Relative Risk Assessment Research Articles

Effects of an educational technology on self-efficacy for breastfeeding and practice of exclusive breastfeeding.

To evaluate the effects of using a flipchart (serial album) on maternal self-efficacy in breastfeeding and its effects on exclusive breastfeeding (EBF) in children's first two months of life. Clinical trial in Recife, Northeastern Brazil, with 112 women in the third trimester of gestation, randomly distributed in intervention group (IG) and control group (CG). The intervention was the use of the flipchart in IG. Data collection was performed through interviews in the prenatal period, and telephone contact at second, fourth and eighth weeks postpartum. The Breastfeeding Self-Efficacy Scale-Short-Form (BSES-SF) was used to measure self-efficacy scores. In the analysis, was used descriptive, bivariate statistics through tests of comparisons of proportions and means, and relative risk assessment. There was a statistically significant difference in mean values of self-efficacy scores between women in the IG and CG (p<0.001) and in EBF rates (p<0.001). The probability of exclusively breastfeeding in IG was twice as high than in CG (RR 2.2, CI 1.51-3.21). The use of a flipchart as an educational tool had positive effects on self-efficacy scores for breastfeeding and in maintenance of EBF in the IG. Brazilian Registry of Clinical Trials: RBR-5N7K99.

Is the aquatic environment sufficiently protected from chemicals discharged with treated ballast water from vessels worldwide? – A decadal environmental perspective and risk assessment

Ballast water managements systems (BWMS) installed on vessels may use active substances to inactivate or kill organisms in the ballast water. This paper provides new insights in this global issue - discharge of hazardous disinfection by-products with ballast water and related risk assessment for the environment. Considering the possible extent of this issue, the International Maritime Organization (IMO) engaged the Joint Group of Experts on the Scientific Aspects of Marine Environmental Protection (GESAMP)-Ballast Water Working Group (BWWG) to oversee the evaluation process of BWMS that make use of active substances to prevent negative effects. We analysed all BWMS that received IMO final approval over a decade until 2017 and provide an overview of active substances used for ballast water treatment and disinfection by-products in the discharged ballast water. A risk assessment was conducted using the GESAMP-BWWG methodology for two very different commercial ports (Koper, Slovenia and Hamburg, Germany). Some relevant chemicals (chloropicrin, monochloroacetic acid, and dibromoacetonitrile) and other chemicals (isocyanuric acid and sodium thiosulphate) reached levels of concern, indicating a risk for aquatic organisms after discharge of that ballast water. From this analysis, it became clear GESAMP-BWWG worst-case scenario assumptions do not fully account for the potential environmental risks. We provide recommendations how to make this risk assessment more robust, recommend further research, and urge for policy as well as regulatory responses.

Bioaccumulation of heavy metals in local edible plants near a municipal landfill and the related human health risk assessment

ABSTRACTThe increase in municipal solid waste generation, along with high concentrations of heavy metals in environments near municipal landfill, has led to human health hazards. This study investigated heavy metal contamination in water, sediment, and edible plants near a municipal landfill, including the bioaccumulation factor (BAF) and potential health risks. The heavy metal concentrations in the samples were analyzed using inductively coupled plasma optical emission spectrometry (ICP-OES). The concentrations of arsenic (As), lead (Pb), cadmium (Cd), and chromium (Cr) in water samples were not detected (ND), ND, 0.006 ± 0.01 mg/L, and ND, respectively, and in sediment samples, the concentrations were 1.19 ± 0.44, 3.20 ± 0.62, 0.46 ± 0.21, and 6.97 ± 0.34 mg/kg, respectively. The highest concentrations of As (5.03 ± 0.38), Pb (1.81 ± 0.37), and Cd (1.93 ± 0.13) were found in Marsilea crenata, whereas that of Cr (5.68 ± 0.79) was detected in Ipomoea aquatica. The Cr concentration in all plant species exceeded the standard for vegetables. The BAF values followed the heavy metal concentrations. All plant species have a low potential for accumulating Pb and Cr. The edible plants in this study area might cause health hazards to consumers from As, Pb, and Cd contamination.

