are clustered around three recurrent topics that can be considered as the most prominent generators of stress, namely: ‘lack of organization and cooperation’, ‘not been able to do enough’, and ‘hard to take it and to process it’. Factor analysis (Maximum likelihood extraction, Promax rotation) have shown that ST comprises of two correlated factors (r = .533, p < .01), namely Psychological deficits and Intrusions. Results have shown that risk factor for ST could be find in three interrelated sources: 1) work-related problems; 2) personality-related risk factors and 3) clients’ traumatic experiences. Among personality related factors, it was shown that risk factor for Intrusions could be find in – high Emotionality (β = .221, p < .05), and Altruism (β = .322, p < .01), while low Extraversion (β = -.365, p < .01) represents risk factor for Psychological deficits. In addition, usage of maladaptive coping mechanisms –mental disengagement (r = .253, p < .01), behavioral disengagement (r = .274, p < .01), focusing on distress and venting of emotions (r = .220, p < .05), denial (r = .164, p < .05), and substance use (r = .232, p < .01) correlate with Psychological deficits while Intrusions corelate with Mental disengagement (r = .251, p < .01) and denial (r = .183, p < .05). Regarding clients’ traumatic experiences it was shown that both quantity of traumatic events in country of origin (for Deficits r = .226, p < .01; for Intrusions r = .174, p < .05) and in transit (for Deficits r = .288, p < .01), as well as certain content-related features of such experiences (especially experiences which are severely dislocated from ‘everyday reality’) are related to ST. In addition, Psychological deficits and Intrusions have shown to be accompanied by symptoms of depression (r = .760, p < .01; r = .552, p < .01) and anxiety (r = .740, p < .01; r = .447, p < .01) and overall lower life quality (r = -.454, p < .01; r = .256, p < .01). Results indicate that psychological vulnerability of persons who are working with traumatized individuals can be found in certain personality traits, and usage of maladaptive coping mechanisms, which disable one to deal with work-related issues, and to cope with quantity and quality of traumatic experiences they were faced with, affecting ones’ psychological well-being. Acknowledgement: This research was funded by IRC Serbia.

Keywords: mental health, refugees, secondary traumatization, traumatic experiences

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Authors: D. Subedi, S. Pradhan

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Current transformers are an integral part of power system because it provides a proportional safe amount of current for protection and measurement applications. However when the power system experiences an abnormal situation leading to huge current flow, then this huge current is proportionally injected to the protection and metering circuit. Since the protection and metering equipment’s are designed to withstand only certain amount of current with respect to time, these high currents pose a risk to man and equipment. Therefore during such instances, the CT saturation characteristics have a huge influence on the safety of both man and equipment and also on the reliability of the protection and metering system. This paper shows the effect of burden on the Accuracy Limiting factor/ Instrument security factor of current transformers and also the change in saturation characteristics of the CT’s. The response of the CT to varying levels of overcurrent at different connected burden will be captured using the data acquisition software LabVIEW. Analysis is done on the real time data gathered using LabVIEW. Variation of current transformer saturation characteristics with changes in burden will be discussed.

Keywords: accuracy limiting factor, burden, current transformer, instrument security factor, saturation characteristics

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Authors: Nur H. Ahmad, Silvia S. Inge, Vanessa A. Julliete, A. Veraditias, Laila F. Febinda

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Abdominal obesity is a risk factor for metabolic syndrome and mostly found in adolescents. Waist circumference is related to abdominal obesity which has a significant effect on the increase of blood pressure. Inulin is one of prebiotic, that has health benefits by offering the potential for lipid management, that can be useful to decrease the risk factor of metabolic syndrome. The aim of the research is to evaluate the effect of 10 gram inulin-substituted ice cream in waist circumference and blood pressure of abdominal obesity adolescents. Inulin had the ability to produce Short Chain Fatty Acid which can improve blood pressure and waist circumference. Systolic blood pressure was significantly decreased in the treatment group (p=0.028) with the mean of reduction 7.35 ± 11.59 mmHg. However, diastolic blood pressure and waist circumference showed no significant effect. Waist circumference, systolic blood pressure and diastolic blood pressure was decreased in control group. These results suggest that inulin-substituted ice cream used as therapeutics and prevention for the early onset of metabolic syndrome.

