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نتیجه جستجو - Risk Factors

تعداد مقالات یافته شده: 112
ردیف عنوان نوع
1 Improvements in biometric health measures among individuals with intellectual disabilities: A controlled evaluation of the Fit 5 program
بهبود اقدامات سلامت بیومتریک در افراد دارای معلولیت فکری: ارزیابی کنترل شده از برنامه Fit 5-2021
Background: Individuals with intellectual disabilities (ID) have poorer health statuses compared to the general population. Actions are needed to address
health disparities and promote healthy lifestyles among individuals with ID. Moreover, studies that consider program settings for this population are needed. Objective: The Special Olympics health program, Fit 5, was evaluated to assess effectiveness in improving health measures for individuals with ID. The settings of programs’ implementation were also considered. Methods: Four Special Olympics basketball teams participated as an intervention group, and three teams as a control group, in a study of the Fit 5 program that was implemented during, and as part of, a regular 8-week basketball season. Resting heart rate (RHR) and blood pressure, and height and weight to calculate Body Mass Index (BMI), were measured before and after the program. Differences in pre- and post-measures were compared between the two groups with paired samples t-tests and ANCOVA. Results: Participants in the intervention group had significantly greater improvements in resting systolic and diastolic blood pressures (p ¼ 0.02 and 0.03, respectively) and RHR (p ¼ 0.003). BMI increased for both groups; however, the increase in the intervention group was significantly less (p ¼ 0.006). The Special Olympics setting was considered familiar and supportive and effectively reached individuals with ID.
Conclusion: The Fit 5 program positively impacts RHR and blood pressure, and could help reduce extents of BMI increases, in individuals with ID when implemented in a common setting. Further investigation of the impact of Fit 5 and similar programs in additional settings is warranted.© 2020 Elsevier Inc. All rights reserved.
Keywords: Intellectual disability | Health promotion | Physical activity | Health risk factors | Program settings
مقاله انگلیسی
2 Evaluation on risks of sustainable supply chain based on optimized BP neural networks in fresh grape industry
ارزیابی خطرات زنجیره تأمین پایدار بر اساس شبکه های عصبی بهینه شده BP در صنعت انگور تازه-2021
In order to improve the risk evaluation and management in fresh grape supply chain and enhance the sustainable level of the supply chain, this study applied neural network to evaluate the risk of fresh grape supply chain from the perspective of sustainable development. Firstly, the possible risk factors in the supply chain were identified and the risk evaluation index system were proposed; then risk evaluation models based on single BP and optimized BP (GABP and PSO-BP) neural network were established; and then the models were trained, tested and evaluated using data set from supply chain survey. The survey and analysis results showed that the risk of fresh grape supply chain was at a low level but the risk in each link was discrepant, the biggest risk was the risks among the links in the chain (R0), and the high risk dimensions were the economic risk, social risk and cooperation risk; most risky events were located in the second quadrant (small probability & high damage risk events). The results of models training and testing indicated that the optimized model was superior to single BP neural network for risk assessment in grape sustainable supply chain, and the PSO-BP model was more accurate and suitable with less evaluation errors and a bigger R2. The results also extracted the risk factors that contributed most to the overall risk of grape sustainable supply chain. This paper enriches the method of supply chain risk assessment theoretically, and provides practical suggestions for risk prevention, stable operation and sustainability improvement of fresh grape supply chain.
Keywords: Sustainable supply chain | Supply chain risk | GA-BP neural network | PSO-BP neural network | Risk evaluation
مقاله انگلیسی
3 Ontology knowledge base combined with Bayesian networks for integrated corridor risk warning
پایگاه دانش هستی شناسی همراه با شبکه های بیزی برای هشدار خطر یکپارچه راهرو-2021
With the accelerated urbanization process, the emergence of urban underground integrated pipeline corridors is the trend for cities, especially large and medium-sized cities. However, due to the complexity of the internal system of the integrated corridor, there are various risks in the process of its construction and operation and maintenance, and the risk factors are complex and diverse. In this paper, we introduce ontology technology and knowledge base construction into the risk management of integrated pipeline corridor, build an ontology-based knowledge base of integrated pipeline corridor risk, and construct a Bayesian network based on the established risk knowledge base for risk evaluation of identified risk factors. The combination of ontology knowledge base construction and Bayesian network method of integrated pipeline corridor risk makes the risk identification system completer and more effective, and the method can effectively evaluate the disaster risk level of integrated pipeline corridor operation and maintenance, which can meet the practical needs of integrated pipeline corridor operation and maintenance risk management and disaster prevention and mitigation work.
