جستجوی مقالات مرتبط با کلیدواژه « risk » در نشریات گروه « پزشکی »

This study aimed to fire risk assessment and prioritize the preventive measures using a FRAME‑TOPSIS method in the Isfahan School of Health Library.

This descriptive‑analytical study was conducted in 2023. First, the FRAME method was used to calculate this risk score in three areas: individuals, buildings and their contents, and activities. Second, the Fuzzy Delphi method was used to identify the preventive measures. Finally, the TOPSIS method was applied to prioritize preventive measures. Excel 2019 was used for TOPSIS and Fuzzy Delphi, and FRAME was calculated by FRAME software.

The results of the FRAME method showed the risk levels of fire for the Isfahan School of Health Library were unacceptable in individuals (R = 1.04) and activities (R = 1.32). The TOPSIS method revealed that the most important control measures for reducing fire risk levels in the library are installing an automatic fire alarm (0.732), improving electrical safety (0.694), and use of fireproof partitions (0.660).

The study library has identified a high level of risk, necessitating the thorough implementation of control measures. Moreover, the methodology presented in this study can be applied to other locations where fire safety is of paramount importance, including hospitals, buildings, and industries.

Over the past decade, Iranian households have experienced a decline in dairy product consumption. This study aimed to evaluate the population-attributable risk of prevalent non-communicable diseases related to dairy product consumption.

This cross-sectional analytical study involved 628 adults over 18 years old in Hamadan City in 2021. Clusters were selected based on comprehensive urban health centers. The standardized Iranian version of the food frequency questionnaire was used. Participants were categorized into 3 levels of dairy product consumption: >1 serving per day, 1–2 servings per day, and ≥3 servings per day.

The mean age of the 628 participants was 38.05 (SD: 12.5), with 42.36% being male. Cheese (54.5%), yogurt (39.7%), and milk (30.4%) were consumed most frequently. The prevalence of insufficient dairy product consumption was 48.6%, higher than that reported in previous studies. Insufficient dairy product consumption was associated with hypertension (9.3%), cardiovascular disease (5.6%), and osteoporosis (5.1%).

Individuals with lower education levels, female gender, lowest quartile of socioeconomic status, and those diagnosed with cardiovascular disease were more likely to have insufficient dairy product consumption. Insufficient dairy product consumption was associated with hypertension, cardiovascular disease, and osteoporosis.

Ecological conditions can change infection routes and increase the risks of outbreaks. The aim of this study is risk assessment of foodborne disease outbreaks based on dispersed regional climatic and demographic variables in Yazd Province, Iran.

In this cross-sectional study, data of temporal climatic parameters and regional demographic factors linked to bacterial foodborne diseases were addressed. A multi-level regression analysis model was used to detect associations between the risk of outbreaks and ecological risk factors; the relationships were verified using (P<0.05).

Significant associations were observed between the outbreaks and age )P<0.001(, community type (P<0.001), temperature (P=0.04), rainfall (P=0.03) and dust pollution (P<0.001) in scattered parts of the province. The maximum rate of outbreaks was seen in spring, while the frequency of the outbreaks increased during April and October, compared to other months of the year (2012–2016).

Consequences have revealed interventions of the environmental exposures in transmissions of microbial agents by complex ecological processes that caused the outbreaks.

The aim of risk assessment is to use a rational method to analyze risks and to identify the possible hazards and outcomes for people, equipment, materials, and the environment. The criteria and indices for assessing the environmental, health, and safety risks of the hydrocracker unit were determined by a Delphi questionnaire in this study. Then, an Environmental Failure Mode and Effects Analysis was applied to evaluate, score, and rank the risks based on their probability of occurrence, severity, probability of detection, extent of pollution, and potential of recycling. According to the results of the Delphi process, 19 out of the 22 items were identified as the main criteria in the environmental, health, and safety risk evaluation of the hydrocracker unit at the Abadan Oil Refinery. However, the results indicated that 67% of the risks associated with the life cycle operation were low while 33% of them were high in terms of intensity. In contrast, 75% of the risks associated with control room operators were low and 25% were high in terms of intensity. On the other hand, 64, 7, and 29% of the risks associated with the activities of site employees were low, moderate, and high in terms of intensity, respectively, while the corresponding figures were 14, 29, and 57% in the case of risks associated with repairs. Based on the results of techniques of environmental failure modes and effects analysis (EFMEA) and Delphi, appropriate methods can be used to identify and reduce risks in similar industries.

 The COVID-19 pandemic is significant due to its global impact on public health and life situations. It has led to widespread infections and strained healthcare systems, causing significant loss of life. The pandemic has underscored the urgent need for effective measures to control its spread and protect communities worldwide.

 The main goal of this research was to evaluate the clinical symptoms, risk factors, and manifestations linked to COVID-19 among the vaccinated healthcare worker (HCW) population under study.

