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Risk Assessment (risk + assessment)
Kinds of Risk Assessment Terms modified by Risk Assessment Selected AbstractsPARTNER VIOLENCE AND RISK ASSESSMENT IN CHILD CUSTODY EVALUATIONSFAMILY COURT REVIEW, Issue 4 2001William G. Austin How to integrate the problem of partner violence into a child custody evaluation is analyzed within a risk-assessment approach. The research literature on partner violence is reviewed to examine the issues of establishing a base rate for partner violence and its relative frequencies for both genders. Theoretical typologies of partner violence are reviewed and a new typology presented that is more suitable to the predictive task in the custody evaluation. A model of how the evaluator should approach partner violence is described, with an integration of a risk-assessment approach to child developmental outcomes as associated with custody and parenting time arrangements and a violence risk assessment of a perpetrator/parent. [source] THE UNDERPINNINGS OF COUNTRY RISK ASSESSMENTJOURNAL OF ECONOMIC SURVEYS, Issue 3 2008Susan K. Schroeder Abstract This paper surveys the history and current status of country risk assessment. The motivation is to understand why it is that country risk assessors have such a poor track record in anticipating the onset of financial crises. The development of the field reflects changes in the composition of international capital flows. These changes have confounded a definition of country risk, especially if a definition is centered on a particular event. It is then argued that the field has reached an impasse, and this impasse is related to the methods of abstraction and the current crisis of vision within the science of economics. This crisis of vision, as it pertains to theories of financial crises, has led to increased reliance on quantitative methods in the field of country risk. The paper concludes by proposing a new direction for the field, the first step towards which is to recognize that the object of country risk assessment is not to monitor for a particular event or symptom of financial crisis, but, rather, to monitor for a particular state of the economy. [source] Fuzzy Monte Carlo Simulation and Risk Assessment in ConstructionCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 4 2010N. Sadeghi However, subjective and linguistically expressed information results in added non-probabilistic uncertainty in construction management. Fuzzy logic has been used successfully for representing such uncertainties in construction projects. In practice, an approach that can handle both random and fuzzy uncertainties in a risk assessment model is necessary. This article discusses the deficiencies of the available methods and proposes a Fuzzy Monte Carlo Simulation (FMCS) framework for risk analysis of construction projects. In this framework, we construct a fuzzy cumulative distribution function as a novel way to represent uncertainty. To verify the feasibility of the FMCS framework and demonstrate its main features, the authors have developed a special purpose simulation template for cost range estimating. This template is employed to estimate the cost of a highway overpass project. [source] The Effectiveness of Alternative Risk Assessment and Program Planning Tools in a Fraud Setting,CONTEMPORARY ACCOUNTING RESEARCH, Issue 2 2004STEPHEN K. ASARE Abstract This study examines the impact of alternative risk assessment (standard risk checklist versus no checklist) and program development (standard program versus no program) tools on two facets of fraud planning effectiveness: (1) the quality of audit procedures relative to a benchmark validated by a panel of experts, and (2) the propensity to consult fraud experts. A between-subjects experiment, using an SEC enforcement fraud case, was conducted to examine these relationships. Sixty-nine auditors made risk assessments and designed an audit program. We found that auditors who used a standard risk checklist, structured by SAS No. 82 risk categories, made lower risk assessments than those without a checklist. This suggests that the use of the checklist was associated with a less effective diagnosis of the fraud. We also found that auditors with a standard audit program designed a relatively less effective fraud program than those without this tool but were not more willing to seek consultation with fraud experts. This suggests that standard programs may impair auditors' ability to respond to fraud risk. Finally, our results show that fraud risk assessment (FRASK) was not associated with the planning of more effective fraud procedures but was directly associated with the desire to consult with fraud specialists. This suggests that one benefit of improved FRASK is its relation with consultation. Overall, the findings call into question the effectiveness of standard audit tools in a fraud setting and highlight the need for a more strategic reasoning approach in an elevated risk situation. [source] Learning from others: the scope and challenges for participatory disaster risk assessmentDISASTERS, Issue 4 2007Mark Pelling This paper develops a