Displaying publications 61 - 80 of 4452 in total

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  1. Liew SM, Jackson R, Mant D, Glasziou P
    BMJ Open, 2012;2(2):e000728.
    PMID: 22382122 DOI: 10.1136/bmjopen-2011-000728
    OBJECTIVES: To assess whether delaying risk reduction treatment has a different impact on potential life years lost in younger compared with older patients at the same baseline short-term cardiovascular risk.
    DESIGN: Modelling based on population data.
    METHODS: Potential years of life lost from a 5-year treatment delay were estimated for patients of different ages but with the same cardiovascular risk (either 5% or 10% 5-year risk). Two models were used: an age-based residual life expectancy model and a Markov simulation model. Age-specific case fatality rates and time preferences were applied to both models, and competing mortality risks were incorporated into the Markov model.
    RESULTS: Younger patients had more potential life years to lose if untreated, but the maximum difference between 35 and 85 years was <1 year, when models were unadjusted for time preferences or competing risk. When these adjusters were included, the maximum difference fell to about 1 month, although the direction was reversed with older people having more to lose.
    CONCLUSIONS: Surprisingly, age at onset of treatment has little impact on the likely benefits of interventions that reduce cardiovascular risk because of the opposing effects of life expectancy, case fatality, time preferences and competing risks. These findings challenge the appropriateness of recommendations to use lower risk-based treatment thresholds in younger patients.
    Matched MeSH terms: Risk Factors; Risk Reduction Behavior
  2. Flaherty GT, Choi J
    J Travel Med, 2016 Feb;23(2):tav026.
    PMID: 26858274 DOI: 10.1093/jtm/tav026
    Photography is an integral component of the international travel experience. Self-photography is becoming a mainstream behaviour in society and it has implications for the practice of travel medicine. Travellers who take selfies, including with the use of selfie sticks, may be subject to traumatic injuries associated with this activity. This review article is the first in the medical literature to address this emerging phenomenon.
    Matched MeSH terms: Risk-Taking*
  3. Kanis JA, Harvey NC, McCloskey E, Bruyère O, Veronese N, Lorentzon M, et al.
    Osteoporos Int, 2020 Jan;31(1):1-12.
    PMID: 31720707 DOI: 10.1007/s00198-019-05176-3
    Guidance is provided in an international setting on the assessment and specific treatment of postmenopausal women at low, high and very high risk of fragility fractures.

    INTRODUCTION: The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2019. This manuscript seeks to apply this in an international setting, taking additional account of further categorisation of increased risk of fracture, which may inform choice of therapeutic approach.

    METHODS: Clinical perspective and updated literature search.

    RESULTS: The following areas are reviewed: categorisation of fracture risk and general pharmacological management of osteoporosis.

    CONCLUSIONS: A platform is provided on which specific guidelines can be developed for national use to characterise fracture risk and direct interventions.

    Matched MeSH terms: Risk Factors; Risk Assessment
  4. Salvaraji L, Jeffree MS, Avoi R, Atil A, Mohd Akhir H, Shamsudin SBB, et al.
    J Public Health Res, 2020 Oct 14;9(4):1994.
    PMID: 33312989 DOI: 10.4081/jphr.2020.1994
    An increasing amount of waste concurrently further extends the risk of exposure to hazardous material among waste collectors. In light of the COVID-19 crisis, municipal waste collectors are one of the most at-risk groups of SARS-Cov-2 exposure. Risk assessment included hazard identification, evaluation of existing control level at the workplace, estimation of likelihood and severity of hazard, risk determination, and control measure recommendations. Five waste collection activities were identified and reviewed. High-risk exposure includes collection of garbage, mechanical manipulation of compactor lorries and unloading of garbage at the disposal site. There is poor practice of personal hygiene and unestablished continuous monitoring of personal protective equipment supplies. The preventive measures in the waste collection industry are influenced by several factors. Until the preventive measures are adopted into practice and adapted according to each company's requirements, biological agents continue to be risk factor to the health workers.
    Matched MeSH terms: Risk Factors; Risk Assessment
  5. Quek DKL
    Family Practitioner, 1988;11(1):90-91.
    Cardiovascular disease has been the premier cause of hospital-registered deaths in Malaysia for the past 8 years. Among these reported deaths, 31% were caused by coronary heart disease in 1982. A healthy lifestyle to control the coronary risk factors would help to reduce the incidence of coronary heart disease in future.
    Matched MeSH terms: Risk; Risk Factors
  6. Wong MCS, Rerknimitr R, Lee Goh K, Matsuda T, Kim HS, Wu DC, et al.
    Clin Gastroenterol Hepatol, 2021 01;19(1):119-127.e1.
    PMID: 31923642 DOI: 10.1016/j.cgh.2019.12.031
    BACKGROUND & AIMS: Patients found to be at high risk of advanced proximal neoplasia (APN) after flexible sigmoidoscopy screening should be considered for colonoscopy examination. We developed and validated a scoring system to identify persons at risk for APN.

