Displaying publications 1 - 20 of 624 in total

  1. Jeevanandam J, Barhoum A, Chan YS, Dufresne A, Danquah MK
    Beilstein J Nanotechnol, 2018;9:1050-1074.
    PMID: 29719757 DOI: 10.3762/bjnano.9.98
    Nanomaterials (NMs) have gained prominence in technological advancements due to their tunable physical, chemical and biological properties with enhanced performance over their bulk counterparts. NMs are categorized depending on their size, composition, shape, and origin. The ability to predict the unique properties of NMs increases the value of each classification. Due to increased growth of production of NMs and their industrial applications, issues relating to toxicity are inevitable. The aim of this review is to compare synthetic (engineered) and naturally occurring nanoparticles (NPs) and nanostructured materials (NSMs) to identify their nanoscale properties and to define the specific knowledge gaps related to the risk assessment of NPs and NSMs in the environment. The review presents an overview of the history and classifications of NMs and gives an overview of the various sources of NPs and NSMs, from natural to synthetic, and their toxic effects towards mammalian cells and tissue. Additionally, the types of toxic reactions associated with NPs and NSMs and the regulations implemented by different countries to reduce the associated risks are also discussed.
    Matched MeSH terms: Risk Assessment
  2. Roslina Mohammad, Zamree Amin, Norazli Othman
    The aim of this paper is to identify, review and carry out comparison to seven guidelines where the main focus is on its risk
    assessment elements related to confined space activities. This is due to lack of the specific approach of the Legislation for confined
    space such as entry procedure requirements, risk assessment method, existing practice of risk assessment is too general and additional
    references are required for conducting risk assessment which would lead to poor response from industries. The selected guidelines will
    be summarized on its requirements, followed by a review of each guideline and finally the comparison of Legislations will be carried
    out. The results from the study would be used as a contribution factor to promote an ideal method in developing an effective risk
    assessment tools for working safely in confined space. Furthermore, several literatures which have been referred could give additional
    input for developing the risk assessment tools.
    Matched MeSH terms: Risk Assessment
  3. Karupaiah T, Tan HK, Ong WW, Tan CH, Sundram K
    PMID: 24872121 DOI: 10.1080/19440049.2014.929183
    The extent of industrial trans fatty acids (TFA) in the food supply is unknown in Malaysia, whilst TFA disclosure on food labels is not mandatory by Malaysian food standards. Supermarket foods such as dairy products, fats and oils, meat products, snack foods, soups, and confectionery are commonly cited to be major contributors of TFA in the diet. A consumer survey (n = 622) was used to develop a food listing of these 'high risk' foods. TFA content of high-risk foods were analysed by gas chromatography. Food samples (n = 158) were analysed and their total TFA content were compared with Malaysian Food Standards. A wide variation in TFA content within food categories was indicated. Of the foods containing TFA, many food labels did not cite TFA content or the use of partially hydrogenated vegetable oils (PHVO) as an ingredient. Hypothesised estimates of TFA intake from these supermarket foods in a sample day's menu providing 2000 kcal projected a minimum intake of 0.5 g and a maximum intake of 5.2 g TFA. This study found there was no voluntary disclosure of TFA content on food labels or identifying PHVO as an ingredient. It appears that health education targeting consumers to minimise TFA consumption is required supported by mandatory PHVO disclosure on the food label.
    Matched MeSH terms: Risk Assessment*
  4. 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*
  5. Saleem F, Hassali M, Shafie A, Atif M
    J Young Pharm, 2012 Apr;4(2):101-7.
    PMID: 22754262 DOI: 10.4103/0975-1483.96624
    The study is aimed to explore the perceptions and experiences of hypertensive patients toward medication use and adherence. The study was qualitative in nature conducted at Sandamen Provisional Hospital of Quetta city, Pakistan; a public hospital catering to the health needs of about 40% of the population. A qualitative approach was used to gain an in-depth knowledge of the issues. Sixteen patients were interviewed, and the saturation point was achieved after the 14(th) interview. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Thematic content analysis yielded five major themes. (1) Perceived benefits and risks of medications, (2) physician's interaction with patients, (3) perception toward traditional remedies, (4) layman concept toward medications, and (5) beliefs toward hypertension and its control. The majority of the patients carried specific unrealistic beliefs regarding the long-term use of medication; yet these beliefs were heavily accepted and practiced by the society. The study indicated a number of key themes that can be used in changing the beliefs and experiences of hypertensive patients. Physician's attitude, patient's past experiences, and knowledge related to hypertension were noted as major contributing factors thus resulting in nonadherence to therapy prescribed.