framework based on procedural, methodological and ideological elements of participatory vulnerability and risk assessment tools for placing individual approaches within the wide range of work that claims a participatory, local or community orientation. In so doing it draws on relevant experience from other areas of development practice from which the disasters field can learn. Participatory disaster risk assessments are examined for their potential to be empowering, to generate knowledge, to be scaled up, to be a vehicle for negotiating local change and as part of multiple-methods approaches to disaster risk identification and reduction. The paper is a response to an international workshop on Community Risk Assessment organised by ProVention Consortium and the Disaster Mitigation for Sustainable Livelihoods Programme, University of Cape Town. The workshop brought together practitioners and academics to review the challenges and opportunities for participatory methodologies in the field of disaster risk reduction. In conclusion the contribution made by participatory methodologies to global disaster risk reduction assessment and policy is discussed. [source] SCALES: a large-scale assessment model of soil erosion hazard in Basse-Normandie (northern-western France)EARTH SURFACE PROCESSES AND LANDFORMS, Issue 8 2010P. Le Gouée Abstract The cartography of erosion risk is mainly based on the development of models, which evaluate in a qualitative and quantitative manner the physical reproduction of the erosion processes (CORINE, EHU, INRA). These models are mainly semi-quantitative but can be physically based and spatially distributed (the Pan-European Soil Erosion Risk Assessment, PESERA). They are characterized by their simplicity and their applicability potential at large temporal and spatial scales. In developing our model SCALES (Spatialisation d'éChelle fine de l'ALéa Erosion des Sols/large-scale assessment and mapping model of soil erosion hazard), we had in mind several objectives: (1) to map soil erosion at a regional scale with the guarantee of a large accuracy on the local level, (2) to envisage an applicability of the model in European oceanic areas, (3) to focus the erosion hazard estimation on the level of source areas (on-site erosion), which are the agricultural parcels, (4) to take into account the weight of the temporality of agricultural practices (land-use concept). Because of these objectives, the nature of variables, which characterize the erosion factors and because of its structure, SCALES differs from other models. Tested in Basse-Normandie (Calvados 5500,km2) SCALES reveals a strong predisposition of the study area to the soil erosion which should require to be expressed in a wet year. Apart from an internal validation, we tried an intermediate one by comparing our results with those from INRA and PESERA. It appeared that these models under estimate medium erosion levels and differ in the spatial localization of areas with the highest erosion risks. SCALES underlines here the limitations in the use of pedo-transfer functions and the interpolation of input data with a low resolution. One must not forget however that these models are mainly focused on an interregional comparative approach. Therefore the comparison of SCALES data with those of the INRA and PESERA models cannot result on a convincing validation of our model. For the moment the validation is based on the opinion of local experts, who agree with the qualitative indications delivered by our cartography. An external validation of SCALES is foreseen, which will be based on a thorough inventory of erosion signals in areas with different hazard levels. Copyright © 2010 John Wiley & Sons, Ltd. [source] Evaluation of the PESERA model in two contrasting environmentsEARTH SURFACE PROCESSES AND LANDFORMS, Issue 5 2009F. Licciardello Abstract The performance of the Pan-European Soil Erosion Risk Assessment (PESERA) model was evaluated by comparison with existing soil erosion data collected in plots under different land uses and climate conditions in Europe. In order to identify the most important sources of error, the PESERA model was evaluated by comparing model output with measured values as well as by assessing the effect of the various model components on prediction accuracy through a multistep approach. First, the performance of the hydrological and erosion components of PESERA was evaluated separately by comparing both runoff and soil loss predictions with measured values. In order to assess the performance of the vegetation growth component of PESERA, the predictions of the model based on observed values of vegetation ground cover were also compared with predictions based on the simulated vegetation cover values. Finally, in order to evaluate the sediment transport model, predicted monthly erosion rates were also calculated using observed values of runoff and vegetation cover instead of simulated values. Moreover, in order to investigate the capability of PESERA to reproduce seasonal trends, the observed and simulated monthly runoff and erosion values were aggregated at different temporal scale and we investigated