Varying Levels Of Risk Research Articles

Trajectories of maternal aggression in early childhood: Associations with parenting stress, family resources, and neighborhood cohesion

BackgroundThe effects of family risk on parenting can be ameliorated or exacerbated depending on factors internal (e.g., appraisals, regulation) and external (e.g., resources, social support) to the role of parenting. Therefore, it is important to distinguish between sources of stress when exploring associations with parenting behaviors. ObjectiveWe aimed to identify trajectories of maternal aggression among families across various levels of risk, and explore associations with factors internal and external to parenting. Participants and settingParticipants included children in large U.S. cities born between 1998 and 2000, followed through age 9, in the Fragile Families and Child Well-being Study with medical records data available (N = 3529). MethodLatent growth curve modeling was conducted to identify trajectories of maternal aggression measured through a survey at child age 3, 5, and 9. Correlates of maternal aggression (i.e., family risk for maltreatment, income-to-poverty ratios, maternal education, parenting stress, and neighborhood cohesion) were measured through medical records and maternal surveys at birth, age 1, and age 3. ResultsMaternal aggression similarly declined between child age 3 and 9 across low-, moderate-, and high-risk families. Across all families, neighborhood social cohesion was significantly, negatively associated with maternal aggression, (β’s = −.20 to −.28, p’s < .001) and increases in parenting stress were significant predictors among Low Risk (β = .12, p = .006) and High Risk (β = .10, p = .02) families. ConclusionThe results suggest that families could benefit from supportive neighborhood environments or parenting stress reduction techniques, regardless of level of risk at birth.

Assessing the Effectiveness of Weighted Information Gap Decision Theory Integrated With Energy Management Systems for Isolated Microgrids

In the context of microgrid, renewable energy variations are still a major concern for operators, especially in industrial applications in which microgrids are typically located in remote areas and are operated autonomously. Information gap decision theory (IGDT) is a nonprobabilistic method utilized to appraise various levels of risk without the availability of statistical data, such as probability density functions of uncertain parameters. Despite such a rewarding feature, the IGDT in its current form is unable to obtain time-varying robustness bands, meaning that it does not take into consideration the system risk imposed by renewable energy injections at each individual time interval in a short-term operation horizon. To overcome this issue, this article presents a modified version of the IGDT named weighted IGDT (W-IGDT), yielding risk-based time-varying robustness bands rather than time-independent ones. This article also proposes a W-IGDT-based energy management system (EMS) based on a linked unit commitment-optimal power flow (UC-OPF) framework, which simultaneously incorporates the generating units on/off status as well as power flow limits into the optimization procedure. In order to illustrate the performance of the proposed EMS, a CIGRE microgrid benchmark is utilized, and the results indicate the effectiveness of the W-IGDT-based EMS in terms of optimal operation and addressing the intermittency of renewable energy sources.

Determining the post-elimination level of vaccination needed to prevent re-establishment of dog rabies.

BackgroundOnce a canine rabies-free status has been achieved, there is little guidance available on vaccination standards to maintain that status. In areas with risk of reintroduction, it may be practical to continue vaccinating portions of susceptible dogs to prevent re-establishment of canine rabies.MethodsWe used a modified version of RabiesEcon, a deterministic mathematical model, to evaluate the potential impacts and cost-effectiveness of preventing the reintroduction of canine rabies through proactive dog vaccination. We analyzed four scenarios to simulate varying risk levels involving the reintroduction of canine rabies into an area where it is no longer present. In a sensitivity analysis, we examined the influences of reintroduction frequency and intensity, the density of susceptible dog population, dog birth rate, dog life expectancy, vaccine efficacy, rate of loss of vaccine immunity, and the basic reproduction number (R0).ResultsTo prevent the re-establishment of canine rabies, it is necessary to vaccinate 38% to 56% of free-roaming dogs that have no immunity to rabies. These coverage levels were most sensitive to adjustments in R0 followed by the vaccine efficacy and the rate of loss of vaccine immunity. Among the various preventive vaccination strategies, it was most cost-effective to continue dog vaccination at the minimum coverage required, with the average cost per human death averted ranging from $257 to $398 USD.ConclusionsWithout strong surveillance systems, rabies-free countries are vulnerable to becoming endemic when incursions happen. To prevent this, it may be necessary to vaccinate at least 38% to 56% of the susceptible dog population depending on the risk of reintroduction and transmission dynamics.