    METHODS: We collected data from 7954 asymptomatic subjects (age, 50-75 y) who received screening colonoscopy examinations at 14 sites in Asia. We randomly assigned 5303 subjects to the derivation cohort and the remaining 2651 to the validation cohort. We collected data from the derivation cohort on age, sex, family history of colorectal cancer, smoking, drinking, body mass index, medical conditions, and use of nonsteroidal anti-inflammatory drugs or aspirin. Associations between the colonoscopic findings of APN and each risk factor were examined using the Pearson χ2 test, and we assigned each participant a risk score (0-15), with scores of 0 to 3 as average risk and scores of 4 or higher as high risk. The scoring system was tested in the validation cohort. We used the Cochran-Armitage test of trend to compare the prevalence of APN among subjects in each group.

    RESULTS: In the validation cohort, 79.5% of patients were classified as average risk and 20.5% were classified as high risk. The prevalence of APN in the average-risk group was 1.9% and in the high-risk group was 9.4% (adjusted relative risk, 5.08; 95% CI, 3.38-7.62; P < .001). The score included age (61-70 y, 3; ≥70 y, 4), smoking habits (current/past, 2), family history of colorectal cancer (present in a first-degree relative, 2), and the presence of neoplasia in the distal colorectum (nonadvanced adenoma 5-9 mm, 2; advanced neoplasia, 7). The c-statistic of the score was 0.74 (95% CI, 0.68-0.79), and for distal findings alone was 0.67 (95% CI, 0.60-0.74). The Hosmer-Lemeshow goodness-of-fit test statistic was greater than 0.05, indicating the reliability of the validation set. The number needed to refer was 11 (95% CI, 10-13), and the number needed to screen was 15 (95% CI, 12-17).

    CONCLUSIONS: We developed and validated a scoring system to identify persons at risk for APN. Screening participants who undergo flexible sigmoidoscopy screening with a score of 4 points or higher should undergo colonoscopy evaluation.