    Matched MeSH terms: Risk Assessment
  6. Abdelhaq M, Alsaqour R, Abdelhaq S
    PLoS ONE, 2015;10(5):e0120715.
    PMID: 25946001 DOI: 10.1371/journal.pone.0120715
    A mobile ad hoc network (MANET) is a set of mobile, decentralized, and self-organizing nodes that are used in special cases, such as in the military. MANET properties render the environment of this network vulnerable to different types of attacks, including black hole, wormhole and flooding-based attacks. Flooding-based attacks are one of the most dangerous attacks that aim to consume all network resources and thus paralyze the functionality of the whole network. Therefore, the objective of this paper is to investigate the capability of a danger theory-based artificial immune algorithm called the mobile dendritic cell algorithm (MDCA) to detect flooding-based attacks in MANETs. The MDCA applies the dendritic cell algorithm (DCA) to secure the MANET with additional improvements. The MDCA is tested and validated using Qualnet v7.1 simulation tool. This work also introduces a new simulation module for a flooding attack called the resource consumption attack (RCA) using Qualnet v7.1. The results highlight the high efficiency of the MDCA in detecting RCAs in MANETs.
    Matched MeSH terms: Risk Assessment
  7. Buurman J, Zhang S, Babovic V
    Risk Anal., 2009 Mar;29(3):366-79.
    PMID: 19076327 DOI: 10.1111/j.1539-6924.2008.01160.x
    Complex engineering systems are usually designed to last for many years. Such systems will face many uncertainties in the future. Hence the design and deployment of these systems should not be based on a single scenario, but should incorporate flexibility. Flexibility can be incorporated in system architectures in the form of options that can be exercised in the future when new information is available. Incorporating flexibility comes, however, at a cost. To evaluate if this cost is worth the investment a real options analysis can be carried out. This approach is demonstrated through analysis of a case study of a previously developed static system-of-systems for maritime domain protection in the Straits of Malacca. This article presents a framework for dynamic strategic planning of engineering systems using real options analysis and demonstrates that flexibility adds considerable value over a static design. In addition to this it is shown that Monte Carlo analysis and genetic algorithms can be successfully combined to find solutions in a case with a very large number of possible futures and system designs.
    Matched MeSH terms: Risk Assessment
  8. Hassan, S.H., John Kua, S.B., Harun, H.
    The attention on genetically modified (GM) food industry is increasing due to the flourishing
    of biotechnology. However, there are some debates on the associated benefits and risks of
    employing modification technology in food industry. This study strives to examine the causes
    that determine consumers’ benefit and risk perceptions on GM foods. Besides, the influence of
    perceived benefit and risk of GM food on consumers’ attitude is investigated. The empirical
    results of this study showed that GM food knowledge, and GM food characteristics have been
    acting as important predictors of both benefits and risks perceptions. Further, it is also found
    that perceived benefits showed significant positive influence on attitude, and attitude affects
    purchase intention towards GM food. Research implications to policy makers, scientists, and
    market practitioners are covered, in which suggestions and recommendations are provided
    to these parties. Lastly, research implications and recommendations to future research are
    Matched MeSH terms: Risk Assessment
  9. Norhidayah Mat Sout, Muhamad Arifpin Mansor, Ahmad Rasdan Ismail
    Ergonomics can be viewed as an approach to reduce injury and illness rates to improve the overall working
    conditions for employees by addressing risk factor exposure that may occur during manual tasks. The objective
    of this research was to analyze ergonomics risk factors by associating the perception of employer and employees
    towards their workplace condition in quarry and mining industry. A Questionnaire on Ergonomics Risk Assessment
