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Journal articles on the topic 'Risk assessemnt'

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Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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1

Najib, Mehdi, Abdelaziz El Fazziki, and Jaouad Boukachour. "Risk management impact assessement: maritme container terminal performance." International Journal of Academic Research 6, no. 1 (January 30, 2014): 239–49. http://dx.doi.org/10.7813/2075-4124.2014/6-1/a.31.

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2

de Souza, R. M., A. R. Lazzaron, R. Defferrari, A. A. Borba, L. Scherer, and A. L. Frasson. "Individual breast cancer risk assessement in postmenopausal women." European Journal of Cancer 34 (September 1998): S24—S25. http://dx.doi.org/10.1016/s0959-8049(98)80098-1.

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3

Mosescu, Monica, Roxana Chirita, Magdalena Dragu, and Vasile Chirita. "Assessement and management of violence risk in Forensic Psychiatry." Romanian Journal of Legal Medicine 18, no. 4 (2010): 289–94. http://dx.doi.org/10.4323/rjlm.2010.289.

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4

Giardino, N. "A NOVEL TOTAL EXPOSURE MODELING APPROACH TO RISK ASSESSEMENT." Epidemiology 9, Supplement (July 1998): S36. http://dx.doi.org/10.1097/00001648-199807001-00059.

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5

Chappel, Clifford I. "A review and biological risk assessement of sodium saccharin." Regulatory Toxicology and Pharmacology 15, no. 3 (June 1992): 253–70. http://dx.doi.org/10.1016/0273-2300(92)90037-a.

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6

Vaagland, Eva Jakobson. "88 Teaming up for safety – using risk assessement tools." Injury Prevention 22, Suppl 2 (September 2016): A33.3—A34. http://dx.doi.org/10.1136/injuryprev-2016-042156.88.

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7

Kasyanova, S. A. "Assessement Methods of an Entity’s Economic Risks in Compiling the Accounting Policy." Accounting. Analysis. Auditing 9, no. 6 (January 23, 2023): 6–21. http://dx.doi.org/10.26794/2408-9303-2022-9-6-6-21.

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The accounting policy of any economic entity is a strategically important tool for organizing accounting processes. Obviously, the assessment of economic activity risks affecting the choice of the most optimal accounting method allows it to identify the degree of impact of an event on the formation of accounting (financial) reporting indicators and prevent its material misstatements. Currently, in the Russian Federation, there is no methodology for assessing the risks of economic activity conducted at the legislative level for commercial organizations. The author’s working out presented in the paper fills the gap. This development is necessary in preparing the organizational, technical and methodological sections of the accounting policy of a commercial organization. It is based on the link between control procedures and risk assessment. The latter is stated in points, based on administrative responsibility for violation of the requirements for accounting and compiling of financial statements in Articles 15.11, 15.15.6 of the Code of Administrative Offenses. Also, it reflects the results of the audit, the nature of violations, and recommendations for their elimination. The study’s purpose works out a methodology for assessing the organization’s internal control system based on the development of methodological tools for identifying the consequences of the risk of economic activity at the stage of compiling the accounting policy of the commercial entity. The author used logical methods of cognition, system analysis and synthesis, modeling in practice. The significance of the results lies in deepening knowledge about the risk of economic activity, ways and methods of its assessment. The research gives a possibility to apply such tools and mechanisms in the organization’s internal control system.
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8

De Martelaer, Kristine, Wander Nerinckx, Lise Buelens, Joost Bierens, Martin Van Rooijen, Jarno Hilhorst, and Eva D’Hondt. "Development of a tool for individual aquatic risk management among children." Revista de Investigación en Actividades Acuáticas 6, no. 11 (April 29, 2022): 29–36. http://dx.doi.org/10.21134/riaa.v6i11.1661.

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Background: When it comes to children’s competence in, on and around water, their risk competence also plays an important role. For an optimal and save participation in aquatic recreation, there is a crucial need to communicate about a realistic perception of potential dangers in relation to one’s own acutal and perceived aquatic skills. Goals: The aim of this study was to develop and validate a tool for Individual Aquatic Risk Management for Children (IARM-C) useful in both research and practice regarding water safety for elementary school children and their families, as offered in schools, by local communities and different (water) sport organisations. Method: The IARM-C tool was developed and validated in three subsequent phases: (1) a selection of relevant aquatic situations with possible risks for children based on the literature and discussed with experts, resulting in 10 aquatic situations that were drawn, (2) a pilot study with 22 children to test content (face) validity, and (3) a cross-sectional study with 70 children (6-12 years, 35 girls and 35 boys, 8.9 +/- 2.0 yearsrecruited via convenience sampling in different (swimming) schools in Brussel (Belgium) to test their risk perception, assessement and decision making in these 10 situations. Results: For each of the 10 aquatic risk situations of the IARM-C, data collection was organised in a one-on-one interview in order to assist the child in completing the questionnaire. Six of the 10 pictures resulted in a correct risk perception for > 80% (range between 83-94%) of the children. For one drawn aquatic risk situation in the swimming pool context (i.e. falling on someone else), only 60% of the children gave a correct description of the situation. In the drawn open water aquatic risk situations, three pictures scored quite low (about 50% (range between 49%-54%)): warning flag at sea, dangerous objects in open water and sandbank at the sea. Conclusions: The IARM-C tool, showing pictures of aquatic risk situations followed by three categories of questions (risk perception, assessement and decision making), is a usefull instrument for further research and education purposes, especially the swimming pool cases (> 80%).
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9

Fenwick, Craig D., Christopher A. Vassilas, Helen Carter, and M. Sayeed Haque. "Training health professionals in the recognition, assessement and management of suicide risk." International Journal of Psychiatry in Clinical Practice 8, no. 2 (June 2004): 117–21. http://dx.doi.org/10.1080/13651500410005658.

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10

Estudante, Margarida, and Dinah Duarte. "Safety signals assessed by the pharmacovigilance risk assessement committee: biologics vs conventional medicines." Journal Biomedical and Biopharmaceutical Research 16, no. 2 (December 2019): 202–12. http://dx.doi.org/10.19277/bbr.16.2.213.

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11

Lüscher, Thomas F. "Managing aortic stenosis with TAVI or surgery: risk assessement and long-term outcome." European Heart Journal 38, no. 45 (December 1, 2017): 3327–29. http://dx.doi.org/10.1093/eurheartj/ehx681.

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12

Menoni, O., N. Battevi, M. G. Ricci, and E. Occhipinti. "Methods of Exposure Assessement of Patient Handling Tasks: A New Risk Index (MAPO)." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 44, no. 31 (July 2000): 5–789. http://dx.doi.org/10.1177/154193120004403146.