Keywords: Integrated corridor | Risk warning | Ontology knowledge | Bayesian networks
مقاله انگلیسی
4 tr
دانش فعلی و مدیریت ترومبوز ورید پورتال در سیروز-2021
Portal vein thrombosis (PVT) is an increasingly recognised complication of cirrhosis whose incidence increases in parallel with the severity of cirrhosis. Several risk factors have been associated with the occurrence and progression of PVT. Although the negative effect of complete PVT on the surgical outcome of liver transplant recipients is clear, its impact on cirrhosis progression remains uncertain. Treatment options include anticoagulants and interventional thrombolytic therapies, which are chosen almost on a case-by-case basis depending on the characteristics of the patient and the thrombus. In this manuscript, we review current knowledge regarding the epidemiology, risk factors, diagnosis and classification, natural history, clinical consequences and treatment of non-neoplastic PVT in cirrhosis.
Keywords: Cirrhosis | Coagulopathy | Portal hypertension | Portal vein thrombosis | TIPS | Transplant
مقاله انگلیسی
5 Role and knowledge of critical care nurses in the assessment and management of hypophosphataemia and refeeding syndrome: A descriptive exploratory study
نقش و شناخت پرستاران مراقبت های ویژه در ارزیابی و مدیریت هیپوفسفاتهمی و سندرم ریزش شده:یک مطالعه اکتشافی توصیفی-2021
Objective: To assess the perceived and actual role of critical care nurses in nutritional care, and their knowledge regarding the identification and management of hypophosphataemia and refeeding syndrome. Design and methods: Data were collected in one intensive care unit in Israel, from a self-administered questionnaire completed by 42 critical care nurses. The questionnaire was designed to assess their perceived and actual roles in the administration of nutritional care, and knowledge regarding electrolyte monitoring, hypophosphataemia and refeeding syndrome, including risk factors, consequences, and treatment.
Results: The majority participants that dieticians are solely responsible for nutrition care and follow-up. Most agreed that the measurement of phosphate levels was not important and that patients should receive full nutrition upon admission, while important risk factors for the development of refeeding syndrome were not recognised or considered. This informed their actual practice. A correlation was found between nurses’ knowledge and their actual practice so that the greater the nurses’ knowledge, the more they adhered to current nutrition guidelines (p < 0.05).
Conclusions: This study revealed critical care nurses’ lack of clarity of their role and lack of knowledge regarding nutrition care. We suggest that this complex task is best managed by a multidisciplinary team, including nurses and dieticians, with clear role definitions.
keywords: پرستاری مراقبت های ویژه | مطالعه اکتشافی توصیفی | هیپوفسفاتیه | سندرم ریزش | Critical care nursing | Descriptive exploratory study | Hypophosphataemia | Refeeding syndrome
مقاله انگلیسی
6 Implementation of a standardized voiding management protocol to reduce unnecessary re-catheterization - A quality improvement project
اجرای یک پروتکل استاندارد مدیریت تخلیه برای کاهش دوباره کاتتریزاسیون غیر ضروری - یک پروژه بهبود کیفیت-2020
Objective. To design and implement a standardized postoperative voiding management protocol that accurately identifies patients with urinary retention and reduces unnecessary re-catheterization. Methods. A postoperative voiding management protocol was designed and implemented in patients undergoing major, inpatient, non-radical abdominal surgery with a gynecologic oncologist. No patients had epidural catheters. The implemented quality improvement (QI) protocol included: 1) Foley removal at six hours postoperatively; 2) universal bladder scan after the first void; and 3) limiting re-catheterization to patientswith bladder scan volumes N150 ml. A total of 96 patients post-protocol implementation were compared to 52 patients preprotocol. Along with baseline demographic data and timing of catheter removal,we recorded the presence or absence of urinary retention and/or unnecessary re-catheterization and postoperative urinary tract infection rates. Fishers exact test and students t-tests were performed for comparisons. Results. The overall rate of postoperative urinary retention was 21.6% (32/148). The new voiding management protocol reduced the rate of unnecessary re-catheterization by 90% (13.5% vs 2.1%, p = 0.01), without overlooking true urinary retention (23.1% vs 20.8%, p = 0.83). Additionally, there was a significant increase in hospital-defined early discharge prior to 11:00 AM (4.0% vs 22.0%, p = 0.022). There was no difference in the postoperative urinary tract infection rate between the groups (p=1.00). Risk factors associatedwith urinary retention included older age (p b 0.01), use of medications with anticholinergic properties (p b 0.01), and preexisting urinary dysfunction (p b 0.01). Conclusions. Implementation of this new voiding management protocol reduced unnecessary recatheterization, captured and treated true urinary retention, and facilitated early hospital discharge
Keywords: Quality improvement | Bladder voiding | Urinary retention | Postoperative management | Gynecologic Oncology surgery | Urinary tract infection
مقاله انگلیسی
7 Qualitative and quantitative project risk assessment using a hybrid PMBOK model developed under uncertainty conditions
ارزیابی ریسک کمی و کیفی پروژه با استفاده از یک مدل توسعه یافته PMBOK تحت شرایط غیر قطعی-2020
This study presented a qualitative and quantitative project risk assessment using a hybrid PMBOK model developed under uncertainty conditions. Accordingly, an exploratory and applied research design was employed in this study. The research sample included 15 experienced staff working in main and related positions in Neyr Perse Company. After reviewing the literature and the Project Management Body of Knowledge (PMBOK), 32 risk factors were identified and their number reduced to 17 risks using the expert opinions via the fuzzy Delphi technique run through three stages. The results of the confirmatory factor analysis showed that all risks were confirmed by the members of the research sample. Then the identified risks were structured and ranked using fuzzy DEMATEL and fuzzy ANP techniques. The final results of the study showed that the political and economic sanctions had the highest weight followed by foreign investors’ attraction and the lack of regional infrastructure.