    Matched MeSH terms: Risk Factors; Risk Assessment
  7. Anuar, I., Zahedi, F., Kadir, A., Mokhtar, A.B.
    MyJurnal
    Background : Risk management strategy at the workplace needs two way interactions between employee and employer. Therefore, study on risk perception among workers based on scientific analysis is needed to gain knowledge and understanding on how workers perceived risk at the workplace in order to design risk management strategies more effectively.
    Methodology : A cross sectional study was carried out among 628 respondents from 36 medical laboratories in the public and private sector in Klang Valley. Using a self administered questionnaire, respondents were required to perceive risk on 30 hazards which have been identified in the medical laboratory. Each hazard was encoded by using Likert scale 1= not risky, 2= risky but low, 3= moderate risk, 4= high risk and 5= very high risk.
    Result : Overall, the study showed that working in the medical laboratory was perceived to of moderate risk. When comparing among ethic groups, the Malays had the highest perception of risk (3.07±0.88) as compared with Indians (3.03±0.88) and the Chinese (2.78±0.90). Employee with higher education and position level perceived low level of risk compared to those with lower education and position level. For those working in different types of laboratories, there are significant difference on risk perception, (p=0.001). Employees who work in government sector perceived higher (3.12±0.93) risk compared to workers in private sector (2.85±0.88). In terms of OSH based knowledge, those with higher level of education and position have a high score knowledge on OSH compared to those have lower education and position level.
    Conclusion : This study showed that risk perception among workers in medical laboratory is influenced by socio-demography factor such race, education level, job position and the laboratory where the respondents are working.
    Matched MeSH terms: Risk; Risk Management
  8. Aziz Basiran, Ismail Bahari
    MyJurnal
    Various types of Occupational Safety and Health Management Systems (OSH-MS) exist in the market. Basically, these systems have similar basic principles and even elements. However, the importance of these elements in terms of successful management of OSH differs according to the end-user. OSH Practitioners with different roles and responsibilities have different views on which element or elements contribute significantly to the overall success of OSH management. There are no standardization in terms quantifying the elements that qualifies an OSH-MS. A study was carried out to quantify the implementation of an OSH-MS through the determination of weighing factors for the different elements in an OSH-MS. Respondents for this study comprised of top safety and health management, safety and health officers (SHO) / radiation protection officers (RPO), DOSH officers, auditors and consultants who are very familiar with OSH-MS. Sample of this study was based on purposive sampling due to strict criteria and prerequisites to be met. Questionnaires were distributed to the identified organizations and personnel. Results from this study established that, auditor has the highest level of understanding of OSH-MS compared with top safety and health management, SHO / RPO, DOSH officers and OSH consultants. Among all the elements in the OSH-MS studied for their levels of importance in terms of the overall success of implementing an OSH-MS, OSH policy is the most critical element, followed by hazard identification, risk assessment and control, employee participation, responsibility and accountability and competence and training. The weighing factor for these top 5 elements are OSH policy (0.36); hazard identification, risk assessment and risk control (0.25); employee participation (0.15); responsibility and accountability (0.14); and competence and training (0.10). Application of the weighing factors of these elements allows the quantification of audit status (Audit Score) based on the equation: audit score = 0.36 [OSH Policy] + 0.25 [Hazard Identification, Risk Assessment and Risk Control] + 0.15 [Employee Participation] + 0.14 [Responsibility and Accountability] + 0.10 [Competence and Training]. Minimum tolerable target for each element of an OSH-MS was also determined. The minimum tolerable frequency of OSH policy is reviewed by top management is yearly; the minimum tolerable frequency of risk management is reviewed is yearly; the minimum tolerable percentage of employees who should be made known on relevant legal and other requirements is ≥90%; the minimum tolerable percentage of OSH objectives and programme(s) achieved / implemented is between 80 – 89%; the minimum tolerable percentage of money budgeted for OSH in a year compared to organization revenue is between 1 – 5%; the minimum tolerable number of hours for each employee needed to be trained on OSH per year is between 30 – 39 hours; the minimum tolerable percentage of employees who should be communicated on matters related to OSH is ≥90%; the minimum tolerable percentage of employees participation and involvement in hazard identification, risk assessment and determining controls is ≥90%; the minimum tolerable percentage of employees who should be involved in establishing OSH documents is
    Matched MeSH terms: Risk Management; Risk Assessment
  9. Abdul Hadi H
    MyJurnal
    A cross sectional study was conducted among tea plantation workers in Cameron Highlands from July to December 2006 to study the prevalence of low back pain and factors associated with it. One hundred and six tea plantation field workers participated in the study. Data was collected using self-administered questionnaire. Time motion studies were also conducted for 3 different job categories. The prevalence of back pain experienced throughout their work in the plantation was 81.1% and the prevalence of low
    back pain experienced in the past 12 months was 64.2%. Feeling the need to work as fast as possible was a significant predictor of low back pain and increased the risk by 3.5 times, therefore it is suggested that both the management and workers give serious attention to this particular aspect to reduce the incidence of low back pain.
    Matched MeSH terms: Risk Factors*
  10. Norhayati MN, Masseni AA, Azlina I
    PeerJ, 2017;5:e2983.
    PMID: 28243527 DOI: 10.7717/peerj.2983
    BACKGROUND: The outcomes of the physician-patient discussion intervene in the satisfaction of cardiovascular disease risk patients. Adherence to treatment, provision of continuous care, clinical management of the illness and patients' adjustment are influenced by satisfaction with physician-patient interaction. This study aims to determine the patient satisfaction with doctor-patient interaction and over six months after following prevention counselling, its associations with modifiable cardiovascular risk factors amongst moderately-high risk patients in a primary healthcare clinic in Kelantan, Malaysia.
    METHODS: A prospective survey was conducted amongst patients with moderately-high cardiovascular risk. A total of 104 moderately-high risk patients were recruited and underwent structured prevention counselling based on the World Health Organization guideline, and their satisfaction with the doctor-patient interaction was assessed using 'Skala Kepuasan Interaksi Perubatan-11,' the Malay version of the Medical Interview Satisfaction Scale-21. Systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol were measured at baseline and at a follow-up visit at six months. Descriptive analysis, paired t test and linear regression analyses were performed.
    RESULTS: A total of 102 patients responded, giving a response rate of 98.1%. At baseline, 76.5% of the respondents were satisfied with the relation with their doctor, with the favourable domain of distress relief (85.3%) and rapport/confidence (91.2%). The unfavourable domain was interaction outcome, with satisfaction in only 67.6% of the respondents. Between the two visits, changes had occurred in total cholesterol (P = 0.022) and in systolic blood pressure (P risks.
    DISCUSSION: The 'Skala Kepuasan Interaksi Perubatan-11' which represents a component of the interpersonal doctor-patient relationship can be used to assess improvements of the medical skills and in medical training to enhance the quality of therapeutic communication.
    Matched MeSH terms: Risk Factors*
  11. Adeleke AQ, Bahaudin AY, Kamaruddeen AM, Bamgbade JA, Salimon MG, Khan MWA, et al.
    Saf Health Work, 2018 Mar;9(1):115-124.
    PMID: 30363069 DOI: 10.1016/j.shaw.2017.05.004
    Background: Substantial empirical research has shown conflicting results regarding the influence of organizational external factors on construction risk management, suggesting the necessity to introduce a moderator into the study. The present research confirmed whether rules and regulations matter on the relationships between organizational external factors and construction risk management.