at what extend the model prediction error could be reduced by output aggregation. PESERA showed promise to predict annual average spatial variability quite well. In its present form, short-term temporal variations are not well captured probably due to various reasons. The multistep approach showed that this is not only due to unrealistic simulation of cover and runoff, being erosion prediction also an important source of error. Although variability between the investigated land uses and climate conditions is well captured, absolute rates are strongly underestimated. A calibration procedure, focused on a soil erodibility factor, is proposed to reduce the significant underestimation of soil erosion rates. Copyright © 2009 John Wiley & Sons, Ltd. [source] Role of Dobutamine Stress Echocardiography for Preoperative Cardiac Risk Assessment Before Major Vascular Surgery: A Diagnostic Tool Comes of AgeECHOCARDIOGRAPHY, Issue 1 2000DON POLDERMANS M.D. Background: Cardiac complications are a major cause for perioperative mortality and morbidity Also, the presence and severity of underlying coronary artery disease (CAD) determine long-ten prognosis after successful surgery. Aim: This overview evaluates the additional value ofdobutamir, stress echocardiography (DSE) to common clinical cardiac risk factors and other noninvasii cardiac imaging modalities for perioperative and late cardiac prognosis. Results: DSE provides tl attending physician with preoperative prognostic information for perioperative and long-ten prognosis for cardiac events. It also enables the selection of high risk patients for evaluation i cardiac risk reduction therapies. Conclusions: DSE is a useful tool for preoperative cardiac ris evaluation in addition to common clinical cardiac risk factors. (ECHOCARDIOGRAPHY, Vo ume 17, January 2000) [source] Risk Assessment and Withdrawal Behavior by Two Species of Aposematic Poison Frogs, Dendrobates auratus and Oophaga pumilio, on Forest TrailsETHOLOGY, Issue 4 2009William E. Cooper Jr Many chemically defended prey advertize toxicity to predators by aposematic coloration. When aposematic prey are approached, they often move slowly or not at all, allowing predators to evaluate their unprofitability. Poison frogs (Dendrobatidae) are toxic, aposematically colored, forage openly and diurnally, and are much easier to capture than many palatable frogs. Although protected against diverse predators, they are sometimes attacked and are subjected to injury by large animals without predatory intent. We predicted that they have limited escape behavior, but retain ability to assess and respond to risk. When we approached Dendrobates auratus and Oophaga pumilio on forest trails, both species hopped by the shortest route to the nearer forest edge and stopped there. When approached, D. auratus moved after shorter latency at an angle closer to perpendicular to the forest edge, were more likely to leave the trail, and left the trail sooner with fewer changes in direction after moving a shorter distance than when not approached. In agreement with predictions of optimal escape theory based on risk, flight initiation distance by D. auratus was greater when approached directly than indirectly and rapidly than slowly, and was greater when frogs were in the open than partially concealed. Frogs neither attempted rapid escape nor entered refuges. Both species hopped leisurely and remained visible after stopping. They exhibit the diminished escape behavior of aposematic prey, yet retain the capacity to assess risk and adjust behavior accordingly. Their behavior demonstrates continued need for escape behavior by highly toxic aposematic prey. [source] Avian Risk Assessment: Effects of Perching Height and DetectabilityETHOLOGY, Issue 4 2004Daniel T. Blumstein We studied two components of predator risk assessment in birds. While many species are limited to seeking safety under cover or under ground, some birds can fly away from their predators and escape to trees. If birds in fact ,feel' safer (e.g. perceive less risk) in trees, we would expect them to tolerate closer approach by a potential terrestrial predator. Another component of safety is at which point the animal detects an approaching threat, which we expected to increase with eye size, assuming eye size is a surrogate for visual acuity. We used the distance birds moved away from an approaching human [flight initiation distance (FID)] as a metric to determine whether birds associated a lower risk of predation by being in trees, and we used the distance at which birds first displayed alert behaviors from an approaching human (alert distance) to determine if birds with larger eyes had higher detection distances. Although some species were affected by tree height, we found no clear pattern that birds assessed themselves to be at a lower risk of predation when they were ,3 m above the ground compared with being <3 m above ground. In the 10 species for which height had any significant effect on FID, birds ,3 m off the ground had greater FIDs in six species, but the remaining three species had the opposite response. While we found a significant positive relationship