Keywords: Project risks | Project management body of knowledge (PMBOK) | Uncertainty | Mixed qualitative and quantitative risk assessment approach | Mathematics | Probability theory | Engineering | Industrial engineering | Business
مقاله انگلیسی
8 Gender-specific participation and outcomes among jail diversion clients with co-occurring substance use and mental health disorders
مشارکت و نتایج خاص جنسیت در میان انحراف مراجعه کنندگان به زندان با مصرف همزمان مواد و اختلالات سلامت روان-2020
Men and women with co-occurring substance use disorders and mental illness are at relatively high risk for becoming involved in the criminal justice system. Programs, such as post-booking jail diversion, aim to connect these individuals to community-based treatment services in lieu of pursuing criminal prosecution. Gender ap- pears to have an important influence on risk factors and pathways through the criminal justice system, which in turn may influence how interventions like jail diversion work to engage men and women in treatment services and reduce recidivism. Different circumstances, levels of engagement, and outcomes by gender may be related to both person-level characteristics and external factors such as availability of gender-specific services and re- sources. This mixed-methods study identified specific ways in which men and women use services and reoffend after being diverted, and complemented those findings with in-depth insights from program clinicians about how program experiences and resources differ in important ways by gender. We matched and merged administrative records from 2007 to 2009 for 16,233 adults from several state agencies in Connecticut, and included data on demographic characteristics, clinical diagnoses, outpatient and inpatient behavioral health treatment utilization, arrest, and incarceration. Using propensity analysis, the 1693 men and women who participated in the statewide jail diversion program were matched to respective comparison groups of nondiverted men and women. We used longitudinal multivariable regression analyses to estimate the effects of jail diversion participation on treatment utilization, arrest, and incarceration, separately for men and women. We conducted three focus groups with jail diversion clinicians from around the state (n = 21) to gain in-depth insight from them about how circumstances, program experiences, and resources differ by gender in important ways; these subjective clinician insightscomplement the quantitative analyses of diversion outcomes for men and women. For both men and women, diversion was associated with reductions in risk for incarceration and increases in utilization of outpatient treatment services. For men only, diversion was associated with higher utilization of inpatient mental health care. No differences in treatment or criminal justice outcomes were observed in models that compared men and women directly. Major themes from the focus groups included: the existence of too few inpatient and residential resources for women with co-occurring disorders; different challenges to treatment engagement that men and women face; and a need for more effective, gender-specific services for all program participants. Results from this mixed-methods study offer information on gender-specific program outcomes and surrounding circum- stances that can help programs to better understand and address unique risks and needs for men and women with co-occurring substance use and mental health disorders who are involved in the criminal justice system.