Keywords: blood pressure, inulin, metabolic syndrome, waist circumference

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Authors: Sadia Saleem

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Infertility is a global health concern that may have a long-lasting effect on the psychosocial functioning of an individual. Rich research evidence has shown that women with infertility are at greater risk of adverse psychological experiences than men. The culture plays a risk factor when it comes to infertility. Family is considered as a central focus of a collectivistic culture like Pakistan and having children is the key factor that determines the quality of a marital relationship, individual well-being and overall standing in the society. In this collectivistic cultural context, women usually get the blame and experience more psychological distress and social isolation. A total sample of 121 (M 28.17, SD 4.73) women with primary infertility selected through purposive sampling were tested using Emotional Disclosure Questionnaire, Couple Satisfaction Index and Depression Anxiety Stress Scale. The results indicate that negative emotional disclosure positively mediates the relationship between marital satisfaction and mental health problems (p < .001) in women with primary infertility. The results are discussed in terms of psychosocial counseling and family psychoeducation in Pakistani collectivistic cultural context.

Keywords: infertility, couple satisfaction, emotional disclosure, mental health

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Authors: Ladda Thiamwong, Renata Komalasari

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Falls are the leading cause of disability and hospitalization in low-income older adults. Fear of falling is present in 20% to 85 % of older adults and has been identified as an independent risk factor of fall risk, activity restriction, and loss of independence. About 12% of American older adults have subjective cognitive decline. Cognitive impairment is also an established factor of fall risk. However, it is unclear whether measures of fear of falling and subjective cognitive decline have the greatest association with fall risk in low-income older adults. The aim of this study was to evaluate the association between fear of falling, subjective cognitive decline-functional performance (SCD-FP), and fall risk using simple screening tools. In this cross-section study, we collected data from community-dwelling older adults 60 years or older in low-income settings in Central Florida, and 86 participants were included in the data analysis. Fear of falling was assessed by the Short Fall Efficacy Scale- International (Short FES-I) with seven items. Subjective cognitive decline-functional performance (SCD-FP) was assessed by a self-reported experience of worsening or more frequent confusion or memory loss in the past 12 months and its functional implications. Fall risk was evaluated by the Centers for Disease Control and Prevention (CDC)'s Stay Independent checklist with 12 items. The majority of participants were female, and more than half of the participants were African American. More than half of the participants had a higher school degree or higher, and less than 20% had no financial problems. Less than 30% of the participants perceived their general health as very good- excellent. More than half of the participants lived alone, and less than 15% lived with a partner or spouse. About 60% of the participants had hypertension, 40% had diabetes, 16% had cancer, and 50% had arthritis. About 30% of the participants had difficulty walking up ten steps without resting, more than 40% felt unsteady when walking, and 30% had been advised to use a cane or walker to get around safely. Regression analysis showed that fall risk was associated with fear of falling ( = .524, p <.001) and subjective cognitive decline-functional performance ( = .465, p =.027). The structure coefficient showed that fear of falling (rs2 = .922) was a stronger predictor of fall risk than subjective cognitive decline-functional performance (rs2= .200). Fear of falling and subjective cognitive decline-functional performance are growing public health issues, and addressing those issues is a public priority. Proactive screening for fear of falling and subjective cognitive decline-functional performance is critical in fall prevention. A combination of all three self-reported tools (Short FES-I, SCD-FP, and CDC's Stay Independent checklist) takes less than 5 minutes to complete. Primary care providers or public health professionals should consider including these tools to screen fear of falling and subjective cognitive decline-functional performance as part of fall risk assessment, especially in low-income settings. Thus, encouraging older adults and healthcare professionals to discuss fear of falling, subjective cognitive decline, and fall risk during routine medical office visits.