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13

Lüscher, Thomas F. "Risk assessement and its management: from SCORE to statins, ezetimibe to PCSK inhibitors." European Heart Journal 38, no. 29 (August 1, 2017): 2233–36. http://dx.doi.org/10.1093/eurheartj/ehx435.

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14

Catalano, Marc F., Urooj Ahmed, Shailendra S. Chauhan, Sandeep N. Patel, and Joseph E. Geenen. "Risk Factor Assessement Predisposing To Recurrent CBD Stones Following Duct Clearance: New Insights." Gastrointestinal Endoscopy 61, no. 5 (April 2005): AB200. http://dx.doi.org/10.1016/s0016-5107(05)01136-3.

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15

Lüscher, Thomas F. "Frontiers in heart failure: assessement, risk factors, and novel genetic and cell-based therapies." European Heart Journal 37, no. 21 (June 1, 2016): 1629–32. http://dx.doi.org/10.1093/eurheartj/ehw214.

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16

Chatzikonstantinou, Anastasios, and Michael G. Hennerici. "Is There an Optimal Management Regimen for Transient Ischemic Attack Patients to Best Prevent Stroke?" US Neurology 06, no. 02 (2010): 48. http://dx.doi.org/10.17925/usn.2010.06.02.48.

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Transient ischemic attacks (TIAs) are associated with a high risk of subsequent stroke and often pose a diagnostic and treatment challenge. It is important to separate TIAs from stroke as well as from TIA mimics to estimate individual stroke risk early and properly. New definitions and standards of clinical investigations are supportive: clinical parameters as symptom fluctuations, clinical scores (such as the ABCD2 score) and advanced magnetic resonance brain imaging in particular. Management should take place in a stroke-specialized center and consist of rapid assessment and identification of those patients at highest risk for subsequent strokes, including extensive brain and vascular imaging as well as cardiological assessement. Based on these work-up results, best suitable prevention should start immediately, usually consisting of antiplatelet agents, anticoagulation, statins, antihypertensive, and/or antidiabetic drugs and lifestyle modifications, including cessation of smoking. Studies have demonstrated that such an optimal management can reduce the risk of stroke following TIA by up to 80%.
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17

Chatzikonstantinou, Anastasios, and Michael G. Hennerici. "Is There an Optimal Management Regimen for Transient Ischaemic Attack Patients to Best Prevent Stroke?" European Neurological Review 5, no. 2 (2010): 62. http://dx.doi.org/10.17925/enr.2010.05.02.62.

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Transient ischaemic attacks (TIAs) are associated with a high risk of subsequent stroke and often pose a diagnostic and treatment challenge. It is important to separate TIAs from stroke as well as from TIA mimics to estimate individual stroke risk early and properly. New definitions and standards of clinical investigations are supportive: clinical parameters as symptom fluctuations, clinical scores (like the ABCD2 score) and advanced magnetic resonance brain imaging in particular. Management should take place in a stroke-specialised centre and consist of rapid assessment and identification of those patients at highest risk for subsequent strokes, including extensive brain and vascular imaging as well as cardiological assessement. Based on these work-up results, best suitable prevention should start immediately, usually consisting of antiplatelet agents, anticoagulation, statins, antihypertensive and/or antidiabetic drugs and lifestyle modifications, including cessation of smoking. Studies have demonstrated that such an optimal management can reduce the risk of stroke following TIA by up to 80%.
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18

Suryanti, Fitri, and Mulyono Mulyono. "Hazard Identification Dan Risk Assessement (HIRA) Pada pengoperasian Forklift Di PT Bangun Sarana Baja Gresik." Jurnal Ilmiah Kesehatan Media Husada 6, no. 2 (December 6, 2018): 205–14. http://dx.doi.org/10.33475/jikmh.v6i2.39.

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Masyarakat modern saat ini cenderung membutuhkan peran alat bantu yang mampu mempersingkat waktu pekerjaan. Tak heran bila teknologi mutakhir menjadi basic pengoperasian alat bantu kerja dewasa ini. Salah satunya adalah pesawat angkat angkut, yakni suatu alat bantu yang berfungsi sebagai pemindah, pengangkat atau pengangkut barang maupun orang secara vertikal dan atau horizontal dengan jarak tertentu. Alat bantu forklift tergolong sebagai pesawat angkat angkut. PT. Bangun Sarana Baja – Gresik merupakan perusahaan yang bergerak dalam bidang fabrikasi dan konstruksi baja memanfaatkan forklift sebagai material handling equipment. Penelitian ini merupakan penelitian deskriptif dengan menggunakan rancang bangun cross sectional. Pengumpulan data dilakukan dengan observasi dan wawancara kepada 15 operator forklift serta tim HSE PT. Bangun Sarana Baja – Gresik guna mengevaluasi hazard identification dan risk assessment (HIRA) pada pengoperasian forklift. Untuk mendapatkan tingkat risiko pada risk assessment maka dilakukan perhitungan nilai severity dan probability. Hasil penelitian menunjukan bahwa hazard identification dan risk assessment pada pengoperasian forklift di PT. Bangun Sarana Baja – Gresik didapati 31 potensi bahaya yang dikategorikan sebagai potensi bahaya dengan tingkat risiko kategori ekstrim sebanyak 14, potensi bahaya dengan tingkat risiko kategori tinggi sebanyak 6, serta potensi bahaya dengan tingkat risiko kategori sedang sebanyak 11. Kegiatan hazard identification dan risk assessment (HIRA) yang dilakukan dengan memperluas objek pengamatan pada tahapan aktivitas pengoperasian forklift dan lingkungan kerja akan membantu mengendalikan bahaya lingkungan kerja, sehingga dapat meminimalisir kecelakaan kerja di PT. Bangun Sarana Baja – Gresik
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19

Mohammadi, P., R. Dekker, V. Brown, T. Attaye, SJ Huisman, AA Hettinga-Roest, and PWB Nanayakkara. "A prospective, observational study of the performance of MEWS, NEWS, SIRS and qSOFA for early risk stratification for adverse outcomes in patients with suspected infections at the emergency department." Acute Medicine Journal 20, no. 2 (April 1, 2021): 116–24. http://dx.doi.org/10.52964/amja.0851.