Understanding the impact of a syndemic on the use of pre-exposure prophylaxis in a community-based sample of behaviorally PrEP-eligible BMSM in the United States

ABSTRACTHIV Pre-Exposure Prophylaxis (PrEP) has shown great promise in reducing HIV transmission among affected populations; however, PrEP uptake among Black men who have sex with men (BMSM) has stalled. This study compares BMSM using PrEP and BMSM at risk for HIV not using PrEP based on differences in behavior, psychosocial conditions and the presence of a syndemic (n = 1,411). BMSM reporting PrEP use were significantly more likely to report three of five HIV risk behaviors and three of four psychosocial conditions. Odds of reporting PrEP use increased as the number of psychosocial conditions increased such that BMSM with three psychosocial conditions (AOR = 5.65, 95% CI: 3.17, 10.08) and four conditions (AOR = 18.34, 95% CI: 5.01, 67.20) demonstrated significantly greater odds of PrEP use compared to BMSM reporting one or less conditions. While BMSM at greatest risk are using PrEP, strategies are still needed for men at varying risk levels.

Bank Level Challenges on Management of Loan Quality in Public Sector Banks

This Paper investigates the challenges faced by public sector banks in India on Management of loan quality. The focal point of a financial institution is purely based on credit growth, CASA Ration and viable environment to enhance the overall bank performance. But the formation of non-performing assets affects the loan quality severely. The Formation of Non-Performing Assets is seen as a crucial part of banks and the magnitude would expose to various levels of risks across the nation’s activities. The past literature discussed on determinants of non-performing assets, in terms of factors influencing by macroeconomic factors, borrower’s centric factors, and bank-specific factors. On which a few kinds of literature focused on what are the bank-level challenges to maintain asset quality To answer the research objectives, the structured questionnaire framed for the dimensions were taken all legal measures and bank level challenges factors to examine the study. A total of 135bank officials of different public sector banks branches were contacted and 100 responses were received. The data collected was subjected to statistical analysis. The results showed that all the causes for NPA are prominent; inappropriate Legal Measures and asset quality tools required careful scrutiny to reduce risk of NPA.

Reward Processing in Drug-Naive Youth with Various Levels of Risk for Substance Use Disorders: A Pilot Study.

Background: It has been hypothesized that attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) share common neurobiological features. When abnormalities in the mesolimbic reward system are characteristic of children with ADHD, it is unclear whether youth at particularly elevated risk for SUD may exhibit any further disturbances. The objective of this pilot study is to examine possible neurobiological differences among youth with different levels of SUD risk before exposure to any abusable substances. Methods: We recruited 47 drug-naive children aged 8-13 divided into (1) Low Risk (LR)-ADHD only (n = 16); (2) High Risk (HR)-ADHD+familial SUD (n = 17); and (3) healthy controls (HC, n = 14) who underwent one functional magnetic resonance imaging scan while performing a hybrid task. We used the omnibus analysis of covariance model to assess for group differences in brain activation in regions linked to the brain reward and behavioral control systems. Results: Behavioral analysis showed significant Cue and Flanker main effects, but no significant main effect for Group. Whole-brain analysis showed significant differences in widely distributed networks related to both reward processing and behavioral control. Region of interest (ROI) activations showed that the HR group had the highest activation in the right putamen during both expected rewards and unexpected nonreward outcomes and in the anterior cingulate cortex (ACC) during unexpected nonreward outcomes, while LR and HC youth showed similarly low activation during these contrasts. Furthermore, the LR and HR groups showed lower activation than HC in the right ACC and the right caudate during flanker contrasts. Conclusions: These are the first preliminary results to demonstrate that the magnitude of activation during reward notification differs as a function of reward outcome in youth at high versus LR for SUD, such that youth at LR for SUD exhibit the highest activation for positive rewards, whereas those at HR for SUD exhibit the highest activation during negative rewards.

Factors associated with intentions for breast cancer risk management: Does risk group matter?

