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Sample records for risk factors costs

  1. External risk factors affecting construction costs

    Science.gov (United States)

    Mubarak, Husin, Saiful; Oktaviati, Mutia

    2017-11-01

    Some risk factors can have impacts on the cost, time, and performance. Results of previous studies indicated that the external conditions are among the factors which give effect to the contractor in the completion of the project. The analysis in the study carried out by considering the conditions of the project in the last 15 years in Aceh province, divided into military conflict phase (2000-2004), post tsunami disaster rehabilitation and reconstruction phase (2005-2009), and post-rehabilitation and reconstruction phase (2010-present). This study intended to analyze the impact of external risk factors, primarily related to the impact on project costs and to investigate the influence of the risk factors and construction phases impacted the project cost. Data was collected by using a questionnaire distributed in 15 large companies qualification contractors in Aceh province. Factors analyzed consisted of socio-political, government policies, natural disasters, and monetary conditions. Data were analyzed using statistical application of severity index to measure the level of risk impact. The analysis results presented the tendency of impact on cost can generally be classified as low. There is only one variable classified as high-impact, variable `fuel price increases', which appear on the military conflict and post tsunami disaster rehabilitation and reconstruction periods. The risk impact on costs from the factors and variables classified with high intensity needs a serious attention, especially when the high level impact is followed by the high frequency of occurrences.

  2. Risk factor and cost accounting analysis for dialysis patients in Taiwan.

    Science.gov (United States)

    Su, Bin-Guang; Tsai, Kai-Li; Yeh, Shu-Hsing; Ho, Yi-Yi; Liu, Shin-Yi; Rivers, Patrick A

    2010-05-01

    According to the 2004 US Renal Data System's annual report, the incidence rate of chronic renal failure in Taiwan increased from 120 to 352 per million populations between 1990 and 2003. This incidence rate is the highest in the world. The prevalence rate, which ranks number two in the world (Japan ranks number one), also increased from 384 to 1630 per million populations. Based on 2005 Taiwan national statistics, there were 52,958 end-stage renal disease (ESRD) patients receiving routine dialysis treatment. This number, which comprised less than 0.2% of the total population and consumed $2.6 billion New Taiwan dollars, was more than 6.12% of the total annual spending of national health insurance during 2005. Dialysis expenditures for patients with ESRD rank the highest among all major injuries (traumas) and diseases. This article identifies and discusses the risk factors associated with consumption of medical resources during dialysis. Instead of using reimbursement data to estimate cost, as seen in previous studies, this study uses cost data within organizations and focuses on evaluating and predicting the resource consumption pattern for dialysis patients with different risk factors. Multiple regression analysis was used to identify 23 risk factors for routine dialysis patients. Of these risk factors, six were associated with the increase of dialysis cost: age (i.e. 75 years old and older), liver function disorder, hypertension, bile-duct disorder, cancer and high blood lipids. Patients with liver function disorder incurred much higher costs for injection medication and supplies. Hypertensive patients incurred higher costs for injection medication, supplies and oral medication. Patients with bile-duct disorder incurred a significant difference in check-up costs (i.e. costs were higher for those aged 75 years and older than those who were younger than 30 years of age). Cancer patients also incurred significant differences in cost of medical supplies. Patients

  3. Risk Factors Associated with Mortality and Increased Drug Costs in Nonvariceal Upper Gastrointestinal Bleeding.

    Science.gov (United States)

    Lu, Mingliang; Sun, Gang; Zhang, Xiu-li; Zhang, Xiao-mei; Liu, Qing-sen; Huang, Qi-yang; Lau, James W Y; Yang, Yun-sheng

    2015-06-01

    To determine risk factors associated with mortality and increased drug costs in patients with nonvariceal upper gastrointestinal bleeding. We retrospectively analyzed data from patients hospitalized with nonvariceal upper gastrointestinal bleeding between January 2001-December 2011. Demographic and clinical characteristics and drug costs were documented. Univariate analysis determined possible risk factors for mortality. Statistically significant variables were analyzed using a logistic regression model. Multiple linear regression analyzed factors influencing drug costs. p study included data from 627 patients. Risk factors associated with increased mortality were age > 60, systolic blood pressurebleeding rate is 11.20% and mortality is 5.74%. The mortality risk in patients with comorbidities was higher than in patients without comorbidities, and was higher in patients requiring blood transfusion than in patients not requiring transfusion. Rebleeding was associ-ated with mortality. Rebleeding, blood transfusion, and prolonged hospital stay were associated with increased drug costs, whereas bleeding from lesions in the esophagus and duodenum was associated with lower drug costs.

  4. Absenteeism and Employer Costs Associated With Chronic Diseases and Health Risk Factors in the US Workforce.

    Science.gov (United States)

    Asay, Garrett R Beeler; Roy, Kakoli; Lang, Jason E; Payne, Rebecca L; Howard, David H

    2016-10-06

    Employers may incur costs related to absenteeism among employees who have chronic diseases or unhealthy behaviors. We examined the association between employee absenteeism and 5 conditions: 3 risk factors (smoking, physical inactivity, and obesity) and 2 chronic diseases (hypertension and diabetes). We identified 5 chronic diseases or risk factors from 2 data sources: MarketScan Health Risk Assessment and the Medical Expenditure Panel Survey (MEPS). Absenteeism was measured as the number of workdays missed because of sickness or injury. We used zero-inflated Poisson regression to estimate excess absenteeism as the difference in the number of days missed from work by those who reported having a risk factor or chronic disease and those who did not. Covariates included demographics (eg, age, education, sex) and employment variables (eg, industry, union membership). We quantified absenteeism costs in 2011 and adjusted them to reflect growth in employment costs to 2015 dollars. Finally, we estimated absenteeism costs for a hypothetical small employer (100 employees) and a hypothetical large employer (1,000 employees). Absenteeism estimates ranged from 1 to 2 days per individual per year depending on the risk factor or chronic disease. Except for the physical inactivity and obesity estimates, disease- and risk-factor-specific estimates were similar in MEPS and MarketScan. Absenteeism increased with the number of risk factors or diseases reported. Nationally, each risk factor or disease was associated with annual absenteeism costs greater than $2 billion. Absenteeism costs ranged from $16 to $81 (small employer) and $17 to $286 (large employer) per employee per year. Absenteeism costs associated with chronic diseases and health risk factors can be substantial. Employers may incur these costs through lower productivity, and employees could incur costs through lower wages.

  5. Absenteeism and Employer Costs Associated With Chronic Diseases and Health Risk Factors in the US Workforce

    Science.gov (United States)

    Roy, Kakoli; Lang, Jason E.; Payne, Rebecca L.; Howard, David H.

    2016-01-01

    Introduction Employers may incur costs related to absenteeism among employees who have chronic diseases or unhealthy behaviors. We examined the association between employee absenteeism and 5 conditions: 3 risk factors (smoking, physical inactivity, and obesity) and 2 chronic diseases (hypertension and diabetes). Methods We identified 5 chronic diseases or risk factors from 2 data sources: MarketScan Health Risk Assessment and the Medical Expenditure Panel Survey (MEPS). Absenteeism was measured as the number of workdays missed because of sickness or injury. We used zero-inflated Poisson regression to estimate excess absenteeism as the difference in the number of days missed from work by those who reported having a risk factor or chronic disease and those who did not. Covariates included demographics (eg, age, education, sex) and employment variables (eg, industry, union membership). We quantified absenteeism costs in 2011 and adjusted them to reflect growth in employment costs to 2015 dollars. Finally, we estimated absenteeism costs for a hypothetical small employer (100 employees) and a hypothetical large employer (1,000 employees). Results Absenteeism estimates ranged from 1 to 2 days per individual per year depending on the risk factor or chronic disease. Except for the physical inactivity and obesity estimates, disease- and risk-factor–specific estimates were similar in MEPS and MarketScan. Absenteeism increased with the number of risk factors or diseases reported. Nationally, each risk factor or disease was associated with annual absenteeism costs greater than $2 billion. Absenteeism costs ranged from $16 to $81 (small employer) and $17 to $286 (large employer) per employee per year. Conclusion Absenteeism costs associated with chronic diseases and health risk factors can be substantial. Employers may incur these costs through lower productivity, and employees could incur costs through lower wages. PMID:27710764

  6. Costs and Risk Factors for Hospital Readmission After Periprosthetic Knee Fractures in the United States.

    Science.gov (United States)

    Reeves, Russell A; Schairer, William W; Jevsevar, David S

    2018-02-01

    Periprosthetic fractures (PPFX) around total knee arthroplasty (TKA) are devastating complications with significant morbidity. With growing healthcare costs, hospital readmissions have become a marker for quality healthcare delivery. However, little is known about the risk factors or costs associated with readmission after treatment of PPFX. We sought to identify the patient demographics, prevalence of treatment types (open reduction internal fixation [ORIF] vs revision TKA), 30 and 90-day readmission rates, costs of initial treatment and readmission, and risk factors for readmission. We used the 2013 Nationwide Readmissions Database to select patients who underwent TKA, revision TKA, and treatment of PPFX with either ORIF or revision TKA. The 90-day readmission rate was determined through a survival analysis, and risk factors were identified using a cox proportional hazards model that adjusted for patient and hospital characteristics. We identified 1526 patients with PPFX treated with ORIF and 1458 treated with revision TKA. Ninety-day readmissions were 20.5% and 21.8%, respectively. Patients with ORIF were more often female and had multiple medical comorbidities. Patient factors associated with readmission included advanced age, male gender, comorbidities, discharge to a skilled nursing facility or home with health aide, and Medicare or Medicaid insurance. Treatment at a teaching hospital was the only hospital-associated risk factor identified. ORIF cost USD 25,539 and revision THA cost USD 37,680, with associated readmissions costing 15,269 and 16,806, respectively. PPFX results in greater costs compared to primary and revision TKA. This study highlights risk factors for readmission after PPFX treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Prevalence of cardiovascular risk factors in a middle-income country and estimated cost of a treatment strategy

    Directory of Open Access Journals (Sweden)

    Gabriel Anne

    2006-01-01

    Full Text Available Abstract Background We assessed the prevalence of risk factors for cardiovascular disease (CVD in a middle-income country in rapid epidemiological transition and estimated direct costs for treating all individuals at increased cardiovascular risk, i.e. following the so-called "high risk strategy". Methods Survey of risk factors using an age- and sex-stratified random sample of the population of Seychelles aged 25–64 in 2004. Assessment of CVD risk and treatment modalities were in line with international guidelines. Costs are expressed as US$ per capita per year. Results 1255 persons took part in the survey (participation rate of 80.2%. Prevalence of main risk factors was: 39.6% for high blood pressure (≥140/90 mmHg or treatment of which 59% were under treatment; 24.2% for high cholesterol (≥6.2 mmol/l; 20.8% for low HDL-cholesterol (2 and 22.1% for the metabolic syndrome. Overall, 43% had HBP, high cholesterol or diabetes and substantially increased CVD risk. The cost for medications needed to treat all high-risk individuals amounted to US $45.6, i.e. $11.2 for high blood pressure, $3.8 for diabetes, and $30.6 for dyslipidemia (using generic drugs except for hypercholesterolemia. Cost for minimal follow-up medical care and laboratory tests amounted to $22.6. Conclusion High prevalence of major risk factors was found in a rapidly developing country and costs for treatment needed to reduce risk factors in all high-risk individuals exceeded resources generally available in low or middle income countries. Our findings emphasize the need for affordable cost-effective treatment strategies and the critical importance of population strategies aimed at reducing risk factors in the entire population.

  8. Drug development costs when financial risk is measured using the Fama-French three-factor model.

    Science.gov (United States)

    Vernon, John A; Golec, Joseph H; Dimasi, Joseph A

    2010-08-01

    In a widely cited article, DiMasi, Hansen, and Grabowski (2003) estimate the average pre-tax cost of bringing a new molecular entity to market. Their base case estimate, excluding post-marketing studies, was $802 million (in $US 2000). Strikingly, almost half of this cost (or $399 million) is the cost of capital (COC) used to fund clinical development expenses to the point of FDA marketing approval. The authors used an 11% real COC computed using the capital asset pricing model (CAPM). But the CAPM is a single factor risk model, and multi-factor risk models are the current state of the art in finance. Using the Fama-French three factor model we find that the cost of drug development to be higher than the earlier estimate. Copyright (c) 2009 John Wiley & Sons, Ltd.

  9. Cost Analysis of Universal Screening vs. Risk Factor-Based Screening for Methicillin-Resistant Staphylococcus aureus (MRSA.

    Directory of Open Access Journals (Sweden)

    Virginia R Roth

    Full Text Available The literature remains conflicted regarding the most effective way to screen for MRSA. This study was designed to assess costs associated with universal versus risk factor-based screening for the reduction of nosocomial MRSA transmission.The study was conducted at The Ottawa Hospital, a large multi-centre tertiary care facility with approximately 47,000 admissions annually. From January 2006-December 2007, patients underwent risk factor-based screening for MRSA on admission. From January 2008 to August 2009 universal MRSA screening was implemented. A comparison of costs incurred during risk factor-based screening and universal screening was conducted. The model incorporated probabilities relating to the likelihood of being tested and the results of polymerase chain reaction (PCR testing with associated effects in terms of MRSA bacteremia and true positive and negative test results. Inputted costs included laboratory testing, contact precautions and infection control, private room costs, housekeeping, and length of hospital stay. Deterministic sensitivity analyses were conducted.The risk factor-based MRSA screening program screened approximately 30% of admitted patients and cost the hospital over $780 000 annually. The universal screening program screened approximately 83% of admitted patients and cost over $1.94 million dollars, representing an excess cost of $1.16 million per year. The estimated additional cost per patient screened was $17.76.This analysis demonstrated that a universal MRSA screening program was costly from a hospital perspective and was previously known to not be clinically effective at reducing MRSA transmission. These results may be useful to inform future model-based economic analyses of MRSA interventions.

  10. What factors increase the risk of incurring high market impact costs?

    NARCIS (Netherlands)

    Bikker, Jacob A.; Spierdijk, Laura; van der Sluis, Pieter-Jelle

    2010-01-01

    This article applies quantile regression to assess the factors that influence the risk of incurring high trading costs. Using data on the equity trades of the world's second largest pension fund in the first quarter of 2002, we show that trade timing, momentum, volatility and the type of broker

  11. What factors increase the risk of incurring high market impact costs?

    NARCIS (Netherlands)

    Bikker, Jacob A.; Spierdijk, L.; van der Sluis, Pieter Jelle

    2010-01-01

    This article applies quantile regression to assess the factors that influence the risk of incurring high trading costs. Using data on the equity trades of the world’s second largest pension fund in the first quarter of 2002, we show that trade timing, momentum, volatility and the type of broker

  12. Absenteeism and Employer Costs Associated With Chronic Diseases and Health Risk Factors in the US Workforce

    OpenAIRE

    Asay, Garrett R. Beeler; Roy, Kakoli; Lang, Jason E.; Payne, Rebecca L.; Howard, David H.

    2016-01-01

    Introduction Employers may incur costs related to absenteeism among employees who have chronic diseases or unhealthy behaviors. We examined the association between employee absenteeism and 5 conditions: 3 risk factors (smoking, physical inactivity, and obesity) and 2 chronic diseases (hypertension and diabetes). Methods We identified 5 chronic diseases or risk factors from 2 data sources: MarketScan Health Risk Assessment and the Medical Expenditure Panel Survey (MEPS). Absenteeism was measur...

  13. Cost-effectiveness analysis of risk-factor guided and birth-cohort screening for chronic hepatitis C infection in the United States.

    Directory of Open Access Journals (Sweden)

    Shan Liu

    Full Text Available No consensus exists on screening to detect the estimated 2 million Americans unaware of their chronic hepatitis C infections. Advisory groups differ, recommending birth-cohort screening for baby boomers, screening only high-risk individuals, or no screening. We assessed one-time risk assessment and screening to identify previously undiagnosed 40-74 year-olds given newly available hepatitis C treatments.A Markov model evaluated alternative risk-factor guided and birth-cohort screening and treatment strategies. Risk factors included drug use history, blood transfusion before 1992, and multiple sexual partners. Analyses of the National Health and Nutrition Examination Survey provided sex-, race-, age-, and risk-factor-specific hepatitis C prevalence and mortality rates. Nine strategies combined screening (no screening, risk-factor guided screening, or birth-cohort screening and treatment (standard therapy-peginterferon alfa and ribavirin, Interleukin-28B-guided (IL28B triple-therapy-standard therapy plus a protease inhibitor, or universal triple therapy. Response-guided treatment depended on HCV genotype. Outcomes include discounted lifetime costs (2010 dollars and quality adjusted life-years (QALYs. Compared to no screening, risk-factor guided and birth-cohort screening for 50 year-olds gained 0.7 to 3.5 quality adjusted life-days and cost $168 to $568 per person. Birth-cohort screening provided more benefit per dollar than risk-factor guided screening and cost $65,749 per QALY if followed by universal triple therapy compared to screening followed by IL28B-guided triple therapy. If only 10% of screen-detected, eligible patients initiate treatment at each opportunity, birth-cohort screening with universal triple therapy costs $241,100 per QALY. Assuming treatment with triple therapy, screening all individuals aged 40-64 years costs less than $100,000 per QALY.The cost-effectiveness of one-time birth-cohort hepatitis C screening for 40-64 year olds

  14. Risk factors and direct medical cost of early versus late unplanned readmissions among diabetes patients at a tertiary hospital in Singapore.

    Science.gov (United States)

    Png, May Ee; Yoong, Joanne; Chen, Cynthia; Tan, Chuen Seng; Tai, E Shyong; Khoo, Eric Y H; Wee, Hwee Lin

    2018-02-20

    To examine the risk factors and direct medical costs associated with early (≤30 days) versus late (31-180 days) unplanned readmissions among patients with type 2 diabetes in Singapore. Risk factors and associated costs among diabetes patients were investigated using electronic medical records from a local tertiary care hospital from 2010 to 2012. Multivariable logistic regression was used to identify risk factors associated with early and late unplanned readmissions while a generalized linear model was used to estimate the direct medical cost. Sensitivity analysis was also performed. A total of 1729 diabetes patients had unplanned readmissions within 180 days of an index discharge. Length of index stay (a marker of acute illness burden) was one of the risk factors associated with early unplanned readmission while patient behavior-related factors, like diabetes-related medication adherence, were associated with late unplanned readmission. Adjusted mean cost of index admission was higher among patients with unplanned readmission. Sensitivity analysis yielded similar results. Existing routinely captured data can be used to develop prediction models that flag high risk patients during their index admission, potentially helping to support clinical decisions and prevent such readmissions.

  15. Trend, Risk Factors, and Costs of Clostridium difficile Infections in Vascular Surgery.

    Science.gov (United States)

    Egorova, Natalia N; Siracuse, Jeffrey J; McKinsey, James F; Nowygrod, Roman

    2015-01-01

    Starting in December 2013, the Hospital Inpatient Quality Reporting Program included Clostridium difficile infection (CDI) rates as a new publically reported quality measure. Our goal was to review the trend, hospital variability in CDI rates, and associated risk factors and costs in vascular surgery. The rates of CDI after major vascular procedures including aortic abdominal aneurysm (AAA) repair, carotid endarterectomy or stenting, lower extremity revascularization (LER), and LE amputation were identified using Nationwide Inpatient Sample database for 2000-2011. Risk factors associated with CDI were analyzed with hierarchical multivariate logistic regression. Extra costs, length of stay (LOS), and mortality were assessed for propensity-matched hospitalizations with and without CDI. During the study period, the rates of CDI after vascular procedures had increased by 74% from 0.6 in 2000 to 1.05% in 2011, whereas the case fatality rate was stable at 9-11%. In 2011, the highest rates were after ruptured aortic abdominal aneurysm (rAAA) repair (3.3%), followed by lower extremity amputations (2.3%) and elective open AAA (1.3%). The rates of CDI increased after all vascular procedures during the 12 years. The highest increase was after endovascular LER (151.8%) and open rAAA repair (135.7%). In 2011, patients who had experienced CDI had median LOS of 15 days (interquartile range, 9-25 days) compared with 8.3 days for matched patients without CDI, in-hospital mortality 9.1% (compared with 5.0%), and $13,471 extra cost per hospitalization. The estimated cost associated with CDI in vascular surgery in the United States was ∼$98 million in 2011. Hospital rates of CDI varied from 0 to 50% with 3.5% of hospitals having infection rates ≥5%. Factors associated with CDI included multiple chronic conditions, female gender, surgery type, emergent and weekend hospitalizations, hospital transfers, and urban locations. Despite potential reduction of infection rates as evidenced

  16. Cost-effectiveness analysis of cardiovascular risk factor screening in women who experienced hypertensive pregnancy disorders at term

    NARCIS (Netherlands)

    van Baaren, Gert-Jan; Hermes, Wietske; Franx, Arie; van Pampus, Maria G.; Bloemenkamp, Kitty W. M.; van der Post, Joris A.; Porath, Martina; Ponjee, Gabrielle A. E.; Tamsma, Jouke T.; Mol, Ben Willem J.; Opmeer, Brent C.; de Groot, Christianne J. M.

    2014-01-01

    Objectives: To assess the cost-effectiveness of post-partum screening on cardiovascular risk factors and subsequent treatment in women with a history of gestational hypertension or pre-eclampsia at term. Study design: Two separate Markov models evaluated the cost-effectiveness analysis of

  17. Health risk factors as predictors of workers' compensation claim occurrence and cost

    Science.gov (United States)

    Schwatka, Natalie V; Atherly, Adam; Dally, Miranda J; Fang, Hai; vS Brockbank, Claire; Tenney, Liliana; Goetzel, Ron Z; Jinnett, Kimberly; Witter, Roxana; Reynolds, Stephen; McMillen, James; Newman, Lee S

    2017-01-01

    Objective The objective of this study was to examine the predictive relationships between employee health risk factors (HRFs) and workers' compensation (WC) claim occurrence and costs. Methods Logistic regression and generalised linear models were used to estimate the predictive association between HRFs and claim occurrence and cost among a cohort of 16 926 employees from 314 large, medium and small businesses across multiple industries. First, unadjusted (HRFs only) models were estimated, and second, adjusted (HRFs plus demographic and work organisation variables) were estimated. Results Unadjusted models demonstrated that several HRFs were predictive of WC claim occurrence and cost. After adjusting for demographic and work organisation differences between employees, many of the relationships previously established did not achieve statistical significance. Stress was the only HRF to display a consistent relationship with claim occurrence, though the type of stress mattered. Stress at work was marginally predictive of a higher odds of incurring a WC claim (p<0.10). Stress at home and stress over finances were predictive of higher and lower costs of claims, respectively (p<0.05). Conclusions The unadjusted model results indicate that HRFs are predictive of future WC claims. However, the disparate findings between unadjusted and adjusted models indicate that future research is needed to examine the multilevel relationship between employee demographics, organisational factors, HRFs and WC claims. PMID:27530688

  18. Causes, costs, and risk factors for unplanned return visits after adenotonsillectomy in children.

    Science.gov (United States)

    Duval, Melanie; Wilkes, Jacob; Korgenski, Kent; Srivastava, Rajendu; Meier, Jeremy

    2015-10-01

    To review the causes, costs, and risk factors for unplanned return visits and readmissions after pediatric adenotonsillectomy (T&A). Review of administrative database of outpatient adenotonsillectomy performed at any facility within a vertically integrated health care system in the Intermountain West on children age 1-18 years old between 1998 and 2012. Data reviewed included demographic variables, diagnosis associated with return visit and costs associated with return visits. Data from 39,906 children aged 1-18 years old were reviewed. A total of 2499 (6.3%) children had unplanned return visits. The most common reasons for return visits were bleeding (2.3%), dehydration, (2.3%) and throat pain (1.2%). After multivariate analysis, the main risk factors for any type of return visits were Medicaid insurance (OR=1.64 95% CI 1.47-1.84), Hispanic race (OR=1.36 95% CI 1.13-1.64), and increased severity of illness (SOI) (OR=11.29 95% CI 2.69-47.4 for SOI=3). The only factor associated with increased odds of requiring an inpatient admission on return visit was length of time spent in PACU (prelationship was also observed between the child's age and the risk of post-tonsillectomy hemorrhage. Children with increased severity of illness, those insured with Medicaid, and children of Hispanic ethnicity should be targeted with increased education and interventions in order to reduce unplanned visits after T&A. Further studies on post-tonsillectomy complications should include evaluating the effect of surgical technique and post-operative pain management on all complications and not solely post-tonsillectomy hemorrhage. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Methods for cost-benefit-risk analysis of material-accounting upgrades

    International Nuclear Information System (INIS)

    Fishbone, L.G.; Gordon, D.M.; Higinbotham, W.; Keisch, B.

    1988-01-01

    The authors have developed a cost-benefit-risk methodology for evaluating material-accounting upgrades at key measurement points in nuclear facilities. The focus of this methodology is on nuclear-material measurements and their effects on inventory differences and shipper/receiver differences. The methodology has three main components: cost, benefits, and risk factors. The fundamental outcome of the methodology is therefore cost-benefit ratios characterizing the proposed upgrades, with the risk factors applied as necessary to the benefits. Examples illustrate the methodology's use

  20. Cost Risk Analysis Based on Perception of the Engineering Process

    Science.gov (United States)

    Dean, Edwin B.; Wood, Darrell A.; Moore, Arlene A.; Bogart, Edward H.

    1986-01-01

    In most cost estimating applications at the NASA Langley Research Center (LaRC), it is desirable to present predicted cost as a range of possible costs rather than a single predicted cost. A cost risk analysis generates a range of cost for a project and assigns a probability level to each cost value in the range. Constructing a cost risk curve requires a good estimate of the expected cost of a project. It must also include a good estimate of expected variance of the cost. Many cost risk analyses are based upon an expert's knowledge of the cost of similar projects in the past. In a common scenario, a manager or engineer, asked to estimate the cost of a project in his area of expertise, will gather historical cost data from a similar completed project. The cost of the completed project is adjusted using the perceived technical and economic differences between the two projects. This allows errors from at least three sources. The historical cost data may be in error by some unknown amount. The managers' evaluation of the new project and its similarity to the old project may be in error. The factors used to adjust the cost of the old project may not correctly reflect the differences. Some risk analyses are based on untested hypotheses about the form of the statistical distribution that underlies the distribution of possible cost. The usual problem is not just to come up with an estimate of the cost of a project, but to predict the range of values into which the cost may fall and with what level of confidence the prediction is made. Risk analysis techniques that assume the shape of the underlying cost distribution and derive the risk curve from a single estimate plus and minus some amount usually fail to take into account the actual magnitude of the uncertainty in cost due to technical factors in the project itself. This paper addresses a cost risk method that is based on parametric estimates of the technical factors involved in the project being costed. The engineering

  1. Factors influencing cost over-run in Indian construction projects

    Directory of Open Access Journals (Sweden)

    Cindrela Devi A.

    2017-01-01

    Full Text Available Construction cost is the most important criteria of project success and hence the construction project performance is generally expressed in terms of cost and its variance from the budget. In spite of having extant literature, cost estimation methods, cost indices etc., construction projects rarely meet the budgeted cost. This research study focuses on the construction cost overrun and to identify the various factors that affects the construction cost performance. Based on an extensive literature review and input from industry experts, sixty eight factors that causes cost overrun were identified for investigation. Further, a structured questionnaire survey was conducted among the industry experts and the collected data has been analysed statistically. It is concluded that the factors namely scope creep, construction delays, rework and practise of awarding the contract to the lowest bidder are most significant factors for construction cost overrun in non-infrastructural Indian projects. The relative importance of the listed factors used to guide the project team in addressing the cost related risks involved in the projects. The findings are expected to bridge the gap in the current construction cost management practices.

  2. Cost-effectiveness analysis of cardiovascular risk factor screening in women who experienced hypertensive pregnancy disorders at term.

    Science.gov (United States)

    van Baaren, Gert-Jan; Hermes, Wietske; Franx, Arie; van Pampus, Maria G; Bloemenkamp, Kitty W M; van der Post, Joris A; Porath, Martina; Ponjee, Gabrielle A E; Tamsma, Jouke T; Mol, Ben Willem J; Opmeer, Brent C; de Groot, Christianne J M

    2014-10-01

    To assess the cost-effectiveness of post-partum screening on cardiovascular risk factors and subsequent treatment in women with a history of gestational hypertension or pre-eclampsia at term. Two separate Markov models evaluated the cost-effectiveness analysis of hypertension (HT) screening and screening on metabolic syndrome (MetS), respectively, as compared to current practice in women with a history of term hypertensive pregnancy disorders. Analyses were performed from the Dutch health care perspective, using a lifetime horizon. One-way sensitivity analyses and Monte Carlo simulation evaluated the robustness of the results. Both screening on HT and MetS in women with a history of gestational hypertension or pre-eclampsia resulted in increase in life expectancy (HT screening 0.23year (95% CI -0.06 to 0.54); MetS screening 0.14years (95% CI -0.16 to 0.45)). The gain in QALYs was limited, with HT screening and MetS screening generating 0.04 QALYs (95% CI -0.12 to 0.20) and 0.03 QALYs (95% CI -0.14 to 0.19), resulting in costs to gain one QALY of €4228 and €28,148, respectively. Analyses for uncertainty showed a chance of 74% and 75%, respectively, that post-partum screening is cost-effective at a threshold of €60,000/QALY. According to the available knowledge post-partum screening on cardiovascular risk factors and subsequent treatment in women with a history of gestational hypertension or pre-eclampsia at term is likely to be cost-effective. Copyright © 2014 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

  3. Cost control and risk mitigation of major projects

    International Nuclear Information System (INIS)

    Caddy, D.G.

    1993-01-01

    In this paper and presentation, the four major types of estimates will be discussed, i.e., capacity factored, equipment factored, semi-detailed and detailed. Key relationships between particular portions of estimates will be discussed such as the relationship between direct field labor and indirect field costs. Having set the basis for developing a project's cost through estimating, the paper will then list and discuss the fifteen key steps which must be followed to control the costs of a project. Next, the subject of allowances and contingency will be discussed and defined and the differences between the two will be highlighted. Having established exactly what contingency is, the subject of risk analysis through RANGE estimating will be discussed. The methods used to establish a precise contingency and probability of an over/under run will be discussed. Finally, the paper will discuss the methods by which a project manager, owner or contractor can mitigate risks; that is to eliminate, transfer or minimize their effect

  4. Costs and risk factors for ventilator-associated pneumonia in a Turkish University Hospital's Intensive Care Unit: A case-control study

    Directory of Open Access Journals (Sweden)

    Serin Simay

    2004-04-01

    Full Text Available Abstract Background Ventilator-associated pneumonia (VAP which is an important part of all nosocomial infections in intensive care unit (ICU is a serious illness with substantial morbidity and mortality, and increases costs of hospital care. We aimed to evaluate costs and risk factors for VAP in adult ICU. Methods This is a-three year retrospective case-control study. The data were collected between 01 January 2000 and 31 December 2002. During the study period, 132 patients were diagnosed as nosocomial pneumonia of 731 adult medical-surgical ICU patients. Of these only 37 VAP patients were assessed, and multiple nosocomially infected patients were excluded from the study. Sixty non-infected ICU patients were chosen as control patients. Results Median length of stay in ICU in patients with VAP and without were 8.0 (IQR: 6.5 and 2.5 (IQR: 2.0 days respectively (P Conclusion Respiratory failure, coma, depressed consciousness, enteral feeding and length of stay are independent risk factors for developing VAP. The cost of VAP is approximately five-fold higher than non-infected patients.

  5. Industrial risk factors for colorectal cancer

    International Nuclear Information System (INIS)

    Lashner, B.A.; Epstein, S.S.

    1990-01-01

    Colorectal cancer is the second most common malignancy in the United States, and its incidence rates have sharply increased recently, especially in males. Industrial exposures, both occupational and environmental, are important colorectal cancer risk factors that are generally unrecognized by clinicians. Migration studies have documented that colorectal cancer is strongly associated with environmental risk factors. The causal role of occupational exposures is evidenced by a substantial literature associating specific work practices with increased colorectal cancer risks. Industrially related environmental exposures, including polluted drinking water and ionizing radiation, have also been associated with excess risks. Currently, there is a tendency to attribute colorectal cancer, largely or exclusively, to dietary and other lifestyle factors, thus neglecting these industrially related effects. Concerted efforts are needed to recognize the causal role of industrial risk factors and to encourage government and industry to reduce carcinogenic exposures. Furthermore, cost-effective screening programs for high-risk population groups are critically needed to further reduce deaths from colorectal cancer. 143 references

  6. Risk Factors, Health Care Resource Utilization, and Costs Associated with Nonadherence to Antiretrovirals in Medicaid-Insured Patients with HIV.

    Science.gov (United States)

    Dunn, Keith; Lafeuille, Marie-Hélène; Jiao, Xiaolong; Romdhani, Hela; Emond, Bruno; Woodruff, Kimberly; Pesa, Jacqueline; Tandon, Neeta; Lefebvre, Patrick

    2018-06-07

    Adherence to antiretrovirals (ARVs) is critical to achieving durable virologic suppression. To investigate risk factors of poor adherence and the effect of suboptimal adherence on health care resource utilization (HCRU) and costs in Medicaid patients. A retrospective longitudinal study was conducted using Medicaid data. Adults (aged ≥ 18 years) with human immunodeficiency virus (HIV)-1 initiating selected ARVs (index date) were identified. Adherence was measured using medication possession ratio (MPR) and proportion of days covered (PDC) at 6 and 12 months post-index. Risk factors of poor adherence (PDC logistic regression. HCRU and costs were compared between suboptimal (80% ≤ PDC costs (mean monthly cost difference = $339; 95% CI = $153-$536; P costs (mean monthly cost difference = $259; 95% CI = $122-$418; P costs. Age, insurance type and coverage, previous ARV treatment, and HIV symptoms were predictors of adherence. Treatment options that enhance adherence and prevent developing virologic failure with drug resistance should be considered for HIV patients. This study was supported by Janssen Scientific Affairs, which was involved in the study design, data collection, data analysis, manuscript preparation, and publication decisions. Emond, Lafeuille, Romdhani, and Lefebvre are employees of Analysis Group, a consulting company that received research grants from Janssen Scientific Affairs to conduct this study. Dunn, Woodruff, Pesa, and Tandon are current employees and stockholders of Johnson & Johnson, owner of Janssen Scientific Affairs. Jiao was an employee of Janssen at the time of the study. Emond has received grants from Novartis, Regeneron, Aegerion, Lundbeck, Bristol-Myers Squibb, Bayer, Millennium, Allergan, AbbVie, and GlaxoSmithKline unrelated to this study. Part of the material in this study was presented at the Academy of Managed Care Pharmacy 2017 Annual Meeting, March 27-30, 2017, in Denver, Colorado, and at the 9th International AIDS Society

  7. Differences in Health Care Costs and Utilization among Adults with Selected Lifestyle-Related Risk Factors.

    Science.gov (United States)

    Tucker, Larry A.; Clegg, Alan G.

    2002-01-01

    Examined the relationship between lifestyle-related health risks and health care costs and utilization among young adults. Data collected at a primarily white collar worksite in over 2 years indicated that health risks, particularly obesity, stress, and general lifestyle, were significant predictors of health care costs and utilization among these…

  8. Financial costs due to excess health risks among active employees of a utility company.

    Science.gov (United States)

    Yen, Louis; Schultz, Alyssa; Schnueringer, Elaine; Edington, Dee W

    2006-09-01

    The objective of this study was to examine the health risk-related excess costs of time away from work, medical claims, pharmacy claims, and total costs with and without considering the prevalence of health risks. A total of 2082 of 4266 employees of a Midwest utility participated in a health risk appraisal (HRA). Individuals were classified by their HRA participation status and also by 15 health risks. Total and excess costs were analyzed for all employees. There were significant excess costs due to individual risks and overall excess health risks in all cost measures. Both excess cost per risk and prevalence of the risk were important factors in determining the excess costs in the population. As compared with low-risk participants, HRA nonparticipants and the medium- and high-risk participants were 1.99, 2.22, and 3.97 times more likely to be high cost status. Approximately one third of corporate costs in medical claims, pharmacy claims, and time away from work could be defined as excess costs associated with excess health risks.

  9. Systematization of Cost Factors for Cost Management at Industrial Enterprises

    Directory of Open Access Journals (Sweden)

    N. Y.

    2017-12-01

    Full Text Available Identification and structuring of factors determining the cost level has significant importance in cost analysis and control. Cost factors need to be systematized for more effective cost management. The objective of the study is to identify and structure the factors with impact on the enterprise costs. The external and internal factors with impact on the enterprise costs in industry are highlighted. For cost management purposes, it is proposed to group the cost factors into the two categories: structural and functional. The essence of structural and functional factors is shown; a classification of functional factors is given. The effect of a structural factor such as products range (complexity is illustrated. As the factor of complexity, combined with cost analysis systems and innovative tools of analysis (ABC and XYZ methods, has been increasingly in focus of analysts, three problems are described which, once dealt with, will enable ABC method to fit into the cost management system. The importance of another structural factor of costs, technology selection, in cost management is shown. The analysis allows for the following conclusions: for purposes of current cost management, including one based on operational analysis, the output needs to be addressed as the central factor determining the cost level; in the strategic perspective, an enterprise needs to concentrate on calculating the costs for the structural alternatives that are supposed to determine its competitive position; for cost management purposes, the cost factors should be broken into two categories, structural and functional; a specific management system exists for each cost factor, which is greatly important for the positioning of an enterprise.

  10. Lifestyle factors, direct and indirect costs for a Brazilian airline company

    NARCIS (Netherlands)

    F.M. Rabacow (Fabiana Maluf); O. Do Carmo Luiz (Olinda); A.M. Malik (Ana Maria); A. Burdorf (Alex)

    2014-01-01

    textabstractObjective: To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. Methods: In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave

  11. Construction cost impacts related to manpower, material, and equipment factors in contractor firms perspective

    Science.gov (United States)

    Husin, Saiful; Abdullah, Riza, Medyan; Afifuddin, Mochammad

    2017-11-01

    Risk can be defined as consequences which possible happened inscrutably. Although an activity has planned as good as possible, but it keep contains uncertainty. Implementation of construction project was encountering various risk impacts from a number of risk factors. This study was intended to analyze the impacts of construction cost to for contractor firms as construction project executor related to the factors of manpower, material and equipment. The study was using data obtained from questionnaires distributed to 15 large qualification contractor firms. The period of study classified into conflict period (2000-2004), post tsunami disaster rehabilitation and reconstruction period (2005-2009), and post rehabilitation and reconstruction period (2010-present). The statistical analysis of severity index and variance used to analyze the data. The three risk factors reviewed generally affected the cost in a medium impact. The high impact occurred in minor variables, which are `increase in material prices', `theft of materials', and `the fuel scarcity'. In overall, the three risk factors and the observed period contributed significant impact on construction costs.

  12. Estimation of the burden of cardiovascular disease attributable to modifiable risk factors and cost-effectiveness analysis of preventative interventions to reduce this burden in Argentina

    Directory of Open Access Journals (Sweden)

    Martí Sebastián

    2010-10-01

    Full Text Available Abstract Background Cardiovascular disease (CVD is the primary cause of mortality and morbidity in Argentina representing 34.2% of deaths and 12.6% of potential years of life lost (PYLL. The aim of the study was to estimate the burden of acute coronary heart disease (CHD and stroke and the cost-effectiveness of preventative population-based and clinical interventions. Methods An epidemiological model was built incorporating prevalence and distribution of high blood pressure, high cholesterol, hyperglycemia, overweight and obesity, smoking, and physical inactivity, obtained from the Argentine Survey of Risk Factors dataset. Population Attributable Fraction (PAF of each risk factor was estimated using relative risks from international sources. Total fatal and non-fatal events, PYLL and Disability Adjusted Life Years (DALY were estimated. Costs of event were calculated from local utilization databases and expressed in international dollars (I$. Incremental cost-effectiveness ratios (ICER were estimated for six interventions: reducing salt in bread, mass media campaign to promote tobacco cessation, pharmacological therapy of high blood pressure, pharmacological therapy of high cholesterol, tobacco cessation therapy with bupropion, and a multidrug strategy for people with an estimated absolute risk > 20% in 10 years. Results An estimated total of 611,635 DALY was lost due to acute CHD and stroke for 2005. Modifiable risk factors explained 71.1% of DALY and more than 80% of events. Two interventions were cost-saving: lowering salt intake in the population through reducing salt in bread and multidrug therapy targeted to persons with an absolute risk above 20% in 10 years; three interventions had very acceptable ICERs: drug therapy for high blood pressure in hypertensive patients not yet undergoing treatment (I$ 2,908 per DALY saved, mass media campaign to promote tobacco cessation amongst smokers (I$ 3,186 per DALY saved, and lowering cholesterol with

  13. Risk Factors Influencing Construction Procurement Performance in Nigeria

    Directory of Open Access Journals (Sweden)

    Alhassan Dahiru

    2015-08-01

    Full Text Available One of the challenges facing construction procurement performance is the failure to determine the risk related factors limiting its success. These risk factors can cause a significant increase in the procurement cost leading to an increase in the overall project cost. The purpose of this study is to identify and evaluate the risk factors influencing construction procurement performance with a view to achieve the overall project performance. The objectives are to establish a relative significance index score for the most important risk factors limiting the procurement performance of the projects. A self administered questionnaire was employed to the construction industry professionals for responses. A total of 78 questionnaires were distributed to these professionals (architects, quantity surveyors, engineers, and contractors but 62 were returned and analyzed using influential index and later ranked in order of importance. Results of the analysis indicate a disparity in terms of ranking of the factors influencing construction procurement performance. Corruption related risk, conflict of interest, ineffective project technical feasibility, and lack of commitment to transparency were found to be the most significant factors limiting construction procurement performance. Communication barriers and unconfidential tender evaluation process were found to be the low weighted risk factors. The findings can serve as a supportive mechanism for risks management in public construction procurement management. Therefore, construction procurement personnel at all levels of government may find this study relevant, while improving construction procurement performance in the country. It is recommended that construction procurement system should be focused on risks related to corruption, conflict of interest, and effective technical feasibility for improving the overall project performance.

  14. Integrated framework for the external cost assessment of nuclear power plant accident considering risk aversion: The Korean case

    International Nuclear Information System (INIS)

    Lee, Sang Hun; Kang, Hyun Gook

    2016-01-01

    Recently, the estimation of accident costs within the social costs of nuclear power plants (NPPs) has garnered substantial interest. In particular, the risk aversion behavior of the public toward an NPP accident is considered an important factor when integrating risk aversion into NPP accident cost. In this study, an integrated framework for the external cost assessment of NPP accident that measures the value of statistical life (VSL) and the relative risk aversion (RRA) coefficient for NPP accident based on an individual-level survey is proposed. To derive the willingness to pay and the RRA coefficient for NPP accident risks, a survey was conducted on a sample of 1550 individuals in Korea. The estimation obtained a mean VSL of USD 2.78 million and an RRA coefficient of 1.315. Based on the estimation results in which various cost factors were considered, a multiplication factor of 5.16 and an external cost of NPP accidents of 4.39E−03 USD-cents/kW h were estimated. This study is expected to provide insight to energy policy decision-makers on analyzing the economic validity of NPP compared to other energy sources by reflecting the estimated external cost of NPP accident into the unit electricity generation cost of NPP. - Highlights: •External cost assessment framework for NPP is proposed considering risk aversion. •VSL was derived from WTP for mortality risk reduction from hypothetical NPP accident. •RRA was derived to integrate public risk aversion into external cost of NPP accident. •Individual-level survey was conducted to derive WTP and RRA for NPP accident risk. •The external cost was estimated considering the direct cost factors of NPP accident.

  15. Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.

    Science.gov (United States)

    Ndindjock, Roger; Gedeon, Jude; Mendis, Shanthi; Paccaud, Fred; Bovet, Pascal

    2011-04-01

    To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.

  16. Managing the total cost of risk exposures through risk mapping techniques

    International Nuclear Information System (INIS)

    Unione, A.J.; Rode, D.M.

    1998-01-01

    In a competitive power market, power producers are exposed to an increasingly broad spectrum of financial risks. The cumulative impact of these financial risks is known collectively as the Total of Cost of Risk. The concept of Total of Cost of Risk presents the business reality of a company's exposure to potentially devastating financial consequences in an integrated and useful way. In this way, a strategy of managing Total Cost of Risk in the most cost effective way can become a means of ensuring long term business health and security. This paper will examine the use of risk mapping as a tool for visually understanding Total Cost of Risk, thus creating an enhanced situational awareness and an integrated basis for risk management decision. The evaluation process, available through the use of risk maps allows the power producers to pro-actively implement prudent business decisions concerning the design, operation and maintenance of power plants. Risk mapping is thus a means for harmonizing operational objectives, such as improved plant reliability, with corporate strategies and goals in terms of an effective risk management program

  17. Development of Risk Uncertainty Factors from Historical NASA Projects

    Science.gov (United States)

    Amer, Tahani R.

    2011-01-01

    NASA is a good investment of federal funds and strives to provide the best value to the nation. NASA has consistently budgeted to unrealistic cost estimates, which are evident in the cost growth in many of its programs. In this investigation, NASA has been using available uncertainty factors from the Aerospace Corporation, Air Force, and Booz Allen Hamilton to develop projects risk posture. NASA has no insight into the developmental of these factors and, as demonstrated here, this can lead to unrealistic risks in many NASA Programs and projects (P/p). The primary contribution of this project is the development of NASA missions uncertainty factors, from actual historical NASA projects, to aid cost-estimating as well as for independent reviews which provide NASA senior management with information and analysis to determine the appropriate decision regarding P/p. In general terms, this research project advances programmatic analysis for NASA projects.

  18. Regulatory cost-risk study

    International Nuclear Information System (INIS)

    1983-04-01

    This study is intended to provide some quantitative perspective by selecting certain examples of criteria for which estimates of risks and costs can be obtained, and the balance of the various risks, (i.e., internal versus external risks), can be put into perspective. 35 refs., 39 tabs

  19. Regulatory cost-risk study

    Energy Technology Data Exchange (ETDEWEB)

    1983-04-01

    This study is intended to provide some quantitative perspective by selecting certain examples of criteria for which estimates of risks and costs can be obtained, and the balance of the various risks, (i.e., internal versus external risks), can be put into perspective. 35 refs., 39 tabs. (JDB)

  20. Preoperative modifiable risk factors in colorectal surgery

    DEFF Research Database (Denmark)

    van Rooijen, Stefanus; Carli, Francesco; Dalton, Susanne O

    2017-01-01

    in higher mortality rates and greater hospital costs. The number and severity of complications is closely related to patients' preoperative performance status. The aim of this study was to identify the most important preoperative modifiable risk factors that could be part of a multimodal prehabilitation...... program. METHODS: Prospectively collected data of a consecutive series of Dutch CRC patients undergoing colorectal surgery were analyzed. Modifiable risk factors were correlated to the Comprehensive Complication Index (CCI) and compared within two groups: none or mild complications (CCI ... complications (CCI ≥20). Multivariate logistic regression analysis was done to explore the combined effect of individual risk factors. RESULTS: In this 139 patient cohort, smoking, malnutrition, alcohol consumption, neoadjuvant therapy, higher age, and male sex, were seen more frequently in the severe...

  1. A mathematical model for crashing projects by considering time, cost, quality and risk

    Directory of Open Access Journals (Sweden)

    Amin Mahmoudi

    2017-01-01

    Full Text Available Employers are looking for reducing execution time and maintaining the quality of the projects that are the main objective of the projects. In this article, we focus on crashing projects by con-sidering different factors such as cost, time, quality and risk. For the proposed integer linear model, cost of conformance and cost of non-conformance are considered as parts of the costs of quality of deliverables in projects. The cost of conformance consists of the costs of training the project team, inspection and test of deliverables. The cost of non-conformance also includes costs of rework and scrap. Project risk management is one of the important aspects of the pro-jects. The present study also considers the impact of risks, which is highly applicable in projects with a high level of uncertainty. Results are presented using integer programming approach with the aim of minimizing the costs of the project.

  2. From Physical Process to Economic Cost - Integrated Approaches of Landslide Risk Assessment

    Science.gov (United States)

    Klose, M.; Damm, B.

    2014-12-01

    The nature of landslides is complex in many respects, with landslide hazard and impact being dependent on a variety of factors. This obviously requires an integrated assessment for fundamental understanding of landslide risk. Integrated risk assessment, according to the approach presented in this contribution, implies combining prediction of future landslide occurrence with analysis of landslide impact in the past. A critical step for assessing landslide risk in integrated perspective is to analyze what types of landslide damage affected people and property in which way and how people contributed and responded to these damage types. In integrated risk assessment, the focus is on systematic identification and monetization of landslide damage, and analytical tools that allow deriving economic costs from physical landslide processes are at the heart of this approach. The broad spectrum of landslide types and process mechanisms as well as nonlinearity between landslide magnitude, damage intensity, and direct costs are some main factors explaining recent challenges in risk assessment. The two prevailing approaches for assessing the impact of landslides in economic terms are cost survey (ex-post) and risk analysis (ex-ante). Both approaches are able to complement each other, but yet a combination of them has not been realized so far. It is common practice today to derive landslide risk without considering landslide process-based cause-effect relationships, since integrated concepts or new modeling tools expanding conventional methods are still widely missing. The approach introduced in this contribution is based on a systematic framework that combines cost survey and GIS-based tools for hazard or cost modeling with methods to assess interactions between land use practices and landslides in historical perspective. Fundamental understanding of landslide risk also requires knowledge about the economic and fiscal relevance of landslide losses, wherefore analysis of their

  3. Costs of heart disease and risk behaviour: implications for expenditure on prevention

    DEFF Research Database (Denmark)

    Kruse, Marie; Davidsen, Michael; Madsen, Mette

    2008-01-01

    , physical inactivity and smoking among future heart patients were estimated with the same method. RESULTS: Individuals with heart disease cost the healthcare system on average 3,195 (punhealthy lifestyle factors...... or cease unhealthy lifestyle may not only result in cost savings due to avoided heart disease. Additional cost savings may be obtained because heart patients who prior to the disease led a more healthy life consume fewer healthcare resources.......AIMS: The objective of this paper is firstly to estimate the healthcare costs attributable to heart disease in Denmark using recently available data for 2002-05. Secondly, to estimate the attributable healthcare costs of lifestyle risk factors among heart patients, in order to inform decision...

  4. Identification and assessment of risk factors affecting construction projects

    Directory of Open Access Journals (Sweden)

    Mohamed Sayed Bassiony Ahmed Abd El-Karim

    2017-08-01

    Unexpected increase in cost and delays in construction projects are caused by owner, contractor, environments, etc. in which several types of risk factors may occur concurrently. The effect of cost overrun and schedule overrun do not only influence the construction industry but the overall economy as well. Even though construction project increasing in cost and schedule has received extensive attention of researchers, but because of continuous changes and development in the field, the study considered of added value to the construction industry in Egypt, in addition to risk strategy and plan analysis. In order to meet the deadline of a project and due to the complex nature of construction projects, cost and scheduling should be flexible enough to accommodate changes without negatively affecting the overall project cost and duration. As such, the objectives of the presented research in this paper are to identify, study, and assess the effect of the factors that affect cost and time contingency. Data are collected from sixteen construction companies in Egypt. The collected data, output charts and analyses spreadsheets will be used for the development of computerized model built by the authors with identification abbreviation RIAM.

  5. Risk adjusted financial costs of photovoltaics

    Energy Technology Data Exchange (ETDEWEB)

    Szabo, Sandor; Jaeger-Waldau, Arnulf [Joint Research Centre, Institute for Energy, Via E. Fermi 2749, I-21020 Ispra (Italy); Szabo, Laszlo [Joint Research Centre, Institute for Prospective Technological Studies C. Inca Garcilaso, 3. E-41092 Sevilla (Spain)

    2010-07-15

    Recent research shows significant differences in the levelised photovoltaics (PV) electricity cost calculations. The present paper points out that no unique or absolute cost figure can be justified, the correct solution is to use a range of cost figures that is determined in a dynamic power portfolio interaction within the financial scheme, support mechanism and industry cost reduction. The paper draws attention to the increasing role of financial investors in the PV segment of the renewable energy market and the importance they attribute to the risks of all options in the power generation portfolio. Based on these trends, a former version of a financing model is adapted to project the energy mix changes in the EU electricity market due to investors behaviour with different risk tolerance/aversion. The dynamic process of translating these risks into the return expectation in the financial appraisal and investment decision making is also introduced. By doing so, the paper sets up a potential electricity market trend with the associated risk perception and classification. The necessary risk mitigation tasks for all stakeholders in the PV market are summarised which aims to avoid the burden of excessive risk premiums in this market segment. (author)

  6. Risk adjusted financial costs of photovoltaics

    International Nuclear Information System (INIS)

    Szabo, Sandor; Jaeger-Waldau, Arnulf; Szabo, Laszlo

    2010-01-01

    Recent research shows significant differences in the levelised photovoltaics (PV) electricity cost calculations. The present paper points out that no unique or absolute cost figure can be justified, the correct solution is to use a range of cost figures that is determined in a dynamic power portfolio interaction within the financial scheme, support mechanism and industry cost reduction. The paper draws attention to the increasing role of financial investors in the PV segment of the renewable energy market and the importance they attribute to the risks of all options in the power generation portfolio. Based on these trends, a former version of a financing model is adapted to project the energy mix changes in the EU electricity market due to investors behaviour with different risk tolerance/aversion. The dynamic process of translating these risks into the return expectation in the financial appraisal and investment decision making is also introduced. By doing so, the paper sets up a potential electricity market trend with the associated risk perception and classification. The necessary risk mitigation tasks for all stakeholders in the PV market are summarised which aims to avoid the burden of excessive risk premiums in this market segment.

  7. Got Risk? Using Risk Transfers to Control Costs

    Science.gov (United States)

    Bambino, Robert

    2010-01-01

    For public school districts, risk financing is the financial outlay associated with litigation, such as settlements, verdicts, and the cost of legal defense. Even when districts purchase insurance to finance risk, a viable risk transfer program can still benefit districts in different ways: (1) Liability policies are generally experience-rated;…

  8. Optimising the management of vaginal discharge syndrome in Bulgaria: cost effectiveness of four clinical algorithms with risk assessment.

    Science.gov (United States)

    Cornier, Nadine; Petrova, Elena; Cavailler, Philippe; Dentcheva, Rossitza; Terris-Prestholt, Fern; Janin, Arnaud; Ninet, Béatrice; Anguenot, Jean-Luc; Vassilakos, Pierre; Gerbase, Antonio; Mayaud, Philippe

    2010-08-01

    To evaluate the performance and cost effectiveness of the WHO recommendations of incorporating risk-assessment scores and population prevalence of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) into vaginal discharge syndrome (VDS) algorithms. Non-pregnant women presenting with VDS were recruited at a non-governmental sexual health clinic in Sofia, Bulgaria. NG and CT were diagnosed by PCR and vaginal infections by microscopy. Risk factors for NG/CT were identified in multivariable analysis. Four algorithms based on different combinations of behavioural factors, clinical findings and vaginal microscopy were developed. Performance of each algorithm was evaluated for detecting vaginal and cervical infections separately. Cost effectiveness was based on cost per patient treated and cost per case correctly treated. Sensitivity analysis explored the influence of NG/CT prevalence on cost effectiveness. 60% (252/420) of women had genital infections, with 9.5% (40/423) having NG/CT. Factors associated with NG/CT included new and multiple sexual partners in the past 3 months, symptomatic partner, childlessness and >or=10 polymorphonuclear cells per field on vaginal microscopy. For NG/CT detection, the algorithm that relied solely on behavioural risk factors was less sensitive but more specific than those that included speculum examination or microscopy but had higher correct-treatment rate and lower over-treatment rates. The cost per true case treated using a combination of risk factors, speculum examination and microscopy was euro 24.08. A halving and tripling of NG/CT prevalence would have approximately the inverse impact on the cost-effectiveness estimates. Management of NG/CT in Bulgaria was improved by the use of a syndromic approach that included risk scores. Approaches that did not rely on microscopy lost sensitivity but were more cost effective.

  9. Cost Model for Risk Assessment of Company Operation in Audit

    Directory of Open Access Journals (Sweden)

    S. V.

    2017-12-01

    Full Text Available This article explores the approach to assessing the risk of company activities termination by building a cost model. This model gives auditors information on managers’ understanding of factors influencing change in the value of assets and liabilities, and the methods to identify it in more effective and reliable ways. Based on this information, the auditor can assess the adequacy of use of the assumption on continuity of company operation by management personnel when preparing financial statements. Financial uncertainty entails real manifestations of factors creating risks of the occurrence of costs, revenue losses due their manifestations, which in the long run can be a reason for termination of company operation, and, therefore, need to be foreseen in the auditor’s assessment of the adequacy of use of the continuity assumption when preparing financial statements by company management. The purpose of the study is to explore and develop a methodology for use of cost models to assess the risk of termination of company operation in audit. The issue of methodology for assessing the audit risk through analyzing methods for company valuation has not been dealt with. The review of methodologies for assessing the risks of termination of company operation in course of audit gives grounds for the conclusion that use of cost models can be an effective methodology for identification and assessment of such risks. The analysis of the above methods gives understanding of the existing system for company valuation, integrated into the management system, and the consequences of its use, i. e. comparison of the asset price data with the accounting data and the market value of the asset data. Overvalued or undervalued company assets may be a sign of future sale or liquidation of a company, which may signal on high probability of termination of company operation. A wrong choice or application of valuation methods can be indicative of the risk of non

  10. The System Cost Model: A tool for life cycle cost and risk analysis

    International Nuclear Information System (INIS)

    Hsu, K.; Lundeen, A.; Shropshire, D.; Sherick, M.

    1996-01-01

    In May of 1994, Lockheed Idaho Technologies Company (LITCO) in Idaho Falls, Idaho and subcontractors began development of the System Cost Model (SCM) application. The SCM estimates life cycle costs of the entire US Department of Energy (DOE) complex for designing; constructing; operating; and decommissioning treatment, storage, and disposal (TSD) facilities for mixed low-level, low-level, and transuranic waste. The SCM uses parametric cost functions to estimate life cycle costs for various treatment, storage, and disposal modules which reflect planned and existing waste management facilities at DOE installations. In addition, SCM can model new TSD facilities based on capacity needs over the program life cycle. The user can provide input data (default data is included in the SCM) including the volume and nature of waste to be managed, the time period over which the waste is to be managed, and the configuration of the waste management complex (i.e., where each installation's generated waste will be treated, stored, and disposed). Then the SCM uses parametric cost equations to estimate the costs of pre-operations (designing), construction, operations and maintenance, and decommissioning these waste management facilities. The SCM also provides transportation costs for DOE wastes. Transportation costs are provided for truck and rail and include transport of contact-handled, remote-handled, and alpha (transuranic) wastes. A complement to the SCM is the System Cost Model-Risk (SCM-R) model, which provides relative Environmental, Safety, and Health (ES and H) risk information. A relative ES and H risk basis has been developed and applied by LITCO at the INEL. The risk basis is now being automated in the SCM-R to facilitate rapid risk analysis of system alternatives. The added risk functionality will allow combined cost and risk evaluation of EM alternatives

  11. Lifestyle factors, direct and indirect costs for a Brazilian airline company

    Science.gov (United States)

    Rabacow, Fabiana Maluf; Luiz, Olinda do Carmo; Malik, Ana Maria; Burdorf, Alex

    2014-01-01

    OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population. PMID:26039398

  12. Lifestyle factors, direct and indirect costs for a Brazilian airline company.

    Science.gov (United States)

    Rabacow, Fabiana Maluf; Luiz, Olinda do Carmo; Malik, Ana Maria; Burdorf, Alex

    2014-12-01

    OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.

  13. Lifestyle factors, direct and indirect costs for a Brazilian airline company

    Directory of Open Access Journals (Sweden)

    Fabiana Maluf Rabacow

    2014-12-01

    Full Text Available OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking, was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.

  14. Risk Factors

    Science.gov (United States)

    ... cells do not invade nearby tissues or spread. Risk Factors Key Points Factors That are Known to ... chemicals . Factors That are Known to Increase the Risk of Cancer Cigarette Smoking and Tobacco Use Tobacco ...

  15. Factors affecting mining costs

    International Nuclear Information System (INIS)

    Lowell, A.F.

    1977-01-01

    The subject is discussed under the following headings: investment decision-making, unit cost factors (declining ore grade, low-price contracts, ore grade/output relationship, above average cost increases). Economic, environmental, sociological and political aspects are considered. (U.K.)