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Background: Many patients with suspected infection are presented to the emergency Department. Several scoring systems have been proposed to identify patients at high risk of adverse outcomes. Methods: We compared generic early warning scores (MEWS and NEWS) to the (SIRS) criteria and quick Sequential Organ Failure Assessement (qSOFA), for early risk stratification in 1400 patients with suspected infection in the ED. The primary study end point was 30-day mortality. Results: The AUROC of the NEWS score for predicting 30-day mortality was 0.740 (95% Confidence Interval 0.682-0.798), higher than qSOFA (AUROC of 0.689, 95% CI 0.615- 0.763), MEWS (AUROC 0.643 (95% CI 0.583-0.702) and SIRS (AUROC 0.586, 95%CI 0.521 – 0.651). The sensitivity was also highest for NEWS≥ 5 (sensitivity 75,8% specificity of 67,4%). Conclusion: Among patients presenting to the ED with suspected infection, early risk stratification with NEWS (cut-off of ≥5) is more sensitive for prediction of mortality than qSOFA, MEWS or SIRS, with adequate specificity.
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20

Uotani, Tomofumi, Yasunori Nishida, Noriaki Odagiri, Seijiro Yoshifuku, Kenju Ko, Kotaro Sasahara, Hirofumi Kishimoto, Tsutomu Fujii, and Katsunori Tauchi. "Preoperative Risk Assessement of Emergency Gastrointestinal Surgeries in Elderly Patients over 90 Years of Age." Japanese Journal of Gastroenterological Surgery 53, no. 7 (July 1, 2020): 549–57. http://dx.doi.org/10.5833/jjgs.2019.0072.

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21

Tokuno, Koichi, and Shigeru Yamada. "Markovian Availability Measurement and Assessement for Hardware-Software System." International Journal of Reliability, Quality and Safety Engineering 04, no. 03 (September 1997): 257–68. http://dx.doi.org/10.1142/s0218539397000187.

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It is important to take into account the trade-off between hardware and software systems when total computer-system reliability/performance are evaluated and assessed. We develop an availability model for a hardware-software system. The system treated here consists of one hardware subsystem and one software subsystem and it is assumed that the system is down and restored whenever a hardware or a software failure occurs. Especially, for the software subsystem, it is supposed that (i) the restoration actions are not always performed perfectly, (ii) the restoration times for later software failures become longer and (iii) reliability growth occurs in the perfect restoration action. The hardware and the software failure-occurrence phenomena are respectively described by constant and geometrically decreasing hazard rates. The time-dependent behavior of the system, which alternately repeats the operational state that a system is operating without failures and the restoration state that a system is inoperable and restored, is described by a Markov process. Useful expressions for several quantitative measures of system performance are derived from this model. Finally, numerical examples are presented for illustration of system availability measurement and assessment.
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22

Madycki and Staszkiewicz. "Detailed plaque texture analysis as the alternate method of ultrasound image analysis in predicting the risk of intraoperative microembolism and perioperative complications." Vasa 35, no. 2 (May 1, 2006): 78–85. http://dx.doi.org/10.1024/0301-1526.35.2.78.

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Background: The aim of the study was to assess the value of an alternative method of carotid plaque ultrasound image analysis in relation to the perioperative complications and the main risk factor: the microembolism (ME). Material and methods: 96 plaques were evaluated following carotid endarterectomy. Preoperatively, each plaque was screened by ultrasound and assessed by means of 2 computer assisted methods. All patients were evaluated for ME (measured as hits) intraoperatively. The removed plaques were assessed visually (intraoperative assessement) and histologically. A number of risk factors were included as a final outcome event for the purpose of multivariate regression analysis. Results: Detailed plaque texture analysis (DPTA) predicts best the risk of perioperative complications and ME (p = 0.029 and p = 0.028 respectively). The results of the standard gray-scale median (GSM) analysis did not reach the statistical significance (p > 0.1). The predictive value of the model (ROC) was 0.88. The multivariate model for ME revealed that from the level of > 5 HITS, a rapid increase in the risk of perioperative complications (rise of 5% by every 1 hit) is seen and correlates well with the DPTA. ROC was 0.77. A direct correlation between the DPTA and perioperative ME was shown. Conclusions: DPTA analysis of a carotid plaque is more predictive of the likelihood of microembolism than the GSM analysis. There is a direct correlation between the perioperative ME and plaque morphology, as assessed by DPTA. This supports the need for further refinements in noninvasive analysis of carotid plaques.
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23

Shishkin, K. V., A. A. Belik, A. A. Kokoreva, and Z. S. Ezhelev. "Adequateness assessement of percolate and temperature model using MSU Large lysimeters." Dokuchaev Soil Bulletin, no. 99 (December 9, 2019): 76–91. http://dx.doi.org/10.19047/0136-1694-2019-99-76-91.

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The assessement of PEARL model adequateness was carried out on the basis of temperature and percolate data obtained by means of MSU Large Lysimeters. Lysimeters are used in experimental soil science mostly for investigating water balance and substance or ions transport from observed horizons or full soil profile. PEARL 4 model, the water prediction block of which is built on the basis of classical SWAP model, uses preferential water flow describing mechanism. Systematical observation of experimental soils in MSU Large lysimeters allowed obtaining extensive data on temperature and soil moisture dynamics, as well as percolate from bottom border. Thеsе measurements are unique and can become the basis for adaptation, verification and setting of mass and energy transfer models. It was shown, that mathematical parametric model requires adjustment for reaching reliable values of percolate from bottom border, moisture and temperature profiles. It can be achieved by selection of water retention curve (WTC) approximation parameters. It was noticed that the error for all predicted parameters increases in winter period. Thereby, the use of such matter transfer models in soil are problematic for long-term prognosis. For example, due to the annual error accumulation before the spring season such models cannot be applied for estimation of the risk of ground water pollution with agrochemicals.
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24

Baygildina, Asiya A., Denis V. Islamgulov, Felix Kh Kamilov, Tamara A. Khabelova, and Ildar R. Minniakhmetov. "Molecular-genetic risk assessement of determining angiotensin-converting enzyme hyperactivity in hemorrhagic fever with renal syndrome." Russian Open Medical Journal 1, no. 2 (September 25, 2012): 0201. http://dx.doi.org/10.15275/rusomj.2012.0201.

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25

MOTOSHIMA, Takayuki, Hironori ONOE, Yuji IJIRI, Hiroyasu OHTSU, and Hiromitsu SAEGUSA. "A STUDY ON RISK ASSESSEMENT APPROACH OF WATER INFLOW INTO A SHAFT IN FRACTURED ROCK MASS." Doboku Gakkai Ronbunshuu C 66, no. 2 (2010): 370–86. http://dx.doi.org/10.2208/jscejc.66.370.

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26

Drapkina, O. M., O. N. Korneeva, and N. V. Mankova. "Subclinical atherosclerosis: The benefits of calcium antagonists." "Arterial’naya Gipertenziya" ("Arterial Hypertension") 18, no. 2 (April 28, 2012): 118–25. http://dx.doi.org/10.18705/1607-419x-2012-18-2-118-125.