between eye size and alert distance in 23 species, the relationship was not present in a phylogenetic analysis using independent contrasts, which suggests that the apparent relationship was influenced strongly by the association between the studied species. Together, these results suggest that birds do not obviously associate being in a tree with safety, and that variations in visual acuity, per se, cannot be used as a general indicator of differences in alert distances, as previously suggested in the literature. [source] Cardiovascular Risk Assessment and TriptansHEADACHE, Issue 2004Vasilios Papademetriou MD Identifying the patient for whom triptans are contraindicated because of recognized, diagnosed cardiovascular disease is relatively straightforward. Determining whether a patient with potential unrecognized cardiovascular disease is an appropriate candidate for triptan therapy, however, constitutes a difficult challenge, especially in the absence of a framework for workup of patients. This article discusses the pathophysiology of coronary heart disease and issues involved in assessing cardiovascular risk, and it attempts to provide a framework for cardiovascular risk assessment that can be applied to decisions for prescribing triptans. Current guidelines for cardiovascular risk assessment allow stratification of patients to low, intermediate, or high risk of coronary heart disease events. This framework for risk assessment can be applied to decisions for prescribing triptans. Cardiovascular risk-assessment algorithms discussed elsewhere in this supplement suggest that patients at low risk (1 or no risk factors) of coronary heart disease can be prescribed triptans without the need for a more intensive cardiovascular evaluation. Conversely, patients with established coronary heart disease or coronary heart disease risk equivalents should not be prescribed triptans according to the current prescribing recommendations. Patients at intermediate risk (2 or more risk factors) of coronary heart disease require cardiovascular evaluation before triptans can be prescribed. Current understanding suggests that the risk of future acute coronary events is a function of the absolute number of vulnerable plaques present, a variable that cannot be accurately determined using available technology or risk-prediction models. Cardiovascular risk-assessment guidelines should be evaluated in the context of this limitation. [source] Approaches for derivation of environmental quality criteria for substances applied in risk assessment of discharges from offshore drilling operationsINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 2 2008Dag Altin Abstract In order to achieve the offshore petroleum industries "zero harm" goal to the environment, the environmental impact factor for drilling discharges was developed as a tool to identify and quantify the environmental risks associated with disposal of drilling discharges to the marine environment. As an initial step in this work the main categories of substances associated with drilling discharges and assumed to contribute to toxic or nontoxic stress were identified and evaluated for inclusion in the risk assessment. The selection were based on the known toxicological properties of the substances, or the total amount discharged together with their potential for accumulation in the water column or sediments to levels that could be expected to cause toxic or nontoxic stress to the biota. Based on these criteria 3 categories of chemicals were identified for risk assessment the water column and sediments: Natural organic substances, metals, and drilling fluid chemicals. Several approaches for deriving the environmentally safe threshold concentrations as predicted no effect concentrations were evaluated in the process. For the water column consensus were reached for using the species sensitivity distribution approach for metals and the assessment factor approach for natural organic substances and added drilling chemicals. For the sediments the equilibrium partitioning approach was selected for all three categories of chemicals. The theoretically derived sediment quality criteria were compared to field-derived threshold effect values based on statistical approaches applied on sediment monitoring data from the Norwegian Continental Shelf. The basis for derivation of predicted no effect concentration values for drilling discharges should be consistent with the principles of environmental risk assessment as described in the Technical Guidance Document on Risk Assessment issued by the European Union. [source] Trait-based ecological risk assessment (TERA): The new frontier?INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 1 2008Donald J Baird Traits describe the physical characteristics, ecological niche, and functional role of species within ecosystems, and trait-based approaches are now being introduced into the field of Ecological Risk Assessment (ERA). The costs and benefits arising from the adoption of these approaches in the assessment of risks from toxic substances are described, and the path forward for this new frontier in risk assessment science