    Methods: Based on discouragement and organizational control theory, this research examined the effects of organizational external factors and rules and regulations on construction risk management among 238 employees operating in construction companies in Abuja and Lagos, Nigeria. A personally administered questionnaire was used to acquire the data. The data were analyzed using partial least squares structural equation modeling.

    Results: A significant positive relationship between organizational external factors and construction risk management was asserted. This study also found a significant positive relationship between rules and regulations and construction risk management. As anticipated, rules and regulations were found to moderate the relationship between organizational external factors and construction risk management, with a significant positive result. Similarly, a significant interaction effect was also found between rules and regulations and organizational external factors. Implications of the research from a Nigerian point of view have also been discussed.

    Conclusion: Political, economy, and technology factors helped the construction companies to reduce the chance of risk occurrence during the construction activities. Rules and regulations also helped to lessen the rate of accidents involving construction workers as well as the duration of the projects. Similarly, the influence of the organizational external factors with rules and regulations on construction risk management has proven that most of the construction companies that implement the aforementioned factors have the chance to deliver their projects within the stipulated time, cost, and qualities, which can be used as a yardstick to measure a good project.

    Matched MeSH terms: Risk; Risk Management
  12. Huynh-Le MP, Karunamuni R, Fan CC, Asona L, Thompson WK, Martinez ME, et al.
    Prostate Cancer Prostatic Dis, 2022 Apr;25(4):755-761.
    PMID: 35152271 DOI: 10.1038/s41391-022-00497-7
    BACKGROUND: Prostate cancer risk stratification using single-nucleotide polymorphisms (SNPs) demonstrates considerable promise in men of European, Asian, and African genetic ancestries, but there is still need for increased accuracy. We evaluated whether including additional SNPs in a prostate cancer polygenic hazard score (PHS) would improve associations with clinically significant prostate cancer in multi-ancestry datasets.

