Search results for: health risk

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: L. Lindsay, S. A. Coleman, D. Kerr, B. J. Taylor, A. Moorhead

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Cognitive decline and frailty is apparent in older adults leading to an increased likelihood of the risk of falling. Currently health care professionals have to make professional decisions regarding such risks, and hence make difficult decisions regarding the future welfare of the ageing population. This study uses health data from The Irish Longitudinal Study on Ageing (TILDA), focusing on adults over the age of 50 years, in order to analyse health risk factors and predict the likelihood of falls. This prediction is based on the use of machine learning algorithms whereby health risk factors are used as inputs to predict the likelihood of falling. Initial results show that health risk factors such as long-term health issues contribute to the number of falls. The identification of such health risk factors has the potential to inform health and social care professionals, older people and their family members in order to mitigate daily living risks.

Keywords: Classification, falls, health risk factors, machine learning, older adults.

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Authors: M. M. Mortula

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Bottle water is getting very popular all through the world; especially in the gulf countries as the main source of drinking water. However, concerns over leaching of toxic chemicals are increasing. In this study, a health risk assessment was conducted in accordance with the guidelines indicated by United States Environmental Protection Agency (USEPA). It is conducted based on leaching of Diethyl Phthalate (DEP) from Polyethylene terephthalate (PET). The toxicity and exposure assessment of diethyl phthalate was conducted to characterize its risk on human health. Risk management is also discussed.

Keywords: Toxicity, diethyl phthalate, PET, risk Assessment.

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Authors: Sadovska V.

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The progress of concentrations of particular heavy metals was assessed in chosen localities in region Moravia, the Czech Republic, from 2007 to 2009. Particular metals were observed in localities with various types and characterization of zone. Pb, Ni, As and Cd were emphasized as a result of their toxicity and potential adverse health effect to the exposed population. The progress of metal concentrations and their health effects in the most polluted localities were examined. According to the results, the air pollution limit values were not exceeded. Based on the health risk assessment, the probability of developing tumorous diseases is acceptable, except for the increased probability of cancer risk from long-term exposure to As.

Keywords: Air pollution, heavy metals, health risk assessment, individual lifetime cancer risk

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Authors: S. A. Nta

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Application of health risk assessment methods is important in order to comprehend the risk of human exposure to heavy metals and other dangerous pollutants. Four soil samples were collected at distances of 10, 20, 30 m and the control 100 m away from the dump site at depths of 0.3, 0.6 and 0.9 m. The collected soil samples were examined for Zn, Cu, Pb, Cd and Ni using standard methods. The health risks via the main pathways of human exposure to heavy metal were detected using relevant standard equations. Hazard quotient was calculated to determine non-carcinogenic health risk for each individual heavy metal. Life time cancer risk was calculated to determine the cumulative life cancer rating for each exposure pathway. The estimated health risk values for adults and children were generally lower than the reference dose. The calculated hazard quotient for the ingestion, inhalation and dermal contact pathways were less than unity. This means that there is no detrimental concern to the health on human exposure to heavy metals in contaminated soil. The life time cancer risk 5.4 × 10^-2 was higher than the acceptable threshold value of 1 × 10^-4 which is reflected to have significant health effects on human exposure to heavy metals in contaminated soil. Good hygienic practices are recommended to ease the potential risk to children and adult who are exposed to contaminated soils. Also, the local authorities should be made aware of such health risks for the purpose of planning the management strategy accordingly.

Keywords: Health risk assessment, pollution, heavy metals, soil.

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Authors: Juan P. Zamora, Wilson Adarme, Laura Palacios

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This paper shows a traceability framework for supply risk monitoring, beginning with the identification, analysis, and evaluation of the supply chain risk and focusing on the supply operations of the Health Care Institutions with oncology services in Bogota, Colombia. It includes a brief presentation of the state of the art of the Supply Chain Risk Management and traceability systems in logistics operations, and it concludes with the methodology to integrate the SCRM model with the traceability system.

Keywords: Supply risk, risk monitoring, supply chain risk management, cancer drugs, traceability systems.