  16. Risk-Assessment Score and Patient Optimization as Cost Predictors for Ventral Hernia Repair.

    Science.gov (United States)

    Saleh, Sherif; Plymale, Margaret A; Davenport, Daniel L; Roth, John Scott

    2018-04-01

    Ventral hernia repair (VHR) is associated with complications that significantly increase healthcare costs. This study explores the associations between hospital costs for VHR and surgical complication risk-assessment scores, need for cardiac or pulmonary evaluation, and smoking or obesity counseling. An IRB-approved retrospective study of patients having undergone open VHR over 3 years was performed. Ventral Hernia Risk Score (VHRS) for surgical site occurrence and surgical site infection, and the Ventral Hernia Working Group grade were calculated for each case. Also recorded were preoperative cardiology or pulmonary evaluations, smoking cessation and weight reduction counseling, and patient goal achievement. Hospital costs were obtained from the cost accounting system for the VHR hospitalization stratified by major clinical cost drivers. Univariate regression analyses were used to compare the predictive power of the risk scores. Multivariable analysis was performed to develop a cost prediction model. The mean cost of index VHR hospitalization was $20,700. Total and operating room costs correlated with increasing CDC wound class, VHRS surgical site infection score, VHRS surgical site occurrence score, American Society of Anesthesiologists class, and Ventral Hernia Working Group (all p variance in costs (p optimization significantly reduced direct and operating room costs (p < 0.05). Cardiac evaluation was associated with increased costs. Ventral hernia repair hospital costs are more accurately predicted by CDC wound class than VHR risk scores. A straightforward 6-factor model predicted most cost variation for VHR. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Risk information in support of cost estimates for the Baseline Environmental Management Report (BEMR). Section 1

    International Nuclear Information System (INIS)

    Gelston, G.M.; Jarvis, M.F.; Warren, B.R.; Von Berg, R.

    1995-06-01

    The Pacific Northwest Laboratory (PNL)(1) effort on the overall Baseline Environmental Management Report (BEMR) project consists of four installation-specific work components performed in succession. These components include (1) development of source terms, 92) collection of data and preparation of environmental settings reports, (3) calculation of unit risk factors, and (4) utilization of the unit risk factors in Automated Remedial Action Methodology (ARAM) for computation of target concentrations and cost estimates. This report documents work completed for the Nevada Test Site, Nevada, for components 2 and 3. The product of this phase of the BEMR project is the development of unit factors (i.e., unit transport factors, unit exposure factors, and unit risk factors). Thousands of these unit factors are gene rated and fill approximately one megabyte of computer information per installation. The final unit risk factors (URF) are transmitted electronically to BEMR-Cost task personnel as input to a computer program (ARAM). Abstracted files and exhibits of the URF information are included in this report. These visual formats are intended to provide a sample of the final task deliverable (the URF files) which can be easily read without a computer

  18. Specific Features of Diagnostics of Efficiency of Management of Innovation Risks at Enterprises of the Baking Industry (Cost-is-no-object Approach

    Directory of Open Access Journals (Sweden)

    Bilynska Juliana V.

    2014-03-01

    Full Text Available The article analyses diagnostics of efficiency of management of innovation risks through cost optimisation. Management of costs on innovation grounds is carried out with the aim of their reduction. In order to realise measures on reduction of influence of innovation risks in the system of cost management the article specifies the most important factors and builds multi-factor models. The process of study of influence of the innovation risk upon the cost value of the sold products of bakeries is presented in the form of a scheme of logically united stages. The article takes into account all restrictions and requirements, eliminates multi-collinearity and uses MS Excel Regression analysis for modelling dynamic multi-factor models of cost value of sold products of the studied bakeries. In the result of the study the article obtains main factors that would be used for forecasting tendencies of development of the studied enterprises, development of the decision making system and improvement of methodical provision of innovation risk management.

  19. Risk Factors in Euro Adoption by Romania

    Directory of Open Access Journals (Sweden)

    Roxana Maria BĂDÎRCEA

    2014-11-01

    Full Text Available The costs and benefits of adopting a unique currency have been studied and outlined by the optimum currency areas theory. This theory of Mundell has suffered modifications, a series of economists identifying and introducing a series of subsequent or additional criteria in the analysis. Starting from the costs indicated by the optimum currency areas theory and its further developments, I have identified a series of factors that I believe to represent future risks for the Romanian economy within the process of adopting the unique euro currency.

  20. Levelized cost-risk reduction prioritization of waste disposal options

    International Nuclear Information System (INIS)

    Wilkinson, V.K.; Young, J.M.

    1992-01-01

    The prioritization of solid waste disposal options in terms of reduced risk to workers, the public, and the environment has recently generated considerable governmental and public interest. In this paper we address the development of a methodology to establish priorities for waste disposal options, such as incineration, landfills, long-term storage, waste minimization, etc. The study is one result of an overall project to develop methodologies for Probabilistic Risk Assessments (PRAs) of non-reactor nuclear facilities for the US Department of Energy. Option preferences are based on a levelized cost-risk reduction analysis. Option rankings are developed as functions of disposal option cost and timing, relative long- and short-term risks, and possible accident scenarios. We examine the annual costs and risks for each option over a large number of years. Risk, in this paper, is defined in terms of annual fatalities (both prompt and long-term) and environmental restoration costs that might result from either an accidental release or long-term exposure to both plant workers and the public near the site or facility. We use event timing to weigh both costs and risks; near-term costs and risks are discounted less than future expenditures and fatalities. This technique levels the timing of cash flows and benefits by converting future costs and benefits to present value costs and benefits. We give an example Levelized Cost-Benefit Analysis of incinerator location options to demonstrate the methodology and required data

  1. A study on the estimation method of nuclear accident risk cost

    International Nuclear Information System (INIS)

    Matsuo, Yuji

    2016-01-01

    The methodology of estimating nuclear accident risk cost, as a part of nuclear power generation cost, has hardly been established due mainly to the extremely wide range of the estimation of the accident frequency. This study estimates the expected nuclear accident frequency for Japan, making use of the method of Bayesian statistics, which exploits both the information obtained by Probabilistic Risk Assessment (PRA) and the observed historical accident frequencies. Using the PRA estimation of the Containment Failure Frequency (CFF) for Tomari nuclear power plant unit 3 of Hokkaido Electric Power Company (average: 2.1 x 10 -4 , 95th percentile: 7.7 x 10 -4 ) and the actual large-scale accident frequency (once in 1,460 reactor-years), the posterior CFF was estimated at 3.8 x 10 -4 . This study also took into account the 'external' factor causing unexpected nuclear accidents, concluding that such factor could result in higher CFF estimations, especially with larger observed accident numbers. (author)

  2. Calculating the Unit Cost Factors for Decommissioning Cost Estimation of the Nuclear Research Reactor

    International Nuclear Information System (INIS)

    Jeong, Kwan Seong; Lee, Dong Gyu; Jung, Chong Hun; Lee, Kune Woo

    2006-01-01

    The estimated decommissioning cost of nuclear research reactor is calculated by applying a unit cost factor-based engineering cost calculation method on which classification of decommissioning works fitted with the features and specifications of decommissioning objects and establishment of composition factors are based. Decommissioning cost of nuclear research reactor is composed of labor cost, equipment and materials cost. Labor cost of decommissioning costs in decommissioning works are calculated on the basis of working time consumed in decommissioning objects. In this paper, the unit cost factors and work difficulty factors which are needed to calculate the labor cost in estimating decommissioning cost of nuclear research reactor are derived and figured out.

  3. Risk-Cost Estimation of On-Site Wastewater Treatment System Failures Using Extreme Value Analysis.

    Science.gov (United States)

    Kohler, Laura E; Silverstein, JoAnn; Rajagopalan, Balaji

    2017-05-01

      Owner resistance to increasing regulation of on-site wastewater treatment systems (OWTS), including obligatory inspections and upgrades, moratoriums and cease-and-desist orders in communities around the U.S. demonstrate the challenges associated with managing risks of inadequate performance of owner-operated wastewater treatment systems. As a result, determining appropriate and enforceable performance measures in an industry with little history of these requirements is challenging. To better support such measures, we develop a statistical method to predict lifetime failure risks, expressed as costs, in order to identify operational factors associated with costly repairs and replacement. A binomial logistic regression is used to fit data from public records of reported OWTS failures, in Boulder County, Colorado, which has 14 300 OWTS to determine the probability that an OWTS will be in a low- or high-risk category for lifetime repair and replacement costs. High-performing or low risk OWTS with repairs and replacements below the threshold of $9000 over a 40-year life are associated with more frequent inspections and upgrades following home additions. OWTS with a high risk of exceeding the repair cost threshold of $18 000 are further analyzed in a variation of extreme value analysis (EVA), Points Over Threshold (POT) where the distribution of risk-cost exceedance values are represented by a generalized Pareto distribution. The resulting threshold cost exceedance estimates for OWTS in the high-risk category over a 40-year expected life ranged from $18 000 to $44 000.

  4. Heart disease - risk factors

    Science.gov (United States)

    Heart disease - prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk ... a certain health condition. Some risk factors for heart disease you cannot change, but some you can. ...

  5. Recurrent Shoulder Dystocia: Risk Factors and Counseling.

    Science.gov (United States)

    Gurewitsch Allen, Edith D

    2016-12-01

    A prior history of delivery complicated by shoulder dystocia confers a 6-fold to nearly 30-fold increased risk of shoulder dystocia recurrence in a subsequent vaginal delivery, with most reported rates between 12% and 17%. Whereas prevention of shoulder dystocia in the general population is neither feasible nor cost-effective, directing intervention efforts at the particular subgroup of women with a prior history of shoulder dystocia has merit. Potentially modifiable risk factors and individualized management strategies that may reduce shoulder dystocia recurrence and its associated significant morbidities are reviewed.

  6. Acute kidney injury risk factor recognition in three teaching hospitals ...

    African Journals Online (AJOL)

    developing countries, which lack access to renal replacement therapy, ... To examine the relationship between AKI risk factor recognition and monitoring of renal ..... Travel costs were supported by the award of a Baxter Clinical Evidence.

  7. An empirical study for ranking risk factors using linear assignment: A case study of road construction

    Directory of Open Access Journals (Sweden)

    Amin Foroughi

    2012-04-01

    Full Text Available Road construction projects are considered as the most important governmental issues since there are normally heavy investments required in such projects. There is also shortage of financial resources in governmental budget, which makes the asset allocation more challenging. One primary step in reducing the cost is to determine different risks associated with execution of such project activities. In this study, we present some important risk factors associated with road construction in two levels for a real-world case study of rail-road industry located between two cities of Esfahan and Deligan. The first group of risk factors includes the probability and the effects for various attributes including cost, time, quality and performance. The second group of risk factors includes socio-economical factors as well as political and managerial aspects. The study finds 21 main risk factors as well as 193 sub risk factors. The factors are ranked using groups decision-making method called linear assignment. The preliminary results indicate that the road construction projects could finish faster with better outcome should we carefully consider risk factors and attempt to reduce their impacts.

  8. The benefits of integrating cost-benefit analysis and risk assessment

    International Nuclear Information System (INIS)

    Fisher, K.; Clarke-Whistler, K.

    1995-01-01

    It has increasingly been recognized that knowledge of risks in the absence of benefits and costs cannot dictate appropriate public policy choices. Recent evidence of this recognition includes the proposed EPA Risk Assessment and Cost-Benefit Analysis Act of 1995, a number of legislative changes in Canada and the US, and the increasing demand for field studies combining measures of impacts, risks, costs and benefits. Failure to consider relative environmental and human health risks, benefits, and costs in making public policy decisions has resulted in allocating scarce resources away from areas offering the highest levels of risk reduction and improvements in health and safety. The authors discuss the implications of not taking costs and benefits into account in addressing environmental risks, drawing on examples from both Canada and the US. The authors also present the results of their recent field work demonstrating the advantages of considering costs and benefits in making public policy and site remediation decisions, including a study on the benefits and costs of prevention, remediation and monitoring techniques applied to groundwater contamination; the benefits and costs of banning the use of chlorine; and the benefits and costs of Canada's concept of disposing of high-level nuclear waste. The authors conclude that a properly conducted Cost-Benefit Analysis can provide critical input to a Risk Assessment and can ensure that risk management decisions are efficient, cost-effective and maximize improvement to environmental and human health

  9. Risk evaluation: A cost-oriented approach

    International Nuclear Information System (INIS)

    Rogers, B.H.

    1998-01-01

    This method provides a structured and cost-oriented way to determine risks associated with loss and destruction of industrial security interests consisting of material assets and human resources. Loss and destruction are assumed to be adversary perpetrated, high-impact events in which the health and safety of people or high-value property is at risk. This concept provides a process for: (1) assessing effectiveness of all integrated protection system, which includes facility operations, safety, emergency and security systems, and (2) a qualitative prioritization scheme to determine the level of consequence relative to cost and subsequent risk. The method allows managers the flexibility to establish asset protection appropriate to programmatic requirements and priorities and to decide if funding is appropriate. The evaluation objectives are to: (1) provide for a systematic, qualitative tabletop process to estimate the potential for an undesirable event and its impact; and (2) identify ineffective protection and cost-effective solutions

  10. Cancer risks, risk-cost-benefit analyses, and the scientific method

    International Nuclear Information System (INIS)

    Seiler, F.A.; Alvarez, J.L.

    1995-01-01

    Two main changes in risk analysis are increasingly beginning to influence the manner in which, in the perception of scientists, low-dose modeling of radiation carcinogenesis is supposed to be done. In the past, efforts to model radiation risks have been carried out under the banner of scientific endeavors. On closer inspection, however, it has become obvious that these efforts were not guided by the scientific method and that a change in approach is needed. We realize increasingly that risk analysis is not done in a vacuum and that any action taken due to the result of the analysis not only has a benefit in the form of a risk reduction but leads inevitably to an increase in cost and an increase in the risks of persons effecting the benefit. Thus, a risk-cost-benefit analysis should be done and show a clear-cut net benefit before a remedial action is taken

  11. The Earnings/Price Risk Factor in Capital Asset Pricing Models

    Directory of Open Access Journals (Sweden)

    Rafael Falcão Noda

    2015-01-01

    Full Text Available This article integrates the ideas from two major lines of research on cost of equity and asset pricing: multi-factor models and ex ante accounting models. The earnings/price ratio is used as a proxy for the ex ante cost of equity, in order to explain realized returns of Brazilian companies within the period from 1995 to 2013. The initial finding was that stocks with high (low earnings/price ratios have higher (lower risk-adjusted realized returns, already controlled by the capital asset pricing model's beta. The results show that selecting stocks based on high earnings/price ratios has led to significantly higher risk-adjusted returns in the Brazilian market, with average abnormal returns close to 1.3% per month. We design asset pricing models including an earnings/price risk factor, i.e. high earnings minus low earnings, based on the Fama and French three-factor model. We conclude that such a risk factor is significant to explain returns on portfolios, even when controlled by size and market/book ratios. Models including the high earnings minus low earnings risk factor were better to explain stock returns in Brazil when compared to the capital asset pricing model and to the Fama and French three-factor model, having the lowest number of significant intercepts. These findings may be due to the impact of historically high inflation rates, which reduce the information content of book values, thus making the models based on earnings/price ratios better than those based on market/book ratios. Such results are different from those obtained in more developed markets and the superiority of the earnings/price ratio for asset pricing may also exist in other emerging markets.

  12. Recovery Risk and Labor Costs in Public-Private Partnerships : Contractual Choice in the US Water industry

    OpenAIRE

    Albalate, Daniel, 1980-; Bel i Queralt, Germà, 1963-; Geddes, R. Richard

    2012-01-01

    We use an ordered logistic model to empirically examine the factors that explain varying degrees of private involvement in the U.S. water sector through public-private partnerships. Our estimates suggest that a variety of factors help explain greater private participation in this sector. We find that the risk to private participants regarding cost recovery is an important driver of private participation. The relative cost of labor is also a key factor in determining the degree of private invo...

  13. Life cycle cost and risk estimation of environmental management options

    International Nuclear Information System (INIS)

    Shropshire, D.; Sherick, M.

    1996-01-01

    The evaluation process is demonstrated in this paper through comparative analysis of two alternative scenarios identified for the management of the alpha-contaminated fixed low-level waste currently stored at INEL. These two scenarios, the Base Case and the Delay Case, are realistic and based on actual data, but are not intended to exactly match actual plans currently being developed at INEL. Life cycle cost estimates were developed for both scenarios using the System Cost Model; resulting costs are presented and compared. Life cycle costs are shown as a function of time and also aggregated by pretreatment, treatment, storage, and disposal activities. Although there are some short-term cost savings for the Delay Case, cumulative life cycle costs eventually become much higher than costs for the Base Case over the same period of time, due mainly to the storage and repackaging necessary to accommodate the longer Delay Case schedule. Life cycle risk estimates were prepared using a new risk analysis method adapted to the System Cost Model architecture for automated, systematic cost/risk applications. Relative risk summaries are presented for both scenarios as a function of time and also aggregated by pretreatment, treatment, storage, and disposal activities. Relative risk of the Delay Case is shown to be higher than that of the Base Case. Finally, risk and cost results are combined to show how the collective information can be used to help identify opportunities for risk or cost reduction and highlight areas where risk reduction can be achieved most economically

  14. Cost Effectiveness of Primary Pegfilgrastim Prophylaxis in Patients With Breast Cancer at Risk of Febrile Neutropenia

    NARCIS (Netherlands)

    Aarts, Maureen J.; Grutters, Janneke P.; Peters, Frank P.; Mandigers, Caroline M.; Dercksen, M. Wouter; Stouthard, Jacqueline M.; Nortier, Hans J.; van Laarhoven, Hanneke W.; van Warmerdam, Laurence J.; van de Wouw, Agnes J.; Jacobs, Esther M.; Mattijssen, Vera; van der Rijt, Carin C.; Smilde, Tineke J.; van der Velden, Annette W.; Temizkan, Mehmet; Batman, Erdogan; Muller, Erik W.; van Gastel, Saskia M.; Joore, Manuela A.; Borm, George F.; Tjan-Heijnen, Vivianne C.

    2013-01-01

    Purpose Guidelines advise primary granulocyte colony-stimulating factor (G-CSF) prophylaxis during chemotherapy if risk of febrile neutropenia (FN) is more than 20%, but this comes with considerable costs. We investigated the incremental costs and effects between two treatment strategies of primary

  15. Cost effectiveness of primary pegfilgrastim prophylaxis in patients with breast cancer at risk of febrile neutropenia

    NARCIS (Netherlands)

    Aarts, M.J.; Grutters, J.P.C.; Peters, F.P.; Mandigers, C.M.P.W.; Dercksen, M.W.; Stouthard, J.M.; Nortier, H.J.; Laarhoven, H.W.M. van; Warmerdam, L.J. van; Wouw, A.J. van de; Jacobs, E.M.G.; Mattijssen, V.; Rijt, C.C. van der; Smilde, T.J.; Velden, A.W. van der; Temizkan, M.; Batman, E.; Muller, E.W.; Gastel, S.M. van; Joore, M.A.; Borm, G.F.; Tjan-Heijnen, V.C.

    2013-01-01

    PURPOSE: Guidelines advise primary granulocyte colony-stimulating factor (G-CSF) prophylaxis during chemotherapy if risk of febrile neutropenia (FN) is more than 20%, but this comes with considerable costs. We investigated the incremental costs and effects between two treatment strategies of primary

  16. Diagnosis and treatment strategies of thrombophilic risk factors

    Directory of Open Access Journals (Sweden)

    Murat Albayrak

    2010-09-01

    Full Text Available Thrombophilia is defined as the general name for a group of genetic and acquired situations, arising from defects of hemostasis mechanism and generating tendency to thrombosis. Examples of the acquired risk factors that increase the tendency to thrombosis are venous catheters, sepsis, surgery, hyperlipidemia, congestive heart disease, increased lipoprotein a, old age, antiphospholipid syndrome, nephrotic syndrome, hyperviscosity, chronic myeloproliferative neoplasms, paroxysmal nocturnal hemoglobinuria, heparin induced thrombocytopenia, vasculitis, immobility, obesity, major surgery, trauma, burns, malignancy, pregnancy and oral contraceptive usage. Genetic tendency to venous thromboembolism in early ages, even without any known cause, is named as thrombophilia. Factor V Leiden, prothrombin G20210A, methylenetetrahydrofolate reductase gene mutations, factor VIII elevation, protein C, protein S and antithrombin deficiency parameters are suggested for evaluation, in patient groups suspected of inherited thrombophilia. Detection of inherited thrombophilic factors in selected patient groups is a guide in developing treatment strategies and in establishing prognosis. Due to the genetic heterogeneities, each society should determine their thrombophilic risk pool. Thus, with the determination of the risk factors, unnecessary assessments will be prevented and a cost-effective approach can be developed.

  17. Cost effective radiation risk management in a generic nuclear plant design

    International Nuclear Information System (INIS)

    Maan, M.A.

    1982-11-01

    To determine whether any further dose reduction measures are justified, a method appropriate for cost effective radiation risk management has been developed. This new method is based on the radiation detriment optimization measures advocated in the revised (1977) ALARA concept. The methodology includes the determination of available alternatives, and the determination of the variable monetary ceiling on expenditures to reduce the radiological detriment (both occupational and public). The method used to determine the maximum justifiable expenditure for additional reduction of detriment takes into account the economic and social climate, administrative/legal exposure limits, and the actual magnitude of risk. All these factors may vary from country to country. The variable monetary ceiling, sensitive to an actual level of risk, provides a handy measure allowing designers to make a decision whether or not the modification of design is necessary and/or cost effective. This will ensure rationally and consistently that the utilities and their customers (public) get maximum benefit for their safety dollars

  18. Risk factors

    International Nuclear Information System (INIS)

    Dennery, M.; Dupont, M.A.

    2007-01-01

    This article deals with the development of risk management in the gas sector business: why a risk factor legal mention must precede any published financial information? Do gas companies have to face new risks? Is there specific risks bound to gas activities? Why companies want to master their risks? Is it mandatory or just a new habit? Do they expect a real benefit in return? These are the risk management questions that are analyzed in this article which is based on the public communication of 15 gas companies randomly selected over the world. The information comes from their annual reports or from documents available on their web sites. The intention of this document is not to be exhaustive or to make statistics but only to shade light on the risk factors of the gas sector. (J.S.)

  19. 76 FR 80448 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2011-12-23

    ... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. EP 290 (Sub-No. 5) (2012-1)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the first quarter 2012 rail cost adjustment factor (RCAF...

  20. Replica Approach for Minimal Investment Risk with Cost

    Science.gov (United States)

    Shinzato, Takashi

    2018-06-01

    In the present work, the optimal portfolio minimizing the investment risk with cost is discussed analytically, where an objective function is constructed in terms of two negative aspects of investment, the risk and cost. We note the mathematical similarity between the Hamiltonian in the mean-variance model and the Hamiltonians in the Hopfield model and the Sherrington-Kirkpatrick model, show that we can analyze this portfolio optimization problem by using replica analysis, and derive the minimal investment risk with cost and the investment concentration of the optimal portfolio. Furthermore, we validate our proposed method through numerical simulations.

  1. Cost and risk tradeoff for routing nuclear spent fuel movements

    International Nuclear Information System (INIS)

    Chin, S.M.

    1988-01-01

    In the transportation industry, much effort has been devoted to finding the least cost routes for shipping goods from their production sites to the market areas. In addition to cost, the decision maker must take the risk of an incident into consideration for transportation routing involving hazardous materials. The transportation of spent nuclear fuel from reactor sites to repositories is an example. Given suitable network information, existing routing methods can readily determine least cost or least risk routes for any shipment. These two solutions, however, represent the extremes of a large number of alternatives with different combinations of risk and cost. In the selection of routes and also in the evaluation of alternative storage sites it is not enough to know which is the lease cost or lowest risk. Intelligent decision-marking requires knowledge of how much it will cost to lower risk by a certain amount. The objective of this study is to develop an automated system to evaluate the tradeoff between transportation cost and potential population at risk under different nuclear spent fuel transportation strategies

  2. 78 FR 37660 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2013-06-21

    ..., http://www.stb.dot.gov . Copies of the decision may be purchased by contacting the Office of Public...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, DOT. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board approves the third quarter 2013 Rail Cost Adjustment Factor...

  3. 77 FR 58910 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2012-09-24

    ..., http://www.stb.dot.gov . Copies of the decision may be purchased by contacting the Office of Public...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the fourth quarter 2012 rail cost adjustment factor (RCAF...

  4. Estimation of Partial Safety Factors and Target Failure Probability Based on Cost Optimization of Rubble Mound Breakwaters

    DEFF Research Database (Denmark)

    Kim, Seung-Woo; Suh, Kyung-Duck; Burcharth, Hans F.

    2010-01-01

    The breakwaters are designed by considering the cost optimization because a human risk is seldom considered. Most breakwaters, however, were constructed without considering the cost optimization. In this study, the optimum return period, target failure probability and the partial safety factors...

  5. A utility/cost analysis of breast cancer risk prediction algorithms

    Science.gov (United States)

    Abbey, Craig K.; Wu, Yirong; Burnside, Elizabeth S.; Wunderlich, Adam; Samuelson, Frank W.; Boone, John M.

    2016-03-01

    Breast cancer risk prediction algorithms are used to identify subpopulations that are at increased risk for developing breast cancer. They can be based on many different sources of data such as demographics, relatives with cancer, gene expression, and various phenotypic features such as breast density. Women who are identified as high risk may undergo a more extensive (and expensive) screening process that includes MRI or ultrasound imaging in addition to the standard full-field digital mammography (FFDM) exam. Given that there are many ways that risk prediction may be accomplished, it is of interest to evaluate them in terms of expected cost, which includes the costs of diagnostic outcomes. In this work we perform an expected-cost analysis of risk prediction algorithms that is based on a published model that includes the costs associated with diagnostic outcomes (true-positive, false-positive, etc.). We assume the existence of a standard screening method and an enhanced screening method with higher scan cost, higher sensitivity, and lower specificity. We then assess expected cost of using a risk prediction algorithm to determine who gets the enhanced screening method under the strong assumption that risk and diagnostic performance are independent. We find that if risk prediction leads to a high enough positive predictive value, it will be cost-effective regardless of the size of the subpopulation. Furthermore, in terms of the hit-rate and false-alarm rate of the of the risk prediction algorithm, iso-cost contours are lines with slope determined by properties of the available diagnostic systems for screening.

  6. Risks, revenues and investment in electricity generation. Why policy needs to look beyond costs

    International Nuclear Information System (INIS)

    Gross, Robert; Heptonstall, Philip; Blyth, William

    2010-01-01

    Energy policy goals frequently depend upon investment in particular technologies, or categories of technology. Whilst the British government has often espoused the virtues of technological neutrality, UK policies now seek to promote nuclear power, coal with CO 2 capture and storage, and renewable energy. Policy decisions are often informed by estimates of cost per unit of output (for example, pound /MWh), also known as levelised costs. Estimates of these costs for different technologies are often used to provide a 'ballpark' guide to the levels of financial support needed (if any) to encourage uptake, or direct investment away from the technologies the market might otherwise have chosen. Levelised cost estimates can also help to indicate the cost of meeting public policy objectives, and whether there is a rationale for intervention (for example, based on net welfare gains). In the UK electricity sector, investment is undertaken by private companies, not governments. Investment is driven by expected returns, in the light of a range of risks related to both costs and revenues. Revenue risks are not captured in estimates of cost or cost-related risks. An important category of revenue risk is associated with electricity price fluctuations. Exposure to price risks differs by technology. Low electricity prices represent a revenue risk to technologies that cannot influence electricity prices. By contrast, 'price makers' that set marginal prices are, to an extent, able to pass fuel price increases through to consumers. They have an inherent 'hedge' against fuel and electricity price fluctuations. Based on recent research by the UK Energy Research Centre, this paper considers the implications of such price risks for policy design. The authors contrast the range of levelised costs estimated for different generating options with the spread of returns each is exposed to when electricity price fluctuations are factored in. Drawing on recent policy experiences in the renewable

  7. Risk factors for 30-day unplanned readmission following infrainguinal endovascular interventions

    NARCIS (Netherlands)

    Bodewes, Thomas C F; Soden, Peter A.; Ultee, Klaas H J; Zettervall, Sara L.; Pothof, Alexander B.; Deery, Sarah E.; Moll, Frans L.; Schermerhorn, Marc L.

    2017-01-01

    Objective Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular

  8. Cost effectiveness of risk-based closures at UST sites

    International Nuclear Information System (INIS)

    Scruton, K.M.; Baker, J.N.

    1995-01-01

    Risk-based closures have been achieved at Underground Storage Tank (UST) sites throughout the country for a major transportation company. The risk-based closures were cost-effective because a streamlined risk-based approach was used instead of the generic baseline risk assessment approach. USEPA has recently provided guidance encouraging the use of risk-based methodology for achieving closure at UST sites. The risk-based approach used in achieving the site closures involved an identification of potential human and ecological receptors and exposure pathways, and a comparison of maximum onsite chemical concentrations to applicable or relevant and appropriate requirements (ARARs). The ARARs used in the evaluation included Federal and/or State Maximum Contaminant Levels (MCLs) for groundwater and risk-based screening levels for soils. If the maximum concentrations were above the screening levels, a baseline risk assessment was recommended. In several instances, however, the risk-based approach resulted in a regulatory agency acceptance of a ''no further action'' alternative at UST sites which did not pose a significant threat to human health and the environment. The cost of the streamlined risk-based approach is approximately $3,500, while a baseline risk assessment for the same UST site could cost up to $10,000 or more. The use of the streamlined risk-based approach has proven to be successful for achieving a ''no further action'' outcome for the client at a reasonable cost

  9. Risk Factors for Scleroderma

    Science.gov (United States)

    ... You are here: Home For Patients Risk Factors Risk Factors for Scleroderma The cause of scleroderma is ... what biological factors contribute to scleroderma pathogenesis. Genetic Risk Scleroderma does not tend to run in families ...

  10. Risk Factors and Prevention

    Science.gov (United States)

    ... Resources Risk Factors & Prevention Back to Patient Resources Risk Factors & Prevention Even people who look healthy and ... Blood Pressure , high cholesterol, diabetes, and thyroid disease. Risk Factors For Arrhythmias and Heart Disease The following ...

  11. Cardiac Surgery Costs According to the Preoperative Risk in the Brazilian Public Health System

    Directory of Open Access Journals (Sweden)

    David Provenzale Titinger

    2015-01-01

    Full Text Available Abstract Background: Heart surgery has developed with increasing patient complexity. Objective: To assess the use of resources and real costs stratified by risk factors of patients submitted to surgical cardiac procedures and to compare them with the values reimbursed by the Brazilian Unified Health System (SUS. Method: All cardiac surgery procedures performed between January and July 2013 in a tertiary referral center were analyzed. Demographic and clinical data allowed the calculation of the value reimbursed by the Brazilian SUS. Patients were stratified as low, intermediate and high-risk categories according to the EuroSCORE. Clinical outcomes, use of resources and costs (real costs versus SUS were compared between established risk groups. Results: Postoperative mortality rates of low, intermediate and high-risk EuroSCORE risk strata showed a significant linear positive correlation (EuroSCORE: 3.8%, 10%, and 25%; p < 0.0001, as well as occurrence of any postoperative complication EuroSCORE: 13.7%, 20.7%, and 30.8%, respectively; p = 0.006. Accordingly, length-of-stay increased from 20.9 days to 24.8 and 29.2 days (p < 0.001. The real cost was parallel to increased resource use according to EuroSCORE risk strata (R$ 27.116,00 ± R$ 13.928,00 versus R$ 34.854,00 ± R$ 27.814,00 versus R$ 43.234,00 ± R$ 26.009,00, respectively; p < 0.001. SUS reimbursement also increased (R$ 14.306,00 ± R$ 4.571,00 versus R$ 16.217,00 ± R$ 7.298,00 versus R$ 19.548,00 ± R$935,00; p < 0.001. However, as the EuroSCORE increased, there was significant difference (p < 0.0001 between the real cost increasing slope and the SUS reimbursement elevation per EuroSCORE risk strata. Conclusion: Higher EuroSCORE was related to higher postoperative mortality, complications, length of stay, and costs. Although SUS reimbursement increased according to risk, it was not proportional to real costs.

  12. Pediatric unintentional injury: behavioral risk factors and implications for prevention.

    Science.gov (United States)

    Schwebel, David C; Gaines, Joanna

    2007-06-01

    Unintentional injury is the leading cause of death for children and adolescents between the ages of 1 and 18 in the United States, accounting for more deaths than the next 20 causes of mortality combined. It is estimated that pediatric injury accounts for more than $50 billion in annual losses from medical care costs, future wages, and quality of life. Despite these numbers, much remains to be learned about the behavioral risks for pediatric unintentional injury. This article reviews behavioral risk factors for pediatric unintentional injury risk, with a particular focus on four broad areas. First, we discuss the effects of demographic risk factors, including gender, socioeconomic status, and ethnicity. Second, we present information about child-specific risk factors, including temperament, personality, psychopathology, and cognitive development. Third, we discuss the influence of parents and other primary caregivers on childhood injury risk, with a particular focus on the effects of supervision and parenting quality and style. Finally, we discuss the role of peers on child injury risk. We conclude with a discussion of the ways in which the material reviewed has been translated into injury prevention techniques, with a focus on how pediatricians might use knowledge about etiological risk to prioritize safety counseling topics. We also present thoughts on four priorities for future research: injury risk in diverse nations and cultures; developmental effects of injury; the influence of multiple risk factors together on injury risk; and translation of knowledge about risk for injury into intervention and prevention techniques.

  13. Modifiable risk factors for schizophrenia and autism--shared risk factors impacting on brain development.

    Science.gov (United States)

    Hamlyn, Jess; Duhig, Michael; McGrath, John; Scott, James

    2013-05-01

    Schizophrenia and autism are two poorly understood clinical syndromes that differ in age of onset and clinical profile. However, recent genetic and epidemiological research suggests that these two neurodevelopmental disorders share certain risk factors. The aims of this review are to describe modifiable risk factors that have been identified in both disorders, and, where available, collate salient systematic reviews and meta-analyses that have examined shared risk factors. Based on searches of Medline, Embase and PsycINFO, inspection of review articles and expert opinion, we first compiled a set of candidate modifiable risk factors associated with autism. Where available, we next collated systematic-reviews (with or without meta-analyses) related to modifiable risk factors associated with both autism and schizophrenia. We identified three modifiable risk factors that have been examined in systematic reviews for both autism and schizophrenia. Advanced paternal age was reported as a risk factor for schizophrenia in a single meta-analysis and as a risk factor in two meta-analyses for autism. With respect to pregnancy and birth complications, for autism one meta-analysis identified maternal diabetes and bleeding during pregnancy as risks factors for autism whilst a meta-analysis of eight studies identified obstetric complications as a risk factor for schizophrenia. Migrant status was identified as a risk factor for both autism and schizophrenia. Two separate meta-analyses were identified for each disorder. Despite distinct clinical phenotypes, the evidence suggests that at least some non-genetic risk factors are shared between these two syndromes. In particular, exposure to drugs, nutritional excesses or deficiencies and infectious agents lend themselves to public health interventions. Studies are now needed to quantify any increase in risk of either autism or schizophrenia that is associated with these modifiable environmental factors. Copyright © 2012 Elsevier Inc

  14. A Novel Dynamic Algorithm for IT Outsourcing Risk Assessment Based on Transaction Cost Theory

    Directory of Open Access Journals (Sweden)

    Guodong Cong

    2015-01-01

    Full Text Available With the great risk exposed in IT outsourcing, how to assess IT outsourcing risk becomes a critical issue. However, most of approaches to date need to further adapt to the particular complexity of IT outsourcing risk for either falling short in subjective bias, inaccuracy, or efficiency. This paper proposes a dynamic algorithm of risk assessment. It initially forwards extended three layers (risk factors, risks, and risk consequences of transferring mechanism based on transaction cost theory (TCT as the framework of risk analysis, which bridges the interconnection of components in three layers with preset transferring probability and impact. Then, it establishes an equation group between risk factors and risk consequences, which assures the “attribution” more precisely to track the specific sources that lead to certain loss. Namely, in each phase of the outsourcing lifecycle, both the likelihood and the loss of each risk factor and those of each risk are acquired through solving equation group with real data of risk consequences collected. In this “reverse” way, risk assessment becomes a responsive and interactive process with real data instead of subjective estimation, which improves the accuracy and alleviates bias in risk assessment. The numerical case proves the effectiveness of the algorithm compared with the approach forwarded by other references.

  15. Risks factoring business: accounting measurement

    Directory of Open Access Journals (Sweden)

    Z.V. Gutsaylyuk

    2015-06-01

    Full Text Available The paper carried out the identification of risk factors for the development of possible accounting software management. Studied theoretical and methodological aspects of the risk classification of factoring operations in the part of the risk assessment factors. It is proposed to consider the risks factors as the risk that is acceptable controlled by accounting instruments and the risks that can not be taken into account in the accounting records. To minimize the risk factor, accounting-driven tools, a method of self-insurance, which is a factor in the creation of provision for factoring transactions designed to cover unexpected expenses and losses. Provision for factoring factor will establish more stable conditions of financial activity and avoid the fluctuations of profit factor in relation to the writing off of losses on factoring operatsіyam.Developed proposals allow for further research to improve the organizational and methodological basis of accounting and analysis of information as a basis for providing risk management factor, particularly in terms of improving the evaluation questions such risks and their qualitative and quantitative analysis.

  16. Stroke - risk factors

    Science.gov (United States)

    ... oxygen. Brain cells can die, causing lasting damage. Risk factors are things that increase your chance of ... a disease or condition. This article discusses the risk factors for stroke and things you can do ...

  17. A new energy paradigm for Turkey: A political risk-inclusive cost analysis for sustainable energy

    International Nuclear Information System (INIS)

    Oksay, Serhan; Iseri, Emre

    2011-01-01

    Implementing sustainable development policies in order to achieve economic and social development while maintaining adequate environmental protection to minimize the damage inflicted by the constantly increasing world population must be a major priority in the 21st century. While the emerging global debate on potential cost-effective responses has produced potential solutions such as cap and trade systems and/or carbon taxes as part of evolving sustainable energy/environmental policies, this kind of intellectual inquiry does not seem to be an issue among Turkish policy-making elites. This is mainly due to their miscalculation that pursuing sustainable energy policies is much more expensive in comparison to the utilization of fossil fuels such as natural gas. Nevertheless, the pegged prices of an energy sector dominated by natural gas are illusive, as both the political risks and environmental damage have not been incorporated into the current cost calculations. This paper evaluates energy policies through a lens of risk management and takes an alternative approach to calculating energy costs by factoring in political risks. This formulation reveals that the cost of traditional fossil-based energy is in fact more expensive than renewable energy. In addition to being environmentally friendly, the paradigm shift towards renewable energy policies would provide Turkey with a significant opportunity to stimulate its economy by being one of the first countries to develop green technologies and as a result this burgeoning sector would prompt job creation as well; mainly due to the externalities. - Research highlights: → This paper evaluates Turkish energy policies through risk management scope and takes an alternative approach on calculating electricity costs by factoring in political risks. → The cost of traditional fossil-based energy turns out to be more expensive than renewable energy. → The paradigm shift towards renewable energy policies could provide Turkey

  18. A new energy paradigm for Turkey: A political risk-inclusive cost analysis for sustainable energy

    Energy Technology Data Exchange (ETDEWEB)

    Oksay, Serhan, E-mail: serhano@khas.edu.t [Kadir Has University, Department of Business Administration (Turkey); Iseri, Emre, E-mail: eiseri@khas.edu.t [Kadir Has University, Department of International Relations, Cibali Campus, Kadir Has Caddesi 34083, Istanbul (Turkey)

    2011-05-15

    Implementing sustainable development policies in order to achieve economic and social development while maintaining adequate environmental protection to minimize the damage inflicted by the constantly increasing world population must be a major priority in the 21st century. While the emerging global debate on potential cost-effective responses has produced potential solutions such as cap and trade systems and/or carbon taxes as part of evolving sustainable energy/environmental policies, this kind of intellectual inquiry does not seem to be an issue among Turkish policy-making elites. This is mainly due to their miscalculation that pursuing sustainable energy policies is much more expensive in comparison to the utilization of fossil fuels such as natural gas. Nevertheless, the pegged prices of an energy sector dominated by natural gas are illusive, as both the political risks and environmental damage have not been incorporated into the current cost calculations. This paper evaluates energy policies through a lens of risk management and takes an alternative approach to calculating energy costs by factoring in political risks. This formulation reveals that the cost of traditional fossil-based energy is in fact more expensive than renewable energy. In addition to being environmentally friendly, the paradigm shift towards renewable energy policies would provide Turkey with a significant opportunity to stimulate its economy by being one of the first countries to develop green technologies and as a result this burgeoning sector would prompt job creation as well; mainly due to the externalities. - Research highlights: {yields} This paper evaluates Turkish energy policies through risk management scope and takes an alternative approach on calculating electricity costs by factoring in political risks. {yields} The cost of traditional fossil-based energy turns out to be more expensive than renewable energy. {yields} The paradigm shift towards renewable energy policies could

  19. 75 FR 17462 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2010-04-06

    ... decision may be purchased by contacting the office of Public Assistance, Governmental Affairs, and...-2)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the second quarter 2010 Rail Cost...

  20. Risk-based security cost-benefit analysis: method and example applications - 59381

    International Nuclear Information System (INIS)

    Wyss, Gregory; Hinton, John; Clem, John; Silva, Consuelo; Duran, Felicia A.

    2012-01-01

    Document available in abstract form only. Full text of publication follows: Decision makers wish to use risk-based cost-benefit analysis to prioritize security investments. However, understanding security risk requires estimating the likelihood of attack, which is extremely uncertain and depends on unquantifiable psychological factors like dissuasion and deterrence. In addition, the most common performance metric for physical security systems, probability of effectiveness at the design basis threat [P(E)], performs poorly in cost-benefit analysis. It is extremely sensitive to small changes in adversary characteristics when the threat is near a systems breaking point, but very insensitive to those changes under other conditions. This makes it difficult to prioritize investment options on the basis of P(E), especially across multiple targets or facilities. To overcome these obstacles, a Sandia National Laboratories Laboratory Directed Research and Development project has developed a risk-based security cost-benefit analysis method. This approach characterizes targets by how difficult it would be for adversaries to exploit each targets vulnerabilities to induce consequences. Adversaries generally have success criteria (e.g., adequate or desired consequences and thresholds for likelihood of success), and choose among alternative strategies that meet these criteria while considering their degree of difficulty in achieving their successful outcome. Investments reduce security risk as they reduce the severity of consequences available and/or increase the difficulty for an adversary to successfully accomplish their most advantageous attack

  1. Application of Delphi method for determining the affecting factors upon audit risk model

    Directory of Open Access Journals (Sweden)

    Zohreh Hajiha

    2012-01-01

    Full Text Available The assessment of risks in an audit work could directly influence the costs, timing, and strategies as well as audit quality. The purpose of this paper is to identify the critical affecting factors on risks proposed in Audit Risk Model (ARM, in Iranian audit environment of Iran. In the present, the Delphi Method consists of 60 audit partners and managers is employed. The panel consists of two equally divided groups, one from audit organization, a governmental organization, and the other from private audit firms. We employ two rounds of Delphi and 58 critical risk factors extracted from auditing literature and Iranian auditing standards and present them to the experts. There are 43 factors categorized as important factors to assess the risks in ARM. The results are considerable in an Iranian audit environment, findings show the most important factors are in inherent risk factors. Finally, we made a comparison with a similar study in Taiwan. Differences indicate that in professional judgment issues like risk assessment, the consideration of particular culture and environment could help enhance the precision of assessments, especially in assessing control risk factors.

  2. The unit cost factors and calculation methods for decommissioning - Cost estimation of nuclear research facilities

    International Nuclear Information System (INIS)

    Kwan-Seong Jeong; Dong-Gyu Lee; Chong-Hun Jung; Kune-Woo Lee

    2007-01-01

    Available in abstract form only. Full text of publication follows: The uncertainties of decommissioning costs increase high due to several conditions. Decommissioning cost estimation depends on the complexity of nuclear installations, its site-specific physical and radiological inventories. Therefore, the decommissioning costs of nuclear research facilities must be estimated in accordance with the detailed sub-tasks and resources by the tasks of decommissioning activities. By selecting the classified activities and resources, costs are calculated by the items and then the total costs of all decommissioning activities are reshuffled to match with its usage and objectives. And the decommissioning cost of nuclear research facilities is calculated by applying a unit cost factor method on which classification of decommissioning works fitted with the features and specifications of decommissioning objects and establishment of composition factors are based. Decommissioning costs of nuclear research facilities are composed of labor cost, equipment and materials cost. Of these three categorical costs, the calculation of labor costs are very important because decommissioning activities mainly depend on labor force. Labor costs in decommissioning activities are calculated on the basis of working time consumed in decommissioning objects and works. The working times are figured out of unit cost factors and work difficulty factors. Finally, labor costs are figured out by using these factors as parameters of calculation. The accuracy of decommissioning cost estimation results is much higher compared to the real decommissioning works. (authors)

  3. Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities

    International Nuclear Information System (INIS)

    Coles, G.A.; Egge, R.G.; Senger, E.; Shultz, M.W.; Taylor, W.E.

    1994-02-01

    This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km 2 Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This cost-comparison evaluation (1) determines relative costs for reducing risk to acceptable levels; (2) compares the cost of reducing risk using different risk-reduction options; and (3) compares the cost of reducing risks at different facilities. The result is an identification of the cost effective risk-reduction measures. Supporting information required to develop costs of the various risk-reduction options also is included

  4. Risk and cost tradeoffs for remote retrieval of buried waste

    International Nuclear Information System (INIS)

    Hyde, R.A.; Grienbenow, B.E.; Nickelson, D.F.

    1994-01-01

    The Buried Waste Integrated Demonstration is supporting the development, demonstration, testing, and evaluation of a suite of technologies that, when integrated with commercially available technologies, form a comprehensive system for the remediation of radioactive and hazardous buried waste. As a part of the program's technology development, remote retrieval equipment is being developed and tested for the remediation of buried waste. During remedial planning, several factors are considered when choosing remote versus manual retrieval systems. Time that workers are exposed to radioactivity, chemicals, air particulate, and industrial hazards is one consideration. The generation of secondary waste is also a consideration because it amounts to more waste to treat and some wastes may require special handling or treatment. Cost is also a big factor in determining whether remote or manual operations will be used. Other considerations include implementability, effectiveness, and the number of required personnel. This paper investigates each of these areas to show the risk and cost benefits and limitations for remote versus manual retrieval of buried waste

  5. Fracture Risk and Risk Factors for Osteoporosis.

    Science.gov (United States)

    Schürer, Christian; Wallaschofski, Henri; Nauck, Matthias; Völzke, Henry; Schober, Hans-Christof; Hannemann, Anke

    2015-05-25

    As the population ages, diseases of the elderly are becoming more common, including osteoporosis. Ways to assess the risk of fracture and the distribution and effects of known risk factors for osteoporosis will be important in planning for future healthcare needs, as well as in the development of preventive strategies. The study population included 6029 men and women aged 20-90 who underwent examination in the second follow-up wave of the Study of Health in Pomerania (SHIP-2) or in the basal SHIP-Trend Study. The risk of fracture was estimated on the basis of quantitative ultrasonography of the calcaneus. Prior fractures and risk factors for osteoporosis were ascertained in standardized interviews. 4.6% of the male subjects and 10.6% of the female subjects were judged to have an elevated risk of fracture. The corresponding percentages among subjects over age 65 were 8.8% for men and 28.2% for women. Even among subjects under age 55, risk factors for osteoporosis were associated with lower bone stiffness: the mean stiffness index was 103/98 (men/women) without risk factors, 99/96 with one risk factor, and 93/95 with more than one risk factor. Logistic regression analysis yielded an odds ratio of 1.89 (95% confidence interval: 1.44-2.50; p<0.01) for prevalent fractures among subjects aged 75 and older compared to subjects under age 55. The data indicate a high prevalence of osteoporosis from age 65 onward. These findings are consistent with those of other studies from Germany and across Europe. Younger men and women should already begin taking steps to counteract modifiable risk factors.

  6. 76 FR 59483 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2011-09-26

    ... the decision may be purchased by contacting the Office of Public Assistance, Governmental Affairs, and...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, DOT. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the fourth quarter 2011 Rail Cost Adjustment...

  7. Who Gets Diabetic Macular Oedema; When; and Why? Pathogenesis and Risk Factors

    Directory of Open Access Journals (Sweden)

    Banu Turgut Ozturk

    2014-10-01

    Full Text Available Diabetic macular oedema (DMO presents an enormous rise in the last decades with an increasing number of diabetic patients. It has a negative impact on the health-related quality of life beside the related visual loss. Additionally, it incurs more health centre visits, higher health costs, and lower working performance. Therefore, early diagnosis and preventive measures gain more and more importance in the management of DMO. Risk factors for DMO can be divided into systemic and ocular risk factors. The leading systemic risk factors include age, type and duration of diabetes, insulin use, and glucose regulation. Hypertension, nephropathy, hyperlipidaemia, anaemia, cardiovascular disease, smoking, and amputation are other risk factors reported. In addition, susceptibility in cases with endothelial nitric oxide synthase polymorphism and vascular endothelial growth factor C634-G polymorphism has been reported. The severity of diabetic retinopathy, microaneurysm turnover, cataract surgery, incomplete vitreous detachment, and peripheral retinal ischaemia are among ocular risk factors. Though avoiding changes in the metabolic memory related to hyperglycaemia in the early period seems to be the most efficient treatment, nowadays close follow-up of patients with high risk and effort to control the modifiable risk factors seems to be the ideal treatment.

  8. Wind turbine cost of electricity and capacity factor

    International Nuclear Information System (INIS)

    Cavallo, A.J.

    1995-01-01

    Wind turbines are currently designed to minimize the cost of electricity at the wind turbine (the busbar cost) in a given wind regime, ignoring constraints on the capacitor factor (the ratio of the average power output to the maximum power output). The trade-off between these two quantities can be examined in a straightforward fashion; it is found that the capacitor factor can be increased by a factor of 1.3 above its value at the cost minimum for a 10 percent increase in the cost of electricity. This has important implications for the large scale integration of wind electricity on utility grids where the cost of transmission and storage may be a significant fraction of the cost of delivered electricity. (Author)

  9. Financial Risk Factor Analysis for Facility Gas Leakages of H2 and NG

    Directory of Open Access Journals (Sweden)

    In-Bok Lee

    2016-09-01

    Full Text Available Fuel cells may be the key to a more environmentally-friendly future because they emit low carbon dioxide per unit of energy supplied. However, little work has investigated the potential financial risks pertaining to fuel cell systems. Often used in the analysis of the safety of systems involving flammable or hazardous materials, risk factor analysis has recently been used to analyze the potential financial losses that may occur from industrial hazards. Therefore, this work undertakes a financial risk factor analysis to determine the costs of leakages of hydrogen and natural gas, which are used in fuel cell systems. Total leakage was calculated from an analysis of several leakage rates and modes. The impact of applying appropriate detection and prevention systems was also investigated. The findings were then used to analyze the consequences for various sections of the system and to calculate the overall cost based on facility outage or damage, and the cost of taking safety precautions. This provides a basis for comparison among proposed potential reactionary measures.

  10. 75 FR 35877 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2010-06-23

    ... available on our Web site, http://www.stb.dot.gov . Copies of the decision may be purchased by contacting...-3)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the third quarter 2010 rail cost...

  11. 76 FR 37191 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2011-06-24

    ... our Web site, http://www.stb.dot.gov . Copies of the decision may be purchased by contacting the...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, DOT. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the third quarter 2011 Rail Cost Adjustment...

  12. 75 FR 80895 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2010-12-23

    ..., http://www.stb.dot.gov . Copies of the decision may be purchased by contacting the Office of Public...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, DOT. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the first quarter 2011 Rail Cost Adjustment...

  13. 77 FR 37958 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2012-06-25

    ..., http://www.stb.dot.gov . Copies of the decision may be purchased by contacting the Office of Public...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, DOT. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the third quarter 2012 rail cost adjustment...

  14. 78 FR 17764 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2013-03-22

    ..., http://www.stb.dot.gov . Copies of the decision may be purchased by contacting the Office of Public...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, DOT. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the second quarter 2013 Rail Cost Adjustment...

  15. 76 FR 16037 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2011-03-22

    ..., http://www.stb.dot.gov . Copies of the decision may be purchased by contacting the Office of Public...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, DOT. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the second quarter 2011 Rail Cost Adjustment...

  16. 75 FR 58019 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2010-09-23

    ..., http://www.stb.dot.gov . Copies of the decision may be purchased by contacting the office of Public...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, DOT. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the fourth quarter 2010 Rail Cost Adjustment...

  17. The JPL Cost Risk Analysis Approach that Incorporates Engineering Realism

    Science.gov (United States)

    Harmon, Corey C.; Warfield, Keith R.; Rosenberg, Leigh S.

    2006-01-01

    This paper discusses the JPL Cost Engineering Group (CEG) cost risk analysis approach that accounts for all three types of cost risk. It will also describe the evaluation of historical cost data upon which this method is based. This investigation is essential in developing a method that is rooted in engineering realism and produces credible, dependable results to aid decision makers.

  18. Cost-effectiveness of Nutritional Counseling for Obese Patients and Patients at Risk of Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Olsen, Jens; Willain, I.; Ladelund, S.

    2005-01-01

    OBJECTIVES: Obesity and dyslipidemia are risk factors for ischemic heart disease, and prevention and treatment in primary care can reduce these risks. The objective of this cost-effectiveness analysis was to compare the costs and effects (in terms of life years gained) of providing nutritional...... counseling by a general practitioner (GP) or a dietician. METHODS: A total of 60 GPs, who accepted to participate, were randomized either to give nutritional counseling or to refer patients to a dietician for counseling. The life years gained was estimated using a Cox regression model. Costs were estimated...... proven that the GP group was the most cost-effective-the cost of gaining 1 extra life year was estimated to be 8213 DKK compared with the dietician group, for which the incremental cost-effectiveness ratio was estimated to be 59,987 DKK. CONCLUSIONS: The effects were moderate, but other studies of other...

  19. Quantifying Cost Risk Early in the Life Cycle

    International Nuclear Information System (INIS)

    Mar, B.

    2004-01-01

    A new method for analyzing life cycle cost risk on large programs is presented that responds to an increased emphasis on improving sustainability for long-term programs. This method provides better long-term risk assessment and risk management techniques. It combines standard Monte Carlo analysis of risk drivers and a new data-driven method developed by the BMDO. The approach permits quantification of risks throughout the entire life cycle without resorting to difficult to support subjective methods. The BMDO methodology is shown to be relatively straightforward to apply to a specific component or process within a project using standard technical risk assessment methods. The total impact on system is obtained using the program WBS, which allows for the capture of correlated risks shared by multiple WBS items. Once the correlations and individual component risks are captured, a Monte Carlo simulation can be run using a modeling tool such as ANALYTICA to produce the overall life cycle cost risk

  20. Simple steps help minimize costs, risks in project contracts

    International Nuclear Information System (INIS)

    Camps, J.A.

    1996-01-01

    Contrary to prevailing opinion, risks and project financing costs can be higher for lump sum (LS) project contracts than under reimbursable-type contracts. An element-by-element analysis of the risks and costs associated with a project enables investors to develop variations of reimbursable contracts. Project managers can use this three-step procedure, along with other recommendations, to measure the hidden project costs and risks associated with LS contracts. The author bases his conclusions on case studies of recent projects in the petroleum refining and petrochemical industries. The findings, however, are general enough to be applicable in other industrial sectors

  1. Benefits, risks, and costs of mammography

    International Nuclear Information System (INIS)

    Richter, B.; Rausch, L.

    1977-01-01

    The risk seems to be acceptable if the age-dependency of the frequency of breast cancer is disregarded, i.e. if calculation is done with average values, as is being done frequently (15, 25, 32, 48). This procedure however veils the real circumstances in the examination of young women thus also veiling a risk which could otherwise be made precise and avoidable. The risk of radiation-induced cancerogenesis in the female breast was verified by similar statements made by several empiric investigations on man. The course of the dose-effect-relation in the region of few rad is still unexplained however, although the results do not contradict to the assumption of a linear dose-effect-relation. Thus it seems not advisable to ignore the induction of carcinomas by x-radiation for the sphere of mammography with the doses usually applied today. A reduction of radiation exposition by dose-saving measures to one tenth of the present value (or less) however would make the risk highly unimportant. Advantage/risk/cost-analyses should encourage the responsible persons to make reasonable proposals for the application of methods, in this case mammography. The discouraging of patients whom mammography is indicated for would be a side-effect which is not desired. Just as wrong would be the stimulation of an unjustified feeling of being sure and the demand for costly medical measures by uncritical reports of success. The indication of the considerably high costs of mammography should, together with the advantage expected, be a quantitative criterion for the optimal distribution of limited means the necessity of which cannot be denied. (orig.) [de

  2. Role of Risk Factors in the Incidence of Multidrug-Resistant Tuberculosis

    Directory of Open Access Journals (Sweden)

    Alya Putri Khairani

    2017-09-01

    Full Text Available Objective: To determine the risk factors that played roles in the incidence of multidrug-resistant tuberculosis (MDR-TB in such patients. Multidrug-Resistant Tuberculosis is a form of tuberculosis caused by Mycobacterium tuberculosis that is resistant to at least isoniazid and rifampicin. Methods: This was a case control study to compare MDR-TB to non-MDR-TB pulmonary tuberculosis outpatients in Dr. Hasan Sadikin General Hospital, Bandung on August–September 2014. Fifty MDR-TB outpatients were included as the cases and 50 non-MDR-TB outpatients as controls. Data was collected by questionnaires and patient’s registration forms. Bivariate and multivariate analyses were performed using chi-square test and multiple logistic regression test, with p<0.05 considered significant. Results: From bivariate analysis, number of previous tuberculosis treatments, regularity of previous treatment, and burden of cost were significant risk factors for developing MDR-TB (p<0.05; while from multivariate analysis, number of previous TB treatments was the only risk factor that played a significant role in the incidence of MDR-TB (OR 24.128 95% CI 6.771-85,976. Conclusions: Patients and medication factors are risk factors that play roles in the incidence of MDR-TB. The significant risk factor is the number of previous TB treatment.

  3. Risk Factors for Dog Relinquishment to a Los Angeles Municipal Animal Shelter

    Science.gov (United States)

    Dolan, Emily D.; Scotto, Jamie; Slater, Margaret; Weiss, Emily

    2015-01-01

    Simple Summary Low income has been reported to be a risk factor for dog relinquishment to shelters in the U.S. The majority of people with lower incomes, however, do not relinquish. Risk factors for relinquishment in a low socioeconomic region of Los Angeles were examined. Cost was associated with relinquishment, and most people were not aware of available assistance. Those who relinquished reported emotional attachment to the dog and higher perceived stress than a comparison group. The majority of reasons for relinquishment were likely solvable with assistance, highlighting an opportunity to provide community-specific alternatives to relinquishment. Abstract Dog relinquishment is a large component of shelter intake in the United States. Research has shown traits of the dog are associated with relinquishment as well as general characteristics of those relinquishing. Low income is often cited as a risk factor for relinquishment. The majority of people with lower incomes, however, do not relinquish. A group of people accessing a shelter in a low socioeconomic region of Los Angeles to relinquish their dogs was surveyed. This study examined risk factors for relinquishment, controlling for household income, compared to a group utilizing low cost spay/neuter services. A total of 76.9% of those relinquishing noted cost as a reason for relinquishment. Of participants in the relinquishment group, 80.7% reported not being aware of any services available to them. Most notable in the findings was that the odds of relinquishment were generally higher as the amount of perceived stress in the home in the past three months increased. The majority of people in both groups reported being emotionally attached to the dog. In this sample from a South Los Angeles community, the majority of reasons for relinquishment were likely solvable with assistance. These findings highlight an opportunity to assess community needs and provide community specific alternatives to relinquishment. PMID

  4. Cost benefit and risk assessment for selected tank waste process testing alternatives

    International Nuclear Information System (INIS)

    Gasper, K.A.

    1995-01-01

    The US Department of Energy has established the Tank Waste Remediation System (TWRS) program to safely manage wastes currently stored in underground tank at the Hanford Site. A TWRS testing and development strategy was recently developed to define long-range TWRS testing plans. The testing and development strategy considered four alternatives. The primary variable in the alternatives is the level of pilot-scale testing involving actual waste. This study evaluates the cost benefit and risks associated with the four alternatives. Four types of risk were evaluated: programmatic schedule risk, process mishap risk, worker risk, and public health risk. The structure of this report is as follows: Section 1 introduces the report subject; Section 2 describes the test strategy alternative evaluation; Section 3 describes the approach used in this study to assess risk and cost benefit; Section 4 describes the assessment methodologies for costs and risks; Section 5 describes the bases and assumptions used to estimate the costs and risks; Section 6 presents the detailed costs and risks; and Section 7 describes the results of the cost benefit analysis and presents conclusions

  5. [Risk factors of schizophrenia].

    Science.gov (United States)

    Suvisaari, Jaana

    2010-01-01

    Schizophrenia is a multifactorial, neurodevelopmental disorder caused by a combination of genetic and environmental risk factors. Disturbances of brain development begin prenatally, while different environmental insults further affect postnatal brain maturation during childhood and adolescence. Genome-wide association studies (GWAS) have succeeded in identifying hundreds of new risk variants for common, multifactorial diseases. In schizophrenia research, GWAS have found several rare copy number variants that considerably increase the risk of schizophrenia, and have shown an association between schizophrenia and the major histocompatibility complex. Research on environmental risk factors in recent years has provided new information particularly on risk factors related to pregnancy and childhood rearing environment. Gene-environment interactions have become a central research topic. There is evidence that genetically susceptible children are more vulnerable to the effects of unstable childhood rearing environment and other environmental risk factors.