Keywords: falls, fall risk, fear of falling, cognition, subjective cognitive decline, low-income, older adults, community, screening, nursing, primary care

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Authors: Gerhard Grebe, Johan Marx

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The aim of the study is to assess the state of operational risk management and the adoption of an appropriate risk culture in Ghanaian banks. The Bank of Ghana (BoG) joined the Basel Consultative Group (BCG) of the Basel Committee on Bank Supervision (BCBS) in 2021 and is proceeding with the implementation of the Basel III international regulatory framework for banks. The BoG’s Directive about risk management encourages, inter alia, the creation of an appropriate risk culture by Ghanaian banks. However, it is not evident how the risk management staff of Ghanaian banks experience the risk culture and the implementation of operational risk management in the banks where they are employed. Ghana is a developing economy, and it is addressing challenges with its organisational culture. According to Transparency International, successive Ghanaian governments claim to be fighting corruption, but little success has been achieved so far. This points to a possible lack of accountability, transparency, and integrity in the environment in which Ghanaian banks operate and which could influence their risk culture negatively. Purposive sampling was used for the survey, and the questionnaire was completed byGhanaian bank personnel who specializesin operational risk management, risk governance, and compliance, bank supervision, risk analyses, as well as the implementation of the operational risk management requirements of the Basel regulatory frameworks. The respondents indicated that they are fostering a risk culture and implementing monitoring and reporting procedures; the three lines of defence (3LOD); compliance; internal auditing; disclosure of operational risk information; and receiving guidance from the bank supervisor in an attempt to improve their operational risk management practices. However, the respondents reported the following challenges with staff members who are not inside the risk management departments(in order of priority), namelydemonstrating a risk culture, training and development; communication; reporting and disclosure; roles and responsibilities; performance appraisal; and technological and environmental barriers. Recommendations to address these challenges are provided

Keywords: ghana, operational risk, risk culture, risk management

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Authors: Masoud Ghahvechi Pour

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Risk management is a systematic and regular process of identifying, analyzing and responding to risks throughout the project's life cycle in order to achieve the optimal level of elimination, reduction or control of risk. The purpose of project risk management is to increase the probability and effect of positive events and reduce the probability and effect of unpleasant events on the project. Risk management is one of the most fundamental parts of project management, so that unmanaged or untransmitted risks can be one of the primary factors of failure in a project. Effective risk management does not apply to risk regression, which is apparently the cheapest option of the activity. However, the main problem with this option is the economic sensitivity, because what is potentially profitable is by definition risky, and what does not pose a risk is economically interesting and does not bring tangible benefits. Therefore, in relation to the implemented project, effective risk management is finding a "middle ground" in its management, which includes, on the one hand, protection against risk from a negative direction by means of accurate identification and classification of risk, which leads to analysis And it becomes a comprehensive analysis. On the other hand, management using all mathematical and analytical tools should be based on checking the maximum benefits of these decisions. Detailed analysis, taking into account all aspects of the company, including stakeholder analysis, will allow us to add what will become tangible benefits for our project in the future to effective risk management. Identifying the risk of the project is based on the theory that which type of risk may affect the project, and also refers to specific parameters and estimating the probability of their occurrence in the project. These conditions can be divided into three groups: certainty, uncertainty, and risk, which in turn support three types of investment: risk preference, risk neutrality, specific risk deviation, and its measurement. The result of risk identification and project analysis is a list of events that indicate the cause and probability of an event, and a final assessment of its impact on the environment.