Clinical Utility Gene Card For: GALNT3 defective congenital disorder of glycosylation.

Review of the analytical and clinical validity as well as of the clinical utility of DNA-based testing for mutations in PGM3 in diagnostic, predictive and prenatal settings, and for risk assessment in relatives.

Urinary metal concentrations among mothers and children in a Mexico City birth cohort study.

Personal care product use is a potential source of metals exposure among children, but studies have been limited. We measured urinary concentrations of 10 metals (aluminum, arsenic [As], barium [Ba], cadmium, cobalt [Co], lead [Pb], manganese [Mn], molybdenum [Mo], nickel, and zinc [Zn]) in third trimester pregnant women (n = 212) and their children at 8-14 years of age (n = 250). Demographic factors (child sex, age, socioeconomic status, and maternal education), body mass index (BMI) z-score, and child personal care product use in the 24 h prior to urine collection were examined as predictors of urinary metal concentrations. Metals were detected in 80-100% of urine samples, with significant differences in maternal versus childhood levels. However, metal concentrations were not strongly correlated within or between time points. In linear regression models including all demographic characteristics, BMI z-score, and specific gravity, age was associated with higher Co (6% [95% CI: 2, 10]), while BMI z-score was associated with lower Mo (-6% [95% CI: -11, -1). In addition, significantly higher metal concentrations were observed among users of colored cosmetics (Mo: 42% [95% CI: 1, 99]), deodorant (Ba: 28% [3, 58]), hair spray/hair gel (Mn: 22% [3, 45]), and other toiletries (As: 50% [9, 108]), as well as with an increasing number of personal care products used (As: 7% [3, 11]) after adjustment for child sex, age, total number of products used, and specific gravity. However, significantly lower metal concentrations were noted for users of hair cream (As and Zn: -20% [-36, -2] and -21% [-35, -2], respectively), shampoo (Pb: -40% [-62, -7]), and other hair products (Pb: -44% [-65, -9]). We found that personal care product use may be a predictor of exposure to multiple metals among children. Further research is recommended to inform product-specific exposure source identification and related child health risk assessment efforts.

Nasal carriage and antimicrobial susceptibility of Coagulase–Negative Staphylococci (CoNS) among healthy veterinary students in Greece

During last decades CoNS and especially the methicillin-resistant (MRCoNS) ones have become important pathogens and their infections are usually associated with healthcare settings. CoNS are considered as source of antimicrobial resistance traits for other bacteria and thus the evaluation of their prevalence in the community contributes significantly to the risk assessment in relation to public health. The aim of the present study was the investigationof the nasal carriage and antimicrobial susceptibly of CoNS among healthy veterinary students. From 81 healthy students of the School of Veterinary Medicine, Aristotle University of Thessaloniki, Greece, 24 strains were isolated from 22 (27.16%) students. Of them 54% were identified as Staphylococcus haemolyticus, 45.8% as Staphylococcus warneri, 16.6% as Staphylococcus epidermidis, 4.2% as Staphylococcus pasteuri and 4.2% as Staphylococcus capitis. All isolates were resistant to penicillin, 33.3% were resistant to amoxicillin/clavulanic acid, 29.2% to erythromycin, 4.2% to oxacillin, 4.2% to gentamycin and 4.2% to trimethoprim/sulfamethoxazole. The resistant to oxacillin isolate belonged to the S. epidermidis species and proved to carry the mecA gene. This study showed that the rate of nasal carriage of CoNS among veterinary students in Greece was low. The analysis of the standardised questionnaire, that was completed for each participating student during sampling, showed that pet owners tested positive for the coagulase-negative staphylococci were at a significantly lower rate (p-value=0.007) compared to non-pet owners. Moreover, among the participants who had visited a hospital over the last six months, the percentage of positive results in coagulase-negative staphylococci was significantly lower compared to that of the other participants (p-value=0.048). Although only one student found to carry methicillin-resistant S. epidermidis, its presence is evidence that this pathogen may circulate among veterinarians and the personnel of veterinary health establishments. Surveillance programs should also be performed in veterinary units because the emergence resistant bacteria in this environment may represent a risk to public health.

