risk screening
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Author(s):  
Reza Fathi-Fazl ◽  
ZHEN CAI ◽  
W. Leonardo Cortés-Puentes ◽  
Farrokh Fazileh

The National Research Council Canada (NRC) recently developed a semi-quantitative seismic risk screening tool (SQST) for existing buildings in Canada. The SQST aims to supersede the Manual for Screening of Buildings for Seismic Investigation developed by NRC in the early 1990s. The SQST consists of three key components: (1) a structural scoring system that quantitatively assesses the structural seismic risk based on probability of collapse; (2) a non-structural component scoring system that qualitatively assesses the seismic risk of non-structural components based on seismic demand; and (3) a ranking procedure that prioritizes potentially hazardous buildings for seismic evaluations and possible upgrading. The SQST intends to inexpensively identify and exempt buildings with acceptable life safety risk and optimize the allocation of resources to assess the seismic risk of portfolios of buildings. Seismic screening with the SQST can be completed with either paper-based screening forms or a web-based application. The applicability of the SQST is demonstrated by conducting a pilot study for 33 existing buildings across Canada.


PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261518
Author(s):  
Lal B. Rawal ◽  
Yuewen Sun ◽  
Padam K. Dahal ◽  
Sushil C. Baral ◽  
Sudeepa Khanal ◽  
...  

Introduction Non-Communicable Diseases (NCDs) have become the leading public health problems worldwide and the cardiovascular diseases (CVDs) is one of the major NCDs. Female Community Health Volunteers (FCHVs) in Nepal are the key drivers to implementing frontline health services. We explored the potential for engaging FCHVs for CVD risk screening at the community level in Nepal. Methods We used multiple approaches (quantitative and qualitative) for data collection. The trained FCHVs administered CVD risk screening questionnaire among 491 adults in rural and urban areas and calculated the CVD risk scores. To maintain consistency and quality, a registered medical doctor also, using the same risk scoring chart, independently calculated the CVD risk scores. Kappa statistics and concordance coefficient were used to compare these two sets of risk screening results. Sensitivity and specificity analyses were conducted. Two focus group discussions among the FCHVs were conducted to determine their experiences with CVD risk screening and willingness to engage with CVD prevention and control efforts. Results The mean level of agreement between two sets of risk screening results was 94.5% (Kappa = 0.77, P<0.05). Sensitivity of FCHV screening was 90.3% (95% CI: 0.801–0.964); and the specificity was 97% (95% CI: 0.948, 0.984). FCHVs who participated in the FGDs expressed a strong enthusiasm and readiness to using the CVD risk screening tools. Despite their busy workload, all FCHVs showed high level of motivation and willingness in using CVD risk screening tools and contribute to the prevention and control efforts of NCDs. The FCHVs recommended needs for providing additional training and capacity building opportunities. Conclusion We conclude that there is a potential for engaging FCHVs to use simple CVD risk screening tools at the community level. The findings are promising, however, further studies engaging larger number of FCHVs and larger population would warrant feasibility of such tools within the existing healthcare systems in Nepal.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Thiago Rocha de Pinho ◽  
Simone Mayane Mendes dos Santos ◽  
Renara Leite Rodrigues Rocha

The presence of malnutrition in hospitalized patients is prevalent and studies show its association with a higher incidence of complications, mortality, length of stay, costs, and increased frequency of hospital readmission. Routine use of simple tracking procedures is recommended. Nutritional screening detects individuals who are malnourished or at risk of developing malnutrition, and who can receive specific nutritional support. Nutritional Risk Screening (NRS 2002) is a nutritional screening method recommended by the European Society for Clinical and Metabolism (ESPEN) and identifies the risk of developing malnutrition in hospitalized patients. The aim of this paper is to review the literature on the NRS screening method (2002) and its relationship with clinical outcomes in hospitalized patients.


2021 ◽  
Vol 8 ◽  
Author(s):  
Hongpeng Liu ◽  
Baoyun Song ◽  
Jingfen Jin ◽  
Yilan Liu ◽  
Xianxiu Wen ◽  
...  

Purpose: Evidence of the impact of nutritional risk on health outcomes and hospital costs among Chinese older inpatients is limited. Relatively few studies have investigated the association between clinical and cost outcomes and nutritional risk in immobile older inpatients, particularly those with neoplasms, injury, digestive, cardiac, and respiratory conditions.Methods: This China-wide prospective observational cohort study comprised 5,386 immobile older inpatients hospitalized at 25 hospitals. All patients were screened for nutritional risk using the Nutrition Risk Screening (NRS 2002). A descriptive analysis of baseline variables was followed by multivariate analysis (Cox proportional hazards models and generalized linear model) to compare the health and economic outcomes, namely, mortality, length of hospital stay (LoS), and hospital costs associated with a positive NRS 2002 result.Results: The prevalence of a positive NRS 2002 result was 65.3% (n = 3,517). The prevalence of “at-risk” patients (NRS 2002 scores of 3+) was highest in patients with cardiac conditions (31.5%) and lowest in patients with diseases of the respiratory system (6.9%). Controlling for sex, age, education, type of insurance, smoking status, the main diagnosed disease, and Charlson comorbidity index (CCI), the multivariate analysis showed that the NRS 2002 score = 3 [hazard ratio (HR): 1.376, 95% CI: 1.031–1.836] were associated with approximately a 1.5-fold higher likelihood of death. NRS 2002 scores = 4 (HR: 1.982, 95% CI: 1.491–2.633) and NRS scores ≥ 5 (HR: 1.982, 95% CI: 1.498–2.622) were associated with a 2-fold higher likelihood of death, compared with NRS 2002 scores &lt;3. An NRS 2002 score of 3 (percentage change: 16.4, 95% CI: 9.6–23.6), score of 4 (32.4, 95% CI: 24–41.4), and scores of ≥ 5 (36.8, 95% CI 28.3–45.8) were associated with a significantly (16.4, 32.4, and 36.8%, respectively) higher likelihood of increased LoS compared with an NRS 2002 scores &lt;3. The NRS 2002 score = 3 group (17.8, 95% CI: 8.6–27.7) was associated with a 17.8%, the NRS 2002 score = 4 group (31.1, 95% CI: 19.8–43.5) a 31.1%, and the NRS 2002 score ≥ 5 group (44.3, 95% CI: 32.3–57.4) a 44.3%, higher likelihood of increased hospital costs compared with a NRS 2002 scores &lt;3 group. Specifically, the most notable mortality-specific comorbidity and LoS-specific comorbidity was injury, while the most notable cost-specific comorbidity was diseases of the digestive system.Conclusions: This study demonstrated the high burden of undernutrition at the time of hospital admission on the health and hospital cost outcomes for older immobile inpatients. These findings underscore the need for nutritional risk screening in all Chinese hospitalized patients, and improved diagnosis, treatment, and nutritional support to improve immobile patient outcomes and to reduce healthcare costs.


2021 ◽  
pp. 1-10
Author(s):  
L. D. VanTil ◽  
M. B. MacLean ◽  
J. Coulthard ◽  
R. Murray ◽  
S. Lourenso ◽  
...  

Author(s):  
Oliver Frenzel ◽  
Heidi Eukel ◽  
Emily Lothspeich ◽  
Elizabeth Skoy ◽  
Jayme Steig ◽  
...  

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