scholarly journals Exploring the Risk Factors of Infrastructure PPP Projects for Sustainable Delivery: A Social Network Perspective

2020 ◽  
Vol 12 (10) ◽  
pp. 4152 ◽  
Author(s):  
Yan Wang ◽  
Yujie Wang ◽  
Xiuyu Wu ◽  
Jiwang Li
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Social Network ◽  
Credit Rating ◽  
Legal Change ◽  
Structured Interviews ◽  
Chain Reactions ◽  
Financing Risk ◽  
Government Credit ◽  
Reaction Chain

Due to the relatively long period and large capital flow of public-private partnership (PPP) projects, PPP participants are faced with a complex risk situation impeding the sustainable project delivery. In recent years, risk management of PPP projects has received increasing attention. In this paper, twenty risk factors associated with infrastructure PPP projects were identified by literature review and in-depth case studies. Relationship data for these twenty typical risk factors were obtained through structured interviews. Based on the obtained data, the risk relationship network within infrastructure PPP projects was identified, and the network structure characteristics were analyzed, including individual node attributes and the influence and cohesion of subgroups. The results indicate that key risk factor nodes can form a reaction chain via bridge nodes that can trigger a risk domino effect within PPP projects. Specifically, the key risk factors of PPP projects are divided into two categories, the first of which include risk factors that have powerful and independent influence, such as delay in government approval, government credit, and imperfect legal and regulatory systems. The second category includes risk factors that are highly vulnerable and easily influenced, such as completion risks, insufficient revenue in the market, and fee change. A key risk factor reaction chain is one in which legal change leads to a decline in government credit rating, triggering a contract risk. Twelve bridge nodes were identified that play an important intermediary role in the network, e.g., legal change, public objection, and financing risk. This paper extends the application of social network analysis in PPP projects management research and identifies the key risk factors and crucial factors influencing chain reactions in PPP projects. The results provide a more in-depth understanding of sustainable PPP project management for government agencies and private enterprises.

Abstract WMP51: Patients’ Social Networks Influence Timing of Hospital Arrival After Acute Ischemic Stroke: a Mixed Methods Study

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Amar Dhand ◽  
Douglas Luke ◽  
Michael Tsiaklides ◽  
Catherine Lang ◽  
Jin-Moo Lee
Keyword(s):  
Risk Factors ◽  
Social Networks ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Social Network ◽  
Network Structure ◽  
Independent Risk Factor ◽  
Hospital Arrival ◽  
Prehospital Delay ◽  
Social Network Structure

Introduction: Delay in hospital arrival is a major reason for stroke patients’ exclusion from acute therapy. Risk factors for delay include older age, minor symptoms, and living alone. Personal social networks, consisting of the structure and content of relationships around a patient, are important and modifiable factors to health behavior. This study examined the role and mechanisms of patients’ social networks in prehospital delay. Hypothesis: Social network structure is an independent risk factor of prehospital delay through social influence mechanisms. Methods: Seventy consecutive patients with mild acute ischemic stroke were interviewed in the hospital. An established social network analysis instrument was used to assess personal network structure and composition. This was followed by semi-structured interviews in 14 patients focused on the arrival process. Fast arrival was defined as before 6 hours, and slow was after 6 hours. Results: There were 32 slow and 38 fast arrivers. The mean age (63) and NIHSS (3) did not differ between groups. Subcortical stroke location (53% versus 26%) and being unmarried (75% versus 44%) were more common in slow compared to fast arrivers (p<0.05). After controlling for known risk factors, social network structure was significantly associated with arrival time. As shown in figure 1, patients (A) who had networks with high constraint (e.g., strong ties among all network members) were slower to arrive than patients (B) with low constraint (e.g., weak or no ties among network members). Constraint had an adjusted OR=1.08 (95% CI 1.03-1.13, p<0.005) for slow arrival. Mechanisms revealed from qualitative analysis were social capital benefits in fast arrivers, and family members’ perceptual bias to minimize symptoms in slow arrivers. Conclusions: Patients’ social network structure is an independent risk factor for prehospital delay. These results may be used to develop network-tailored stroke education.