An Assessment of Relative Risks to Human/Ecological Health Biotech Crops versus Other Human Activities

In the age of biotechnology and genomics, often we are confronted with the question whether or not we are taking due precautions in conducting research involving recombinant

Clinical utility gene card for McArdle disease.

Name of the disease (synonyms) McArdle disease (glycogenosis type V; glycogen storage disease V (GSDV); PYGM deficiency; muscle glycogen phosphorylase deficiency; myophosphorylase deficiency). OMIM# of the disease #232600. Name of the analysed genes or DNA/chromosome segments Muscle glycogen phosphoryalse (PYGM). OMIM# of the gene(s) #608455.Review of the analytical and clinical validity as well as of the clinical utility of DNA-based testing for variants in the PYGM gene(s) in⊠ diagnostic,⊠ predictive and⊠ prenatal settings and for⊠ risk assessment in relatives.

Sustainable Urban Water Management: Application for Integrated Assessment in Southeast Asia

The design, development, and operation of current and future urban water infrastructure in many parts of the world increasingly rely on and apply the principles of sustainable development. However, this approach suffers from a lack of the necessary knowledge, skills, and practice of how sustainable development can be attained and promoted in a given city. This paper presents the framework of an integrated systems approach analysis that deals with the abovementioned issues. The “Water and Urban Initiative” project, which was implemented by the United Nations University’s Institute for the Advanced Study of Sustainability, focused on urban water and wastewater systems, floods, and their related health risk assessment, and the economics of water quality improvements. A team of researchers has investigated issues confronting cities in the developing countries of Southeast Asia, in relation to sustainable urban water management in the face of such ongoing changes as rapid population growth, economic development, and climate change; they have also run future scenarios and proposed policy recommendations for decision-makers in selected countries in Southeast Asia. The results, lessons, and practical recommendations of this project could contribute to the ongoing policy debates and decision-making processes in these countries.

Intracellular and extracellular retinoid-like activity of widespread cyanobacterial species

Cyanobacterial species produce wide range of bioactive compounds. This study characterized production of retinoid-like compounds with embryotoxic and teratogenic potential by commonly occurring cyanobacterial species with tendency to form massive water blooms. The major goal was to simultaneously assess the intracellular and extracellular retinoid-like activity from several independent cultivations of one coccal (Microcystis aeruginosa) and four filamentous cyanobacteria (Aphanizomenon gracile, Cylindrospermopsis raciborskii, Limnothrix redekeii, and Planktothrix agardhii) and characterize the variability in its production among cultivations. The retinoid-like activity was evaluated by in vitro assay along with chemical analyses of nine retinoids: all-trans retinoic acid (ATRA), 9-cis retinoic acid (9cis-RA), 13cis-RA, 13cis-RA methyl ester, 5,6 epoxy-RA, 4keto-ATRA, 4keto-retinal, 4hydoxy-retinoic acid (4OH-ATRA), retinal and retinol. The production of retinoid-like compounds was recalculated per volume, per biomass dry weight and per cell to provide relevant data for risk assessment in relation to occurrence of massive water blooms in the environment. Total produced retinoid-like activity of five selected species ranged from 170 to 25,600 ng ATRA-equivalents (REQ)/g dm corresponding to 0.001–0.392 ng REQ/106 cyanobacterial cells. Results from chemical analyses showed that all tested extracts contained 4keto-ATRA and retinal. All-trans retinoic acid, 9/13cis-retinoic acid and 5,6 epoxy-retinoic acid were detected in most exudate and extract samples. The reported results of recalculated total retinoid-like activity enable potential predictions of its production by the studied species in water blooms of known cell densities relevant for risk assessment.