National guidelines provide breast cancer (BC) risk management recommendations based on estimated lifetime risk. Despite this specificity, it is unclear if women's risk management intentions are or are not guideline concordant. To address this knowledge gap, women at varying risk levels reported intentions for risk-reducing behaviors. Factors associated with intentions, informed by the Health Beliefs Model, were also studied. Women with elevated BC risk (N=103) were studied and categorized by risk level: moderate (15%-20%), high (greater than or equal to 20%), or very high (BRCA1/2 positive). Participants self-reported BC susceptibility, self-efficacy, and benefits, barriers, and intentions for risk-reducing mastectomy (RRM), risk-reducing salpingo-oophorectomy (RRSO), chemoprevention, improving diet or physical activity, and reducing alcohol use. Groups significantly differed in RRSO intentions (P<.01); BRCA1/2 positive women had greater intentions for RRSO. Groups did not differ in intentions for RRM, chemoprevention, or lifestyle changes (Ps>.28). In hierarchical linear regression models examining Health Belief Model (HBM) factors, perceived susceptibility was associated with intentions for RRM (β=.169, P=.08). Perceived benefits was associated with intentions for RRM (β=.237, P=.02) and chemoprevention (β=.388, P<.01). Self-efficacy was associated with intentions for physical activity (β=.286, P<.01). Consistent with guidelines, BRCA1/2 positive women reported greater intentions for RRSO, and risk groups did not differ in intentions for lifestyle changes. Notably, women's intentions for RRM and chemoprevention were guideline discordant; groups did not differ in intentions for these behaviors. Accounting for the effects of risk group, modifiable health beliefs were also associated with risk management intentions; these may represent targets for decision support interventions.

Increasing return response to changes in risk

AbstractRisk aversion theory is based on an individual's choice among risky assets with expected utility in its foundation. It is about investor behavior (i.e., investor choice), under normal circumstances, toward assets with various levels of risk. A positive and marginally diminishing relationship between risk and return exists. This study is about investor behavior related to their response (not choice) to risk. We present an argument and supporting evidence that investors’ return response to risk is increasing with the level of risk. Thus, investor behavior is subject to change and the level of risk is a determinant of such change. We also explain the negative time‐series correlation between risk and return.

Fuzzy Bi-Objective Model for a Supply Chain Network Design Problem Considering Stochastic Transportation Leadtime

In this paper, a fuzzy bi-objective integer programming for a supply chain network design (SCND) problem considering stochastic transportation leadtime is proposed. The conflicting objectives considered in this study are maximizing the total net profit related to the supply chain network design and minimizing the probability of tardiness associated with transportation leadtime between manufacturing plant and distribution centers, and distribution centers and customers. It is assumed that possible risk associated with transportation leadtime follows a normal distribution with the established mean and standard deviation. The model was tested by varying risk levels in order to achieve the maximum satisfaction level in the network. By considering the acceptable satisfaction levels, analyzing the results of the proposed model will be providing different scenarios, which helps decision makers to have better insight to design the desired supply chain network. Results indicate that by decreasing the risk level, probability of earliness to deliver products to customers increases while profit decreases.

Mathematical Modeling for Identifying Cost-Effective Policy of Municipal Solid Waste Management under Uncertainty

In municipal solid waste (MSW) management, many impact factors, such as waste generation rate, treatment capacity, diversion goal, and disposal cost appear uncertain. These uncertainties can result in difficulties in the long-term planning of MSW management activities. A critical issue that decision makers should mitigate is how to address these uncertainties due to a lack of knowledge founded on an incomplete characterization, understanding or measurement of MSW systems. In this study, an inexact twostage waste management (ITWM) model is developed for planning long-term MSW management in the City of Changchun, China. The ITWM model incorporates the techniques of interval-parameter programming (IPP) and two-stage stochastic programming (TSP) within an integer programming framework, such that uncertainties expressed as both intervals and probabilities can be reflected; it can also analyze different policy scenarios that are associated with different economic penalty levels. Two cases related to different waste management policies are examined, generating varied levels of waste-management cost and system-failure risk. The results obtained are valuable for addressing issues of waste diversion and capacity expansion with a minimized system cost. They also suggest that the developed model be meaningful for real-world planning problems and the practicality of this approach can be extended to other environmental planning applications containing significant sources of uncertainty.