Keywords: risk, management, knowledge, risk management

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Authors: Ulas Cinar, Omer Faruk Ugurlu, Selcuk Cebi

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Occupational safety risk management is the most important element of a safe working environment. Effective risk management can only be possible with accurate analysis and evaluations. Scoring-based risk assessment methods offer considerable ease of application as they convert linguistic expressions into numerical results. It can also be easily adapted to any field. Contrary to all these advantages, important problems in scoring-based methods are frequently discussed. Effective measurability is one of the most critical problems. Existing methods allow experts to choose a score equivalent to each parameter. Therefore, experts prefer the score of the most likely outcome for risk. However, all other possible consequences are neglected. Assessments of the existing methods express the most probable level of risk, not the real risk of the enterprises. In this study, it is aimed to develop a method that will present a more comprehensive evaluation compared to the existing methods by evaluating the probability and severity scores, all sub-parameters, and potential results, and a new scoring-based method is proposed in the literature.

Keywords: occupational health and safety, risk assessment, scoring based risk assessment method, underground mining, weighted risk scores

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Authors: Steven Walker

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This paper assesses recent data on the prevalence of poverty among children and young people diagnosed with mental health problems. The paper will demonstrate that the current hierarchy of risk factors for developing mental health problems needs adjusting to place poverty among the highest risk factors. Globally poverty is calculated to keep rising especially among less developed countries, and the post-Covid 19 economic recession in developed countries is set to rise. The experience of young people enduring Pandemic isolation is already being quantified and is expected to increase referrals for specialist intervention. Searches on several medical/psychological/social databases using keywords: poverty, children, mental illness were undertaken between 2018 and 2021. Worldwide, 700 million people still live in extreme poverty, half of whom are children. Children are physically and mentally disproportionately affected. Children who grow up impoverished lack the basic necessities they need to survive and thrive. 150 million children have been plunged into multidimensional poverty due to COVID-19. The poorest children are twice as likely to die in childhood than their wealthier peers. For those growing up in humanitarian crises such as Ukraine, the risks of deprivation and exclusion are magnified. In the world’s richest countries, one in seven children still live in poverty. Currently, one in four children in the European Union are at risk of falling into poverty. In Europe the impact of Brexit on the UK economy is predicted to reduce GDP by 5% in 2021 with a corresponding rise in poverty. According to the global charity Oxfam wealth inequality impacts levels of child abuse and affects women and girls worse and is a contributory factor in the risk of developing childhood mental illness. In the UK 2000 Foodbanks have opened since 2010, handing out 2 million food parcels annually, where there are currently 4 million children officially living in poverty. This research demonstrates that there is a strong association between families’ socio-economic circumstances and the chances that their children will experience mental illness. Evidence of this association is found repeatedly across developed countries. The paper will conclude by arguing that psychologists, psychiatrists, psychotherapists, social workers and CAMHS specialists need to place more importance on this critical socio-economic variable when assessing referred children and also advocate for political priorities in governments to reduce poverty and lower the risk of childhood mental illness.

Keywords: poverty, resilience, risk factor, socio economic, susceptibility

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Authors: Lenka Jesonkova, Frantisek Bozek

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Trihalogenmethanes (THMs) are disinfection byproducts with non-carcinogenic and genotoxic effects. The contamination of 6 sites close to the water treatment plant has been monitored in second largest city of the Czech Republic. Health risk assessment including both non-carcinogenic and genotoxic risk for long term exposition was realized using the critical concentrations. Concentrations of trihalogenmethanes met national standards in all samples. Risk assessment proved that health risks from trihalogenmethanes are acceptable on each site.

Keywords: drinking water, health risk assessment, trihalogenmethanes, water pollution

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Authors: Guo Yu, Haoming Ma, Peiru Zhou