scholarly journals FAKTOR RISIKO DAN PROTEKTIF PEKERJA PENGGUNA NARKOBA YANG MENJALANI REHABILITASI DI BNNP JAWA BARAT

2021 ◽  
Vol 6 (1) ◽  
pp. 1-7
Author(s):  
Rahma Dilla Arnanda ◽  
Ahmad Gimmy Prathama
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Drug Abuse ◽  
Case Studies ◽  
Protective Factor ◽  
Negative Impact ◽  
Self Esteem ◽  
External Factors ◽  
Structured Interviews ◽  
Convenience Sampling

Drug abuse is increasing and spreading throughout all circles, including workers. During this time many studies related to drug abuse focused on adolescents, even though workers also have a high-risk factor. Risk factor is something that can predict an increase in the likelihood of violations or mistakes later on. One step that can be done to reduce risk factors of drug abuse is to undergo rehabilitation. Therefore, this study aimed to explore the risk factors of drug abuse on workers who are undergoing rehabilitation in the Badan Narkotika Nasional Provinsi (BNNP) Jawa Barat. This study involved four drug user workers who are undergoing rehabilitation at BNNP Jawa Barat, which was obtained using convenience sampling technique. Data collection was carried out by structured interviews. This research used a qualitative approach with collective case studies design. The results showed that risk factors of drug abuse involved internal and external factors. Internal factors such low of self-esteem and difficulties to reject invitations from friends to use drugs. External factors consist of family factor, friends, environment, and socio-economic status. In addition to risk factors, researcher also found protective factors that are the user’s awareness about negative impact of drug abuse and motivation for having a better life. Besides family factors, especially social support that come from their wife and work environment that demand for professionals also become a protective factor for drug abuse. Keywords: Risk Factor, Protective Factor, Drug Abuse, Workers, BNNP Jawa Barat Penyalahgunaan narkoba semakin hari semakin meningkat dan menyebar di berbagai kalangan, termasuk pada kalangan pekerja. Selama ini banyak penelitian terkait penyalahgunaan narkoba yang berfokus pada remaja, padahal para pekerja juga memiliki faktor risiko yang tinggi. Faktor risiko adalah sesuatu yang dapat memprediksi peningkatan kemungkinan pelanggaran atau kesalahan di kemudian hari. Salah satu langkah yang dapat dilakukan mengurangi faktor risiko penggunaan narkoba adalah dengan menjalani rehabilitasi. Maka dari itu penelitian ini bertujuan untuk mengeksplorasi faktor risiko pada pekerja pengguna narkoba yang menjalani rehabilitasi di Badan Narkotika Nasional Provinsi (BNNP) Jawa Barat. Penelitian ini melibatkan empat orang pekerja pengguna narkoba yang sedang menjalani rehabilitasi di BNNP Jawa Barat, yang diperoleh dengan menggunakan teknik convenience sampling. Pengumpulan data dilakukan melalui cara wawancara terstruktur. Penelitian ini menggunakan pendekatan kualitatif dengan rancangan collective case studies. Berdasarkan penelitian, diperoleh hasil bahwa faktor risiko yang berperan terhadap penggunaan narkoba berasal dari faktor internal dan faktor eksternal. Faktor internal berupa self-esteem yang rendah dan sulitnya menolak ajakan dari teman. Adapun faktor eksternal terdiri dari faktor keluarga, teman dan lingkungan, serta keadaan sosio-ekonomi. Selain faktor risiko, peneliti juga menemukan adanya faktor protektif yang berasal dari internal pengguna berupa kesadaran akan dampak negatif dari narkoba dan keinginan akan kehidupan yang lebih baik. Selain itu faktor keluarga, terutama dukungan dari istri dan lingkungan kerja yang menuntut untuk profesional juga menjadi faktor protektif penggunaan narkoba. Kata Kunci: Faktor Risiko, Faktor Protektif, Penyalahgunaan Narkoba, Pekerja, BNNP Jawa Barat.

scholarly journals Decreased COPD prevalence in Sweden after decades of decrease in smoking

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Helena Backman ◽  
Lowie Vanfleteren ◽  
Anne Lindberg ◽  
Linda Ekerljung ◽  
Caroline Stridsman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Smoking Prevalence ◽  
Fixed Ratio ◽  
Occupational Exposures ◽  
Sensitivity Analyses ◽  
Northern Sweden ◽  
Structured Interviews ◽  
Lower Limit Of Normal ◽  
Severe Copd