    was used to determine the comparison level awareness and perception analysis among quarry and mining industry in
    Malaysia. The findings of this research prove that the exposure of ergonomics risk factors towards the workers is in
    a moderate level with a mean of 3.59 for the overall respondent review about the ergonomics risk among workers at
    their workplace. Besides, the most concern in ergonomics is about the awkward posture at work. Some 8.8% of them
    agreed and 6.6% of them totally agreed that they were in awkward posture while doing their work. As a conclusion,
    assessment of ergonomics in quarry and mining industry will be a platform to provide a safe and healthy working
    Matched MeSH terms: Risk Assessment
  10. Raslan R, Hassim MH, Chemmangattuvalappil NG, Ng DKS, Ten JY
    Regul. Toxicol. Pharmacol., 2020 Oct;116:104753.
    PMID: 32745583 DOI: 10.1016/j.yrtph.2020.104753
    Consumers are commonly exposed to numerous chemical ingredients found in various formulated products especially household and personal care products. Therefore, identification of hazardous ingredients contained in those products should be performed at the early stages of product design to reduce the high cost of redesigning the products at the final stage. Thus, a systematic safety and health risk assessment methodology is required for the product formulation design. In this work, a two-step index-based methodology is presented to estimate the severity of the hazards and the magnitude of risks. In Tier 1 assessment, potential hazards of the ingredients were identified by following the Product Ingredient Safety Index (PISI). The basic toxicology information of ingredients was required for this assessment. In Tier 2 assessment, the extent of risks of the ingredients via dermal and inhalation exposure routes were evaluated. At this stage, the concentration of ingredients and the amount of exposure were considered. The value of Margin of Exposure (MOE) was used as an indicator in the development of Product Ingredient Exposure Index (PIEI). To demonstrate the proposed methodology, a case study on the evaluation of potential hazards and the risks from ingredients used in personal care product formulations were performed.
    Matched MeSH terms: Risk Assessment
  11. Yusof AAM, Harun MN, Nasruddin FA, Syahrom A
    Int J Sports Med, 2020 Aug 25.
    PMID: 32842154 DOI: 10.1055/a-1231-5268
    According to numerous studies, rowing performance is influenced by several factors including rower's biomechanics, rower's physiology, the force generated and stroke style. However, there is a missing gap linking such factors with rowing performance in the available literature. This paper aims to investigate the rowing mechanism in terms of rower anthropometry and physiology, which can impact its biomechanics and performance. The corresponding hydrodynamic force generated by the oar blade to accelerate the boat is also considered in the current study. To test the objectives, systematical online searching was conducted in search of the inclusion literature criteria. All included studies used Preferred Reporting item for Systematic Review and Meta-analysis (PRISMA) guidelines to obtain the final collection of articles for this review. In order to rate the quality of the articles, risk bias assessment was performed. A total of 35 studies were included in the assessment. The studies discussed the aspects of anthropometry and physiological of the rower, the biomechanics of the rower, corresponding hydrodynamic force on the oar blade and the rowing mechanism concerning boat performance. Based on the information obtained, an understanding of the important aspects of the rowing mechanism was achieved to provide an update for comprehensive improvement.
    Matched MeSH terms: Risk Assessment
  12. Noor Adilah Hamzah, Ahmad Rasdan Ismail, Nor Kamilah Makhtar, Khairul Azhar Mat Daud, Norhidayah Mat Sout
    Today, more accidents reported in school, resulting not only minor injuries but also severe injuries such as fire in schools, mercury spills and falling from high places. The study was aimed at measuring the level of occupational safety and health practices in schools. The study was conducted at 205 schools in Kelantan, Malaysia. This study is a semi-quantitative study using observation method. Data collection is conducted based on Hazard Identification, Risk Assessment and Risk Control (HIRARC) Guidelines provided by the Department of Occupational Safety and Health, Malaysia. Hazard identification, risk assessment and risk control are determined using the HIRARC form. The findings were measured by determining the discrete data according to the number of low, medium and high-risk levels found. The study found that there were two dominant hazards namely physical hazard and ergonomic hazard. Therefore, the management should increase and improve classroom safety awareness to ensure safety and health of all occupants.