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Authors: Smita S. D. Goorah, Dilish Jokhoo

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A personal estimate of a health risk may not correspond to a scientific assessment of the health risk. Hence, there is a need to investigate perceived health risks in the public. In this study, a young, educated and healthy group of people from a tertiary institute were questioned about their health concerns. Ethics clearance was obtained and data was collected by means of a questionnaire. 362 students participated in the study. Tobacco use, heavy alcohol drinking, illicit drugs, unsafe sex and potential carcinogens were perceived to be the five greatest threats to health in this cohort. On the other hand natural health products, unemployment, unmet contraceptive needs, family violence and homelessness were felt to be the least perceived health risks. Nutrition-related health risks as well as health risks due to physical inactivity and obesity were not perceived as major health threats. Such a study of health perceptions may guide health promotion campaigns.

Keywords: Health promotion, perceptions of health risks, university students.

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Authors: Kevin Fong-Rey Liu, Ken Yeh, Cheng-Wu Chen, Han-Hsi Liang

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This paper proposes the use of Bayesian belief networks (BBN) as a higher level of health risk assessment for a dumping site of lead battery smelter factory. On the basis of the epidemiological studies, the actual hospital attendance records and expert experiences, the BBN is capable of capturing the probabilistic relationships between the hazardous substances and their adverse health effects, and accordingly inferring the morbidity of the adverse health effects. The provision of the morbidity rates of the related diseases is more informative and can alleviate the drawbacks of conventional methods.

Keywords: Bayesian belief networks, lead battery smelter factory, health risk assessment.

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Authors: N. W. Paul, M. Banerjee

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

Keywords: Ebola, Epidemic Risk, Medical Ethics, Medical Humanities.

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Authors: K. Sekulová, M. Šimon

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This article focuses on upper-extremity musculoskeletal disorders risk assessment model at workplace. In this model are used risk factors that are responsible for musculoskeletal system damage. Based on statistic calculations the model is able to define what risk of MSD threatens workers who are under risk factors. The model is also able to say how MSD risk would decrease if these risk factors are eliminated.

 

Keywords: Ergonomics, musculoskeletal disorders, occupational diseases, risk factors.

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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: O. O. Olawusi-Peters, K. I. Adejugbagbe

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The concentration of heavy metal (Cd, Pb, Fe, Zn, Cu) in Clarias gariepinus collected from fish markets; Fanibi (Station I) and Fiwasaye (Station II) in Akure metropolis, Ondo state, Nigeria were investigated to ascertain the safety for the consumers. 60 samples were collected from the two markets in three batches (I, II, III) for a period of six months and analyzed for heavy metals in the gills and muscles of the fish. Also, the Health Risk Index (HRI) was used to determine the health risk of these metals to the consumer. The results showed that the investigated metal concentration was higher in station I than station II, except Pb having higher concentration in station II than station I. In both stations, the highest concentration of Fe was recorded in the gills (12.60 ± 1.51; 6.94 ± 1.38) and muscles (3.72 ± 0.09; 3.86 ± 0.33) of samples in batch I. Also, the HRI revealed that consumption of Clarias gariepinus from these study areas did not pose any health risk (HRI < 1). In addition, concentrations of the heavy metals were all below the permissible limits recommended by FAO/WHO.

Keywords: Health risk index, heavy metals, Clarias gariepinus, Akure metropolis, fish monger.

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Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

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Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: Cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma.

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Authors: Frantisek Bozek, Alexandr Bozek, Alena Bumbova, Jiri Dvorak, Lenka Jesonkova

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The contamination of 15 ground water resources of a selected region earmarked for the emergency supply of population has been monitored. The resources have been selected on the basis of previous assessment of natural conditions and the exploitation of territory in their surroundings and infiltration area. Two resources out of 15 have been excluded from further exploitation, because they have not met some of the 72 assessed hygienic indicators of extended analysis. The remaining 13 resources have been the subject of health risk analysis in relation to the contamination by arsenic, lead, cadmium, mercury, nickel and manganese. The risk analysis proved that all 13 resources meet health standards with regard to the above mentioned purposefully selected elements and may thus be included into crisis plans. Water quality of ground resources may be assessed in the same way with regard to other contaminants.

Keywords: Contamination, drinking water, emergency supply, health risk, hygienic limits, metals, risk assessment.