  6. Capital Cost Optimization for Prefabrication: A Factor Analysis Evaluation Model

    Directory of Open Access Journals (Sweden)

    Hong Xue

    2018-01-01

    Full Text Available High capital cost is a significant hindrance to the promotion of prefabrication. In order to optimize cost management and reduce capital cost, this study aims to explore the latent factors and factor analysis evaluation model. Semi-structured interviews were conducted to explore potential variables and then questionnaire survey was employed to collect professionals’ views on their effects. After data collection, exploratory factor analysis was adopted to explore the latent factors. Seven latent factors were identified, including “Management Index”, “Construction Dissipation Index”, “Productivity Index”, “Design Efficiency Index”, “Transport Dissipation Index”, “Material increment Index” and “Depreciation amortization Index”. With these latent factors, a factor analysis evaluation model (FAEM, divided into factor analysis model (FAM and comprehensive evaluation model (CEM, was established. The FAM was used to explore the effect of observed variables on the high capital cost of prefabrication, while the CEM was used to evaluate comprehensive cost management level on prefabrication projects. Case studies were conducted to verify the models. The results revealed that collaborative management had a positive effect on capital cost of prefabrication. Material increment costs and labor costs had significant impacts on production cost. This study demonstrated the potential of on-site management and standardization design to reduce capital cost. Hence, collaborative management is necessary for cost management of prefabrication. Innovation and detailed design were needed to improve cost performance. The new form of precast component factories can be explored to reduce transportation cost. Meanwhile, targeted strategies can be adopted for different prefabrication projects. The findings optimized the capital cost and improved the cost performance through providing an evaluation and optimization model, which helps managers to

  7. Risk factors for stress fractures.

    Science.gov (United States)

    Bennell, K; Matheson, G; Meeuwisse, W; Brukner, P

    1999-08-01

    Preventing stress fractures requires knowledge of the risk factors that predispose to this injury. The aetiology of stress fractures is multifactorial, but methodological limitations and expediency often lead to research study designs that evaluate individual risk factors. Intrinsic risk factors include mechanical factors such as bone density, skeletal alignment and body size and composition, physiological factors such as bone turnover rate, flexibility, and muscular strength and endurance, as well as hormonal and nutritional factors. Extrinsic risk factors include mechanical factors such as surface, footwear and external loading as well as physical training parameters. Psychological traits may also play a role in increasing stress fracture risk. Equally important to these types of analyses of individual risk factors is the integration of information to produce a composite picture of risk. The purpose of this paper is to critically appraise the existing literature by evaluating study design and quality, in order to provide a current synopsis of the known scientific information related to stress fracture risk factors. The literature is not fully complete with well conducted studies on this topic, but a great deal of information has accumulated over the past 20 years. Although stress fractures result from repeated loading, the exact contribution of training factors (volume, intensity, surface) has not been clearly established. From what we do know, menstrual disturbances, caloric restriction, lower bone density, muscle weakness and leg length differences are risk factors for stress fracture. Other time-honoured risk factors such as lower extremity alignment have not been shown to be causative even though anecdotal evidence indicates they are likely to play an important role in stress fracture pathogenesis.

  8. Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

    Science.gov (United States)

    Shishko, Robert; Jorgensen, Edward J.

    1996-01-01

    This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

  9. Comparative risk-benefit-cost effectiveness in nuclear and alternate power sources: methodology, perspective, limitations

    International Nuclear Information System (INIS)

    Vinck, W.; Van Reijen, G.; Maurer, H.; Volta, G.

    1980-01-01

    A critical survey is given of the use of quantitative risk assessment in defining acceptable limits of safety and of its use together with cost-benefit analyses for decision making. The paper indicates uncertainties and even unknowns in risk assessment in particular if the whole fuel cycle for energy production is considered. It is made clear that for decisions on acceptance of risk also the risk perception factor must be considered. A difficult issue here is the potential for low-probability/large consequence accidents. Examples are given, suggestions for improvement are made and perspectives are outlined

  10. 77 FR 17121 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2012-03-23

    ... decision may be purchased by contacting the Office of Public Assistance, Governmental Affairs, and...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, Department of Transportation. ACTION: Approval of rail cost adjustment factor. [[Page 17122

  11. Factors influencing the cost of prosthetic joint infection treatment.

    Science.gov (United States)

    Peel, T N; Cheng, A C; Lorenzo, Y P; Kong, D C M; Buising, K L; Choong, P F M

    2013-11-01

    Prosthetic joint infection (PJI) is associated with significant costs to the healthcare system. Current literature examines the cost of specific treatment modalities without assessing other cost drivers for PJI. To examine the overall cost of the treatment of PJI and to identify factors associated with management costs. The costs of treatment of prosthetic joint infections were examined in 139 patients across 10 hospitals over a 3-year period (January 2006 to December 2008). Cost calculations included hospitalization costs, surgical costs, hospital-in-the-home costs and antibiotic therapy costs. Negative binomial regression analysis was performed to model factors associated with total cost. The median cost of treating prosthetic joint infection per patient was Australian $34,800 (interquartile range: 20,305, 56,929). The following factors were associated with increased treatment costs: septic revision arthroplasty (67% increase in treatment cost; P = 0.02), hypotension at presentation (70% increase; P = 0.03), polymicrobial infections (41% increase; P = 0.009), surgical treatment with one-stage exchange (100% increase; P = 0.002) or resection arthroplasty (48% increase; P = 0.001) were independently associated with increased treatment costs. Culture-negative prosthetic joint infections were associated with decreased costs (29% decrease in treatment cost; P = 0.047). Treatment failure was associated with 156% increase in treatment costs. This study identifies clinically important factors influencing treatment costs that may be of relevance to policy-makers, particularly in the setting of hospital reimbursement and guiding future research into cost-effective preventive strategies. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  12. Are cardiovascular disease risk assessment and management programmes cost effective? A systematic review of the evidence.

    Science.gov (United States)

    Lee, John Tayu; Lawson, Kenny D; Wan, Yizhou; Majeed, Azeem; Morris, Stephen; Soljak, Michael; Millett, Christopher

    2017-06-01

    The World Health Organization recommends that countries implement population-wide cardiovascular disease (CVD) risk assessment and management programmes. The aim of this study was to conduct a systematic review to evaluate whether this recommendation is supported by cost-effectiveness evidence. Published economic evaluations were identified via electronic medical and social science databases (including Medline, Web of Science, and the NHS Economic Evaluation Database) from inception to March 2016. Study quality was evaluated using a modified version of the Consolidated Health Economic Evaluation Reporting Standards. Fourteen economic evaluations were included: five studies based on randomised controlled trials, seven studies based on observational studies and two studies using hypothetical modelling synthesizing secondary data. Trial based studies measured CVD risk factor changes over 1 to 3years, with modelled projections of longer term events. Programmes were either not, or only, cost-effective under non-verified assumptions such as sustained risk factor changes. Most observational and hypothetical studies suggested programmes were likely to be cost-effective; however, study deigns are subject to bias and subsequent empirical evidence has contradicted key assumptions. No studies assessed impacts on inequalities. In conclusion, recommendations for population-wide risk assessment and management programmes lack a robust, real world, evidence basis. Given implementation is resource intensive there is a need for robust economic evaluation, ideally conducted alongside trials, to assess cost effectiveness. Further, the efficiency and equity impact of different delivery models should be investigated, and also the combination of targeted screening with whole population interventions recognising that there multiple approaches to prevention. Copyright © 2017. Published by Elsevier Inc.

  13. Risk and cost tradeoffs for remote retrieval of buried waste

    Energy Technology Data Exchange (ETDEWEB)

    Hyde, R.A.; Grienbenow, B.E.; Nickelson, D.F.

    1994-12-31

    The Buried Waste Integrated Demonstration is supporting the development, demonstration, testing, and evaluation of a suite of technologies that, when integrated with commercially available technologies, form a comprehensive system for the remediation of radioactive and hazardous buried waste. As a part of the program`s technology development, remote retrieval equipment is being developed and tested for the remediation of buried waste. During remedial planning, several factors are considered when choosing remote versus manual retrieval systems. Time that workers are exposed to radioactivity, chemicals, air particulate, and industrial hazards is one consideration. The generation of secondary waste is also a consideration because it amounts to more waste to treat and some wastes may require special handling or treatment. Cost is also a big factor in determining whether remote or manual operations will be used. Other considerations include implementability, effectiveness, and the number of required personnel. This paper investigates each of these areas to show the risk and cost benefits and limitations for remote versus manual retrieval of buried waste.

  14. Securitization of residential solar photovoltaic assets: Costs, risks and uncertainty

    International Nuclear Information System (INIS)

    Alafita, T.; Pearce, J.M.

    2014-01-01

    Limited access to low-cost financing is an impediment to high-velocity technological diffusion and high grid penetration of solar photovoltaic (PV) technology. Securitization of solar assets provides a potential solution to this problem. This paper assesses the viability of solar asset-backed securities (ABS) as a lower cost financing mechanism and identifies policies that could facilitate implementation of securitization. First, traditional solar financing is examined to provide a baseline for cost comparisons. Next, the securitization process is modeled. The model enables identification of several junctures at which risk and uncertainty influence costs. Next, parameter values are assigned and used to generate cost estimates. Results show that, under reasonable assumptions, securitization of solar power purchase agreements (PPA) can significantly reduce project financing costs, suggesting that securitization is a viable mechanism for improving the financing of PV projects. The clear impediment to the successful launch of a solar ABS is measuring and understanding the riskiness of underlying assets. This study identifies three classes of policy intervention that lower the cost of ABS by reducing risk or by improving the measurement of risk: (i) standardization of contracts and the contracting process, (ii) improved access to contract and equipment performance data, and (iii) geographic diversification. - Highlights: • Limited access to low-cost financing is hampering penetration of solar PV. • Solar asset-backed securities (ABS) provide a low cost financing mechanism. • Results for securitization of solar leases and power purchase agreements (PPA). • Securitization can significantly reduce project financing costs. • Identifies policy intervention that lower cost of ABS by reducing risk

  15. Factors associated with metabolic syndrome and related medical costs by the scale of enterprise in Korea.

    Science.gov (United States)

    Kong, Hyung-Sik; Lee, Kang-Sook; Yim, Eun-Shil; Lee, Seon-Young; Cho, Hyun-Young; Lee, Bin Na; Park, Jee Young

    2013-10-21

    The purpose of this study was to identify the risk factors of metabolic syndrome (MS) and to analyze the relationship between the risk factors of MS and medical cost of major diseases related to MS in Korean workers, according to the scale of the enterprise. Data was obtained from annual physical examinations, health insurance qualification and premiums, and health insurance benefits of 4,094,217 male and female workers who underwent medical examinations provided by the National Health Insurance Corporation in 2009. Logistic regression analyses were used to the identify risk factors of MS and multiple regression was used to find factors associated with medical expenditures due to major diseases related to MS. The study found that low-income workers were more likely to work in small-scale enterprises. The prevalence rate of MS in males and females, respectively, was 17.2% and 9.4% in small-scale enterprises, 15.9% and 8.9% in medium-scale enterprises, and 15.9% and 5.5% in large-scale enterprises. The risks of MS increased with age, lower income status, and smoking in small-scale enterprise workers. The medical costs increased in workers with old age and past smoking history. There was also a gender difference in the pattern of medical expenditures related to MS. Health promotion programs to manage metabolic syndrome should be developed to focus on workers who smoke, drink, and do little exercise in small scale enterprises.

  16. Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities. Volume 4

    Energy Technology Data Exchange (ETDEWEB)

    Coles, G.A.; Egge, R.G.; Senger, E.; Shultz, M.W.; Taylor, W.E.

    1994-02-01

    This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km{sup 2} Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This cost-comparison evaluation (1) determines relative costs for reducing risk to acceptable levels; (2) compares the cost of reducing risk using different risk-reduction options; and (3) compares the cost of reducing risks at different facilities. The result is an identification of the cost effective risk-reduction measures. Supporting information required to develop costs of the various risk-reduction options also is included.

  17. Fall Risk Assessment Through Automatic Combination of Clinical Fall Risk Factors and Body-Worn Sensor Data.

    Science.gov (United States)

    Greene, Barry R; Redmond, Stephen J; Caulfield, Brian

    2017-05-01

    Falls are the leading global cause of accidental death and disability in older adults and are the most common cause of injury and hospitalization. Accurate, early identification of patients at risk of falling, could lead to timely intervention and a reduction in the incidence of fall-related injury and associated costs. We report a statistical method for fall risk assessment using standard clinical fall risk factors (N = 748). We also report a means of improving this method by automatically combining it, with a fall risk assessment algorithm based on inertial sensor data and the timed-up-and-go test. Furthermore, we provide validation data on the sensor-based fall risk assessment method using a statistically independent dataset. Results obtained using cross-validation on a sample of 292 community dwelling older adults suggest that a combined clinical and sensor-based approach yields a classification accuracy of 76.0%, compared to either 73.6% for sensor-based assessment alone, or 68.8% for clinical risk factors alone. Increasing the cohort size by adding an additional 130 subjects from a separate recruitment wave (N = 422), and applying the same model building and validation method, resulted in a decrease in classification performance (68.5% for combined classifier, 66.8% for sensor data alone, and 58.5% for clinical data alone). This suggests that heterogeneity between cohorts may be a major challenge when attempting to develop fall risk assessment algorithms which generalize well. Independent validation of the sensor-based fall risk assessment algorithm on an independent cohort of 22 community dwelling older adults yielded a classification accuracy of 72.7%. Results suggest that the present method compares well to previously reported sensor-based fall risk assessment methods in assessing falls risk. Implementation of objective fall risk assessment methods on a large scale has the potential to improve quality of care and lead to a reduction in associated hospital

  18. 77 FR 76169 - Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2012-12-26

    ....stb.dot.gov . Copies of the decision may be purchased by contacting the Office of Public Assistance...)] Quarterly Rail Cost Adjustment Factor AGENCY: Surface Transportation Board, DOT. ACTION: Approval of rail cost adjustment factor. SUMMARY: The Board has approved the AAR's proposed rebasing calculations and...

  19. Risk Factor Assessment Branch (RFAB)

    Science.gov (United States)

    The Risk Factor Assessment Branch (RFAB) focuses on the development, evaluation, and dissemination of high-quality risk factor metrics, methods, tools, technologies, and resources for use across the cancer research continuum, and the assessment of cancer-related risk factors in the population.

  20. Cardiovascular risk factors and dementia.

    Science.gov (United States)

    Fillit, Howard; Nash, David T; Rundek, Tatjana; Zuckerman, Andrea

    2008-06-01

    Dementias, such as Alzheimer's disease (AD) and vascular dementia, are disorders of aging populations and represent a significant economic burden. Evidence is accumulating to suggest that cardiovascular disease (CVD) risk factors may be instrumental in the development of dementia. The goal of this review was to discuss the relationship between specific CVD risk factors and dementia and how current treatment strategies for dementia should focus on reducing CVD risks. We conducted a review of the literature for the simultaneous presence of 2 major topics, cardiovascular risk factors and dementia (eg, AD). Special emphasis was placed on clinical outcome studies examining the effects of treatments of pharmacologically modifiable CVD risk factors on dementia and cognitive impairment. Lifestyle risk factors for CVD, such as obesity, lack of exercise, smoking, and certain psychosocial factors, have been associated with an increased risk of cognitive decline and dementia. Some evidence suggests that effectively managing these factors may prevent cognitive decline/dementia. Randomized, placebo-controlled trials of antihypertensive medications have found that such therapy may reduce the risk of cognitive decline, and limited data suggest a benefit for patients with AD. Some small open-label and randomized clinical trials of statins have observed positive effects on cognitive function; larger studies of statins in patients with AD are ongoing. Although more research is needed, current evidence indicates an association between CVD risk factors--such as hypertension, dyslipidemia, and diabetes mellitus--and cognitive decline/dementia. From a clinical perspective, these data further support the rationale for physicians to provide effective management of CVD risk factors and for patients to be compliant with such recommendations to possibly prevent cognitive decline/dementia.

  1. Phenotypic risk factors for new-onset diabetes mellitus (NODAT in renal transplant recipients

    Directory of Open Access Journals (Sweden)

    Katarzyna Hap

    2014-11-01

    Full Text Available New-onset diabetes mellitus after transplantation (NODAT is defined as diabetes which developed after organ transplantation. NODAT occurs in approximately 16-20% of recipients one year after kidney transplantation and is the main factor for the increased mortality and morbidity, increased medical costs, progressive graft failure and decreased patients’ quality of life. Determination of phenotypic risk factors allows to define the scale of the risk of NODAT and can be helpful in detecting patients at risk of post-transplant diabetes. Overweight and obesity are well-known phenotypic risk factors that can be modified by lifestyle-change intervention. Adequate education about the principles of healthy lifestyle is one of the most important prevention factors. The medical staff should organize health education which should begin long before the planned transplantation, even at the stage of predialysis treatment or dialysis and be continued after transplantation. Early assessment of the risk of developing glucose metabolism disorders also allows the selection of immunosuppressive therapy less likely to affect carbohydrate metabolism. The article presents examples of simple risk scores and also principles of prevention and treatment of NODAT. The article presents the definition of NODAT, risk factors, especially overweight or obesity, risk scores and also principles of prevention and treatment of NODAT.

  2. The development of the risk-based cost-benefit analysis framework for risk-informed regulation

    International Nuclear Information System (INIS)

    Yang, Z. A.; Hwang, M. J.; Lee, K. S.

    2001-01-01

    US NRC (Nuclear Regulatory Committee) introduces the Risk-informed Regulation (RIR) to allocate the resources of NRC effectively and to reduce the unnecessary burden of utilities. This approach inherently includes the cost-benefit analysis (CBA) concept. The CBA method has been widely used for many problems in order to support the decision making by analyzing the effectiveness of the proposed plan and/or activity in the aspect of cost and benefit. However, in general, the conventional CBA method does not use the information such as risk that is the essential element of RIR. So, we developed a revised CBA framework that incorporates the risk information in analyzing the cost and benefit of the regulatory and/or operational activities in nuclear industry

  3. Risk factors for postoperative complications in robotic general surgery.

    Science.gov (United States)

    Fantola, Giovanni; Brunaud, Laurent; Nguyen-Thi, Phi-Linh; Germain, Adeline; Ayav, Ahmet; Bresler, Laurent

    2017-03-01

    The feasibility and safety of robotically assisted procedures in general surgery have been reported from various groups worldwide. Because postoperative complications may lead to longer hospital stays and higher costs overall, analysis of risk factors for postoperative surgical complications in this subset of patients is clinically relevant. The goal of this study was to identify risk factors for postoperative morbidity after robotic surgical procedures in general surgery. We performed an observational monocentric retrospective study. All consecutive robotic surgical procedures from November 2001 to December 2013 were included. One thousand consecutive general surgery patients met the inclusion criteria. The mean overall postoperative morbidity and major postoperative morbidity (Clavien >III) rates were 20.4 and 6 %, respectively. This included a conversion rate of 4.4 %, reoperation rate of 4.5 %, and mortality rate of 0.2 %. Multivariate analysis showed that ASA score >3 [OR 1.7; 95 % CI (1.2-2.4)], hematocrit value surgery [OR 1.5; 95 % CI (1-2)], advanced dissection [OR 5.8; 95 % CI (3.1-10.6)], and multiquadrant surgery [OR 2.5; 95 % CI (1.7-3.8)] remained independent risk factors for overall postoperative morbidity. It also showed that advanced dissection [OR 4.4; 95 % CI (1.9-9.6)] and multiquadrant surgery [OR 4.4; 95 % CI (2.3-8.5)] remained independent risk factors for major postoperative morbidity (Clavien >III). This study identifies independent risk factors for postoperative overall and major morbidity in robotic general surgery. Because these factors independently impacted postoperative complications, we believe they could be taken into account in future studies comparing conventional versus robot-assisted laparoscopic procedures in general surgery.

  4. Categorization of potential project cost overrun factors in construction industry

    Science.gov (United States)

    Karunakaran, P.; Abdullah, A. H.; Nagapan, S.; Sohu, S.; Kasvar, K. K.

    2018-04-01

    Cost overrun has been severely hit down the economy and reputations for many construction industry around the world. Many project management tools developed to control the budget of a project. However, the cost management is still considered poor as there are many cost overrun issues occurred in the construction industry. Thus, this paper aims to identify and cluster the potential construction project cost overrun factors according to their originating groups using the thematic approach. Basically, through literature review, all the potential factors that may cause cost overrun were screened thoroughly before they were clustered into seven (7) groups of the originating factors, namely project, contract, client, contractor, consultant, labour and external. Each potential factor was explained clearly with some examples based on the Malaysian case studies to illustrate the cost overrun scenario. These findings may aid in the future to highlight on how to mitigate the critical potential factors of cost overrun to reduce or overcome its impact on all the stakeholders involved.

  5. Debt as a Criminal Risk Factor in Denmark

    DEFF Research Database (Denmark)

    Olesen, Annette

    2016-01-01

    due to the ex-prisoners’ debt. Those convicted in Denmark are personally liable for their own legal costs. Thus, we must regard most ex-prisoners as being highly indebted to the state. The debt of ex-prisoners was generally understood as being the cause of financial problems, but legal regulation......Existing studies of crime preventive factors have illustrated that ex-prisoners who began a course of education, obtained employment and/or had permanent housing were less likely to relapse into crime. However, this study shows that the aforementioned crime preventing factors became less effective...... and informal punishment, as unintended consequences of indebtedness, were still poorly explored. This research indicates that legal regulation and informal punishment based on indebtedness may serve as an argument for considering debt as a criminal risk factor which has made the preventive factors less...

  6. Debt as a Criminal Risk Factor in Denmark

    DEFF Research Database (Denmark)

    Olesen, Annette

    2016-01-01

    and informal punishment, as unintended consequences of indebtedness, were still poorly explored. This research indicates that legal regulation and informal punishment based on indebtedness may serve as an argument for considering debt as a criminal risk factor which has made the preventive factors less......Existing studies of crime preventive factors have illustrated that ex-prisoners who began a course of education, obtained employment and/or had permanent housing were less likely to relapse into crime. However, this study shows that the aforementioned crime preventing factors became less effective...... due to the ex-prisoners’ debt. Those convicted in Denmark are personally liable for their own legal costs. Thus, we must regard most ex-prisoners as being highly indebted to the state. The debt of ex-prisoners was generally understood as being the cause of financial problems, but legal regulation...

  7. On the rate of return and risk factors to international oil companies in Iran's buy-back service contracts

    International Nuclear Information System (INIS)

    Ghandi, Abbas; Lin Lawell, C.-Y. Cynthia

    2017-01-01

    We analyze the rate of return (ROR) and risk factors faced by Shell Exploration, an international oil company (IOC), in its Soroosh and Nowrooz buy-back service contract in Iran. In particular, based on our models of cash flow, we analyze the buy-back contract specific risk factors that can contribute to a reduction in the rate of return for the international oil company. Our cash flow models resemble the cash flow of buy-back service contracts before the Iranian government changed the way it determined the capital cost ceiling and pre-defined the oil price in these contracts in 2008–2009. Our actual and contractual cash flow models reveal that Shell Exploration's actual ROR was much lower than the contractual level. Furthermore, we find that among the risk factors that we considered, a capital cost overrun has the greatest negative effect on the IOC's ROR. Moreover, we show that there is a potential for modifying the contracts in order for the IOC to face an actual ROR closer to the contractual ROR even if the contract faces cost overrun or delay, without exceeding the maximum contractual ROR that the National Iranian Oil Company is willing to give. - Highlights: • Buy-back contract specific risk factors can reduce the rate of return. • Shell Exploration's actual ROR was much lower than the contractual level. • A capital cost overrun has the greatest negative effect on the rate of return. • Contracts can be modified to better share the risk.

  8. A non-stationary cost-benefit analysis approach for extreme flood estimation to explore the nexus of 'Risk, Cost and Non-stationarity'

    Science.gov (United States)

    Qi, Wei

    2017-11-01

    Cost-benefit analysis is commonly used for engineering planning and design problems in practice. However, previous cost-benefit based design flood estimation is based on stationary assumption. This study develops a non-stationary cost-benefit based design flood estimation approach. This approach integrates a non-stationary probability distribution function into cost-benefit analysis, and influence of non-stationarity on expected total cost (including flood damage and construction costs) and design flood estimation can be quantified. To facilitate design flood selections, a 'Risk-Cost' analysis approach is developed, which reveals the nexus of extreme flood risk, expected total cost and design life periods. Two basins, with 54-year and 104-year flood data respectively, are utilized to illustrate the application. It is found that the developed approach can effectively reveal changes of expected total cost and extreme floods in different design life periods. In addition, trade-offs are found between extreme flood risk and expected total cost, which reflect increases in cost to mitigate risk. Comparing with stationary approaches which generate only one expected total cost curve and therefore only one design flood estimation, the proposed new approach generate design flood estimation intervals and the 'Risk-Cost' approach selects a design flood value from the intervals based on the trade-offs between extreme flood risk and expected total cost. This study provides a new approach towards a better understanding of the influence of non-stationarity on expected total cost and design floods, and could be beneficial to cost-benefit based non-stationary design flood estimation across the world.

  9. External Cost Assessment of Nuclear Power Plant Accident considering Public Risk Aversion Behavior: the Korean Case

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Hun; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of)

    2016-05-15

    The conventional approach for monetary valuation of NPP accident consequence consists of calculating the expected value of various accident scenarios. However, the main criticism of the conventional approach is that there is a discrepancy between the social acceptability of the risk and the estimated expected value of NPP accident. Therefore, an integrated framework for the estimation of the external cost associated with an NPP accident considering the public risk aversion behavior was proposed in this study based on the constructed theoretical framework for estimating both the value of statistical life (VSL) and the risk aversion coefficient associated with an NPP accident to take account of the accident cost into the unit electricity generation cost of NPP. To estimate both parameters, an individual-level survey was conducted on a sample of 1,364 participants in Korea. Based on the collected survey responses, both parameters were estimated based on the proposed framework and the external cost of NPP accident was estimated based on the consequence analysis and considering the direct cost factors for NPP accident. Internalization of external costs into the comprehensive energy production cost has been considered as a potentially efficient policy instrument for a more sustainable energy supply and use. However, the internalization of externalities, such as public health damage, have raised a number of generic policy issues in a nuclear energy sector, with specific challenges resulting from the distinct characteristics of external cost estimation. Especially, the major challenge remained to address the public safety concerns regarding a nuclear accident, which can be specified as low-probability high-consequence accident, driven by the aspects of public risk aversion.

  10. External Cost Assessment of Nuclear Power Plant Accident considering Public Risk Aversion Behavior: the Korean Case

    International Nuclear Information System (INIS)

    Lee, Sang Hun; Kang, Hyun Gook

    2016-01-01

    The conventional approach for monetary valuation of NPP accident consequence consists of calculating the expected value of various accident scenarios. However, the main criticism of the conventional approach is that there is a discrepancy between the social acceptability of the risk and the estimated expected value of NPP accident. Therefore, an integrated framework for the estimation of the external cost associated with an NPP accident considering the public risk aversion behavior was proposed in this study based on the constructed theoretical framework for estimating both the value of statistical life (VSL) and the risk aversion coefficient associated with an NPP accident to take account of the accident cost into the unit electricity generation cost of NPP. To estimate both parameters, an individual-level survey was conducted on a sample of 1,364 participants in Korea. Based on the collected survey responses, both parameters were estimated based on the proposed framework and the external cost of NPP accident was estimated based on the consequence analysis and considering the direct cost factors for NPP accident. Internalization of external costs into the comprehensive energy production cost has been considered as a potentially efficient policy instrument for a more sustainable energy supply and use. However, the internalization of externalities, such as public health damage, have raised a number of generic policy issues in a nuclear energy sector, with specific challenges resulting from the distinct characteristics of external cost estimation. Especially, the major challenge remained to address the public safety concerns regarding a nuclear accident, which can be specified as low-probability high-consequence accident, driven by the aspects of public risk aversion

  11. Risk factors for neoplasms

    International Nuclear Information System (INIS)

    Brachner, A.; Grosche, B.

    1991-06-01

    A broad survey is given of risk factors for neoplasms. The main carcinogenic substances (including also ionizing radiation and air pollution) are listed, and are correlated with the risk factors for various cancers most frequently explained and discussed in the literature. The study is intended to serve as a basis for a general assessment of the incidence of neoplasms in children, and of cancer mortality in the entire population of Bavaria in the years 1983-1989, or 1979-1988, respectively, with the principal idea of drawing up an environment-related health survey. The study therefore takes into account not only ionizing radiation as a main risk factor, but also other risk factors detectable within the ecologic context, as e.g. industrial installations and their effects, refuse incineration plants or waste dumps, or the social status. (orig./MG) [de

  12. Analyzing Integrated Cost-Schedule Risk for Complex Product Systems R&D Projects

    Directory of Open Access Journals (Sweden)

    Zhe Xu

    2014-01-01

    Full Text Available The vast majority of the research efforts in project risk management tend to assess cost risk and schedule risk independently. However, project cost and time are related in reality and the relationship between them should be analyzed directly. We propose an integrated cost and schedule risk assessment model for complex product systems R&D projects. Graphical evaluation review technique (GERT, Monte Carlo simulation, and probability distribution theory are utilized to establish the model. In addition, statistical analysis and regression analysis techniques are employed to analyze simulation outputs. Finally, a complex product systems R&D project as an example is modeled by the proposed approach and the simulation outputs are analyzed to illustrate the effectiveness of the risk assessment model. It seems that integrating cost and schedule risk assessment can provide more reliable risk estimation results.

  13. Risk factors for nosocomial pneumonia. Focus on prophylaxis.

    Science.gov (United States)

    Fleming, C A; Balaguera, H U; Craven, D E

    2001-11-01

    Despite an increased understanding of the pathogenesis of NP and advances in diagnosis and treatment, the risk, cost, morbidity, and mortality of NP remain unacceptably high. This article has identified strategic areas for primary and secondary prophylaxis that are simple and cost-effective. Realizing that the pathogenesis of NP requires bacterial colonization and the subsequent entry of these bacteria into the lower respiratory tree helps highlight the role of cross-infection and the importance of standard infection control procedures. Similarly the role of sedation and devices as risk factors can be reduced by minimizing the duration and intensity of sedation and length of exposure to invasive devices. Additional low-cost interventions that have been shown to be effective in preventing NP are the positioning of patients in a semirecumbent position and the appropriate use of enteral feeding, antibiotics, and selected medical devices. Prophylaxis of NP and VAP is carried out best by a multidisciplinary management team comprised of physicians (critical care, pulmonary medicine, infectious diseases, and primary care), critical care and infection control nurses, and respiratory therapists, even though this approach may result in decreased professional autonomy and freedom. This group should review the current guidelines, pathways, and standards for short-term and long-term prophylaxis of NP and VAP, then integrate them into and monitor their use for routine patient care. The risk factors and prophylaxis strategies for NP discussed in this article apply primarily to patients in acute care facilities, but also are relevant to alternative health care settings as well as the care of ill patients in ambulatory settings. The routine use of effective team policies for prophylaxis needs to be monitored by the Joint Commission for the Accreditation of Health Care or other agencies. Research to delineate the most effective and feasible strategies for prophylaxis NP has been

  14. Cost-effective treatment of low-risk carcinoma not invading bladder muscle.

    Science.gov (United States)

    Green, David A; Rink, Michael; Cha, Eugene K; Xylinas, Evanguelos; Chughtai, Bilal; Scherr, Douglas S; Shariat, Shahrokh F; Lee, Richard K

    2013-03-01

    Study Type - Therapy (cost effectiveness analysis) Level of Evidence 2a What's known on the subject? and What does the study add? Bladder cancer is one of the costliest malignancies to treat throughout the life of a patient. The most cost-effective management for low-risk non-muscle-invasive bladder cancer is not known. The current study shows that employing cystoscopic office fulguration for low-risk appearing bladder cancer recurrences can materially impact the cost-effectiveness of therapy. In a follow-up protocol where office fulguration is routinely employed for low-risk bladder cancers, peri-operative intravesical chemotherapy may not provide any additional cost-effectiveness benefit. To examine the cost-effectiveness of fulguration vs transurethral resection of bladder tumour (TURBT) with and without perioperative intravesical chemotherapy (PIC) for managing low-risk carcinoma not invading bladder muscle (NMIBC). Low-risk NMIBC carries a low progression rate, lending support to the use of office-based fulguration for small recurrences rather than traditional TURBT. A Markov state transition model was created to simulate treatment of NMIBC with vs without PIC, with recurrence treated by formal TURBT vs treatment with fulguration. Costing data were obtained from the Medicare Resource Based Relative Value Scale. Data regarding the success of PIC were obtained from the peer-reviewed literature, as were corresponding utilities for bladder cancer-related procedures. Sensitivity analyses were performed. At 5-year follow-up, a strategy of fulguration without PIC was the most cost-effective (mean cost-effectiveness = US $654.8/quality-adjusted life year), despite a lower recurrence rate with PIC. Both fulguration strategies dominated each TURBT strategy. Sensitivity analysis showed that fulguration without PIC dominated all other strategies when the recurrence rate after PIC was increased to ≥14.2% per year. Similarly, the cost-effectiveness of TURBT becomes more

  15. The relative importance of factors that determine log-hauling costs

    Science.gov (United States)

    A. Jeff Martin; A. Jeff Martin

    1971-01-01

    Hauling costs are a major expense to lumbermen, but little is known about which factors affect hauling costs the most. A recent Forest Service study of hauling costs on 34 logging operations sheds light on whmich factors of cost are important and which might require less attention. These results should help lumbermen adopt a cost accounting procedure and help them with...

  16. Cost risk analysis of radioactive waste management Preliminary study

    International Nuclear Information System (INIS)

    Forsstroem, J.

    2006-12-01

    This work begins with exposition of the basics of risk analysis. These basics are then applied to the Finnish radioactive waste disposal environment in which the nuclear power companies are responsible for all costs of radioactive waste management including longterm disposal of spent fuel. Nuclear power companies prepare cost estimates of the waste disposal on a yearly basis to support the decision making on accumulation of resources to the nuclear waste disposal fund. These cost estimates are based on the cost level of the ongoing year. A Monte Carlo simulation model of the costs of the waste disposal system was defined and it was used to produce preliminary results of its cost risk characteristics. Input data was synthesised by modifying the original coefficients of cost uncertainty to define a cost range for each cost item. This is a suitable method for demonstrating results obtainable by the model but it is not accurate enough for supporting decision making. Two key areas of further development were identified: the input data preparation and identifying and handling of (i.e. eliminating or merging) interacting cost elements in the simulation model. Further development in both of the mentioned areas can be carried out by co-operating with the power companies as they are the sources of the original data. (orig.)

  17. Attitudes, norms and controls influencing lifestyle risk factor management in general practice

    Directory of Open Access Journals (Sweden)

    McKenzie Suzanne H

    2009-08-01

    patient's motivation, and cost and accessibility of services to patients. Conclusion General practitioner attitudes, normative influences from both patients and the profession, and perceived external control factors (time, cost, availability and practice capacity all influence management of behavioural risk factors. Provider education, community awareness raising, support and capacity building may improve the uptake of lifestyle modification interventions.

  18. Attitudes, norms and controls influencing lifestyle risk factor management in general practice.

    Science.gov (United States)

    Ampt, Amanda J; Amoroso, Cheryl; Harris, Mark F; McKenzie, Suzanne H; Rose, Vanessa K; Taggart, Jane R

    2009-08-26

    With increasing rates of chronic disease associated with lifestyle behavioural risk factors, there is urgent need for intervention strategies in primary health care. Currently there is a gap in the knowledge of factors that influence the delivery of preventive strategies by General Practitioners (GPs) around interventions for smoking, nutrition, alcohol consumption and physical activity (SNAP). This qualitative study explores the delivery of lifestyle behavioural risk factor screening and management by GPs within a 45-49 year old health check consultation. The aims of this research are to identify the influences affecting GPs' choosing to screen and choosing to manage SNAP lifestyle risk factors, as well as identify influences on screening and management when multiple SNAP factors exist. A total of 29 audio-taped interviews were conducted with 15 GPs and one practice nurse over two stages. Transcripts from the interviews were thematically analysed, and a model of influencing factors on preventive care behaviour was developed using the Theory of Planned Behaviour as a structural framework. GPs felt that assessing smoking status was straightforward, however some found assessing alcohol intake only possible during a formal health check. Diet and physical activity were often inferred from appearance, only being assessed if the patient was overweight. The frequency and thoroughness of assessment were influenced by the GPs' personal interests and perceived congruence with their role, the level of risk to the patient, the capacity of the practice and availability of time. All GPs considered advising and educating patients part of their professional responsibility. However their attempts to motivate patients were influenced by perceptions of their own effectiveness, with smoking causing the most frustration. Active follow-up and referral of patients appeared to depend on the GPs' orientation to preventive care, the patient's motivation, and cost and accessibility of

  19. Risk factors in school shootings.

    Science.gov (United States)

    Verlinden, S; Hersen, M; Thomas, J

    2000-01-01

    Nine incidents of multiple-victim homicide in American secondary schools are examined and common risk factors are identified. The literature dealing with individual, family, social, societal, and situational risk factors for youth violence and aggression is reviewed along with existing risk assessment methods. Checklists of risk factors for serious youth violence and school violence are used in reviewing each school shooting case. Commonalties among the cases and implications for psychologists practicing in clinical and school settings are discussed.

  20. Clustering of risk factors for non-communicable disease and healthcare expenditure in employees with private health insurance presenting for health risk appraisal: a cross-sectional study.

    Science.gov (United States)

    Kolbe-Alexander, Tracy L; Conradie, Jaco; Lambert, Estelle V

    2013-12-21

    The global increase in the prevalence of NCD's is accompanied by an increase in risk factors for these diseases such as insufficient physical activity and poor nutritional habits. The main aims of this research study were to determine the extent to which insufficient physical activity (PA) clustered with other risk factors for non-communicable disease (NCD) in employed persons undergoing health risk assessment, and whether these risk factors were associated with higher healthcare costs. Employees from 68 companies voluntarily participated in worksite wellness days, that included an assessment of self-reported health behaviors and clinical measures, such as: blood pressure (BP), Body Mass Index (BMI), as well as total cholesterol concentrations from capillary blood samples. A risk-related age, 'Vitality Risk Age' was calculated for each participant using an algorithm that incorporated multiplicative pooled relative risks for all cause mortality associated with smoking, PA, fruit and vegetable intake, BMI, BP and cholesterol concentration. Healthcare cost data were obtained for employees (n = 2 789). Participants were 36±10 years old and the most prevalent risk factors were insufficient PA (67%) and BMI ≥ 25 (62%). Employees who were insufficiently active also had a greater number of other NCD risk factors, compared to those meeting PA recommendations (chi2 = 43.55; p employees meeting PA guidelines had significantly fewer visits to their family doctor (GP) (2.5 versus 3.11; p Physical inactivity was associated with clustering of risk factors for NCD in SA employees. Employees with lower BMI, better self-reported health status and readiness to change were more likely to meet the PA guidelines. These employees might therefore benefit from physical activity intervention programs that could result in improved risk profile and reduced healthcare expenditure.

  1. Complications of thoracentesis: incidence, risk factors, and strategies for prevention.

    Science.gov (United States)

    Cantey, Eric P; Walter, James M; Corbridge, Thomas; Barsuk, Jeffrey H

    2016-07-01

    Although thoracentesis is generally considered safe, procedural complications are associated with increased morbidity, mortality, and healthcare costs. In this article, we review the risk factors and prevention of the most common complications of thoracentesis including pneumothorax, bleeding (chest wall hematoma and hemothorax), and re-expansion pulmonary edema. Recent data support the importance of operator expertise and the use of ultrasound in reducing the risk of iatrogenic pneumothorax. Although coagulopathy or thrombocytopenia and the use of anticoagulant or antiplatelet medications have traditionally been viewed as contraindications to thoracentesis, new evidence suggests that patients may be able to safely undergo thoracentesis without treating their bleeding risk. Re-expansion pulmonary edema, a rare complication of thoracentesis, is felt to result in part from the generation of excessively negative pleural pressure. When and how to monitor changes in pleural pressure during thoracentesis remains a focus of ongoing study. Major complications of thoracentesis are uncommon. Clinician awareness of risk factors for procedural complications and familiarity with strategies that improve outcomes are essential components for safely performing thoracentesis.

  2. Risk-Sensitive Control with Near Monotone Cost

    International Nuclear Information System (INIS)

    Biswas, Anup; Borkar, V. S.; Suresh Kumar, K.

    2010-01-01

    The infinite horizon risk-sensitive control problem for non-degenerate controlled diffusions is analyzed under a 'near monotonicity' condition on the running cost that penalizes large excursions of the process.

  3. Risk Factor Analysis for Mastectomy Skin Flap Necrosis: Implications for Intraoperative Vascular Analysis.

    Science.gov (United States)

    Reintgen, Christian; Leavitt, Adam; Pace, Elizabeth; Molas-Pierson, Justine; Mast, Bruce A

    2016-06-01

    Skin flap necrosis after mastectomy can be a devastating complication significantly affecting patient outcomes. Routine vascular analysis (fluorescein or laser angiography) of mastectomy skin flaps in all patients has been advocated but is of questionable cost-effectiveness. The purpose of this study was to identify the incidence and causative risk factors for mastectomy skin flap necrosis and thereby calculate the fiscal reality of intraoperative vascular screening. This is an institutional review board-approved retrospective study of all patients from 2007 to 2013 who underwent mastectomy related to breast cancer. Skin flap necrosis was defined as major if it necessitated return to the operating room. Data analysis was done for determination of causative factors of necrosis, including age, body mass index, smoking, previous irradiation, coronary artery disease, chronic obstructive pulmonary disorder, hypertension, gastroesophageal reflux disease, hyperlipidemia, obstructive sleep apnea, asthma, diabetes, thyroid disease, history of lumpectomy, and breast reduction or augmentation. During this time, intraoperative vascular screening was not done. Five hundred eighty-one patients underwent 616 mastectomies with a total of 34 necrotic events (5.5%)-16 major and 18 minor. Analyses via Student t tests, univariate analyses, χ testing, and logistic regression showed that history of smoking was the only patient factor associated with postoperative necrosis (P = 0.008). More frequently represented in the necrosis group, but without statistical significance, are previous lumpectomy (P = 0.069) and immediate reconstruction (P = 0.078).For the entire study period, the actual cost to the hospital for major necrotic events was $7,123.10 or $445.19 for each of the 16 major necrotic events and $209.50 for all 34 necrotic events. Per-patient cost-effective screening would need to be less than $11.54 for all patients, $100.33 for highest risk patients (smokers), and $21.65 for

  4. Transforming Wartime Contracting: Controlling Costs, Reducing Risks

    Science.gov (United States)

    2011-08-01

    conceptual ambiguity lies nestled in the meaning ascribed to “inherent.” The language of the Instruction also serves as an illustration that...other factors to the composite rate to present a fuller accounting of the cost of military personnel. It adds costs for recruitment and advertising ...Defense Adds to above: Costs for recruitment and advertising , training, subsidized groceries (commissaries), education assistance, child-development

  5. Stroke Risk Factors and Symptoms

    Science.gov (United States)

    ... » [ pdf, 433 kb ] Order Materials » Stroke Risk Factors and Symptoms Risk Factors for a Stroke Stroke prevention is still ... it. Treatment can delay complications that increase the risk of stroke. Transient ischemic attacks (TIAs). Seek help. ...

  6. Seismic Risk Perception compared with seismic Risk Factors

    Science.gov (United States)

    Crescimbene, Massimo; La Longa, Federica; Pessina, Vera; Pino, Nicola Alessandro; Peruzza, Laura

    2016-04-01

    The communication of natural hazards and their consequences is one of the more relevant ethical issues faced by scientists. In the last years, social studies have provided evidence that risk communication is strongly influenced by the risk perception of people. In order to develop effective information and risk communication strategies, the perception of risks and the influencing factors should be known. A theory that offers an integrative approach to understanding and explaining risk perception is still missing. To explain risk perception, it is necessary to consider several perspectives: social, psychological and cultural perspectives and their interactions. This paper presents the results of the CATI survey on seismic risk perception in Italy, conducted by INGV researchers on funding by the DPC. We built a questionnaire to assess seismic risk perception, with a particular attention to compare hazard, vulnerability and exposure perception with the real data of the same factors. The Seismic Risk Perception Questionnaire (SRP-Q) is designed by semantic differential method, using opposite terms on a Likert scale to seven points. The questionnaire allows to obtain the scores of five risk indicators: Hazard, Exposure, Vulnerability, People and Community, Earthquake Phenomenon. The questionnaire was administered by telephone interview (C.A.T.I.) on a statistical sample at national level of over 4,000 people, in the period January -February 2015. Results show that risk perception seems be underestimated for all indicators considered. In particular scores of seismic Vulnerability factor are extremely low compared with house information data of the respondents. Other data collected by the questionnaire regard Earthquake information level, Sources of information, Earthquake occurrence with respect to other natural hazards, participation at risk reduction activities and level of involvement. Research on risk perception aims to aid risk analysis and policy-making by

  7. Impact of Real-world Factors Influencing Investment Decisions on the Costs and Distribution of Climate Change Mitigation

    Science.gov (United States)

    Edmonds, J.; Iyer, G.; McJeon, H. C.; Leon, C.; Hultman, N.

    2015-12-01

    Strategies to mitigate dangerous anthropogenic climate change require a dramatic transformation of the energy system to reduce greenhouse gas emissions, that in turn requires large-scale investments. Investment decisions depend not only on investment capital availability but also on investment risks. A number of factors such as national policy environments, quality of public and private institutions, sector, firm and technology specific characteristics can affect investors' assessments of risks, leading to a wide variation in the business climate for investment. Such heterogeneity in investment risks can have important implications, as investors usually respond to risks by requiring higher returns for riskier projects; delaying or forgoing the investments; or preferring to invest in existing, familiar projects. We study the impact of variation in investment risks on regional patterns of emissions mitigation, the cost of emissions mitigation and patterns of technology deployment. We modify an integrated assessment model, widely used in global climate policy analyses (the Global Change Assessment Model) and incorporate decisions on investments based on risks along two dimensions. Along the first dimension, we vary perceived risks associated with particular technologies. To do so, we assign a higher cost of capital for investment in low-carbon technologies as these involve intrinsically higher levels of regulatory and market risk. The second dimension uses a proxy to vary investment risks across regions, based on an institutional quality metric published by the World Economic Forum. Explicit representation of investment risks has two major effects. First, it raises the cost of emissions mitigation relative to a world with uniform investment risks. Second, it shifts the pattern of emissions mitigation, with industrialized countries mitigating more, and developing countries mitigating less. Our results suggest that institutional reforms aimed at lowering investment

  8. The role of risk and cost benefit in program budgeting

    Energy Technology Data Exchange (ETDEWEB)

    Henry, C.J.; Alchowiak, J. [Dept. of Energy, Washington, DC (United States)

    1995-12-31

    The primary Environmental Management (EM) program mission is protecting human health and the environment. EM is currently facing a decreasing budget while still having to deal with competing requirements and risks to workers, public, and environment. There has been no consistent framework for considering in an integrated fashion the multiple types of risks and hazards present in the nuclear weapons complex. Therefore, to allocate resources during the budget process, EM is using risk, long term costs, mortgage reduction, compliance issues, and stakeholders concerns to prioritize the funding of activities. Risk and cost-benefit analysis are valuable tools to help make decisions to reduce risks to health, safety, and the environment in a sensible and cost-effective manner. Principles for priority setting using risk analysis are to seek to compare risks by grouping them into broad categories of concern (e.g., high, medium, and low); to set priorities in managing risks to account for relevant management and social considerations; to inform priorities by as broad a range of views as possible, ideally with consensus; and, to try to coordinate risk reduction efforts among programs. The Draft Risk Report to Congress, Risks and the Risk Debate: Searching for Common Ground {open_quote}The First Step,{close_quote} provides the first link between budget, compliance requirements, and risk reduction/pollution prevention activities. The process used for the report provides an initial framework to capture the spectrum of risks associated with environmental management activities and to link these risks in a qualitative fashion to compliance and the budget.

  9. The role of risk and cost benefit in program budgeting

    International Nuclear Information System (INIS)

    Henry, C.J.; Alchowiak, J.

    1995-01-01

    The primary Environmental Management (EM) program mission is protecting human health and the environment. EM is currently facing a decreasing budget while still having to deal with competing requirements and risks to workers, public, and environment. There has been no consistent framework for considering in an integrated fashion the multiple types of risks and hazards present in the nuclear weapons complex. Therefore, to allocate resources during the budget process, EM is using risk, long term costs, mortgage reduction, compliance issues, and stakeholders concerns to prioritize the funding of activities. Risk and cost-benefit analysis are valuable tools to help make decisions to reduce risks to health, safety, and the environment in a sensible and cost-effective manner. Principles for priority setting using risk analysis are to seek to compare risks by grouping them into broad categories of concern (e.g., high, medium, and low); to set priorities in managing risks to account for relevant management and social considerations; to inform priorities by as broad a range of views as possible, ideally with consensus; and, to try to coordinate risk reduction efforts among programs. The Draft Risk Report to Congress, Risks and the Risk Debate: Searching for Common Ground open-quote The First Step,close-quote provides the first link between budget, compliance requirements, and risk reduction/pollution prevention activities. The process used for the report provides an initial framework to capture the spectrum of risks associated with environmental management activities and to link these risks in a qualitative fashion to compliance and the budget

  10. Environmental non-occupational risk factors associated with bladder cancer.

    Science.gov (United States)

    Ferrís, J; Berbel, O; Alonso-López, J; Garcia, J; Ortega, J A

    2013-10-01

    Bladder carcinoma (BC), due its high morbidity and relapsing course, generates significant economic and health care costs. Accordingly, review the environmental nonoccupational risk factors (RF), more or less evidence-based, in the etiology and pathogenesis of BC, because the involvement of urologists is essential for prevention. Review of the peer-reviewed literature (1987-2012) on nonoccupational environmental RF associated with BC retrieved from Medline, Embase and Science Citation Index. The search profiles have been "Risk factors/Epidemiology/Tobacco-smoking/Diet-nutrition-water-liquids/Radiation/Infectious/Farmacological drugs" and "Bladder cancer". Smoking was associated with 50% of BC in both sexes. Smokers have a 2-5 times higher risk than nonsmokers, directly proportional to the amount and duration of addiction. Drinking water contaminated with arsenic and chromium chlorination byproducts increases the risk of BC. High consumption of red meat and saturated fat may increase the risk, while high intake of fruits and vegetables decreases it. Patients treated with cyclophosphamide, ifosfamide and ionizing radiation have an increased risk of BC. Frequent and prolonged use of hair dyes and Schistosoma haematobium infestation increases the risk of BC. The reduction or the cessation of smoking decrease BC. The contaminant-free water consumption with the increase of vegetal foods favour BC prevention. Cancer survivors treated with cyclophosphamide, ifosfamide and radiation therapy should be monitored for early diagnosis of BC. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  11. Implementing a least cost and risk focused maintenance process

    International Nuclear Information System (INIS)

    Darling, S.S.

    1996-01-01

    The paper will focus on the vital role maintenance, big ''M'' (spares, PM program, planning and scheduling, turning the wrench), has in preserving return of investment, and safety in operation of high risk high value facilities/platforms. The maintenance process of today and for the future must utilize risk assessment and reliability engineering techniques to prioritize plant resources. The new process must provide for high levels of safety assurance yet allow for improved generation and transmission capacity while maintaining adequate system reliability. This approach ultimately leads to continuous and sustained reduction in operating cost, improved production capacity, and a safety culture based upon a risk determent cost-beneficial decision process

  12. Perinatal risk factors for strabismus

    DEFF Research Database (Denmark)

    Torp-Pedersen, Tobias; Boyd, Heather A; Poulsen, Gry

    2010-01-01

    Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype.......Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype....

  13. Risk- and cost-benefit analyses of breast screening programs derived from absorbed dose measurements in the Netherlands

    International Nuclear Information System (INIS)

    Zuur, C.; Broerse, J.J.

    1985-01-01

    Risk- and cost benefit analyses for breast screening programs are being performed, employing the risk-factors for induction of breast cancer from six extensive follow-up studies. For women of the age group above 35 years and for a risk period of 30 years after a 10-year latency period, a factor of extra cases of 20 x 10 -6 mGy -1 can be estimated. Measurements are being performed in Dutch hospitals to determine the mean absorbed tissue dose. These doses vary from 0.6 to 4.4 mGy per radiography. For a dose of 1 mGy per radiograph and yearly screening of women between 35 and 75 years, the risk of radiogenic breast cancer is about 1% of the natural incidence (85,000 per 10 6 women) in this group. A recommended frequency of screening has to be based on medical, social and financial considerations. The gain in woman years and in completely cured women is being estimated for screening with intervals of 12 instead of 24 months. The medical and social benefit is 1,520 years life-time and 69 more cases completely cured per 1,000 breast cancer patients. The financial profit of a completely cured instead of an ultimately fatal cancer can be roughly estimated at 55,000 guilders. In addition the costs per gained woman-year are about 5,000 guilders. In consequence, the extra costs of annual additional rounds of mammographic screening are balanced by the benefit. (Auth.)

  14. The burden of disease preventable by risk factor reduction in Serbia

    Directory of Open Access Journals (Sweden)

    Šipetić Sandra

    2013-01-01

    Full Text Available Background/Aim. Reliable and comparable analysis of health risks is an important component of evidence-based and preventive programs. The aim of this study was to analyze the impact of the most relevant avoidable risk factors on the burden of the selected conditions in Serbia. Methods. Attributable fractions were calculated from the survey information on the prevalence of a risk factor and the relative risk of dying if exposed to a risk factor. The population-attributable risks were applied to deaths, years of life lost due to premature mortality (YLL, years of life with disability (YLD and disability adjusted life years (DALY. Results. More than 40% of all deaths and of the total YLL are attributable to cigarette smoking, overweight, physical inactivity, inadequate intake of fruit and vegetables, hypertension and high blood cholesterol. Alcohol consumption has in total a beneficial effect. According to the percent of DALY for the selected conditions attributable to the observed risk factors, their most harmful effects are as follows: alcohol consumption on road traffic accidents; cigarette smoking on lung cancer; physical inactivity on cerebrovascular disease (CVD, ischemic heart disease (IHD and colorectal cancer; overweight on type 2 diabetes; hypertension on renal failure and CVD; inadequate intake of fruit and vegetables on IHD and CVD, and high blood cholesterol on IHD. Conclusions. This study shows that a high percentage of disease and injury burden in Serbia is attributable to avoidable risk factors, which emphasizes the need for improvement of relevant preventive strategies and programs at both individual and population levels. Social preferences should be determined for a comprehensive set of conditions and cost effectiveness analyses of potential interventions should be carried out. Furthermore, positive measures, derived from health, disability and quality of life surveys, should be included. [Projekat Ministarstva nauke Republike

  15. Decisions on the tolerability of risk: The use of quantitative risk assessment and the relevance of other factors

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, A V [Health and Safety Executive, Baynards House, London (United Kingdom)

    1989-07-01

    A recent Discussion Document of the UK Health and Safety Executive proposes guidelines on the tolerable levels of individual and societal risks from nuclear power stations. At the various proposed levels a risk would be just tolerable and must be reduced further 'as low as reasonably practicable' (i.e. taking account of costs and benefits). These levels are induced from contemporary experience. No uniform upper level is proposed for tolerability for all societal risks. A stricter level is explicitly suggested for nuclear plant. A further study currently under way shows that FN curves suggest that (predictions for the very low probability of very high consequences apart) nuclear reactors rank favourably compared to many important non nuclear installations; in contrast to views held by some. Other factors are evidently involved in these views; there are some aspects of risk which cannot readily be presented on an FN curve, and there are 'dread' associations for some of the nuclear risks. The study is therefore also examining some decisions that have been taken in the UK about nuclear and non nuclear risks, based in part on estimates of societal risk. Comparison suggests that different levels of tolerability seem to be applied, according to the specific circumstances. Factors other than those shown in an FN curve evidently apply to these actual decisions as well. A preliminary identification of some of these factors is made. (author)

  16. Synthesizing Risk from Summary Evidence Across Multiple Risk Factors.

    Science.gov (United States)

    Shrier, Ian; Colditz, Graham A; Steele, Russell J

    2018-07-01

    Although meta-analyses provide summary effect estimates that help advise patient care, patients often want to compare their overall health to the general population. The Harvard Cancer Risk Index was published in 2004 and uses risk ratio estimates and prevalence estimates from original studies across many risk factors to provide an answer to this question. However, the published version of the formula only uses dichotomous risk factors and its derivation was not provided. The objective of this brief report was to provide the derivation of a more general form of the equation that allows the incorporation of risk factors with three or more levels.

  17. Risk factors for bango abuse in upper Egypt.

    Science.gov (United States)

    Yassa, Heba A; Dawood, Abd El-Wahaab A; Shehata, Manal M; Abdel-Hady, Randa H; Abdel-Aal, Khaled M

    2009-11-01

    Cannabis is the most commonly abused drug in the world. In Egypt, the Anti Narcotic General Administration, showed that the narcotics problem costs the Egyptian economy approximately 800 million dollars annually. The present study was designed to determine the risk factors that lead to bango abuse among secondary school students and drivers in Assiut province. Urine samples were taken from 1000 volunteers after filling questionnaires and the risk factors were determined. Ethical consideration and informed consent was taken on. In drivers, the study found that bango abuse was concentrated in age group (21 to abuse concentrated in male students by 100%, and in those with high daily fund. The abused students tend to be more aggressive. Also, tend to be lazy to share in school activities. Abused students present in large family (8-11 persons) and families with troubles between parents (81% in divorced parents). In conclusion, bango abuse leads to deterioration of the academic achievement, and may be associated with antisocial and violent behavior. Copyright © 2009 Elsevier B.V. All rights reserved.

  18. Specialized surveillance for individuals at high risk for melanoma: a cost analysis of a high-risk clinic.

    Science.gov (United States)

    Watts, Caroline G; Cust, Anne E; Menzies, Scott W; Coates, Elliot; Mann, Graham J; Morton, Rachael L

    2015-02-01

    Regular surveillance of individuals at high risk for cutaneous melanoma improves early detection and reduces unnecessary excisions; however, a cost analysis of this specialized service has not been undertaken. To determine the mean cost per patient of surveillance in a high-risk clinic from the health service and societal perspectives. We used a bottom-up microcosting method to measure resource use in a consecutive sample of 102 patients treated in a high-risk hospital-based clinic in Australia during a 12-month period. Surveillance and treatment of melanoma. All surveillance and treatment procedures were identified through direct observation, review of medical records, and interviews with staff and were valued using scheduled fees from the Australian government. Societal costs included transportation and loss of productivity. The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]); the cost discounted across 20 years was A $11,546 (95% CI, A $10,263-$12,829) (US $7839 [95% CI, US $6969-$8710]). The mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710]); the cost discounted across 20 years was A $12,721 (95% CI, A $12,554-$14,463) (US $8637 [95% CI, US $8523-$9820]). Diagnosis of melanoma or nonmelanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for positively skewed health system costs. Microcosting techniques provide an accurate cost estimate for the provision of a specialized service. The high societal cost reflects the time that patients are willing to invest to attend the high-risk clinic. This alternative model of care for a high-risk population has relevance for decision making about health policy.

  19. Specifying the ovarian cancer risk threshold of 'premenopausal risk-reducing salpingo-oophorectomy' for ovarian cancer prevention: a cost-effectiveness analysis.

    Science.gov (United States)

    Manchanda, Ranjit; Legood, Rosa; Antoniou, Antonis C; Gordeev, Vladimir S; Menon, Usha

    2016-09-01

    Risk-reducing salpingo-oophorectomy (RRSO) is the most effective intervention to prevent ovarian cancer (OC). It is only available to high-risk women with >10% lifetime OC risk. This threshold has not been formally tested for cost-effectiveness. To specify the OC risk thresholds for RRSO being cost-effective for preventing OC in premenopausal women. The costs as well as effects of surgical prevention ('RRSO') were compared over a lifetime with 'no RRSO' using a decision analysis model. RRSO was undertaken in premenopausal women >40 years. The model was evaluated at lifetime OC risk levels: 2%, 4%, 5%, 6%, 8% and 10%. Costs and outcomes are discounted at 3.5%. Uncertainty in the model was assessed using both deterministic sensitivity analysis and probabilistic sensitivity analysis (PSA). Outcomes included in the analyses were OC, breast cancer (BC) and additional deaths from coronary heart disease. Total costs and effects were estimated in terms of quality-adjusted life-years (QALYs); incidence of OC and BC; as well as incremental cost-effectiveness ratio (ICER). Published literature, Nurses Health Study, British National Formulary, Cancer Research UK, National Institute for Health and Care Excellence guidelines and National Health Service reference costs. The time horizon is lifetime and perspective: payer. Premenopausal RRSO is cost-effective at 4% OC risk (life expectancy gained=42.7 days, ICER=£19 536/QALY) with benefits largely driven by reduction in BC risk. RRSO remains cost-effective at >8.2% OC risk without hormone replacement therapy (ICER=£29 071/QALY, life expectancy gained=21.8 days) or 6%if BC risk reduction=0 (ICER=£27 212/QALY, life expectancy gained=35.3 days). Sensitivity analysis indicated results are not impacted much by costs of surgical prevention or treatment of OC/ BC or cardiovascular disease. However, results were sensitive to RRSO utility scores. Additionally, 37%, 61%, 74%, 84%, 96% and 99.5% simulations on PSA are cost

  20. Risk Consideration and Cost Estimation in Construction Projects Using Monte Carlo Simulation

    Directory of Open Access Journals (Sweden)

    Claudius A. Peleskei

    2015-06-01

    Full Text Available Construction projects usually involve high investments. It is, therefore, a risky adventure for companies as actual costs of construction projects nearly always exceed the planed scenario. This is due to the various risks and the large uncertainty existing within this industry. Determination and quantification of risks and their impact on project costs within the construction industry is described to be one of the most difficult areas. This paper analyses how the cost of construction projects can be estimated using Monte Carlo Simulation. It investigates if the different cost elements in a construction project follow a specific probability distribution. The research examines the effect of correlation between different project costs on the result of the Monte Carlo Simulation. The paper finds out that Monte Carlo Simulation can be a helpful tool for risk managers and can be used for cost estimation of construction projects. The research has shown that cost distributions are positively skewed and cost elements seem to have some interdependent relationships.