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BACKGROUND: In addition to hyperglycemia, hypoglycemia, and glycemic variability, a decrease in the time in the targeted blood glucose range (TIR) may be associated with an increased risk of death for critically ill patients. However, the relationship between the TIR and mortality may be influenced by the presence of diabetes and glycemic variability. METHODS: A total of 998 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The TIR is defined as the percentage of time spent in the target blood glucose range of 3.9–10.0 mmol/L within 24 hours. The relationship between TIR and in-hospital in diabetic and non-diabetic patients was analyzed. The effect of glycemic variability was also analyzed. RESULTS: The binary logistic regression model showed that there was a significant association between the TIR as a continuous variable and the in-hospital death of severely ill non-diabetic patients (OR=0.991, P=0.015). As a classification variable, TIR≥70% was significantly associated with in-hospital death (OR=0.581, P=0.003). Specifically, TIR≥70% was a protective factor for the in-hospital death of severely ill non-diabetic patients. The TIR of severely ill diabetic patients was not significantly associated with in-hospital death; however, glycemic variability was significantly and independently associated with in-hospital death (OR=1.042, P=0.027). Binary logistic regression analysis of comprehensive indices showed that for non-diabetic patients, the C3 index (low TIR & high CV) was a risk factor for increased mortality (OR=1.642, P<0.001). In addition, for diabetic patients, the C3 index was an independent risk factor for death (OR=1.994, P=0.008), and the C4 index (low TIR & low CV) was independently associated with increased survival. CONCLUSIONS: The TIR of non-diabetic patients during ICU hospitalization was associated with in-hospital death even after adjusting for disease severity and glycemic variability. There was no significant association between the TIR and mortality of diabetic patients. However, for both diabetic and non-diabetic critically ill patients, the combined effect of high TIR and low CV was significantly associated with ICU mortality. Diabetic patients seem to have higher blood glucose fluctuations and can tolerate a large TIR range. Both diabetic and non-diabetic critically ill patients should maintain blood glucose levels within the target range to reduce mortality.

Keywords: severe disease, diabetes, blood glucose control, time in targeted blood glucose range, glycemic variability, mortality

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Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav

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Public Sector Undertakings (PSUs), being government-owned organizations have commitments for the economic and social wellbeing of the society; this commitment needs to be reflected in their risk-taking, decision-making and governance structures. Therefore, the primary objective of the study is to suggest measures that may lead to improvement in performance of PSUs. To achieve this objective two normative frameworks (one relating to risk levels and other relating to governance structure) are being put forth. The risk index is based on nine risks, such as, solvency risk, liquidity risk, accounting risk, etc. and each of the risks have been scored on a scale of 1 to 5. The governance index is based on eleven variables, such as, board independence, diversity, risk management committee, etc. Each of them are scored on a scale of 1 to five. The sample consists of 39 PSUs that featured in Nifty 500 index and, the study covers a 10 year period from April 1, 2005 to March, 31, 2015. Return on assets (ROA) and return on equity (ROE) have been used as proxies of firm performance. The control variables used in the model include, age of firm, growth rate of firm and size of firm. A dummy variable has also been used to factor in the effects of recession. Given the panel nature of data and possibility of endogeneity, dynamic panel data- generalized method of moments (Diff-GMM) regression has been used. It is worth noting that the corporate governance index is positively related to both ROA and ROE, indicating that with the improvement in governance structure, PSUs tend to perform better. Considering the components of CGI, it may be suggested that (i). PSUs ensure adequate representation of women on Board, (ii). appoint a Chief Risk Officer, and (iii). constitute a risk management committee. The results also indicate that there is a negative association between risk index and returns. These results not only validate the framework used to develop the risk index but also provide a yardstick to PSUs benchmark their risk-taking if they want to maximize their ROA and ROE. While constructing the CGI, certain non-compliances were observed, even in terms of mandatory requirements, such as, proportion of independent directors. Such infringements call for stringent penal provisions and better monitoring of PSUs. Further, if the Securities and Exchange Board of India (SEBI) and Ministry of Corporate Affairs (MCA) bring about such reforms in the PSUs and make mandatory the adherence to the normative frameworks put forth in the study, PSUs may have more effective and efficient decision-making, lower risks and hassle free management; all these ultimately leading to better ROA and ROE.