INNOVATIVE PROCESS IN RISK MANAGEMENT BASED ON EXAMPLE OF AN ATTEMPT AT DEFINING THE EFFECT OF REPAIR COSTS AT THE HEIGHT OF INDIVIDUAL INDIVIDUAL INTERRUPTION OF THE INSURANCE RATES

The purpose of the article is to try to examine the impact of vehicle repair costs on thelevel of the insurance rate. The verification of the following research hypothesis was used to achievethis goal. Shaping the insurance rate based on the repair cost parameter may lead to the developmentof an innovative method of risk assessment in relation to motor insurance and in particular, voluntaryinsurance such as comprehensive insurance. Achieving this task required the use of appropriateresearch methods and techniques, such as: analysis of available literature sources, methods ofinduction and deduction, and conducting a numerical experiment, in order to assess the impact ofrepair costs on the insurance rate.On the other hand, direct recipients of the presented research results may be insurance companies,which in the near future are considering changes in the methods of determining risk and shaping theinsurance rate in the case of voluntary motor insurance.

Dynamical modeling approach to risk assessment for radiogenic leukemia among astronauts engaged in interplanetary space missions

A recently developed biologically motivated dynamical model of the assessment of the excess relative risk (ERR) for radiogenic leukemia among acutely/continuously irradiated humans (Smirnova, 2015, 2017) is applied to estimate the ERR for radiogenic leukemia among astronauts engaged in long-term interplanetary space missions. Numerous scenarios of space radiation exposure during space missions are used in the modeling studies. The dependence of the ERR for leukemia among astronauts on several mission parameters including the dose equivalent rates of galactic cosmic rays (GCR) and large solar particle events (SPEs), the number of large SPEs, the time interval between SPEs, mission duration, the degree of astronaut's additional shielding during SPEs, the degree of their additional 12-hour's daily shielding, as well as the total mission dose equivalent, is examined. The results of the estimation of ERR for radiogenic leukemia among astronauts, which are obtained in the framework of the developed dynamical model for various scenarios of space radiation exposure, are compared with the corresponding results, computed by the commonly used linear model. It is revealed that the developed dynamical model along with the linear model can be applied to estimate ERR for radiogenic leukemia among astronauts engaged in long-term interplanetary space missions in the range of applicability of the latter. In turn, the developed dynamical model is capable of predicting the ERR for leukemia among astronauts for the irradiation regimes beyond the applicability range of the linear model in emergency cases. As a supplement to the estimations of cancer incidence and death (REIC and REID) (Cucinotta etal., 2013, 2017), the developed dynamical model for the assessment of the ERR for leukemia can be employed on the pre-mission design phase for, e.g., the optimization of the regimes of astronaut's additional shielding in the course of interplanetary space missions. The developed model can also be used on the phase of the real-time responses during the space mission to make the decisions on the operational application of appropriate countermeasures to minimize the risks of occurrences of leukemia, especially, for emergency cases.

Metabolic syndrome and cardiovascular risk assessment tools’ estimations of 10-year cardiovascular risk: a population-based study