 The study population comprised HCWs with respiratory symptoms who received three doses of vaccination homogeneously. Real-time polymerase chain reaction (RT-PCR) testing was conducted on nasopharyngeal and nasal swab samples using a one-step RT-PCR. The enzyme-linked immunosorbent assay also evaluated immunoglobulin G antibody levels.

 Among the most commonly reported symptoms, general fatigue, fever, and cough were the most prevalent, divided by vaccine type. Furthermore, among the associated risk factors, concerns about transmission to other family members, anxiety, and depression were found to be prominent.

 The study findings highlight that the vaccine type is associated with clinical manifestations. Additionally, the result reveals the significant contribution of occupational roles to the experiences of HCWs during the COVID-19 pandemic. The findings emphasize the need for tailored support systems to address the diverse challenges faced by HCWs, such as concerns about transmission, anxiety, and occupational stress.

Among non-communicable diseases, myocardial infarction (MI) and stroke are the most common cause of death in the world. The current study aimed to investigate the relationship between risk level and preventive behaviors of heart in people aged 30 to 60 years of Jiroft city in 2022.

This research was a cross-sectional study. The population under study is 383 middle-aged individuals (30-60 year) of Jiroft city with the combined sampling method. The data collection tools was reseacher made, included demographic questions, risk perception questionnaires, and preventive behavior questions for MI and stroke. Information was analyzed by SPSSv21 software and further analyzed with descriptive statistics tests, chi-square test, independent t-test, one-way ANOVA, and Pearson correlation test at level 0.05.

The participants' average age was 41.26 ± 8.32 years. The highest percentage (51.4%) of middle-aged individuals had a risk level between 10 and 20% for cardiovascular diseases. The study investigated a significant correlation (p < 0.01) between risk level, risk perception, and preventive behaviors for MI and stroke. Smoking and physical activity failed to reveal a significant correlation (p > 0.05), but other dimensions of preventive behaviors correlated positively and significantly with the total score of preventive behaviors (p < 0.01).

According to study findings, risk perception plays a significant role in influencing preventive behaviors for MI and stroke. It is recommended to conduct educational interventions to enhance understanding of the actual risk of MI and stroke, particularly among individuals with a high-risk assessment level. This would encourage the adoption of preventive behaviors in this population.

Multiple sclerosis is an autoimmune disease of central nervous system (CNS). There are a few articles studying the risk factors of developing MS in men. Male infertility can stem from a range of etiological factors such as genetics or environment. In the context of MS, research suggests a potential link, possibly due to shared immunological and inflammatory mechanisms. Therefore, we designed this study to evaluate the relationship between male infertility and MS development.

We systematically searched PubMed, Embase, Scopus, web of science, Google scholar and gray literature including references of the references as well as conference papers which were published up to June 2021. The search strategy in PubMed was ("Infertility, Male"[Mesh] OR [Male Infertility] OR [Sterility, Male] OR [Male Sterility] OR [Subfertility, Male] OR [Male Subfertility] OR [Sub-Fertility, Male] OR [Male Sub-Fertility] OR [Sub Fertility, Male]) AND ("Multiple Sclerosis"[Mesh] OR [Sclerosis, Multiple] OR [Sclerosis, disseminated] OR [Disseminated Sclerosis] OR [MS] OR [Multiple Sclerosis, Acute Fulminating]) AND ("Testicular Diseases"[Mesh] OR [Disease, Testicular] OR [Diseases, Testicular] OR [Testicular Disease]) AND ("Multiple Sclerosis"[Mesh] OR [Sclerosis, Multiple] OR [Sclerosis, disseminated] OR [Disseminated Sclerosis] OR [Multiple Sclerosis, Acute Fulminating] OR [MS]).

The literature search revealed 197 articles, after deleting duplicates 109 remained. For the meta-analysis, 3 studies were included. Totally, 2090 MS cases as well as 3895562 healthy subjects were enrolled. One hundred and fourteen infertile men were in MS group and 139716 infertile men were in controls. The pooled OR for male factor infertility and odds of developing MS was1.87 (95% CI: 0.89-3.94) (I2=86.1%, P=0.001).

The results of this systematic review and meta-analysis show that there is no relationship between male factor infertility and risk of MS.

 The safety of women during childbirth and personnel working in maternity care amidst the COVID-19 pandemic is a priority for the health system. Hence, good risk management practices need to be implemented to reduce the spread of infection between healthcare workers and pregnant women who have contracted COVID-19. Therefore, this study aimed to establish a risk map for managing dyspneic parturients suffering from COVID-19-related pneumopathy during delivery.

 This study focuses on examining potential risks beforehand in the context of the management of a dyspneic parturient suffering from COVID-19-related pneumopathy during delivery, executed using the method FMECA (Failure Mode, Effects and Criticality Analysis); this was conducted from September to December 2021 in the maternity service of the Hospital Center ElJadida, Morocco.