Keywords: PSU, risk governance, diff-GMM, firm performance, the risk index

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Authors: Preeda Sansakorn, Min An

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In order to be capable of dealing with uncertainties, subjectivities, including vagueness arising in building construction projects, the application of fuzzy reasoning technique based on fuzzy set theory is proposed. This study contributes significantly to the development of a fuzzy reasoning safety risk assessment model for building construction projects that could be employed to assess the risk magnitude of each hazardous event identified during construction, and a third parameter of probability of consequence is incorporated in the model. By using the proposed safety risk analysis methodology, more reliable and less ambiguities, which provide the safety risk management project team for decision-making purposes.

Keywords: safety risk assessment, building construction safety, fuzzy reasoning, construction risk assessment model, building construction projects

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Authors: Nataliya V. Dolgushina, Elena A. Gorodnova, Olga S. Beznoshenco, Andrey Yu Romanov, Irina V. Menzhinskaya, Lyubov V. Krechetova, Gennady T. Suchich

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In patients with COVID-19, generalized hypercoagulability can lead to the development of severe coagulopathy. This event is accompanied by the development of a pronounced inflammatory reaction. The observational prospective study included 39 patients with mild COVID-19 and 102 patients with moderate and severe COVID-19. Patients were then stratified into groups depending on the risk of venous thromboembolism. vWF to ADAMTS-13 concentrations and activity ratios were significantly higher in patients with a high venous thromboembolism risks in patients with moderate and severe forms COVID-19.

Keywords: ADAMTS-13, COVID-19, hypercoagulation, thrombosis, von Willebrand factor

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Authors: Mohammad Hadi Khorashadi Zadeh, Amin Karkon, Seyd Mohammad Reza Mashhoori

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The technology of computer audit played a major role in the progress and prospects of a proper application to improve the quality and efficiency of audit work. But due to the technical complexity and the specific risks of computer audit, it should be shown effective in audit and preventive action. Mainly through research in this paper, we propose the causes of audit risk in a computer environment and the risk of further proposals for measures to control, to some extent reduce the risk of computer audit and improve the audit quality.

Keywords: computer auditing, risk, measures to prevent, information management

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Authors: Sean Sloan

Abstract:

Probability Risk Assessments (PRA) can be a difficult concept for students to grasp. So in searching for different ways to describe PRA to relate it to their lives; COVID-19 came up. The parallels are amazing. Soon students began analyzing acceptable risk with the virus. This helped them to quantify just how dangerous is dangerous. The original lesson was dismissed and for the remainder of the period, the probability of risk, and the lethality of risk became the topic. Spreading events such as a COVID carrier on an airline became analogous to single fault casualties such as a Tsunami. Odds of spreading became odds of backup-diesel-generator failure – like with Fukashima Daiichi. Fatalities of the disease became expected fatalities due to radiation spread. Quantification from this discussion took it from hyperbole and emotion into one where we could rationally base guidelines. It has been one of the most effective educational devices observed.

Keywords: COVID, education, probability, risk

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Authors: Alan Walsh, Peter Walker, Michael Ellis

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There is a real danger that both practitioners and researchers considering risks associated with megaprojects ignore or underestimate the impacts of cultural risk. The paper investigates the potential impacts of a failure to achieve cultural unity between the principal actors executing a megaproject. The principle relationships include the relationships between the principle Contractors and the project stakeholders or the project stakeholders and their principle advisors, Western Consultants. This study confirms that cultural dissonance between these parties can delay or disrupt the megaproject execution and examines why cultural issues should be prioritized as a significant risk factor in megaproject delivery. This paper addresses the practical impacts and potential mitigation measures, which may reduce cultural dissonance for a megaproject's delivery. This information is retrieved from on-going case studies in live infrastructure megaprojects in Europe and the Middle East's GCC states, from Western Consultants' perspective. The collaborating researchers each have at least 30 years of construction experience and are engaged in architecture, project management and contracts management, dealing with megaprojects in Europe or the GCC. After examining the cultural interfaces they have observed during the execution of megaprojects, they conclude that globally, culture significantly influences their efficient delivery. The study finds that cultural risk is ever-present, where different nationalities co-manage megaprojects and that cultural conflict poses a real threat to the timely delivery of megaprojects. The study indicates that the higher the cultural distance between the principal actors, the more pronounced the risk, with the risk of cultural dissonance more prominent in GCC megaprojects. The findings support a more culturally aware and cohesive team approach and recommend cross-cultural training to mitigate the effects of cultural disparity.