    METHODS: In total, 299 SNPs previously associated with prostate cancer were evaluated for inclusion in a new PHS, using a LASSO-regularized Cox proportional hazards model in a training dataset of 72,181 men from the PRACTICAL Consortium. The PHS model was evaluated in four testing datasets: African ancestry, Asian ancestry, and two of European Ancestry-the Cohort of Swedish Men (COSM) and the ProtecT study. Hazard ratios (HRs) were estimated to compare men with high versus low PHS for association with clinically significant, with any, and with fatal prostate cancer. The impact of genetic risk stratification on the positive predictive value (PPV) of PSA testing for clinically significant prostate cancer was also measured.

    RESULTS: The final model (PHS290) had 290 SNPs with non-zero coefficients. Comparing, for example, the highest and lowest quintiles of PHS290, the hazard ratios (HRs) for clinically significant prostate cancer were 13.73 [95% CI: 12.43-15.16] in ProtecT, 7.07 [6.58-7.60] in African ancestry, 10.31 [9.58-11.11] in Asian ancestry, and 11.18 [10.34-12.09] in COSM. Similar results were seen for association with any and fatal prostate cancer. Without PHS stratification, the PPV of PSA testing for clinically significant prostate cancer in ProtecT was 0.12 (0.11-0.14). For the top 20% and top 5% of PHS290, the PPV of PSA testing was 0.19 (0.15-0.22) and 0.26 (0.19-0.33), respectively.

    CONCLUSIONS: We demonstrate better genetic risk stratification for clinically significant prostate cancer than prior versions of PHS in multi-ancestry datasets. This is promising for implementing precision-medicine approaches to prostate cancer screening decisions in diverse populations.

    Matched MeSH terms: Risk Factors; Risk Assessment
  13. Kasim S, Malek S, Song C, Wan Ahmad WA, Fong A, Ibrahim KS, et al.
    PLoS One, 2022;17(12):e0278944.
    PMID: 36508425 DOI: 10.1371/journal.pone.0278944
    BACKGROUND: Conventional risk score for predicting in-hospital mortality following Acute Coronary Syndrome (ACS) is not catered for Asian patients and requires different types of scoring algorithms for STEMI and NSTEMI patients.

    OBJECTIVE: To derive a single algorithm using deep learning and machine learning for the prediction and identification of factors associated with in-hospital mortality in Asian patients with ACS and to compare performance to a conventional risk score.

    METHODS: The Malaysian National Cardiovascular Disease Database (NCVD) registry, is a multi-ethnic, heterogeneous database spanning from 2006-2017. It was used for in-hospital mortality model development with 54 variables considered for patients with STEMI and Non-STEMI (NSTEMI). Mortality prediction was analyzed using feature selection methods with machine learning algorithms. Deep learning algorithm using features selected from machine learning was compared to Thrombolysis in Myocardial Infarction (TIMI) score.

    RESULTS: A total of 68528 patients were included in the analysis. Deep learning models constructed using all features and selected features from machine learning resulted in higher performance than machine learning and TIMI risk score (p < 0.0001 for all). The best model in this study is the combination of features selected from the SVM algorithm with a deep learning classifier. The DL (SVM selected var) algorithm demonstrated the highest predictive performance with the least number of predictors (14 predictors) for in-hospital prediction of STEMI patients (AUC = 0.96, 95% CI: 0.95-0.96). In NSTEMI in-hospital prediction, DL (RF selected var) (AUC = 0.96, 95% CI: 0.95-0.96, reported slightly higher AUC compared to DL (SVM selected var) (AUC = 0.95, 95% CI: 0.94-0.95). There was no significant difference between DL (SVM selected var) algorithm and DL (RF selected var) algorithm (p = 0.5). When compared to the DL (SVM selected var) model, the TIMI score underestimates patients' risk of mortality. TIMI risk score correctly identified 13.08% of the high-risk patient's non-survival vs 24.7% for the DL model and 4.65% vs 19.7% of the high-risk patient's non-survival for NSTEMI. Age, heart rate, Killip class, cardiac catheterization, oral hypoglycemia use and antiarrhythmic agent were found to be common predictors of in-hospital mortality across all ML feature selection models in this study. The final algorithm was converted into an online tool with a database for continuous data archiving for prospective validation.