Abstract Background COPD has increased in prevalence worldwide over several decades until the first decade after the millennium shift. Evidence from a few recent population studies indicate that the prevalence may be levelling or even decreasing in some areas in Europe. Since the 1970s, a substantial and ongoing decrease in smoking prevalence has been observed in several European countries including Sweden. The aim of the current study was to estimate the prevalence, characteristics and risk factors for COPD in the Swedish general population. A further aim was to estimate the prevalence trend of COPD in Northern Sweden from 1994 to 2009. Methods Two large random population samples were invited to spirometry with bronchodilator testing and structured interviews in 2009–2012, one in south-western and one in northern Sweden, n = 1839 participants in total. The results from northern Sweden were compared to a study performed 15 years earlier in the same area and age-span. The diagnosis of COPD required both chronic airway obstruction (CAO) and the presence of respiratory symptoms, in line with the GOLD documents since 2017. CAO was defined as post-bronchodilator FEV1/FVC < 0.70, with sensitivity analyses based on the FEV1/FVC < lower limit of normal (LLN) criterion. Results Based on the fixed ratio definition, the prevalence of COPD was 7.0% (men 8.3%; women 5.8%) in 2009–2012. The prevalence of moderate to severe (GOLD ≥ 2) COPD was 3.5%. The LLN based results were about 30% lower. Smoking, occupational exposures, and older age were risk factors for COPD, whereof smoking was the most dominating risk factor. In northern Sweden the prevalence of COPD, particularly moderate to severe COPD, decreased significantly from 1994 to 2009, and the decrease followed a decrease in smoking. Conclusions The prevalence of COPD has decreased in Sweden, and the prevalence of moderate to severe COPD was particularly low. The decrease follows a major decrease in smoking prevalence over several decades, but smoking remained the dominating risk factor for COPD.

Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

2012 ◽  
Vol 32 (S 01) ◽  
pp. S39-S42 ◽  
Author(s):  
S. Kocher ◽  
G. Asmelash ◽  
V. Makki ◽  
S. Müller ◽  
S. Krekeler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Observational Study ◽  
Retrospective Observational Study ◽  
Frequent Change ◽  
Patient Age ◽  
Treatment Regimens ◽  
Patient Âgé ◽  
The Relationship ◽  
Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

Risk Factors of Collateralized Loan Obligations and Corporate Bonds

2020 ◽  
Vol 32 (6) ◽  
pp. 347-355
Author(s):  
Mark Wahrenburg ◽  
Andreas Barth ◽  
Mohammad Izadi ◽  
Anas Rahhal
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Asset Pricing ◽  
Systemic Risk ◽  
Corporate Bonds ◽  
Risk Exposure ◽  
Expected Returns ◽  
Yield Spreads ◽  
Pricing Factors ◽  
Return Difference

AbstractStructured products like collateralized loan obligations (CLOs) tend to offer significantly higher yield spreads than corporate bonds (CBs) with the same rating. At the same time, empirical evidence does not indicate that this higher yield is reduced by higher default losses of CLOs. The evidence thus suggests that CLOs offer higher expected returns compared to CB with similar credit risk. This study aims to analyze whether this return difference is captured by asset pricing factors. We show that market risk is the predominant risk factor for both CBs and CLOs. CLO investors, however, additionally demand a premium for their risk exposure towards systemic risk. This premium is inversely related to the rating class of the CLO.

Cardiovascular Risk in Perimenopausal Women

2019 ◽  
Vol 17 (6) ◽  
pp. 591-594 ◽  
Author(s):  
John C. Stevenson ◽  
Sophia Tsiligiannis ◽  
Nick Panay
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ovarian Function ◽  
Density Lipoprotein ◽  
Premenopausal Women ◽  
Therapeutic Interventions ◽  
Additional Risk Factor ◽  
Chd Risk ◽  
Perimenopausal Women ◽  
Chd Risk Factors