Background: This cross-sectional study determines the association between 10-year cardiovascular disease (CVD) risk, estimated using four CVD risk assessment tools, and metabolic syndrome (MetS) in northern Iranian general population. Methods: We used the data of 2371 participants aged 40–74 without any history of diabetes mellitus from a cohort study conducted among 6140 subjects aged 10–90 years in northern Iran. Three definitions of MetS were used. The four CVD risk assessment tools used to estimate the 10-year CVD risk included pooled cohort equations of ACC/AHA, Systematic Coronary Risk Evaluation (SCORE) equations (for low-risk and high-risk European countries), and Framingham general cardiovascular risk profile for use in primary care. Logistic regression was used to determine the association between various definitions of MetS and 10-year CVD risk of ≥5%, ≥ 7.5%, and ≥10%, based on the related risk assessment tools. Results: In men, univariate logistic regression analysis showed the strongest association between 10-year risk of ≥0.1 estimated by Framingham risk profile and the three definitions of MetS. In women, the 10-year risks by Framingham risk profile and SCORE equations for high-risk European countries had stronger associations with various definitions of MetS than others. No significant associations were detected between estimated risks of four risk assessment tools and various definitions of MetS in multivariate logistic regression analyses. Conclusion: No independent associations were observed between estimations of 10-year CVD risk using four risk assessment tools and various definitions of MetS.

A new definition of complexity in a risk analysis setting

In this paper, we discuss the concept of complexity in a risk analysis context. Inspired by the work of Johansen and Rausand, a new perspective on complexity is presented which includes several common definitions of complexity as special cases. The idea is to link complexity to activities, to the knowledge about the activity and its consequences (including scenarios, events, outcomes), and to the knowledge about the sub-activities: an activity is considered complex if we have poor knowledge about the consequences of the activity, even if we have strong knowledge about the consequences of its sub-activities. In the paper, we show how this perspective provides new insights about the complexity concept and related risk understanding, risk assessment and risk management. The perspective allows in particular for novel ways of characterizing the risk of complex systems and activities. Some examples are used to illustrate the perspective and the discussion.

Road traffic injuries, mobility and gender. Patterns of risk in Southern Europe

Abstract Background The identification of risk groups for road traffic injuries (RTI) is essential for effective prevention strategies. This information is still limited in several geographical areas. The aim of this study was to evaluate the risk of RTI according to gender, age, mode of transport, type of journey and injury severity in a Southern European region. Methods A cross-sectional study was conducted during the period from January 2008 to December 2013 in Andalusia (South of Spain). We estimated the specific morbidity rates by gender, mode of transport and age. The relative risk assessment was performed by Poisson regression models adjusted by gender, age, type of journey, injury severity and mode of transport. The measure of exposure was person − hours travelled. Results Except for pedestrians, the highest RTI rates were found in women. This pattern was still fulfilled in minor injuries. In serious and fatal injuries, the trend was reversed with the risk of increased RTI in men. The most hazardous mode of transport was motorcycles, while public transport was the safest. Injury severity was positively associated with age for all modes of transport, except motorcycles where the opposite was the case. Finally, the risk of serious or fatal injury was greater in long-distance trips. Conclusions In our Southern European region, preventive strategies should be targeted in men, young and older people, motorcycles and long-distance drivers, as they present a higher risk of serious and fatal injuries.

ХВОРОБИ СИСТЕМИ КРОВООБІГУ ТА СОЦІАЛЬНО-ЕКОЛОГІЧНІ ФАКТОРИ РИЗИКУ

РЕЗЮМЕ. Захворюваність і смертність від хвороб системи кровообігу (ХСК) становлять одну із провідних проблем сучасної системи охорони здоров’я. На відміну від провідних країн світу, ХСК в Україні протягом останніх десятиліть продовжують зростати і залишаються важливою медико-соціальною проблемою.Мета – оцінити вплив факторів ризику (ФР) на поширеність ХСК в окремих районах України.Матеріал і методи дослідження. Матеріалом дослідження слугували дані галузевої статистичної звітності України про рівень поширеності ХСК серед населення України, рівень безробіття (розрахованого за методологією МОП), поширеність тютютнопаління та рівень викидів забруднюючих речовин і оксиду вуглецю в Україні протягом 2009-2015 років.У дослідженні використано такі методи: демографічне районування, системного аналізу, статистичний.Результати аналізу оцінки відносного ризику впливу ФР на поширеність ХСК за період 2009-2015 років дозволяють стверджувати, що тютюнопаління сприяє розвитку ХСК переважно у Південно-Східному, Південному та Північно-Східному районах. Рівень безробіття має істотний вплив на поширеність ХСК у Північно-Східному, Західному та Центральному районах. Рівні викидів забруднюючих речовин та оксиду вуглецю найбільше впливають на стан серцево-судинної системи у Південно-Східному районі.Висновки. Оцінка відносного ризику ФР на поширеність ХСК вказує на істотний вплив поведінкових, соціальних та екологічних чинників. Їх асоціація найістотніше сприяє росту серцево-судинної захворюваності в Південно-Східному районі України.