    CONCLUSIONS: ACS patients were better classified using a combination of machine learning and deep learning in a multi-ethnic Asian population when compared to TIMI scoring. Machine learning enables the identification of distinct factors in individual Asian populations to improve mortality prediction. Continuous testing and validation will allow for better risk stratification in the future, potentially altering management and outcomes.

    Matched MeSH terms: Risk Factors; Risk Assessment
  14. Sany SB, Hashim R, Rezayi M, Rahman MA, Razavizadeh BB, Abouzari-lotf E, et al.
    Environ Sci Pollut Res Int, 2015 Aug;22(15):11193-208.
    PMID: 25953606 DOI: 10.1007/s11356-015-4511-x
    Current ecological risk assessment (ERA) schemes focus mainly on bioaccumulation and toxicity of pollutants in individual organisms. Ecological models are tools mainly used to assess ecological risks of pollutants to ecosystems, communities, and populations. Their main advantage is the relatively direct integration of the species sensitivity to organic pollutants, the fate and mechanism of action in the environment of toxicants, and life-history features of the individual organism of concern. To promote scientific consensus on ERA schemes, this review is intended to provide a guideline on short-term ERA involving dioxin chemicals and to identify key findings for exposure assessment based on policies of different agencies. It also presents possible adverse effects of dioxins on ecosystems, toxicity equivalence methodology, environmental fate and transport modeling, and development of stressor-response profiles for dioxin-like chemicals.
    Matched MeSH terms: Risk Assessment/methods*
  15. Xiong J, Domnic Jacob GA, Xiong JG
    Am J Health Behav, 2023 Feb 28;47(1):165-172.
    PMID: 36945091 DOI: 10.5993/AJHB.47.1.17
    Objectives: In this study, we analyzed negative online public opinion in tertiary hospitals and evaluated corresponding risk by applying the Kaiser Model. Methods: Through data and expert group discussion, combined with the hospital's actual negative online public opinion management, we determined the opinions posing higher risk. The hospital's risk questionnaire for negative opinion was designed based on the Kaiser Model. The whole hospital staff was then trained and investigated. An Excel worksheet was used for statistical analysis and risk calculation.Results: According to the ranking of risk value, the top 5 negative online public opinions were drug supply and demand, in-hospital parking, handling of public health emergencies, the service attitude of hospital guidance staff, and interpretation of medical insurance policies. Conclusion: The hospital needs to revise and improve the emergency response plan for negative online public opinion based on the analysis results and reports of opinion risks. This is helpful for strengthening hospital-level emergency training, improving the hospital's ability to manage negative opinion risks, and promoting the hospital to become passive about negative online public opinion.
    Matched MeSH terms: Risk Management*
  16. Ong MF, Soh KL, Saimon R, Myint WW, Pawi S, Saidi HI
    Int J Nurs Pract, 2023 Aug;29(4):e13083.
    PMID: 35871775 DOI: 10.1111/ijn.13083
    AIMS: The aim of this study is to evaluate an evidence-based fall risk screening tool to predict the risk of falls suitable for independent community-dwelling older adults guided by the World Health Organization's International Classification of Functioning, Disability and Health (WHO-ICF) components, and to examine the reliability and validity of the fall risk screening tool to predict fall risks, and to examine the feasibility of tools among independent community-dwelling older adults.

    METHODS: A systematic literature search guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was performed using the EBSCOHost® platform, ScienceDirect, Scopus and Google Scholar between July and August 2021. Studies from January 2010 to January 2021 were eligible for review. Nine articles were eligible and included in this systematic review. The risk of bias assessment used the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies. The WHO-ICF helped to guide the categorization of fall risk factors.

    RESULTS: Seven screening tools adequately predicted fall risk among community-dwelling older adults. Six screening tools covered most of the components of the WHO-ICF, and three screening tools omitted the environmental factors. The modified 18-item Stay Independent Brochure demonstrated most of the predictive values in predicting fall risk. All tools are brief and easy to use in community or outpatient settings.

    CONCLUSION: The review explores the literature evaluating fall risk screening tools for nurses and other healthcare providers to assess fall risk among independent community-dwelling older adults. A fall risk screening tool consisting of risk factors alone might be able to predict fall risk. However, further refinements and validations of the tools before use are recommended.