    Matched MeSH terms: Risk Assessment
  13. Aliff, Farhan Bustani M., Siti Aslina Hussain
    Quantitative Risk Assessment (QRA) nowadays is an established risk assessment method used worldwide for the evaluation of risks on onshore plant and offshore facilities which associated with the major hazard installations. However, there are still many issues on QRA used. These include lack of consistency, complexity of the overall model structure, incorporation of new data, methodology and model analysis. Common problem observed for the onshore QRA methodology is conservatism of fire and explosion consequence results using DNV PhastRisk 6.7 software which is mainly contributed from the high release rate due to loss of containment. This paper presents an alternative way to predict the actual release rate for fire and explosion modelling which called limiting flowrate technique. This method has been applied for calculating risk in Onshore Gas Terminal (OGT) Plant. Adopting the limiting flowrate technique has provide more precise model towards real scenarios. Challenges facing during this research such as using the unmodified United Kingdom (UK) HSE hydrocarbon release database without integrate with the actual failure frequencies from the plant, the risk results tend to be much higher than actual experience. It should be noted that the development of improved onshore risk model has been used as an example for this research but many of the issues are equally applicable to offshore studies as well.
    Matched MeSH terms: Risk Assessment
  14. Lewiecki EM, Binkley N, Morgan SL, Shuhart CR, Camargos BM, Carey JJ, et al.
    J Clin Densitom, 2016 Apr-Jun;19(2):127-40.
    PMID: 27020004 DOI: 10.1016/j.jocd.2016.03.003
    Dual-energy X-ray absorptiometry (DXA) is a technology that is widely used to diagnose osteoporosis, assess fracture risk, and monitor changes in bone mineral density (BMD). The clinical utility of DXA is highly dependent on the quality of the scan acquisition, analysis, and interpretation. Clinicians are best equipped to manage patients when BMD measurements are correct and interpretation follows well-established standards. Poor-quality acquisition, analysis, or interpretation of DXA data may mislead referring clinicians, resulting in unnecessary diagnostic evaluations, failure to evaluate when needed, inappropriate treatment, or failure to provide medical treatment, with potentially ineffective, harmful, or costly consequences. Misallocation of limited healthcare resources and poor treatment decisions can be minimized, and patient care optimized, through meticulous attention to DXA instrument calibration, data acquisition and analysis, interpretation, and reporting. This document from the International Society for Clinical Densitometry describes quality standards for BMD testing at DXA facilities worldwide to provide guidance for DXA supervisors, technologists, interpreters, and clinicians. High-quality DXA testing is necessary for correct diagnostic classification and optimal fracture risk assessment, and is essential for BMD monitoring.
    Matched MeSH terms: Risk Assessment/methods
  15. Chia YC
    Singapore Med J, 2011 Feb;52(2):116-23.
    PMID: 21373738
    Cardiovascular Disease (CVD) is the leading cause of death in both developed and developing countries. While it is relatively easy to identify those who are obviously at high risk and those at the lowest risk for CVD, it is often the large group of individuals with what appears to be modestly abnormal risk factors who contributes most to the burden of CVD. This is where estimation of CVD risk is necessary. Many tools for risk assessment have been devised. All these risk scores have their own inherent advantages and disadvantages. Furthermore, they may also not be directly applicable to a local population. Ideally, each country should have its own risk score that takes into account other factors as well. In the interim, it is worthwhile to be familiar with one of these scores, select one that is most appropriate for your patient and discuss treatment options based on the estimated risk.
    Matched MeSH terms: Risk Assessment/methods*
  16. Joseph P, Yusuf S, Lee SF, Ibrahim Q, Teo K, Rangarajan S, et al.
    Heart, 2018 04;104(7):581-587.
    PMID: 29066611 DOI: 10.1136/heartjnl-2017-311609
    OBJECTIVE: To evaluate the performance of the non-laboratory INTERHEART risk score (NL-IHRS) to predict incident cardiovascular disease (CVD) across seven major geographic regions of the world. The secondary objective was to evaluate the performance of the fasting cholesterol-based IHRS (FC-IHRS).