is presented. In particular, the necessity for more open collaboration and web-based data-sharing to facilitate the development of these exciting new tools is stressed, and the role of scientific organizations such as SETAC as promoters of this ambitious program is highlighted. [source] Internal Auditing and Risk Assessment in Large Italian Companies: an Empirical SurveyINTERNATIONAL JOURNAL OF AUDITING, Issue 3 2003Marco Allegrini This paper aims at achieving an overall view regarding the state of the art of internal auditing in large Italian companies. Mainly, it is focused on risk assessment practices and on the execution of a risk-based approach in the audit process. The research is based on a survey carried out on the ,Top100' companies listed at the Italian Stock Exchange. Survey results reveal that practices vary significantly among three different models: 1A few companies (25%) carry out mainly traditional compliance activities and they generally follow an audit-cycle approach for the annual audit planning; 2In most companies (67%), internal auditors adopt the COSO model and perform mainly operational auditing. Risk-based approach is applied predominantly at macro level. 3Finally, it is possible to identify a very few large companies (8%), in which auditors are applying a risk-based approach both at macro and micro level. [source] Forensic Risk Assessment in Intellectual Disabilities: The Evidence Base and Current Practice in One English RegionJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2000Stephen Turner The growing interest in forensic risk assessment in intellectual disability services reflects the perception that deinstitutionalization has exposed more people to a greater risk of offending. However, ,risk' and the related idea of ,dangerousness' are problematic concepts because of connotations of dichotomous definition, stability and predictability. Assessment instruments in mainstream forensic psychiatry often combine actuarial and clinical data, and increasingly stress the dynamic nature of risk as well as the importance of situational and accidental triggers. Despite this increasing sophistication of research in mainstream forensic psychiatry, the ability to predict future offending behaviour remains very limited. Furthermore, actuarial predictors developed in studies of psychiatric or prison populations may not be valid for individuals with intellectual disabilities. Offending behaviour among people with intellectual disabilities is also hard to circumscribe because it often does not invoke full legal process or even reporting to the police. In order to discover how such problems were reflected in practice, a survey of providers in the North-west Region of England was undertaken. Seventy out of 106 providers identified as possibly relevant to this inquiry responded to a short postal questionnaire. Twenty-nine (42%) respondents , mainly in the statutory sector , reported operating a risk assessment policy relating to offending. The number of risk assessments completed in the previous year varied from none to ,several hundred'. Providers reported three main kinds of problems: (1) resources or service configuration; (2) interagency or interdisciplinary cooperation or coordination; and (3) issues relating to the effectiveness, design and content of assessment. [source] Captan: Transition from ,B2' to ,not likely'.JOURNAL OF APPLIED TOXICOLOGY, Issue 5 2007How pesticide registrants affected the EPA Cancer Classification Update Abstract On 24 November 2004 EPA changed the cancer classification of captan from a ,probable human carcinogen' (Category B2) to ,not likely' when used according to label directions. The new cancer classification considers captan to be a potential carcinogen at prolonged high doses that cause cytotoxicity and regenerative cell hyperplasia. These high doses of captan are many orders of magnitude above those likely to be consumed in the diet, or encountered by individuals in occupational or residential settings. This revised cancer classification reflects EPA's implementation of their new cancer guidelines. The procedures involved in the reclassification effort were agreed upon with EPA and involved an Independent Transparent Review as it related to four components that formed the basis of the original 1986 B2 classification: mouse tumors; rat tumors; mutagenicity; and structural similarity to other carcinogens. A Peer Review Panel organized and administered by Toxicology Excellence for Risk Assessment (TERA) met on 2,3 September 2003. The Panel concluded that captan acted through a non-mutagenic threshold mode of action that required prolonged irritation of the duodenal villi as the initial key event. EPA's Cancer Assessment Review Committee (CARC) met on 9 June 2004 and endorsed the Peer Review findings. EPA intended to have the FIFRA Scientific Advisory Panel (SAP) consider the basis for this reclassification but found the science was robust and judged that a SAP review was not warranted. Using the revised classification, the margin of exposure is approximately 1,200,000, supporting the ,not likely' characterization. Copyright © 2007 John