Keywords: Substance use disorders | Mental illness | Co-occurring disorders | Jail diversion | Gender
مقاله انگلیسی
9 Risk assessment of agricultural supermarket supply chain in big data environment
ارزیابی ریسک زنجیره تأمین سوپرمارکت های کشاورزی در محیط داده های کلان-2020
Article history:Received 20 November 2019Received in revised form 30 June 2020 Accepted 14 July 2020Available online 16 July 2020Keywords:Big dataAgricultural super-docking Supply chainRisk analysisWith the application of big data in all walks of life, big data thinking is effectively improving the cir- culation efficiency of agricultural products supply chain by driving management changes in business decision-making and f¨armer-supermarket dockinga¨ s an innovative mode of agricultural products circu- lation. Based on the current situation of China’s agricultural supermarket supply chain development, this paper makes an in-depth study on the supply chain risk of agricultural products of large retail enterprises under the mode of a¨ gricultural supermarket docking¨, and then introduces the agricultural supermarket docking supply chain under the big data environment. This paper uses big data to analyze the risks that may arise in the supply chain of a¨ gricultural supermarket docking¨in large retail enterprises. This paper from the aspects of production, processing, distribution, retail and consumption, introduces the new risks of agricultural supermarket supply chain after introducing big data. Secondly, Qualitative analysis and quantitative calculation are combined to conduct risk assessment. Through empirical analysis, the ranking of all risk factors is obtained, and the relevant fuzzy evaluation grade and risk evaluation criteria are given. Through expert evaluation, a new risk ranking is also obtained, which is not much different from the results of empirical analysis, and the empirical results are also verified. Therefore, develop this study is helpful to prevent the risk of agricultural supermarket supply chain connection. At the same time, the information integration, sharing and feedback of the big database provide a new idea for the optimization of the supply chain connecting agricultural production.it also has reference significance for other supply chain risk management.© 2020 Elsevier Inc. All rights reserved.
Keywords: Big data | Agricultural super-docking | Supply chain | Risk analysis
مقاله انگلیسی
10 اجرای یک پروتکل استاندارد مدیریت خالی سازی جهت کاهش میله گذاری دوباره غیرضروری – یک پروژه بهبود کیفیت
سال انتشار: 2020 - تعداد صفحات فایل pdf انگلیسی: 7 - تعداد صفحات فایل doc فارسی: 19
هدف: طراحی و اجرای یک پروتکل استاندارد مدیریت پساعملی خالی سازی که بیمارانی با نگه داشتن ادرار را به صورت دقیق شناسایی می کند و میله گذاری ضروری دوباره را کاهش می دهد. روشها: یک پروتکل پساعملی مدیریت خالی سازی در بیمارانی که عمل جراحی شدید، بستری شدن و وریدهای شکمی غیر ریشه ای را تحمل می کنند با یک تومورشناس زنان طراحی و اجرا شد. هیچ بیماری میله اپیدورالی نداشت. پروتکل بهبود کیفیت اجرا شده شامل موارد زیر بود: 1) حذف صدا در شش ساعت به صورت پساعملی؛ 2) اسکن عمومی مثانه پس از اولین خالی سازی؛ و 3) کاهش میله گذاری دوباره برای بیمارانی با حجم اسکن مثانه ای بیشتر از 150 میلی لیتر. درکل اجرای پساپروتکل 96 بیمار با پیش- پروتکل 52 بیمار مقایسه شد. درکنار داده های جمعیتی مبنا و زمان سنجی حذف میله گذاری، ما حضور یا عدم حضور نگه داشتن ادرار یا میله گذاری دوباره غیرضروری و نرخ عفونت پساعملیاتی دسته تارهای ادراری را ثبت کردیم. آزمایش واقعی فیشر و آزمایش های t دانشجویی برای مقایسه ها انجام شد. نتایج: نرخ کلی نگه داشتن ادرار پس از عمل جراحی برابر با 6/21% (148/32) بود. پروتکل جدید مدیریت خالی سازی، نرخ میله گذاری دوباره غیرضروری را تا 90 درصد (5/13 درصد دربرابر ½ درصد، 01/0 = p)، بدون چشم پوشی از نگه داشتن واقعی ادرار (1/23% دربرابر 8/20%، 83/0 = p) کاهش داد. به علاوه، افزایش قابل توجهی در ترخیص زودتر از زمان تعریف شده توسط بیمارستان قبل از ساعت 11 قبل از ظهر وجود داشت (40% دربرابر 22%، 022/0 = p). هیچ تفاوتی در نرخ عفونت تارهای ادراری پسا از عمل بین گروهها وجود نداشت (1 = p). عوامل خطر درکنار نگه داشتن ادرار شامل سن بالا (01/0>p)، استفاده از داروهایی با ویژگی های استیل کولین (01/0>p) و عملکرد غیرمعمول ادرارِ ازقبل موجود می شود. نتیجه گیری ها: اجرای این پروتکل مدیریتی جدید خالی سازی، میله گذاری دوباره غیرضروری را کاهش داد، نگه داشتن ادرار واقعی را به دست داد و ترخیص بیمارستانی پیشین را تسهیل کرد.
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