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Recently the research has been focused on the earlier stages of the atherosclerotic process, i.e. subclinical atherosclerosis. Endothelial dysfunction is a suitable marker of subclinical atherosclerosis. In routine clinical practice, ultrasonography is the most useful and accessible non-invasive method for diagnosis of subclinical atherosclerosis. Carotid intimai media thickness (IMT) was shown to be predictive for the risk of cardiovascular events. Furthermore, vascular stiffness can be a helpful marker for assessment of the vascular wall state and blood flow. Calcium antagonists (CA) seem to be promising for the prevention of subclinical atherosclerosis progression, and amlodipine has the priority due to the metabolic neutralilty, vasodilation effect and favourable effects on renal hemodynamics. The data on IMT assessement showed that amlodipine slows down the development of atherosclerotic lesions in hypertensive patients.
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27

García-Vilana, Silvia, David Sánchez-Molina, Juan Velázquez-Ameijide, and Jordi Llumà. "Injury Metrics for Assessing the Risk of Acute Subdural Hematoma in Traumatic Events." International Journal of Environmental Research and Public Health 18, no. 24 (December 17, 2021): 13296. http://dx.doi.org/10.3390/ijerph182413296.

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Worldwide, the ocurrence of acute subdural hematomas (ASDHs) in road traffic crashes is a major public health problem. ASDHs are usually produced by loss of structural integrity of one of the cerebral bridging veins (CBVs) linking the parasagittal sinus to the brain. Therefore, to assess the risk of ASDH it is important to know the mechanical conditions to which the CBVs are subjected during a potentially traumatic event (such as a traffic accident or a fall from height). Recently, new studies on CBVs have been published allowing much more accurate prediction of the likelihood of mechanical failure of CBVs. These new data can be used to propose new damage metrics, which make more accurate predictions about the probability of occurrence of ASDH in road crashes. This would allow a better assessement of the effects of passive safety countermeasures and, consequently, to improve vehicle restraint systems. Currently, some widely used damage metrics are based on partially obsolete data and measurements of the mechanical behavior of CBVs that have not been confirmed by subsequent studies. This paper proposes a revision of some existing metrics and constructs a new metric based on more accurate recent data on the mechanical failure of human CBVs.
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28

McDowell, Ian, Margaret Stewart, Betsy Kristjansson, Elizabeth Sykes, Gerry Hill, and Joan Lindsay. "Data Collected in the Canadian Study of Health and Aging." International Psychogeriatrics 13, S1 (February 2001): 29–39. http://dx.doi.org/10.1017/s1041610202007962.

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The Canadian Study of Health and Aging collected data focusing on the epidemiology of dementia, using interviews and questionnaires, clinical and neuropsychological examinations, physical measurements and blood collection, and access to public records such as death certificates, from people 65 and over in community (N = 9,008) institutional settings (N = 1,255). The study produced 12 data sets, including community health interviews, clinical and neuropsychological assessements, risk factor questionnaires, and caregiver interviews. This report describes the data collection and processing procedures, summarizes the content of each data set, and outlines the information collected in sufficient detail to permit its suitability for secondary analyses to be scrutinized.
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29

Christopher, Christopher, Bashiru Turay, and Sampson Akwafuo. "Does Flooding Undermine the Management Capacities of the COVID-19 Pandemic? A Study of Lagos State, Nigeria." Central European Journal of Geography and Sustainable Development 4, no. 2 (October 31, 2022): 50. http://dx.doi.org/10.47246/cejgsd.2022.4.2.3.

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Given the dynamics of climate events (hazards) and their linkages to human health, it is imperative to continuallly check the impacts of these events on the public health system. While efforts have been made to understand fluvial flood and COVID-19 vulnerability and impacts, substantial gaps about impacts of their simultaneous occurrence on densely-populated communities abound. This paper presents an assessement of the occurrence of fluvial flooding and its potential to undermine the management of the COVID-19 pandemic in Lagos State, Nigeria. This study applied the indicator-based risk assessment method to determine the pattern of COVID-19 risk in the study area. Flood hazard and health facilities datasets of Lagos State were also used to determine the flood extent and pattern of flood-exposed health facilities in ArcGIS 10.7.1. Results revealed that Apapa, Eti Osa, Ibeju Lekki, Mushin, and Lagos Mainland local government areas (LGAs) were at a very high risk of COVID-19. Results also highlight six LGAs that should be prioritized in managing COVID-19 due to the exposure of the majority of its health facilities to flood. Far-reaching recommendations on the need to prioritize these flood-exposed health facilities for COVID-19 risk reduction, humanitarian aid and prevention strategies is made. Also, future research in the study area should explore sustainable strategies to adapt to COVID-19 and flood events from an interdisciplinary perspective.
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30

Ding, Yew Yoong. "Risk Adjustment: Towards Achieving Meaningful Comparison of Health Outcomes in the Real World." Annals of the Academy of Medicine, Singapore 38, no. 6 (June 15, 2009): 552–58. http://dx.doi.org/10.47102/annals-acadmedsg.v38n6p552.

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Health outcomes evaluation seeks to compare a new treatment or novel programme with the current standard of care, or to identify variation of outcomes across different healthcare providers. In the real world, it is not always possible to conduct randomised controlled trials to address the issue of comparator groups being different with respect to baseline risk factors for the outcomes. Therefore, risk adjustment is required to address patient factors that may lead to biases in estimates of treatment effects. It is essential when conducting outcomes evaluation of more than trivial significance. Risk adjustment begins by asking 4 questions: what outcome, what time frame, what population, and what purpose. Next, design issues are considered. This involves choosing the data source, planning data collection, defining the sample required, and selecting the variables carefully. Finally, analytical issues are considered. Regression modelling is central to every analytic strategy. Other methods that may augment regression include restriction, stratification, propensity scores, instrumental variables, and difference-in-differences. The construction of risk adjustment models is an iterative process requiring both art and science. Derived models should be validated. Limitations of risk adjustment include reliance on data availability and quality, imperfect method, ineffectiveness when comparators are very different, and sensitivity to different methods used. Thoughtful application of risk adjustment can improve the validity of comparisons between different treatments, programmes and providers. The extent of risk adjustment should be guided by its purpose. Finally, its methodology should be made explicit, so that informed readers can judge the robustness of results obtained. Key words: Health Services Research, Outcome assessement, Regression analysis, Risk adjustment
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31

Kotwal, Tejas, Kerushan Thomas, Carlos Escudero King, and Avirup Gupta. "Assessement of a structured technological support intervention on uptake of video consultations." BJPsych Open 7, S1 (June 2021): S201—S202. http://dx.doi.org/10.1192/bjo.2021.540.

