862 resultados para suicide risk prediction model
Resumo:
In this article we operationalise the theoretical concepts of the Good Lives Model (GLM) of offender rehabilitation by providing a step-by-step framework for assessment, formulation, treatment planning, and monitoring with a high-risk violent offender residing in the community. The case study illustrates how the GLM can be applied to complement and enhance traditional Risk-Management interventions and shows how the GLM's clinical relevance extends from sex offending to broader offending typologies.
Resumo:
Purpose: To develop and evaluate a fracture risk (FRISK) score based on multiple-site bone mineral density (BMD) measurements and other risk factors, to enable prediction of future fracture occurrence.
Materials and Methods: All participants gave written informed consent, and the study was approved by the Barwon Health Research and Ethics Advisory Committee. BMD was measured at the femoral neck and spine in two concurrently recruited groups: women 60 years of age or older who had sustained a low-trauma fracture of the hip, spine, humerus or distal forearm during a 2-year ascertainment period (n = 231; mean age, 74 years ± 7 [standard deviation]) and a population-based random sample of women who had not sustained a fracture during the recruitment period (n = 448; mean age, 72 years ± 8). Falls in the previous year and the number of self-reported fractures in adult life were recorded. Coefficients of a multiple logistic regression model were used as weightings for a combined model. A longitudinal population-based sample was used to assess the fracture risk equation (n = 600; median age, 74 years; interquartile range, 67–82 years).
Results: The FRISK score was obtained from the following equation: 9.304 − 4.735BMDSP − 4.530BMDFN + 1.127FS + 0.344NPF + 0.037W, where BMDSP is spinal BMD (in grams per square centimeter), BMDFN is femoral neck BMD, FS is falls score, NPF is number of previous fractures, and W is weight (in kilograms). The FRISK score successfully predicted 75% of fractures 2 years after baseline measurements in subjects in the longitudinal study with 68% specificity.
Conclusion: This study resulted in the derivation of a fracture risk score that successfully predicted 75% of fractures 2 years after baseline.
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Background
The study was undertaken to evaluate the contribution of a process which uses clinical trial data plus linked de-identified administrative health data to forecast potential risk of adverse events associated with the use of newly released drugs by older Australian patients.
Methods
The study uses publicly available data from the clinical trials of a newly released drug to ascertain which patient age groups, gender, comorbidities and co-medications were excluded in the trials. It then uses linked de-identified hospital morbidity and medications dispensing data to investigate the comorbidities and co-medications of patients who suffer from the target morbidity of the new drug and who are the likely target population for the drug. The clinical trial information and the linked morbidity and medication data are compared to assess which patient groups could potentially be at risk of an adverse event associated with use of the new drug.
Results
Applying the model in a retrospective real-world scenario identified that the majority of the sample group of Australian patients aged 65 years and over with the target morbidity of the newly released COX-2-selective NSAID rofecoxib also suffered from a major morbidity excluded in the trials of that drug, indicating a substantial potential risk of adverse events amongst those patients. This risk was borne out in post-release morbidity and mortality associated with use of that drug.
Conclusions
Clinical trial data and linked administrative health data can together support a prospective assessment of patient groups who could be at risk of an adverse event if they are prescribed a newly released drug in the context of their age, gender, comorbidities and/or co-medications. Communication of this independent risk information to prescribers has the potential to reduce adverse events in the period after the release of the new drug, which is when the risk is greatest.
Note: The terms 'adverse drug reaction' and 'adverse drug event' have come to be used interchangeably in the current literature. For consistency, the authors have chosen to use the wider term 'adverse drug event' (ADE).
A conceptual model of psychosocial risk and protective factors for excessive gestational weight gain
Resumo:
There are two fundamental challenges in effectively performing security risk assessment in today's IT projects.The first is the project manager's need to know what IT security risks face the project before the project begins. At this stage IT security staff are unable to answer this question without first knowing the system requirements for the project which are yet to be defined. Second organisations that deal with a large project throughput each year find the current IT security risk assessment process to be tedious and expensive, especially when the same process has to be repeated for each individual project. This also makes it difficult for an organisation to prioritise which projects require more investment in IT security in order to fit within budget constraints. This paper presents a conceptual model that is based on an agile approach to alleviate these challenges. We do this by first analysing two online database resources of vulnerabilities by comparing them to each other, and then compare them to the agile criteria of the conceptual model which we define. The conceptual model is then presented and an example is given of how it can be applied to an actual project. We then briefly discuss what further work needs to be done to implement the conceptual model and validate it against an existing IT project.
Resumo:
This paper develops and tests a model to predict small and medium enterprise (SME) financial distress based on empirical evidence from Thailand. A sample comprising 198 financial statements of non-financially distressed and 68 statements of financially distressed SMEs were used. A parametric t-test was conducted to establish differences between financial characteristics of the two groups of SMEs.
Results show statistically significant differences (t values significant at .001) between the two groups of SMEs in the financial ratios used for the study. Discriminant analysis was then conducted to develop a model for predicting the likelihood of an SME experiencing financial distress.
The model hits an accuracy level of 97%, which compares favourably with the probability of accurate classification by chance (i.e., 65% after adjusting for the unequal sample sizes of the two groups of SMEs). A test of the model with a new sample shows the validity of the model beyond the original sample, confirming that Thai SME financial distress is amenable to prediction to a statistically significant extent. The model is expected to serve SME managers and creditors in assessing financial health of SMEs before making important decisions. The results are also expected to inform policymakers in formulating economic policies concerning SMEs.
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To develop a mathematical model to predict the probability of having community-acquired pneumonia and to evaluate an already developed prediction rule that has not been validated in a clinical scenario.
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In some advanced sheet metal forming processes such as the incremental forming process, a local fracture strain after necking is very important. In order to accurately predict necking and fracture phenomena, a crystal plasticity model is introduced in the finite element analysis of tensile tests. A tensile specimen is modeled by many grains that have their own crystalline orientation. And each of the grains is discretized by many elements. Using this analysis, necking behavior of a tensile specimen can be predicted without any initial imperfections. A damage model is also implemented to predict sudden drops of load carrying capacity after necking and to reflect the void nucleation and growth of the severely deformed region. From an analysis of the tensile test, the necking behavior is well predicted. Finally, analyses are carried out for various strain paths, and FLDs up to necking and fracture are predicted.