  1. Identifying factors causing cost overrun of the construction projects ...

    Indian Academy of Sciences (India)

    Swapnil P Wanjari

    Cost overrun in India; ANOVA; factor analysis; construction projects. 1. Introduction ... gramme Implementation in India [2], projects of public .... case if a respondent never came across of such factor. ..... The co-relation matrix for variables of cost overruns was ..... There are various problems observed due to communication.

  2. Risk preference, option pricing and portfolio hedging with proportional transaction costs

    International Nuclear Information System (INIS)

    Wang, Xiao-Tian; Li, Zhe; Zhuang, Le

    2017-01-01

    Highlights: • Scaling is a key factor in option pricing. • The model is theoretically analyzed and the results are new. • Some numerical examples are performed. • The implied-volatility-frown is affected by the risk preference and scaling. - Abstract: This paper is concerned in the option pricing and portfolio hedging in a discrete time case with the proportional transaction costs. Through the Monte Carlo simulations it has been shown that the fractal scaling and risk preference of traders have an important influence on the hedging performances in both option pricing and portfolio hedging in a discrete time case. In addition, the relation between preference of traders and implied volatility frown is discussed. We conclude that the risk preferences of traders play an important role in determining the shape of the implied-volatility-frown and the different options having the different hedging frequencies is another reason for the implied volatility frown.

  3. Worldwide analysis of marine oil spill cleanup cost factors

    International Nuclear Information System (INIS)

    Etkin, D.S.

    2000-01-01

    The many factors that influence oil spill response costs were discussed with particular emphasis on how spill responses differ around the world because of differing cultural values, socio-economic factors and labor costs. This paper presented an analysis of marine oil spill cleanup costs based on the country, proximity to shoreline, spill size, oil type, degree of shoreline oiling and cleanup methodology. The objective was to determine how each factor impacts per-unit cleanup costs. Near-shore spills and in-port spills were found to be 4-5 times more expensive to clean than offshore spills. Responses to spills of heavy fuels also cost 10 times more than for lighter crudes and diesel. Spill responses for spills under 30 tonnes are 10 times more costly than on a per-unit basis, for spills of 300 tonnes. A newly developed modelling technique that can be used on different types of marine spills was described. It is based on updated cost data acquired from case studies of more than 300 spills in 40 countries. The model determines a per-unit cleanup cost estimation by taking into consideration oil type, location, spill size, cleanup methodology, and shoreline oiling. It was concluded that the actual spill costs are totally dependent on the actual circumstances of the spill. 13 refs., 10 tabs., 3 figs

  4. Motor Performance as Risk Factor for Lower Extremity Injuries in Children

    DEFF Research Database (Denmark)

    Runge, Lisbeth; Kristensen, Peter Lund; Junge, Tina

    2016-01-01

    PURPOSE: Physical activity related injuries in children constitute a costly public health matter. The influence of motor performance on injury risk is unclear. The purpose was to examine if motor performance was a risk factor of traumatic and overuse lower extremity injuries in a normal population...... motor performance (core stability, vertical jump, shuttle run) was positively associated with traumatic and overuse injuries, and negatively (single leg hop) associated with traumatic injuries, indicating different influence on injury risk. Previous injury was a confounder affecting the effect size...... and the significance. More studies are needed to consolidate the findings, to clarify the influence of different performance tests on different types of injuries and to examine the influence of behaviour in relation to injury risk....

  5. Cardiovascular risk-factor knowledge and risk perception among HIV-infected adults.

    Science.gov (United States)

    Cioe, Patricia A; Crawford, Sybil L; Stein, Michael D

    2014-01-01

    Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in HIV-infected adults. Research in noninfected populations has suggested that knowledge of CVD risk factors significantly influences perceptions of risk. This cross-sectional study describes CVD risk factor knowledge and risk perception in HIV-infected adults. We recruited 130 HIV-infected adults (mean age = 48 years, 62% male, 56% current smokers, mean years since HIV diagnosis, 14.7). The mean CVD risk factor knowledge score was fairly high. However, controlling for age, CVD risk factor knowledge was not predictive of perceived risk [F(1, 117) = 0.13, p > .05]. Estimated risk and perceived risk were weakly but significantly correlated; r (126) = .24, p = .01. HIV-infected adults are at increased risk for CVD. Despite having adequate risk-factor knowledge, CVD risk perception was inaccurate. Improving risk perception and developing CVD risk reduction interventions for this population are imperative. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  6. Cost effectiveness of withdrawal of fall-risk-increasing drugs in geriatric outpatients.

    Science.gov (United States)

    van der Velde, Nathalie; Meerding, Willen Jan; Looman, Caspar W; Pols, Huibert A P; van der Cammen, Tischa J M

    2008-01-01

    Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. Within a common geriatric outpatient population, patients with a history of falls were assessed for falls risk (n = 139). Fall-risk-increasing drugs were withdrawn when appropriate (n = 75). All participants had a 2-month follow-up for fall incidents. The number of prevented falls was calculated using a loglinear regression model. The savings on health expenditures as a result of prevented injuries (estimated from a literature review) and reduced consumption of pharmaceuticals were compared with the intervention costs. After adjustment for confounders, drug withdrawal resulted in a falls risk reduction of 0.89 (95% CI 0.33, 0.98) per patient compared with the non-withdrawal group. Net cost savings were euro1691 (95% CI 662, 2181) per patient in the cohort. This resulted in a cost saving of euro491 (95% CI 465, 497) per prevented fall. Withdrawal of fall-risk-increasing drugs generates significant cost savings. Extrapolation of these findings to a national scale results in an estimated reduction of euro60 million in healthcare expenditures, that is, 15% of fall-related health costs.

  7. Conversion from laparoscopic to open cholecystectomy: Multivariate analysis of preoperative risk factors

    Directory of Open Access Journals (Sweden)

    Khan M

    2005-01-01

    Full Text Available BACKGROUND: Laparoscopic cholecystectomy has become the gold standard in the treatment of symptomatic cholelithiasis. Some patients require conversion to open surgery and several preoperative variables have been identified as risk factors that are helpful in predicting the probability of conversion. However, there is a need to devise a risk-scoring system based on the identified risk factors to (a predict the risk of conversion preoperatively for selected patients, (b prepare the patient psychologically, (c arrange operating schedules accordingly, and (d minimize the procedure-related cost and help overcome financial constraints, which is a significant problem in developing countries. AIM: This study was aimed to evaluate preoperative risk factors for conversion from laparoscopic to open cholecystectomy in our setting. SETTINGS AND DESIGNS: A case control study of patients who underwent laparoscopic surgery from January 1997 to December 2001 was conducted at the Aga Khan University Hospital, Karachi, Pakistan. MATERIALS AND METHODS: All those patients who were converted to open surgery (n = 73 were enrolled as cases. Two controls who had successful laparoscopic surgery (n = 146 were matched with each case for operating surgeon and closest date of surgery. STATISTICAL ANALYSIS USED: Descriptive statistics were computed and, univariate and multivariate analysis was done through multiple logistic regression. RESULTS: The final multivariate model identified two risk factors for conversion: ultrasonographic signs of inflammation (adjusted odds ratio [aOR] = 8.5; 95% confidence interval [CI]: 3.3, 21.9 and age > 60 years (aOR = 8.1; 95% CI: 2.9, 22.2 after adjusting for physical signs, alkaline phosphatase and BMI levels. CONCLUSION: Preoperative risk factors evaluated by the present study confirm the likelihood of conversion. Recognition of these factors is important for understanding the characteristics of patients at a higher risk of conversion.

  8. Frequent hospital admissions in Singapore: clinical risk factors and impact of socioeconomic status.

    Science.gov (United States)

    Low, Lian Leng; Tay, Wei Yi; Ng, Matthew Joo Ming; Tan, Shu Yun; Liu, Nan; Lee, Kheng Hock

    2018-01-01

    Frequent admitters to hospitals are high-cost patients who strain finite healthcare resources. However, the exact risk factors for frequent admissions, which can be used to guide risk stratification and design effective interventions locally, remain unknown. Our study aimed to identify the clinical and sociodemographic risk factors associated with frequent hospital admissions in Singapore. An observational study was conducted using retrospective 2014 data from the administrative database at Singapore General Hospital, Singapore. Variables were identified a priori and included patient demographics, comorbidities, prior healthcare utilisation, and clinical and laboratory variables during the index admission. Multivariate logistic regression analysis was used to identify independent risk factors for frequent admissions. A total of 16,306 unique patients were analysed and 1,640 (10.1%) patients were classified as frequent admitters. On multivariate logistic regression, 16 variables were independently associated with frequent hospital admissions, including age, cerebrovascular disease, history of malignancy, haemoglobin, serum creatinine, serum albumin, and number of specialist outpatient clinic visits, emergency department visits, admissions preceding index admission and medications dispensed at discharge. Patients staying in public rental housing had a 30% higher risk of being a frequent admitter after adjusting for demographics and clinical conditions. Our study, the first in our knowledge to examine the clinical risk factors for frequent admissions in Singapore, validated the use of public rental housing as a sensitive indicator of area-level socioeconomic status in Singapore. These risk factors can be used to identify high-risk patients in the hospital so that they can receive interventions that reduce readmission risk. Copyright: © Singapore Medical Association

  9. Multiple-factor analysis of the net cost of drilling operations

    Energy Technology Data Exchange (ETDEWEB)

    Karnaushevskaya, Zh I; Kukhtevich, L I; Lisovskaya, G F; Maguryak, N S; Nasinnik, Z A

    1979-01-01

    Basic factors in the rise in net cost of drilling operations are examined in the association ''Ukrneft''. A mathematical model of their net cost is constructed which takes into consideration the given factors. A number of measures are suggested and their specific influence on the decrease in net cost of well construction is defined.

  10. The Cost-Effectiveness of Antibiotic Prophylaxis for Patients at Risk of Infective Endocarditis.

    Science.gov (United States)

    Franklin, Matthew; Wailoo, Allan; Dayer, Mark J; Jones, Simon; Prendergast, Bernard; Baddour, Larry M; Lockhart, Peter B; Thornhill, Martin H

    2016-11-15

    In March 2008, the National Institute for Health and Care Excellence recommended stopping antibiotic prophylaxis (AP) for those at risk of infective endocarditis (IE) undergoing dental procedures in the United Kingdom, citing a lack of evidence of efficacy and cost-effectiveness. We have performed a new economic evaluation of AP on the basis of contemporary estimates of efficacy, adverse events, and resource implications. A decision analytic cost-effectiveness model was used. Health service costs and benefits (measured as quality-adjusted life-years) were estimated. Rates of IE before and after the National Institute for Health and Care Excellence guidance were available to estimate prophylactic efficacy. AP adverse event rates were derived from recent UK data, and resource implications were based on English Hospital Episode Statistics. AP was less costly and more effective than no AP for all patients at risk of IE. The results are sensitive to AP efficacy, but efficacy would have to be substantially lower for AP not to be cost-effective. AP was even more cost-effective in patients at high risk of IE. Only a marginal reduction in annual IE rates (1.44 cases in high-risk and 33 cases in all at-risk patients) would be required for AP to be considered cost-effective at £20 000 ($26 600) per quality-adjusted life-year. Annual cost savings of £5.5 to £8.2 million ($7.3-$10.9 million) and health gains >2600 quality-adjusted life-years could be achieved from reinstating AP in England. AP is cost-effective for preventing IE, particularly in those at high risk. These findings support the cost-effectiveness of guidelines recommending AP use in high-risk individuals. © 2016 The Authors.

  11. The Influence of Organizational External Factors on Construction Risk Management among Nigerian Construction Companies

    Directory of Open Access Journals (Sweden)

    A.Q. Adeleke

    2018-03-01

    aforementioned factors have the chance to deliver their projects within the stipulated time, cost, and qualities, which can be used as a yardstick to measure a good project. Keywords: construction risk management, Nigeria, organizational control theory, organizational external factors, rules and regulations

  12. Shoulder dystocia: risk factors, predictability, and preventability.

    Science.gov (United States)

    Mehta, Shobha H; Sokol, Robert J

    2014-06-01

    Shoulder dystocia remains an unpredictable obstetric emergency, striking fear in the hearts of obstetricians both novice and experienced. While outcomes that lead to permanent injury are rare, almost all obstetricians with enough years of practice have participated in a birth with a severe shoulder dystocia and are at least aware of cases that have resulted in significant neurologic injury or even neonatal death. This is despite many years of research trying to understand the risk factors associated with it, all in an attempt primarily to characterize when the risk is high enough to avoid vaginal delivery altogether and prevent a shoulder dystocia, whose attendant morbidities are estimated to be at a rate as high as 16-48%. The study of shoulder dystocia remains challenging due to its generally retrospective nature, as well as dependence on proper identification and documentation. As a result, the prediction of shoulder dystocia remains elusive, and the cost of trying to prevent one by performing a cesarean delivery remains high. While ultimately it is the injury that is the key concern, rather than the shoulder dystocia itself, it is in the presence of an identified shoulder dystocia that occurrence of injury is most common. The majority of shoulder dystocia cases occur without major risk factors. Moreover, even the best antenatal predictors have a low positive predictive value. Shoulder dystocia therefore cannot be reliably predicted, and the only preventative measure is cesarean delivery. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Quantifying Cardiometabolic Risk Using Modifiable Non–Self-Reported Risk Factors

    Science.gov (United States)

    Marino, Miguel; Li, Yi; Pencina, Michael J.; D’Agostino, Ralph B.; Berkman, Lisa F.; Buxton, Orfeu M.

    2014-01-01

    Background Sensitive general cardiometabolic risk assessment tools of modifiable risk factors would be helpful and practical in a range of primary prevention interventions or for preventive health maintenance. Purpose To develop and validate a cumulative general cardiometabolic risk score that focuses on non–self-reported modifiable risk factors such as glycosylated hemoglobin (HbA1c) and BMI so as to be sensitive to small changes across a span of major modifiable risk factors, which may not individually cross clinical cut off points for risk categories. Methods We prospectively followed 2,359 cardiovascular disease (CVD)-free subjects from the Framingham offspring cohort over a 14–year follow-up. Baseline (fifth offspring examination cycle) included HbA1c and cholesterol measurements. Gender–specific Cox proportional hazards models were considered to evaluate the effects of non–self-reported modifiable risk factors (blood pressure, total cholesterol, high–density lipoprotein cholesterol, smoking, BMI, and HbA1c) on general CVD risk. We constructed 10–year general cardiometabolic risk score functions and evaluated its predictive performance in 2012–2013. Results HbA1c was significantly related to general CVD risk. The proposed cardiometabolic general CVD risk model showed good predictive performance as determined by cross-validated discrimination (male C-index=0.703, 95% CI=0.668, 0.734; female C-index=0.762, 95% CI=0.726, 0.801) and calibration (lack-of-fit χ2=9.05 [p=0.338] and 12.54 [p=0.128] for men and women, respectively). Conclusions This study presents a risk factor algorithm that provides a convenient and informative way to quantify cardiometabolic risk based on modifiable risk factors that can motivate an individual’s commitment to prevention and intervention. PMID:24951039

  14. Quantifying cardiometabolic risk using modifiable non-self-reported risk factors.

    Science.gov (United States)

    Marino, Miguel; Li, Yi; Pencina, Michael J; D'Agostino, Ralph B; Berkman, Lisa F; Buxton, Orfeu M

    2014-08-01

    Sensitive general cardiometabolic risk assessment tools of modifiable risk factors would be helpful and practical in a range of primary prevention interventions or for preventive health maintenance. To develop and validate a cumulative general cardiometabolic risk score that focuses on non-self-reported modifiable risk factors such as glycosylated hemoglobin (HbA1c) and BMI so as to be sensitive to small changes across a span of major modifiable risk factors, which may not individually cross clinical cut-off points for risk categories. We prospectively followed 2,359 cardiovascular disease (CVD)-free subjects from the Framingham offspring cohort over a 14-year follow-up. Baseline (fifth offspring examination cycle) included HbA1c and cholesterol measurements. Gender-specific Cox proportional hazards models were considered to evaluate the effects of non-self-reported modifiable risk factors (blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking, BMI, and HbA1c) on general CVD risk. We constructed 10-year general cardiometabolic risk score functions and evaluated its predictive performance in 2012-2013. HbA1c was significantly related to general CVD risk. The proposed cardiometabolic general CVD risk model showed good predictive performance as determined by cross-validated discrimination (male C-index=0.703, 95% CI=0.668, 0.734; female C-index=0.762, 95% CI=0.726, 0.801) and calibration (lack-of-fit chi-square=9.05 [p=0.338] and 12.54 [p=0.128] for men and women, respectively). This study presents a risk factor algorithm that provides a convenient and informative way to quantify cardiometabolic risk on the basis of modifiable risk factors that can motivate an individual's commitment to prevention and intervention. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Introduction to cost-effectiveness analysis of risk reduction measures in energy systems

    International Nuclear Information System (INIS)

    1986-07-01

    The aim of this report is to introduce readers to methods of cost-effectiveness analysis and their application in risk reduction, especially in connection with the energy-producing industries. The background to the assessment of risk and the problems in estimating it quantitatively are outlined. The methodology of cost-effectiveness analysis is then described, particular attention being given to the way in which results are derived and the overall use that can be made of them. This is followed by a discussion of quantitative applications and an outline of the methods that may be used to derive estimates both of risk and the cost of reducing it. The use of cost-effectiveness analysis is illustrated in an appendix, which gives as a worked example a case study on the reduction of public risk associated with radioactive releases during normal operation of a PWR. After drawing some general conclusions the report recommends that such analyses should normally be used as an aid to risk management whenever several alternative risk reduction measures are under consideration

  16. Costs and Risks of Continuous Purges for Instruments

    Science.gov (United States)

    Secunda, M.; De Garcia, K. Montt

    2018-01-01

    As instruments are built, tested, and launched, they are exposed to environments that have various levels of cleanliness. Often, Scientists and Contamination Control Engineers specify a purge to mitigate the instrument's exposure to a non-clean environment, protect sensitive optics from a specific threat, such as water, or as insurance against things going wrong in a clean environment. The cost of the purge, in effort, dollars and risk, is often understated when the requirements are being established, and the need for purge is not clearly justifiable. This paper will more clearly define some of the costs and risks associated with the continuous purging of instruments during the course of building, testing and launching instruments.

  17. Java project on periodontal diseases. The natural development of periodontitis: risk factors, risk predictors and risk determinants : risk factors, risk predictors and risk determinants

    NARCIS (Netherlands)

    Van der Velden, U.; Abbas, F.; Armand, S.; Loos, B. G.; Timmerman, M. F.; Van der Weijden, G. A.; Van Winkelhoff, A. J.; Winkel, E. G.

    Objective: To identify risk factors, risk predictors and risk determinants for onset and progression of periodontitis. Material and Methods: For this longitudinal, prospective study all subjects in the age range 15-25 years living in a village of approximately 2000 inhabitants at a tea estate on

  18. The relationship between health risks and health and productivity costs among employees at Pepsi Bottling Group.

    Science.gov (United States)

    Henke, Rachel M; Carls, Ginger S; Short, Meghan E; Pei, Xiaofei; Wang, Shaohung; Moley, Susan; Sullivan, Mark; Goetzel, Ron Z

    2010-05-01

    To evaluate relationships between modifiable health risks and costs and measure potential cost savings from risk reduction programs. Health risk information from active Pepsi Bottling Group employees who completed health risk assessments between 2004 and 2006 (N = 11,217) were linked to medical care, workers' compensation, and short-term disability cost data. Ten health risks were examined. Multivariate analyses were performed to estimate costs associated with having high risk, holding demographics, and other risks constant. Potential savings from risk reduction were estimated. High risk for weight, blood pressure, glucose, and cholesterol had the greatest impact on total costs. A one-percentage point annual reduction in the health risks assessed would yield annual per capita savings of $83.02 to $103.39. Targeted programs that address modifiable health risks are expected to produce substantial cost reductions in multiple benefit categories.

  19. Exploring the Key Risk Factors for Application of Cloud Computing in Auditing

    Directory of Open Access Journals (Sweden)

    Kuang-Hua Hu

    2016-08-01

    Full Text Available In the cloud computing information technology environment, cloud computing has some advantages such as lower cost, immediate access to hardware resources, lower IT barriers to innovation, higher scalability, etc., but for the financial audit information flow and processing in the cloud system, CPA (Certified Public Accountant firms need special considerations, for example: system problems, information security and other related issues. Auditing cloud computing applications is the future trend in the CPA firms, given this issue is an important factor for them and very few studies have been conducted to investigate this issue; hence this study seeks to explore the key risk factors for the cloud computing and audit considerations. The dimensions/perspectives of the application of cloud computing audit considerations are huge and cover many criteria/factors. These risk factors are becoming increasingly complex, and interdependent. If the dimensions could be established, the mutually influential relations of the dimensions and criteria determined, and the current execution performance established; a prioritized improvement strategy designed could be constructed to use as a reference for CPA firm management decision making; as well as provide CPA firms with a reference for build auditing cloud computing systems. Empirical results show that key risk factors to consider when using cloud computing in auditing are, in order of priority for improvement: Operations (D, Automating user provisioning (C, Technology Risk (B and Protection system (A.

  20. Assessing the cost-effectiveness of seismic risk reduction options in oil industry

    International Nuclear Information System (INIS)

    Nasserasadi, K.; Ghafory-Ashtiany, M.

    2007-01-01

    An integrated probabilistic methodology for cost-efficiency estimation of different sort of seismic risk management measures are introduced by adding Cost Benefit Analysis (CBA) module to an integrated seismic risk assessment model. An oil refinery in Iran has been selected for case study and cost-efficiency of software and hardware mitigation measures are evaluated. The results have shown that: (1) software mitigation measures have more benefit than hardware ones, (2) considering indirect loss in CBA lead to more benefit-cost ratio and (3) although increase of discount ratio decreases the benefit-cost ratio, the arrangement of mitigation measures from benefit-cost viewpoint are constant. (authors)

  1. Conflict translates environmental and social risk into business costs.

    Science.gov (United States)

    Franks, Daniel M; Davis, Rachel; Bebbington, Anthony J; Ali, Saleem H; Kemp, Deanna; Scurrah, Martin

    2014-05-27

    Sustainability science has grown as a field of inquiry, but has said little about the role of large-scale private sector actors in socio-ecological systems change. However, the shaping of global trends and transitions depends greatly on the private sector and its development impact. Market-based and command-and-control policy instruments have, along with corporate citizenship, been the predominant means for bringing sustainable development priorities into private sector decision-making. This research identifies conflict as a further means through which environmental and social risks are translated into business costs and decision making. Through in-depth interviews with finance, legal, and sustainability professionals in the extractive industries, and empirical case analysis of 50 projects worldwide, this research reports on the financial value at stake when conflict erupts with local communities. Over the past decade, high commodity prices have fueled the expansion of mining and hydrocarbon extraction. These developments profoundly transform environments, communities, and economies, and frequently generate social conflict. Our analysis shows that mining and hydrocarbon companies fail to factor in the full scale of the costs of conflict. For example, as a result of conflict, a major, world-class mining project with capital expenditure of between US$3 and US$5 billion was reported to suffer roughly US$20 million per week of delayed production in net present value terms. Clear analysis of the costs of conflict provides sustainability professionals with a strengthened basis to influence corporate decision making, particularly when linked to corporate values. Perverse outcomes of overemphasizing a cost analysis are also discussed.

  2. New risk factors for atherosclerosis and patient risk assessment

    NARCIS (Netherlands)

    Fruchart, Jean-Charles; Nierman, Melchior C.; Stroes, Erik S. G.; Kastelein, John J. P.; Duriez, Patrick

    2004-01-01

    Advances in our understanding of the ways in which the traditional cardiovascular risk factors, including standard lipid (eg, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) and nonlipid (eg, hypertension) risk factors, interact to initiate

  3. Risk-based cost-benefit analysis for evaluating microbial risk mitigation in a drinking water system.

    Science.gov (United States)

    Bergion, Viktor; Lindhe, Andreas; Sokolova, Ekaterina; Rosén, Lars

    2018-04-01

    Waterborne outbreaks of gastrointestinal diseases can cause large costs to society. Risk management needs to be holistic and transparent in order to reduce these risks in an effective manner. Microbial risk mitigation measures in a drinking water system were investigated using a novel approach combining probabilistic risk assessment and cost-benefit analysis. Lake Vomb in Sweden was used to exemplify and illustrate the risk-based decision model. Four mitigation alternatives were compared, where the first three alternatives, A1-A3, represented connecting 25, 50 and 75%, respectively, of on-site wastewater treatment systems in the catchment to the municipal wastewater treatment plant. The fourth alternative, A4, represented installing a UV-disinfection unit in the drinking water treatment plant. Quantitative microbial risk assessment was used to estimate the positive health effects in terms of quality adjusted life years (QALYs), resulting from the four mitigation alternatives. The health benefits were monetised using a unit cost per QALY. For each mitigation alternative, the net present value of health and environmental benefits and investment, maintenance and running costs was calculated. The results showed that only A4 can reduce the risk (probability of infection) below the World Health Organization guidelines of 10 -4 infections per person per year (looking at the 95th percentile). Furthermore, all alternatives resulted in a negative net present value. However, the net present value would be positive (looking at the 50 th percentile using a 1% discount rate) if non-monetised benefits (e.g. increased property value divided evenly over the studied time horizon and reduced microbial risks posed to animals), estimated at 800-1200 SEK (€100-150) per connected on-site wastewater treatment system per year, were included. This risk-based decision model creates a robust and transparent decision support tool. It is flexible enough to be tailored and applied to local

  4. Human Leptospirosis and risk factors.

    Directory of Open Access Journals (Sweden)

    Yanelis Emilia Tabío Henry

    2010-09-01

    Full Text Available The human leptospirosis is a zoonosis of world distribution, were risk factors exist that have favored the wild and domestic animal propagation and so man. A descpitive investigation was made with the objective of determining the behavior of risk factors in outpatients by human leptospirosis in “Camilo Cienfuegos“ University General Hospital from Sncti Spíritus In the comprised time period betwen december 1 st and 3 st , 2008.The sample of this study was conformed by 54 risk persons that keep inclusion criteria. Some variables were used:age, sex, risk factors and number of ill persons, according to the month. Some patients of masculine sex prevailed (61,9%, group of ages between 15-29 and 45-59 years (27,7%, patients treated since october to december (53,7%, the direct and indirect contact with animals (46,2 %. The risk factors cassually associated to human leptospirosis turned to be: the masculine sex, the contac with animals, the occupational exposition and the inmersion on sources of sweet water.

  5. Vitamin D and cardiometabolic risk factors and diseases.

    Science.gov (United States)

    Mousa, A; Naderpoor, N; Teede, H J; De Courten, M P J; Scragg, R; De Courten, B

    2015-09-01

    Obesity, type 2 diabetes, and cardiovascular disease (CVD) are the most common preventable causes of morbidity and mortality worldwide. Insulin resistance, which is a shared feature in these conditions, is also strongly linked to the development of polycystic ovary syndrome (PCOS), which is the most common endocrine disease in women of reproductive age and a major cause of infertility. Vitamin D deficiency has reached epidemic proportions worldwide, primarily due to the shift to sedentary, indoor lifestyles and sun avoidance behaviours to protect against skin cancer. In recent years, vitamin D deficiency has been implicated in the aetiology of type 2 diabetes, PCOS and CVD, and has been shown to be associated with their risk factors including obesity, insulin resistance, hypertension, as well as chronic low-grade inflammation. Treating vitamin D deficiency may offer a feasible and cost-effective means of reducing cardiometabolic risk factors at a population level in order to prevent the development of type 2 diabetes and CVD. However, not all intervention studies show that vitamin D supplementation alleviates these risk factors. Importantly, there is significant heterogeneity in existing studies with regards to doses and drug regimens used, populations studied (i.e. vitamin D deficient or sufficient), and the lengths of supplementation, and only few studies have directly examined the effect of vitamin D on insulin secretion and resistance with the use of clamp methods. Therefore, there is a need for well-designed large scale trials to clarify the role of vitamin D supplementation in the prevention of type 2 diabetes, PCOS, and CVD.

  6. School-related risk factors for drunkenness among adolescents: risk factors differ between socio-economic groups

    DEFF Research Database (Denmark)

    Andersen, Anette; Holstein, Bjørn E; Due, Pernille

    2006-01-01

    Purpose: To examine, separately for boys and girls, whether socio-economic differences in drunkenness exist in adolescence, whether the level of exposure to school-related risk factors differ between socio-economic groups, and whether the relative contribution of school-related risk factors......) was measured by parental occupation. RESULTS: Among girls, exposures to school-related risk factors were more prevalent in lower socio-economic groups. Poor school satisfaction was associated with drunkenness among girls from high SEP, odds ratio (OR) = 2.98 (0.73-12.16). Among boys from high SEP autonomy...

  7. Cardiovascular risk factors in men

    DEFF Research Database (Denmark)

    Gyllenborg, J; Rasmussen, S L; Borch-Johnsen, Knut

    2001-01-01

    Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross-sectional de......Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross...

  8. Shifting orders among suppliers considering risk, price and transportation cost

    Science.gov (United States)

    Revitasari, C.; Pujawan, I. N.

    2018-04-01

    Supplier order allocation is an important supply chain decision for an enterprise. It is related to the supplier’s function as a raw material provider and other supporting materials that will be used in production process. Most of works on order allocation has been based on costs and other supply chain performance, but very limited of them taking risks into consideration. In this paper we address the problem of order allocation of a single commodity sourced from multiple suppliers considering supply risks in addition to the attempt of minimizing transportation costs. The supply chain risk was investigated and a procedure was proposed in the risk mitigation phase as a form of risk profile. The objective including risk profile in order allocation is to maximize the product flow from a risky supplier to a relatively less risky supplier. The proposed procedure is applied to a sugar company. The result suggests that order allocations should be maximized to suppliers that have a relatively low risk and minimized to suppliers that have a relatively larger risks.

  9. Prevalence of stroke/cardiovascular risk factors in Hungary

    Science.gov (United States)

    Bodo, M.; Sipos, K.; Thuroczy, G.; Panczel, G.; Ilias, L.; Szonyi, P.; Bodo, M., Jr.; Nebella, T.; Banyasz, A.; Nagy, Z.

    2010-04-01

    A cross-sectional survey was conducted in Hungary using the Cerberus system which includes: 1) a questionnaire addressing the risk factors for stroke/cardiovascular disease; 2) amplifiers to record the pulse waves of cerebral arteries (rheoencephalography) and peripheral arteries, electrocardiogram and electroencephalogram. Additionally, subjects were measured for carotid stenosis by Doppler ultrasound and 12-lead electrocardiogram; subjects were also screened for blood cholesterol, glucose, and triglyceride levels. Prevalence of the following stroke risk factors was identified: overweight, 63.25%; sclerotic brain arteries (by rheoencephalogram), 54.29%; heart disease, 37.92%; pathologic carotid flow, 34.24%; smoking, 30.55%; high blood cholesterol, 28.70%; hypertension, 27.83%; high triglyceride, 24.35%; abnormality in electrocardiogram, 20%; high glucose, 15.95%; symptoms of transient ischemic attack, 16.07%; alcohol abuse, 6.74%; and diabetes, 4.53%. The study demonstrates a possible model for primary cardiovascular disease/stroke prevention. This method offers a standardizable, cost effective, practical technique for mass screenings by identifying the population at high risk for cardiovascular disturbances, especially cerebrovascular disease (primary prevention). In this model, the rheoencephalogram can detect cerebrovascular arteriosclerosis in the susceptibility/presymptomatic phase, earlier than the Doppler ultrasound technique. The method also provides a model for storing analog physiological signals in a computer-based medical record and is a first step in applying an expert system to stroke prevention.

  10. Risk factor for febrile seizures

    Directory of Open Access Journals (Sweden)

    Odalović Dragica

    2014-01-01

    Full Text Available Febrile seizures are the most frequent neurological disorder in the childhood. According to American Academy of Pediatrics (AAP, they have been defined as seizures provoked by high temperature in children aged between 6 months and 5 years, without previous history of afebrile seizures, intracranial infections and other possible causes of seizures. Seizures can be typical and atypical, according to the characteristics. Pathogenesis of this disorder has not been clarified yet, and it is believed to be a combination of genetic factors, high body temperature and brain maturation. The risk factors for recurrence of febrile seizures are: age in which seizures appeared for the first time, epilepsy in the first degree relative, febrile seizures in the first degree relative, frequent diseases with fever and low body temperature on the beginning of seizures. The frequency of recurrent seizures The risk for occurrence of epilepsy in children with simple seizures is about 1-1.5%, which is slightly higher compared to general population, while it increases to 4-15% in patients with complex seizures. However, there is no evidence that therapy prevents occurrence of epilepsy. When the prevention of recurrent seizures is considered, it is necessary to separate simple from complex seizures. The aim of this paper was to analyze the most important risk factors for febrile seizures, and to evaluate their impact on occurrence of recurrent seizures. Our study included 125 children with febrile seizures, aged from 6 months to 5 years. The presence of febrile seizures and epilepsy in the first degree relative has been noted in 22% of children. Typical febrile seizures were observed in 76% of cases, and atypical in 24%. Most patients had only one seizure (73.6%. Children, who had seizure earlier in life, had more frequent recurrences. Both risk factors were present in 25% of patients, while 68% of patients had only one risk factor. For the children with febrile disease

  11. Global timber investments, wood costs, regulation, and risk

    International Nuclear Information System (INIS)

    Cubbage, Frederick; Koesbandana, Sadharga; Gonzalez, Ronalds; Carrero, Omar; MacIntyre, Charles; Abt, Robert; Phillips, Richard; Mac Donagh, Patricio; Rubilar, Rafael; Balmelli, Gustavo; Olmos, Virginia Morales; De La Torre, Rafael; Murara, Mauro; Hoeflich, Vitor Afonso; Kotze, Heynz; Frey, Gregory; Adams, Thomas; Turner, James; Lord, Roger; Huang, Jin; McGinley, Kathleen

    2010-01-01

    We estimated financial returns and wood production costs in 2008 for the primary timber plantation species. Excluding land costs, returns for exotic plantations in almost all of South America - Brazil, Argentina, Uruguay, Chile, Colombia, Venezuela, and Paraguay - were substantial. Eucalyptus species returns were generally greater than those for Pinus species in each country, with most having Internal Rates of Return (IRRs) of 20% per year or more, as did teak. Pinus species in South America were generally closer to 15%, except in Argentina, where they were 20%. IRRs were less, but still attractive for plantations of coniferous or deciduous species in China, South Africa, New Zealand, Indonesia, and the United States, ranging from 7% to 12%. Costs of wood production at the cost of capital of 8% per year were generally cheapest for countries with high rates of return and for pulpwood fiber production, which would favor vertically integrated firms in Latin America. But wood costs at stumpage market prices were much greater, making net wood costs for open market wood more similar among countries. In the Americas, Chile and Brazil had the most regulatory components of sustainable forest management, followed by Misiones, Argentina and Oregon in the U.S. New Zealand, the United States, and Chile had the best rankings regarding risk from political, commercial, war, or government actions and for the ease of doing business. Conversely, Venezuela, Indonesia, Colombia, and Argentina had high risk ratings, and Brazil, Indonesia, and Venezuela were ranked as more difficult countries for ease of business. (author)

  12. Global timber investments, wood costs, regulation, and risk

    Energy Technology Data Exchange (ETDEWEB)

    Cubbage, Frederick; Koesbandana, Sadharga; Gonzalez, Ronalds; Carrero, Omar; MacIntyre, Charles; Abt, Robert; Phillips, Richard [Forestry and Environmental Resources, North Carolina State University, Raleigh, NC (United States); Mac Donagh, Patricio [Universidad Nacional de Misiones (UNAM), Lisandro de la Torre s/n, CP 3380, Eldorado, Misiones (Argentina); Rubilar, Rafael [Universidad de Concepcion, Victoria 631, Casilla 160-C - Correo 3, Concepcion (Chile); Balmelli, Gustavo [Instituto Nacional de Investigacion Agropecuria, INIA Tacuarembo, Ruta 5, Km 386, Tacuarembo (Uruguay); Olmos, Virginia Morales [Weyerhaeuser Company, La Rosa 765, Melo (Uruguay); De La Torre, Rafael [CellFor, 247 Davis Street, Athens, GA (United States); Murara, Mauro [Universidade do Contestado, R. Joaquim Nabuco, 314 Bairro Cidade Nova, Porto Uniao, Santa Catarina (Brazil); Hoeflich, Vitor Afonso [Universidade Federal do Parana, Av. Pref. Lothario Meissner, 900, 80210-170, Jardim Botanico, Curitiba, Parana (Brazil); Kotze, Heynz [Komatiland Forests (Pty) Ltd, P.O. Box 14228, Nelspruit (South Africa); Frey, Gregory [World Bank, 1818 H. Street NW, Washington, DC (United States); Adams, Thomas; Turner, James [New Zealand Forest Research Institute Ltd., Scion, 49 Sala St., Rotorua (New Zealand); Lord, Roger [Mason, Bruce, and Girard, Inc., 707 SW Washington St., Portland, Oregon (United States); Huang, Jin [Abt Associates, 4550 Montgomery Avenue, Bethesda, MD (United States); McGinley, Kathleen [International Institute of Tropical Forestry, USDA Forest Service, c/o 920 Main Campus Dr. Suite 300, Raleigh, NC (United States)

    2010-12-15

    We estimated financial returns and wood production costs in 2008 for the primary timber plantation species. Excluding land costs, returns for exotic plantations in almost all of South America - Brazil, Argentina, Uruguay, Chile, Colombia, Venezuela, and Paraguay - were substantial. Eucalyptus species returns were generally greater than those for Pinus species in each country, with most having Internal Rates of Return (IRRs) of 20% per year or more, as did teak. Pinus species in South America were generally closer to 15%, except in Argentina, where they were 20%. IRRs were less, but still attractive for plantations of coniferous or deciduous species in China, South Africa, New Zealand, Indonesia, and the United States, ranging from 7% to 12%. Costs of wood production at the cost of capital of 8% per year were generally cheapest for countries with high rates of return and for pulpwood fiber production, which would favor vertically integrated firms in Latin America. But wood costs at stumpage market prices were much greater, making net wood costs for open market wood more similar among countries. In the Americas, Chile and Brazil had the most regulatory components of sustainable forest management, followed by Misiones, Argentina and Oregon in the U.S. New Zealand, the United States, and Chile had the best rankings regarding risk from political, commercial, war, or government actions and for the ease of doing business. Conversely, Venezuela, Indonesia, Colombia, and Argentina had high risk ratings, and Brazil, Indonesia, and Venezuela were ranked as more difficult countries for ease of business. (author)

  13. Vertigo and dizziness in adolescents: Risk factors and their population attributable risk.

    Science.gov (United States)

    Filippopulos, Filipp M; Albers, Lucia; Straube, Andreas; Gerstl, Lucia; Blum, Bernhard; Langhagen, Thyra; Jahn, Klaus; Heinen, Florian; von Kries, Rüdiger; Landgraf, Mirjam N

    2017-01-01

    To assess potential risk factors for vertigo and dizziness in adolescents and to evaluate their variability by different vertigo types. The role of possible risk factors for vertigo and dizziness in adolescents and their population relevance needs to be addressed in order to design preventive strategies. The study population consisted of 1482 school-children between the age of 12 and 19 years, who were instructed to fill out a questionnaire on different vertigo types and related potential risk factors. The questionnaire specifically asked for any vertigo, spinning vertigo, swaying vertigo, orthostatic dizziness, and unspecified dizziness. Further a wide range of potential risk factors were addressed including gender, stress, muscular pain in the neck and shoulder region, sleep duration, migraine, coffee and alcohol consumption, physical activity and smoking. Gender, stress, muscular pain in the neck and shoulder region, sleep duration and migraine were identified as independent risk factors following mutual adjustment: The relative risk was 1.17 [1.10-1.25] for female sex, 1.07 [1.02-1.13] for stress, 1.24 [1.17-1.32] for muscular pain, and 1.09 [1.03-1.14] for migraine. The population attributable risk explained by these risk factors was 26%, with muscular pain, stress, and migraine accounting for 11%, 4%, and 3% respectively. Several established risk factors in adults were also identified in adolescents. Risk factors amenable to prevention accounted for 17% of the total population risk. Therefore, interventions targeting these risk factors may be warranted.

  14. Hidden Risk Factors for Women

    Science.gov (United States)

    ... A.S.T. Quiz Hidden Stroke Risk Factors for Women Updated:Nov 22,2016 Excerpted from "What Women Need To Know About The Hidden Risk Factors ... 2012) This year, more than 100,000 U.S. women under 65 will have a stroke. Stroke is ...

  15. Factors Associated with Photovoltaic System Costs (Topical Issues Brief)

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, J.

    2001-06-12

    A variety of factors can affect the cost of photovoltaic systems. This report analyses the relationship among such factors by using information entered into a voluntary registry of PV systems and performing regression analyses. The results showed statistically significant relationships between photovoltaic system cost and (a) grid connection, (b) installation year, (c) areas where the utility had entered into volume purchasing agreements.

  16. [Integrated Management Area of Vascular Risk: A new organisational model for global control of risk factors].

    Science.gov (United States)

    Armario, P; Jericó, C; Vila, L; Freixa, R; Martin-Castillejos, C; Rotllan, M

    Cardiovascular disease (CVD), is a major cause of morbidity and mortality that increases the cost of care. Currently there is a low degree of control of the main cardiovascular risk factors, although we have a good therapeutic arsenal. To achieve the improvement of this reality, a good coordination and multidisciplinary participation are essential. The development of new organizational models such as the Integrated Management Area of Vascular Risk can facilitate the therapeutic harmonization and unification of the health messages offered by different levels of care, based on clinical practice guidelines, in order to provide patient-centred integrated care. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Risks and Transaction Costs of Distributed-Ledger Fintech: Boundary Effects and Consequences

    OpenAIRE

    Kaivanto, Kim; Prince, Daniel

    2017-01-01

    Fintech business models based on distributed ledgers -- and their smart-contract variants in particular -- offer the prospect of democratizing access to faster, anywhere-accessible, lower cost, reliable-and-secure high-quality financial services. In addition to holding great, economically transformative promise, these business models pose new, little-studied risks and transaction costs. However, these risks and transaction costs are not evident during the demonstration and testing phases of d...

  18. The global geographical overlap of aflatoxin and hepatitis C: Controlling risk factors for liver cancer worldwide

    Science.gov (United States)

    Palliyaguru, Dushani L.; Wu, Felicia

    2012-01-01

    About 85% of hepatocellular carcinoma (HCC, liver cancer) cases occur in low-income countries, where the risk factors of dietary aflatoxin exposure and chronic hepatitis B and C (HBV and HCV) viral infection are common. While studies have shown synergism between aflatoxin and HBV in causing HCC, much less is known about whether aflatoxin and HCV synergize similarly. From an exposure perspective, we examine whether there is a geographical overlap in populations worldwide exposed to high dietary aflatoxin levels and with high HCV prevalence. While HCV is one of the most important risk factors for HCC in high-income nations (where aflatoxin exposure is low), we find that HCV prevalence is much higher in Africa and Asia, where aflatoxin exposure is also high. However, within a given world region, there are some inconsistencies regarding exposure and cancer risk. Therefore, there is a need to control risk factors such as aflatoxin and hepatitis viruses in a cost-effective manner to prevent global HCC, while continuing to evaluate biological mechanisms by which these risk factors interact to increase HCC risk. PMID:23281740

  19. Strategic cost management, contingent factors and performance in services

    Directory of Open Access Journals (Sweden)

    Odysseas Pavlatos

    2018-06-01

    Full Text Available The purpose of this paper is to investigate the relationship between contextual factors identified from contingency-based research, the extent of the use of strategic cost management (SCM techniques and business performance in services. An empirical survey was conducted on a sample of 88 services in Greece. The analysis of the survey data indicates that the use of strategic cost management techniques in services can be considered quite satisfactory. By drawing on the grounds of contingency theory, five factors were identified as potentially exhibiting an emergent relationship with strategic cost management. The five factors are; (1 Perceived environmental uncertainty, (2 Structure, (3 Organizational life cycle stage, (4 Strategy and (5 Size. The survey revealed that SCM usage is positively affected by these five contingent factors, while SCM usage, in turn, positively affects performance. A significant mediating effect of SCM usage on performance is evident.

  20. Identification of complexity cost factors in manufacturing companies

    DEFF Research Database (Denmark)

    Myrodia, Anna; Hvam, Lars

    2015-01-01

    Complexity tends to be arguably the biggest challenge of manufacturing companies. As the demand from the customers increases in volume and diversity, the number of finished products and components increases as well. This increasing product complexity has a direct effect on the production processes....... This research focuses on the relation between product and process complexity. Complexity cost factors are identified and categorized under the industrial standard APQC for process classification. Then, this categorization is used as a tool for identification of complexity cost factors in seven companies...

  1. Factoral analysis of the cost of preparing oil

    Energy Technology Data Exchange (ETDEWEB)

    Avdeyeva, L A; Kudoyarov, G Sh; Shmatova, M F

    1979-01-01

    Mathematical statistics methods (basically correlational and regression analysis) are used to study the factors which form the level of cost of preparing oil with consideration of the mutual influence of the factors. Selected as the claims for inclusion into a mathematical model was a group of five a priori justified factors: the water level of the oil being extracted (%); the specific expenditure of deemulsifiers; the volume of oil preparation; the quality of oil preparation (the salt content) and the level of use of the installations' capacities (%). To construct an economic and mathematical model of the cost of the technical preparation (SPP) of the oil, all the unions which make up the Ministry of the Oil Industry were divided into two comparable totalities. The first group included unions in which the oil SPP was lower than the branch average and the second, unions in which the SPP was higher than the branch wide cost. Using the coefficients of regression, special elasticity coefficients and the fluctuation indicators, the basic factors were finally identified which have the greatest influence on the formation of the oil SPP level separately for the first and second groups of unions.

  2. The Cost-Effectiveness of High-Risk Lung Cancer Screening and Drivers of Program Efficiency.

    Science.gov (United States)

    Cressman, Sonya; Peacock, Stuart J; Tammemägi, Martin C; Evans, William K; Leighl, Natasha B; Goffin, John R; Tremblay, Alain; Liu, Geoffrey; Manos, Daria; MacEachern, Paul; Bhatia, Rick; Puksa, Serge; Nicholas, Garth; McWilliams, Annette; Mayo, John R; Yee, John; English, John C; Pataky, Reka; McPherson, Emily; Atkar-Khattra, Sukhinder; Johnston, Michael R; Schmidt, Heidi; Shepherd, Frances A; Soghrati, Kam; Amjadi, Kayvan; Burrowes, Paul; Couture, Christian; Sekhon, Harmanjatinder S; Yasufuku, Kazuhiro; Goss, Glenwood; Ionescu, Diana N; Hwang, David M; Martel, Simon; Sin, Don D; Tan, Wan C; Urbanski, Stefan; Xu, Zhaolin; Tsao, Ming-Sound; Lam, Stephen

    2017-08-01

    Lung cancer risk prediction models have the potential to make programs more affordable; however, the economic evidence is limited. Participants in the National Lung Cancer Screening Trial (NLST) were retrospectively identified with the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. The high-risk subgroup was assessed for lung cancer incidence and demographic characteristics compared with those in the low-risk subgroup and the Pan-Canadian Early Detection of Lung Cancer Study (PanCan), which is an observational study that was high-risk-selected in Canada. A comparison of high-risk screening versus standard care was made with a decision-analytic model using data from the NLST with Canadian cost data from screening and treatment in the PanCan study. Probabilistic and deterministic sensitivity analyses were undertaken to assess uncertainty and identify drivers of program efficiency. Use of the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial with a threshold set at 2% over 6 years would have reduced the number of individuals who needed to be screened in the NLST by 81%. High-risk screening participants in the NLST had more adverse demographic characteristics than their counterparts in the PanCan study. High-risk screening would cost $20,724 (in 2015 Canadian dollars) per quality-adjusted life-year gained and would be considered cost-effective at a willingness-to-pay threshold of $100,000 in Canadian dollars per quality-adjusted life-year gained with a probability of 0.62. Cost-effectiveness was driven primarily by non-lung cancer outcomes. Higher noncurative drug costs or current costs for immunotherapy and targeted therapies in the United States would render lung cancer screening a cost-saving intervention. Non-lung cancer outcomes drive screening efficiency in diverse, tobacco-exposed populations. Use of risk selection can reduce the budget impact, and

  3. Quantifying IT estimation risks

    NARCIS (Netherlands)

    Kulk, G.P.; Peters, R.J.; Verhoef, C.

    2009-01-01

    A statistical method is proposed for quantifying the impact of factors that influence the quality of the estimation of costs for IT-enabled business projects. We call these factors risk drivers as they influence the risk of the misestimation of project costs. The method can effortlessly be

  4. Vertigo and dizziness in adolescents: Risk factors and their population attributable risk.

    Directory of Open Access Journals (Sweden)

    Filipp M Filippopulos

    Full Text Available To assess potential risk factors for vertigo and dizziness in adolescents and to evaluate their variability by different vertigo types. The role of possible risk factors for vertigo and dizziness in adolescents and their population relevance needs to be addressed in order to design preventive strategies.The study population consisted of 1482 school-children between the age of 12 and 19 years, who were instructed to fill out a questionnaire on different vertigo types and related potential risk factors. The questionnaire specifically asked for any vertigo, spinning vertigo, swaying vertigo, orthostatic dizziness, and unspecified dizziness. Further a wide range of potential risk factors were addressed including gender, stress, muscular pain in the neck and shoulder region, sleep duration, migraine, coffee and alcohol consumption, physical activity and smoking.Gender, stress, muscular pain in the neck and shoulder region, sleep duration and migraine were identified as independent risk factors following mutual adjustment: The relative risk was 1.17 [1.10-1.25] for female sex, 1.07 [1.02-1.13] for stress, 1.24 [1.17-1.32] for muscular pain, and 1.09 [1.03-1.14] for migraine. The population attributable risk explained by these risk factors was 26%, with muscular pain, stress, and migraine accounting for 11%, 4%, and 3% respectively.Several established risk factors in adults were also identified in adolescents. Risk factors amenable to prevention accounted for 17% of the total population risk. Therefore, interventions targeting these risk factors may be warranted.

  5. The Research on Influencing Factors of Medical Logistics Cost Based on ISM Model

    Directory of Open Access Journals (Sweden)

    Zhai Yunkai

    2017-01-01

    Full Text Available The reason why medical logistics cost remains high is a system problem, this paper analyzes the system through the ISM model. The result presents that medical logistics cost factors have four levels of relationship, primary factor is the national policies, secondary factors are the talent construction and pharmaceutical enterprise scale, Intermediate factors are medical information management system and inventory cost, the key factors are transportation cost and distribution center location. Finally, according to the four levels of relationship, this paper put forward specific suggestions to reduce logistics cost.

  6. The risk factor of thyroid

    International Nuclear Information System (INIS)

    Kusama, Tomoko

    1979-01-01

    For the purposes of radiation protection, the noteworthy risk of thyroid is carcinogenesis. The risk factor which ICRP presented in the publication-26 is 5 x 10 - 6 rem - 1 . This numerical value is based upon the estimated likelihood of inducing fatal thyroid cancer. On the other hand, the risk factor presented by the BEIR report is 4 x 10 - 6 yr - 1 . This value was decided after consideration of the risks of both fatal and non-fatal cancer of thyroid. The following features distinguished thyroid cancer from malignancy of other tissue from medical point of view. 1) A large difference between incidence and mortality in case of thyroid cancer is recognized, because the thyroid cancer could be successfully treated by surgical or radiological treatment. 2) The high prevalence of clinically silent tumor in thyroid gland has been reported. The incidence of thyroid cancer, therefore, is very dependent on methods of medical inspection. The prevalence of radiation induced thyroid cancer is modified by various factors such as age, sex, latency, dose and dose rate. The latent period is very important factors such as ave, sex, latency, dose and dose rate. The latent period is a very important factor in the estimation of accumulated total risk of thyroid malignancy. What is included in the risk caused by thyroid irradiation must be investigated. The risk of non-fatal cancer should be considered in the same way as that of fatal cancer. The dose-equivalent limit of thyroid in non-uniform irradiation caused by radioactive iodine is decided by the limit for non-stochastic effects. Therefore the further consideration of non-stochastic effects of thyroid is necessary. (author)

  7. Time-Dependent Risk Estimation and Cost-Benefit Analysis for Mitigation Actions

    Science.gov (United States)

    van Stiphout, T.; Wiemer, S.; Marzocchi, W.

    2009-04-01

    Earthquakes strongly cluster in space and time. Consequently, the most dangerous time is right after a moderate earthquake has happened, because their is a ‘high' (i.e., 2-5 percent) probability that this event will be followed by a subsequent aftershock which happens to be as large or larger than the initiating event. The seismic hazard during this time-period exceeds the background probability significantly and by several orders of magnitude. Scientists have developed increasingly accurate forecast models that model this time-dependent hazard, and such models are currently being validated in prospective testing. However, this probabilistic information in the hazard space is difficult to digest for decision makers, the media and general public. Here, we introduce a possible bridge between seismology and decision makers (authorities, civil defense) by proposing a more objective way to estimate time-dependent risk assessment. Short Term Earthquake Risk assessment (STEER) combines aftershock hazard and loss assessments. We use site-specific information on site effects and building class distribution and combine this with existing loss models to compute site specific time-dependent risk curves (probability of exceedance for fatalities, injuries, damages etc). We show the effect of uncertainties in the different components using Monte Carlo Simulations of the input parameters. This time-dependent risk curves can act as a decision support. We extend the STEER approach by introducing a Cost-Benefit approach for certain mitigation actions after a medium-sized earthquake. Such Cost-Benefit approaches have been recently developed for volcanic risk assessment to rationalize precautionary evacuations in densely inhabitated areas threatened by volcanoes. Here we extend the concept to time-dependent probabilistic seismic risk assessment. For the Cost-Benefit analysis of mitigation actions we calculate the ratio between the cost for the mitigation actions and the cost of the

  8. Population-Attributable Risk Proportion of Clinical Risk Factors for Breast Cancer.

    Science.gov (United States)

    Engmann, Natalie J; Golmakani, Marzieh K; Miglioretti, Diana L; Sprague, Brian L; Kerlikowske, Karla

    2017-09-01

    Many established breast cancer risk factors are used in clinical risk prediction models, although the proportion of breast cancers explained by these factors is unknown. To determine the population-attributable risk proportion (PARP) for breast cancer associated with clinical breast cancer risk factors among premenopausal and postmenopausal women. Case-control study with 1:10 matching on age, year of risk factor assessment, and Breast Cancer Surveillance Consortium (BCSC) registry. Risk factor data were collected prospectively from January 1, 1996, through October 31, 2012, from BCSC community-based breast imaging facilities. A total of 18 437 women with invasive breast cancer or ductal carcinoma in situ were enrolled as cases and matched to 184 309 women without breast cancer, with a total of 58 146 premenopausal and 144 600 postmenopausal women enrolled in the study. Breast Imaging Reporting and Data System (BI-RADS) breast density (heterogeneously or extremely dense vs scattered fibroglandular densities), first-degree family history of breast cancer, body mass index (>25 vs 18.5-25), history of benign breast biopsy, and nulliparity or age at first birth (≥30 years vs breast cancer. Of the 18 437 women with breast cancer, the mean (SD) age was 46.3 (3.7) years among premenopausal women and 61.7 (7.2) years among the postmenopausal women. Overall, 4747 (89.8%) premenopausal and 12 502 (95.1%) postmenopausal women with breast cancer had at least 1 breast cancer risk factor. The combined PARP of all risk factors was 52.7% (95% CI, 49.1%-56.3%) among premenopausal women and 54.7% (95% CI, 46.5%-54.7%) among postmenopausal women. Breast density was the most prevalent risk factor for both premenopausal and postmenopausal women and had the largest effect on the PARP; 39.3% (95% CI, 36.6%-42.0%) of premenopausal and 26.2% (95% CI, 24.4%-28.0%) of postmenopausal breast cancers could potentially be averted if all women with heterogeneously or extremely dense

  9. Costs and cost-effectiveness of carotid stenting versus endarterectomy for patients at standard surgical risk: results from the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST).

    Science.gov (United States)

    Vilain, Katherine R; Magnuson, Elizabeth A; Li, Haiyan; Clark, Wayne M; Begg, Richard J; Sam, Albert D; Sternbergh, W Charles; Weaver, Fred A; Gray, William A; Voeks, Jenifer H; Brott, Thomas G; Cohen, David J

    2012-09-01

    from this controlled clinical trial demonstrate only trivial differences in overall healthcare costs and quality-adjusted life expectancy between the 2 strategies. If the CREST results can be replicated in clinical practice, these findings suggest that factors other than cost-effectiveness should be considered when deciding between treatment options for carotid artery stenosis in patients at standard risk for surgical complications. Clinical Trial Registration- URL: http://clinicaltrials.gov. Unique Identifier: NCT00004732.

  10. Factors Affecting Time, Cost and Quality Management in Building ...

    African Journals Online (AJOL)

    The study is an assessment of time, cost and quality management in the Nigerian construction industry, and it aims to explore time cost and quality management in the construction industry. The objective of the study is to identify factors affecting time; cost and quality management in building construction projects. This study ...

  11. Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.

    Directory of Open Access Journals (Sweden)

    Celine Larkin

    Full Text Available BACKGROUND: Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic review published which synthesises the extensive evidence on risk factors for repetition. OBJECTIVE: This review is intended to identify risk factors for prospective repetition of self-harm after an index self-harm presentation, irrespective of suicidal intent. DATA SOURCES: PubMed, PsychInfo and Scirus were used to search for relevant publications. We included cohort studies which examining factors associated with prospective repetition among those presenting with self-harm to emergency departments. Journal articles, abstracts, letters and theses in any language published up to June 2012 were considered. Studies were quality-assessed and synthesised in narrative form. RESULTS: A total of 129 studies, including 329,001 participants, met our inclusion criteria. Some factors were studied extensively and were found to have a consistent association with repetition. These included previous self-harm, personality disorder, hopelessness, history of psychiatric treatment, schizophrenia, alcohol abuse/dependence, drug abuse/dependence, and living alone. However, the sensitivity values of these measures varied greatly across studies. Psychological risk factors and protective factors have been relatively under-researched but show emerging associations with repetition. Composite risk scales tended to have high sensitivity but poor specificity. CONCLUSIONS: Many risk factors for repetition of self-harm match risk factors for initiation of self-harm, but the most consistent evidence for increased risk of repetition comes from long-standing psychosocial vulnerabilities, rather than characteristics of an index episode

  12. Cost-effectiveness and harm-benefit analyses of risk-based screening strategies for breast cancer.

    Directory of Open Access Journals (Sweden)

    Ester Vilaprinyo

    Full Text Available The one-size-fits-all paradigm in organized screening of breast cancer is shifting towards a personalized approach. The present study has two objectives: 1 To perform an economic evaluation and to assess the harm-benefit ratios of screening strategies that vary in their intensity and interval ages based on breast cancer risk; and 2 To estimate the gain in terms of cost and harm reductions using risk-based screening with respect to the usual practice. We used a probabilistic model and input data from Spanish population registries and screening programs, as well as from clinical studies, to estimate the benefit, harm, and costs over time of 2,624 screening strategies, uniform or risk-based. We defined four risk groups, low, moderate-low, moderate-high and high, based on breast density, family history of breast cancer and personal history of breast biopsy. The risk-based strategies were obtained combining the exam periodicity (annual, biennial, triennial and quinquennial, the starting ages (40, 45 and 50 years and the ending ages (69 and 74 years in the four risk groups. Incremental cost-effectiveness and harm-benefit ratios were used to select the optimal strategies. Compared to risk-based strategies, the uniform ones result in a much lower benefit for a specific cost. Reductions close to 10% in costs and higher than 20% in false-positive results and overdiagnosed cases were obtained for risk-based strategies. Optimal screening is characterized by quinquennial or triennial periodicities for the low or moderate risk-groups and annual periodicity for the high-risk group. Risk-based strategies can reduce harm and costs. It is necessary to develop accurate measures of individual risk and to work on how to implement risk-based screening strategies.

  13. Environmental risk factors and pressures

    International Nuclear Information System (INIS)

    Klinda, J.; Lieskovska, Z.