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AimsThe coronavirus pandemic has led to an increased reliance on remote patient-clinician interactions, mainly the use of telephone and video consultations. Video consultations are key in psychiatric care, as telephone appointments do not sufficiently allow clinicians to accurately ascertain a patient's mental status and perform a risk assessment. The aim of our quality improvement project was to increase the uptake of video consultations within a community mental health team, focusing on substituting telephone consultations for video.MethodWe accessed Electronic Patient Records to retrospectively quantify the method of contact for 130 consultations delivered over a 4-week period. After collecting baseline data, we conducted focused interviews with 10 care providers, identifying the specific clinician and patient barriers to video uptake that informed our intervention design.Our intervention consisted of two 4-week Plan, Do, Study, Act (PDSA) cycles.PDSA 1 involved delivering a focused PowerPoint presentation to the care team, highlighting the benefits of video consultation technology and encouraging clinicians to use it as their primary method of remote communication with patients. Additionally, we conducted qualitative interviews with members of the team to highlight the successes and challenges thus far.PDSA 2 involved creating a video consultation instructional PDF which highlighted how to operate the technological aspects of both Microsoft Teams and WhatsApp Video Call. This included: how to set-up video calls, accept invitations, and overcome common troubleshooting issues.The proportion of remote consultations was quantified retrospectively to compare trends in video consultation uptake from baseline to the conclusion of PDSA 2.ResultOverall, we saw a 15% increase in video consultations with respect to baseline. The greatest change was attributable to PDSA cycle 1, which incurred an 8% increase in video consultation uptake, from 13.85% to 21.9%. PDSA cycle 2 further increased video consultation uptake by 6.97%, from 21.9% to 28.87%. Specifically focusing on remote consultations, the proportion conducted with video rather than telephone increased by 17.3%. Interviewed clinicians reported limited financial access, technological fluency, and issues with patient privacy as the most important barriers to the uptake of video consultations.ConclusionOur project successfully increased the proportion of consultations conducted by video. This was achieved by targeting interventions to address both patient and clinician barriers to video consultation uptake. Moreover, we understand that motivating and mobilising the care team was a key factor. Possible future work includes improving the sustainability of the interventions and assessing their efficacy in other care teams.
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Senore, Carlo, Arrigo Arrigoni, Paola Cassoni, Mario Fracchia, Lorenzo Orione, Paola Armaroli, Stefano Rosso, Cesare Hassan, and Nereo Segnan. "Follow-Up of Patients Unndergoing Colonoscopy Assessement Following a Positive Screening Test. Compliance with Surveillance Recommendations and CRC Risk." Gastroenterology 152, no. 5 (April 2017): S545—S546. http://dx.doi.org/10.1016/s0016-5085(17)31982-0.

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Jayais, P., J. P. Duffet, J. Amaro, P. Massabie, A. Horon, and J. Y. Neveux. "Preoperative risk assessement in cardiac surgery. Comparison of predicted and observed results. A prospective study on 243 consecutive patients." Journal of Cardiothoracic and Vascular Anesthesia 8, no. 3 (June 1994): 107. http://dx.doi.org/10.1016/1053-0770(94)90510-x.

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Berumen Jiménez, Mauricio, Ricardo David Valdez Cepeda, Santiago de Jesús Méndez Gallegos, Jorge Cadena Íñiguez, Alfredo Esparza Orozco, and Luis Antonio Tarango Arámbula. "DETERMINATION OF THE CONSERVATION STATUS OF THE “ESCAMOLERA” ANT (Liometopum apiculatum MAYR) IN MEXICO BY THE SPECIES RISK ASSESSEMENT METHODOLOGY – MER." Agrociencia 55, no. 6 (September 30, 2021): 539–55. http://dx.doi.org/10.47163/agrociencia.v55i6.2558.

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The larvae and pupae of Liometopum apiculatum, an ant species known as “escamolera” (Lap), are valued for their flavour and nutritional value. Currently demand at restaurants trade, high price and other factors have threatened their populations. However, in Mexico there is no risk assessment for this species. Therefore, information was compiled to evaluate the conservation status of L apiculatum. The species Risk Assessment Methodology (MER) of Appendix I in the Mexican Standard NOM-059-SEMARNAT-2010 determines the risk category of a species based on scores of four criteria and places a species as “Extinct in the wild, subject to special protection, threatened or in danger of extinction”. In this study, the related scores were, for Criterion A (taxon distributional area), 3 points (restricted distribution); Criterion B (habitat status regarding its natural development), 1 point (apt, or not limiting); Criterion C (biological vulnerability), 1 point (low vulnerability); and criterion D (impact of human activity on the taxon) scored 3 points (medium impact). The sum of the scores of the four MER criteria indicated that Lap (the escamolera ant) should be placed in the category of Subject to special protection (SSP). This information shall be used to design management and conservation policies for edible insects in Mexico.
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Thin, Kyu Kyu, Win Win Zin, Zin Mar Lar Tin San, Akiyuki Kawasaki, Abdul Moiz, and Seemanta Sharma Bhagabati. "Estimation of Run-of-River Hydropower Potential in the Myitnge River Basin." Journal of Disaster Research 15, no. 3 (March 30, 2020): 267–76. http://dx.doi.org/10.20965/jdr.2020.p0267.

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The need for electricity is rapidly increasing, especially in developing countries. There is vast hydropower potential existing globally that has not yet been explored. This could be the only solution to solve future global power shortage. Hydropower is a clean and renewable source of energy because it does not exploit the use of water. However, using the conventional approach to harness hydropower results in several challenges. It is difficult to identify suitable sites and assess site potential during the planning stage of hydropower projects. In this study, run-of-river hydropower potential for the Myitnge River Basin was estimated by intergrating a Geographic Information System (GIS) and Soil & Water Assessement Tool (SWAT) model. A GIS based tool was developed using Python to spot the potential locations of the hydropower plants. The hydrological model (SWAT) was designed in order to obtain the values of monthly discharge for all potential hydropwer sites. The flow duration curves at potential locations were developed and the design discharge for hydropower was identified. Forty-four run-of-river (ROR) type potential hydropower sites were identified by considering only the topographic factors. After simulation with SWAT model, twenty potential sites with a hydropower generation potential of 292 MW were identified. Currently, only one 790 MW Yeywa Hydropower Plant, which is the largest plant in Myanmar, exists in the Myitnge River Basin. The amount of estimated power generated from ROR may increase the existing power system of Myitnge Basin by 36%. This study will assist stakeholders in the energy sector to optimize the available resources to select appropiate sites for small hydropower plants with high power potential.
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Martsevich, S. Yu, L. P. Ivanova, O. V. Lerman, Yu V. Lukina, A. V. Zakharova, and N. V. Kiseleva. "THE OUTPATIENT REGISTRY PROFILE UTILIZATION FOR OBESITY PATIENTS SURVEYING WITH THE AIM OF FOOD RELATED AND EXERCISE RELATED CARDIOVASCULAR RISK ASSESSEMENT." Cardiovascular Therapy and Prevention 16, no. 4 (January 1, 2017): 56–61. http://dx.doi.org/10.15829/1728-8800-2017-4-56-61.