Monitoring the elimination of human African trypanosomiasis: Update to 2016.

BackgroundHuman African trypanosomiasis (HAT) is a neglected tropical disease targeted for elimination ‘as a public health problem’ by 2020. The indicators to monitor progress towards the target are based on the number of reported cases, the related areas and populations exposed at various levels of risk, and the coverage of surveillance activities. Based on data provided by the National Sleeping Sickness Control Programmes (NSSCP), Non-Governmental Organizations (NGOs) and research institutions—and assembled in the Atlas of HAT—the World Health Organization (WHO) provides here an update to 2016 for these indicators, as well as an analysis of the epidemiological situation.ResultsTrends for the two primary indicators of elimination are on track for the 2020 goal: 2,164 cases of HAT were reported in 2016 (as compared to the milestone of 4,000 cases), and for the period 2012–2016 280,000 km2 are estimated to be at moderate risk or higher (i.e. ≥ 1 case/10,000 people/year), as compared to the milestone of 230,000 km2. These figures correspond to reductions of 92% and 61% as compared to the respective baselines (i.e. 26,550 HAT cases in the year 2000, and 709,000 km2 exposed at various levels of risk for the period 2000–2004). Among the secondary indicators, an overall improvement in the coverage of at risk populations by surveillance activities was observed. Regarding passive surveillance, the number of fixed health facilities providing gambiense HAT diagnosis or treatment expanded, with 1,338 enumerated in endemic countries in 2017 (+52% as compared to the survey completed only sixteen months earlier). Concerning rhodesiense HAT, 124 health facilities currently provide diagnosis or treatment. The broadening of passive surveillance is occurring in a context of fairly stable intensity of active case finding, with between 1.8 million and 2.4 million people screened per year over the period 2012–2016.DiscussionElimination of HAT as a public health problem by 2020 seems within reach, as the epidemiological trends observed in previous years are confirmed in this latest 2016 monitoring update. However, looking beyond 2020, and in particular to the 2030 goal of elimination of transmission as zero cases for the gambiense form of the disease only, there is no room for complacency. Challenges still abound, including ensuring the effective integration of HAT control activities in the health system, sustaining the commitment of donors and HAT endemic countries, and clarifying the extent of the threat posed by cryptic reservoirs (e.g. human asymptomatic carriers and the possible animal reservoirs in gambiense HAT epidemiology). WHO provides through the network for HAT elimination the essential coordination of the wide range of stakeholders to ensure synergy of efforts.

Digital adherence technologies for the management of tuberculosis therapy: mapping the landscape and research priorities

Poor medication adherence may increase rates of loss to follow-up, disease relapse and drug resistance for individuals with active tuberculosis (TB). While TB programmes have historically used directly observed therapy...

Physiologic childbirth and active management of the third stage of labor: A latent class model of risk for postpartum hemorrhage.

Postpartum hemorrhage (PPH) is a threat to maternal mortality worldwide. Evidence supports active management of third stage labor (AMTSL) for preventing PPH. However, trials of AMTSL include women at varying risk levels, such as women undergoing physiologic labor and those with labor complications. Counseling women about their risk for PPH and AMTSL is difficult as many women who appear low-risk can still have PPH. This study uses outcomes of 2322 vaginal births from a hospital midwifery service in the United States to examine risks for PPH and effectiveness of AMTSL. Using a latent class analysis approach, physiologic birth practices and other risk factors for PPH were analyzed to understand if discrete classes of clinical characteristics would emerge. The effect of AMTSL on the PPH outcome was also considered by class. A four-class solution best fit the data; each class was clinically distinct. The two largest Classes (A and B) represented women with term births and lower average parity, with higher rates of nulliparity in Class B. Class A women had more physiologic birth elements and less labor induction or labor dysfunction compared with Class B. PPH and AMTSL use was higher in Class B. In Class B, AMTSL lowered risk for PPH. However, in Class A, AMTSL was associated with higher risk for PPH and delayed placental delivery (>30minutes). AMTSL may not be as beneficial to women undergoing physiologic birth. Further study of the etiology of PPH in these women is indicated to inform preventive care.