    1998-01-01

    In this chapter the physical risk factors (as radiation [air contamination, contamination of the environment components and food contamination], radon and its radioactive decay products, radioactive wastes, noise), chemical risk factors [chemical substances, xenobiotics in the food chain the ozone depletion], wastes (waste generation, waste management, municipal waste management, import, export and transit of waste) and natural an technological hazards (water quality deterioration as a result of various accidents and fire risk) in the Slovak Republic in 1997 are reviewed

  14. Risk Factors for Internet Gaming Disorder: Psychological Factors and Internet Gaming Characteristics.

    Science.gov (United States)

    Rho, Mi Jung; Lee, Hyeseon; Lee, Taek-Ho; Cho, Hyun; Jung, Dong Jin; Kim, Dai-Jin; Choi, In Young

    2017-12-27

    Background : Understanding the risk factors associated with Internet gaming disorder (IGD) is important to predict and diagnose the condition. The purpose of this study is to identify risk factors that predict IGD based on psychological factors and Internet gaming characteristics; Methods : Online surveys were conducted between 26 November and 26 December 2014. There were 3568 Korean Internet game users among a total of 5003 respondents. We identified 481 IGD gamers and 3087 normal Internet gamers, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria. Logistic regression analysis was applied to identify significant risk factors for IGD; Results : The following eight risk factors were found to be significantly associated with IGD: functional and dysfunctional impulsivity (odds ratio: 1.138), belief self-control (1.034), anxiety (1.086), pursuit of desired appetitive goals (1.105), money spent on gaming (1.005), weekday game time (1.081), offline community meeting attendance (2.060), and game community membership (1.393; p < 0.05 for all eight risk factors); Conclusions : These risk factors allow for the prediction and diagnosis of IGD. In the future, these risk factors could also be used to inform clinical services for IGD diagnosis and treatment.

  15. Bevacizumab in Treatment of High-Risk Ovarian Cancer—A Cost-Effectiveness Analysis

    Science.gov (United States)

    Herzog, Thomas J.; Hu, Lilian; Monk, Bradley J.; Kiet, Tuyen; Blansit, Kevin; Kapp, Daniel S.; Yu, Xinhua

    2014-01-01

    Objective. The objective of this study was to evaluate a cost-effectiveness strategy of bevacizumab in a subset of high-risk advanced ovarian cancer patients with survival benefit. Methods. A subset analysis of the International Collaboration on Ovarian Neoplasms 7 trial showed that additions of bevacizumab (B) and maintenance bevacizumab (mB) to paclitaxel (P) and carboplatin (C) improved the overall survival (OS) of high-risk advanced cancer patients. Actual and estimated costs of treatment were determined from Medicare payment. Incremental cost-effectiveness ratio per life-year saved was established. Results. The estimated cost of PC is $535 per cycle; PCB + mB (7.5 mg/kg) is $3,760 per cycle for the first 6 cycles and then $3,225 per cycle for 12 mB cycles. Of 465 high-risk stage IIIC (>1 cm residual) or stage IV patients, the previously reported OS after PC was 28.8 months versus 36.6 months in those who underwent PCB + mB. With an estimated 8-month improvement in OS, the incremental cost-effectiveness ratio of B was $167,771 per life-year saved. Conclusion. In this clinically relevant subset of women with high-risk advanced ovarian cancer with overall survival benefit after bevacizumab, our economic model suggests that the incremental cost of bevacizumab was approximately $170,000. PMID:24721817

  16. Unintended benefits: the potential economic impact of addressing risk factors to prevent Alzheimer's disease.

    Science.gov (United States)

    Lin, Pei-Jung; Yang, Zhou; Fillit, Howard M; Cohen, Joshua T; Neumann, Peter J

    2014-04-01

    Certain chronic conditions appear to be modifiable risk factors of Alzheimer's disease and related dementias. To understand the potential health and economic impacts of addressing those risk factors, we used data on a Medicare cohort to simulate four scenarios: a 10 percent reduction in the prevalence of diabetes, hypertension, cardiovascular diseases, respectively, and a 10 percent reduction in body mass index among beneficiaries who were overweight or obese. Our simulation demonstrated that reducing the prevalence of these conditions may yield "unintended benefits" by lowering the risk, delaying the onset, reducing the duration, and lowering the costs of dementia. More research is needed to clarify the exact relationship between various other chronic diseases and dementia. However, our findings highlight potential health gains and savings opportunities stemming from the better management of other conditions associated with dementia.

  17. The influence of risk mitigation measures on the risks, costs and routing of CO2 pipelines

    NARCIS (Netherlands)

    Knoope, M. M J|info:eu-repo/dai/nl/364248149; Raben, I. M E; Ramírez, A.|info:eu-repo/dai/nl/284852414; Spruijt, M. P N; Faaij, A. P C|info:eu-repo/dai/nl/10685903X

    2014-01-01

    The aim of this study was to analyze whether, and if so, in what way risks would influence the design, costs and routing of CO2 pipelines. This article assesses locational and societal risks of CO2 pipeline transport and analyses whether rerouting or implementing additional risk mitigation measures

  18. The influence of risk mitigation measures on the risks, costs and routing of CO 2pipelines

    NARCIS (Netherlands)

    Knoope, M.M.J.; Raben. I.M.E.; Ramírez, A.; Spruijt, M.P.N.; Faaij, A.P.C.

    2014-01-01

    The aim of this study was to analyze whether, and if so, in what way risks would influence the design,costs and routing of CO2pipelines. This article assesses locational and societal risks of CO2pipelinetransport and analyses whether rerouting or implementing additional risk mitigation measures is

  19. Cardiovascular Risk Factors among First Year Medical Students

    Directory of Open Access Journals (Sweden)

    Raj Krishna Dangol

    2017-12-01

    Full Text Available Introduction: Detection of cardiovascular risk in young age is important to motivate them to modify life styles and seek health care early to lower the chances of acquiring cardiovascular disease in later age. This study was done to assess cardiovascular risk factors among first year medical students. Methods: A cross-sectional study was conducted throughout September and October 2017 in which all first year medical students from a medical college were assessed for the presence of cardiovascular risk factors. Participants’ demography, family history of illness, anthropometric measurements, and blood reports of lipid profile and fasting glucose were acquired. Data were analyzed with Statistical Package for Social Sciences (SPSS-21. Result: There were 99 participants; 55 males and 44 females. One or more risk factors were present in 87 (87.9% participants. Moreover, 67.7% (n = 67 participants had more than one risk factors. Low HDL-cholesterol was the most common (n = 55, 55.6% risk factor followed by elevated triacylglycerol (n = 47, 47.5% and family history of hypertension (n = 45, 45.5%. There was no significant difference in presence of various risk factors between genders. Conclusion: There was higher prevalence of cardiovascular risk factors among first year medical students. Majority of them had more than one risk factors. Low HDL-cholesterol was the most common risk factor. The risk factors were comparable in males and females.

  20. [Risk factors of necrotizing enterocolitis].

    Science.gov (United States)

    Tapia-Rombo, C A; Velasco-Lavín, M R; Nieto-Caldelas, A

    1993-09-01

    The purpose of the present study is to compare risk factors of necrotizing enterocolitis (NEC) between two group: group A, newborns with the disease and group B, newborns with other diseases different from NEC, in order to know if these risk factors are more frequent or not in the first group. We assessed the clinical records of all the patients hospitalized in the Neonatal Intensive Care Unit and Neonatology Service of the La Raza General Hospital between 1987 and 1991 with the diagnosis of NEC. They were compared with 65 clinical records chosen at random of patients hospitalized in the same Unit with other diagnosis at the same time, and who were discharged by improvement or deceased. In all of them were look for known risk factors for NEC generally accepted such as: prematurity, neonatal asphyxia, poliglobulia, cyanotic congenital heart disease, patent ductus arteriosus, respiratory distress syndrome, catheterization of umbilical vessels, early feeding of elevated formula increases, exchange exchange transfusion, hypoxic ischemic encephalopathy, infection, etc. Just 25 records of the possible 50 with the diagnosis of NEC full filled inclusion criteria. There were no statistically significant difference in weight, sex, mortality and known risk factors of NEC between both groups. Were concluded that NEC is a disease of unknown etiology that should be studied more thoroughly. The known risk factors must be avoided because the patient susceptibility probably play an important role.

  1. Beyond the learning curve: factors influencing cost reductions in photovoltaics

    International Nuclear Information System (INIS)

    Nemet, Gregory F.

    2006-01-01

    The extent and timing of cost-reducing improvements in low-carbon energy systems are important sources of uncertainty in future levels of greenhouse-gas emissions. Models that assess the costs of climate change mitigation policy, and energy policy in general, rely heavily on learning curves to include technology dynamics. Historically, no energy technology has changed more dramatically than photovoltaics (PV), the cost of which has declined by a factor of nearly 100 since the 1950s. Which changes were most important in accounting for the cost reductions that have occurred over the past three decades? Are these results consistent with the notion that learning from experience drove technical change? In this paper, empirical data are assembled to populate a simple model identifying the most important factors affecting the cost of PV. The results indicate that learning from experience, the theoretical mechanism used to explain learning curves, only weakly explains change in the most important factors-plant size, module efficiency, and the cost of silicon. Ways in which the consideration of a broader set of influences, such as technical barriers, industry structure, and characteristics of demand, might be used to inform energy technology policy are discussed

  2. Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis

    Directory of Open Access Journals (Sweden)

    Andressa Magalhães Teixeira

    Full Text Available ABSTRACT Objective: to identify evidence in the literature on the possible risk factors for the risk of unstable blood glucose diagnosis in individuals with type 2 diabetes mellitus, and to compare them with the risk factors described by NANDA International. Method: an integrative literature review guided by the question: what are the risk factors for unstable blood glucose level in people with type 2 diabetes mellitus? Primary studies were included whose outcomes were variations in glycemic levels, published in English, Portuguese or Spanish, in PubMed or CINAHL between 2010 and 2015. Results: altered levels of glycated hemoglobin, body mass index>31 kg/m2, previous history of hypoglycemia, cognitive deficit/dementia, autonomic cardiovascular neuropathy, comorbidities and weight loss corresponded to risk factors described in NANDA International. Other risk factors identified were: advanced age, black skin color, longer length of diabetes diagnosis, daytime sleepiness, macroalbuminuria, genetic polymorphisms, insulin therapy, use of oral antidiabetics, and use of metoclopramide, inadequate physical activity and low fasting glycemia. Conclusions: risk factors for the diagnosis, risk for unstable blood glucose level, for persons with type 2 diabetes mellitus were identified, and 42% of them corresponded to those of NANDA International. These findings may contribute to the practice of clinical nurses in preventing the deleterious effects of glycemic variation.

  3. ERP adoption cost factors identification and classification: a study in SMEs

    Directory of Open Access Journals (Sweden)

    Moutaz Haddara

    2013-01-01

    Full Text Available Enterprise resource planning (ERP systems adoptions require substantial resources and investments. The majority of businesses around the globe can be considered to be small and medium sized enterprises (SMEs. Thus, SMEs are seen to be typical companies that are the cornerstone of most economies. Compared with large enterprises, an SME-context contains several characteristics, and scarcity of resources is among the top of them. For SMEs, unplanned costs escalation could pose a serious threat to their stability and survival in the market. Frequently, ERP projects have crossed their estimated budgets and schedules. Researchers and practitioners state that a prevailing number of ERP adoption projects fail due to inaccurate or to too optimistic budgets/schedules. In addition, many organizations face difficulties in identifying the potential cost factors that could occur during their ERP adoption lifecycle. While focusing on the SME-context, this research attempts to identify potential costs that could occur in ERP adoptions. The research method employed in this study targeted diverse stakeholders and experts involved in ERP projects in Egypt. This research provides a list of cost factors and their classifications that could aid adopting organizations to better estimate their needed ERP project budgets. In particular, this research explores the direct and indirect cost factors that occur in ERP adoptions in Egyptian SMEs. Also, this study investigates the influence of some SME-specific contextual factors on costs. Moreover, the paper provides a ranking of cost factors according to their impact on total adoption costs.

  4. System Dynamics Modeling of interactive cost factors for small modular reactors

    International Nuclear Information System (INIS)

    Ahn, Nam Sung; Lee, Keun Dae; Yoon, Suk Ho

    2011-01-01

    As a part of the Study on Economic Efficiency and Marketability of small modular reactors project, we at Nemo partners NEC consulting corporation were studying the various cost factors on small modular reactors (SMRs). To have a better knowledge of the interaction between the cost factors, System Dynamics Modeling has been developed. This model will contribute to our understanding of the interaction on the major factors effecting on the unit cost of SMRs to the SMRs' market share in the market economics as competition

  5. Skin Cancer: Biology, Risk Factors & Treatment

    Science.gov (United States)

    ... turn Javascript on. Feature: Skin Cancer Skin Cancer: Biology, Risk Factors & Treatment Past Issues / Summer 2013 Table ... Articles Skin Cancer Can Strike Anyone / Skin Cancer: Biology, Risk Factors & Treatment / Timely Healthcare Checkup Catches Melanoma ...

  6. Awareness of risk factors for cancer

    DEFF Research Database (Denmark)

    Lagerlund, Magdalena; Hvidberg, Line; Hajdarevic, Senada

    2015-01-01

    Background: Sweden and Denmark are neighbouring countries with similarities in culture, healthcare, and economics, yet notable differences in cancer statistics. A crucial component of primary prevention is high awareness of risk factors in the general public. We aimed to determine and compare...... awareness of risk factors for cancer between a Danish and a Swedish population sample, and to examine whether there are differences in awareness across age groups. Methods: Data derive from Module 2 of the International Cancer Benchmarking Partnership. Telephone interviews were conducted with 3000 adults...... in Denmark and 3070 in Sweden using the Awareness and Beliefs about Cancer measure. Data reported here relate to awareness of 13 prompted risk factors for cancer. Prevalence ratios with 95 % confidence intervals were calculated to examine associations between country, age, and awareness of risk factors...

  7. Prelimanary Investigation on The Factors That Influencing The Maintenance Cost of Apartment

    Directory of Open Access Journals (Sweden)

    Salleh Nor Aini

    2016-01-01

    Full Text Available Housing is a basic need for all. The increasing numbers of population and income had increase in housing demand. Thus, it has led to the construction of apartments to meet the needs of people and to reduce the use of land to build residential buildings. From year to year, maintenance costs of the building are increased. To ensure the maintenance cost for apartment residence maintenance can be reduced, it is important to determine the factor that influence the maintenance cost of the apartment. This paper is to investigate and identify the factors contributing the increase of maintenance costs. The first objective of this study is to determine the factors that affect the cost of maintaining the apartment and meanwhile the second objective is to rank the factors that influence the maintenance cost of the apartment at Johor Baharu Tengah. To achieve the objectives of the study, the questionnaires were distributed to the parties involved in the management of building. Results of this study concluded that there are five factors that influence maintenance cost are the expectations of tenants, building age, building material, failure to execute maintenance at the right time and budget constraints.

  8. A classification of risk factors in serious juvenile offenders and the relation between patterns of risk factors and recidivism.

    Science.gov (United States)

    Mulder, Eva; Brand, Eddy; Bullens, Ruud; Van Marle, Hjalmar

    2010-02-01

    There has been a lot of research on risk factors for recidivism among juvenile offenders, in general, and on individual risk factors, but less focus on subgroups of serious juvenile offenders and prediction of recidivism within these. To find an optimal classification of risk items and to test the predictive value of the resultant factors with respect to severity of recidivism among serious juvenile offenders. Seventy static and dynamic risk factors in 1154 juvenile offenders were registered with the Juvenile Forensic Profile. Recidivism data were collected on 728 of these offenders with a time at risk of at least 2 years. After factor analysis, independent sample t-tests were used to indicate differences between recidivists and non-recidivists. Logistic multiple linear regression analyses were used to test the potential predictive value of the factors for violent or serious recidivism. A nine-factor solution best accounted for the data. The factors were: antisocial behaviour during treatment, sexual problems, family problems, axis-1 psychopathology, offence characteristics, conscience and empathy, intellectual and social capacities, social network, and substance abuse. Regression analysis showed that the factors antisocial behaviour during treatment, family problems and axis-1 psychopathology were associated with seriousness of recidivism. The significance of family problems and antisocial behaviour during treatments suggest that specific attention to these factors may be important in reducing recidivism. The fact that antisocial behaviour during treatment consists mainly of dynamic risk factors is hopeful as these can be influenced by treatment. Consideration of young offenders by subgroup rather than as a homogenous population is likely to yield the best information about risk of serious re-offending and the management of that risk.

  9. Cost-effectiveness and radiological risk associated with mass chest screening

    International Nuclear Information System (INIS)

    Stieve, F.E.

    1987-01-01

    This report presents in summary the cost effectiveness and radiological risks associated with mass chest tuberculosis screening in major European countries. The state of tuberculosis in west Europe, the cost effectiveness of mass screening, international standards regarding radiation doses as well as the need for quality control are addressed

  10. Contributing risk factors for orthopedic device related infections in sina hospital, tehran, iran.

    Science.gov (United States)

    Hadadi, A; Zehtab, M J; Babagolzadeh, H; Ashraf, H

    2011-02-01

    In spite of decreasing incidence of orthopedic device-related infections to 1%, nowadays, device-related infection still remains a diagnostic, therapeutic and cost-related problem. The objective of this study is to evaluate the contributing risk factors for orthopedic device-related infections in Sina Hospital, Tehran, Iran. Three hundred and thirty patients who underwent orthopedic device implantation from 2002-2006 were enrolled; among them, 110 patients were complicated with infection. Descriptive and logistic regression analyses were performed to determine the risk factors for device related infections. Patients with infection were older compared to those without infection. The Staphylococcus aureus was the commonest organism. A correlation was observed between wound infection and external fixation, an underlying health condition, and addiction which were independent risk factors for a device related infection. Orthopedic device-related infection puts a great financial burden on patients and hospital resources and could lead to morbidity and mortality in patients. So, appropriate pre and postoperative wound care for dirty wounds, especially when external fixators are used, and in patients with poor conditions or addiction should be done with more caution.

  11. Risk Factors for Internet Gaming Disorder: Psychological Factors and Internet Gaming Characteristics

    Directory of Open Access Journals (Sweden)

    Mi Jung Rho

    2017-12-01

    Full Text Available Background: Understanding the risk factors associated with Internet gaming disorder (IGD is important to predict and diagnose the condition. The purpose of this study is to identify risk factors that predict IGD based on psychological factors and Internet gaming characteristics; Methods: Online surveys were conducted between 26 November and 26 December 2014. There were 3568 Korean Internet game users among a total of 5003 respondents. We identified 481 IGD gamers and 3087 normal Internet gamers, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5 criteria. Logistic regression analysis was applied to identify significant risk factors for IGD; Results: The following eight risk factors were found to be significantly associated with IGD: functional and dysfunctional impulsivity (odds ratio: 1.138, belief self-control (1.034, anxiety (1.086, pursuit of desired appetitive goals (1.105, money spent on gaming (1.005, weekday game time (1.081, offline community meeting attendance (2.060, and game community membership (1.393; p < 0.05 for all eight risk factors; Conclusions: These risk factors allow for the prediction and diagnosis of IGD. In the future, these risk factors could also be used to inform clinical services for IGD diagnosis and treatment.

  12. Risk Factors for Internet Gaming Disorder: Psychological Factors and Internet Gaming Characteristics

    Science.gov (United States)

    Lee, Hyeseon; Lee, Taek-Ho; Cho, Hyun; Kim, Dai-Jin; Choi, In Young

    2017-01-01

    Background: Understanding the risk factors associated with Internet gaming disorder (IGD) is important to predict and diagnose the condition. The purpose of this study is to identify risk factors that predict IGD based on psychological factors and Internet gaming characteristics; Methods: Online surveys were conducted between 26 November and 26 December 2014. There were 3568 Korean Internet game users among a total of 5003 respondents. We identified 481 IGD gamers and 3087 normal Internet gamers, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria. Logistic regression analysis was applied to identify significant risk factors for IGD; Results: The following eight risk factors were found to be significantly associated with IGD: functional and dysfunctional impulsivity (odds ratio: 1.138), belief self-control (1.034), anxiety (1.086), pursuit of desired appetitive goals (1.105), money spent on gaming (1.005), weekday game time (1.081), offline community meeting attendance (2.060), and game community membership (1.393; p < 0.05 for all eight risk factors); Conclusions: These risk factors allow for the prediction and diagnosis of IGD. In the future, these risk factors could also be used to inform clinical services for IGD diagnosis and treatment. PMID:29280953

  13. Approaches to acceptable risk

    International Nuclear Information System (INIS)

    Whipple, C.

    1997-01-01

    Several alternative approaches to address the question open-quotes How safe is safe enough?close quotes are reviewed and an attempt is made to apply the reasoning behind these approaches to the issue of acceptability of radiation exposures received in space. The approaches to the issue of the acceptability of technological risk described here are primarily analytical, and are drawn from examples in the management of environmental health risks. These include risk-based approaches, in which specific quantitative risk targets determine the acceptability of an activity, and cost-benefit and decision analysis, which generally focus on the estimation and evaluation of risks, benefits and costs, in a framework that balances these factors against each other. These analytical methods tend by their quantitative nature to emphasize the magnitude of risks, costs and alternatives, and to downplay other factors, especially those that are not easily expressed in quantitative terms, that affect acceptance or rejection of risk. Such other factors include the issues of risk perceptions and how and by whom risk decisions are made

  14. Risk factors for venous thromboembolism during pregnancy

    DEFF Research Database (Denmark)

    Jensen, Thomas Bo; Gerds, Thomas Alexander; Grøn, Randi

    2013-01-01

    Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated.......Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated....

  15. On Modeling and Analyzing Cost Factors in Information Systems Engineering

    NARCIS (Netherlands)

    Mutschler, B.B.; Reichert, M.U.

    Introducing enterprise information systems (EIS) is usually associated with high costs. It is therefore crucial to understand those factors that determine or influence these costs. Though software cost estimation has received considerable attention during the last decades, it is difficult to apply

  16. Risk factors for recurrent spontaneous epistaxis.

    Science.gov (United States)

    Abrich, Victor; Brozek, Annabelle; Boyle, Timothy R; Chyou, Po-Huang; Yale, Steven H

    2014-12-01

    To identify risk factors associated with spontaneous recurrent epistaxis. This was a retrospective cohort study assessing patients in the Marshfield Clinic system diagnosed as having epistaxis between January 1, 1991, and January 1, 2011. There were 461 cases with at least 2 episodes of spontaneous epistaxis within 3 years and 912 controls with only 1 episode in the same time frame. More than 50 potential risk factors were investigated, including demographic features, substance use, nasal anatomical abnormalities, nasal infectious and inflammatory processes, medical comorbidities, medications, and laboratory values. A Cox proportional hazards regression modeling approach was used to calculate hazard ratios of epistaxis recurrence. Traditional risk factors for epistaxis, including nasal perforation, nasal septum deviation, rhinitis, sinusitis, and upper respiratory tract infection, did not increase the risk of recurrence. Significant risk factors for recurrent epistaxis included congestive heart failure, diabetes mellitus, hypertension, and a history of anemia. Warfarin use increased the risk of recurrence, independent of international normalized ratio. Aspirin and clopidogrel were not found to increase the risk of recurrence. Few major adverse cardiovascular events were observed within 30 days of the first epistaxis event. Congestive heart failure is an underappreciated risk factor for recurrent epistaxis. Hypertension and diabetes mellitus may induce atherosclerotic changes in the nasal vessels, making them friable and more at risk for bleeding. Patients with recurrent epistaxis may also be more susceptible to developing anemia. Physicians should promote antiplatelet and antithrombotic medication adherence despite an increased propensity for recurrent epistaxis to prevent major adverse cardiovascular events. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  17. Sexual harassment: identifying risk factors.

    Science.gov (United States)

    O'Hare, E A; O'Donohue, W

    1998-12-01

    A new model of the etiology of sexual harassment, the four-factor model, is presented and compared with several models of sexual harassment including the biological model, the organizational model, the sociocultural model, and the sex role spillover model. A number of risk factors associated with sexually harassing behavior are examined within the framework of the four-factor model of sexual harassment. These include characteristics of the work environment (e.g., sexist attitudes among co-workers, unprofessional work environment, skewed sex ratios in the workplace, knowledge of grievance procedures for sexual harassment incidents) as well as personal characteristics of the subject (e.g., physical attractiveness, job status, sex-role). Subjects were 266 university female faculty, staff, and students who completed the Sexual Experience Questionnaire to assess the experience of sexual harassment and a questionnaire designed to assess the risk factors stated above. Results indicated that the four-factor model is a better predictor of sexual harassment than the alternative models. The risk factors most strongly associated with sexual harassment were an unprofessional environment in the workplace, sexist atmosphere, and lack of knowledge about the organization's formal grievance procedures.

  18. Survey of risk factors urinary tract infection

    OpenAIRE

    A Dehghani; M zahedi; M moezzi; M dafei; H Falahzadeh

    2016-01-01

    Introduction: Women are very susceptible to urinary tract infections and pregnancy raises the risk of urinary tract infection. In general, little information on the risk factors of urinary tract infection in pregnancy is underway. Urinary tract infection in pregnancy is an important risk factor for pregnancy dire consequences. The purpose of this study is to find risk factors associated with urinary tract infection in pregnant women. Methods: The study was observational and retrospective ...

  19. A risk standard based on societal cost with bounded consequences

    International Nuclear Information System (INIS)

    Worledge, D.H.

    1982-01-01

    A risk standard is proposed that relates the frequency of occurrence of single events to the consequences of the events. Maximum consequences and risk aversion are used to give the cumulative risk curve a shape similar to the results of a risk assessment and to bound the expectation of deaths. Societal costs in terms of deaths are used to fix the parameters of the model together with an approximate comparison with individual risks. The proposed standard is compared with some practical applications of risk assessment to nuclear reactor systems

  20. Impact of cardiovascular risk factors on medical expenditure: evidence from epidemiological studies analysing data on health checkups and medical insurance.

    Science.gov (United States)

    Nakamura, Koshi

    2014-01-01

    Concerns have increasingly been raised about the medical economic burden in Japan, of which approximately 20% is attributable to cardiovascular disease, including coronary heart disease and stroke. Because the management of risk factors is essential for the prevention of cardiovascular disease, it is important to understand the relationship between cardiovascular risk factors and medical expenditure in the Japanese population. However, only a few Japanese epidemiological studies analysing data on health checkups and medical insurance have provided evidence on this topic. Patients with cardiovascular risk factors, including obesity, hypertension, and diabetes, may incur medical expenditures through treatment of the risk factors themselves and through procedures for associated diseases that usually require hospitalization and sometimes result in death. Untreated risk factors may cause medical expenditure surges, mainly due to long-term hospitalization, more often than risk factors preventively treated by medication. On an individual patient level, medical expenditures increase with the number of concomitant cardiovascular risk factors. For single risk factors, personal medical expenditure may increase with the severity of that factor. However, on a population level, the medical economic burden attributable to cardiovascular risk factors results largely from a single, particularly prevalent risk factor, especially from mildly-to-moderately abnormal levels of the factor. Therefore, cardiovascular risk factors require management on the basis of both a cost-effective strategy of treating high-risk patients and a population strategy for reducing both the ill health and medical economic burdens that result from cardiovascular disease.

  1. Risk Factors for Developing Atopic Dermatitis

    DEFF Research Database (Denmark)

    G. Carson, Charlotte

    2013-01-01

    The aim of this thesis was to investigate possible risk factors affecting the development of AD. AD is a frequent disease among children and has a substantial impact on the lives of both the child and its family. A better understanding of the disease would enable better treatment, prevention...... and information to the families involved. Previous risk factor studies have been hampered by an unsuitable study design and/or difficulties in standardization when diagnosing AD, which limit their conclusions. In paper I, we conducted a traditional cross-sectional analysis testing 40 possible risk factors...... exposure to dog was the only environmental exposure that significantly reduced the disease manifestation, suggesting other, yet unknown environmental factors affecting the increasing prevalence of AD in children. Length at birth was shown to be inversely associated with the risk of later developing AD...

  2. [Pathological gambling: risk factors].

    Science.gov (United States)

    Bouju, G; Grall-Bronnec, M; Landreat-Guillou, M; Venisse, J-L

    2011-09-01

    In France, consumption of gambling games increased by 148% between 1960 and 2005. In 2004, gamblers lost approximately 0.9% of household income, compared to 0.4% in 1960. This represents approximately 134 Euros per year and per head. In spite of this important increase, the level remains lower than the European average (1%). However, gambling practices may continue to escalate in France in the next few years, particularly with the recent announce of the legalisation of online games and sports betting. With the spread of legalised gambling, pathological gambling rates may increase in France in the next years, in response to more widely available and more attractive gambling opportunities. In this context, there is a need for better understanding of the risk factors that are implicated in the development and maintenance of pathological gambling. This paper briefly describes the major risk factors for pathological gambling by examining the recent published literature available during the first quarter of 2008. This documentary basis was collected by Inserm for the collective expert report procedure on Gambling (contexts and addictions). Seventy-two articles focusing on risk factors for pathological gambling were considered in this review. Only 47 of them were taken into account for analysis. The selection of these 47 publications was based on the guide on literature analysis established by the French National Agency for Accreditation and Assessment in Health (ANAES, 2000). Some publications from more recent literature have also been added, mostly about Internet gambling. We identify three major types of risk factors implicated in gambling problems: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors), and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling seems to be

  3. Assessment of risk factors for noncommunicable disease risk factors among men of working age

    Directory of Open Access Journals (Sweden)

    M. Yu. Vasilyev

    2013-01-01

    Full Text Available Objective: the investigation of some modifiable and non-modifiable risk factors and poor explored as well of non-convectional diseases among men of working age.Subjects and methods. Seven thousand thirty five men in age of 18 to 60 years were examined. History data included age, gender, nationality,high blood pressure (BP episodes, antihypertensive drugs taking in case of arterial hypertension, smoking. Instrumental examination included BP measurement when seated after 5 minutes of the rest with mean BP calculation. Total cholesterol and creatinine in blood, clearance of creatinine calculation by Cockcroft–Gault formula, microalbuminuria were assayed; depression level was estimated by Beck score. With purpose to analyze the risk factors structure all examined subjects were divided into three groups according to SCORE scale.Results. Cholesterol level analysis revealed the increasing of parameter in 41.7 % of examined patients (n = 307. Microalbuminuria was revealed in 13.8 % (n = 102 of men, and 19.3 % of them (n = 80 had increased blood pressure. Some levels of depression were revealed in 42.5 % (n = 312, among them the arterial hypertension was observed in 62,5 % (n = 195. The group with low and moderate cardiovascular risk consisted of 594 persons (80.8 %. High cardiovascular risk was determined in 15.2 % men of working age (n = 112. Very high cardiovascular risk was revealed in 3.9 % (n = 29 of responders.Conclusion. Increasing of traditional risk factors rate is associated with increasing of additional risk factors. Received data are widening the perception about risk factors structure in population. Particularly the question about renal filtration function role, depressive syndrome, trophologic insufficiency is raised. Consideration of those in prophylaxis system consideration requires a specific education of general practitioners.

  4. Factors causing cost variation for constructing wastewater projects in Egypt

    Directory of Open Access Journals (Sweden)

    Remon Fayek Aziz

    2013-03-01

    Full Text Available Cost is one of the major considerations throughout the project management life cycle and can be regarded as one of the most important parameters of a project and the driving force of project success. Despite its proven importance, it is common to see a construction project failing to achieve its objectives within the specific cost. Cost variation is a very frequent phenomenon and is almost associated with nearly constructing all wastewater projects. Maintaining steady cost projection on wastewater projects had been recently an issue of serious concern, both to the client and project contractors. Cost deviation from initial cost plan had been prevalent on construction sites. However, little or no effort has been made to curtail the phenomenon, this research work attempts to identify, investigate and rank factors perceived to affect cost variation in the Egyptian wastewater projects with respect to their relative importance so as to proffer possible ways of coping with this phenomenon. To achieve this objective, author invited practitioners and experts, comprising a statistically representative sample, to participate in a structured questionnaire survey. Brain storming was taken into consideration, through which a number of cost variation factors were identified for constructing wastewater projects. Totally 52 factors were short-listed to be made part of the questionnaire survey and the survey was conducted with experts and representatives from private, public and local general construction firms. The data were analyzed using Relative Importance Index, ranking and simple percentages. It was analytically discovered that factors such as: (1 Lowest bidding procurement method; (2 Additional work; (3 Bureaucracy in bidding/tendering method; (4 Wrong method of cost estimation; and (5 Funding problems were critical for causing cost variation, while (1 Inaccurate cost estimation; (2 Mode of financing and payment for completed work; (3 Unexpected ground

  5. Cost effectiveness of primary pegfilgrastim prophylaxis in patients with breast cancer at risk of febrile neutropenia.

    Science.gov (United States)

    Aarts, Maureen J; Grutters, Janneke P; Peters, Frank P; Mandigers, Caroline M; Dercksen, M Wouter; Stouthard, Jacqueline M; Nortier, Hans J; van Laarhoven, Hanneke W; van Warmerdam, Laurence J; van de Wouw, Agnes J; Jacobs, Esther M; Mattijssen, Vera; van der Rijt, Carin C; Smilde, Tineke J; van der Velden, Annette W; Temizkan, Mehmet; Batman, Erdogan; Muller, Erik W; van Gastel, Saskia M; Joore, Manuela A; Borm, George F; Tjan-Heijnen, Vivianne C

    2013-12-01

    Guidelines advise primary granulocyte colony-stimulating factor (G-CSF) prophylaxis during chemotherapy if risk of febrile neutropenia (FN) is more than 20%, but this comes with considerable costs. We investigated the incremental costs and effects between two treatment strategies of primary pegfilgrastim prophylaxis. Our economic evaluation used a health care perspective and was based on a randomized study in patients with breast cancer with increased risk of FN, comparing primary G-CSF prophylaxis throughout all chemotherapy cycles (G-CSF 1-6 cycles) with prophylaxis during the first two cycles only (G-CSF 1-2 cycles). Primary outcome was cost effectiveness expressed as costs per patient with episodes of FN prevented. The incidence of FN increased from 10% in the G-CSF 1 to 6 cycles study arm (eight of 84 patients) to 36% in the G-CSF 1 to 2 cycles study arm (30 of 83 patients), whereas the mean total costs decreased from € 20,658 (95% CI, € 20,049 to € 21,247) to € 17,168 (95% CI € 16,239 to € 18,029) per patient, respectively. Chemotherapy and G-CSF determined 80% of the total costs. As expected, FN-related costs were higher in the G-CSF 1 to 2 cycles arm. The incremental cost effectiveness ratio for the G-CSF 1 to 6 cycles arm compared with the G-CSF 1 to 2 cycles arm was € 13,112 per patient with episodes of FN prevented. We conclude that G-CSF prophylaxis throughout all chemotherapy cycles is more effective, but more costly, compared with prophylaxis limited to the first two cycles. Whether G-CSF prophylaxis throughout all chemotherapy cycles is considered cost effective depends on the willingness to pay per patient with episodes of FN prevented.

  6. Costs of Reproduction in Breeding Female Mallards: Predation Risk during Incubation Drives Annual Mortality

    Directory of Open Access Journals (Sweden)

    Todd W. Arnold

    2012-06-01

    Full Text Available The effort expended on reproduction may entail future costs, such as reduced survival or fecundity, and these costs can have an important influence on life-history optimization. For birds with precocial offspring, hypothesized costs of reproduction have typically emphasized nutritional and energetic investments in egg formation and incubation. We measured seasonal survival of 3856 radio-marked female Mallards (Anas platyrhynchos from arrival on the breeding grounds through brood-rearing or cessation of breeding. There was a 2.5-fold direct increase in mortality risk associated with incubating nests in terrestrial habitats, whereas during brood-rearing when breeding females occupy aquatic habitats, mortality risk reached seasonal lows. Mortality risk also varied with calendar date and was highest during periods when large numbers of Mallards were nesting, suggesting that prey-switching behaviors by common predators may exacerbate risks to adults in all breeding stages. Although prior investments in egg laying and incubation affected mortality risk, most relationships were not consistent with the cost of reproduction hypothesis; birds with extensive prior investments in egg production or incubation typically survived better, suggesting that variation in individual quality drove both relationships. We conclude that for breeding female Mallards, the primary cost of reproduction is a fixed cost associated with placing oneself at risk to predators while incubating nests in terrestrial habitats.

  7. Risk Factors for Dog Relinquishment to a Los Angeles Municipal Animal Shelter

    Directory of Open Access Journals (Sweden)

    Emily D. Dolan

    2015-12-01

    Full Text Available Dog relinquishment is a large component of shelter intake in the United States. Research has shown traits of the dog are associated with relinquishment as well as general characteristics of those relinquishing. Low income is often cited as a risk factor for relinquishment. The majority of people with lower incomes, however, do not relinquish. A group of people accessing a shelter in a low socioeconomic region of Los Angeles to relinquish their dogs was surveyed. This study examined risk factors for relinquishment, controlling for household income, compared to a group utilizing low cost spay/neuter services. A total of 76.9% of those relinquishing noted cost as a reason for relinquishment. Of participants in the relinquishment group, 80.7% reported not being aware of any services available to them. Most notable in the findings was that the odds of relinquishment were generally higher as the amount of perceived stress in the home in the past three months increased. The majority of people in both groups reported being emotionally attached to the dog. In this sample from a South Los Angeles community, the majority of reasons for relinquishment were likely solvable with assistance. These findings highlight an opportunity to assess community needs and provide community specific alternatives to relinquishment.

  8. Prevalence of myopia and its risk factors in urban school children in Delhi: the North India Myopia Study (NIM Study.

    Directory of Open Access Journals (Sweden)

    Rohit Saxena

    Full Text Available Assess prevalence of myopia and identify associated risk factors in urban school children.This was a cross-sectional study screening children for sub-normal vision and refractive errors in Delhi. Vision was tested by trained health workers using ETDRS charts. Risk factor questionnaire was filled for children with vision 11 years children (p 5 hours per day (p 2 hours / day (p 2 hours in a day.Myopia is a major health problem in Indian school children. It is important to identify modifiable risk factors associated with its development and try to develop cost effective intervention strategies.

  9. Prevalence of myopia and its risk factors in urban school children in Delhi: the North India Myopia Study (NIM Study).

    Science.gov (United States)

    Saxena, Rohit; Vashist, Praveen; Tandon, Radhika; Pandey, R M; Bhardawaj, Amit; Menon, Vimala; Mani, Kalaivani

    2015-01-01

    Assess prevalence of myopia and identify associated risk factors in urban school children. This was a cross-sectional study screening children for sub-normal vision and refractive errors in Delhi. Vision was tested by trained health workers using ETDRS charts. Risk factor questionnaire was filled for children with vision 11 years) children (phistory (p 5 hours per day (p 2 hours / day (p video/mobile games (p 2 hours in a day. Myopia is a major health problem in Indian school children. It is important to identify modifiable risk factors associated with its development and try to develop cost effective intervention strategies.

  10. Understanding the Risk Factors of Trauma Center Closures

    Science.gov (United States)

    Shen, Yu-Chu; Hsia, Renee Y.; Kuzma, Kristen

    2011-01-01

    Objectives We analyze whether hazard rates of shutting down trauma centers are higher due to financial pressures or in areas with vulnerable populations (such as minorities or the poor). Materials and Methods This is a retrospective study of all hospitals with trauma center services in urban areas in the continental US between 1990 and 2005, identified from the American Hospital Association Annual Surveys. These data were linked with Medicare cost reports, and supplemented with other sources, including the Area Resource File. We analyze the hazard rates of trauma center closures among several dimensions of risk factors using discrete-time proportional hazard models. Results The number of trauma center closures increased from 1990 to 2005, with a total of 339 during this period. The hazard rate of closing trauma centers in hospitals with a negative profit margin is 1.38 times higher than those hospitals without the negative profit margin (P lower hazard of shutting down trauma centers (ratio: 0.58, P penetration face a higher hazard of trauma center closure (ratio: 2.06, P < 0.01). Finally, hospitals in areas with higher shares of minorities face a higher risk of trauma center closure (ratio: 1.69, P < 0.01). Medicaid load and uninsured populations, however, are not risk factors for higher rates of closure after we control for other financial and community characteristics. Conclusions Our findings give an indication on how the current proposals to cut public spending could exacerbate the trauma closure particularly among areas with high shares of minorities. In addition, given the negative effect of health maintenance organizations on trauma center survival, the growth of Medicaid managed care population should be monitored. Finally, high shares of Medicaid or uninsurance by themselves are not independent risk factors for higher closure as long as financial pressures are mitigated. Targeted policy interventions and further research on the causes, are needed to

  11. Injury-free running - a utopia? Risk factors of running-related injuries in men and women

    NARCIS (Netherlands)

    Worp, M.P. van der

    2016-01-01

    Running is a popular sport worldwide and has a positive effect on health and well-being. However, the rate of running-related injuries and the associated costs are high. Van der Worp performed a systematic review to examine which factors increase the risk of running injuries, and whether this is the

  12. Intrinsic Risk Factors of Falls in Elderly

    Directory of Open Access Journals (Sweden)

    Yasmin Amatullah

    2016-09-01

    Full Text Available Background: Falls are common geriatric problems. The risk factors of falls are the intrinsic and extrinsic risk factors. Studies on falls are scarcely conducted in Indonesia, especially in Bandung. Therefore, this study was conducted to identify the intrinsic risk factors of falls among elderly. Methods: A descriptive study was carried out from August to October 2013 at the Geriatric Clinic of Dr. Hasan Sadikin General Hospital Bandung. Fifty three participants were selected according to the inclusion and exclusion criteria using consecutive sampling. The determined variables in this study were classification of the risk of falls, demographic profile, history of falls, disease, and medications. After the selection, the participants were tested by Timed up-and-go test (TUGT. Moreover, an interview and analysis of medical records were carried out to discover the risk factors of falls. The collected data were analyzed and presented in the form of percentages shown in tables. Results: From 53 patients, women (35.66% were considered to have higher risk of fall than men (18.34%. The majority of patients (66% with the risk of fall were from the age group 60–74 years. The major diseases suffered by patients were hypertension, osteoarthritis and diabetes mellitus. Drugs that were widely used were antihypertensive drugs; analgesic and antipyretic drugs and antidiabetic drugs. Conclusions: There are various intrinsic risk factors of falls in elderly and each of the elderly has more than one intrinsic risk factor of falls.

  13. Migration towards fibre to the home: key cost factors

    Science.gov (United States)

    Zhou, L. W.; Mas Machuca, C.; Zhao, R.; Grunert, K.

    2010-12-01

    This paper presents a comprehensive cost model for migration towards FTTH, some case study results from different network area scenarios, as well as the identification of the most important cost factors to be considered by operators aiming at increasing the profitability of their networks.

  14. Prevalence of coronary artery disease risk factors in Iran: a population based survey

    Directory of Open Access Journals (Sweden)

    Gafarzadeh Motlag A

    2007-10-01

    Full Text Available Abstract Background Coronary artery disease (CAD is a leading cause of mortality, morbidity, and disability with high health care cost in Iran. It accounts for nearly 50 percent of all deaths per year. Yet little is known about CAD and CAD risk factors in the Iranian population. We aimed to assess the prevalence of different CAD risk factors in an Iranian population. Methods A descriptive cross sectional survey was conducted involving 3000 healthy adults at 18 years of age or above who were recruited with cluster random sampling. Demographic data and risk factors were determined by taking history, physical examination and laboratory tests. Results The average age was 36.23 ± 15.26. There was 1381 female (46% and 1619 male (54% out of which 6.3% were diabetic, 21.6% were smoker, and 15% had positive familial heart disease history. 61% had total cholesterol level > 200 mg/dL, 32% triglyceride > 200 mg/dl, 47.5% LDL-c > 130 mg/dl, 5.4% HDL-c 140 mmHg, 9.1% diastolic blood pressure > 90 mmHg and 87% of them were physically inactive. Conclusion Clinical and Para-clinical data indicated that Iranian adult population are of a high level of CAD risk factors, which may require urgent decision making to address national control measures regarding CAD.

  15. Risk factors for the development of pneumonia in acute psychotropic drugs poisoning

    OpenAIRE

    Vučinić Slavica

    2005-01-01

    Background/Aim. Pneumonia is the most frequent complication in acute psychotropic drugs poisoning, which results in substantial morbidity and mortality, but which also increases the costs of treatment. Risk factors for pneumonia are numerous: age, sex, place of the appearance of pneumonia, severity of underlying disease, airway instrumentation (intubation, reintubation, etc). The incidence of pneumonia varies in poisoning caused by the various groups of drugs. The aim of this study was to det...

  16. Clinical effectiveness and cost-effectiveness of HIV pre-exposure prophylaxis in men who have sex with men: risk calculators for real-world decision-making.

    Directory of Open Access Journals (Sweden)

    Anders Chen

    Full Text Available BACKGROUND: Oral pre-exposure prophylaxis (PrEP can be clinically effective and cost-effective for HIV prevention in high-risk men who have sex with men (MSM. However, individual patients have different risk profiles, real-world populations vary, and no practical tools exist to guide clinical decisions or public health strategies. We introduce a practical model of HIV acquisition, including both a personalized risk calculator for clinical management and a cost-effectiveness calculator for population-level decisions. METHODS: We developed a decision-analytic model of PrEP for MSM. The primary clinical effectiveness and cost-effectiveness outcomes were the number needed to treat (NNT to prevent one HIV infection, and the cost per quality-adjusted life-year (QALY gained. We characterized patients according to risk factors including PrEP adherence, condom use, sexual frequency, background HIV prevalence and antiretroviral therapy use. RESULTS: With standard PrEP adherence and national epidemiologic parameters, the estimated NNT was 64 (95% uncertainty range: 26, 176 at a cost of $160,000 (cost saving, $740,000 per QALY--comparable to other published models. With high (35% HIV prevalence, the NNT was 35 (21, 57, and cost per QALY was $27,000 (cost saving, $160,000, and with high PrEP adherence, the NNT was 30 (14, 69, and cost per QALY was $3,000 (cost saving, $200,000. In contrast, for monogamous, serodiscordant relationships with partner antiretroviral therapy use, the NNT was 90 (39, 157 and cost per QALY was $280,000 ($14,000, $670,000. CONCLUSIONS: PrEP results vary widely across individuals and populations. Risk calculators may aid in patient education, clinical decision-making, and cost-effectiveness evaluation.

  17. The costs and risk of introduction of the euro in Poland

    Directory of Open Access Journals (Sweden)

    Aldona Kozakiewicz

    2012-09-01

    Full Text Available On the 1st of May 2004, Poland became a member state of the European Union. At the moment, it doesn’t fulfill the convergence criteria required for the introduction of the euro, but will have to adapt in the future. The aim of this article is to identify potential risks and economic costs that could occur due to Poland’s integration with the eurozone. The joining country loses the ability to run an autonomous monetary policy. The scale of adverse effects depends, among other factors, on decisions made by the European Central Bank, effectiveness of adjustment mechanisms and types of shocks. Economic costs may occur on a long time scale, which is related to the fact that economic structure of Polish economy is not exactly similar to the EU and there is low flexibility of wages in Poland. Most countries of the eurozone do not fulfill the fiscal criteria, creating a threat to the economy. The article sums up possible consequences of introducing the single currency that are expected and should be taken into consideration before joining the eurozone.

  18. Epidemiology and risk factors of schizophrenia.

    Science.gov (United States)

    Janoutová, Jana; Janácková, Petra; Serý, Omar; Zeman, Tomás; Ambroz, Petr; Kovalová, Martina; Varechová, Katerina; Hosák, Ladislav; Jirík, Vitezslav; Janout, Vladimír

    2016-01-01

    Schizophrenia is a severe mental disorder that affects approximately one percent of the general population. The pathogenesis of schizophrenia is influenced by many risk factors, both environmental and genetic. The environmental factors include the date of birth, place of birth and seasonal effects, infectious diseases, complications during pregnancy and delivery, substance abuse and stress. At the present time, in addition to environmental factors, genetic factors are assumed to play a role in the development of the schizophrenia. The heritability of schizo- phrenia is up to 80%. If one parent suffers from the condition, the probability that it will be passed down to the offspring is 13%. If it is present in both parents, the risk is more than 20%. The opinions are varied as to the risk factors affecting the development of schizophrenia. Knowing these factors may greatly contribute to prevention of the condition.

  19. Risk factors of recurrent anal sphincter ruptures

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, J; Rosthøj, Steen

    2012-01-01

    Please cite this paper as: Jangö H, Langhoff-Roos J, Rosthøj S, Sakse A. Risk factors of recurrent anal sphincter ruptures: a population-based cohort study. BJOG 2012;00:000-000 DOI: 10.1111/j.1471-0528.2012.03486.x. Objective  To determine the incidence and risk factors of recurrent anal sphincter...... were used to determine risk factors of recurrent ASR. Main outcome measures  The incidence of recurrent ASR and odds ratios for possible risk factors of recurrent ASR: age, body mass index, grade of ASR, birthweight, head circumference, gestational age, presentation, induction of labour, oxytocin...... augmentation, epidural, episiotomy, vacuum extraction, forceps, shoulder dystocia, delivery interval and year of second delivery. Results  Out of 159 446 women, 7336 (4.6%) experienced an ASR at first delivery, and 521 (7.1%) had a recurrent ASR (OR 5.91). The risk factors of recurrent ASR in the multivariate...

  20. Risk factors of workplace bullying for men and women: the role of the psychosocial and physical work environment.

    Science.gov (United States)

    Salin, Denise

    2015-02-01

    Workplace bullying has been shown to be a severe social stressor at work, resulting in high costs both for the individuals and organizations concerned. The aim of this study is to analyze risk factors in a large, nationally representative sample of Finnish employees (n = 4,392). The study makes three important contributions to the existing literature on workplace bullying: first, it demonstrates the role of the physical work environment alongside the psychosocial work environment - employees with a poor physical work environment are more likely than others to report having been subjected to or having observed bullying. Second, contrary to common assumptions, the results suggest that performance-based pay is associated with a lower, rather than higher risk of bullying. Third, the findings suggest that there are gender differences in risk factors, thereby constituting a call for more studies on the role of gender when identifying risk factors. Increased knowledge of risk factors is important as it enables us to take more effective measures to decrease the risk of workplace bullying. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  1. 78 FR 56911 - Notice of Certain Operating Cost Adjustment Factors for 2014

    Science.gov (United States)

    2013-09-16

    ... Cost Adjustment Factors for 2014 AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This notice establishes operating cost adjustment factors (OCAFs... date on or after February 11, 2014. OCAFs are annual factors used to adjust Section 8 rents renewed...

  2. Cooperation under Predation Risk: Experiments on Costs and Benefits

    Science.gov (United States)

    Milinski, Manfred; Luthi, Jean H.; Eggler, Rolf; Parker, Geoffrey A.

    1997-06-01

    Two fish that cooperatively inspect a predator may have negotiated the share of the risk that each takes. A test of both the costs of predator inspection dependent on the distance from which the predator is approached and the potential benefits of cooperation was carried out strictly experimentally. We made either singletons or pairs of dead sticklebacks, Gasterosteus aculeatus, approach hungry pike, Esox lucius, by remote control according to an algorithm that mimicked natural inspection. The predation risk of both single inspectors and parallel inspecting pairs increased with closer inspection distances. A member of an inspecting pair had only about half the risk of that of a single inspector. In pairs, a companion diluted the lead fish's risk of being caught, depending on its distance behind the leader. The absolute risk difference between leader and follower was greatest for close inspection distances and decreased further away from the predator. The leader's relative risk increased with its distance ahead of the laggard. However, for a given distance between leader and laggard, the relative risks to the two fish remained similar with distance from the predator. The cost side of the inequalities that define a 'Prisoner's Dilemma' has thus been measured for this system. In a second experiment the 'attack deterrence hypothesis' of predator inspection (i.e. inspection decreases attack probability) was tested. The pike was offered a choice between two sticklebacks, one of which had carried out a predator inspection visit. There was no indication of attack deterrence through predator inspection.

  3. Low-risk factor profile, estrogen levels, and breast cancer risk among postmenopausal women

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Hansen, Ase Marie; Nielsen, Jens

    2008-01-01

    Obesity, alcohol consumption, physical inactivity and postmenopausal hormone use are known modifiable risk factors for breast cancer. We aim to measure incidence rates of breast cancer for women with favorable levels on all 4 risk factors (BMI......Obesity, alcohol consumption, physical inactivity and postmenopausal hormone use are known modifiable risk factors for breast cancer. We aim to measure incidence rates of breast cancer for women with favorable levels on all 4 risk factors (BMI...

  4. Physical risk factors for neck pain

    NARCIS (Netherlands)

    Ariëns, Geertje A M; Van Mechelen, Willem; Bongers, Paulien M.; Bouter, Lex M.; Van Der Wal, Gerrit

    2000-01-01

    To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on methodological quality and study design, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22

  5. Musculoskeletal Risk Factors in the Young Athlete.

    Science.gov (United States)

    Moskwa, C A; Nicholas, J A; Goldberg, B

    1989-11-01

    In brief: Many children and adolescents participate in sports that put them at risk for musculoskeletal injuries. Underlying physical conditions, or risk factors, may predispose them to particular types of sports injuries. Research shows that these risk factors fall into five categories: body type, flexibility, muscle strength, inadequate rehabilitation of a previous injury, and skeletal malalignment and anomalies. Some findings show, for example, that youthful football players who are also heavy have an increased rate of injury, sprains and strains are less common in flexible athletes, and patellar pain or subluxation may be related to a variety of malalignment factors. The authors recommend using a systematic, integrated approach to risk assessment of the athlete, both for detecting risk factors and determining their potential for con tribu ting to a sports injury.

  6. Cost-effectiveness and radiation risk of breast cancer screening

    International Nuclear Information System (INIS)

    Rombach, J.J.

    1987-01-01

    Base cost effectiveness risk associated with radiological screening for tuberculosis and lung tumor the Government of Netherlands advised against mass screening. However, mass screening remains an important method in the case of breast cancer

  7. Low-cost risk reduction strategy for small workplaces: how can we spread good practices?

    Science.gov (United States)

    Kogi, K

    2006-01-01

    Recent advances in health risk reduction approaches are examined based on inter-country networking experiences. A noteworthy progress is the wider application of low-cost improvements to risk reduction particularly in small enterprises and agriculture in both industrially developing and developed countries. This is helped by the readiness of managers and workers to implement these improvements despite many constraints. Typical improvements include mobile racks, simple workstation changes, screening hazards, better welfare facilities and teamwork arrangements. In view of the complex circumstances of work-related health risks, it is important to know whether a low-cost strategy can advance risk reduction practices effectively and what support measures are necessary. It is confirmed that the strategy can overcome related constraints through its advantages. Main advantages lie in (a) the facilitation of improved practices in multiple technical areas, (b) the strengthening of realistic stepwise risk reduction, and (c) the enhanced multiplier effects through training of local trainers. Action-oriented risk assessment tools, such as action checklists and low-cost improvement guides, can encourage risk-reducing measures adjusted to each local situation. It is suggested to spread the low-cost risk reduction strategy for improving small workplaces in diversified settings with the support of these locally tailored tools.

  8. Epigenetic Risk Factors in PTSD and Depression

    Directory of Open Access Journals (Sweden)

    Florian Joachim Raabe

    2013-08-01

    Full Text Available Epidemiological and clinical studies have shown that children exposed to adverse experiences are at increased risk for the development of depression, anxiety disorders and PTSD. A history of child abuse and maltreatment increases the likelihood of being subsequently exposed to traumatic events or of developing PTSD as an adult. The brain is highly plastic during early life and encodes acquired information into lasting memories that normally subserve adaptation. Translational studies in rodents showed that enduring sensitization of neuronal and neuroendocrine circuits in response to early life adversity are likely risk factors of life time vulnerability to stress. Hereby, the hypothalamic-pituitary-adrenal (HPA axis integrates cognitive, behavioural and emotional responses to early-life stress and can be epigenetically programmed during sensitive windows of development. Epigenetic mechanisms, comprising reciprocal regulation of chromatin structure and DNA methylation, are important to establish and maintain sustained, yet potentially reversible, changes in gene transcription. The relevance of these findings for the development of PTSD requires further studies in humans where experience-dependent epigenetic programming can additionally depend on genetic variation in the underlying substrates which may protect from or advance disease development. Overall, identification of early-life stress associated epigenetic risk markers informing on previous stress history can help to advance early diagnosis, personalized prevention and timely therapeutic interventions, thus reducing long-term social and health costs.

  9. Transient risk factors of acute occupational injuries

    DEFF Research Database (Denmark)

    Østerlund, Anna H; Lander, Flemming; Nielsen, Kent

    2017-01-01

    Objectives The objectives of this study were to (i) identify transient risk factors of occupational injuries and (ii) determine if the risk varies with age, injury severity, job task, and industry risk level. Method A case-crossover design was used to examine the effect of seven specific transient...... risk factors (time pressure, disagreement with someone, feeling sick, being distracted by someone, non-routine task, altered surroundings, and broken machinery and materials) for occupational injuries. In the study, 1693 patients with occupational injuries were recruited from a total of 4002...... in relation to sex, age, job task, industry risk level, or injury severity. Conclusion Use of a case-crossover design identified several worker-related transient risk factors (time pressure, feeling sick, being distracted by someone) that led to significantly increased risks for occupational injuries...

  10. [Identification of risk factors for congenital malformations].

    Science.gov (United States)

    Canals C, Andrea; Cavada C, Gabriel; Nazer H, Julio

    2014-11-01

    The relative importance of congenital malformations as a cause of death in the first year of life is increasing along with the control of preventable causes of perinatal mortality. To identify risk factors for congenital malformations. Retrospective case-control study of births registered in the database of The Latin American Collaborative Study of Congenital Malformations (ECLAMC), in the period 2001-2010. Birth weight and gestational age were significantly lower in cases than controls, behaving as risk factors and associated with a greater severity of congenital malformations. The risk and severity of congenital malformations increased along with mother's age. Fetal growth retardation, a history of congenital malformations in the family, physical factors and acute illnesses of the mother in the first trimester of pregnancy were also significant risk factors for congenital malformations and their severity. The educational level of the mother was a protective factor for congenital malformations and their severity. Variables previously identified as risk factors for congenital malformations, were significantly related with the occurrence of congenital malformations and their severity.

  11. Risk factors affecting survival in heart transplant patients.

    Science.gov (United States)

    Almenar, L; Cardo, M L; Martínez-Dolz, L; García-Palomar, C; Rueda, J; Zorio, E; Arnau, M A; Osa, A; Palencia, M

    2005-11-01

    Certain cardiovascular risk factors have been linked to morbidity and mortality in heart transplant (HT) patients. The sum of various risk factors may have a large cumulative negative effect, leading to a substantially worse prognosis and the need to consider whether HT is contraindicated. The objective of this study was to determine whether the risk factors usually available prior to HT result in an excess mortality in our setting that contraindicates transplantation. Consecutive patients who underwent heart transplantation from November 1987 to January 2004 were included. Heart-lung transplants, retransplants, and pediatric transplants were excluded. Of the 384 patients, 89% were men. Mean age was 52 years (range, 12 to 67). Underlying disease included ischemic heart disease (52%), idiopathic dilated cardiomyopathy (36%), valvular disease (8%), and other (4%). Variables considered risk factors were obesity (BMI >25), dyslipidemia, hypertension, prior thoracic surgery, diabetes, and history of ischemic heart disease. Survival curves by number of risk factors using Kaplan-Meier and log-rank for comparison of curves. Overall patient survival at 1, 5, 10, and 13 years was 76%, 68%, 54%, and 47%, respectively. Survival at 10 years, if fewer than two risk factors were present, was 69%; 59% if two or three factors were present; and 37% if more than three associated risk factors were present (P = .04). The presence of certain risk factors in patients undergoing HT resulted in lower survival rates. The combination of various risk factors clearly worsened outcomes. However, we do not believe this should be an absolute contraindication for transplantation.

  12. Supply risk management from a transaction cost and social exchange theory perspective

    OpenAIRE

    Hoffmann, Petra; Schiele, Holger; Song, Michael; Krabbendam, Johannes Jacobus

    2012-01-01

    Supply risk management gained prominence over the last decade, both in the academic discourse and in practical application. This research examines the influence of Transaction Cost characteristics -behavioral uncertainty, environmental uncertainty and asset specificity on supply risk management performance. We also identify two antecedents of the transaction cost constructs based on social exchange theory: dependency and preferred customer status. We used survey data to discover a positive in...

  13. Repeat workers' compensation claims: risk factors, costs and work disability

    Science.gov (United States)

    2011-01-01

    Background The objective of our study was to describe factors associated with repeat workers' compensation claims and to compare the work disability arising in workers with single and multiple compensation claims. Methods All initial injury claims lodged by persons of working age during a five year period (1996 to 2000) and any repeat claims were extracted from workers' compensation administrative data in the state of Victoria, Australia. Groups of workers with single and multiple claims were identified. Descriptive analysis of claims by affliction, bodily location, industry segment, occupation, employer and workplace was undertaken. Survival analysis determined the impact of these variables on the time between the claims. The economic impact and duration of work incapacity associated with initial and repeat claims was compared between groups. Results 37% of persons with an initial claim lodged a second claim. This group contained a significantly greater proportion of males, were younger and more likely to be employed in manual occupations and high-risk industries than those with single claims. 78% of repeat claims were for a second injury. Duration between the claims was shortest when the working conditions had not changed. The initial claims of repeat claimants resulted in significantly (p claims. Conclusions A substantial proportion of injured workers experience a second occupational injury or disease. These workers pose a greater economic burden than those with single claims, and also experience a substantially greater cumulative period of work disability. There is potential to reduce the social, health and economic burden of workplace injury by enacting prevention programs targeted at these workers. PMID:21696637

  14. [Risk factors associated to preclampsia].