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Dănciulescu Miulescu, Rucsandra, Suzana Dănoiu, Denisa Margină, Sorin Păun, and Cătălina Poiană. "Dynamics of Prostate-Specific Antigen Levels During Treatment with Testosterone Undecanoate in Patients with Type 2 Diabetes Mellitus." Romanian Journal of Diabetes Nutrition and Metabolic Diseases 19, no. 4 (December 1, 2012): 397–403. http://dx.doi.org/10.2478/v10255-012-0046-9.

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AbstractObjectives. Prostate-specific antigen (PSA) is the most used and validated marker ofprostate cancer risk. The aim of this study was to assess PSA levels during treatmentwith testosteronum undecanoat in patients with type 2 diabetes (T2DM). Material and Methods. We evaluated 38 T2DM patients aged between 48 and 61 years withconfirmed hypogonadism. 1000 mg testosterone undecanoate was injectedintramuscular every 10 to 14 weeks. Total testosterone and PSA levels were assessedat baseline and after 6, 12, 24 months of treatment. Results. The average age was55.03 ± 2.40 years and 3 patients (7.89%) had a family history of prostate cancer.Treatment with testosterone undecanoate generated significant changes in serumtotal testosterone (482.29±50.78 ng/dl vs. 246.66±51.50 ng/dl, p < 0.001) but not inserum PSA levels (2.11±.0.49 ng/ml vs. 2.09±0.47 ng/ml, p - NS). Conclusion.Testosterone replacement therapy may normalize serum androgen levels but appearsto have little effect on PSA levels.
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Woźniak, Ewelina, Paulina Sicińska, Jaromir Michałowicz, Katarzyna Woźniak, Edyta Reszka, Bogumiła Huras, Jerzy Zakrzewski, and Bożena Bukowska. "The mechanism of DNA damage induced by Roundup 360 PLUS, glyphosate and AMPA in human peripheral blood mononuclear cells - genotoxic risk assessement." Food and Chemical Toxicology 120 (October 2018): 510–22. http://dx.doi.org/10.1016/j.fct.2018.07.035.

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Umami, Mufidha Khoirul. "Correlation between Age, Nutritional Status, and Working Posture and Musculoskeletal Disorders in PT ARPS." Indonesian Journal of Occupational Safety and Health 8, no. 3 (December 27, 2019): 283. http://dx.doi.org/10.20473/ijosh.v8i3.2019.283-291.

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Introduction: Musculoskeletal disorders occur due to various factors: main factors, such as extortion of the muscles, repetitive activities, non-ergonomic working postures; secondary factors (pressure, vibrant, microclimate), and individual factors (age, years of service, sex, nutritional status, physical endurance, smoking habits, physical strength and anthropometry). The workers in the Injection Department at PT. ARPS mostly work with non-ergonomic working postures. The aim of this study is to analyze the correlation between age, nutritional status, and working postures and the complaints on musculoskeletal disorders among the workers in the Injection department at PT. ARPS. Metods: This study applies analytic observational method with a cross-sectional design. The sample is chosen by implementing simple random sampling with a total of 52 respondents. The data collection to measure the ratio risk level of the working postures of the injection workers is completed by using Rapid Upper Limb Assessment (RULA) measurement method, while Nordic Body Map (NBM) questionnaire form is used to measure risk level of the disorder, and anthropometry measurement is applied to evaluate the nutritional status of the workers, such as their height and weight. The data are analyzed using Spearman Rho’s Correlation (significance level α = 5%). Results: The percentage of injection workers are <35 years old (76.9%), have normal nutritional status (59.6%), 27 workers (51.9%) have low musculoskeletal disorders and 19 others (36.5%) have low-risk postures. Concluded: That there is a correlation between age (ρ-value = 0.005), nutritional status (ρ-value = 0.003) and working postures (ρ-value = 0.036) and musculoskeletal disorders on the injection workers at PT. ARPS. Keywords: injection worker, musculoskeletal disorders, Nordic Body Map, Rapid Upper Limb Assessement, working postures
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Umami, Mufidha Khoirul. "Correlation between Age, Nutritional Status, and Working Posture and Musculoskeletal Disorders in PT ARPS." Indonesian Journal of Occupational Safety and Health 8, no. 3 (December 27, 2019): 283. http://dx.doi.org/10.20473/ijosh.v8i3.2019.286-294.

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Introduction: Musculoskeletal disorders occur due to various factors: main factors, such as extortion of the muscles, repetitive activities, non-ergonomic working postures; secondary factors (pressure, vibrant, microclimate), and individual factors (age, years of service, sex, nutritional status, physical endurance, smoking habits, physical strength and anthropometry). The workers in the Injection Department at PT. ARPS mostly work with non-ergonomic working postures. The aim of this study is to analyze the correlation between age, nutritional status, and working postures and the complaints on musculoskeletal disorders among the workers in the Injection department at PT. ARPS. Metods: This study applies analytic observational method with a cross-sectional design. The sample is chosen by implementing simple random sampling with a total of 52 respondents. The data collection to measure the ratio risk level of the working postures of the injection workers is completed by using Rapid Upper Limb Assessment (RULA) measurement method, while Nordic Body Map (NBM) questionnaire form is used to measure risk level of the disorder, and anthropometry measurement is applied to evaluate the nutritional status of the workers, such as their height and weight. The data are analyzed using Spearman Rho’s Correlation (significance level α = 5%). Results: The percentage of injection workers are <35 years old (76.9%), have normal nutritional status (59.6%), 27 workers (51.9%) have low musculoskeletal disorders and 19 others (36.5%) have low-risk postures. Concluded: That there is a correlation between age (ρ-value = 0.005), nutritional status (ρ-value = 0.003) and working postures (ρ-value = 0.036) and musculoskeletal disorders on the injection workers at PT. ARPS. Keywords: injection worker, musculoskeletal disorders, Nordic Body Map, Rapid Upper Limb Assessement, working postures
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Vu, Thuc, Thieu Le, Anh Dang, Long Nguyen, Binh Nguyen, Bach Tran, Carl Latkin, Cyrus Ho, and Roger Ho. "Socioeconomic Vulnerability to Depressive Symptoms in Patients with Chronic Hepatitis B." International Journal of Environmental Research and Public Health 16, no. 2 (January 17, 2019): 255. http://dx.doi.org/10.3390/ijerph16020255.