Evaluation of Flooding Risk and Engineering Protection Against Floods for Ulan-Ude

The report presents the results of the study on analysis and risk assessment in relation to floods for Ulan-Ude and provides the developed recommendations of the activities for engineering protection of the population and economic installations. The current situation is reviewed and the results of the site survey are shown to identify the challenges and areas of negative water influence along with the existing security system. The report presents a summary of floods and index risk assessment. The articles describes the scope of eventual flooding, underflooding and enumerates the economic installations inside the urban areas’ research-based zones of flooding at the rated levels of water to identify the likeliness of exceedance. The assessment of damage from flood equal to 1% is shown.

A Flood Risk Assessment Model for Companies and Criteria for Governmental Decision-Making to Minimize Hazards

Flood risks in the industrial sector and economic damages are increasing because of climate change. In addition to changes in precipitation patterns due to climate change; factors that increase flood damage include infrastructure deterioration and lack of storage facilities. Therefore; it is necessary for companies and the government to actively establish flood management policies. However; no evaluation method is currently available to determine which items should be invested in first by small and medium-sized enterprises that have limited finances. Because the government should make comprehensive and fair decisions; the purpose of this study is to propose priority investment risk items and an assessment method to decide which companies should be invested in first in flood risk management due to climate change. The multispatial scale of the method takes both the location and characteristics of the company into account. Future climate change scenarios were used to evaluate the changing patterns of flood risks. We developed the relative Flood Risk Assessment for Company (FRAC model) methodology to support the government’s policymaking. This method was applied to four companies belonging to four different industries and three risk items were derived that are likely to harm the company owing to flooding.

Probabilistic estimation of long-term volcanic hazard under evolving tectonic conditions in a 1 Ma timeframe

Risk assessments in relation to the siting of potential deep geological repositories for radioactive wastes demand the estimation of long-term tectonic hazards such as volcanicity and rock deformation. Owing to their tectonic situation, such evaluations concern many industrial regions around the world. For sites near volcanically active regions, a prevailing source of uncertainty is related to volcanic hazard. For specific situations, in particular in relation to geological repository siting, the requirements for the assessment of volcanic and tectonic hazards have to be expanded to 1millionyears. At such time scales, tectonic changes are likely to influence volcanic hazard and therefore a particular stochastic model needs to be developed for the estimation of volcanic hazard. The concepts and theoretical basis of the proposed model are given and a methodological illustration is provided using data from the Tohoku region of Japan.

Flood risk assessment model using the fuzzy analytic hierarchy process

Sustainable development and natural disasters are closely interlinked. The impact of catastrophic events on the environment is still very difficult to determine, and such losses are generally underestimated. Development is never neutral in relation to catastrophes: it creates, enhances or reduces the risk of their occurrence. Selection of appropriate methods and mathematical models for risk assessment in relation to the specific features and characteristics of the considered system and available information and resources, is a key parameter of reliability assessment. Numerous authors applied AHP methods with flood risk assessment, but very limited literature is avaliable on the use of fuzzy multiobjective analysis in flood studies. In the recent years, the fuzzy approach for flood risk assessments has gained greater importance. In this paper, we present the fuzzy analytic hierarchy process (FAHP) model for flood risk assessments. Two flood hazard indexes were defined, one based on natural factors and one based on anthropogenic factors. FAHP is applied to data sets to illustrate a model.