    Science.gov (United States)

    López-Carbajal, Mario Joaquín; Manríquez-Moreno, María Esther; Gálvez-Camargo, Daniela; Ramírez-Jiménez, Evelia

    2012-01-01

    preeclampsia constitutes one of the main causes of maternal and perinatal morbidity and mortality. The aim was to identify the risk factors associated to the developmental of preeclampsia mild-moderate and severe, as well as the force of association of these factors in a hospital of second-level medical care. study of cases and controls, a relation 1:1, in women withdrawn of the Service of Gynecology and Obstetrics during 2004 to 2007. Pregnant women with more than 20 weeks gestation were included. In the cases group we included patients with diagnosis of preeclampsia mild-moderate or severe (corroborated clinical and laboratory). In the controls group that had a normal childbirth without pathology during the pregnancy. 42 cases and 42 controls. The average age was of 27 years. The associated risk factors were overweight, obesity, irregular prenatal control, short or long intergenesic period, history of caesarean or preeclampsia in previous pregnancies. the knowledge of the risk factors will allow the accomplishment of preventive measures and decrease the fetal and maternal morbidity and mortality due to preeclampsia.

  15. Development of Advanced Life Cycle Costing Methods for Technology Benefit/Cost/Risk Assessment

    Science.gov (United States)

    Yackovetsky, Robert (Technical Monitor)

    2002-01-01

    The overall objective of this three-year grant is to provide NASA Langley's System Analysis Branch with improved affordability tools and methods based on probabilistic cost assessment techniques. In order to accomplish this objective, the Aerospace Systems Design Laboratory (ASDL) needs to pursue more detailed affordability, technology impact, and risk prediction methods and to demonstrate them on variety of advanced commercial transports. The affordability assessment, which is a cornerstone of ASDL methods, relies on the Aircraft Life Cycle Cost Analysis (ALCCA) program originally developed by NASA Ames Research Center and enhanced by ASDL. This grant proposed to improve ALCCA in support of the project objective by updating the research, design, test, and evaluation cost module, as well as the engine development cost module. Investigations into enhancements to ALCCA include improved engine development cost, process based costing, supportability cost, and system reliability with airline loss of revenue for system downtime. A probabilistic, stand-alone version of ALCCA/FLOPS will also be developed under this grant in order to capture the uncertainty involved in technology assessments. FLOPS (FLight Optimization System program) is an aircraft synthesis and sizing code developed by NASA Langley Research Center. This probabilistic version of the coupled program will be used within a Technology Impact Forecasting (TIF) method to determine what types of technologies would have to be infused in a system in order to meet customer requirements. A probabilistic analysis of the CER's (cost estimating relationships) within ALCCA will also be carried out under this contract in order to gain some insight as to the most influential costs and the impact that code fidelity could have on future RDS (Robust Design Simulation) studies.

  16. Perceptions of risk factors for road traffic accidents

    OpenAIRE

    Smith, Andrew; Smith, Hugo

    2017-01-01

    Research has identified a number of risk factors for road traffic accidents. Some of these require education of drivers and a first step in this process is to assess perceptions of these risk factors to determine the current level of awareness. An online survey examined risk perception with the focus being on driver behavior, risk taking and fatigue. The results showed that drivers’ perceptions of the risk from being fatigued was lower than the perceived risk from the other factors.

  17. Cost sharing and hereditary cancer risk: predictors of willingness-to-pay for genetic testing.

    Science.gov (United States)

    Matro, Jennifer M; Ruth, Karen J; Wong, Yu-Ning; McCully, Katen C; Rybak, Christina M; Meropol, Neal J; Hall, Michael J

    2014-12-01

    Increasing use of predictive genetic testing to gauge hereditary cancer risk has been paralleled by rising cost-sharing practices. Little is known about how demographic and psychosocial factors may influence individuals' willingness-to-pay for genetic testing. The Gastrointestinal Tumor Risk Assessment Program Registry includes individuals presenting for genetic risk assessment based on personal/family cancer history. Participants complete a baseline survey assessing cancer history and psychosocial items. Willingness-to-pay items include intention for: genetic testing only if paid by insurance; testing with self-pay; and amount willing-to-pay ($25-$2,000). Multivariable models examined predictors of willingness-to-pay out-of-pocket (versus only if paid by insurance) and willingness-to-pay a smaller versus larger sum (≤$200 vs. ≥$500). All statistical tests are two-sided (α = 0.05). Of 385 evaluable participants, a minority (42%) had a personal cancer history, while 56% had ≥1 first-degree relative with colorectal cancer. Overall, 21.3% were willing to have testing only if paid by insurance, and 78.7% were willing-to-pay. Predictors of willingness-to-pay were: 1) concern for positive result; 2) confidence to control cancer risk; 3) fewer perceived barriers to colorectal cancer screening; 4) benefit of testing to guide screening (all p testing (all p testing, and anticipate benefits to reducing cancer risk. Identifying factors associated with willingness-to-pay for genetic services is increasingly important as testing is integrated into routine cancer care.

  18. Analysis of risk factors and risk assessment for ischemic stroke recurrence

    Directory of Open Access Journals (Sweden)

    Xiu-ying LONG

    2016-08-01

    Full Text Available Objective To screen the risk factors for recurrence of ischemic stroke and to assess the risk of recurrence. Methods Essen Stroke Risk Score (ESRS was used to evaluate the risk of recurrence in 176 patients with ischemic stroke (96 cases of first onset and 80 cases of recurrence. Univariate and multivariate stepwise Logistic regression analysis was used to screen risk factors for recurrence of ischemic stroke.  Results There were significant differences between first onset group and recurrence group on age, the proportion of > 75 years old, hypertension, diabetes, coronary heart disease, peripheral angiopathy, transient ischemic attack (TIA or ischemic stroke, drinking and ESRS score (P < 0.05, for all. First onset group included one case of ESRS 0 (1.04%, 8 cases of 1 (8.33%, 39 cases of 2 (40.63%, 44 cases of 3 (45.83%, 4 cases of 4 (4.17%. Recurrence group included 2 cases of ESRS 3 (2.50%, 20 cases of 4 (25% , 37 cases of 5 (46.25% , 18 cases of 6 (22.50% , 3 cases of 7 (3.75% . There was significant difference between 2 groups (Z = -11.376, P = 0.000. Logistic regression analysis showed ESRS > 3 score was independent risk factor for recurrence of ischemic stroke (OR = 31.324, 95%CI: 3.934-249.430; P = 0.001.  Conclusions ESRS > 3 score is the independent risk factor for recurrence of ischemic stroke. It is important to strengthen risk assessment of recurrence of ischemic stroke. To screen and control risk factors is the key to secondary prevention of ischemic stroke. DOI: 10.3969/j.issn.1672-6731.2016.07.011

  19. Risk factors for congenital hydrocephalus

    DEFF Research Database (Denmark)

    Munch, Tina Noergaard; Rasmussen, Marie-Louise Hee; Wohlfahrt, Jan

    2014-01-01

    . Furthermore, to identify the risk factors unique for isolated CHC as compared to syndromic CHC. METHODS: We established a cohort of all children born in Denmark between 1978 and 2008. Information on CHC and maternal medical diseases were obtained from the National Patient Discharge Register, maternal intake...... increased risk of isolated CHC compared to unexposed children (RR 2.52, 95% CI 1.47 to 4.29) (1.5/1000 born children). Risk factors also found for syndromic CHC were: Male gender, multiples and maternal diabetes. CONCLUSIONS: The higher risk for isolated CHC in first-born children as well as behavioural......-born children, we observed 1193 cases of isolated CHC (0.062/1000) born children. First-borns had an increased risk of isolated CHC compared to later-borns (1.32 95% CI 1.17 to 1.49) (0.72/1000 born children). First trimester exposure to maternal use of antidepressants was associated with a significantly...

  20. Risk Factors for Homelessness Among US Veterans

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171

  1. Prevalence, risk factors and risk perception of tuberculosis infection ...

    African Journals Online (AJOL)

    Prevalence, risk factors and risk perception of tuberculosis infection among medical students and healthcare workers in Johannesburg, South Africa. A van Rie, K McCarthy, L Scott, A Dow, WDF Venter, WS Stevens ...

  2. COMPLIANCE AS FACTORING BUSINESS RISK MANAGEMENT: CONTROL ASPECTS

    Directory of Open Access Journals (Sweden)

    V.K. Makarovych

    2016-03-01

    Full Text Available Indetermination of modern economy conditions and the lack of theoretical knowledge gained by domestic scientists about risk in factoring business actualize the research concerning the methodology and technique of factoring companies’ risk management. The article examines compliance which is the technology innovative for Ukrainian market of factoring risk management technologies. It is determined that the compliance is the risk management process directed to free will correspondence to state, international legislation as well as to the ethics standards accepted in the field of regulated legal relations and to the traditions of business circulation to sustain the necessary regulations and standards of market behaviour, and to consolidate the image of a factoring company. Compliance risks should be understood as the risks of missed profit or losses caused by the conflicts of interests and the discrepancy of employees’ actions to internal and external standard documents. The attention is paid to the control over the compliance. The author singles out 3 kinds of the compliance control such as institutional, operational and the compliance control over the observance of conducting business professional ethics regulations which are necessary for providing of efficient management of factoring business risks. The paper shows the organizing process of factoring business compliance control (by the development of internal standard documents, a compliance program, the foundation of compliance control subdivision, monitoring of the risks cause the choice, made by management entities of a factoring company, of the management methods of risks for their business. The development of new and improvement of existed forms of compliance control organizing process help satisfy users’ information needs and requests of the risk management factoring company department. The suggestions proposed create the grounds for the transformation and improvement of factoring

  3. Cost benefit risk - a concept for management of integrated urban wastewater systems?

    DEFF Research Database (Denmark)

    Hauger, Mikkel B.; Rauch, W.; Linde, Jens Jørgen

    2002-01-01

    Urban wastewater systems should be evaluated and analysed from an integrated point of view, taking all parts of the system, that is sewer system, wastewater treatment plant and receiving waters into consideration. Risk and parameter uncertainties are aspects that hardly ever have been addressed...... in the evaluation and design of urban wastewater systems. In this paper we present and discuss a probabilistic approach for evaluation of the performance of urban wastewater systems. Risk analysis together with the traditional cost-benefit analysis is a special variant of multi-criteria analysis that seeks to find...... the most feasible improvement alternative for an urban wastewater system. The most feasible alternative in this context is the alternative that has the best performance, meaning that the alternative has the lowest sum of costs, benefits and risks. The sum is expressed as the Net Present Cost (NPC). To use...

  4. Sociomedical risk factors for male infecundity

    Directory of Open Access Journals (Sweden)

    E. A. Epanchintseva

    2016-01-01

    Full Text Available Subjects and methods. A total of 917 men from infertile couples with abnormal ejaculate indicators were examined. Their age was 34.1 ± 6.3 years; the infertility period was 4.6 ± 3.9 years. A retrospective analysis of their case histories, clinical examination, questioning to identify risk factors for infertility, and anthropometric measurements of weight and height were made. Weight was rated normal at a body mass index (BMI of ≤ 24.9 kg/m2 ; overweight at 25.0–29.9 kg/m2 , and obesity at ≥ 30 kg/m2 . When identifying infertility risk factors, the investigators kept in mind 24 risk factors at the moment of examination or in the patient histories, which were grouped into 3 clusters: 1 – environmental factors and occupational hazards; 2 – evidence of congenital and acquired abnormalities; 3 – social and quality-of-life factors; this cluster also includes history and examination evidence of tuberculosis, sexually transmitted diseases, and other social diseases, such as hepatitis B and C, or human immunodeficiency infection. Then the men who did not show an exacerbation of somatic diseases, genetic anomalies associated with reproductive disorders, or an exacerbation of social diseases at the moment of examination were selected from the total sample. These were divided into 2 groups: normal weight and obese patients. The frequency of the above mentioned infertility risk factors and additionally the proportion of persons engaged in intellectual or manual labor were calculated in each group.Results and discussion. In the total sample, the frequency of infertility risk factors including occupational hazards and environmental factors was < 20 %; the incidence of congenital and acquired abnormalities was 1–39 %. The highest frequency of risk factors was noted in cluster 3. Among them, alcohol consumption (75 % occupied the first place; next were the rate of sexually transmitted infections (59 %, emotional stress (44 %, and smoking (42

  5. Cost-effectiveness analysis of a multifactorial fall prevention intervention in older home care clients at risk for falling.

    Science.gov (United States)

    Isaranuwatchai, Wanrudee; Perdrizet, Johnna; Markle-Reid, Maureen; Hoch, Jeffrey S

    2017-09-01

    Falls among older adults can cause serious morbidity and pose economic burdens on society. Older age is a known risk factor for falls and age has been shown to influence the effectiveness of fall prevention programs. To our knowledge, no studies have explicitly investigated whether cost-effectiveness of a multifactorial fall prevention intervention (the intervention) is influenced by age. This economic evaluation explores: 1) the cost-effectiveness of a multifactorial fall prevention intervention compared to usual care for community-dwelling adults ≥ 75 years at risk of falling in Canada; and 2) the influence of age on the cost-effectiveness of the intervention. Net benefit regression was used to examine the cost-effectiveness of the intervention with willingness-to-pay values ranging from $0-$50,000. Effects were measured as change in the number of falls, from baseline to 6-month follow-up. Costs were measured using a societal perspective. The cost-effectiveness analysis was conducted for both the total sample and by age subgroups (75-84 and 85+ years). For the total sample, the intervention was not economically attractive. However, the intervention was cost-effective at higher willingness-to-pay (WTP) (≥ $25,000) for adults 75-84 years and at lower WTP (cost-effectiveness of the intervention depends on age and decision makers' WTP to prevent falls. Understanding the influence of age on the cost-effectiveness of an intervention may help to target resources to those who benefit most. Retrospectively registered. Clinicaltrials.gov identifier: NCT00463658 (18 April 2007).

  6. Do Transaction Costs and Risk Preferences Influence Marketing Arrangements in the Illinois Hog Industry?

    NARCIS (Netherlands)

    Franken, J.R.V.; Pennings, J.M.E.; Garcia, P.

    2008-01-01

    Studies of hog industry structure often invoke risk reduction and transaction costs explanations for empirical observations but fail to directly examine the core concepts of risk behavior and transaction costs theories. Using a more unified conceptual framework and unique survey and accounting data,

  7. Department of Defense Energy and Logistics: Implications of Historic and Future Cost, Risk, and Capability Analysis

    Science.gov (United States)

    Tisa, Paul C.

    Every year the DoD spends billions satisfying its large petroleum demand. This spending is highly sensitive to uncontrollable and poorly understood market forces. Additionally, while some stakeholders may not prioritize its monetary cost and risk, energy is fundamentally coupled to other critical factors. Energy, operational capability, and logistics are heavily intertwined and dependent on uncertain security environment and technology futures. These components and their relationships are less understood. Without better characterization, future capabilities may be significantly limited by present-day acquisition decisions. One attempt to demonstrate these costs and risks to decision makers has been through a metric known as the Fully Burdened Cost of Energy (FBCE). FBCE is defined as the commodity price for fuel plus many of these hidden costs. The metric encouraged a valuable conversation and is still required by law. However, most FBCE development stopped before the lessons from that conversation were incorporated. Current implementation is easy to employ but creates little value. Properly characterizing the costs and risks of energy and putting them in a useful tradespace requires a new framework. This research aims to highlight energy's complex role in many aspects of military operations, the critical need to incorporate it in decisions, and a novel framework to do so. It is broken into five parts. The first describes the motivation behind FBCE, the limits of current implementation, and outlines a new framework that aids decisions. Respectively, the second, third, and fourth present a historic analysis of the connections between military capabilities and energy, analyze the recent evolution of this conversation within the DoD, and pull the historic analysis into a revised framework. The final part quantifies the potential impacts of deeply uncertain futures and technological development and introduces an expanded framework that brings capability, energy, and

  8. Survey of Swiss nuclear's cost study 2016

    International Nuclear Information System (INIS)

    Alt, Stefan; Ustohalova, Veronika

    2017-01-01

    The report discusses the Swiss nuclear cost study 2016 concerning the following issues: evaluation of the aspects of the cost study: cost structure, cost classification and risk provision, additional payment liability, option of lifetime extension for Swiss nuclear power plants; specific indications on the report ''cost study 2016 (KS16) - estimation of the decommissioning cost of Swiss nuclear power plants'': decommissioning costs in Germany, France and the USA, indexing the Swiss cost estimation for decommissioning cost, impact factors on the decommissioning costs; specific indications on the report ''cost study 2016 (KS16) - estimation of the disposal cost - interim storage, transport, containers and reprocessing''; specific indications on the report ''cost studies (KS16) - estimation of disposal costs - geological deep disposal'': time scale and costs incurred, political/social risks, retrievability, comparison with other mining costs.

  9. Disaster risk reduction in developing countries: costs, benefits and institutions.

    Science.gov (United States)

    Kenny, Charles

    2012-10-01

    Some 60,000 people worldwide die annually in natural disasters, mostly due to the collapse of buildings in earthquakes, and primarily in the developing world. This is despite the fact that engineering solutions exist that can eliminate almost completely the risk of such deaths. Why is this? The solutions are expensive and technically demanding, so their cost-benefit ratio often is unfavourable as compared to other interventions. Nonetheless, there are various public disaster risk reduction interventions that are highly cost-effective. That such interventions frequently remain unimplemented or ineffectively executed points to a role for issues of political economy. Building regulations in developing countries appear to have limited impact in many cases, perhaps because of inadequate capacity and corruption. Public construction often is of low quality, perhaps for similar reasons. This suggests the need for approaches that emphasise simple and limited disaster risk regulation covering only the most at-risk structures-and that, preferably, non-experts can monitor-as well as numerous transparency and oversight mechanisms for public construction projects. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

  10. Gambling Risk Groups are Not All the Same: Risk Factors Amongst Sports Bettors.

    Science.gov (United States)

    Russell, Alex M T; Hing, Nerilee; Li, En; Vitartas, Peter

    2018-03-20

    Sports betting is increasing worldwide, with an associated increase in sports betting-related problems. Previous studies have examined risk factors for problem gambling amongst sports bettors and have identified demographic, behavioural, marketing, normative and impulsiveness factors. These studies have generally compared those in problem gambling, or a combination of moderate risk and problem gambling, groups to non-problem gamblers, often due to statistical power issues. However, recent evidence suggests that, at a population level, the bulk of gambling-related harm stems from low risk and moderate risk gamblers, rather than problem gamblers. Thus it is essential to understand the risk factors for each level of gambling-related problems (low risk, moderate risk, problem) separately. The present study used a large sample (N = 1813) to compare each gambling risk group to non-problem gamblers, first using bivariate and then multivariate statistical techniques. A range of demographic, behavioural, marketing, normative and impulsiveness variables were included as possible risk factors. The results indicated that some variables, such as gambling expenditure, number of accounts with different operators, number of different types of promotions used and impulsiveness were significantly higher for all risk groups, while others such as some normative factors, age, gender and particular sports betting variables only applied to those with the highest level of gambling-related problems. The results generally supported findings from previous literature for problem gamblers, and extended these findings to low risk and moderate risk groups. In the future, where statistical power allows, risk factors should be assessed separately for all levels of gambling problems.

  11. [Environmental risk factors for schizophrenia: a review].

    Science.gov (United States)

    Vilain, J; Galliot, A-M; Durand-Roger, J; Leboyer, M; Llorca, P-M; Schürhoff, F; Szöke, A

    2013-02-01

    Evidence of variations in schizophrenia incidence rates has been found in genetically homogenous populations, depending on changes within time or space of certain environmental characteristics. The consideration of the impact of environmental risk factors in etiopathogenic studies has put the environment in the forefront of research regarding psychotic illnesses. Various environmental factors such as urbanicity, migration, cannabis, childhood traumas, infectious agents, obstetrical complications and psychosocial factors have been associated with the risk of developing schizophrenia. These risk factors can be biological, physical, psychological as well as social and may operate at different times in an individual's life (fetal period, childhood, adolescence and early adulthood). Whilst some of these factors act on an individual level, others act on a populational level, modulating the individual risk. These factors can have a direct action on the development of schizophrenia, or on the other hand act as markers for directly implicated factors that have not yet been identified. This article summarizes the current knowledge on this subject. An extensive literature search was conducted via the search engine Pubmed. Eight risk factors were selected and developed in the following paper: urbanicity (or living in an urban area), cannabis, migration (and ethnic density), obstetrical complications, seasonality of birth, infectious agents (and inflammatory responses), socio-demographic factors and childhood traumas. For each of these factors, we provide information on the importance of the risk, the vulnerability period, hypotheses made on the possible mechanisms behind the factors and the level of proof the current research offers (good, medium, or insufficient) according to the amount, type, quality and concordance of the studies at hand. Some factors, such as cannabis, are "unique" in their influence on the development of schizophrenia since it labels only one risk factor

  12. Risk aversion, time preference, and the social cost of carbon

    International Nuclear Information System (INIS)

    Anthoff, David; Tol, Richard S J; Yohe, Gary W

    2009-01-01

    The Stern Review reported a social cost of carbon of over $300/tC, calling for ambitious climate policy. We here conduct a systematic sensitivity analysis of this result on two crucial parameters: the rate of pure time preference, and the rate of risk aversion. We show that the social cost of carbon lies anywhere in between 0 and $120 000/tC. However, if we restrict these two parameters to matching observed behaviour, an expected social cost of carbon of $60/tC results. If we correct this estimate for income differences across the world, the social cost of carbon rises to over $200/tC.

  13. Identifying cost-effective treatment with raloxifene in postmenopausal women using risk algorithms for fractures and invasive breast cancer.

    Science.gov (United States)

    Ivergård, M; Ström, O; Borgström, F; Burge, R T; Tosteson, A N A; Kanis, J

    2010-11-01

    The National Osteoporosis Foundation (NOF) recommends considering treatment in women with a 20% or higher 10-year probability of a major fracture. However, raloxifene reduces both the risk of vertebral fractures and invasive breast cancer so that raloxifene treatment may be clinically appropriate and cost-effective in women who do not meet a 20% threshold risk. The aim of this study was to identify cost-effective scenarios of raloxifene treatment compared to no treatment in younger postmenopausal women at increased risk of invasive breast cancer and fracture risks below 20%. A micro-simulation model populated with data specific to American Caucasian women was used to quantify the costs and benefits of 5-year raloxifene treatment. The population evaluated was selected based on 10-year major fracture probability as estimated with FRAX® being below 20% and 5-year invasive breast cancer risk as estimated with the Gail risk model ranging from 1% to 5%. The cost per QALY gained ranged from US $22,000 in women age 55 with 5% invasive breast cancer risk and 15-19.9% fracture probability, to $110,000 in women age 55 with 1% invasive breast cancer risk and 5-9.9% fracture probability. Raloxifene was progressively cost-effective with increasing fracture risk and invasive breast cancer risk for a given age cohort. At lower fracture risk in combination with lower invasive breast cancer risk or when no preventive raloxifene effect on invasive breast cancer was assumed, the cost-effectiveness of raloxifene worsened markedly and was not cost-effective given a willingness-to-pay of US $50,000. At fracture risk of 15-19.9% raloxifene was cost-effective also in women at lower invasive breast cancer risk. Raloxifene is potentially cost-effective in cohorts of young postmenopausal women, who do not meet the suggested NOF 10-year fracture risk threshold. The cost-effectiveness is contingent on their 5-year invasive breast cancer risk. The result highlights the importance of considering

  14. Managing perceived operational risk factors for effective supply-chain management

    Science.gov (United States)

    Sylla, Cheickna

    2014-12-01

    This research is part of a large scale comprehensive mathematical and empirical modeling investigation projects aimed at developing a better understanding of supply-chain risk management by offering a comprehensive framework including theoretical elements and empirical evidence based on managers' perception of improved organizational level of preparedness to safeguard against the threats of disruptions, delays and stoppage in the supply chain. More specifically, this paper reports the empirical investigation conducted using 92 companies in several eastern USA regions involved in international trades with global supply chains. Among the 56 general hypotheses investigated, the results support that managers strive to balance their control and decision impacts to mold their responses to risk factors with knowledge of the extent of cost consequences as stated in previous research. However, the results also propose new findings which significantly vary from previous research reports.

  15. Risk, Benefit, and Cost Thresholds for Emergency Department Testing: A Cross-sectional, Scenario-based Study.

    Science.gov (United States)

    Meka, Arjun Prasad; Porath, Jonathan Douglas; Iyengar, Rahul; Morrow, Chelsea; Fagerlin, Angela; Meurer, William J

    2017-06-01

    While diagnostic testing is common in the emergency department, the value of some testing is questionable. The purpose of this study was to assess how varying levels of benefit, risk, and costs influenced an individual's desire to have diagnostic testing. A survey through Amazon Mechanical Turk presented hypothetical clinical situations: low-risk chest pain and minor traumatic brain injury. Each scenario included three given variables (benefit, risk, and cost), that was independently randomly varied over four possible values (0.1, 1, 5, and 10% for benefit and risk and $0, $100, $500, and $1,000 for the individual's personal cost for receiving the test). Benefit was defined as the probability of finding the target disease (traumatic intracranial hemorrhage or acute coronary syndrome). One-thousand unique respondents completed the survey. With an increased benefit from 0.1% to 10%, the percentage of respondents who accepted a diagnostic test went from 28.4% to 53.1%. (odds ratio [OR] = 3.42; 95% confidence interval [CI] = 2.57-4.54). As risk increased from 0.1% to 10%, this number decreased from 52.5% to 28.5%. (OR = 0.33; 95% CI = 0.25-0.44). Increasing cost from $0 to $1,000 had the greatest change of those accepting the test from 61.1% to 21.4%, respectively (OR = 0.15; 95% CI = 0.11-0.2). The desire for testing was strongly sensitive to the benefits, risks, and costs. Many participants wanted a test when there was no added cost, regardless of benefit or risk levels, but far fewer elected to receive the test as cost increased incrementally. This suggests that out-of-pocket costs may deter patients from undergoing diagnostic testing with low potential benefit. © 2016 by the Society for Academic Emergency Medicine.

  16. A risk-adjusted financial model to estimate the cost of a video-assisted thoracoscopic surgery lobectomy programme.

    Science.gov (United States)

    Brunelli, Alessandro; Tentzeris, Vasileios; Sandri, Alberto; McKenna, Alexandra; Liew, Shan Liung; Milton, Richard; Chaudhuri, Nilanjan; Kefaloyannis, Emmanuel; Papagiannopoulos, Kostas

    2016-05-01

    To develop a clinically risk-adjusted financial model to estimate the cost associated with a video-assisted thoracoscopic surgery (VATS) lobectomy programme. Prospectively collected data of 236 VATS lobectomy patients (August 2012-December 2013) were analysed retrospectively. Fixed and variable intraoperative and postoperative costs were retrieved from the Hospital Accounting Department. Baseline and surgical variables were tested for a possible association with total cost using a multivariable linear regression and bootstrap analyses. Costs were calculated in GBP and expressed in Euros (EUR:GBP exchange rate 1.4). The average total cost of a VATS lobectomy was €11 368 (range €6992-€62 535). Average intraoperative (including surgical and anaesthetic time, overhead, disposable materials) and postoperative costs [including ward stay, high dependency unit (HDU) or intensive care unit (ICU) and variable costs associated with management of complications] were €8226 (range €5656-€13 296) and €3029 (range €529-€51 970), respectively. The following variables remained reliably associated with total costs after linear regression analysis and bootstrap: carbon monoxide lung diffusion capacity (DLCO) 0.05) in 86% of the samples. A hypothetical patient with COPD and DLCO less than 60% would cost €4270 more than a patient without COPD and with higher DLCO values (€14 793 vs €10 523). Risk-adjusting financial data can help estimate the total cost associated with VATS lobectomy based on clinical factors. This model can be used to audit the internal financial performance of a VATS lobectomy programme for budgeting, planning and for appropriate bundled payment reimbursements. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  17. Systematic assessment of environmental risk factors for bipolar disorder

    DEFF Research Database (Denmark)

    Bortolato, Beatrice; Köhler, Cristiano A.; Evangelou, Evangelos

    2017-01-01

    factors supported by high epidemiological credibility. Methods: We searched the Pubmed/MEDLINE, EMBASE and PsycInfo databases up to 7 October 2016 to identify systematic reviews and meta-analyses of observational studies that assessed associations between putative environmental risk factors and BD......Objectives: The pathophysiology of bipolar disorder is likely to involve both genetic and environmental risk factors. In our study, we aimed to perform a systematic search of environmental risk factors for BD. In addition, we assessed possible hints of bias in this literature, and identified risk...... met the inclusion criteria (seven meta-analyses and nine qualitative systematic reviews). Fifty-one unique environmental risk factors for BD were evaluated. Six meta-analyses investigated associations with a risk factor for BD. Only irritable bowel syndrome (IBS) emerged as a risk factor for BD...

  18. Sensitivity study of the factors affecting first-of-a-kind and Nth-of-a-kind Small Modular Reactor investment costs - 15108

    International Nuclear Information System (INIS)

    Boldon, L.; Liu, L.; Sabharwall, P.; Schneider, E.

    2015-01-01

    Conventional nuclear reactors require significant investment and pose financial, regulatory, and political risks. Small modular reactors (SMRs), on the other hand, provide an attractive alternative due to substantially reduced up-front investment costs and financial risks; more flexible deployment schedules and operations; modular fabrication and faster onsite assembly; and incorporation into hybrid energy systems or even cogeneration applications such as desalination, district heating, and industrial process heat. This paper aims to develop a general methodology of assessing the economics of first-of-a-kind (FOAK) and nth-of-a-kind (NOAK) SMRs as part of an effort to determine the conditions that would make them competitive with other generation technologies. Ultimately, this paper will provide background information on the various factors impacting nuclear reactor capital and operational costs; detail technology independent cost estimates for water-cooled SMRs; and provide a parametric study on learning and construction and deployment effects. This study demonstrates precisely why the financial risks are drastically reduced for an SMR site, making SMR nuclear projects feasible for many companies, rather than just a handful which are able to finance multi-billion dollar projects and handle the potential construction or licensing delays or cost overruns

  19. Cost-effectiveness analysis of risk reduction at nuclear power plants

    International Nuclear Information System (INIS)

    Lochard, J.; Maccia, C.; Pages, P.

    1985-01-01

    Cost-effectiveness analysis of risk reduction is now widely accepted as a rational analytical framework to consistently address the resource allocation problem underlying any risk management process. This paper presents how this technique can be usefully applied to complex systems such as the management of radioactive releases from nuclear power plants into the environment. (orig.) [de

  20. Nanoparticle risk management and cost evaluation: a general framework

    Science.gov (United States)

    Fleury, Dominique; Bomfim, João A. S.; Metz, Sébastien; Bouillard, Jacques X.; Brignon, Jean-Marc

    2011-07-01

    Industrial production of nano-objects has been growing fast during the last decade and a wide range of products containing nanoparticles (NPs) is proposed to the public in various markets (automotive, electronics, textiles...). The issues encountered in monitoring the presence of nano-objects in any media cause a major difficulty for controlling the risk associated to the production stage. It is therefore very difficult to assess the efficiency of prevention and mitigation solutions, which potentially leads to overestimate the level of the protection barriers that are recommended. The extra costs in adding nano-objects to the process, especially that of nanosafety, must be estimated and optimized to ensure the competitiveness of the future production lines and associated products. The risk management and cost evaluation methods presented herein have been designed for application in a pilot production line of injection-moulded nanocomposites.

  1. Nanoparticle risk management and cost evaluation: a general framework

    International Nuclear Information System (INIS)

    Fleury, Dominique; Metz, Sebastien; Bouillard, Jacques X; Brignon, Jean-Marc; Bomfim, Joao A S

    2011-01-01

    Industrial production of nano-objects has been growing fast during the last decade and a wide range of products containing nanoparticles (NPs) is proposed to the public in various markets (automotive, electronics, textiles...). The issues encountered in monitoring the presence of nano-objects in any media cause a major difficulty for controlling the risk associated to the production stage. It is therefore very difficult to assess the efficiency of prevention and mitigation solutions, which potentially leads to overestimate the level of the protection barriers that are recommended. The extra costs in adding nano-objects to the process, especially that of nanosafety, must be estimated and optimized to ensure the competitiveness of the future production lines and associated products. The risk management and cost evaluation methods presented herein have been designed for application in a pilot production line of injection-moulded nanocomposites.

  2. Estimación de la carga de las enfermedades cardiovasculares atribuible a factores de riesgo modificables en Argentina Estimate of the cardiovascular disease burden attributable to modifiable risk factors in Argentina

    Directory of Open Access Journals (Sweden)

    Adolfo Rubinstein

    2010-04-01

    Full Text Available OBJETIVO: Estimar la carga de la enfermedad, su proporción atribuible a los principales factores de riesgo cardiovascular modificables y los costos médicos directos por hospitalización, asociados con las enfermedades coronarias y los accidentes cerebrovasculares en Argentina. MÉTODOS: Se elaboró un modelo analítico a partir de los datos de mortalidad en Argentina en 2005 y la prevalencia de los principales factores de riesgo cardiovascular (hipertensión arterial, hipercolesterolemia, sobrepeso, obesidad, hiperglucemia, tabaquismo actual y pasado, sedentarismo y consumo inadecuado de frutas y verduras. Se estimaron la carga de la enfermedad -años potenciales de vida perdidos (APVP y años de vida saludable (AVISA perdidos- y los costos de hospitalización por las enfermedades cardiovasculares analizadas. RESULTADOS: En 2005 se perdieron en Argentina más de 600 000 AVISA y se contabilizaron casi 400 000 APVP por enfermedades coronarias y accidentes cerebrovasculares; 71,1% de los AVISA perdidos, 73,9% de APVP y 76,0% de los costos asociados son atribuibles a facto-res de riesgo modificables. La hipertensión arterial fue el factor de riesgo de mayor impacto, tanto en hombres como en mujeres: 37,3% del costo total, 37,5% de los APVP y 36,6% de los AVISA perdidos. CONCLUSIONES: La mayor parte de la carga de la enfermedad en Argentina por enfermedades cardiovasculares está relacionada con factores de riesgo modificables -por lo tanto evitables- y podría reducirse mediante intervenciones poblacionales y clínicas basadas en un enfoque de riesgo, que ya han demostrado ser efectivas en función del costo, asequibles y factibles en países como Argentina.OBJETIVE: Estimate the burden of disease, the proportion attributable to the principal modifiable cardiovascular risk factors, and the direct medical cost of hospitalization associated with coronary heart disease and stroke in Argentina. METHODOLOGY: An analitical model was prepared using

  3. Chronic and Acute Relational Risk Factors for Dating Aggression in Adolescence and Young Adulthood.

    Science.gov (United States)

    Collibee, Charlene; Furman, Wyndol

    2016-04-01

    Dating aggression is a prevalent and costly public health concern. Using a relational risk framework, this study examined acute and chronic relational risk factors (negative interactions, jealousy, support, and relationship satisfaction) and their effects on physical and psychological dating aggression. The study also examined the interaction between chronic and acute risk, allowing us to assess how changes in acute risk have differing effects depending on whether the individual is typically at higher chronic risk. A sample of 200 youth (100 female) completed seven waves of data, which spanned 9 years from middle adolescence to young adulthood (M age at Wave 1 = 15.83). Using hierarchical linear modeling, analyses revealed both acute (within-person) and chronic (between-person) levels in jealousy, negative interactions, and relationship satisfaction, were associated with physical and psychological dating aggression. Significant interactions between chronic and acute risk emerged in predicting physical aggression for negative interactions, jealousy, and relationship satisfaction such that those with higher levels of chronic risk are more vulnerable to increases in acute risk. These interactions between chronic and acute risk indicate that risk is not static, and dating aggression is particularly likely to occur at certain times for youth at high risk for dating aggression. Such periods of increased risk may provide opportunities for interventions to be particularly effective in preventing dating aggression or its consequences. Taken together, these findings provide support for the role of relational risk factors for dating aggression. They also underscore the importance of considering risk dynamically.

  4. Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among U.S. males.

    Directory of Open Access Journals (Sweden)

    Stephanie L Sansom

    Full Text Available BACKGROUND: HIV incidence was substantially lower among circumcised versus uncircumcised heterosexual African men in three clinical trials. Based on those findings, we modeled the potential effect of newborn male circumcision on a U.S. male's lifetime risk of HIV, including associated costs and quality-adjusted life-years saved. METHODOLOGY/PRINCIPAL FINDINGS: Given published estimates of U.S. males' lifetime HIV risk, we calculated the fraction of lifetime risk attributable to heterosexual behavior from 2005-2006 HIV surveillance data. We assumed 60% efficacy of circumcision in reducing heterosexually-acquired HIV over a lifetime, and varied efficacy in sensitivity analyses. We calculated differences in lifetime HIV risk, expected HIV treatment costs and quality-adjusted life years (QALYs among circumcised versus uncircumcised males. The main outcome measure was cost per HIV-related QALY saved. Circumcision reduced the lifetime HIV risk among all males by 15.7% in the base case analysis, ranging from 7.9% for white males to 20.9% for black males. Newborn circumcision was a cost-saving HIV prevention intervention for all, black and Hispanic males. The net cost of newborn circumcision per QALY saved was $87,792 for white males. Results were most sensitive to the discount rate, and circumcision efficacy and cost. CONCLUSIONS/SIGNIFICANCE: Newborn circumcision resulted in lower expected HIV-related treatment costs and a slight increase in QALYs. It reduced the 1.87% lifetime risk of HIV among all males by about 16%. The effect varied substantially by race and ethnicity. Racial and ethnic groups who could benefit the most from circumcision may have least access to it due to insurance coverage and state Medicaid policies, and these financial barriers should be addressed. More data on the long-term protective effect of circumcision on heterosexual males as well as on its efficacy in preventing HIV among MSM would be useful.

  5. Cost-benefit and risk-benefit assessment for nuclear power plants

    International Nuclear Information System (INIS)

    Eichholz, G.G.

    1976-01-01

    A cost benefit assessment is an essential part of the Environmental Impact Statement submitted as part of the licensing considerations for a nuclear facility. Such an assessment forms part of the initial decision to build a nuclear facility, enters critically into the selection of a suitable site, and ultimately forms part of the design procedures to optimize engineering solutions to deal with waste-heat dissipation, treatment methods for radioactive effluent control, and land and site use. Whereas the initial decision usually can be made in purely economic terms, the latter stages involve environmental and social issues that are not readily quantified and involve a qualitative judgment of what constitutes the least, readily achievable impact. The radiological impact of the plant on the surrounding population from the release of low-level effluents can be quantified and treated as a financial ''cost.'' Alternatively it can be treated as a ''risk'' and related to other risks modern man is subjected to and can be used as a means to establish site boundaries. Both cost-benefit and risk-benefit analyses represent essentially optimization approaches to the problem of making nuclear power plants economically competitive, socially and politically acceptable, and as safe or innocuous as one can reasonably make them

  6. Risk factors predisposing to congenital heart defects

    International Nuclear Information System (INIS)

    Ul Haq, Faheem; Jalil, Fatima; Hashmi, Saman; Jumani, Maliha Iqbal; Imdad, Aamer; Jabeen, Mehnaz; Hashmi, Javad Tauseef; Irfan, Furqan Bin; Imran, Muhammad; Atiq, Mehnaz

    2011-01-01

    Congenital heart disease (CHD) is associated with multiple risk factors, consanguinity may be one such significant factor. The role of consanguinity in the etiology of CHD is supported by inbreeding studies, which demonstrate an autosomal recessive pattern of inheritance of some congenital heart defects. This study was done to find out the risk factors for CHD. A case-control study was done on pediatric patients at a tertiary care hospital, Aga Khan University Hospital, located in Karachi, Pakistan. A total of 500 patients, 250 cases and 250 controls were included in the study. Amongst the 250 cases (i.e. those diagnosed with CHD), 122 patients (48.8%) were born of consanguineous marriages while in the controls (i.e. non-CHD) only 72 patients (28.9%) showed a consanguinity amongst parents. On multivariate analysis, consanguinity emerged as an independent risk factor for CHD; adjusted odds ratio 2.59 (95% C. I. 1.73 - 3.87). Other risk factors included low birth weight, maternal co-morbidities, family history of CHD and first born child. On the other hand, medications used by the mother during the index pregnancy, maternal age and gender of the child did not significantly increase the risk of developing CHD. Analyses of our results show that parental consanguinity, family history of CHD, maternal co-morbidities, first born child and low birth weight are independent risk factors for CHD

  7. 459 Preventing Cardiovascular Disease Risk Factors through ...

    African Journals Online (AJOL)

    FIRST LADY

    2011-01-18

    Jan 18, 2011 ... injury. Risk factors may be considered as characteristic indicators ... by examining the cardiovascular risk factors that are related to various forms .... Cross country race, Handball, Jogging, Rope jumping, Running Soccer,.

  8. Vascular access complications and risk factors in hemodialysis ...

    African Journals Online (AJOL)

    Vascular access complications and risk factors in hemodialysis patients: A single center study. ... Stenosis was the most common risk factor for vascular failure as it occurred in (29%) of patients. ... Other risk factors for dialysis CRBSI include older age, low serum albumin, high BUN and decreasing the duration of dialysis.

  9. COMPLIANCE AS FACTORING BUSINESS RISK MANAGEMENT: CONTROL ASPECTS

    OpenAIRE

    V.K. Makarovych

    2016-01-01

    Indetermination of modern economy conditions and the lack of theoretical knowledge gained by domestic scientists about risk in factoring business actualize the research concerning the methodology and technique of factoring companies’ risk management. The article examines compliance which is the technology innovative for Ukrainian market of factoring risk management technologies. It is determined that the compliance is the risk management process directed to free will correspondence to sta...

  10. ETHICS, SOCIAL RESPONSIBILITY AND CORRUPTION AS RISK FACTORS

    Directory of Open Access Journals (Sweden)

    Alexandru GRIBINCEA

    2017-03-01

    Full Text Available The financial risk characterises the variability of net profit, subject to the financial structure of the insurance. The capital of the insurance company has two elements (the equity and the borrowed one that differ fundamentally in the cost they generate. If the company uses loans, it will bear systematically the related financial expenses, too. Through its size and cost, indebtedness leads to the variation and changes the size of financial risk. Resorting to the debt is justified through the high remuneration of equity in relation to borrowed capital, thus increasing the financial return.

  11. Risk factors in neuroleptic malignant syndrome.

    Science.gov (United States)

    Gupta, Vinay; Magon, Rakesh; Mishra, B P; Sidhu, G B S; Mahajan, Ranjiv

    2003-01-01

    Neuroleptic malignant syndrome (NMS) is an uncommon but potentially serious idiosyncratic response to neuroleptic antipsychotics. It usually affects young males, but the risk has been seen to increase with certain factors including the administration practices of antipsychotic neuroleptics in these individuals. Even though no predictors for NMS are yet known, this article highlights the findings on certain risk factors as seen from a series of fifteen patients who developed NMS. Cautious use of neuroleptics in those at risk, early recognition and institution of immediate management is important.

  12. Human cost as a factor used in the cost-benefit analysis

    Directory of Open Access Journals (Sweden)

    Karol RÁSTOČNÝ

    2008-01-01

    Full Text Available Cost-benefit analysis (CBA is a prescriptive technique that is performed for the purpose of informing policy makers about what they ought to do. The paper discusses the problem of assigning a monetary value to human life (lifesaving or quality of life as an important factor used in the CBA. Presented ideas come from the project SELCAT solved within the 6th Frame Program.

  13. Levee Setbacks: An Innovative, Cost Effective, and Sustainable Solution for Improved Flood Risk management

    Science.gov (United States)

    2017-06-30

    ER D C/ EL S R- 17 -3 Levee Setbacks: An Innovative , Cost-Effective, and Sustainable Solution for Improved Flood Risk Management En vi...EL SR-17-3 June 2017 Levee Setbacks: An Innovative , Cost-Effective, and Sustainable Solution for Improved Flood Risk Management David L. Smith...alternative view point is necessary. ERDC/EL SR-17-3 4 Levee setbacks are a relatively recent innovation in Corps flood risk management practice

  14. Lung cancer incidence and risk factors

    International Nuclear Information System (INIS)

    Bairakova, A.

    1993-01-01

    The possibility of developing lung cancer (lc) as a consequence of inhaling hot particles from the Chernobyl accident is discussed. The risk from various factors is reviewed in order to assess the rate of contribution for any of them to carcinogenic process. The conclusions are based on data reported by National Centre of Oncology, Sofia (BG). A total of 2873 new cases have been recorded in 1990. The data for the period 1970-1990 show a crude increase for males and tend to stabilization for females. The similar pattern is obtained in other countries and geographic areas with steady rise of lc cases with about 0.5% per year. The contribution of particular risk factor and its interaction with other factors is assessed on the basis of large number of epidemiologic and experimental studies. The risk of cigarette smoking, as the principal cause for lc, is discussed in various aspects - age, duration, possible dropping the habit. The assessment of another risk factor - exposure to relatively high doses of natural radon daughter products - is more complicated. As an occupational hazard in uranium mines radon and its progeny reveals an increase in excess lc incidence. Regarding radon and its daughters as an environmental risk factor in dwellings, no clear positive relationship between exposure and lc incidence has been observed. In this case the assessment for population living in areas with higher concentration of radon products have to rely on data from uranium mines. Non radiation factors as asbestos, ethers, chromates, metallic iron, nickel, beryllium and arsenic, are also considered. The combined effect of all these factors, as well as of pathological cell processes, viruses, malfunctions of immune system, is mentioned as well. The possibility of interpreting the findings from epidemiological studies within the framework of theoretical multistage models of carcinogenic process is pointed out. (author)

  15. Quantifying the social costs of nuclear energy: Perceived risk of accident at nuclear power plants

    International Nuclear Information System (INIS)

    Huhtala, Anni; Remes, Piia

    2017-01-01

    The preferences expressed in voting on nuclear reactor licenses and the risk perceptions of citizens provide insights into social costs of nuclear power and decision making in energy policy. We show analytically that these costs consist of disutility caused by unnecessary anxiety - due to misperceived risks relating to existing reactors - and where licenses for new nuclear reactors are not granted, delayed or totally lost energy production. Empirical evidence is derived from Finnish surveys eliciting explicitly the importance of risk perceptions on preferences regarding nuclear power and its environmental and economic impacts. We show that the estimated marginal impact of a high perceived risk of nuclear accident is statistically significant and that such a perception considerably decreases the probability of a person supporting nuclear power. This result holds across a number of robustness checks including an instrumental variable estimation and a model validation by observed voting behavior of the members of Parliament. The public's risk perceptions translate into a significant social cost, and are likely to affect the revenues, costs and financing conditions in the nuclear power sector in the future. - Highlights: • Survey on preferences regarding nuclear power and its environmental and economic impacts utilized. • A high perceived risk of nuclear accident decreases support for nuclear power. • The public's risk perceptions translate into a significant social cost.

  16. Risk factor characteristics in carers who physically abuse or neglect their elderly dependants.

    Science.gov (United States)

    Reay, A M; Browne, K D

    2001-02-01

    This study investigates the prevalence of, and differences in, risk factor characteristics in a sample of two select populations of carers, one of which physically abused their elderly dependants and one of which neglected them. Nineteen carers (nine who had physically abused and 10 who had neglected their elderly relatives), who were referred to clinical psychology by either their general practitioner or their psychiatrist, were invited to take part in this study. A detailed history of risk factors was obtained, including history of alcohol dependency, type and history of mental ill health, history of maltreatment earlier in life, who they were caring for, how long they had been a carer and whether they felt isolated as a carer. Subjects were then given five assessments to determine whether there were any differences between the two groups. These were the Conflict Tactic Scale, Strain Scale, Beck Depression Inventory, Beck Anxiety Inventory and Cost of Care Index. An examination of the risk factors suggests that heavy alcohol consumption and past childhood abuse by fathers were likely to lead to physical abuse. Significantly higher conflict and depression scores were also present in the physical abuse group, while the neglect group had significantly higher anxiety scores. It is suggested that these findings should be incorporated into an assessment of future risk of abuse or neglect by the carer.

  17. Dynamic Multi-Factor Credit Risk Model with Fat-Tailed Factors

    Czech Academy of Sciences Publication Activity Database

    Gapko, Petr; Šmíd, Martin

    2012-01-01

    Roč. 62, č. 2 (2012), s. 125-140 ISSN 0015-1920 R&D Projects: GA ČR GD402/09/H045; GA ČR GA402/09/0965 Grant - others:Univerzita Karlova(CZ) GAUK 46108 Institutional research plan: CEZ:AV0Z10750506 Keywords : credit risk * probability of default * loss given default * credit loss * credit loss distribution * Basel II Subject RIV: AH - Economics Impact factor: 0.340, year: 2012 http://library.utia.cas.cz/separaty/2012/E/smid-dynamic multi-factor credit risk model with fat-tailed factors.pdf

  18. Population-Level Prediction of Type 2 Diabetes From Claims Data and Analysis of Risk Factors.

    Science.gov (United States)

    Razavian, Narges; Blecker, Saul; Schmidt, Ann Marie; Smith-McLallen, Aaron; Nigam, Somesh; Sontag, David

    2015-12-01

    We present a new approach to population health, in which data-driven predictive models are learned for outcomes such as type 2 diabetes. Our approach enables risk assessment from readily available electronic claims data on large populations, without additional screening cost. Proposed model uncovers early and late-stage risk factors. Using administrative claims, pharmacy records, healthcare utilization, and laboratory results of 4.1 million individuals between 2005 and 2009, an initial set of 42,000 variables were derived that together describe the full health status and history of every individual. Machine learning was then used to methodically enhance predictive variable set and fit models predicting onset of type 2 diabetes in 2009-2011, 2010-2012, and 2011-2013. We compared the enhanced model with a parsimonious model consisting of known diabetes risk factors in a real-world environment, where missing values are common and prevalent. Furthermore, we analyzed novel and known risk factors emerging from the model at different age groups at different stages before the onset. Parsimonious model using 21 classic diabetes risk factors resulted in area under ROC curve (AUC) of 0.75 for diabetes prediction within a 2-year window following the baseline. The enhanced model increased the AUC to 0.80, with about 900 variables selected as predictive (p differences between AUCs). Similar improvements were observed for models predicting diabetes onset 1-3 years and 2-4 years after baseline. The enhanced model improved positive predictive value by at least 50% and identified novel surrogate risk factors for type 2 diabetes, such as chronic liver disease (odds ratio [OR] 3.71), high alanine aminotransferase (OR 2.26), esophageal reflux (OR 1.85), and history of acute bronchitis (OR 1.45). Liver risk factors emerge later in the process of diabetes development compared with obesity-related factors such as hypertension and high hemoglobin A1c. In conclusion, population-level risk

  19. The direct costs of intensive care management and risk factors for financial burden of patients with severe sepsis and septic shock.

    Science.gov (United States)

    Khwannimit, Bodin; Bhurayanontachai, Rungsun

    2015-10-01

    The costs of severe sepsis care from middle-income countries are lacking. This study investigated direct intensive care unit (ICU) costs and factors that could affect the financial outcomes. A prospective cohort study was conducted in the medical ICU of a tertiary referral university teaching hospital in Thailand. A total of 897 patients were enrolled in the study, with 683 (76.1%) having septic shock. Community-, nosocomial, and ICU-acquired infections were documented in 574, 282, and 41 patients, respectively. The median ICU costs per patient were $2716.5 ($1296.1-$5367.6) and $599.9 ($414.3-$948.6) per day. The ICU costs accounted for 64.7% of the hospital costs. In 2008 to 2011, the ICU costs significantly decreased by 40% from $3542.5 to $2124.9, whereas, the daily ICU costs decreased only 3.3% from $609.7 to $589.7. By multivariate logistic regression analysis, age, nosocomial or ICU infection, admission from the emergency department, number of organ failures, ICU length of stay, and fluid balance the first 72 hours were independently associated with ICU costs. The ICU costs of severe sepsis management significantly declined in our study. However, the ICU costs were a financial burden accounting for two thirds of the hospital costs. It is essential for intensivists to contribute a high standard of care within a restricted budget. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Vitamin D deficiency: A potential risk factor for Clostridium difficile infection

    Directory of Open Access Journals (Sweden)

    Youssef D

    2012-10-01

    Full Text Available Dima Youssef,1 William B Grant,2 Alan N Peiris3,41Department of Internal Medicine, Division of Infectious Diseases, 2Sunlight, Nutrition and Health Research Center, San Francisco, CA USA; 3Department of Medicine, Mountain Home VAMC, 4Department of Medicine, East Tennessee State University, Johnson City, Tennessee, USAIn the July 3, 2012 issue of the journal of Risk Management and Healthcare Policy, Martinez et al present a nice review on Clostridium difficile (C. difficile infections.1 The different manifestations of this challenging disease along with the high cost and burden on the health care system were discussed. While the authors did an admirable job in discussing traditional risk factors, they do not mention vitamin D deficiency.View original paper by Martinez and colleagues.

  1. Perioperative risk factors for postoperative pneumonia after major oral cancer surgery: A retrospective analysis of 331 cases.

    Science.gov (United States)

    Xu, Jieyun; Hu, Jing; Yu, Pei; Wang, Weiwang; Hu, Xingxue; Hou, Jinsong; Fang, Silian; Liu, Xiqiang

    2017-01-01

    Postoperative pneumonia (POP) is common and results in prolonged hospital stays, higher costs, increased morbidity and mortality. However, data on the incidence and risk factors of POP after oral and maxillofacial surgery are rare. This study aims to identify perioperative risk factors for POP after major oral cancer (OC) surgery. Perioperative data and patient records of 331 consecutive subjects were analyzed in the period of April 2014 to March 2016. We individually traced each OC patient for a period to discharge from the hospital or 45 days after surgery, whichever occur later. The incidence of POP after major OC surgery with free flap construction or major OC surgery was 11.6% or 4.5%, respectively. Patient-related risk factors for POP were male sex, T stage, N stage, clinical stage and preoperative serum albumin level. Among the investigated procedure-related variables, incision grade, mandibulectomy, free flap reconstruction, tracheotomy, intraoperative blood loss, and the length of the operation were shown to be associated with the development of POP. Postoperative hospital stay was also significantly related to increased incidence of POP. Using a multivariable logistic regression model, we identified male sex, preoperative serum albumin level, operation time and postoperative hospital stay as independent risk factors for POP. Several perioperative risk factors can be identified that are associated with POP. At-risk oral cancer patients should be subjected to intensified postoperative pulmonary care.

  2. Cost-effectiveness criteria for marine oil spill preventive measures

    International Nuclear Information System (INIS)

    Vanem, Erik; Endresen, Oyvind; Skjong, Rolf

    2008-01-01

    Oil tanker accidents resulting in large quantities of oil spills and severe pollution have occurred in the past, leading to major public attention and an international focus on finding solutions for minimising the risks related to such events. This paper proposes a novel approach for evaluating measures for prevention and control of marine oil spills, based on considerations of oil spill risk and cost effectiveness. A cost model that incorporates all costs of a shipping accident has been established and oil tanker spill accidents have been further elaborated as a special case of such accidents. Utilising this model, novel implementation criteria, in terms of the Cost of Averting a Tonne of oil Spilt (CATS), for risk control options aiming at mitigating the environmental risk of accidental oil spills, are proposed. The paper presents a review of previous studies on the costs associated with oil spills from shipping, which is a function of many factors such as location of spill, spill amount, type of oil, etc. However, ships are designed for global trade, transporting different oil qualities. Therefore, globally applicable criteria must average over most of these factors, and the spill amount is the remaining factor that will be used to measure cost effectiveness against. A weighted, global average cleanup cost of USD 16,000/tonne of oil spilt has been calculated, considering the distribution of oil tanker traffic densities. Finally, the criteria are compared with some existing regulations for oil spill prevention, response and compensation (OPA 90)

  3. Smoldering multiple myeloma risk factors for progression

    DEFF Research Database (Denmark)

    Sørrig, Rasmus; Klausen, Tobias W; Salomo, Morten

    2016-01-01

    Several risk scores for disease progression in Smoldering Multiple Myeloma (SMM) patients have been proposed, however, all have been developed using single center registries. To examine risk factors for time to progression (TTP) to Multiple Myeloma (MM) for SMM we analyzed a nationwide population......-based cohort of 321 newly diagnosed SMM patients registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses. We found that both an M-protein ≥ 30g/l and immunoparesis significantly influenced......-high risk of transformation to MM. Using only immunoparesis and M-protein ≥ 30g/l, we created a scoring system to identify low, intermediate and high risk SMM. This first population-based study of SMM patients confirms that an M-protein ≥ 30g/l and immunoparesis remain important risk factors for progression...

  4. Occupational and Cost Risk : Critical Analysis of Monetization Policy Risk Approach to the Spanish Law Standards

    Directory of Open Access Journals (Sweden)

    Marco Antônio César Villatore

    2016-06-01

    Full Text Available The problem that surrounds the issue of occupational risk is a phenomenon that plagues every society, because the work is a central element and gives force to the economy. In this sense, the exposure of workers to harmful activities that may cause damage to your health and physical and mental integrity, based on the monetization policy of risk adopted by the Brazilian legal system, can import costs to the workers, employers, the state and society. Thus, the present study seeks, from the labor law analysis and the use of concepts of Economic Analysis of Law, attest that the social costs caused by worker exposure to risk is, fallaciously shown, in a short-term smaller than that of prevention, but in the long run can import the burden on all parties of the employment relationship as well as the State and society, being necessary to use economic and legal measures for changing the monetization of risk policy, as in alien systems, as the Spanish Law analyzed.

  5. Psychological Factors Linked to Risk Perception

    Science.gov (United States)

    Armaş, I.; Creãu, R. Z.; Stǎnciugelu, I.

    2012-04-01

    Risks are mental models, which allow people to cope with dangerous phenomena (Renn, 2008; Jasanoff, 1998). The term "risk" refers to the likelihood of an adverse effect resulting from an event. The aim of the present study is to identify the psychological factors that are most predictive of risk perception in relation with age, gender, educational level and socio-economical status. Earthquake hazard was considered, because it is an emerging danger for Bucharest. 80% of the laypeople sample are waiting for this event to happen in the next three years. By integrating all the research data, it was attempted to build a risk profile of the investigated population, which could be used by institutions responsible for earthquake risk mitigation situations in Bucharest. This research appealed to the social learning Rotter (1966), auto-effectiveness Bandura (1977; 1983), and anxiety and stress theories. We used psychological variables that measured stress, personal effectiveness and the belief in personal control. The multi-modal risk perception questionnaire was structured on a 49 items sequence. The sample was composed of 1.376 participants recruited on a voluntary basis. The characteristics of risk (like probability and magnitude, time scales) are perceived differently according to psychological factors that play a role also in biases in people's ability to draw inferences from probabilistic information (like cognitive dissonance). Since the 1970's, it has been argued that those who perceive life's events as being beyond their locus of control (external locus of control) are significantly more anxious and less adapted. In this research, strongest associations and significant differences were obtained between sex, age and income categories with Stress vulnerability factor and the External Locus of Control factor. The profile of the low risk perceiver is that of a young, more educated, male individual with a higher self- efficacy level and an internal locus of control.

  6. Risk factors identified for certain lymphoma subtypes

    Science.gov (United States)

    In a large international collaborative analysis of risk factors for non-Hodgkin lymphoma (NHL), scientists were able to quantify risk associated with medical history, lifestyle factors, family history of blood or lymph-borne cancers, and occupation for 11

  7. Biological risk factors for deep vein trombosis.

    Science.gov (United States)

    Vayá, Amparo; Mira, Yolanda; Martínez, Marcial; Villa, Piedad; Ferrando, Fernando; Estellés, Amparo; Corella, Dolores; Aznar, Justo

    2002-01-01

    Hypercoagulable states due either to inherited or acquired thrombotic risk factors are only present in approximately half of cases of DVT, but the causes in the other half, remain unknown. The importance of biological risk factors such as hyperlipidemia, hypofibrinolysis and hemorheological alterations in the pathogenesis of DVT has not been well established. In order to ascertain whether the above mentioned biological factors are associated with DVT and could constitute independent risk factors, we carried out a case-control study in 109 first DVT patients in whom inherited or acquired thrombophilic risk factors had been ruled out and 121 healthy controls age (42+/-15 years) and sex matched. From all the biological variables analyzed (cholesterol, triglycerides, glucose, fibrinogen, erythrocyte aggregation, hematocrit, plasma viscosity and PAI-1) only fibrinogen concentration reached a statistically significant difference on the comparison of means (290+/-73 mg/dl in cases vs 268+/-58 mg/dl in controls, p220 mg/dl, hematocrit >45% and fibrinogen >300 mg/dl was higher in cases than in controls: 38% vs 22%; p30 ng/ml, 37% vs 25% was borderline significant; p=0.055. Multivariate logistic regression analysis showed that cholesterolemia >220 mg/dl and fibrinogen >300 mg/dl constitute independent predictors of venous thrombotic risk. The adjusted OR's were 2.03 (95% CI; 1.12-3.70) for cholesterolemia and 1.94 (95% CI; 1.07-3.55) for fibrinogen. When these two variables combined DVT risk rose about fourfold (3.96; p<0.05). Our results suggest that hypercholesterolemia and hyperfibrinogenemia should be added to the list of known DVT risk factors and we recommend adopting measures to decrease these variables in the population with a high risk of DVT.