 The risk analysis of a dyspneic parturient suffering from COVID-19-related pneumopathy during delivery revealed thirteen failure modes. Proposed are corrective measures aimed at addressing the failure modes of criticality class C3 whose vital risks are linked to the care of the dyspneic parturient suffering from COVID-19-related pneumopathy at the level of the reanimation service and the level of the neonatal intensive care unit.

Employing risk mapping is a fundamental instrument for the ongoing enhancement of quality to maximize the safety of the parturient care process by changing the organizational culture from a reactive to a preventive approach.

Major adverse cardiovascular events (MACEs) are frequently encountered in patients undergoing noncardiac surgeries. This study evaluated the utility of cardiac troponin I (cTnI) and brain natriuretic peptide (BNP) to predict MACE in elderly patients (aged ≥60 years) undergoing noncardiac surgeries.

This comparative cross-sectional study was carried out at a tertiary care center in India between November 2016 and August 2018. A total of 136 consecutive patients (aged ≥60 years) presenting for noncardiac surgeries under general/spinal/regional anesthesia in the departments of surgery, orthopedics, or gynecology were included in the study. Patients with chronic kidney disease stages 4 and 5 and those receiving hemodialysis or peritoneal dialysis for renal failure were excluded from the study. Peripheral blood samples for BNP and cTnI were obtained within 24 h preoperatively. The primary endpoint was the occurrence of MACE, defined as the composite of cardiac death, nonfatal myocardial infarction, heart failure, arrhythmias, and cardiac arrest at 6 days postsurgery.

The mean age of patients was 69.41 ± 7.56 years. Females comprised 54.1% of the study population. During the perioperative period and follow-up of 6 days, 12 MACE were recorded. Preoperative cTnI levels alone or both cTnI and BNP together (cTnI levels >0.07 ng/mL and BNP levels >40 pg/mL) increased significantly in the patients who experienced MACE (P < 0.05). The area under receiver operating characteristics curve for cTnI and BNP for predicting perioperative cardiac events was 0.817 (95% confidence interval [CI] 0.646–0.988; P < 0.001) and 0.520 (95% CI 0.337–0.704; P = 0.817), respectively.

In elderly patients undergoing noncardiac surgeries, a preoperative assessment of BNP and cTnI may help in the assessment of MACE.

Breach awareness in relation to types, mitigation, and reporting should be a routine part of infection prevention training. Understanding breaches can reduce the risk of disease transmission to staff and communities when contextualized to the infectious disease, environment, and situation. At a large-scale Australian COVID-19 quarantine facility, this study examined the core personal protective equipment and infection prevention breaches new quarantine workers identified during their site orientation to inform future breach training.

Methods & Materials: 

Through the application of a qualitative approach, the project implemented a descriptive thematic analysis to identify the different types of breaches staff presented. An additional summative content analysis method was applied to determine if the breaches staff identified were breaching and if the risk level staff allocated to the breach was mapped to the risk of disease transmission. Data were collected from 30 orientation sessions and included 603 breach risk responses for analysis.

There were five core breach areas identified: donning and doffing of personal protective equipment, failure of personal protective equipment or lack of equipment, environmental factors, staff behaviors, and resident behaviors. The breach allocations by staff demonstrated knowledge deficits across health and non-health staff in disease transmission, particularly in the actual level of risk for transmission.

 Breaches awareness in relation to types, mitigation, and reporting should be a routine part of infection prevention training. The five areas of breaches present an adaptable foundation to base infection prevention breach training for any health facility. When contextualized to the communicable disease, environment, and situation, understanding breaches can reduce the risk of disease transmission to staff and communities.

The scattered radiation from the treatment volume might be more significant for children than for adults because of life expectancy. The present study used biological effects of ionizing radiation (BEIR) VII models to estimate radiation-induced secondary cancer risks in irradiated organs following three-dimensional conformal radiation therapy (3D-CRT) of Acute Lymphocytic Leukemia (ALL) in children. Both excess absolute risk (EAR) and excess relative risk (ERR) models were used to estimate the secondary cancer risks of eye lenses, thyroid, parotid, breast, and region overlying ovaries.

In this expository cross-sectional study, from 45 patients who were examined, 16 patients age under 18 years (mean age of 9.6) met the criteria for entering the study in Shahid Ramezanzadeh Hospital in Yazd underwent whole brain radiotherapy (WBRT) using COMPACT accelerator. Measurement was performed using thermoluminescent dosimeters (TLD). After radiation therapy, the secondary cancer risk in these organs was calculated.