Association of Smokeless Tobacco Use and Oral Cancer: A Systematic Global Review and Meta-Analysis.

Smokeless tobacco products have been linked to precancerous and cancers of oral cavity for long. Evidence was available on the association between smokeless tobacco (SLT) products and oral cancers at regional but not at global level. Present meta-analysis is aimed to evaluate the risk of oral cancer with the use of SLT products among "ever" versus "never" users. Studies published for the period (1960-2016) are retrieved using Pubmed, Indmed, EMBASE, and Google Scholar search engines for the subject "ever" versus "never" users of SLT products and estimated the risk association with oral cancer. Summary odds ratios (relative risk) are estimated and meta-analysis was performed using random-effects model. Thirty-seven studies from four of six WHO regions, Southeast Asia region (SEAR), the Eastern Mediterranean Region (EMR), Europe, and region of Americas (North and South) are included in the analysis. Significant risk with SLT products with oral cancer was found for SEAR (4.44, 95% CI = 3.51 to 5.61) and for EMR (1.28, 95% CI = 1.04 to 1.56). Significantly higher risk (p < .001) was found for females (5.83, 95% CI = 2.93 to 11.58). Product wise analysis for different SLT products revealed various levels of risk viz. gutkha (8.67, 95% CI = 3.59 to 20.93), pan tobacco / betel liquid (7.18, 95% CI = 5.48 to 9.41), oral snuff (4.18, 50% CI = 2.37 to 7.38), Mainpuri tobacco (3.32, 95% CI = 1.32 to 8.36), and snus (0.86, 95% CI = 0.58 to 1.29). A significant positive association was observed between SLT use and the risk of oral cancer, in SEAR, EMRs, and among women users. The present meta-analysis demonstrates SLT product use and the risk of oral cancer at global level. Moreover, the present analysis provided data on the risk associated with individual SLT product. The results fulfil the gap in the data on independent effect of individual SLT product use on the outcome of oral cancer at global level, conclusively. Chewing SLT products was associated with higher risk of oral cancer than other types of SLT. This can serve as a useful tool for policy makers in forming strict policies in controlling SLT menace. Hence, we propose that in addition to smoking, efforts should be directed towards SLT product cessation as well in reducing oral cancer incidence.

Characterizing health risks associated with recreational swimming at Taiwanese beaches by using quantitative microbial risk assessment.

Taiwan is surrounded by oceans, and therefore numerous pleasure beaches attract millions of tourists annually to participate in recreational swimming activities. However, impaired water quality because of fecal pollution poses a potential threat to the tourists' health. This study probabilistically characterized the health risks associated with recreational swimming engendered by waterborne enterococci at 13 Taiwanese beaches by using quantitative microbial risk assessment. First, data on enterococci concentrations at coastal beaches monitored by the Taiwan Environmental Protection Administration were reproduced using nonparametric Monte Carlo simulation (MCS). The ingestion volumes of recreational swimming based on uniform and gamma distributions were subsequently determined using MCS. Finally, after the distribution combination of the two parameters, the beta-Poisson dose-response function was employed to quantitatively estimate health risks to recreational swimmers. Moreover, various levels of risk to recreational swimmers were classified and spatially mapped to explore feasible recreational and environmental management strategies at the beaches. The study results revealed that although the health risks associated with recreational swimming did not exceed an acceptable benchmark of 0.019 illnesses daily at all beaches, they approached to this benchmark at certain beaches. Beaches with relatively high risks are located in Northwestern Taiwan owing to the current movements.

Increasing Return Response to Changes in Risk

Risk aversion theory is based on individuals’ choice among risky assets with expected utility in its foundation. It is about investor behavior (i.e. investor choice), under normal circumstances, towards assets with various levels of risk. A positive and marginally diminishing relationship between risk and return exists. This study is about investor behavior as it relates to their response (not choice) to risk. We present an argument and supporting evidence that investors’ return response to risk is increasing in level of risk. Thus, investor behavior is subject to change and level of risk is a determinant of such change. We also explain the negative time-series correlation between risk and return.