    METHODS: Using measures of discrimination and calibration, we tested the performance of the NL-IHRS (n=100 475) and FC-IHRS (n=107 863) for predicting incident CVD in a community-based, prospective study across seven geographic regions: South Asia, China, Southeast Asia, Middle East, Europe/North America, South America and Africa. CVD was defined as the composite of cardiovascular death, myocardial infarction, stroke, heart failure or coronary revascularisation.

    RESULTS: Mean age of the study population was 50.53 (SD 9.79) years and mean follow-up was 4.89 (SD 2.24) years. The NL-IHRS had moderate to good discrimination for incident CVD across geographic regions (concordance statistic (C-statistic) ranging from 0.64 to 0.74), although recalibration was necessary in all regions, which improved its performance in the overall cohort (increase in C-statistic from 0.69 to 0.72, p<0.001). Regional recalibration was also necessary for the FC-IHRS, which also improved its overall discrimination (increase in C-statistic from 0.71 to 0.74, p<0.001). In 85 078 participants with complete data for both scores, discrimination was only modestly better with the FC-IHRS compared with the NL-IHRS (0.74 vs 0.73, p<0.001).

    CONCLUSIONS: External validations of the NL-IHRS and FC-IHRS suggest that regionally recalibrated versions of both can be useful for estimating CVD risk across a diverse range of community-based populations. CVD prediction using a non-laboratory score can provide similar accuracy to laboratory-based methods.

    Matched MeSH terms: Risk Assessment/methods*
  17. Inayat-Hussain SH, Fukumura M, Muiz Aziz A, Jin CM, Jin LW, Garcia-Milian R, et al.
    Environ Int, 2018 08;117:348-358.
    PMID: 29793188 DOI: 10.1016/j.envint.2018.05.010
    BACKGROUND: Recent trends have witnessed the global growth of unconventional oil and gas (UOG) production. Epidemiologic studies have suggested associations between proximity to UOG operations with increased adverse birth outcomes and cancer, though specific potential etiologic agents have not yet been identified. To perform effective risk assessment of chemicals used in UOG production, the first step of hazard identification followed by prioritization specifically for reproductive toxicity, carcinogenicity and mutagenicity is crucial in an evidence-based risk assessment approach. To date, there is no single hazard classification list based on the United Nations Globally Harmonized System (GHS), with countries applying the GHS standards to generate their own chemical hazard classification lists. A current challenge for chemical prioritization, particularly for a multi-national industry, is inconsistent hazard classification which may result in misjudgment of the potential public health risks. We present a novel approach for hazard identification followed by prioritization of reproductive toxicants found in UOG operations using publicly available regulatory databases.

    METHODS: GHS classification for reproductive toxicity of 157 UOG-related chemicals identified as potential reproductive or developmental toxicants in a previous publication was assessed using eleven governmental regulatory agency databases. If there was discordance in classifications across agencies, the most stringent classification was assigned. Chemicals in the category of known or presumed human reproductive toxicants were further evaluated for carcinogenicity and germ cell mutagenicity based on government classifications. A scoring system was utilized to assign numerical values for reproductive health, cancer and germ cell mutation hazard endpoints. Using a Cytoscape analysis, both qualitative and quantitative results were presented visually to readily identify high priority UOG chemicals with evidence of multiple adverse effects.

    RESULTS: We observed substantial inconsistencies in classification among the 11 databases. By adopting the most stringent classification within and across countries, 43 chemicals were classified as known or presumed human reproductive toxicants (GHS Category 1), while 31 chemicals were classified as suspected human reproductive toxicants (GHS Category 2). The 43 reproductive toxicants were further subjected to analysis for carcinogenic and mutagenic properties. Calculated hazard scores and Cytoscape visualization yielded several high priority chemicals including potassium dichromate, cadmium, benzene and ethylene oxide.

    CONCLUSIONS: Our findings reveal diverging GHS classification outcomes for UOG chemicals across regulatory agencies. Adoption of the most stringent classification with application of hazard scores provides a useful approach to prioritize reproductive toxicants in UOG and other industries for exposure assessments and selection of safer alternatives.