  8. Probabilistic cost-benefit analysis of disaster risk management in a development context.

    Science.gov (United States)

    Kull, Daniel; Mechler, Reinhard; Hochrainer-Stigler, Stefan

    2013-07-01

    Limited studies have shown that disaster risk management (DRM) can be cost-efficient in a development context. Cost-benefit analysis (CBA) is an evaluation tool to analyse economic efficiency. This research introduces quantitative, stochastic CBA frameworks and applies them in case studies of flood and drought risk reduction in India and Pakistan, while also incorporating projected climate change impacts. DRM interventions are shown to be economically efficient, with integrated approaches more cost-effective and robust than singular interventions. The paper highlights that CBA can be a useful tool if certain issues are considered properly, including: complexities in estimating risk; data dependency of results; negative effects of interventions; and distributional aspects. The design and process of CBA must take into account specific objectives, available information, resources, and the perceptions and needs of stakeholders as transparently as possible. Intervention design and uncertainties should be qualified through dialogue, indicating that process is as important as numerical results. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

  9. Does mitigation save? Reviewing cost-benefit analyses of disaster risk reduction

    OpenAIRE

    Shreve, Cheney M.; Kelman, Ilan

    2014-01-01

    The benefit-cost-ratio (BCR), used in cost-benefit analysis (CBA), is an indicator that attempts to summarize the overall value for money of a project. Disaster costs continue to rise and the demand has increased to demonstrate the economic benefit of disaster risk reduction (DRR) to policy makers. This study compiles and compares original CBA case studies reporting DRR BCRs, without restrictions as to hazard type, location, scale, or other parameters. Many results were identified supporting ...

  10. [Risk factors found in suicide attempters].

    Science.gov (United States)

    Villa-Manzano, Alberto Iram; Robles-Romero, Miguel Angel; Gutiérrez-Román, Elsa Armida; Martínez-Arriaga, María Guadalupe; Valadez-Toscano, Francisco Javier; Cabrera-Pivaral, Carlos E

    2009-01-01

    A better understanding of risk factors for suicide in general population is crucial for the design of suicide prevention programs. Our objective was to identify personal and family risk factors in suicide attempters. Case-control design. We searched in patients with an acute intoxication, those subjects with and intoxication attributable to suicide attempt. These patients were matched with controls by gender and the date of intoxication. We use a structured questionnaire to identify personal characteristics, family features and network support. Odds ratio (OR) and 95 % confidence interval were obtained. 25 cases and 25 controls were evaluated. The risk factors associated with suicide attempt adjusted by age, were being a student and smoking habits. Family violence background showed OR = 3.8 (IC 95 % = 1.1-13), family disintegration a OR = 8.5 (IC 95 % = 2.1-35), critical events background OR = 8.8 (IC 95 % = 2.1-36), poor self-esteem OR = 8.2 (IC 95 % 2-35), depression OR = 22 (IC 95 % = 3-190), anxiety OR = 9 (IC 95 % = 2-47), family dysfunction OR = 25 (IC 95 % = 4-151). The principal risk factor for suicide attempt was family dysfunction and psychological traits.

  11. A Sustainable Outsourcing Strategy Regarding Cost, Capacity Flexibility, and Risk in a Textile Supply Chain

    Directory of Open Access Journals (Sweden)

    Shaheen Sardar

    2016-03-01

    Full Text Available The textile industry achieves economic benefits through outsourcing to low cost markets. Today, reshoring is an emerging trend due to rising cost and unemployment concerns. This problem is primarily due to an industry-wide focus on economic benefits only. Cost saving is a basic reason for international outsourcing while domestic outsourcing provides capacity flexibility. Moreover, outsourcing risk has a major impact on strategic location of the production destinations. Therefore, the merging of capacity flexibility and outsourcing risk comprises a sustainable outsourcing strategy. This paper suggests a sustainable outsourcing strategy in which a textile manufacturer outsources to international markets for cost savings and outsources to the domestic market for capacity flexibility. The manufacturer reserves some capacity with domestic suppliers, and pays a unit penalty cost if this capacity flexibility is not utilized. The manufacturer seeks minimum risk in international markets. Operational cost, penalty cost, and outsourcing risk are considered to be objective functions. Decisions include the assignment of contracts to suitable facilities, the quantity of each contract, and allocation of reserved capacity flexibility among domestic suppliers. Multi-objective problem of this research was solved using three variants of goal programming. Several insights are proposed for outsourcing decision making in the current global environment.

  12. FACTORS AFFECTING COST PERFORMANCE IN CONSTRUCTION PROJECTS WITHIN KELANTAN STATE IN MALAYSIA

    OpenAIRE

    ABDELNASER OMRAN; SITI NORHYDAYATON BINTI MAMAT

    2011-01-01

    This study investigates the factors affecting cost performance of construction projects in Kelantan State located in the east-coast part of Malaysia. It draws on relevant previous research in the theory of work on cost performance. Thirty-three contractors companies with different working grades in the state of Kelantan were participated in the study. Data were collected from the contractors using a questionnaire survey. The results indicated that the success factors affecting the cost perfor...

  13. Risk Factors in ERP Implementation Projects for Process Oriented

    Directory of Open Access Journals (Sweden)

    Andrzej Partyka

    2009-09-01

    Full Text Available This paper present review and analysis of risk factors, which could affect successful implementation of ERP system, for project performed in project oriented organizations. Presented risk breakdown structure and the list of common risk factors, are well-suited for ERP implementation projects. Considered risk categories allow for complex risk analysis. Additionally, mapping of risk importance for particular implementation phases is presented. Making presented model an important input for project risk management process, especially for the beginning phases which require identification of risk factors.

  14. Risk factors for post-tonsillectomy hemorrhage.

    Science.gov (United States)

    Ikoma, Ryo; Sakane, Sayaka; Niwa, Kazutomo; Kanetaka, Sayaka; Kawano, Toshiro; Oridate, Nobuhiko

    2014-08-01

    The aim of the present study was to investigate the rate of post-tonsillectomy hemorrhage (PTH) in a single institution and to evaluate the clinical risk factors for PTH. We reviewed the records of 692 patients who underwent tonsillectomy (TE) at Yokohama Minami Kyosai Hospital in Japan. PTH grades were grouped into three categories according to the severity of the hemorrhagic episode: (I) minimal hemorrhage that stopped after noninvasive treatment, (II) hemorrhage requiring treatment with local anesthesia, and (III) hemorrhage requiring reoperation under general anesthesia in the operating room. Clinical risk factors such as sex, age (adults vs. children), TE indication, surgeon's skill level, operative time, ligature type, and duration of antibiotic administration for PTH were investigated. Among the 692 patients, 80 (11.6%) showed PTH, with primary and secondary hemorrhage accounting for 1.6% and 10.0%, respectively. A category III PTH was observed in 18 patients; thus, the overall risk of reoperation was 2.6%. The PTH episode most frequently occurred on postoperative days 5 and 6. The frequency of PTH was significantly higher in male patients and in adults (Pdefinition of PTH. Clinical risk factors for PTH were adult age and male gender. The surgeon's skill level was an additional risk factor for category III PTH. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  15. Prioritization of Delay Factors for NPP Construction Risk in International Project by Using AHP Methodology

    Energy Technology Data Exchange (ETDEWEB)

    Hossen, Muhammed Mufazzal; Kang, Sunkoo; Kim, Jonghyun [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2014-10-15

    It is crucial for the nuclear power plant project decision makers and management personnel to identify the actual factors of construction delay and their ranking in order to take preventive actions. NPP project is complex in nature and the construction phase is one of the most key phase which is subject to many factors result from many sources. From experience, nuclear projects have faced challenges similar to other complex mega projects with additional nuclear specific issues and life time cost of nuclear reactor is concentrated upfront as capital cost, and therefore delays in construction may become intolerable in terms of both lost revenues and interest on the capital. Budget over-runs and delays on next generation new build nuclear projects in recent years clearly demonstrate that the nuclear industry continues to repeat its failed management and project control processes of the past. Similar to major infra-structure projects, actual completion times can vary substantially from initial estimates but this uncertainty is too crucial to the nuclear industry due to high levels of capital at risk, for every year a project is delayed the levelized cost of electricity increases by approximately 8-10%. causes of delay, to develop a generalized AHP model for delay factors, and to prioritize the risk in different factors in various levels of construction phase in international turnkey NPP project. This paper describes and prioritizes Nuclear Power Plant (NPP) construction schedule delay factor for turnkey international project. This study also determines the different party's importance in percentage behind the construction schedule delay of NPP which constitutes main contractor (28.4%), regulatory authority (27.3%), financial and country factor (23.5%), and utility (20.8%). Decision makers of nuclear industry can understand the significance of different factors on NPP construction phase and they can apply risk informed decision making to avoid unexpected

  16. Prioritization of Delay Factors for NPP Construction Risk in International Project by Using AHP Methodology

    International Nuclear Information System (INIS)

    Hossen, Muhammed Mufazzal; Kang, Sunkoo; Kim, Jonghyun

    2014-01-01

    It is crucial for the nuclear power plant project decision makers and management personnel to identify the actual factors of construction delay and their ranking in order to take preventive actions. NPP project is complex in nature and the construction phase is one of the most key phase which is subject to many factors result from many sources. From experience, nuclear projects have faced challenges similar to other complex mega projects with additional nuclear specific issues and life time cost of nuclear reactor is concentrated upfront as capital cost, and therefore delays in construction may become intolerable in terms of both lost revenues and interest on the capital. Budget over-runs and delays on next generation new build nuclear projects in recent years clearly demonstrate that the nuclear industry continues to repeat its failed management and project control processes of the past. Similar to major infra-structure projects, actual completion times can vary substantially from initial estimates but this uncertainty is too crucial to the nuclear industry due to high levels of capital at risk, for every year a project is delayed the levelized cost of electricity increases by approximately 8-10%. causes of delay, to develop a generalized AHP model for delay factors, and to prioritize the risk in different factors in various levels of construction phase in international turnkey NPP project. This paper describes and prioritizes Nuclear Power Plant (NPP) construction schedule delay factor for turnkey international project. This study also determines the different party's importance in percentage behind the construction schedule delay of NPP which constitutes main contractor (28.4%), regulatory authority (27.3%), financial and country factor (23.5%), and utility (20.8%). Decision makers of nuclear industry can understand the significance of different factors on NPP construction phase and they can apply risk informed decision making to avoid unexpected

  17. TEPCO's costs and risks which invited the nuclear power plant accident

    International Nuclear Information System (INIS)

    Soeda, Takashi

    2017-01-01

    The National Diet of Japan Fukushima Nuclear Accident Independent Investigation Commission (Diet Accident Investigation Commission) considered two patterns against the tsunami risk of nuclear plant: (1) Risk management for the purpose of safety (Pattern A), and (2) Risk management for the purpose of utilization rate and cost of nuclear reactor (Pattern B). Pattern B emphasizes avoiding 'countermeasure cost generation' and 'operation shutdown' rather than preparing for a tsunami that we do not know when to come. Diet Accident Investigation Commission analyzed that the behavioral principles concerning the crisis response of Tokyo Electric Power Company (TEPCO) had the stronger tendency of Pattern B. Regarding the accident of TEPCO, there were class actions that asked the responsibility of TEPCO and the government. This paper examined the contents of the opinions of government-side experts submitted for this issue. The government-side experts argued that there was no 'scientific consensus' for tsunami forecast, and that preliminary measures against unexpected tsunami was impossible. However, both of these government's arguments are irrational due to difference from the fact. TEPCO president at the time of accident insisted in the firm that 'cost cut in another dimension' was indispensable and reduced expenses. TEPCO and the government had continued Pattern B, even knowing that tsunami risk measures were insufficient from more than ten years ago. (A.O.)

  18. Costs of fear: Behavioral and life-history responses to risk and their demographic consequences vary across species

    Science.gov (United States)

    LaManna, Joseph A.; Martin, Thomas E.

    2016-01-01

    Behavioural responses to reduce predation risk might cause demographic ‘costs of fear’. Costs differ among species, but a conceptual framework to understand this variation is lacking. We use a life-history framework to tie together diverse traits and life stages to better understand interspecific variation in responses and costs. We used natural and experimental variation in predation risk to test phenotypic responses and associated demographic costs for 10 songbird species. Responses such as increased parental attentiveness yielded reduced development time and created benefits such as reduced predation probability. Yet, responses to increased risk also created demographic costs by reducing offspring production in the absence of direct predation. This cost of fear varied widely across species, but predictably with the probability of repeat breeding. Use of a life-history framework can aid our understanding of potential demographic costs from predation, both from responses to perceived risk and from direct predation mortality.

  19. Risk factors for cataract: A case control study

    Directory of Open Access Journals (Sweden)

    Ughade Suresh

    1998-01-01

    Full Text Available The present study was designed as a hospital-based, group-matched, case-control investigation into the risk factors associated with age-related cataract in central India. The study included 262 cases of age-related cataract and an equal number of controls. A total of 21 risk factors were evaluated: namely, low socioeconomic status (SES, illiteracy, marital status, history of diarrhoea, history of diabetes, glaucoma, use of cholinesterase inhibitors, steroids, spironolactone, nifedipine, analgesics, myopia early in life, renal failure, heavy smoking, heavy alcohol consumption, hypertension, low body mass index (BMI, use of cheaper cooking fuel, working in direct sunlight, family history of cataract, and occupational exposure. In univariate analysis, except marital status, low BMI, renal failure, use of steroids, spironolactone, analgesics, and occupational exposure, all 14 other risk factors were found significantly associated with age-related cataract. Unconditional multiple logistic regression analysis confirmed the significance of low SES, illiteracy, history of diarrhoea, diabetes, glaucoma, myopia, smoking, hypertension and cheap cooking fuel. The etiological role of these risk factors in the outcome of cataract is confirmed by the estimates of attributable risk proportion. The estimates of population attributable risk proportion for these factors highlight the impact of elimination of these risk factors on the reduction of cataract in this population.

  20. Cardiovascular risk factors and collateral artery formation.

    Science.gov (United States)

    de Groot, D; Pasterkamp, G; Hoefer, I E

    2009-12-01

    Arterial lumen narrowing and vascular occlusion is the actual cause of morbidity and mortality in atherosclerotic disease. Collateral artery formation (arteriogenesis) refers to an active remodelling of non-functional vascular anastomoses to functional collateral arteries, capable to bypass the site of obstruction and preserve the tissue that is jeopardized by ischaemia. Hemodynamic forces such as shear stress and wall stress play a pivotal role in collateral artery formation, accompanied by the expression of various cytokines and invasion of circulating leucocytes. Arteriogenesis hence represents an important compensatory mechanism for atherosclerotic vessel occlusion. As arteriogenesis mostly occurs when lumen narrowing by atherosclerotic plaques takes place, presence of cardiovascular risk factors (e.g. hypertension, hypercholesterolaemia and diabetes) is highly likely. Risk factors for atherosclerotic disease affect collateral artery growth directly and indirectly by altering hemodynamic forces or influencing cellular function and proliferation. Adequate collateralization varies significantly among atherosclerotic patients, some profit from the presence of extensive collateral networks, whereas others do not. Cardiovascular risk factors could increase the risk of adverse cardiovascular events in certain patients because of the reduced protection through an alternative vascular network. Likewise, drugs primarily thought to control cardiovascular risk factors might contribute or counteract collateral artery growth. This review summarizes current knowledge on the influence of cardiovascular risk factors and the effects of cardiovascular medication on the development of collateral vessels in experimental and clinical studies.

  1. Occupational risk factors and voice disorders.

    Science.gov (United States)

    Vilkman, E

    1996-01-01

    From the point of view of occupational health, the field of voice disorders is very poorly developed as compared, for instance, to the prevention and diagnostics of occupational hearing disorders. In fact, voice disorders have not even been recognized in the field of occupational medicine. Hence, it is obviously very rare in most countries that the voice disorder of a professional voice user, e.g. a teacher, a singer or an actor, is accepted as an occupational disease by insurance companies. However, occupational voice problems do not lack significance from the point of view of the patient. We also know from questionnaires and clinical studies that voice complaints are very common. Another example of job-related health problems, which has proved more successful in terms of its occupational health status, is the repetition strain injury of the elbow, i.e. the "tennis elbow". Its textbook definition could be used as such to describe an occupational voice disorder ("dysphonia professional is"). In the present paper the effects of such risk factors as vocal loading itself, background noise and room acoustics and low relative humidity of the air are discussed. Due to individual factors underlying the development of professional voice disorders, recommendations rather than regulations are called for. There are many simple and even relatively low-cost methods available for the prevention of vocal problems as well as for supporting rehabilitation.

  2. Risk Factors for Depression : Differential Across Age?

    NARCIS (Netherlands)

    Schaakxs, Roxanne; Comijs, Hannie C; van der Mast, Roos C; Schoevers, Robert A; Beekman, Aartjan T F; Penninx, Brenda W J H

    INTRODUCTION: The occurrence of well-established risk factors for depression differs across the lifespan. Risk factors may be more strongly associated with depression at ages when occurrence, and therefore expectance, is relatively low ("on-time off-time" hypothesis). This large-scale study examined

  3. Exploring Risk Factors for Follicular Lymphoma

    Directory of Open Access Journals (Sweden)

    Alexander J. Ambinder

    2012-01-01

    Full Text Available Follicular lymphoma (FL is an indolent malignancy of germinal center B cells with varied incidence across racial groups and geographic regions. Improvements in the classification of non-Hodgkin lymphoma subtypes provide an opportunity to explore associations between environmental exposures and FL incidence. Our paper found that aspects of Western lifestyle including sedentary lifestyle, obesity, and diets high in meat and milk are associated with an increased risk of FL. Diets rich in fruits and vegetables, polyunsaturated fatty acids, vitamin D, and certain antioxidants are inversely associated with FL risk. A medical history of Sjogren's syndrome, influenza vaccination, and heart disease may be associated with FL incidence. Associations between FL and exposure to pesticides, industrial solvents, hair dyes, and alcohol/tobacco were inconsistent. Genetic risk factors include variants at the 6p21.32 region of the MHC II locus, polymorphisms of the DNA repair gene XRCC3, and UV exposure in individuals with certain polymorphisms of the vitamin D receptor. Increasing our understanding of risk factors for FL must involve integrating epidemiological studies of genetics and exposures to allow for the examination of risk factors and interactions between genes and environment.

  4. Debt as a Criminal Risk Factor in Denmark

    Directory of Open Access Journals (Sweden)

    Annette Olesen

    2016-09-01

    Full Text Available Existing studies of crime preventive factors have illustrated that ex-prisoners who began a course of education, obtained employment and/or had permanent housing were less likely to relapse into crime. However, this study shows that the aforementioned crime preventing factors became less effective due to the ex-prisoners’ debt. Those convicted in Denmark are personally liable for their own legal costs. Thus, we must regard most ex-prisoners as being highly indebted to the state. The debt of ex-prisoners was generally understood as being the cause of financial problems, but legal regulation and informal punishment, as unintended consequences of indebtedness, were still poorly explored. This research indicates that legal regulation and informal punishment based on indebtedness may serve as an argument for considering debt as a criminal risk factor which has made the preventive factors less effective and has driven ex-prisoners farther from legitimate socio-economic advantaged affiliations and invited criminal behaviour.Estudios existentes sobre factores de prevención de delitos pusieron de manifiesto que era menos probable que los ex presos que iniciaron un curso de educación, consiguieron un empleo y/o tenían una vivienda permanente, recayeran en la delincuencia. Sin embargo, este estudio demuestra que los factores de prevención de delitos anteriormente mencionados resultan menos efectivos debido a la deuda de los ex prisioneros. En Dinamarca, los condenados deben hacerse cargo de sus propios costes legales. Por lo tanto, debemos considerar que la mayoría de los ex presos han contraído una alta deuda con el Estado. Generalmente, se entendía que la deuda de los ex prisioneros era causa de problemas financieros, pero había pocos estudios sobre la regulación legal y el castigo informal, como consecuencias no intencionadas del endeudamiento. Esta investigación indica que la regulación legal y el castigo informal basado en el

  5. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

    Science.gov (United States)

    2011-01-01

    Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92%) used an observational design and focused on women (70%) with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups) and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although evolving, is still

  6. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Tilburt Jon C

    2011-05-01

    Full Text Available Abstract Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92% used an observational design and focused on women (70% with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although

  7. Supply risk management from a transaction cost and social exchange theory perspective

    NARCIS (Netherlands)

    Hoffmann, Petra; Schiele, Holger; Song, Michael; Krabbendam, Johannes Jacobus

    2012-01-01

    Supply risk management gained prominence over the last decade, both in the academic discourse and in practical application. This research examines the influence of Transaction Cost characteristics -behavioral uncertainty, environmental uncertainty and asset specificity on supply risk management

  8. EAMJ Risk Factors 10.indd

    African Journals Online (AJOL)

    2010-02-02

    Feb 2, 2010 ... Several factors have been suggested as independent risk factors for their development. Identification of these ... with age, gender or haematological test. ... A meta-analysis of prospective studies on ..... The marked difference may be because monthly .... and dyslipidemia among patients taking first-line,.

  9. Analysis of benefits, opportunities, costs, and risks (BOCR) with the AHP+ANP : A critical validation

    NARCIS (Netherlands)

    Wijnmalen, D.J.D.

    2007-01-01

    This paper shows that the usual multiplicative synthesis of alternative priorities for benefits, opportunities, costs and risks, obtained from separate Analytic Hierarchy or Network models, can be ambiguous. The ratio of benefit and opportunity priorities to cost and risk priorities can be

  10. The relationship between cardiovascular risk factors and knowledge ...

    African Journals Online (AJOL)

    Adele Burger

    CV risk profile of the group according to the risk score system developed by the ... an individual has about CVD, and the possible risk factors contributing to the .... levels in the lowest tertile of CVD knowledge versus the highest tertile of CVD ..... CV risk factors and health behavior counseling, much can be done to prevent ...

  11. Risk factors for the development of pneumonia in acute psychotropic drugs poisoning

    Directory of Open Access Journals (Sweden)

    Vučinić Slavica

    2005-01-01

    Full Text Available Background/Aim. Pneumonia is the most frequent complication in acute psychotropic drugs poisoning, which results in substantial morbidity and mortality, but which also increases the costs of treatment. Risk factors for pneumonia are numerous: age, sex, place of the appearance of pneumonia, severity of underlying disease, airway instrumentation (intubation, reintubation, etc. The incidence of pneumonia varies in poisoning caused by the various groups of drugs. The aim of this study was to determine the incidence and risk factors for pneumonia in the patients with acute psychotropic drugs poisoning. Methods. A group of 782 patients, out of which 614 (78.5% with psychotropic and 168 (21.5% nonpsychotropic drug poisoning were analyzed prospectively during a two-year period. The diagnosis of pneumonia was made according to: clinical presentation, new and persistent pulmonary infiltrates on chest radiography, positive nonspecific parameters of inflammation, and the microbiological confirmation of causative microorganisms. To analyze predisposing risk factors for pneumonia, the following variables were recorded: sex, age, underlying diseases, endotracheal intubation, coma, severity of poisoning with different drugs, histamine H2 blockers, corticosteroids, mechanical ventilation, central venous catheter. The univariate analysis for pneumonia risk factors in all patients, and for each group separately was done. The multivariate analysis was performed using the logistic regression technique. Results. Pneumonia was found in 94 (12.02% of the patients, 86 of which (91.5% in psychotropic and 8 (8.5% in nonpsychotropic drug poisoning. In the psychotropic drug group, pneumonia was the most frequent in antidepressant (47%, and the rarest in benzodiazepine poisoning (3.8%. A statistically significant incidence of pneumonia was found in the patients with acute antidpressant poisoning (p < 0.001. Univariate analysis showed statistical significance for the

  12. Predictive risk factors for persistent postherniotomy pain

    DEFF Research Database (Denmark)

    Aasvang, Eske K; Gmaehle, Eliza; Hansen, Jeanette B

    2010-01-01

    BACKGROUND: Persistent postherniotomy pain (PPP) affects everyday activities in 5-10% of patients. Identification of predisposing factors may help to identify the risk groups and guide anesthetic or surgical procedures in reducing risk for PPP. METHODS: A prospective study was conducted in 464...... patients undergoing open or laparoscopic transabdominal preperitoneal elective groin hernia repair. Primary outcome was identification of risk factors for substantial pain-related functional impairment at 6 months postoperatively assessed by the validated Activity Assessment Scale (AAS). Data on potential...... risk factors for PPP were collected preoperatively (pain from the groin hernia, preoperative AAS score, pain from other body regions, and psychometric assessment). Pain scores were collected on days 7 and 30 postoperatively. Sensory functions including pain response to tonic heat stimulation were...

  13. Risk Based Milk Pricing Model at Dairy Farmers Level

    Directory of Open Access Journals (Sweden)

    W. Septiani

    2017-12-01

    Full Text Available The milk price from a cooperative institution to farmer does not fully cover the production cost. Though, dairy farmers encounter various risks and uncertainties in conducting their business. The highest risk in milk supply lies in the activities at the farm. This study was designed to formulate a model for calculating milk price at farmer’s level based on risk. Risks that occur on farms include the risk of cow breeding, sanitation, health care, cattle feed management, milking and milk sales. This research used the location of the farm in West Java region. There were five main stages in the preparation of this model, (1 identification and analysis of influential factors, (2 development of a conceptual model, (3 structural analysis and the amount of production costs, (4 model calculation of production cost with risk factors, and (5 risk based milk pricing model. This research built a relationship between risks on smallholder dairy farms with the production costs to be incurred by the farmers. It was also obtained the formulation of risk adjustment factor calculation for the variable costs of production in dairy cattle farm. The difference in production costs with risk and the total production cost without risk was about 8% to 10%. It could be concluded that the basic price of milk proposed based on the research was around IDR 4,250-IDR 4,350/L for 3 to 4 cows ownership. Increasing farmer income was expected to be obtained by entering the value of this risk in the calculation of production costs

  14. Data collection on risk factors in pregnancy

    NARCIS (Netherlands)

    Zetstra-van der Woude, Alethea Priscilla

    2016-01-01

    This thesis aims to investigate the different methods of data collection of risk factors in pregnancy. Several observational epidemiologic study designs were used to assess associations between risk factors and negative birth outcomes. We especially looked at the use of folic acid around pregnancy

  15. Quantitative influence of risk factors on blood glucose level.

    Science.gov (United States)

    Chen, Songjing; Luo, Senlin; Pan, Limin; Zhang, Tiemei; Han, Longfei; Zhao, Haixiu

    2014-01-01

    The aim of this study is to quantitatively analyze the influence of risk factors on the blood glucose level, and to provide theory basis for understanding the characteristics of blood glucose change and confirming the intervention index for type 2 diabetes. The quantitative method is proposed to analyze the influence of risk factors on blood glucose using back propagation (BP) neural network. Ten risk factors are screened first. Then the cohort is divided into nine groups by gender and age. According to the minimum error principle, nine BP models are trained respectively. The quantitative values of the influence of different risk factors on the blood glucose change can be obtained by sensitivity calculation. The experiment results indicate that weight is the leading cause of blood glucose change (0.2449). The second factors are cholesterol, age and triglyceride. The total ratio of these four factors reaches to 77% of the nine screened risk factors. And the sensitivity sequences can provide judgment method for individual intervention. This method can be applied to risk factors quantitative analysis of other diseases and potentially used for clinical practitioners to identify high risk populations for type 2 diabetes as well as other disease.

  16. Preliminary assessment of costs and risks of transporting spent fuel by barge

    International Nuclear Information System (INIS)

    Tobin, R.L.; Meshkov, N.K.; Jones, R.H.

    1985-12-01

    The purpose of this study is to analyze the costs and risks associated with transporting spent fuel by barge. The barge movements would be made in combination with rail movements to transport spent fuel from plants to a repository. For the purpose of this analysis, three candidate repository sites are analyzed: Yucca Mountain, Nevada, Deaf Smith, Texas, and Hanford, Washington. This report complements a report prepared by Sandia National Laboratories in 1984 that analyzes the costs and risks of transporting spent fuel by rail and by truck to nine candidate repository sites

  17. LMFBR safety criteria: cost-benefit considerations under the constraint of an a priori risk criterion

    International Nuclear Information System (INIS)

    Hartung, J.

    1979-01-01

    The role of cost-benefit considerations and a priori risk criteria as determinants of Core Disruptive Accident (CDA)-related safety criteria for large LMFBR's is explored with the aid of quantitative risk and probabilistic analysis methods. A methodology is described which allows a large number of design and siting alternatives to be traded off against each other with the goal of minimizing energy generation costs subject to the constraint of both an a priori risk criterion and a cost-benefit criterion. Application of this methodology to a specific LMFBR design project is described and the results are discussed. 5 refs

  18. Review on risk factors related to lower back disorders at workplace

    Science.gov (United States)

    A' Tifah Jaffar, Nur; Nasrull Abdol Rahman, Mohd

    2017-08-01

    This review examines the evidence of the occurrence of risk exposure on work-related lower back disorders in the workplace. This review also investigates potential interactions between the risk factors in the workplace which include heavy physical work risk factor, static work postures risk factor, frequent bending and twisting risk factor, lifting risk factor, pushing and pulling risk factor, repetitive work risk factor, vibration risk factor, psychological and psychosocial risk factor that may be associated with symptoms of musculoskeletal disorders of lower back. These risk factors can reinforce each other and their influence can also be mediated by cultural or social factors. A systematic review of the literature was carried out by searching using databases and the searching strategy was used combined keyword for risk factors, work-related lower back disorders, heavy physical work, static work postures, frequent bending and twisting, lifting, pushing and pulling, repetitive work, vibration, psychological and psychosocial risk factor. A total of 67 articles were identified and reviewed. The risk factors identified that related for low back disorder are seven which are heavy physical work, static work postures, frequent bending and twisting, lifting, pushing and pulling, repetitive work, vibration, psychological and psychosocial risk factor and the level of evidence supporting the relationship with lower back disorders also described such as strong, moderate, insufficient, limited and no evidence. This result confirms that, existing of higher physical and psychosocial demand related to reported risk factors of low back disorders. The result also showed that previous reviews had evaluated relationship between risk factors of low back disorders and specific types of musculoskeletal disorders. This review also highlights the scarves evidence regarding some of the frequently reported risk factors for work related lower back disorders.

  19. Hip protector compliance: a 13-month study on factors and cost in a long-term care facility.

    Science.gov (United States)

    Burl, Jeffrey B; Centola, James; Bonner, Alice; Burque, Colleen

    2003-01-01

    To determine if a high compliance rate for wearing external hip protectors could be achieved and sustained in a long-term care population. A 13-month prospective study of daytime use of external hip protectors in an at-risk long-term care population. One hundred-bed not-for-profit long-term care facility. Thirty-eight ambulatory residents having at least 1 of 4 risk factors (osteoporosis, recent fall, positive fall screen, previous fracture). The rehabilitation department coordinated an implementation program. Members of the rehabilitation team met with eligible participants, primary caregivers, families, and other support staff for educational instruction and a description of the program. The rehabilitation team assumed overall responsibility for measuring and ordering hip protectors and monitoring compliance. By the end of the third month, hip protector compliance averaged greater than 90% daily wear. The average number of falls per month in the hip protector group was 3.9 versus 1.3 in nonparticipants. Estimated total indirect staff time was 7.75 hours. The total cost of the study (hip protectors and indirect staff time) was 6,300 US dollars. High hip protector compliance is both feasible and sustainable in an at-risk long-term care population. Achieving high compliance requires an interdisciplinary approach with one department acting as a champion. The cost of protectors could be a barrier to widespread use. Facilities might be unable to cover the cost until the product is paid for by third-party payers.

  20. Use of low density lipoprotein particle number levels as an aid in statin treatment decisions for intermediate risk patients: a cost-effectiveness analysis.

    Science.gov (United States)

    Shiffman, Dov; Arellano, Andre R; Caulfield, Michael P; Louie, Judy Z; Bare, Lance A; Devlin, James J; Melander, Olle

    2016-12-07

    The 2013 ACC/AHA guideline recommended either no statin therapy or moderate-intensity statin therapy (MST) for intermediate risk patients-those with 5-7.5% 10-year risk and without cardiovascular disease (CVD), hypercholesterolemia or diabetes. The guideline further suggested that the therapy choice be based on patient-clinician discussions of risks and benefits. Since low-density lipoprotein particle (LDL-P) levels were reported to be associated with CVD independently of traditional risk factors in intermediate and low risk patients, we investigated the cost-effectiveness of using LDL-P levels to identify intermediate risk patients likely to benefit from initiating or intensifying statin therapy. We evaluated 5 care strategies for intermediate risk patients. These included the strategies suggested by the guideline: no-statin therapy and MST. We compared each of these strategies to a related strategy that incorporated LDL-P testing. No-statin therapy was compared with the strategy of MST for those with high LDL-P levels and no statin therapy for all other patients (test-and-MST). MST was compared with the strategy of high-intensity statin therapy (HST) for those with high LDL-P levels and MST for all other patients (test-and-HST). We also evaluated the strategy of HST for all. Costs (payer perspective) and utilities were assessed over a 5-year time horizon in a Markov model of 100,000 hypothetical intermediate risk patients. HST dominated all other strategies, costing less and-despite causing 739 more cases of diabetes than did MST-resulting in more quality adjusted life-years (QALYs). For patient-clinician discussions that would otherwise lead to the MST strategy, we found the test-and-HST strategy reduced costs by $4.67 MM and resulted in 134 fewer CVD events and 115 additional QALYs. For patient-clinician discussions that would otherwise lead to no statin therapy, we found that the test-and-MST strategy reduced costs by $3.25 MM, resulted in 97 fewer CVD events

  1. Cost effectiveness of withdrawal of fall-risk-increasing drugs in geriatric outpatients

    NARCIS (Netherlands)

    van der Velde, Nathalie; Meerding, Willen Jan; Looman, Caspar W.; Pols, Huibert A. P.; van der Cammen, Tischa J. M.

    2008-01-01

    BACKGROUND: Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. METHOD: Within a common geriatric outpatient

  2. [Hepatitis caused by virus C. Risk factors].

    Science.gov (United States)

    Garassini, M E; Pulgar, Y; Alvarado, M; Garassini, M A

    1995-01-01

    To establish the risk factors to hepatitis C virus (HCV) infection, we studied 120 patients divided in 2 groups: A first group of 40 patients with HCV infection, 24 (60%) with past medical history of blood transfusion, 14 (35%) of them also had hemodialysis and 3 Kidney transplant. 10 patients (25%) had mayor surgery without transfusion, 3 had frequent visits to the dentist and 3 month baby whose mother was HCV positive. In 4 patients we found no risk factors. A second group of 80 patients who visit our clinic for the first time, 2 were found positive for HCV (1.6%). 13 of them had blood transfusion, one was HCV+ (OR: 5.5, P = 0.73). 41 had history of mayor surgery, one HCV+ (OR: 0.95, P = 1.000). The risk factors related to HCV infection in our population were blood transfusion, hemodialysis and mayor surgery. The use of EV drugs, tatoos, sexual behavior, interfamiliar or vertical transmission were not risk factor in our population.

  3. 523 factors influencing direct costs dynamics of building projects

    African Journals Online (AJOL)

    Osondu

    2013-08-16

    Aug 16, 2013 ... effect of the direct cost variation factors (p-values between 0.365 and 0.930). Construction, resources, and performance factors are the most significant of the groups (MS range = 3.66 to 4.33), though no .... financial control on site ranked first and second ... order according to the consultants were, inflation.

  4. The urban risk and migration risk factors for schizophrenia: are cats the answer?

    Science.gov (United States)

    Torrey, E Fuller; Yolken, Robert H

    2014-11-01

    Being born in and/or raised in an urban area is a proven risk factor for developing schizophrenia. Migrating from countries such as Jamaica or Morocco to countries such as England or the Netherlands is also a proven risk factor for developing schizophrenia. The transmission of Toxoplasma gondii oocysts to children is reviewed and proposed as a partial explanation for both of these risk factors. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. The role of classic risk factors and prothrombotic factor gene mutations in ischemic stroke risk development in young and middle-aged individuals.

    Science.gov (United States)

    Supanc, Visnja; Sonicki, Zdenko; Vukasovic, Ines; Solter, Vesna V; Zavoreo, Iris; Kes, Vanja B

    2014-03-01

    In young individuals, a genetically predisposing hypercoagulability and classic modifying risk factors can act synergistically on the ischemic stroke risk development. The aim of the study was to compare the prevalence of classic vascular risk factors and polymorphisms of the G20210A coagulation factor II (prothrombin), Arg506Glu coagulation factor V Leiden, C677T methylenetetrahydrofolate reductase (MTHFR), and 4G/5G plasminogen activator inhibitor-1 (PAI-1) and the impact of these gene mutations and classic vascular risk factors on the overall stroke risk in individuals aged 55 years or younger. The study included 155 stroke patients aged 55 years or younger and 150 control subjects. Stroke prevalence and odds ratio (OR) were assessed for the following parameters: G20210A prothrombin, Arg506Glu factor V Leiden, C677T MTHFR, and 4G/5G PAI-1 polymorphisms; total number of study polymorphisms in a particular subject (genetic sum); and classic vascular risk factors of hypertension, obesity, diabetes mellitus, cigarette smoking, hypercholesterolemia, hypertriglyceridemia, and elevated levels of low-density lipoprotein (LDL) cholesterol and very low-density lipoprotein cholesterol. The prevalence of hypertension (P stroke patients. The following parameters were found to act as independent risk factors for ischemic stroke: decreased HDL cholesterol level (P ischemic stroke in young and middle-aged individuals. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. Falling and fall risk factors in adults with haemophilia: an exploratory study.

    Science.gov (United States)

    Sammels, M; Vandesande, J; Vlaeyen, E; Peerlinck, K; Milisen, K

    2014-11-01

    Falls are a particular risk in persons with haemophilia (PWH) because of damaged joints, high risk of bleeding, possible impact on the musculoskeletal system and functioning and costs associated with treatment for these fall-related injuries. In addition, fall risk increases with age and PWH are increasingly entering the over 65 age group. The aim of this study was to determine the occurrence of falls during the past year and to explore which fall risk factors are present in community-dwelling PWH. Dutch speaking community-dwelling adults were included from the age of 40 years with severe or moderate haemophilia A or B, independent in their mobility and registered at the University Hospitals Leuven. They were asked to come to the haemophilia centre; otherwise a telephone survey was conducted. Demographic and social variables, medical variables, fall evaluation and clinical variables were queried. From the 89 PWH, 74 (83.1%) participated in the study. Twenty-four (32.4%) fell in the past year, and 10 of them (41.7%) more than once with an average of four falls. Living conditions, physical activity, avoidance of winter sports due to fear of falling, orthopaedic status, urinary incontinence and mobility impairments are potential fall risk factors in adult PWH. This exploratory study indicates that PWH are attentive to falling since they are at higher risk for falls and because of the serious consequences it might have. Screening and fall prevention should be stimulated in the daily practice of haemophilia care. © 2014 John Wiley & Sons Ltd.

  7. Urban seismic risk assessment: statistical repair cost data and probable structural losses based on damage scenario—correlation analysis

    Science.gov (United States)

    Eleftheriadou, Anastasia K.; Baltzopoulou, Aikaterini D.; Karabinis, Athanasios I.

    2016-06-01

    The current seismic risk assessment is based on two discrete approaches, actual and probable, validating afterwards the produced results. In the first part of this research, the seismic risk is evaluated from the available data regarding the mean statistical repair/strengthening or replacement cost for the total number of damaged structures (180,427 buildings) after the 7/9/1999 Parnitha (Athens) earthquake. The actual evaluated seismic risk is afterwards compared to the estimated probable structural losses, which is presented in the second part of the paper, based on a damage scenario in the referring earthquake. The applied damage scenario is based on recently developed damage probability matrices (DPMs) from Athens (Greece) damage database. The seismic risk estimation refers to 750,085 buildings situated in the extended urban region of Athens. The building exposure is categorized in five typical structural types and represents 18.80 % of the entire building stock in Greece. The last information is provided by the National Statistics Service of Greece (NSSG) according to the 2000-2001 census. The seismic input is characterized by the ratio, a g/ a o, where a g is the regional peak ground acceleration (PGA) which is evaluated from the earlier estimated research macroseismic intensities, and a o is the PGA according to the hazard map of the 2003 Greek Seismic Code. Finally, the collected investigated financial data derived from different National Services responsible for the post-earthquake crisis management concerning the repair/strengthening or replacement costs or other categories of costs for the rehabilitation of earthquake victims (construction and function of settlements for earthquake homeless, rent supports, demolitions, shorings) are used to determine the final total seismic risk factor.

  8. Perioperative risk factors for postoperative pneumonia after major oral cancer surgery: A retrospective analysis of 331 cases.

    Directory of Open Access Journals (Sweden)

    Jieyun Xu

    Full Text Available Postoperative pneumonia (POP is common and results in prolonged hospital stays, higher costs, increased morbidity and mortality. However, data on the incidence and risk factors of POP after oral and maxillofacial surgery are rare. This study aims to identify perioperative risk factors for POP after major oral cancer (OC surgery.Perioperative data and patient records of 331 consecutive subjects were analyzed in the period of April 2014 to March 2016. We individually traced each OC patient for a period to discharge from the hospital or 45 days after surgery, whichever occur later.The incidence of POP after major OC surgery with free flap construction or major OC surgery was 11.6% or 4.5%, respectively. Patient-related risk factors for POP were male sex, T stage, N stage, clinical stage and preoperative serum albumin level. Among the investigated procedure-related variables, incision grade, mandibulectomy, free flap reconstruction, tracheotomy, intraoperative blood loss, and the length of the operation were shown to be associated with the development of POP. Postoperative hospital stay was also significantly related to increased incidence of POP. Using a multivariable logistic regression model, we identified male sex, preoperative serum albumin level, operation time and postoperative hospital stay as independent risk factors for POP.Several perioperative risk factors can be identified that are associated with POP. At-risk oral cancer patients should be subjected to intensified postoperative pulmonary care.

  9. [Perception of health risks: psychological and social factors].

    Science.gov (United States)

    Kurzenhäuser, S; Epp, A

    2009-12-01

    This article reviews central findings and current developments of psychological and sociological research on the perception of health risks. Risk perception is influenced by numerous psychological, social, political, and cultural factors. These factors can be categorized into (a) risk characteristics, (b) characteristics of the risk perceiving person and his/her situation, and (c) characteristics of risk communication. Thus, besides individual cognitive and affective processing of risk information, social processes of risk amplification (e.g., media effects) are also involved in the construction of individual risk perceptions. We discuss the recommendations for health risk communication that follow from these findings with regard to different communication goals.

  10. Statin cost effectiveness in primary prevention: A systematic review of the recent cost-effectiveness literature in the United States

    Directory of Open Access Journals (Sweden)

    Mitchell Aaron P

    2012-07-01

    Full Text Available Abstract Background The literature on the cost-effectiveness of statin drugs in primary prevention of coronary heart disease is complex. The objective of this study is to compare the disparate results of recent cost-effectiveness analyses of statins. Findings We conducted a systematic review of the literature on statin cost-effectiveness. The four studies that met inclusion criteria reported varying conclusions about the cost-effectiveness of statin treatment, without a clear consensus as to whether statins are cost-effective for primary prevention. However, after accounting for each study’s assumptions about statin costs, we found substantial agreement among the studies. Studies that assumed statins to be more expensive found them to be less cost-effective, and vice-versa. Furthermore, treatment of low-risk groups became cost-effective as statins became less expensive. Conclusions Drug price is the primary determinant of statin cost-effectiveness within a given risk group. As more statin drugs become generic, patients at low risk for coronary disease may be treated cost-effectively. Though many factors must be weighed in any medical decision, from a cost-effectiveness perspective, statins may now be considered an appropriate therapy for many patients at low risk for heart disease.

  11. Modifiable risk factors of hypertension and socio demographic ...

    African Journals Online (AJOL)

    Background: Factors associated with the development of hypertension can be categorized into modifiable and non‑modifiable risk factors. The modifiable risk factors include obesity, physical inactivity, high salt diet, smoking alcohol consumption and others. Aim: This study was aimed to determine the prevalence of ...

  12. Management of construction cost contingency covering upside and downside risks

    Directory of Open Access Journals (Sweden)

    Ibrahim Adel Eldosouky

    2014-12-01

    Full Text Available Many contractors are of the opinion that adding contingency funds to the tender price of a project may lead to loss of the tender. This research is a trial to put an end to this incorrect opinion. A more mature attitude to risk would recognize that contingency exists to be spent in order to avoid or minimize threats and to exploit or maximize opportunities. This research proposes an approach for determination and monitoring of Cost Contingency Reserve (CCR for a project. Control of CCR is interfaced with Earned Value Management. Application to a real project is carried out. Post-mitigation simulations show that value of CCR is 2.88% of project cost but there is a potential saving due to opportunities. The project is monitored after eight months from its assumed start date with one assumed emergent risk. The final results are as follows: CCR is enough to cover project current and residual threats and the contractor has a considerable amount of money that will be transferred to his margin at project closure assuming the project will not be exposed to additional emergent risks. A contractor can balance project upside risks and its downsides to increase his chance to win tender of the project.

  13. Causative factors of cost overrun in highway projects of Sindh province of Pakistan

    Science.gov (United States)

    Sohu, S.; Halid, A.; Nagapan, S.; Fattah, A.; Latif, I.; Ullah, K.

    2017-11-01

    Cost overrun is an increase of cost of project from approved budget which was signed by parties at the time of tender. Cost overrun in construction of highway projects is a common problem worldwide and construction industry of Pakistan is also facing this crucial problem of cost overrun in highway projects of Pakistan. The main objective of this research is to identify the causative factors of cost overrun in highway projects of Sindh province of Pakistan. A well designed questionnaire was developed based on 64 common factors of cost overrun from literature review. Developed questionnaire was distributed among selected 30 experts from owner/client, designer/consultant and contractor who have experience more than 20 years’ experience in highway projects. The collected data was statistical analyzed. After analysis results showed that delay process in payment by client, inadequate planning, client interference, poor contract management, delay of decision making, change of scope of project and financial problems faced by client were most causative factors of cost overrun in highway projects. This research will provide alertness to stakeholders of highway projects of Sindh province to avoid cost overrun in projects.

  14. Violence Victimization in Korean Adolescents: Risk Factors and Psychological Problems.

    Science.gov (United States)

    Park, Subin; Lee, Yeeun; Jang, Hyesue; Jo, Minkyung

    2017-05-19

    We examined the risk factors for and psychological problems associated with violence victimization in a nationwide representative sample of Korean adolescents. Data from the 2016 Korean Youth Risk Behavior Web-based Survey was used. Participants were asked about their experience of being a victim of violence that required medical treatment during the past 12 months, as well as their perceived health, happiness, sleep satisfaction, stress, depressed mood, and suicidality. The 12-month prevalence of violence victimization requiring medical treatment was 2.4%. The results indicated that adolescents were at an increased risk for violence victimization if they were male, older, had parents of a foreign nationality, did not reside with their family, worked part time, resided in small cities or rural areas, were high or low in socioeconomic status (SES), exhibited high or low levels of academic performance, used alcohol or tobacco, and were sexually active. In addition, while violence victimization was negatively associated with perceived health and happiness, it was positively associated with perceived stress, depressed mood, and suicidality. The results indicate that a social disadvantage, involvement in risky behavior, and psychological problems are associated with violence victimization. Effective violence prevention efforts should thus target high-risk groups, and clinical attention is needed to address the psychological costs associated with violence victimization.

  15. Life cycle cost-based risk model for energy performance contracting retrofits

    Science.gov (United States)

    Berghorn, George H.

    Buildings account for 41% of the primary energy consumption in the United States, nearly half of which is accounted for by commercial buildings. Among the greatest energy users are those in the municipalities, universities, schools, and hospitals (MUSH) market. Correctional facilities are in the upper half of all commercial building types for energy intensity. Public agencies have experienced reduced capital budgets to fund retrofits; this has led to the increased use of energy performance contracts (EPC), which are implemented by energy services companies (ESCOs). These companies guarantee a minimum amount of energy savings resulting from the retrofit activities, which in essence transfers performance risk from the owner to the contractor. Building retrofits in the MUSH market, especially correctional facilities, are well-suited to EPC, yet despite this potential and their high energy intensities, efficiency improvements lag behind that of other public building types. Complexities in project execution, lack of support for data requests and sub-metering, and conflicting project objectives have been cited as reasons for this lag effect. As a result, project-level risks must be understood in order to support wider adoption of retrofits in the public market, in particular the correctional facility sub-market. The goal of this research is to understand risks related to the execution of energy efficiency retrofits delivered via EPC in the MUSH market. To achieve this goal, in-depth analysis and improved understanding was sought with regard to ESCO risks that are unique to EPC in this market. The proposed work contributes to this understanding by developing a life cycle cost-based risk model to improve project decision making with regard to risk control and reduction. The specific objectives of the research are: (1) to perform an exploratory analysis of the EPC retrofit process and identify key areas of performance risk requiring in-depth analysis; (2) to construct a

  16. Cardiovascular disease risk factors and cognitive impairment.

    Science.gov (United States)

    Nash, David T; Fillit, Howard

    2006-04-15

    The role of cardiovascular disease risk factors in the occurrence and progression of cognitive impairment has been the subject of a significant number of publications but has not achieved widespread recognition among many physicians and educated laymen. It is apparent that the active treatment of certain of these cardiovascular disease risk factors is accompanied by a reduced risk for cognitive impairment. Patients with hypertension who are treated experience fewer cardiovascular disease events as well as less cognitive impairment than similar untreated patients. Patients who exercise may present with less cognitive impairment, and obesity may increase the risk for cognitive impairment. Lipid abnormalities and genetic markers are associated with an increased risk for cardiovascular disease and cognitive impairment. Autopsy studies have demonstrated a correlation between elevated levels of cholesterol and amyloid deposition in the brain. Research has demonstrated a relation between atherosclerotic obstruction lesions in the circle of Willis and dementia. Diabetes mellitus is associated with an increased risk for cardiovascular disease and cognitive impairment. A number of nonpharmacologic factors have a role in reducing the risk for cognitive impairment. Antioxidants, fatty acids, and micronutrients may have a role, and diets rich in fruits and vegetables and other dietary approaches may improve the outlook for patients considered at risk for cognitive impairment.

  17. Methodology to estimate the cost of the severe accidents risk / maximum benefit

    International Nuclear Information System (INIS)

    Mendoza, G.; Flores, R. M.; Vega, E.

    2016-09-01

    For programs and activities to manage aging effects, any changes to plant operations, inspections, maintenance activities, systems and administrative control procedures during the renewal period should be characterized, designed to manage the effects of aging as required by 10 Cfr Part 54 that could impact the environment. Environmental impacts significantly different from those described in the final environmental statement for the current operating license should be described in detail. When complying with the requirements of a license renewal application, the Severe Accident Mitigation Alternatives (SAMA) analysis is contained in a supplement to the environmental report of the plant that meets the requirements of 10 Cfr Part 51. In this paper, the methodology for estimating the cost of severe accidents risk is established and discussed, which is then used to identify and select the alternatives for severe accident mitigation, which are analyzed to estimate the maximum benefit that an alternative could achieve if this eliminate all risk. Using the regulatory analysis techniques of the US Nuclear Regulatory Commission (NRC) estimates the cost of severe accidents risk. The ultimate goal of implementing the methodology is to identify candidates for SAMA that have the potential to reduce the severe accidents risk and determine if the implementation of each candidate is cost-effective. (Author)

  18. Factors that modify risks of radiation-induced cancer

    International Nuclear Information System (INIS)

    Fabrikant, J.I.

    1988-11-01

    The collective influence of biologic and physical factors that modify risks of radiation-induced cancer introduces uncertainties sufficient to deny precision of estimates of human cancer risk that can be calculated for low-dose radiation in exposed populations. The important biologic characteristics include the tissue sites and cell types, baseline cancer incidence, minimum latent period, time-to-tumor recognition, and the influence of individual host (age and sex) and competing etiologic influences. Physical factors include radiation dose, dose rate, and radiation quality. Statistical factors include time-response projection models, risk coefficients, and dose-response relationships. Other modifying factors include other carcinogens, and other biological sources (hormonal status, immune status, hereditary factors)

  19. [Analysis of risk factors associated with professional drivers’ work].

    Science.gov (United States)

    Czerwińska, Maja; Hołowko, Joanna; Stachowska, Ewa

    Professional driver is an occupation associated with high health risk. The factors which increase the risk of developing lifestyle diseases are closely related to working conditions. The aim of this study was to analyse the risk factors which are associated with professional drivers’ lifestyle. The material consisted of 23 articles from PubMed.gov. Risk factors related to drivers’ work have a signiicant impact on their health.

  20. Cost-benefit considerations in regulatory analysis

    Energy Technology Data Exchange (ETDEWEB)

    Mubayi, V.; Sailor, V.; Anandalingam, G.

    1995-10-01

    Justification for safety enhancements at nuclear facilities, e.g., a compulsory backfit to nuclear power plants, requires a value-impact analysis of the increase in overall public protection versus the cost of implementation. It has been customary to assess the benefits in terms of radiation dose to the public averted by the introduction of the safety enhancement. Comparison of such benefits with the costs of the enhancement then requires an estimate of the monetary value of averted dose (dollars/person rem). This report reviews available information on a variety of factors that affect this valuation and assesses the continuing validity of the figure of $1000/person-rem averted, which has been widely used as a guideline in performing value-impact analyses. Factors that bear on this valuation include the health risks of radiation doses, especially the higher risk estimates of the BEIR V committee, recent calculations of doses and offsite costs by consequence codes for hypothesized severe accidents at U.S. nuclear power plants under the NUREG-1150 program, and recent information on the economic consequences of the Chernobyl accident in the Soviet Union and estimates of risk avoidance based on the willingness-to-pay criterion. The report analyzes these factors and presents results on the dollars/person-rem ratio arising from different assumptions on the values of these factors.

  1. Cost-benefit considerations in regulatory analysis

    International Nuclear Information System (INIS)

    Mubayi, V.; Sailor, V.; Anandalingam, G.

    1995-10-01

    Justification for safety enhancements at nuclear facilities, e.g., a compulsory backfit to nuclear power plants, requires a value-impact analysis of the increase in overall public protection versus the cost of implementation. It has been customary to assess the benefits in terms of radiation dose to the public averted by the introduction of the safety enhancement. Comparison of such benefits with the costs of the enhancement then requires an estimate of the monetary value of averted dose (dollars/person rem). This report reviews available information on a variety of factors that affect this valuation and assesses the continuing validity of the figure of $1000/person-rem averted, which has been widely used as a guideline in performing value-impact analyses. Factors that bear on this valuation include the health risks of radiation doses, especially the higher risk estimates of the BEIR V committee, recent calculations of doses and offsite costs by consequence codes for hypothesized severe accidents at U.S. nuclear power plants under the NUREG-1150 program, and recent information on the economic consequences of the Chernobyl accident in the Soviet Union and estimates of risk avoidance based on the willingness-to-pay criterion. The report analyzes these factors and presents results on the dollars/person-rem ratio arising from different assumptions on the values of these factors

  2. Risks, costs and benefits analysis for exhumation of buried radioactive materials at a nuclear fuel fabrication facility

    International Nuclear Information System (INIS)

    Kirk, J.S.; Moore, R.A.; Huston, T.E.

    1996-01-01

    A Risks, Costs and Benefits analysis provides a tool for selecting a cost-effective remedial action alternative. This analysis can help avoid transferring risks to other populations and can objectively measure the benefits of a specific remedial action project. This paper describes the methods and results of a Risks, Costs and Benefits analysis performed at a nuclear fuel fabrication facility. The analysis examined exhuming and transporting radioactive waste to an offsite disposal facility. Risks evaluated for the remedial action project were divided into two categories: risks posed to the worker and risks posed to public health. Risks to workers included exposure to radioactive contaminants during excavation and packaging of waste materials and the use of heavy machinery. Potential public health risks included exposure to radioactive materials during transport from the exhumation site to the disposal facility. Methods included use of site-specific and published data, and existing computer models. Occupational risks were quantified using data from similar onsite remedial action projects. Computer modeling was used to evaluate public health risks from transporting radioactive materials; the consequences or probability of traffic accidents; and radiation exposure to potential inhabitants occupying the site considering various land use scenarios. A costs analysis was based on data obtained from similar onsite remedial action projects. Scenarios used to identify benefits resulting from the remedial action project included (1) an evaluation of reduction in risks to human health; (2) cost reductions associated with the unrestricted release of the property; and (3) benefits identified by evaluating regulatory mandates applicable to decommissioning. This paper will provide an overview of the methods used and a discussion of the results of a Risks, Costs and Benefits analysis for a site-specific remedial action scenario

  3. Risk factors of coercion among psychiatric inpatients

    DEFF Research Database (Denmark)

    Thomsen, Christoffer; Starkopf, Liis; Hastrup, Lene Halling

    2017-01-01

    PURPOSE: Reducing the use of coercion among patients with mental disorders has long been a political priority. However, risk factors for coercive measures have primarily been investigated in smaller studies. To reduce the use of coercion, it is crucial to identify people at risk which we aim to do...... and having children, reduced the risk of being subjected to coercive measure (all p risk factors associated with coercive measures. Our findings can assist researchers in identifying patients at risk of coercion and thereby help...... measure (21.9%). Clinical characteristics were the foremost predictors of coercion and patients with organic mental disorder had the highest increased risk of being subjected to a coercive measure (OR = 5.56; 95% CI = 5.04, 6.14). The risk of coercion was the highest in the first admission and decreased...

  4. Vitamin D Deficiency : Universal Risk Factor for Multifactorial Diseases?

    NARCIS (Netherlands)

    de Borst, Martin H.; de Boer, Rudolf A.; Stolk, Ronald P.; Slaets, Joris P. J.; Wolffenbuttel, Bruce H. R.; Navis, Gerjan

    In the Western world, the majority of morbidity and mortality are caused by multifactorial diseases. Some risk factors are related to more than one type of disease. These so-called universal risk factors are highly relevant to the population, as reduction of universal risk factors may reduce the

  5. Risk factors for amiodarone-induced thyroid dysfunction in Japan

    Directory of Open Access Journals (Sweden)

    Sayoko Kinoshita

    2016-12-01

    Conclusion: DCM and cardiac sarcoidosis were identified as risk factors for amiodarone-induced hyperthyroidism. Risk factors for amiodarone-induced hypothyroidism included higher baseline TSH level and lower baseline free T4 level, suggesting that subclinical hypothyroidism may be a potential risk factor for the development of amiodarone-induced hypothyroidism.

  6. FACTORS AFFECTING THE ENTERPRISE’S COST OF CAPITAL IN UKRAINE

    Directory of Open Access Journals (Sweden)

    Tetiana KONIEVA,

    2017-02-01

    Full Text Available Reducing the cost of capital is one of the main tasks of financial management of any enterprise.Because of dynamism of market conditions, the economic situation in the country, the existingrequirements of the legislation, the volume, structure, cost of financial resources of the enterprise fallunder the influence of various factors. The goal of this article is to analyze the specific features of theinfluence of different factors on the weighted average cost of capital in Ukraine as a basis fordevelopment of methods for its reducing. Investigation of factors that influence on the company's financialresources was carried out in the directions determined by the classical formula of the weighted averagecost of capital (WACC, estimation of the cost of net assets’ attracting (CAPM model. Special attentionwas paid to the analysis of the domestic legislative base concerning the permitted forms of businessorganization in Ukraine, requirements for the emission and dividend policy of the enterprise, size of itsregistered, reserve capital, share of net assets in financial resources. Based on the statistical data ofdomestic business entities, their ownership structure, sources of financing, specific features of theeconomic sector’s influence were analyzed. As a result, the prevalence of corporate enterprises in Ukrainewas revealed, which is connected with relatively low costs and favorable conditions for establishment andregistration. As part of the analysis of the financial resources’ structure high level of dependence fromdebts, the popularity of commercial credit, negative effect of financial leverage were found at theUkrainian enterprises. The features of the economic sector of enterprise were analyzed, that determine thevolume of capital investments for creation and development, duration of the operational cycle,seasonality, operating and investment activities, the level of profitability, which affect the volume,structure, cost of the capital of

  7. Power sector investment risk and renewable energy: A Japanese case study using portfolio risk optimization method

    International Nuclear Information System (INIS)

    Bhattacharya, Anindya; Kojima, Satoshi

    2012-01-01

    The conventional pricing mechanism used for electricity systematically hides huge investment risks which are embedded in the overall cost of production. Although consumers are often unaware of these risks, they present a large financial burden on the economy. This study applies the portfolio optimization concepts from the field of finance to demonstrate the scope of greater utilization of renewable energies (RE) while reducing the embedded investment risk in the conventional electricity sector and its related financial burden. This study demonstrates that RE investment can compensate for the risks associated with the total input costs; such costs being external volatilities of fossil fuel prices, capital costs, operating and maintenance costs and the carbon costs. By means of example, this case study shows that Japan could in theory obtain up to 9% of its electricity supply from green sources, as compared to the present 1.37%, based on the utilization of a portfolio risk-analysis evaluation. Explicit comparison of the monetary values of the investment risks of conventional and renewable energy sources shows that renewable energies have high market competitiveness. The study concludes with a recommendation that, as a business objective, investors would benefit by focusing on electricity supply portfolio risk minimization instead of cost. This could also inherently increase the supply of renewable energy in the market. - Research highlights: ►Energy sector investors should not be bothered only about the absolute cost figures of the input factors like fossil fuels but should also be careful about the fluctuation of their costs while making the investment decisions. ►Inclusion of renewable energy in the investment portfolio can increase the cost apparently but can reduce the risk hedging costs, too. ►International carbon price may not be a good factor to encourage renewable energy investment in the market.