Cardiovascular disease, and particularly coronary heart disease (CHD), has a low incidence in premenopausal women. Loss of ovarian hormones during the perimenopause and menopause leads to a sharp increase in incidence. Although most CHD risk factors are common to both men and women, the menopause is a unique additional risk factor for women. Sex steroids have profound effects on many CHD risk factors. Their loss leads to adverse changes in lipids and lipoproteins, with increases being seen in low density lipoprotein (LDL) cholesterol and triglycerides, and decreases in high density lipoprotein (HDL) cholesterol. There is a reduction in insulin secretion and elimination, but increases in insulin resistance eventually result in increasing circulating insulin levels. There are changes in body fat distribution with accumulation in central and visceral fat which links to the other adverse metabolic changes. There is an increase in the incidence of hypertension and of type 2 diabetes mellitus, both major risk factors for CHD. Oestrogens have potent effects on blood vessels and their loss leads to dysfunction of the vascular endothelium. All of these changes result from loss of ovarian function contributing to the increased development of CHD. Risk factor assessment in perimenopausal women is recommended, thereby permitting the timely introduction of lifestyle, hormonal and therapeutic interventions to modify or reverse these adverse changes.

Surviving “Risk Factor Frenzy”: The Perils of Incorrectly Applying Epidemiological Research in Health Education and Promotion

2002 ◽  
Vol 21 (1) ◽  
pp. 83-100 ◽  
Author(s):  
Jonathan I. Robison ◽  
Gregory Kline
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Health Education ◽  
Health Professionals ◽  
Lifestyle Change ◽  
Negative Consequences ◽  
Epidemiological Research ◽  
Health Practitioners ◽  
Health Education And Promotion

In health education and promotion, “risk factors” for disease gathered from epidemiological research form the basis from which the majority of recommendations to individuals for lifestyle change are made. Unfortunately, many health practitioners are unaware that this type of research was never intended to be applied to individuals. The result is ongoing public confusion and anxiety concerning health recommendations and a loss of credibility for health professionals. This article: 1) briefly reviews the most commonly encountered limitations inherent in epidemiological research; 2) explores the problems and potential negative consequences of incorrectly applying epidemiological research in health education and promotion; and 3) makes recommendations to help health practitioners more skillfully interpret and incorporate into their work findings from epidemiological research.

Knowledge, awareness and perceptions of diabetes mellitus among the Saudi population

2020 ◽  
Vol 9 (6) ◽  
pp. 413-422
Author(s):  
Muhammad H Mujammami ◽  
Abdulaziz A Alodhayani ◽  
Mohammad Ibrahim AlJabri ◽  
Ahmad Alhumaidi Alanazi ◽  
Sultan Sayyaf Alanazi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Social Media ◽  
Risk Factor ◽  
Healthcare Workers ◽  
Health Workers ◽  
Saudi Population ◽  
Limited Data ◽  
High Prevalence ◽  
Associated Risk Factors

Background: High prevalence of undiagnosed cases of diabetes mellitus (DM) has increased over the last two decades, most patients with DM only become aware of their condition once they develop a complication. Limited data are available regarding the knowledge and awareness about DM and the associated risk factors, complications and management in Saudi society. Aim: This study aimed to assess knowledge of DM in general Saudi society and among Saudi healthcare workers. Results: Only 37.3% of the participants were aware of the current DM prevalence. Obesity was the most frequently identified risk factor for DM. Most comparisons indicated better awareness among health workers. Conclusion: A significant lack of knowledge about DM in Saudi society was identified. Social media and educational curriculum can improve knowledge and awareness of DM.

scholarly journals A-126 Clinical Utility of Risk Factors to Predict Self-reported Neurobehavioral Outcome Following Traumatic Brain Injury: PTSD, Sleep, Resilience, and Lifetime Blast Exposure

2020 ◽  
Vol 35 (6) ◽  
pp. 919-919
Author(s):  
Lange R ◽  
Lippa S ◽  
Hungerford L ◽  
Bailie J ◽  
French L ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
Clinical Utility ◽  
Poor Sleep ◽  
Post Injury ◽  
Poor Outcome ◽  
Blast Exposure ◽  
Neurobehavioral Outcome