Wiley & Sons, Ltd. [source] Simplified System for Absolute Fracture Risk Assessment: Clinical Validation in Canadian Women,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2009William D Leslie Abstract Absolute 10-yr fracture risk based on multiple factors is the preferred method for risk assessment. A simplified risk assessment system from sex, age, DXA, and two clinical risk factors (CRFs),prior fracture and systemic corticosteroid (CS) use-has been used in Canada since 2005. This study was undertaken to evaluate this system in the Canadian female population. A total of 16,205 women ,50 yr of age at the time of baseline BMD (1998,2002) were identified in a database containing all clinical DXA test results for the Province of Manitoba, Canada. Basal 10-yr fracture risk from age and minimum T-score (lumbar spine, femur neck, trochanter, total hip) was categorized as low (<10%), moderate (10,20%), or high (>20%). Health service records since 1987 were assessed for prior fracture codes (N = 5224), recent major CS use (N = 616), and fracture codes after BMD testing (mean, 3.1 yr of follow-up) for the hip, vertebrae, forearm, or humerus (designated osteoporotic, N = 757). Fracture risk predicted from age and minimum T-score alone showed a significant gradient in observed fracture rates (low 5.1 [95% CI, 4.1,6.4], moderate 11.5 [95% CI, 10.1,13.0], high 25.4 [95% CI, 23.2,27.9] per 1000 person-years; p -for-trend <0.0001). There was an incremental increase in incident fracture rates from a prior fracture (13.9 [95% CI, 11.3,16.4] per 1000 person-years) or major CS use (11.2 [95% CI, 4.1,18.2] per 1000 person-years). This simplified fracture risk assessment system provides an assessment of fracture risk that is consistent with observed fracture rates. [source] Impact of Recent Fracture on Health-Related Quality of Life in Postmenopausal Women,,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 6 2006Susan K Brenneman PT Abstract The effect of fractures other than hip and spine on HRQoL in younger and older women has not been extensively studied. In a cohort of 86,128 postmenopausal women, we found the impact of recent osteoporosis-related fractures on HRQoL to be similar between women <65 compared with those ,65 years of age. The impact of spine, hip, or rib fractures was greater than that of wrist fractures in both age groups. Introduction: Health-related quality of life (HRQoL) after vertebral and hip fractures has been well studied. Less is known about HRQoL after fractures at other sites. We studied the effect of recent clinical fractures on HRQoL, using Short Form-12 (SF-12). Materials and Methods: This study included 86,128 postmenopausal participants in the National Osteoporosis Risk Assessment (NORA) who responded to two follow-up surveys during a 2-year interval. At each survey, they completed the SF-12 HRQoL questionnaire and reported new fractures of the hip, spine, wrist, and rib. The effect of recent fracture on HRQoL was assessed by comparing Physical Component Score (PCS) and Mental Component Score (MCS) means for women with and without new fractures at the second survey. Analyses were by fracture type and by age group (50,64 and 65,99) and were adjusted for PCS and MCS at the first survey. Results: New fractures (320 hip, 445 vertebral, 657 rib, 835 wrist) occurring during the interval between the first and second follow-up surveys were reported by 2257 women. The PCS was poorer in both older and younger women who had fractured the hip, spine, or rib (p , 0.001). Wrist fractures had an impact on PCS in women ,65 years of age (p < 0.001), but not older women (p > 0.10). These differences in PCS by fracture status were similar to those reported for other chronic diseases such as asthma, chronic obstructive pulmonary disease (COPD), and osteoarthritis. MCS was less consistently changed by fracture status, but younger and older women with vertebral fracture (p < 0.004), older women with hip fracture (p < 0.004), and younger women with rib fracture (p < 0.004) had poorer MCS compared with those who did not fracture within their age cohort. Conclusions: Recent osteoporosis-related fractures have significant impact on HRQoL as measured by SF-12. The impact of recent fracture on HRQoL was similar for older and younger postmenopausal women. Fracture prevention and postfracture interventions that target the subsequent symptoms are needed for postmenopausal women of any age. [source] Risk Assessment and Fracture Discrimination by Ultrasound: The Debate ContinuesJOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2005Tuan V Nguyen No abstract is available for this article. [source] Preoperative Electrocardiographic Risk Assessment of Atrial Fibrillation After Coronary Artery Bypass GraftingJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 12 2004Ph.D., YI GANG M.D. Introduction: This study evaluated the role of surface ECG in assessment of risk of new-onset atrial fibrillation (AF) after coronary artery bypass grafting surgery (CABG). Methods and Results: One hundred fifty-one patients (126 men and 25 women; age 65 ± 10 years) without a history of AF undergoing primary elective