    Matched MeSH terms: Risk Factors; Risk Assessment
  17. Rus RM, Daud A, Musa KI, Naing L
    Malays J Med Sci, 2008 Oct;15(4):28-34.
    PMID: 22589635
    The purpose of this study was to determine the sawmill workers' knowledge, attitude and practice (KAP) in relation to noise-induced hearing loss (NIHL). A cross-sectional study was conducted involving 83 workers from 3 factories in Kota Bharu, Kelantan. Questionnaires were distributed to obtain the socio-demography, knowledge, attitude and practice level in relation to noise-induced hearing loss (NIHL). The weak areas identified in the knowledge section were treatment aspects (15.5%), signs and symptoms of NIHL (20.2%) and risk factors (31%). As for attitude; the prevention aspects were the lowest (25.3%), followed by risk taking attitude (26.2%), and causes of hearing loss (42.1%). Overall, the practice was not encouraging at all. It is important to have an education program to raise workers' awareness and to improve their attitude and practices towards noise-induced hearing loss.
    Matched MeSH terms: Risk Factors; Risk-Taking
  18. Tan AL, Phua VC
    Med J Malaysia, 2014 Jun;69(3):124-5.
    PMID: 25326352 MyJurnal
    PURPOSE: Extravasation with intravenous chemotherapy is a common complication of chemotherapy which carries the risk of devastating complications. This study aims to determine the rate of extravasation with intravenous chemotherapy in a major hospital where chemotherapy is delivered in various departments other than the oncology department.

    PATIENTS AND METHODS: All patients who underwent intravenous chemotherapy in the oncology department and surgical wards in Penang General hospital from 1st February 2008 till 31st June 2008 were recruited retrospectively for this study to look at the rate of extravasation.

    RESULTS: A total of 602 patients underwent intravenous chemotherapy during this period. Fifty patients received chemotherapy in the general surgical ward while another 552 patients received chemotherapy in the oncology department. There were 5 cases of extravasation giving an overall extravasation rate of 0.8% (5/602). however, 4 of these cases occurred in the general surgical ward giving it a rate of 8% (4/50).

    CONCLUSION: The rate of extravasation in our hospital was 0.8%. however, this rate can be significantly increased if it is not done under a specialized unit delivering intravenous chemotherapy on a regular basis. Preventive steps including a standard chemotherapy delivery protocol, staff and patient education must be put in place in all units delivering intravenous chemotherapy.
    Matched MeSH terms: Risk
  19. Ong C, Dokos S, Chan B, Lim E, Al Abed A, Bin Abu Osman NA, et al.
    PMID: 23680359 DOI: 10.1186/1742-4682-10-35
    Despite the rapid advancement of left ventricular assist devices (LVADs), adverse events leading to deaths have been frequently reported in patients implanted with LVADs, including bleeding, infection, thromboembolism, neurological dysfunction and hemolysis. Cannulation forms an important component with regards to thrombus formation in assisted patients by varying the intraventricular flow distribution in the left ventricle (LV). To investigate the correlation between LVAD cannula placement and potential for thrombus formation, detailed analysis of the intraventricular flow field was carried out in the present study using a two way fluid structure interaction (FSI), axisymmetric model of a passive LV incorporating an inflow cannula. Three different cannula placements were simulated, with device insertion near the LV apex, penetrating one-fourth and mid-way into the LV long axis. The risk of thrombus formation is assessed by analyzing the intraventricular vorticity distribution and its associated vortex intensity, amount of stagnation flow in the ventricle as well as the level of wall shear stress. Our results show that the one-fourth placement of the cannula into the LV achieves the best performance in reducing the risk of thrombus formation. Compared to cannula placement near the apex, higher vortex intensity is achieved at the one-fourth placement, thus increasing wash out of platelets at the ventricular wall. One-fourth LV penetration produced negligible stagnation flow region near the apical wall region, helping to reduce platelet deposition on the surface of the cannula and the ventricular wall.
    Matched MeSH terms: Risk Factors
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