The organ dose mean values in female patients were 1.8±0.1, 1.65±0.61, 1.47±0.04, 0.1±0.03, and 1.58±0.52 cGy in the eye lenses, parotid, thyroid, breast, and region overlying ovaries, respectively and 2.7±0.6, 0.76±0.17, 0.6±0.05, and 0.005±0.002 cGy for eye lens, parotid, thyroid, breast, and testis of male patient, respectively. The ERR and EAR were estimated after 3, 5, 10, 15 and 20 years for eye lens, parotid breast, and ovary/testis for female/male.

Higher risk values were found for eye lenses and thyroid. The scattered rays decreased by increasing the organ distance from the treatment radiation field.

Context: 

Risk management in hospitals is essential for improving healthcare quality. This study analyzed the characteristics of risk management programs implemented in operating rooms of hospitals across countries worldwide.

Evidence Acquisition: 

This study was a scoping review of online database studies, includingWeb of Knowledge, PubMed, Scopus, Cochrane, Springer, ProQuest, Iranian SID, and Magiran databases and the Google Scholar search engine. Three people independently performed the study selection, quality assessment, data extraction, and analysis among studies that reviewed risk management programs in health systems and those conducted outside the health system. Articles in non-English languages (including Persian) were excluded.

A total of 21 studies with similar purposes and data collection methods were included. The characteristics of risk management programs were classified into six main factors: Objectives, components, steps, results, prerequisites, facilitators of risk management programs, and 35 sub-factors.

The conceptual framework of any risk management program should include at least the objectives Risk eradication, safety promotion, qualityimprovementandpreventionandreduction of risks, component: Communicationandmonitoring; steps: (1) Preoperative evaluation during (logging); (2) evaluation during surgery; (3) post-surgery evaluation (logout); and the results Achieving effective methods in reducing errors; prerequisites: Human resource, knowledge and information, and facilitators such as the use of monitoring technologies and error detection and reporting in the operating room.

Using bone turnover marker (BTM) monitoring to identify “quick losers” who may develop osteoporosis in the coming years is one of the main challenges in clinical practice. This study was implemented to examine the association of BTMs with bone mineral density (BMD) as well as to determine their relationship with the fracture risk assessment tool (FRAX) in women in the postmenopausal period.

This study was observational cross?sectional research that was done on women between the ages of 50 and 65 who were in the postmenopausal period. A dual?energy X?ray absorptiometrywas applied to select 120 eligible women with normal BMD and 120 women without normal BMD. BTMs were assessed using enzyme?linked immunosorbent assay. Osteoporosis’s Odds Ratio (OR) was estimated using a confounder?adjusted logistic regression model. The area under curve was calculated for the differentiation of low BMD in the postmenopausal period through receiver?operator characteristic (ROC) curves. To assess the probability of major osteoporotic fracture and hip fracture for the future 10 years, FRAX was applied.

Higher serum osteocalcin (OC) (OR: 1.134, 95% confidence interval [CI]: 1.086–1.184), osteopontin (OP) (OR: 1.180; 95%CI: 1.105–1.261), and alkaline phosphatase (ALP) (OR: 1.007; 95%CI: 1.001–1.144) concentrations were potential risk factors for developing low BMD in women after menopause. The area under curve (AUC) (95%CI) for OC, OP, and ALP was 0.75 (0.668–0.8130), 0.75 (0.685–0.812), and 0.602 (0.524–0.670), respectively. ROC analysis indicated that at the cut?off point of 16.28 ng/mL, sensitivity and specificity were 70.3% and 70.9%, respectively, for OC. Furthermore, at the cut?off point of 28.85 ng/mL, the sensitivity of 70.3% and specificity of 66.6% were obtained for OP. The serum OC and OP were significantly related to hip and major osteoporotic fractures (P < 0.05).

The higher serum concentration of OC, OP, and ALP had significant associations with lower BMD. These BTMs can be complementary tools and helpful in the postmenopausal period as measures for screening of bone loss and possible bone fracture.

Recognition of probable risk factors for cardiovascular disease is crucial in non-CAD patients for preventive programming. The purpose was determination of 10-year cardiovascular disease (CVD) among patients without current cardiovascular disease.

In this observational study that was performed as a diagnostic survey, 606 consecutive patients without current cardiovascular disease, referring to Modarres and Loghman Hospitals, Tehran, Iran in 2017 and 2018 were enrolled and ASCVD plus score determined the 10-year cardiovascular disease among them.

The results in this study demonstrated that mean ASCVD plus score was 13.1 ± 14.9 points. Among cases 284 (40.9%), 67 (11.1%), 154 (25.4%), and 137 (22.6%) patients were in groups 1, 2, 3, and 4, respectively. The mean risk was higher in men, diabetics, smoker, users of anti-hypertensive, statins, and aspirin, older, with higher blood pressure, and also with higher total and LDL cholesterols.

Totally, according to the obtained results in current study, it may be concluded that 10-year risk of cardiovascular disease is relatively high among patients without current cardiovascular disease. This matter shows the importance of routine screening in such population.