and isolated CABG were studied. Standard 12-lead ECGs and P wave signal-averaged ECG (PSAE) were recorded 24 hours before CABG using a MAC VU ECG recorder. In addition to routine ECG measurements, two P wave (P wave complexity ratio [pCR]; P wave morphology dispersion [PMD]) and six T wave morphology descriptors (total cosine R to T [TCRT]; T wave morphology dispersion of ascending and descending part of the T wave [aTMD and dTMD], and others), and three PSAE indices (filtered P wave duration [PD]; root mean square voltage of terminal 20 msec of averaged P wave [RMS20]; and integral of P wave [Pi]) were investigated. During a mean hospital stay of 7.3 ± 6.2 days after CABG, 40 (26%) patients developed AF (AF group) and 111 remained AF-free (no AF group). AF patients were older (69 ± 9 years vs 64 ± 10 years, P = 0.005). PD (135 ± 9 msec vs 133 ± 12 msec, P = NS) and RMS20 (4.5 ± 1.7 ,V vs 4.0 ± 1.6 ,V, P = NS) in AF were similar to that in no AF, whereas Pi was significantly increased in AF (757 ± 230 ,Vmsec vs 659 ± 206 ,Vmsec, P = 0.007). Both pCR (32 ± 11 vs 27 ± 10) and PMD (31.5 ± 14.0 vs 26.4 ± 12.3) were significantly greater in AF (P = 0.012 and 0.048, respectively). TCRT (0.028 ± 0.596 vs 0.310 ± 0.542, P = 0.009) and dTMD (0.63 ± 0.03 vs 0.64 ± 0.02, P = 0.004) were significantly reduced in AF compared with no AF. Measurements of aTMD and three other T wave descriptors were similar in AF and no AF. Significant variables by univariate analysis, including advanced age (P = 0.014), impaired left ventricular function (P = 0.02), greater Pi (P = 0.012), and lower TCRT (P = 0.007) or dTMD, were entered into multiple logistic regression models. Increased Pi (P = 0.038), reduced TCRT (P = 0.040), and lower dTMD (P = 0.014) predicted AF after CABG independently. In patients <70 years, a linear combination of increased pCR and lower TCRT separated AF and no AF with a sensitivity of 74% and specificity of 62% (P = 0.005). Conclusion: ECG assessment identifies patients vulnerable to AF after CABG. Combination of ECG parameters assessed preoperatively may play an important role in predicting new-onset AF after CABG. [source] Staging of Hypertension and Total Cardiovascular Risk Assessment: Related but Not the Same,Challenge for the Hypertension SpecialistJOURNAL OF CLINICAL HYPERTENSION, Issue 11 2008Thomas D. Giles MD No abstract is available for this article. [source] Hypertensive Risk Assessment: Cardiovascular Risk Factors and HypertensionJOURNAL OF CLINICAL HYPERTENSION, Issue 7 2004William B. Kannel MD First page of article [source] Significance of Periodontal Risk Assessment in the recurrence of periodontitis and tooth lossJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2010G. Matuliene Matuliene G, Studer R, Lang NP, Schmidlin K, Pjetursson BE, Salvi GE, Brägger U, Zwahlen M. Significance of Periodontal Risk Assessment on the recurrence of periodontitis and tooth loss. J Clin Periodontol 2010; 37: 191,199. doi: 10.1111/j.1600-051X.2009.01508.x. Abstract Aim: To investigate the association of the Periodontal Risk Assessment (PRA) model categories with periodontitis recurrence and tooth loss during supportive periodontal therapy (SPT) and to explore the role of patient compliance. Material and Methods: In a retrospective cohort, PRA was performed for 160 patients after active periodontal therapy (APT) and after 9.5 ± 4.5 years of SPT. The recurrence of periodontitis and tooth loss were analysed according to the patient's risk profile (low, moderate or high) after APT and compliance with SPT. The association of risk factors with tooth loss and recurrence of periodontitis was investigated using logistic regression analysis. Results: In 18.2% of patients with a low-risk profile, in 42.2% of patients with a moderate-risk profile and in 49.2% of patients with a high-risk profile after APT, periodontitis recurred. During SPT, 1.61 ± 2.8 teeth/patient were lost. High-risk profile patients lost significantly more teeth (2.59 ± 3.9) than patients with moderate- (1.02 ± 1.8) or low-risk profiles (1.18 ± 1.9) (Kruskal,Wallis test, p=0.0229). Patients with erratic compliance lost significantly (Kruskal,Wallis test, p=0.0067) more teeth (3.11 ± 4.5) than patients compliant with SPT (1.07 ± 1.6). Conclusions: In multivariate logistic regression analysis, a high-risk patient profile according to the PRA model at the end of APT was associated with recurrence of periodontitis. Another significant factor for recurrence of periodontitis was an SPT duration of more than 10 years. [source] Organizational Risk as it Derives from What Managers Value: A Practice-Based Approach to Risk AssessmentJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 3 2010Hervé Corvellec Two observations serve as starting points for this paper. First, conventional risk assessment techniques provide sophisticated ways to identify and estimate hazards, but eschew the fact that there is no risk unless something of value is considered to be at stake. Second, what managers consider as being of value follows from how they organize their managerial practice. Based on a case study of a Swedish public transportation