Dosage is more than just counting program hours: The importance of role-playing in treatment outcomes

ABSTRACTThe risk principle directs correctional practitioners to provide greater amounts of correctional treatment to higher-risk offenders, while the responsivity principle directs practitioners to target criminogenic needs using treatment modalities that have been shown to be the most effective at reducing recidivism for offenders as a group. One such treatment modality is cognitive-behavioral treatment. Consequently, more studies are attempting to identify the most effective amounts of cognitive-behavioral treatment to provide to offenders of varying risk levels in an effort to maximize recidivism reductions. This article builds upon prior dosage research by examining whether time spent on a specific strategy commonly employed in cognitive-behavioral programs—the use of role-play—serves as a moderator of the risk–dosage relationship. It does so using a sample of 980 male offenders who received treatment in a community-based correctional program in Ohio. The results indicate that practitioners should continue to match treatment dosage to risk, strive to provide the optimal amount of dosage suggested by previous studies, and maximize use of behavioral rehearsal techniques such as role-play.

Development of a Risk-based Methodology for Rock Slope Analysis

The objective of this research is to develop a geotechnical risk assessment methodology to concurrently identify and quantify important risk elements in rock slopes. Thus, important geotechnical issues affecting a high rock slope were categorized into three major critical risk groups after a comprehensive literature review and field observation program. A set of knowledge-based fuzzy inference rules were established to set up membership functions and calculate risk index (RI) for each critical risk element (CRE). The CREs were ranked on the basis of the calculated RI. The developed risk algorithm was employed to assess the geotechnical risks associated with the right abutment slope of Vanyar dam, Iran. The analysis results showed that the presence of high water level (RI 4.47), shear strength of discontinuities (RI 4.27), and presence of shear or fault zones in the slope (RI 4.01) were the most critical elements which affected the slope stability, respectively. According to calculated risk indices the engineers should pay more attention to the underground water level in the dam abutments. The proposed method could provide scientific decision-making basis for varying risk levels associated with rock slope engineering and can be used as an aid in corresponding risk control measures. The obtained results indicated that the developed algorithm is beneficial in providing guidelines for design and remedial measures to improve slope construction and performance. The present study proposes a methodology based on a combination of project management, risk modelling, and geotechnical engineering.

The Influence of Load on Risk-Based Small-Disturbance Security Profile of a Power System

This paper establishes a generic severity function that can be used to produce power system security risk profiles. It is illustrated by analyzing the impacts of system load attributes on the small-disturbance rotor angle stability of a power system. The load attributes contributing to the oscillatory modes can be considered as inherent uncertain variables within power systems and include load power variations, load composition, and load model parameters. Uncertainty in the renewable power generation is also incorporated in the probabilistic modelling and risk assessment to demonstrate the flexibility of the approach. A novel approach is proposed to select the severity functions to logically represent small-disturbance security margin. The risk profile of a power system has been presented considering the probability density functions of power system critical modal damping and a selected set of severity functions. The analysis techniques developed are illustrated with a modified version of the 68-bus NETS-NYPS power system with a high amount of renewable power penetration. The relative importance of the load attributes and the impact of these attributes on stability boundaries have been identified at varying risk levels with respect to their contribution to small-disturbance stability.

Discounting in agro-industrial complex. A methodological proposal for risk premium

The estimation of the discount rate is decisive for a reliable economic valuation. The discount rate has to be adjusted for the risks related to the company, the sector which the company has its market, and the risks related to the investment project. We present a proposal to incorporate the risk premium to the discount rate. The novelty of the methodology is that difference risk groups according to activity as a factor to adjust the cost of capital to companies. The study applies the methodology to the Agro-Industrial Complex (AIC) in Spain. The AIC is formed by industries that add value to farming production. This sector’s economic success demands financial management techniques that assess risk. The conventional method responds neither to the heterogeneity of the economic activities that make up the AIC, nor to differentiating risk by groups. The proposed methodology distinguishes activity groups in accordance with the NACE (National Code of Economic Activities) and uses net profitability variability to distinguish the risk in each group. Our results demonstrate the various levels of risk per group. The results show that among all the groups that form the AIC there are wide differences between levels of risk; thus, the risk neutral groups present risk levels on the order of 150 times lower than the groups extreme risk levels.