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Authors: M. N. Huda, S. Yamada, N. Sonehara

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Probability-based identity disclosure risk measurement may give the same overall risk for different anonymization strategy of the same dataset. Some entities in the anonymous dataset may have higher identification risks than the others. Individuals are more concerned about higher risks than the average and are more interested to know if they have a possibility of being under higher risk. A notation of overall risk in the above measurement method doesn-t indicate whether some of the involved entities have higher identity disclosure risk than the others. In this paper, we have introduced an identity disclosure risk measurement method that not only implies overall risk, but also indicates whether some of the members have higher risk than the others. The proposed method quantifies the overall risk based on the individual risk values, the percentage of the records that have a risk value higher than the average and how larger the higher risk values are compared to the average. We have analyzed the disclosure risks for different disclosure control techniques applied to original microdata and present the results.

Keywords: Anonymization, microdata, disclosure risk, privacy.

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Authors: Chun-guang Pan, Ying-wu Chen

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Risk response planning is of importance for software project risk management (SPRM). In CMMI, risk management was in the third capability maturity level, which provides a framework for software project risk identification, assessment, risk planning, risk control. However, the CMMI-based SPRM currently lacks quantitative supporting tools, especially during the process of implementing software project risk planning. In this paper, an economic optimization model for selecting risk reduction actions in the phase of software project risk response planning is presented. Furthermore, an example taken from a Chinese software industry is illustrated to verify the application of this method. The research provides a risk decision method for project risk managers that can be used in the implementation of CMMI-based SPRM.

Keywords: Software project, risk management, CMMI, riskresponse planning.

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Authors: Masood Uzzafer

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A dynamic risk management framework for software projects is presented. Currently available software risk management frameworks and risk assessment models are static in nature and lacks feedback capability. Such risk management frameworks are not capable of providing the risk assessment of futuristic changes in risk events. A dynamic risk management framework for software project is needed that provides futuristic assessment of risk events.

Keywords: Software Risk Management, Dynamic Models, Software Project Managment.

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Authors: Thammarak Srimarut, Witthaya Mekhum

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This study analyzed and developed a model for monk’s food bowl production on occupational health safety and environment at work for the encouragement of Rattanakosin local wisdom at Banbart Community. The process of blowpipe welding was necessary to produce the bowl which was very dangerous or 93.59% risk. After the employment of new sitting posture, the work risk was lower 48.41% or moderate risk. When considering in details, it was found that: 1) the traditional sitting posture could create work risk at 88.89% while the new sitting posture could create the work risk at 58.86%. 2) About the environmental pollution, with the traditional sitting posture, workers exposed to the polluted fume from welding at 61.11% while with the new sitting posture workers exposed to the polluted fume from welding at 40.47%. 3) On accidental risk, with the traditional sitting posture, workers exposed to the accident from welding at 94.44% while with the new sitting posture workers exposed to the accident from welding at 62.54%.

Keywords: Occupational health safety, environment at work, Monk’s food bowl.

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Authors: Hooman Hoodat, Hassan Rashidi

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Despite various methods that exist in software risk management, software projects have a high rate of failure. When complexity and size of the projects are increased, managing software development becomes more difficult. In these projects the need for more analysis and risk assessment is vital. In this paper, a classification for software risks is specified. Then relations between these risks using risk tree structure are presented. Analysis and assessment of these risks are done using probabilistic calculations. This analysis helps qualitative and quantitative assessment of risk of failure. Moreover it can help software risk management process. This classification and risk tree structure can apply to some software tools.

Keywords: Risk analysis, risk assessment, risk classification, risk tree.

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Authors: Nina V. Zaitseva, Pavel Z. Shur, Nina G. Atiskova

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Nowadays harmonization of sanitary and hygienic standards of environmental quality with international standards is crucial part of integration of Russia into the international community. Harmonization of Russian and international ambient air quality standards may be realized by risk-based standards development. In this paper approaches to risk-based standards development and examples of these approaches implementation are presented.

Keywords: Harmonization, health risk assessment, evolutionary modelling, benchmark level, nickel, manganese.