administration, a claim is presented that organizational risk conceptions derive primarily, although not exclusively, from what managers consider being of value both in and for their organizational practice. In particular, it is suggested to begin the risk assessment process with a critical appraisal of what managers hold as being of value and why. [source] Dental Caries Detection and Caries Management by Risk AssessmentJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 1 2007Joel H. Berg dds [source] Salmonella Enteritidis Risk Assessment: A Kinetic AnalysisJOURNAL OF FOOD SCIENCE, Issue 3 2002S. Almonacid ABSTRACT: Egg and egg preparations are important vehicles for Salmonella enteritidis infections. The influence of time-temperature becomes important when the presence of this microorganism is found in commercial shell eggs, particularly in countries where refrigeration is not mandatory as in Chile. The objective of this research was to develop a mathematical model to analyze the Salmonella enteritidis risk under variable ambient temperatures. Breakdown of vitelline egg membrane was assumed to be required for initiation of bacterial growth. When the critical factor concerning safety is the vitelline membrane breakdown, 15 °C was found to be the storage threshold temperature for a 30-d shelf life. This computer based tool can be used as a contribution in current regulation adjustments or modifications. [source] Criminal Offenders with Mental Retardation: Risk Assessment and the Continuum of Community Based Treatment ProgrammesJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 2 2001Edwin J. Mikkelsen Jr [source] Treating Violence: A Guide to Risk Management in Mental Health Violence Risk Assessment and ManagementJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 9 2009MICHAEL COFFEY rmn msc [source] Oral Health of Young Children in Mississippi Delta Child Care Centers: A Second Look at Early Childhood Caries Risk AssessmentJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2008Linda H. Southward PhD Abstract Objectives: To identify the predictors of early childhood caries and urgent dental treatment need among primarily African-American children in child care centers in the Delta region of Mississippi. The purpose of this study was to replicate predictors of caries and urgent dental treatment needs that were identified in an earlier study conducted in Delta child care centers and to assess additional caries risk factors not collected in the original study. Methods: Children in 19 child care centers were examined by the dentists, and the parents provided data on oral health practices, oral health history, and on children's oral health-related quality of life (QOL). The dentists also assessed visible plaque and tested levels of mutans streptococci. Predictors of caries and treatment need among children 24 to 71 months of age were examined using logistic regression. Results: Two parent predictors of caries identified in the earlier study (parent flossing and soft/sugary drink consumption) were not predictive in the current study. Parent history of abscess continued to predict their child's urgent need for treatment. Young children's level of salivary mutans streptococci, maxillary incisor visible plaque, and parents' reports of child oral health-related QOL measures predicted the presence of both caries and urgent treatment need. Some expected predictors, such as frequency of child's toothbrushing, were not predictive of caries. Conclusions: Parental abscess and parent's report of the child's oral health-related QOL are risk indicators for poor oral health outcomes that could be used by nondental personnel to identify young children in need of early preventive intervention and dental referral. [source] Validation of a Simple Approach to Caries Risk AssessmentJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2 2005James D. Bader DDS Abstract Objective: This study examined the predictive validity of a simple subjective method promoted to dentists for assessing their patients' caries risk. Methods: Data from two large group practices that have used guideline-assisted caries risk assessment (CRA) for several years were analyzed retrospectively to determine the receipt of caries-related treatment following a CRA. Patient age and receipt of caries preventive treatment subsequent to the CRA were control variables in logistic regressions to determine the likelihood of caries-related treatment for low, moderate, and high risk groups. Results: Among 45,693 individuals in the two plans, those categorized as being at high caries risk were approximately four times as likely to receive any caries-related treatment as those categorized as being at low caries risk. Those categorized as at moderate risk were approximately twice as likely to receive any treatment. In addition, for those at elevated risk who required any treatment, the number of teeth requiring treatment was larger. Conclusion: The results of this study provide the first large-scale, generalizable evidence for the validity of dentists' subjective assessment of caries risk. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||