Keywords: cultural risk underestimation, cultural distance, megaproject characteristics, megaproject execution

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Authors: Bremmy Laksono, Nurul Qomarilla, Riksa Parikrama, Dyan K. Nugrahaeni, Willyanti Soewondo, Dadang S. H. Effendi, Eriska Rianti, Arlette S. Setiawan, Ine Sasmita, Risti S. Primanti, Erna Kurnikasari, Yunia Sribudiani

Abstract:

Down syndrome is a chromosomal abnormality of chromosome 21 which can appear in man or woman. Maternal age and paternal age, history of radiation are the common risk factors. This study was conducted to observe risk factors which related as causes of Down syndrome. In this case control study using purposive sampling technique, 84 respondents were chosen from Cell Culture and Cytogenetics Laboratory patients in Faculty of Medicine, Universitas Padjadjaran, Indonesia. They were used as study samples and divided into 42 Down syndrome cases and 42 control respondents. This study used univariate and bivariate analysis (chi-square). Samples population were West Java residents, the biggest province in Indonesia in number of population. The results showed maternal age, paternal age, history of radiation exposure and family history were not significantly related to Down syndrome baby. Moreover, all of those factors also did not contribute to the risk of having a child with Down syndrome in patients at Cell Culture and Cytogenetics Laboratory, Faculty of Medicine, Universitas Padjadjaran. Therefore, we should investigate other risk factors of Down syndrome in West Java population.

Keywords: down syndrome, family history, maternal age, paternal age, risk factor

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Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila

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Introduction: The risk factors for the chronicization of postoperative pain are numerous and often intricately intertwined. Among these, the severity of acute postoperative pain is currently recognized as one of the most determining factors. Mastectomy and thoracotomy are described as among the most painful surgeries and the most likely to lead to chronic post-surgical pain (CPSP). Objective: To examine the aspects of acute postoperative pain potentially involved in the development of chronic pain following breast and thoracic surgery. Patients and Methods: A prospective study involving 164 patients was conducted over a six-month period. Postoperative pain (during mobilization) was assessed using a Visual Analog Scale (VAS) at various time points after surgery: Day 0, 1st, 2nd, 5th days, 1st and 6th months. Moderate to severe pain was defined as a VAS score ≥ 4. A comparative analysis (univariate analysis) of postoperative pain intensities at different evaluation phases was performed on patients with and without CPSP to identify potential associations with the risk of chronicization six months after surgery. Results: At the 6th month post-surgery, the incidence of CPSP was 43.0%. Moderate to severe acute postoperative pain (in the first five days) was observed in 64% of patients. The highest pain scores were reported among thoracic surgery patients. Comparative measures revealed a highly significant association between the presence of moderate to severe acute pain, especially lasting for ≥ 48 hours, and the occurrence of CPSP (p-value <0.0001). Likewise, the persistence of subacute pain (up to 4 to 6 weeks after surgery), especially of moderate to severe intensity, was significantly associated with the risk of chronicization at six months (p-value <0.0001). Conclusion: CPSP after breast and thoracic surgery remains a fairly common morbidity that profoundly affects the quality of life. Severe acute postoperative pain, especially if it is prolonged and/or with a slow decline in intensity, can be an important predictive factor for the risk of chronicization. Therefore, more effective and intensive management of acute postoperative pain, as well as longitudinal monitoring of its trajectory over time, should be an essential component of strategies for preventing chronic pain after surgery.

Keywords: chronic post-surgical pain, acute postoperative pain, breast and thoracic surgery, subacute postoperative pain, pain trajectory, predictive factor

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