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Authors: Arie Pujiwati, Kengo Nakamura, Noriaki Watanabe, Takeshi Komai

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Coal mining is well known to cause considerable environmental impacts, including trace element contamination of soil. This study aimed to assess the trace element (As, Cd, Co, Cu, Ni, Pb, Sb, and Zn) contamination of soil in the vicinity of coal mining activities, using the case study of Asam-asam River basin, South Kalimantan, Indonesia, and to assess the human health risk, incorporating total and bioavailable (water-leachable and acid-leachable) concentrations. The results show the enrichment of As and Co in soil, surpassing the background soil value. Contamination was evaluated based on the index of geo-accumulation, I_geo and the pollution index, PI. I_geo values showed that the soil was generally uncontaminated (I_geo ≤ 0), except for elevated As and Co. Mean PI for Ni and Cu indicated slight contamination. Regarding the assessment of health risks, the Hazard Index, HI showed adverse risks (HI > 1) for Ni, Co, and As. Further, Ni and As were found to pose unacceptable carcinogenic risk (risk > 1.10^-5). Farming, settlement, and plantation were found to present greater risk than coal mines. These results show that coal mining activity in the study area contaminates the soils by particular elements and may pose potential human health risk in its surrounding area. This study is important for setting appropriate countermeasure actions and improving basic coal mining management in Indonesia.

Keywords: Coal mine, risk, soil, trace elements.

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Authors: Amirali Shirazibeheshti, Tarik Radwan, Alireza Ettefaghian, Farbod Khanizadeh, George Wilson, Cristina Luca

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. This work evaluates the association between the average risk score and measures of socioeconomic status (index of multiple deprivation) and health (index of health and disability). The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, suggesting that females are more at risk from this kind of multiple medication. The risk may be monitored and controlled in a healthcare management system that is well-equipped with tools implementing appropriate techniques of artificial intelligence.

Keywords: Anticholinergic medication, socioeconomic status, deprivation, clustering, risk analysis.

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Authors: K. Sekulová, M. Šimon

Abstract:

The article demonstrates on a case study how it is possible to identify MSD risk. It is based on a dissertation Risk identification model of occupational diseases formation in relation to the work activity that determines what risk can endanger workers who are exposed to the specific risk factors. It is evaluated based on statistical calculations. These risk factors are main cause of upperextremities musculoskeletal disorders.

Keywords: Case study, upper-extremity musculoskeletal disorders, ergonomics.

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Authors: Milan Rippel, Pert Teplý

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Operational risk has become one of the most discussed topics in the financial industry in the recent years. The reasons for this attention can be attributed to higher investments in information systems and technology, the increasing wave of mergers and acquisitions and emergence of new financial instruments. In addition, the New Basel Capital Accord (known as Basel II) demands a capital requirement for operational risk and further motivates financial institutions to more precisely measure and manage this type of risk. The aim of this paper is to shed light on main characteristics of operational risk management and common applied methods: scenario analysis, key risk indicators, risk control self assessment and loss distribution approach.

Keywords: Operational risk, economic capital, key risk indicators, loss distribution approach.

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Authors: Michael Ajide Oyinloye

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Generally the natural environment is made up of air, water and soil. The release of emission of industrial waste into anyone of the components of the environment causes pollution. Industrial pollution significantly threatens the inherent right of people, to the enjoyment of a safe and secure environment. The aim of this paper is to assess the effect of environmental pollution and health risks of residents living near Ewekoro cement factory. The research made use of IKONOS imagery for Geographical Information System (GIS) to buffer and extract buildings that are less than 1km to the factory, within 1km to 5km and above 5km to the factory. Also questionnaire was used to elicit information on the socio-economic factors, effect of environmental pollution on residents and measures adopted to control industrial pollution on the residents. Findings show that most buildings that fall between less than 1km and 1km to 5km to the factory have high health risk in the study area. The study recommended total relocation for the residents of the study area to reduce health risk problems.

Keywords: Environmental pollution, Ewekoro, GIS, Health risk, Satellite imagery.

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Authors: Phayong Thepaksorn

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The objective of this study was to assess whether living in proximity to a roofing fiber cement factory in southern Thailand was associated with physical, mental, social, and spiritual health domains measured in a self-reported health risk assessment (HRA) questionnaire. A cross-sectional study was conducted among community members divided into two groups: near population (living within 0-2km of factory) and far population (living within 2-5km of factory) (N=198). A greater proportion of those living far from the factory (65.34%) reported physical health problems than the near group (51.04%) (p =0.032). This study has demonstrated that the near population group had higher proportion of participants with positive ratings on mental assessment (30.34%) and social health impacts (28.42%) than far population group (10.59% and 16.67%, respectively) (p <0.001). The near population group (29.79%) had similar proportion of participants with positive ratings in spiritual health impacts compared with far population group (27.08%). Among females, but not males, this study demonstrated that a higher proportion of the near population had a positive summative score for the self-HRA, which included all four health domain, compared to the far population (p<0.001 for females; p = 0.154 for males). In conclusion, this self-HRA of physical, mental, social, and spiritual health domains reflected the risk perceptions of populations living in the vicinity of the roofing fiber cement factory. This type of tool can bring attention to population concerns and complaints in the factory’s surrounding community. Our findings may contribute to future development of self-HRA for HIA development procedure in Thailand.