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Depression is considered one of the most prevalent psychiatric disorders among patients with hepatitis B virus (HBV)-related liver disease and has adverse effects on the disease progression. However, there is a scarcity of studies contributing to the assessement of depression in hepatitis B patients. There is also little research into risk factors, particularly underlying socio-economic factors in Vietnam where the prevalence of hepatitis B is high. This study aimed to examine depression and identify whether differences in socio-economic status is related to the level of depression amongst chronic hepatitis B patients. A cross-sectional study was conducted on 298 patients with chronic hepatitis B at The Chronic Hepatitis Clinic in the Viet-Tiep Hospital, Hai Phong, Vietnam. The Patient Health Questionnaire-9 (PHQ-9) and EuroQol-5 dimensions-5 levels (EQ-5D-5L) were used to assess the severity of depression and health-related quality of life (HRQOL). Of chronic hepatitis B patients, 37.5% experienced depressive symptoms and most of them suffered minimal depressive symptoms (31.4%). According to the result of the multivariate logistic regression model, we found that higher age, lower income level, unemployement, living with spouse/partners were positively associated with having depression. Furthermore, having physical health problems and lower health-related quality of life were also related to a higher risk of depression. We recommend family support, financial support and active participation in consultation should be conducted during treatment to improve the quality of life and the emotional state of HBV patients.
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Burgos, Ursula Maria Moreira Costa, Enaldo Vieira de Melo, Angela Maria da Silva, Antônio Carlos Sobral Sousa, Willams de Matos, Maria Aline Moura Reis, Lucas Alves Bezerra, Dalmo Correia Filho, and Joselina Luzia Menezes Oliveira. "Factors associated with subclinical atherosclerosis in HIV infected patients from northeast of Brazil." Research, Society and Development 10, no. 12 (September 26, 2021): e442101220484. http://dx.doi.org/10.33448/rsd-v10i12.20484.

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Introduction: AIDS has changed its morbidity curve, rising cardiovascular diseases. HIV-infected patients have increased cardiovascular event rates but data on the prevalence of subclinical atherosclerosis are not uniform. Methods: HIV-infected patients underwent to coronary tomography for CACs assessement. We performed a comparison between 97 HIV-infected patients and 129 seronegative healthy controls. The univariable analysis matched the association of HIV infection, cardiovascular risk profile, and HIV-related factors with subclinical atherosclerosis. Results: HIV-infected patients with CACs above zero were older (54.8±7.0 vs. 43.3.5±11.0 years; p<0.001) and more likely to have hypertension (36.7% vs. 12.5%; p=0.07) than HIV(-) CACs zero ones. Factors associated with altered CACs in unadjusted hazard ratio were age (HR=1.13; 95%CI=1.07-1.20; p<0.0001) and hypertension (HR=4.05; 95%CI=1.42-11.60; p=0.0009). When adjusted hazard ratio was constructed age, male gender and protease inhibitors (PI) use appeared as factors associated with coronary calcification. HIV-infected patients were less likely to have hypertension (20.2% vs 50.4%; p<0.001) and diabetes (5.3% vs 23.3%; p<0.001) than HIV uninfected ones. Conversely, both groups have same CACs level. Among HIV-infected patients altered CACs was 30.9%, vs 42.3% among control. Most of HIV-infected patients showed undetectable viremia and high CD4+ count, in parallel with lipid profile disturbances. Conclusion: Increased CAC incidence was associated with age, male gender and PI use among HIV-infected patients. Despite younger, fewer traditional risk factors and with controlled disease, the PLHIV had similar CAC scores compared with controls. Besides viruses itself, antiretroviral drugs play a role, mainly because control viruses at expense of worsening in lipid profile.
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Federico, M., M. Bellei, B. Pro, A. Lopez-Guillermo, L. Marcheselli, M. Trneny, P. Soubeyran, P. McLaughlin, S. Pileri, and P. Solal-Céligny. "Revalidation of FLIPI in patients with follicular lymphoma (FL) registered in the F2 study and treated upfront with immunochemotherapy." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 8008. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.8008.

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8008 Background: The Follicular Lymphoma International Prognostic Index (FLIPI) has become a widely accepted tool for risk assessement of FL. However, the recent shift to upfront immuno-chemotherapy (ICHT) requires confirmation studies of FLIPI discriminant power to ensure that the advent of Anti-CD20 MoAb did not modify its predictive value. Methods: We looked for the role of rituximab and its impact on the predictive value of FLIPI in the group of 1,093 patients diagnosed with FL between January 2003 and May 2005 and registered by 69 European and American Institutions in the F2-study. We identified 827 patients = 18 years of age and treated with systemic therapy. For the purposes of the present examination the prognosis was investigated in terms of progression-free survival (PFS) and the impact of rituximab explored by Cox analysis. Results: Patients characteristics are as follows: median age 57 yrs (21–93), male 50.1%, advanced stage 77.2%, elevated LDH 22.3%. To date central pathology review has been performed in 406 cases and the diagnosis of FL was confirmed in 98.3%. Patients at low risk (LR), intermediate risk (IR) and high risk (HR) on the basis of FLIPI were 40.3%, 32.6% and 27.1% respectively. Five-hundred sixty patients (67.7%) received ICHT, and 267 (32.3%) were treated with CHT only. After a median follow-up of 26 months the 3-yr PFS is 63.0%. Overall, the FLIPI remains highly predictive, being the 3-yr PFS of 77.8%, 60.5% and 49.1% for patients at LR, IR and HR respectively. Moreover, the 3-yr PFS predicted from Cox analysis is 81%, 62%, and 50% for patients at LR, IR and HR treated with ICHT (p<0.001), and 76%, 56%, 43% in those treated with CHT only (p<0.001). Finally, the relative risk for progression adjusted by the use of Anti-CD20 MoAb confirmed the efficacy of rituximab in all risk groups. The relative risk of progression for patients at IR was 2.01 as compared to patients at LR (p<0.001), and that for patients at HR was 1.47 as compared to patients at IR (p=0.021). Conclusions: Our study demonstrates that the FLIPI remains a useful tool to predict outcome even in the era of ICHT. Moreover, rituximab added to upfront chemotherapy improves the outcome of patients with FL in any risk group and in association with any chemotherapy regimen. No significant financial relationships to disclose.
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Roianov, Alexey, and Serhii Garbuz. "THE ASSESSEMENT OF THE SCALES AND THE RISK OF THE APPEARANCE TECHNOGENOUS SITUATIONS DURING THE PROCESS OF DEGASING THE STORAGE TANKS OF LIGHT PETROLEUM PRODUCTS." Advanced Information Systems 2, no. 4 (December 26, 2018): 119–23. http://dx.doi.org/10.20998/2522-9052.2018.4.20.