  8. Risk factors for venous thromboembolic events in pediatric surgical patients: Defining indications for prophylaxis.

    Science.gov (United States)

    Cairo, Sarah B; Lautz, Timothy B; Schaefer, Beverly A; Yu, Guan; Naseem, Hibbut-Ur-Rauf; Rothstein, David H

    2017-12-27

    Venous thromboembolism (VTE) in pediatric surgical patients is a rare event. The risk factors for VTE in pediatric general surgery patients undergoing abdominopelvic procedures are unknown. The American College of Surgeon's National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database (2012-2015) was queried for patients with VTE after abdominopelvic general surgery procedures. Patient and operative variables were assessed to identify risk factors associated with VTE and develop a pediatric risk score. From 2012-2015, 68 of 34,813 (0.20%) patients who underwent abdominopelvic general surgery procedures were diagnosed with VTE. On multivariate analysis, there was no increased risk of VTE based on concomitant malignancy, chemotherapy, inflammatory bowel disease, or laparoscopic surgical approach, while a higher rate of VTE was identified among female patients. The odds of experiencing VTE were increased on stepwise regression for patients older than 15 years and those with preexisting renal failure or a diagnosis of septic shock, patients with American Society of Anesthesia (ASA) classification ≥ 2, and for anesthesia time longer than 2 h. The combination of age > 15 years, ASA classification ≥ 2, anesthesia time > 2 h, renal failure, and septic shock was included in a model for predicting risk of VTE (AUC = 0.907, sensitivity 84.4%, specificity 88.2%). VTE is rare in pediatric patients, but prediction modeling may help identify those patients at heightened risk. Additional studies are needed to validate the factors identified in this study in a risk assessment model as well as to assess the efficacy and cost-effectiveness of prophylaxis methods. Level III, retrospective comparative study. Copyright © 2018. Published by Elsevier Inc.

  9. Effects of Cost Factors on National Manufacturing Based on Global Perspectives

    Directory of Open Access Journals (Sweden)

    Fangtao Liu

    2017-11-01

    Full Text Available Currently, the real economy is the important basis for the development of a country, especially after the global financial crisis in 2008. Given that the manufacturing industry is the main part of the national real economy, many developed and developing countries have paid considerable attention to its significance. This study focused on cost factors given that they influence national manufacturing development. Initially, this study proposed two elements, namely, manufacturing development scale and manufacturing development level, to evaluate national manufacturing development from two aspects: quantity and quality. Subsequently, we extracted a series of cost factors on the bass of the theoretical framework and literature, including labor costs, financing costs, tax and rental costs, energy and raw materials, foreign trade exports and business environments. On the basis of the data of 13 main manufacturing countries around the world from 2000 to 2015, we tested the influence degree of each cost element index on the scale and level of national manufacturing industry development through a two-way fixed effects model and incorporated it with the development of China’s manufacturing industry as a case study. Finally, we deduced the future development trend of the manufacturing industry by specifically analyzing the cost factors affecting the development of this industry and provided policy suggestions. The main innovation and contribution of this study including: to comprehensively evaluate the national manufacturing development from two aspects, namely, “quantity” and “quality”; to identify the impact of national cost of the six elements; to demonstrate and determine the extent of its impact on the development trend of manufacturing sector and carry out pre-judgment through empirical research on each indicator; to provide policy recommendations targeted for each of the indicators.

  10. Factors Influencing Running-Related Musculoskeletal Injury Risk Among U.S. Military Recruits.

    Science.gov (United States)

    Molloy, Joseph M

    2016-06-01

    Running-related musculoskeletal injuries among U.S. military recruits negatively impact military readiness. Low aerobic fitness, prior injury, and weekly running distance are known risk factors. Physical fitness screening and remedial physical training (or discharging the most poorly fit recruits) before entry-level military training have tended to reduce injury rates while decreasing attrition, training, and medical costs. Incorporating anaerobic running sessions into training programs can offset decreased weekly running distance and decrease injury risk. Varying lower extremity loading patterns, stride length or cadence manipulation, and hip stability/strengthening programming may further decrease injury risk. No footstrike pattern is ideal for all runners; transitioning to forefoot striking may reduce risk for hip, knee, or tibial injuries, but increase risk for calf, Achilles, foot or ankle injuries. Minimal evidence associates running surfaces with injury risk. Footwear interventions should focus on proper fit and comfort; the evidence does not support running shoe prescription per foot type to reduce injury risk among recruits. Primary injury mitigation efforts should focus on physical fitness screening, remedial physical training (or discharge for unfit recruits), and continued inclusion of anaerobic running sessions to offset decreased weekly running distance. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  11. Prevalence of health risk factors among fishermen

    DEFF Research Database (Denmark)

    Frantzeskou, Elpida; Jensen, Olaf; Linos, Athena

    2014-01-01

    Background Studies have shown that fishermen have a higher mortality from cardiovascular diseases, cancer and accidents. The majority of cardiovascular disease is caused by external risk factors such as the diet, tobacco, alcohol and lack of physical activity. The purpose of this paper...... was to review the available information on the prevalence of these preventable risk factors in order to strengthen the preventive strategies. Methods A search for the last decade was done via Medline, Google and Google Scholar with the keywords "diet, tobacco, alcohol, physical exercise, overweight....... Of the Danish fishermen 25%-, 34% and 37% were obese in the 18-24, 25-44 and 45-64 years age groups. Conclusion Health risk factors among fishermen need to be highlighted and further investigated as they represent occupational risks of major impact to chronic diseases prevalence with projections to quality...

  12. Erectile dysfunction: prevalence, risk factors and involvement of ...

    African Journals Online (AJOL)

    ISSN: 1596-5996 (print); 1596-9827 (electronic) ... Abstract. Purpose: To explore the literature regarding prevalance, risk factors and the involvement of ..... Cigarette smoking and other vascular risk factors in vasculogenic impotence. Urology.

  13. Fall risk factors in community-dwelling elderly people

    Directory of Open Access Journals (Sweden)

    Astrid Bergland

    2012-11-01

    Full Text Available Falls are a common and serious problem for older adults. Approximately one-third of older communitydwelling people fall at least once a year. The main purpose of this paper is to present risk factors for fall in older people living at home. The databases used for identifying documentation of risk factors are Cinahl, Eric, ISI Web of Science, Cochrane Medline, Psycinfo and dissertation. Many psychosocial and medical conditions and impairment of sensorimotor function, balance and gait have been shown in large epidemiological studies to be strongly associated with falls. Several of the risk factors are interrelated. The intrinsic-extrinsic distinction seem to be an oversimplification. A better understanding of falls is usually obtained when examining the person in association with the environmental factors. Advanced age, history of falls, ADL limitations, impaired gait and mobility, visual impairment, reduced sensation, muscular weakness, poor reaction time, impaired cognition, diseases as stroke, use of psychoactive medication and use of many medications are risk factors shown to be strongly associated with falls. This means recommendation of multifactorial fall risk assessment must incorporate a range of physiological and mental tests in addition to assessing balance and gait as well as taking multiple chronic diseases and medications into account. These finding underscore the importance of multidimensional fall intervention with special focus on modifiable risk factors

  14. Cost-Benefit Analysis on Countermeasures for Health Risk by Exposure to Asbestos in Japan

    Science.gov (United States)

    Fujinaga, Aiichiro; Hihara, Hidemi; Tatsuno, Makoto

    This study examines asbestos mitigation countermeasures by predicting air concentrations of asbestos, and then cost-benefit analyses is performed. A comparative study was conducted on three cases as follows; case one, demolition by machine & landfill, case two, demolition by hand & landfill, and case three demolition by hand & vitrification treatment. The results showed that if demolition by machine is continued, the risk is greater than 10-4 of upper acceptable risk for 2020. However, if demolition is conducted by hand, the risk is under 10-4 for 2010. And also, the risk will be less than 10-5 of the safety level for environmental standards until 2030. The results show that vitrification deletes the risk on future management at a landfill site, however at a higher cost.

  15. Risk factors for Staphylococcus aureus postpartum breast abscess.

    Science.gov (United States)

    Branch-Elliman, Westyn; Golen, Toni H; Gold, Howard S; Yassa, David S; Baldini, Linda M; Wright, Sharon B

    2012-01-01

    Staphylococcus aureus (SA) breast abscesses are a complication of the postpartum period. Risk factors for postpartum SA breast abscesses are poorly defined, and literature is conflicting. Whether risk factors for methicillin-resistant SA (MRSA) and methicillin-susceptible SA (MSSA) infections differ is unknown. We describe novel risk factors associated with postpartum breast abscesses and the changing epidemiology of this infection. We conducted a cohort study with a nested case-control study (n = 216) involving all patients with culture-confirmed SA breast abscess among >30 000 deliveries at our academic tertiary care center from 2003 through 2010. Data were collected from hospital databases and through abstraction from medical records. All SA cases were compared with both nested controls and full cohort controls. A subanalysis was completed to determine whether risk factors for MSSA and MRSA breast abscess differ. Univariate analysis was completed using Student's t test, Wilcoxon rank-sum test, and analysis of variance, as appropriate. A multivariable stepwise logistic regression was used to determine final adjusted results for both the case-control and the cohort analyses. Fifty-four cases of culture-confirmed abscess were identified: 30 MRSA and 24 MSSA. Risk factors for postpartum SA breast abscess in multivariable analysis include in-hospital identification of a mother having difficulty breastfeeding (odds ratio, 5.00) and being a mother employed outside the home (odds ratio, 2.74). Risk factors did not differ between patients who developed MRSA and MSSA infections. MRSA is an increasingly important pathogen in postpartum women; risk factors for postpartum SA breast abscess have not changed with the advent of community-associated MRSA.

  16. Personal and couple level risk factors: Maternal and paternal parent-child aggression risk.

    Science.gov (United States)

    Tucker, Meagan C; Rodriguez, Christina M; Baker, Levi R

    2017-07-01

    Previous literature examining parent-child aggression (PCA) risk has relied heavily upon mothers, limiting our understanding of paternal risk factors. Moreover, the extent to which factors in the couple relationship work in tandem with personal vulnerabilities to impact PCA risk is unclear. The current study examined whether personal stress and distress predicted PCA risk (child abuse potential, over-reactive discipline style, harsh discipline practices) for fathers as well as mothers and whether couple functioning mediated versus moderated the relation between personal stress and PCA risk in a sample of 81 couples. Additionally, the potential for risk factors in one partner to cross over and affect their partner's PCA risk was considered. Findings indicated higher personal stress predicted elevated maternal and paternal PCA risk. Better couple functioning did not moderate this relationship but partially mediated stress and PCA risk for both mothers and fathers. In addition, maternal stress evidenced a cross-over effect, wherein mothers' personal stress linked to fathers' couple functioning. Findings support the role of stress and couple functioning in maternal and paternal PCA risk, including potential cross-over effects that warrant further inquiry. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. 75 FR 33379 - Railroad Cost Recovery Procedures-Productivity Adjustment; Quarterly Rail Cost Adjustment Factor

    Science.gov (United States)

    2010-06-11

    ... information is contained in the Board's June 14, 2010 decision, which is available on our website at http://www.stb.dot.gov . Copies of the decision may be purchased by contacting the office of Public... Cost Adjustment Factor AGENCY: Surface Transportation Board. [[Page 33380

  18. Vitamin D, cardiovascular disease and risk factors

    DEFF Research Database (Denmark)

    Skaaby, Tea; Thuesen, Betina H.; Linneberg, Allan

    2017-01-01

    of vitamin D effects from a cardiovascular health perspective. It focuses on vitamin D in relation to cardiovascular disease, i.e. ischemic heart disease, and stroke; the traditional cardiovascular risk factors hypertension, abnormal blood lipids, obesity; and the emerging risk factors hyperparathyroidism......, microalbuminuria, chronic obstructive pulmonary diseases, and non-alcoholic fatty liver disease. Meta-analyses of observational studies have largely found vitamin D levels to be inversely associated with cardiovascular risk and disease. However, Mendelian randomization studies and randomized, controlled trials...... (RCTs) have not been able to consistently replicate the observational findings. Several RCTs are ongoing, and the results from these are needed to clarify whether vitamin D deficiency is a causal and reversible factor to prevent cardiovascular disease....

  19. Risk factors for community-acquired bacterial meningitis

    DEFF Research Database (Denmark)

    Lundbo, Lene Fogt; Benfield, Thomas

    2017-01-01

    of these are pathogen-specific, while some are shared between different bacteria. METHODS: We searched the database PubMed to identify host risk factors for bacterial meningitis caused by the pathogens Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b, because they are three most common...... causative bacteria beyond the neonatal period. RESULTS: We describe a number of risk factors; including socioeconomic factors, age, genetic variation of the host and underlying medical conditions associated with increased susceptibility to invasive bacterial infections in both children and adults....... CONCLUSIONS: As conjugated vaccines are available for these infections, it is of utmost importance to identify high risk patients to be able to prevent invasive disease....

  20. The Cost of Astronomy

    DEFF Research Database (Denmark)

    Dorch, Bertil F.

    Using Scopus and national sources, I have investigated the evolution of the cost of publishing in Danish astronomy on a fine scale over a number of years. I find that the number of publications per year from Danish astronomers increased by a factor of four during 15 years: naturally, the correspo......Using Scopus and national sources, I have investigated the evolution of the cost of publishing in Danish astronomy on a fine scale over a number of years. I find that the number of publications per year from Danish astronomers increased by a factor of four during 15 years: naturally......, the corresponding potential cost of publishing must have increased similarly. The actual realized cost of publishing in core journals are investigated for a high profile Danish astronomy research institutions. I argue that the situation is highly unstable if the current cost scenario continues, and I speculate...... that Danish astronomy is risking a scholarly communication collapse due to the combination of increasing subscription cost, increased research output, and increased direct publishing costs related to Open access and other page charges....

  1. Risk factors for age-related maculopathy.

    Science.gov (United States)

    Connell, Paul P; Keane, Pearse A; O'Neill, Evelyn C; Altaie, Rasha W; Loane, Edward; Neelam, Kumari; Nolan, John M; Beatty, Stephen

    2009-01-01

    Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.

  2. Risk Factors for Age-Related Maculopathy

    Directory of Open Access Journals (Sweden)

    Paul P. Connell

    2009-01-01

    Full Text Available Age-related maculopathy (ARM is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.

  3. Risk factors for age-related maculopathy.

    LENUS (Irish Health Repository)

    Connell, Paul P

    2012-02-01

    Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715\\/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.

  4. Cardiovascular Risk Factors in the Antiphospholipid Syndrome

    Directory of Open Access Journals (Sweden)

    Felipe Freire da Silva

    2014-01-01

    Full Text Available A major cause of morbidity and mortality in the context of the antiphospholipid syndrome (APS is the occurrence of thrombotic events. Besides the pathogenic roles of antiphospholipid antibodies (aPL, other risk factors and medical conditions, which are conditions for traditional risk of an individual without the APS, can coexist in this patient, raising their risk of developing thrombosis. Therefore, the clinical and laboratory investigation of comorbidities known to increase cardiovascular risk in patients with antiphospholipid antibody syndrome is crucial for the adoption of a more complete and effective treatment. Experimental models and clinical studies show evidence of association between APS and premature formation of atherosclerotic plaques. Atherosclerosis has major traditional risk factors: hypertension, diabetes mellitus, obesity, dyslipidemia, smoking, and sedentary lifestyle that may be implicated in vascular involvement in patients with APS. The influence of nontraditional risk factors as hyperhomocysteinemia, increased lipoprotein a, and anti-oxLDL in the development of thromboembolic events in APS patients has been studied in scientific literature. Metabolic syndrome with all its components also has been recently studied in antiphospholipid syndrome and is associated with arterial events.

  5. Risk factors in young patients of acute myocardial infarction

    International Nuclear Information System (INIS)

    Faisal, A.W.; Khan, R.A.A.T.; Ayub, M.; Husnain, S.S.

    2011-01-01

    Background: Ischemic heart disease is a leading cause of death throughout the world. CAD has been recognized among younger age group more frequently in recent years. Very limited data is available regarding the prevalence of various risk factors in our younger patients that is why this study was planed. Objectives of the study were to look for the risk factors most prevalent in our young patient of first Acute Myocardial Infarction. And to also look for the number of Risk Factors present in each patient. Methods: We studied 100 consecutive patients from 16-45 years of age presenting with first acute MI. Twelve risk factors were studied namely, gender, family history of premature CAD, smoking hypertension, diabetes, dyslipidemia, obesity, mental stress (type A personality), alcohol, oral contraceptive pills (OCPs), physical activity, and diet. We divided the patients into two groups. Group A with patients 35 years of age or less and group B with patients 36-45 years of age. All risk factors were compared in both the groups. Results: Smoking, diabetes mellitus, dyslipidemia and hypertension were statistically different between the two groups. Frequency wise risk factors were lined up as male sex (91%) Diet (66%), Dyslipidemia (62%), smoking (46%), Type A personality(46%), family history (32%), diabetes mellitus (28%), sedentary lifestyle (26%), hypertension (22%), obesity (17%), alcohol (3%), and OCPs (0%) Most of the patients that is 94% had 3 or more risk factors. Conclusion: Smoking, hypertension, diabetes and dyslipidemia are the major modifiable risk factors in our young adults. If a young male who is smoker or a young female who is diabetic, presents in emergency room with chest pain, always suspect coronary artery disease. Other conventional risk factors are also prevalent but alcohol and OCPs are not a major health problem for us. (author)

  6. Risk factors in young patients of acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Faisal, A W; Khan, R A.A.T. [General Physician Minir Hospital, Sargodha (Pakistan); Ayub, M [Munir Hospital, Sargodha (Pakistan); Husnain, S S [Allama Iqbal Medical College, Lahore (Pakistan)

    2011-07-15

    Background: Ischemic heart disease is a leading cause of death throughout the world. CAD has been recognized among younger age group more frequently in recent years. Very limited data is available regarding the prevalence of various risk factors in our younger patients that is why this study was planed. Objectives of the study were to look for the risk factors most prevalent in our young patient of first Acute Myocardial Infarction. And to also look for the number of Risk Factors present in each patient. Methods: We studied 100 consecutive patients from 16-45 years of age presenting with first acute MI. Twelve risk factors were studied namely, gender, family history of premature CAD, smoking hypertension, diabetes, dyslipidemia, obesity, mental stress (type A personality), alcohol, oral contraceptive pills (OCPs), physical activity, and diet. We divided the patients into two groups. Group A with patients 35 years of age or less and group B with patients 36-45 years of age. All risk factors were compared in both the groups. Results: Smoking, diabetes mellitus, dyslipidemia and hypertension were statistically different between the two groups. Frequency wise risk factors were lined up as male sex (91%) Diet (66%), Dyslipidemia (62%), smoking (46%), Type A personality(46%), family history (32%), diabetes mellitus (28%), sedentary lifestyle (26%), hypertension (22%), obesity (17%), alcohol (3%), and OCPs (0%) Most of the patients that is 94% had 3 or more risk factors. Conclusion: Smoking, hypertension, diabetes and dyslipidemia are the major modifiable risk factors in our young adults. If a young male who is smoker or a young female who is diabetic, presents in emergency room with chest pain, always suspect coronary artery disease. Other conventional risk factors are also prevalent but alcohol and OCPs are not a major health problem for us. (author)

  7. Women's Heart Disease: Heart Disease Risk Factors

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk ...

  8. A methodology for spacecraft technology insertion analysis balancing benefit, cost, and risk

    Science.gov (United States)

    Bearden, David Allen

    Emerging technologies are changing the way space missions are developed and implemented. Technology development programs are proceeding with the goal of enhancing spacecraft performance and reducing mass and cost. However, it is often the case that technology insertion assessment activities, in the interest of maximizing performance and/or mass reduction, do not consider synergistic system-level effects. Furthermore, even though technical risks are often identified as a large cost and schedule driver, many design processes ignore effects of cost and schedule uncertainty. This research is based on the hypothesis that technology selection is a problem of balancing interrelated (and potentially competing) objectives. Current spacecraft technology selection approaches are summarized, and a Methodology for Evaluating and Ranking Insertion of Technology (MERIT) that expands on these practices to attack otherwise unsolved problems is demonstrated. MERIT combines the modern techniques of technology maturity measures, parametric models, genetic algorithms, and risk assessment (cost and schedule) in a unique manner to resolve very difficult issues including: user-generated uncertainty, relationships between cost/schedule and complexity, and technology "portfolio" management. While the methodology is sufficiently generic that it may in theory be applied to a number of technology insertion problems, this research focuses on application to the specific case of small (<500 kg) satellite design. Small satellite missions are of particular interest because they are often developed under rigid programmatic (cost and schedule) constraints and are motivated to introduce advanced technologies into the design. MERIT is demonstrated for programs procured under varying conditions and constraints such as stringent performance goals, not-to-exceed costs, or hard schedule requirements. MERIT'S contributions to the engineering community are its: unique coupling of the aspects of performance

  9. Risk factors for tornado injuries.

    Science.gov (United States)

    Eidson, M; Lybarger, J A; Parsons, J E; MacCormack, J N; Freeman, J I

    1990-12-01

    Tornadoes in North and South Carolina on 28 March 1984 caused 252 people to be injured seriously enough to require hospitalization and 59 to be killed. To evaluate risk factors, we gathered information on 238 (94%) of those hospitalized and 46 (78%) of those killed. Those hospitalized or deceased had statistically significantly more deep cuts, concussions, unconsciousness and broken bones than those with them at the time of the tornado who were not hospitalized or killed. People living in mobile homes were more likely to be hospitalized or die than people occupying conventional houses. Other risk factors for hospitalization or death included advanced age (60+ years), no physical protection (not having been covered with a blanket or other object), having been struck by broken window glass or other falling objects, home lifted off its foundation, collapsed ceiling or floor, or walls blown away. More awareness of the tornado risk before it strikes and better adherence to tornado protection guidelines could reduce injuries and deaths in the future.

  10. Risk factors for developing diabetic foot

    Directory of Open Access Journals (Sweden)

    Julia Estela Willrich Boell

    2014-06-01

    Full Text Available The goal of the present study is to identify the risk factors for developing diabetic foot. A cross-sectional study, with a convenience sample, developed with 70 individuals with diabetes mellitus (DM, registered in three basic health units in the municipality of Florianópolis/SC, Brazil, in the period from November 2010 to May 2011. Biometric data was collected regarding their sociodemographic, health and illness conditions. An assessment of the feet was also carried out. The average participant age was 66.17 years and time with diagnosed disease was under ten years (61.42%. The following risk factors were identified: advanced age; time of DM diagnosis; few years of schooling; overweight/obesity; inadequate diet; physical inactivity; inadequate metabolic control; lack of proper and specific foot care; and arterial hypertension. We conclude that the majority of the population presented one or more risk factors that favor the appearance of foot-related complications. doi: 10.5216/ree.v16i2.20460.

  11. Risk Factor and Comorbidity of Migraine

    Directory of Open Access Journals (Sweden)

    Woro Riyadina

    2015-06-01

    Full Text Available Background: Migraine is a chronic daily headache which interfere a quality of life. The purpose of this research is to obtain the prevalence, risk factors, and comorbidity of migraine. Methods: A cross sectional study involving 4771 subjects in 5 villages in the district of Central Bogor, Bogor City 2011–2012. Data collection was performed using WHO STEPS (interview, measurement, physical examination, and laboratory test. Results: In this study, the migraine prevalence was 22.43%, with significant risk factors were sex, age, and stress (p < 0.05. Comorbidity of migraine was coronary heart diseases (p < 0.05. There was no significant correlation between migraine with marital status, level of education, smoking, hypertension, obesity, total cholesterol, LDL, HDL, trigliseride level, and diabetes mellitus (p > 0.05. Conclusions: Risk factors which have significant association with migraine are sex, age, and stress, whereas coronary heart disease existed as a comorbidity with migraine.

  12. Using cost/risk uncertainty spheres to make better environmental restoration decisions

    International Nuclear Information System (INIS)

    Shangraw, R.F.; Cheney, C.S.; Shangraw, W.R.

    1994-01-01

    The process of balancing cost expenditures and risk reductions during environmental restoration (ER) activities (and as part of other environmental programs such as waste management and facility transition) is the critical policy decision facing DOE site decisionmakers and associated stakeholders (including regulators). The ground rules for this process are specified formally in the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended, the Resource Conservation and Recovery Act, as amended, the subsequent regulations (e.g., National Contingency Plan) and policies that EPA and State agencies have issued to implement these programs, and (increasingly) interagency agreements and orders. Clearly, as Federal resources to meet environmental commitments become more constrained, cost and risk management tradeoffs will become even more needed and their results pronounced

  13. Risk factors for nonelective 30-day readmission in pediatric assault victims.

    Science.gov (United States)

    Buicko, Jessica L; Parreco, Joshua; Willobee, Brent A; Wagenaar, Amy E; Sola, Juan E

    2017-10-01

    Hospital readmission in trauma patients is associated with significant morbidity and increased healthcare costs. There is limited published data on early hospital readmission in pediatric trauma patients. As presently in healthcare outcomes and readmissions rates are increasingly used as hospital quality indicators, it is paramount to recognize risk factors for readmission. We sought to identify national readmission rates in pediatric assault victims and identify the most common readmission diagnoses among these patients. The Nationwide Readmission Database (NRD) for 2013 was queried for all patients under 18years of age with a non-elective admission with an E-code that is designed as assault using National Trauma Data Bank Standards. Multivariate logistic regression was implemented using 18 variables to determine the odds ratios (OR) for non-elective readmission within 30-days. There were 4050 pediatric victims of assault and 92 (2.27%) died during the initial admission. Of the surviving patients 128 (3.23%) were readmitted within 30days. Of these readmitted patients 24 (18.75%) were readmitted to a different hospital and 31 (24.22%) were readmitted for repeated assault. The variables associated with the highest risk for non-elective readmission within 30-days were: length of stay (LOS) >7days (OR 3.028, preadmission diagnosis groups were bipolar disorders (8.2%), post-operative, posttraumatic, or other device infections (6.2%), or major depressive disorders and other/unspecified psychoses (5.2%). Readmission after pediatric assault represents a significant resource burden and almost a quarter of those patients are readmitted after a repeated assault. Understanding risk factors and reasons for readmission in pediatric trauma assault victims can improve discharge planning, family education, and outpatient support, thereby decreasing overall costs and resource burden. Psychoses, weight loss, and prolonged hospitalization are independent prognostic indicators of

  14. The Costs and Risks of Maturing Technologies, Traditionally vs. Evolutionary Approaches

    National Research Council Canada - National Science Library

    Pennock, Michael J; Rouse, William B

    2008-01-01

    .... This results in more frequent, smaller increments of deployed capability. In theory, evolutionary acquisition could be more cost effective than traditional acquisition approaches because it avoids most of the risk inherent...

  15. Custom v. Standardized Risk Models

    Directory of Open Access Journals (Sweden)

    Zura Kakushadze

    2015-05-01

    Full Text Available We discuss when and why custom multi-factor risk models are warranted and give source code for computing some risk factors. Pension/mutual funds do not require customization but standardization. However, using standardized risk models in quant trading with much shorter holding horizons is suboptimal: (1 longer horizon risk factors (value, growth, etc. increase noise trades and trading costs; (2 arbitrary risk factors can neutralize alpha; (3 “standardized” industries are artificial and insufficiently granular; (4 normalization of style risk factors is lost for the trading universe; (5 diversifying risk models lowers P&L correlations, reduces turnover and market impact, and increases capacity. We discuss various aspects of custom risk model building.

  16. [Vaginal disbacteriosis--social and sexual risk factors].

    Science.gov (United States)

    Kovachev, S

    2013-01-01

    The vaginal microbe equilibrium could be impaired by different agents. Many of the risk factors can change the preventive mechanisms of the vagina and can lead to inflammation and disease. We even do not suppose about the role of most of them in impairing of vaginal microbe equilibrium. The exact understanding of those risk factors and mechanisms by which they disturb the vaginal microbe balance could reduce female morbidity of vaginal disbacteriosis and vaginal inflammations. The aim of this literature synopsis is to review some of the most frequent risk factors for vaginal disbacteriosis and about how they change vaginal micro-flora with dominant lactobacillus within it. The most informative and detailed articles on the theme which were found in the resent literature as well as in Medline for the period between 1990 and 2012 were selected. The risk agents for vaginal disbacteriosis are: endogenetic, social, sexual, infectious and iatrogenic. The social and sexual factors are the most frequent in our daily round. The intensity and the kind of sexual life, smoking, homosexual connections, vaginal douching and contraception methods are included in them. All these factors depend on us. Thus we hope that through their popularization and discussion will help to prevent the females' health.

  17. Measuring Property Management Risk and Loss: Step One Toward Managing Property on a Foundation of Risk, Cost, and Benefit

    International Nuclear Information System (INIS)

    Johnson, Curtis

    1999-01-01

    This is a period of ever-tightening defense budgets and continuing pressure on the public sector to be more commercial-like, Property policies, practices, and regulations are increasingly being challenged and changed. In these times, we must be leaders in understanding and defining the value of our profession from a commercial standpoint so that we can provide the right services to our customers and explain and defend the value of those services. To do so, we must step outside current property management practices, regulations, and oversight. We must learn to think and speak in the language of those who fund us--a financial language of risk, cost, and benefit. Regardless of regulation and oversight, our bosses are demanding that we demonstrate (financially) the benefits of current practice, or else. This article is intended to be the beginning of an effort to understand and define our profession in terms of risk, cost, and benefit so that we can meet these new challenges. The first step in this effort must be defining and measuring risk, cost, and benefit. Our costs, although sometimes difficult to capture, are easy to understand: they are almost exclusively the effort, both within and without the property management organization, involved in managing property. Unfortunately, property risks and benefits are not so simple or so well understood. Generally, risks and benefits are identified and measured through physical inventory results: potential and actual shortages. This paper will explore the weaknesses in the current understanding and use of shortage information as the yardstick for property management risks and performance. It will define a new framework for understanding the purpose and value of property management. And finally, it will set a course for a new method of measuring and valuing physical inventoty shortages. This new method will yield accurate and useful measures of property management risk and benefit. Once risk and benefit are accurately

  18. Association of breakfast intake with cardiometabolic risk factors

    Directory of Open Access Journals (Sweden)

    Gita Shafiee

    2013-11-01

    Conclusions: skipping breakfast is associated with increased risk of MetS and other cardiometabooic factors in children and adolescents. Promoting the benefit of eating breakfast could be a simple and important implication to prevent these risk factors.

  19. Risk factors for asthma exacerbation in patients presenting to an ...

    African Journals Online (AJOL)

    Background: Asthma exacerbations are caused by a variety of risk factors. Reducing exposure to these risk factors improves the control of asthma and reduces medication needs. Knowledge of the particular risk factors is essential in formulating controlling and treatment protocols. This study set out to determine the risk ...

  20. Remarks on Risk-Sensitive Control Problems

    International Nuclear Information System (INIS)

    Menaldi, Jose-Luis; Robin, Maurice

    2005-01-01

    The main purpose of this paper is to investigate the asymptotic behavior of the discounted risk-sensitive control problem for periodic diffusion processes when the discount factor α goes to zero. If u α (θ,x) denotes the optimal cost function, θ being the risk factor, then it is shown that lim { α to 0}α u α (θ,x)=ξ(θ) where ξ(θ) is the average on ]0,θ[ of the optimal cost of the (usual) infinite horizon risk-sensitive control problem

  1. Fraud Risk Factors and Audit Programme Modifications: Evidence from Jordan

    Directory of Open Access Journals (Sweden)

    Modar Abdullatif

    2013-03-01

    Full Text Available This study explores how audit firms in Jordan deal with the presence of fraud risk factors in audit clients. In doing so, the study seeks to explore which fraud risk factors are more important to Jordanianauditors, and how Jordanian auditors consider modifying their audit programmes when fraud risk factors are present in clients. The study uses a structured questionnaire that was administered to seniorlevel auditors in the largest Jordanian audit firms. The findings show that almost all of the 20 fraud risk factors included in the questionnaire were only slightly important (if not unimportant, a finding that is arguably alarming. The perceived importance of modifying the audit programme in the presence of each fraud risk factor was related to the perceived importance of the fraud risk factor itself. However, changes in the nature and extent of audit procedures were more important than changes in the timing of the procedures or the members of the audit team. The most important fraud risk factors were related to the characteristics of management and its attitude towards the audit, while the least important fraud risk factors were related to the difficulties in the client’s financial performance. Factor analysis found that the fraud risk factors could be classified into four separate groups. Possible interpretations of the findings were discussed, such as considering the Jordanian business environment characteristics, and the findings were compared to those of extant international studies.

  2. Psychosocial and environmental risk factors associated with mental disorders

    Directory of Open Access Journals (Sweden)

    Restrepo, Paula Andrea

    2010-06-01

    Full Text Available In Colombia, there are few studies on the association of psychosocial and environmental factors with the most prevalent mental disorders; such studies are important due to the context of violence, social insecurity, and job and economic instability in the country. The objective of this study was to identify the psychosocial and environmental risk factors for mental disorders, in users of psychological services in Colombia. The Mini International Neuropsychiatric Interview and a Questionnaire to evaluate the Axis-IV of the DSM-IV-TR were applied to 490 participants. The analysis comprised descriptive statistics and risk factors. As risk factors for depression, there were identified housing problems, access to health care services, problems related to the primary group, economics, problems of the social environment, and labor. For generalized anxiety, there were identified economic and education issues. For panic disorders, the risk factors were related to social environment, and for social phobia, the risk factors were problems in education, work and social environment

  3. Risk factors for acute renal failure: inherent and modifiable risks.

    Science.gov (United States)

    Leblanc, Martine; Kellum, John A; Gibney, R T Noel; Lieberthal, Wilfred; Tumlin, James; Mehta, Ravindra

    2005-12-01

    Our purpose is to discuss established risk factors in the development of acute renal failure and briefly overview clinical markers and preventive measures. Findings from the literature support the role of older age, diabetes, underlying renal insufficiency, and heart failure as predisposing factors for acute renal failure. Diabetics with baseline renal insufficiency represent the highest risk subgroup. An association between sepsis, hypovolemia, and acute renal failure is clear. Liver failure, rhabdomyolysis, and open-heart surgery (especially valve replacement) are clinical conditions potentially leading to acute renal failure. Increasing evidence shows that intraabdominal hypertension may contribute to the development of acute renal failure. Radiocontrast and antimicrobial agents are the most common causes of nephrotoxic acute renal failure. In terms of prevention, avoiding nephrotoxins when possible is certainly desirable; fluid therapy is an effective prevention measure in certain clinical circumstances. Supporting cardiac output, mean arterial pressure, and renal perfusion pressure are indicated to reduce the risk for acute renal failure. Nonionic, isoosmolar intravenous contrast should be used in high-risk patients. Although urine output and serum creatinine lack sensitivity and specificity in acute renal failure, they remain the most used parameters in clinical practice. There are identified risk factors of acute renal failure. Because acute renal failure is associated with a worsening outcome, particularly if occurring in critical illness and if severe enough to require renal replacement therapy, preventive measures should be part of appropriate management.

  4. Risk Factors for Post-stroke Depression: A Meta-analysis

    Directory of Open Access Journals (Sweden)

    Yu Shi

    2017-07-01

    Full Text Available Background: Stroke not only impacts patients physically but also economically. Post-stroke depression (PSD, as a common complication of stroke, always obstructs the process of stroke rehabilitation. Accordingly, defining the risk factors associated with PSD has extraordinary importance. Although there have been many studies investigating the risk factors for PSD, the results are inconsistent.Objectives: The objectives of this study were to identify the risk factors for PSD by evidence-based medicine.Data sources: A systematic and comprehensive database search was performed of PubMed, Medline, CENTRAL, EMBASE.com, the Cochrane library and Web of Science for Literature, covering publications from January 1, 1998 to November 19, 2016.Study Selection: Studies on risk factors for PSD were identified, according to inclusion and exclusion criteria. The risk of bias tool, described in the Cochrane Handbook version 5.1.0, was used to assess the quality of each study. Meta-analysis was performed using RevMan 5.3 software.Results: Thirty-six studies were included for review. A history of mental illness was the highest ranking modifiable risk factor; other risk factors for PSD were female gender, age (<70 years, neuroticism, family history, severity of stroke, and level of handicap. Social support was a protective factor for PSD.Conclusion: There are many factors that have effects on PSD. The severity of stroke is an important factor in the occurrence of PSD. Mental history is a possible predictor of PSD. Prevention of PSD requires social and family participation.

  5. The Priority Importance of Economic Motivation Factors Against Risks for Green Building Development in Malaysia

    Directory of Open Access Journals (Sweden)

    Mohamed Ghazali Farid Ezanee

    2017-01-01

    Full Text Available Green building development is an emerging paradigm for the construction industry practice all around the world. The establishement of Green Building rating tool helps to assess the whole life cycle process in planning to operation in a building. The Malaysian construction industry recognizes buildings that have been assessed using established green building tool such Green Building Index, Green RE or My CREST. Eventhough these rating tools provide motivation factors in its criteria and sub-criteria to promote sustainability in Malaysia buildings, there is still a major doubt to developers in terms of risks that may hinder their investments in green buildings. This paper highlights the priority importance of economic motivation factors against risks in the green building development in Malaysia. The data presented in this paper have been mainly derived from responses received through questionnaires completed by building stakeholders involved in green building developments. In order to determine the priority importance of economic motivation factors and risks identified for green building development, the questionnaire outcomes have been thoroughly assessed using the Analytical Hierarchy Process (AHP method. As a result, lack of government incentive and high capital cost, which classified under green building risks, are the two key factors with highest priority importance that influenced most of the decision making for green building development in Malaysia. The results show green buildings have proliferated as governmental support and incentives with more exampler of higher profit return of investment in enhancing developers preference for green building development.

  6. A Prospective Study on the Prevalence and Risk Factors of Poststroke Depression

    Directory of Open Access Journals (Sweden)

    A. De Ryck

    2013-01-01

    Full Text Available Background and Purpose: Poststroke depression (PSD is common. Early detection of depressive symptoms and identification of patients at risk for PSD are important as PSD negatively affects stroke outcome and costs of medical care. Therefore, the aim of this study was to determine incidence and risk factors for PSD at 3 months after stroke. Methods: We conducted a prospective, longitudinal epidemiological study aiming to determine incidence and risk factors for PSD at 1, 3, 6, 12 and 18 months poststroke. The present data analysis covers the convalescent phase of 3 months poststroke. Participants in this study were inpatients, admitted to a stroke unit with first or recurrent stroke. Demographic data and vascular risk factors were collected and patients were evaluated at baseline and 3 months poststroke for functional and cognitive deficits, stroke characteristics, stroke severity and stroke outcome. Signs and symptoms of depression were quantified by means of the Cornell Scale for Depression (CSD and Montgomery and Åsberg Depression Rating Scale (MADRS. Significantly associated variables from univariate analysis were analyzed by using multiple linear and logistic regression methods. Results: Data analysis was performed in 135 patients who completed follow-up assessments at 3 months poststroke. Depression (CSD score ≥8 was diagnosed in 28.1% of the patients. Patients with PSD were significantly more dependent with regard to activities of daily living (ADL and displayed more severe physical and cognitive impairment than patients without PSD. A higher prevalence of speech and language dysfunction and apraxia were observed in patients with PSD (36.8 and 34.3%, respectively compared to non-depressed stroke patients (19.6 and 12.4%; p = 0.036 and p = 0.004, respectively. Applying multiple linear regressions, cognitive impairment and reduced mobility as part of the Stroke Impact Scale were independently associated with PSD, as scored using CSD and

  7. The cost of collective dose equivalent

    International Nuclear Information System (INIS)

    Clark, M.J.; Fleishman, A.B.

    1979-01-01

    The successful application of the ALARA principle is dependent on a monetary evaluation of collective dose, so that the costs of control may be directly compared with the costs of detriment. The paper initially reviews the traditional, quantitative methods of valuing human life from which a monetary value of the man-sievert can be derived by subsequent application of risk factors. The political, ethical and economic implications of employing such techniques in radiological protection are noted. An alternative approach to the problem is then outlined, based on estimating the marginal value of a change in risk. At low levels of individual risk this includes only the tangible, economic consequences of detriment from output losses and medical costs. However, as risk levels rise, social costs related to the anxiety associated with radiation-induced health effects are also incorporated and the valuation increases disproportionally. While such valuations are in principle measurable, in the absence of empirical data a risk/detriment cost relationship is proposed, leading to a variable monetary value of the man-sievert which is a function of the per caput dose of a given population sub-group. Application of this methodology will help to ensure that radiological protection resources are spent in areas where they are most required. (author)

  8. Risk factors and the economic impact of ovarian cysts on reproductive performance of dairy cows in Korea.

    Science.gov (United States)

    Kim, Ki-Doek; Ki, Kwang-Sook; Kang, Hyun-Gu; Kim, Ill-Hwa

    2005-08-01

    The objectives of this study were to determine the risk factors for development of postpartum ovarian cysts by evaluating several reproductive factors in individual cows, and to determine the economic impact of ovarian cysts on subsequent reproductive performance in dairy herds in Korea. The data, including cow parity, abnormal puerperium, endometritis, body condition score (BCS), and breeding status were collected from 634 cows in 9 dairy herds. We used logistic regression to evaluate the effects of these factors on ovarian cysts. A stepwise procedure, used to obtain the appropriate model with alpha=0.05, revealed that cow parity was the most important risk factor for ovarian cyst development within 8 weeks postpartum, while development of endometritis and BCS loss>or=1 from the dry period to 8 weeks postpartum were the most important risk factors for ovarian cyst development beyond 8 weeks postpartum. The occurrence of ovarian cysts beyond 8 weeks postpartum prolonged (Pconception (77 days), and increased (Prate (7.8%), while ovarian cyst development within 8 weeks postpartum did not affect (P>0.05) the mean intervals from calving to first service and conception or the culling rate. The economic loss resulting from the occurrence of ovarian cysts was estimated at approximately 823,996 won ($687) due to effects on the cost of nutrition, average growth of calves, labor and medical costs, and culling. These results suggest that cow parity is correlated with the development of ovarian cysts within 8 weeks postpartum, and endometritis and BCS loss>or=1 from the dry period to 8 weeks postpartum are correlated with the development of ovarian cysts after 8 weeks postpartum, which decreases reproductive performance and results in economic loss in dairy herds in Korea.

  9. Polo pony injuries: player-owner reported risk, perception, mitigation and risk factors.

    Science.gov (United States)

    Inness, C M; Morgan, K L

    2015-07-01

    Polo, one of the world's oldest sports, is unique in merging human skill and balance with animal agility and performance in a contact sport. These modern-day 'centaurs' offer medical, dental and veterinary scientists an unrivalled, if quirky, opportunity to collaborate. Collection of epidemiological data on injuries to UK polo riders and ponies is the first step. To measure the reported risk and risk factors for injuries to UK polo ponies, their perception and mitigation by player-owners. A retrospective cohort design and telephone interviews were used. Data on equine injuries, preseason training and risk perception were collected from a random sample of player-owners using a structured questionnaire. Injuries were defined as requiring veterinary treatment. Frequencies were represented as percentages and 95% confidence intervals (CIs). Risk factors for injuries were identified by univariable and multivariable analyses. The cumulative incidence of player-owner-reported injury was 10.6% (95% CI 8.4-12.7). Tendon injuries were most common (4.3%; 95% CI 2.9-5.7), followed by wounds and splints. The only risk factor was stabling all season (odds ratio 4.79; 95% CI 1.46-15.73). Tendon injuries were perceived as the major risk and hard ground the most important risk factor. Risk mitigation practices were bandaging before exercise (45.7%; 95% CI 34.8-56.5), checking tendons (84.0%; 95% CI 76.0-91.9), cold hosing (40.7%; 95% CI 30.0-51.4), bandaging (38.3%; 95% CI 27.7-48.9) and using clays and coolants after exercise (24.7%; 15.3-34.1). Cuts and wounds were considered most frequent by only 2.5% (95% CI 0.0-3.6) of players but were the second most common injury, accounting for 21.6% of veterinary treatments. Splints accounted for 12.5% of injuries. The risk of injury to polo ponies is similar to that in the general horse population; musculoskeletal injuries, particularly tendon injuries, are most common, followed by wounds and splints. The association between stabling and

  10. Risk factors of intracranial hemorrhage in premature neonates.

    Directory of Open Access Journals (Sweden)

    Nasrin Khalessi

    2014-09-01

    Full Text Available Intraventricular hemorrhage (IVH is an important cause of brain injury in premature neonates. Current study tries to define associated risk factors of IVH in preterm neonates in Aliasghar Children Hospital during 2008 to 2011. In this study, the risk factors have been evaluated in premature neonates with IVH, who had at least one brain sonography since their admission in NICU. A total of 63 premature neonates with IVH were assessed. Mean gestational age was 29.81 (24-34 weeks and mean birth weight was 1290.83±382.96 gr. Other risk factors such as sex, mode of delivery, history of using infertility drugs, maternal disease, maternal hypertension and preeclampsia, lumbar puncture, ventilator therapy and pneumothorax were considered. Because no absolute treatment for IVH is available, identifying risk factors is important in prevention and management of IVH.

  11. Enhancing supply risk management performance : a transaction cost and social exchange theory perspective

    NARCIS (Netherlands)

    Hoffmann, Petra; Schiele, Holger; Song, Michael

    2012-01-01

    Supply risk management gained prominence over the last decade, both in the academic discourse and in practical application. This research examines the influence of Transaction Cost characteristics -behavioral uncertainty, environmental uncertainty and asset specificity- on supply risk management

  12. Enhancing supply risk management performance: a transaction cost and social exchange theory perspective

    NARCIS (Netherlands)

    Hoffmann, Petra; Schiele, Holger; Song, Michael; Krabbendam, Johannes Jacobus

    2011-01-01

    Supply risk management gained prominence over the last decade, both in the academic discourse and in practical application. This research examines the influence of Transaction Cost characteristics -behavioral uncertainty, environmental uncertainty and asset specificity- on supply risk management

  13. Assessing Risk in Costing High-energy Accelerators: from Existing Projects to the Future Linear Collider

    CERN Document Server

    Lebrun, Philippe

    2010-01-01

    High-energy accelerators are large projects funded by public money, developed over the years and constructed via major industrial contracts both in advanced technology and in more conventional domains such as civil engineering and infrastructure, for which they often constitute one-of markets. Assessing their cost, as well as the risk and uncertainty associated with this assessment is therefore an essential part of project preparation and a justified requirement by the funding agencies. Stemming from the experience with large circular colliders at CERN, LEP and LHC, as well as with the Main Injector, the Tevatron Collider Experiments and Accelerator Upgrades, and the NOvA Experiment at Fermilab, we discuss sources of cost variance and derive cost risk assessment methods applicable to the future linear collider, through its two technical approaches for ILC and CLIC. We also address disparities in cost risk assessment imposed by regional differences in regulations, procedures and practices.

  14. Atrial fibrillation and bleeding complication - risk factors and risk marker

    NARCIS (Netherlands)

    Breithardt, G.; Ravens, U.; Kirchhof, P.; van Gelder, I. C.

    2012-01-01

    The development of atrial fibrillation (AF) is closely linked to risk factors like hypertension and heart failure, diabetes mellitus, myocardial infarction and valvular heart disease. These factors partly overlap with those which determine the progression of atrial fibrillation and the incidence of

  15. Risk factors and the occurrence of cerebral palsy in high risk infants

    Directory of Open Access Journals (Sweden)

    Setyo Handryastuti

    2018-04-01

    Full Text Available Background The incidence of cerebral palsy (CP has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention. Objectives To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP. Methods A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age. Results The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53. Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy. Conclusions Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.

  16. Using the Steel Vessel Material-Cost Index to Mitigate Shipbuilder Risk

    National Research Council Canada - National Science Library

    Keating, Edward G; Murphy, Robert; Schank, John F; Birkler, John

    2008-01-01

    This paper describes how the US Navy structures fixed-price and fixed-price, incentive-fee shipbuilding contracts and how labor- and material-cost indexes can mitigate shipbuilder risk in either type of contract...

  17. Changes in CVD risk factors in the activity counseling trial

    Directory of Open Access Journals (Sweden)

    Meghan Baruth

    2011-01-01

    Full Text Available Meghan Baruth1, Sara Wilcox1, James F Sallis3, Abby C King4,5, Bess H Marcus6, Steven N Blair1,21Department of Exercise Science, 2Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Public Health Research Center, Columbia, SC, USA; 3Department of Psychology, San Diego State University, San Diego, CA, USA; 4Department of Health Research and Policy, 5Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; 6Behavioral and Social Sciences Section, Brown University Program in Public Health, Providence, RI, USAAbstract: Primary care facilities may be a natural setting for delivering interventions that focus on behaviors that improve cardiovascular disease (CVD risk factors. The purpose of this study was to examine the 24-month effects of the Activity Counseling Trial (ACT on CVD risk factors, to examine whether changes in CVD risk factors differed according to baseline risk factor status, and to examine whether changes in fitness were associated with changes in CVD risk factors. ACT was a 24-month multicenter randomized controlled trial to increase physical activity. Participants were 874 inactive men and women aged 35–74 years. Participants were randomly assigned to one of three arms that varied by level of counseling, intensity, and resource requirements. Because there were no significant differences in change over time between arms on any of the CVD risk factors examined, all arms were combined, and the effects of time, independent of arm, were examined separately for men and women. Time × Baseline risk factor status interactions examined whether changes in CVD risk factors differed according to baseline risk factor status. Significant improvements in total cholesterol, high-density lipoprotein cholesterol (HDL-C and low-density lipoprotein cholesterol, the ratio of total cholesterol to HDL-C, and triglycerides were seen in

  18. Psychosocial risk factors and heart failure hospitalization

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Andersen, Ingelise; Prescott, Eva

    2011-01-01

    Prospective studies on the role of psychosocial factors in heart failure development are virtually nonexistent. The authors aimed to address the effect of psychosocial factors on the risk of heart failure hospitalization in men and women free of cardiovascular disease. In 1991-1993, the 8......-fourth of the population reported some degree of vital exhaustion. The vital exhaustion score was associated with a higher risk of heart failure in a dose-response manner (P risk of heart failure in both men (hazard ratio = 1.93, 95% confidence...... in the population, even a modestly higher risk of heart failure associated with vital exhaustion may be of importance in the planning of future preventive strategies for heart failure....

  19. Can a Costly Intervention Be Cost-effective?

    Science.gov (United States)

    Foster, E. Michael; Jones, Damon

    2009-01-01

    Objectives To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Design Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. Results Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Conclusions Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations. PMID:17088509

  20. Cost analysis and financial risk profile for severe reactor accidents at Waterford-3

    International Nuclear Information System (INIS)

    Cutbush, J.D.; Abbott, E.C.; Carpenter, W.L. Jr.

    1992-01-01

    To support Louisiana Power and Light Company (LP and L) in determining an appropriate level of nuclear property insurance for Waterford Steam Electric Station, Unit 3 (Waterford-3), ABZ, Incorporated, performed a series of cost analyses and developed a financial risk profile. This five-month study, conducted in 1991, identified the potential Waterford-3 severe reactor accidents and described each from a cleanup perspective, estimated the cost and schedule to cleanup from each accident, developed a probability distribution of associated financial exposure, and developed a profile of financial risk as a function of insurance coverage

  1. 29 CFR 1620.22 - Employment cost not a “factor other than sex.”

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Employment cost not a âfactor other than sex.â 1620.22... THE EQUAL PAY ACT § 1620.22 Employment cost not a “factor other than sex.” A wage differential based on claimed differences between the average cost of employing workers of one sex as a group and the...

  2. Predictive risk factors for moderate to severe hyperbilirubinemia

    OpenAIRE

    Gláucia Macedo de Lima; Maria Amélia Sayeg Campos Porto; Arnaldo Prata Barbosa; Antonio José Ledo Alves da Cunha

    2007-01-01

    Objective: to describe predictive factors for severity of neonataljaundice in newborn infants treated at the University Neonatal Clinic,highlighting maternal, obstetric and neonatal factors. Methods: Acohort retrospective study by means of review of medical charts todefine risk factors associated with moderate and severe jaundice.The cohort consisted of newborns diagnosed with indirect neonatalhyperbilirubinemia and submitted to phototherapy. Risk was classifiedas maternal, prenatal, obstetri...

  3. [Predicting individual risk of high healthcare cost to identify complex chronic patients].

    Science.gov (United States)

    Coderch, Jordi; Sánchez-Pérez, Inma; Ibern, Pere; Carreras, Marc; Pérez-Berruezo, Xavier; Inoriza, José M

    2014-01-01

    To develop a predictive model for the risk of high consumption of healthcare resources, and assess the ability of the model to identify complex chronic patients. A cross-sectional study was performed within a healthcare management organization by using individual data from 2 consecutive years (88,795 people). The dependent variable consisted of healthcare costs above the 95th percentile (P95), including all services provided by the organization and pharmaceutical consumption outside of the institution. The predictive variables were age, sex, morbidity-based on clinical risk groups (CRG)-and selected data from previous utilization (use of hospitalization, use of high-cost drugs in ambulatory care, pharmaceutical expenditure). A univariate descriptive analysis was performed. We constructed a logistic regression model with a 95% confidence level and analyzed sensitivity, specificity, positive predictive values (PPV), and the area under the ROC curve (AUC). Individuals incurring costs >P95 accumulated 44% of total healthcare costs and were concentrated in ACRG3 (aggregated CRG level 3) categories related to multiple chronic diseases. All variables were statistically significant except for sex. The model had a sensitivity of 48.4% (CI: 46.9%-49.8%), specificity of 97.2% (CI: 97.0%-97.3%), PPV of 46.5% (CI: 45.0%-47.9%), and an AUC of 0.897 (CI: 0.892 to 0.902). High consumption of healthcare resources is associated with complex chronic morbidity. A model based on age, morbidity, and prior utilization is able to predict high-cost risk and identify a target population requiring proactive care. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  4. Risk factors for QTc interval prolongation

    NARCIS (Netherlands)

    Heemskerk, Charlotte P.M.; Pereboom, Marieke; van Stralen, Karlijn; Berger, Florine A.; van den Bemt, Patricia M.L.A.; Kuijper, Aaf F.M.; van der Hoeven, Ruud T M; Mantel-Teeuwisse, Aukje K.; Becker, Matthijs L

    2018-01-01

    Purpose: Prolongation of the QTc interval may result in Torsade de Pointes, a ventricular arrhythmia. Numerous risk factors for QTc interval prolongation have been described, including the use of certain drugs. In clinical practice, there is much debate about the management of the risks involved. In

  5. The benefits, risks and costs of privacy: patient preferences and willingness to pay.

    Science.gov (United States)

    Trachtenbarg, David E; Asche, Carl; Ramsahai, Shweta; Duling, Joy; Ren, Jinma

    2017-05-01

    Multiple surveys show that patients want medical privacy; however, there are costs to maintaining privacy. There are also risks if information is not shared. A review of previous surveys found that most surveys asked questions about patient's privacy concerns and willingness to share their medical information. We found only one study that asked about sharing medical information for better care and no survey that asked patients about the risk, cost or comparison between medical privacy and privacy in other areas. To fill this gap, we designed a survey to: (1) compare medical privacy preferences to privacy preferences in other areas; (2) measure willingness to pay the cost of additional privacy measures; and (3) measure willingness to accept the risks of not sharing information. A total of 834 patients attending physician offices at 14 sites completed all or part of an anonymous questionnaire. Over 95% of patients were willing to share all their medical information with their treating physicians. There was no difference in willingness to share between primary care and specialty sites including psychiatry and an HIV clinic. In our survey, there was no difference in sharing preference between standard medical information and information with additional legal protections including genetic testing, drug/alcohol treatment and HIV results. Medical privacy was ranked lower than sharing social security and credit card numbers, but was deemed more private than other information including tax returns and handgun purchases. There was no statistical difference for any questions by site except for HIV/AIDS clinic patients ranking privacy of the medical record more important than reducing high medical costs and risk of medical errors (p risks to keep medical information hidden. Patients were very willing to share medical information with their providers. They were able to see the importance of sharing medical information to provide the best possible care. They were unwilling to

  6. Violence Victimization in Korean Adolescents: Risk Factors and Psychological Problems

    Directory of Open Access Journals (Sweden)

    Subin Park

    2017-05-01

    Full Text Available We examined the risk factors for and psychological problems associated with violence victimization in a nationwide representative sample of Korean adolescents. Data from the 2016 Korean Youth Risk Behavior Web-based Survey was used. Participants were asked about their experience of being a victim of violence that required medical treatment during the past 12 months, as well as their perceived health, happiness, sleep satisfaction, stress, depressed mood, and suicidality. The 12-month prevalence of violence victimization requiring medical treatment was 2.4%. The results indicated that adolescents were at an increased risk for violence victimization if they were male, older, had parents of a foreign nationality, did not reside with their family, worked part time, resided in small cities or rural areas, were high or low in socioeconomic status (SES, exhibited high or low levels of academic performance, used alcohol or tobacco, and were sexually active. In addition, while violence victimization was negatively associated with perceived health and happiness, it was positively associated with perceived stress, depressed mood, and suicidality. The results indicate that a social disadvantage, involvement in risky behavior, and psychological problems are associated with violence victimization. Effective violence prevention efforts should thus target high-risk groups, and clinical attention is needed to address the psychological costs associated with violence victimization.

  7. Health Cost Risk and Optimal Retirement Provision : A Simple Rule for Annuity Demand

    NARCIS (Netherlands)

    Peijnenburg, J.M.J.; Nijman, T.E.; Werker, B.J.M.

    2010-01-01

    We analyze the effect of health cost risk on optimal annuity demand and consumption/savings decisions. Many retirees are exposed to sizeable out-of-pocket medical expenses, while annuities potentially impair the ability to get liquidity to cover these costs and smooth consumption. We find that if

  8. Suicidal ideation and suicide attempts among human immunodeficiency virus-infected adults: differences in risk factors and their implications.

    Science.gov (United States)

    Kang, Cho Ryok; Bang, Ji Hwan; Cho, Sung-Il; Kim, Kui Nam; Lee, Hee-Jin; Ryu, Bo Yeong; Cho, Soo Kyung; Lee, Young Hwa; Oh, Myoung-Don; Lee, Jong-Koo

    2016-01-01

    Many studies have investigated risk factors for suicidal ideation and suicide attempt; however, most have failed to show differences in risk factors between suicidal ideation and suicide attempt among the human immunodeficiency virus (HIV)-infected population. This study was designed to identify differences in risk factors between suicidal ideation and suicide attempts among HIV-infected adults in Seoul. A face-to-face survey of 457 HIV-infected adults was conducted by the Seoul Metropolitan Government in 2013. Multivariate logistic regression analysis was used to identify factors associated with suicidal ideation and suicide attempt. Among 422 participants, 44% had suicidal ideation, and 11% had suicide attempts. The independent risk factors for suicidal ideation were young and middle age, living with someone, history of AIDS-defining opportunistic disease, history of treatment for depression, lower social support, and psychological status. Beneficiaries of National Medical Aid, economic barriers to treatment, history of treatment for depression, and lower psychological status were independently associated with suicide attempts. Patients with HIV in Korea were treated without cost in some centers. Thus, experiencing an economic barrier to treatment might be due in part to ignorance of HIV care policies. Our findings indicate that suicide attempts are associated with socioeconomic factors and information inequality regarding medical care. In conclusion, suicidal ideation closely associated with the psychosocial factors, whereas suicide attempt demonstrates a stronger association with socioeconomic factors. Suicide prevention measures should be implemented to provide information to help HIV-infected patients.

  9. Evidence that Risk Adjustment is Unnecessary in Estimates of the User Cost of Money

    Directory of Open Access Journals (Sweden)

    Diego A. Restrepo-Tobón

    2015-12-01

    Full Text Available Investors value the  special attributes of monetary assets (e.g.,  exchangeability, liquidity, and safety  and pay a premium for holding them in the form of a lower return rate. The user cost of holding monetary assets can be measured approximately by the difference between the  returns on illiquid risky assets and  those of safer liquid assets. A more appropriate measure should adjust this difference by the  differential risk of the  assets in question. We investigate the  impact that time  non-separable preferences has on the  estimation of the  risk-adjusted user cost of money. Using U.K. data from 1965Q1 to 2011Q1, we estimate a habit-based asset pricing model  with money  in the utility function and  find that the  risk  adjustment for risky monetary assets is negligible. Thus, researchers can dispense with risk adjusting the  user cost of money  in constructing monetary aggregate indexes.

  10. Generation choices as influenced by costs, risks and externalities -Germany

    International Nuclear Information System (INIS)

    Strauss, L.

    1994-01-01

    Power generation in Germany is dealing with social acceptability, cost considerations, governmental decisions and protection legislation. In the future, political and sociological factors will become more and more important: social acceptability of the energy sources choice is the most significant factor decision as the future pattern of power generation. (TEC)

  11. Modifiable cardiovascular risk factors among adults in Aleppo, Syria.

    Science.gov (United States)

    Al Ali, Radwan; Rastam, Samer; Fouad, Fouad M; Mzayek, Fawaz; Maziak, Wasim

    2011-12-01

    This report provides the first comprehensive and standardized assessment of the distribution of cardiovascular disease (CVD) risk factors in Syria, where