Keywords: Cement dust, health impact assessment, risk assessment, walk-though survey.

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Authors: Masood Uzzafer

Abstract:

A dynamic software risk assessment model is presented. Analogies between dynamic financial analysis and software risk assessment models are established and based on these analogies it suggested that dynamic risk model for software projects is the way to move forward for the risk assessment of software project. It is shown how software risk assessment change during different phases of a software project and hence requires a dynamic risk assessment model to capture these variations. Further evolution of dynamic financial analysis models is discussed and mapped to the evolution of software risk assessment models.

Keywords: Software Risk Assessment, Software ProjectManagement, Software Cost, Dynamic Modeling.

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Authors: H. B. Nguendo Yongsi, Thora M. Herrmann, A. Lutumba Ntetu, Rémy Sietchiping, Christopher Bryant

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Health problems linked to urban growth are current major concerns of developing countries. In 2002 and 2005, an interdisciplinary program “Populations et Espaces ├á Risques SANitaires" (PERSAN) was set up under the patronage of the Development and Research Institute. Centered on health in Cameroon-s urban environment, the program mainly sought to (i) identify diarrhoea risk factors in Yaoundé, (ii) to measure their prevalence and apprehend their spatial distribution. The crosssectional epidemiological study that was carried out revealed a diarrheic prevalence of 14.4% (437 cases of diarrhoea on the 3,034 children examined). Also, among risk factors studied, household refuse management methods used by city dwellers were statistically associated to these diarrhoeas. Moreover, it happened that levels of diarrhoeal attacks varied consistently from one neighbourhood to another because of the discrepancy urbanization process of the Yaoundé metropolis.

Keywords: Diarrhea, health risk, household refuses handling, sanitation, Yaoundé.

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Authors: H.B. Nguendo Yongsi

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An epidemiological cross sectional study was undertaken in Yaoundé in 2002 and updated in 2005. Focused on health within the city, the objectives were to measure diarrheal prevalence and to identify the risk factors associated with them. Results of microbiological examinations have revealed an urban average prevalence rate of 14.5%. Access to basic services in the living environment appears to be an important risk factor for diarrheas. Statistical and spatial analyses conducted have revealed that prevalence of diarrheal diseases vary among the two main types of settlement (informal and planned). More importantly, this study shows that, diarrhea prevalence rates (notably bacterial and parasitic diarrheas) vary according to the sub- category of settlements. The study draws a number of theoretical and policy implications for researchers and policy decision makers.

Keywords: Cameroon, diarrheal diseases, health risk factor, planned and spontaneous settlement, urban policy, urbanization.

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Authors: Sareh Rajabi, Salwa Bheiry

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In general, Covid-19 created many financial and non-financial damages to the economy and community. Level and severity of covid-19 as pandemic case varies over the region and due to different types of the projects. Covid-19 virus emerged as one of the most imperative risk management factors word-wide recently. Therefore, as part of portfolio management assessment, it is essential to evaluate severity of such risk on the project and program in portfolio management level to avoid any risky portfolio. Covid-19 appeared very effectively in South America, part of Europe and Middle East. Such pandemic infection affected the whole universe, due to lock down, interruption in supply chain management, health and safety requirements, transportations and commercial impacts. Therefore, this research proposes Analytical Hierarchy Process (AHP) to analyze and assess such pandemic case like Covid-19 and its impacts on the construction projects. The AHP technique uses four sub-criteria: Health and safety, commercial risk, completion risk and contractual risk to evaluate the project and program. The result will provide the decision makers with information which project has higher or lower risk in case of Covid-19 and pandemic scenario. Therefore, the decision makers can have most feasible solution based on effective weighted criteria for project selection within their portfolio to match with the organization’s strategies.

Keywords: Portfolio management, risk management, COVID-19, analytical hierarchy process technique.

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