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Costa, Rafaela Lira Mendes, Amuzza Aylla Pereira dos Santos, and Maria Elisângela Torres de Lima Sanches. "Assessement of the Profile of Assisted Women During the Obstetric Risk Classification Process / Avaliação do Perfil de Mulheres que Receberam Assistência Durante a Classificação de Risco Obstétrica." Revista de Pesquisa: Cuidado é Fundamental Online 11, no. 2 (January 21, 2019): 488. http://dx.doi.org/10.9789/2175-5361.2019.v11i2.488-494.

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Objetivo: avaliar o perfil de mulheres assistidas no acolhimento e classificação de Risco em uma maternidade do agreste alagoano. Método: Optou-se pela abordagem quantitativa, retrospectiva e do tipo descritiva com 1.142 prontuários e fichas no período de janeiro a julho de 2015. Resultados: A análise dos resultados evidenciou que a maioria das mulheres atendidas se concentrou na faixa etária de 20 a 29 anos (52,4%); cursou até o ensino fundamental (62,4%); iniciou o acompanhamento da gravidez no primeiro trimestre (72,0%); e foi classificada como risco pouco urgente (30,9%). Conclusão: Portanto, o perfil dessa clientela mostra que os dados encontrados podem fornecer subsídios para a prática assistencial dos profissionais de saúde durante o pré-natal.
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Owhoeke, Elechi, and Julius Nkeonyeasua Ehiwario. "Assessement of Water Quality and Risk of Polyaromatic Hydrocarbons in Lungfish (<i>Protopterus annectens</i>) from Freshwaters of Ogba/Egbema/Ndoni, Rivers State, Nigeria." World Journal of Public Health 6, no. 1 (2021): 6. http://dx.doi.org/10.11648/j.wjph.20210601.12.

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47

Zaitseva, N. V., I. V. May, P. Z. Shur, and D. A. Kiryanov. "Methodological approaches for assessement performance and economical efficiency of the risk-oriented control and supervision of the Federal service on customers' rights protection and human well-being surveillance (Rospotrebnadzor)." Health Risk Analysis, no. 1 (January 2014): 4–13. http://dx.doi.org/10.21668/health.risk/2014.1.01.

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Zaitseva, N. V., I. V. May, P. Z. Shur, and D. A. Kiryanov. "Methodological approaches for assessement performance and economical efficiency of the risk-oriented control and supervision of the Federal service on customers' rights protection and human well-being surveillance (Rospotrebnadzor)." Health Risk Analysis, no. 1 (January 2014): 4–13. http://dx.doi.org/10.21668/health.risk/2014.1.01.eng.

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49

Droz, J., G. Albrand, A. Chaladaj, A. Fléchon, and C. Terret. "Health status in senior adult prostate cancer patients: Limits for active treatment and clinical trials inclusion." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 15550. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.15550.

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15550 Background: Two-third of patients (pts) with prostate cancer are older than 70 years. Patients are likely to receive active treatments in the curative and palliative settings if they have good health status, moreover they are likely to be offered to participate to clinical trials. Health status evaluation is performed by Comprehensive Geriatric Assessement (CGA). Methods: We have prospectively performed a mini- CGA (Terret C, Expert Rev Anticancer Ther. 2004; 4 : 469–75.) in 69 patients with prostate cancer : 33% pts had localized disease, median age was 78.7 years (68–92). Mini-CGA was based on a careful clinical examination with analysis of physical function, nutritional status (MNA), functional domain (ADL, IADL), cognitive and emotional domains (MMSE, GDS), identification and grading of comorbid conditions (CIRS-G), and a medication review. Social and familial evaluations complete the procedure. Results: Dependancy: only 12% pts are fully independant for ADL and 11% for IADL; 20% pts experienced falls and 32% were at risk of fall. Cognitive functions and depression: 60% pts had normal cognitive funtions, 46% and 4% were moderately and deeply depressed respectively. Nutrition: 22% pts had severe weight loss, 23% were mal nourished and 41% at risk of denutrition. Comorbidities: median CISR-G score was 8 (3–12), 80% and 21% pts had at least one grade 3 and one grade 4 comorbidity respectively. The most frequent comorbidities were by decreasing order of incidence : psychologic, hematologic, endocrine and osteo-articular pathologies. Polymedication: median number of drugs taken by pts was 5 (0–14) and iatrogenicity was observed in 30% pts. A caregiver was identified in 83% pts and 16% pts were living alone. None of the pts were fully independant with no major comorbidity. Conclusions: Health status of prostate cancer patients older than 70 years must be evaluated with the objective to either tailor specific clinical trials or apply adapted standard treatments. Task forces of the International Society of Geriatric Oncology (SIOG) are on the process to establish specific guidelines for prostate cancer treatment in the senior adults and for selection of manageable CGA procedures. [Table: see text]
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Horgan, A. M., E. McKeever, and J. J. Knox. "Biliary tract cancer (BTC) in the older adult: Complex decisions for complex patients." Journal of Clinical Oncology 29, no. 4_suppl (February 1, 2011): 295. http://dx.doi.org/10.1200/jco.2011.29.4_suppl.295.

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295 Background: BTC is an uncommon malignancy. Complex patient (pt) factors potentially determine treatment choices in older pts and may independently impact outcomes. Methods: Between 2000 and 2010, 133 pts aged ≥ 75 years with BTC were evaluated at Princess Margaret Hospital. Clinical and histopathological characteristics, geriatric-specific factors, and survival outcomes were studied in a retrospective analysis. Results: Median age was 79 years (range 75-93). Predominant histology was adenocarcinoma (95%). 31 pts (23%) had curative surgery, 4 (13%) had additional (neo)adjuvant chemotherapy (CT) ± radiation therapy (RT). Pathological staging included: I/II: 20 (65%); III: 6 (19%); IV: 5 (16%). 25 pts (19%) received CT ± RT alone, 4 (15%) had stage I/II and 21(84%) stage III/IV disease. 77 pts (58%) received best supportive care (BSC) alone. Radiological complete or partial response was noted for 33% of pts treated with CT [gemcitabine (gem) alone 48%; gem doublet 52%]. 24% pts discontinued CT with toxicity. Untreated pts had greater degrees of functional dependence and poorer social supports. Of those untreated, the risk of treatment was felt to outweigh potential benefit given age ± comorbidities in 17%. In 22%, the pt opted not to receive treatment. Median overall survival was 19.7 months for the surgical group, 12.3 mths for the CT ± RT group and 4.37 mths for the BSC group. Conclusions: Untreated BTC has a poor prognosis. Factors other than clinicopathological features may impact treatment decisions. Integrating geriatric assessements into the evaluation of this vulnerable patient group may help better guide treatment choices. [Table: see text] No significant financial relationships to disclose.
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