Abstract Objective To examine the clinical utility of PTSD, Sleep, Resilience, and Lifetime Blast Exposure as ‘Risk Factors’ for predicting poor neurobehavioral outcome following traumatic brain injury (TBI). Methods Participants were 993 service members/veterans evaluated following an uncomplicated mild TBI (MTBI), moderate–severe TBI (ModSevTBI), or injury without TBI (Injured Controls; IC); divided into three cohorts: (1) &lt; 12 months post-injury, n = 237 [107 MTBI, 71 ModSevTBI, 59 IC]; (2) 3-years post-injury, n = 370 [162 MTBI, 80 ModSevTBI, 128 IC]; and (3) 10-years post-injury, n = 386 [182 MTBI, 85 ModSevTBI, 119 IC]. Participants completed a 2-hour neurobehavioral test battery. Odds Ratios (OR) were calculated to determine whether the ‘Risk Factors’ could predict ‘Poor Outcome’ in each cohort separately. Sixteen Risk Factors were examined using all possible combinations of the four risk factor variables. Poor Outcome was defined as three or more low scores (&lt; 1SD) on five TBI-QOL scales (e.g., Fatigue, Depression). Results In all cohorts, the vast majority of risk factor combinations resulted in ORs that were ‘clinically meaningful’ (ORs &gt; 3.00; range = 3.15 to 32.63, all p’s &lt; .001). Risk factor combinations with the highest ORs in each cohort were PTSD (Cohort 1 & 2, ORs = 17.76 and 25.31), PTSD+Sleep (Cohort 1 & 2, ORs = 18.44 and 21.18), PTSD+Sleep+Resilience (Cohort 1, 2, & 3, ORs = 13.56, 14.04, and 20.08), Resilience (Cohort 3, OR = 32.63), and PTSD+Resilience (Cohort 3, OR = 24.74). Conclusions Singularly, or in combination, PTSD, Poor Sleep, and Low Resilience were strong predictors of poor outcome following TBI of all severities and injury without TBI. These variables may be valuable risk factors for targeted early interventions following injury.

scholarly journals Proposal for the use of echocardiography in bloodstream infections due to different streptococcal species

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sandra Chamat-Hedemand ◽  
Niels Eske Bruun ◽  
Lauge Østergaard ◽  
Magnus Arpi ◽  
Emil Fosbøl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Bloodstream Infections ◽  
Low Risk ◽  
Moderate Risk ◽  
Streptococcal Species ◽  
Very High

Abstract Background Infective endocarditis (IE) is diagnosed in 7–8% of streptococcal bloodstream infections (BSIs), yet it is unclear when to perform transthoracic (TTE) and transoesophageal echocardiography (TOE) according to different streptococcal species. The aim of this sub-study was to propose a flowchart for the use of echocardiography in streptococcal BSIs. Methods In a population-based setup, we investigated all patients admitted with streptococcal BSIs and crosslinked data with nationwide registries to identify comorbidities and concomitant hospitalization with IE. Streptococcal species were divided in four groups based on the crude risk of being diagnosed with IE (low-risk < 3%, moderate-risk 3–10%, high-risk 10–30% and very high-risk > 30%). Based on number of positive blood culture (BC) bottles and IE risk factors (prosthetic valve, previous IE, native valve disease, and cardiac device), we further stratified cases according to probability of concomitant IE diagnosis to create a flowchart suggesting TTE plus TOE (IE > 10%), TTE (IE 3–10%), or “wait & see” (IE < 3%). Results We included 6393 cases with streptococcal BSIs (mean age 68.1 years [SD 16.2], 52.8% men). BSIs with low-risk streptococci (S. pneumoniae, S. pyogenes, S. intermedius) are not initially recommended echocardiography, unless they have ≥3 positive BC bottles and an IE risk factor. Moderate-risk streptococci (S. agalactiae, S. anginosus, S. constellatus, S. dysgalactiae, S. salivarius, S. thermophilus) are guided to “wait & see” strategy if they neither have a risk factor nor ≥3 positive BC bottles, while a TTE is recommended if they have either ≥3 positive BC bottles or a risk factor. Further, a TTE and TOE are recommended if they present with both. High-risk streptococci (S. mitis/oralis, S. parasanguinis, G. adiacens) are directed to a TTE if they neither have a risk factor nor ≥3 positive BC bottles, but to TTE and TOE if they have either ≥3 positive BC bottles or a risk factor. Very high-risk streptococci (S. gordonii, S. gallolyticus, S. mutans, S. sanguinis) are guided directly to TTE and TOE due to a high baseline IE prevalence. Conclusion In addition to the clinical picture, this flowchart based on streptococcal species, number of positive blood culture bottles, and risk factors, can help guide the use of echocardiography in streptococcal bloodstream infections. Since echocardiography results are not available the findings should be confirmed prospectively with the use of systematic echocardiography.

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