    Matched MeSH terms: Risk Assessment/methods*
  18. Taheri E, Mollabahrami F, Farokhzad M, Ghasemi F, Assari MJ
    Int J Environ Health Res, 2020 Apr;30(2):198-211.
    PMID: 30879332 DOI: 10.1080/09603123.2019.1588232
    In the laboratories staffs, there is potential for adverse health effects in exposure to chemicals. Therefore, risk assessment is one of the main issues to prevent these effects. The purpose of this study was to assess the health risk of laboratory staffs and compare the two methods, including 'Chemical Health Risk Assessment' (CHRA) and 'Regional Screening Levels' (RSLs), that developed by the Department of Occupational Safety and Health of Malaysia and the Environmental Protection Agency respectively. Using these two methods, the places with the highest risk were identified. Comparisons showed that RSLs is a precise method without personal judgment. The CHRA is a simple method for wider chemicals that categorize risk. But CHRA includes fewer parameters compared to RSLs, as well as personal judgment. The results of the present study showed that two methods did not compatible. According to the characteristics of these two methods, it is recommended to use them as a compliment each other to obtain accurate results.
    Matched MeSH terms: Risk Assessment/methods*
  19. Chan JCN, Lim LL, Luk AOY, Ozaki R, Kong APS, Ma RCW, et al.
    Diabetes Care, 2019 11;42(11):2022-2031.
    PMID: 31530658 DOI: 10.2337/dci19-0003
    In 1995, the Hong Kong Diabetes Register (HKDR) was established by a doctor-nurse team at a university-affiliated, publicly funded, hospital-based diabetes center using a structured protocol for gathering data to stratify risk, triage care, empower patients, and individualize treatment. This research-driven quality improvement program has motivated the introduction of a territory-wide diabetes risk assessment and management program provided by 18 hospital-based diabetes centers since 2000. By linking the data-rich HKDR to the territory-wide electronic medical record, risk equations were developed and validated to predict clinical outcomes. In 2007, the HKDR protocol was digitalized to establish the web-based Joint Asia Diabetes Evaluation (JADE) Program complete with risk levels and algorithms for issuance of personalized reports to reduce clinical inertia and empower self-management. Through this technologically assisted, integrated diabetes care program, we have generated big data to track secular trends, identify unmet needs, and verify interventions in a naturalistic environment. In 2009, the JADE Program was adapted to form the Risk Assessment and Management Program for Diabetes Mellitus (RAMP-DM) in the publicly funded primary care clinics, which reduced all major events by 30-60% in patients without complications. Meanwhile, a JADE-assisted assessment and empowerment program provided by a university-affiliated, self-funded, nurse-coordinated diabetes center, aimed at complementing medical care in the community, also reduced all major events by 30-50% in patients with different risk levels. By combining universal health coverage, public-private partnerships, and data-driven integrated care, the Hong Kong experience provides a possible solution than can be adapted elsewhere to make quality diabetes care accessible, affordable, and sustainable.
    Matched MeSH terms: Risk Assessment/standards*
  20. Khan MJ, Chelliah S, Haron MS
    Iran. J. Public Health, 2016 Feb;45(2):134-45.
    PMID: 27114978
    BACKGROUND: Role of information source, perceived benefits and risks, and destination image has significantly been examined in travel and tourism literature; however, in medical tourism it is yet to be examined thoroughly. The concept discussed in this article is drawn form well established models in tourism literature.

    METHODS: The purpose of this research was to identify the source of information, travel benefits and perceived risks related to movement of international patients and develop a conceptual model based on well-established theory. Thorough database search (Science Direct, utmj.org, nih.gov, nchu.edu.tw, palgrave-journals, medretreat, Biomedcentral) was performed to fulfill the objectives of the study.

    RESULTS: International patients always concern about benefits and risks related to travel. These benefits and risks form images of destination in the minds of international patients. Different sources of information make international patients acquaint about the associated benefits and risks, which later leads to development of intention to visit. This conceptual paper helps in establishing model for decision-making process of international patients in developing visit intention.

    CONCLUSION: Ample amount of literature is available detailing different factors involved in travel decision making of international patients; however literature explaining relationship between these factors is scarce.

    Matched MeSH terms: Risk Assessment
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