Search results for: seismic risk analysis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 31957

Search results for: seismic risk analysis

28957 The Client-Supplier Relationship in Managing Innovation: Delineating Defence Industry First Mover Challenges within the Government Contract Competition

Authors: Edward Pol

Abstract:

All companies are confronted with the need to innovate in order to meet market demands. In so doing they are challenged with the dilemma of whether to aim to be first into the market with a new innovative product or to deliberately wait and learn from a pioneers’ mistakes; potentially avoiding higher risks. It is therefore important to critically understand from a first-mover advantage and disadvantage perspective the decision-making implications of defence industry transformation onset by an innovative paradigm shift. This paper will argue that the type of industry characteristics matter, especially when considering what role the clients play in the innovation process and what is their level of influence. Through investigation of qualitative case study research, this inquiry will focus on first mover advantages and first mover disadvantages with a view to establish practical and value-added academic findings by focusing on specific industries where the clients play an active role in cooperation with the supplier innovation. The resulting findings will help managers to mitigate risk in innovative technology introduction. A selection from several defense industry innovations is specifically chosen because of the client-supplier relationship typically differing from traditional first-mover research. In this instance, case studies will be used referencing vertical-takeoff-and-landing defence equipment innovations.

Keywords: innovation, pioneer, first-mover advantage, first-mover disadvantage, risk

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28956 Effects of Directivity and Fling Step on Buildings Equipped with J-Hook Sandwich Composite Walls and Reinforced Concrete Shear Walls

Authors: Majid Saaly, Shahriar Tavousi Tafreshi, Mehdi Nazari Afshar

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The structural systems with the sandwich composite wall (SCSSC) are of very popular due to their ductileness and competency to swallow more energy and power than standard reinforced concrete shear walls. The purpose of this enhanced system is in high-rise building, Nuclear power plant facilities, and bridge slabs are much more. SCSSCs showed acceptable seismic performance under experimental tests and cyclic loading from the points of view of in-plane and out-of-plane shear and flexural interaction, in-plane punching shear, and compressive behavior. The use of sandwich composite walls with J-hook connectors has a significant effect on energy dissipation and reduction of dynamic responses of mid-rise and high-rise structural models. By changing the systems of the building from SW to SCWJ, the maximum inter-story drift values of ten- and fifteen-story models are reduced by up to 25% and 35%, respectively.

Keywords: J-Hook sandwich composite walls, fling step, directivity, IDA analyses, fractile curves

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28955 The Study of Musculoskeletal Disorders Produced by Excess Physical Effort in Marines

Authors: R. Domínguez, A. Castro, N. Fernandez, F. Hidalgo, F. Ortiz

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Aims: Study musculoskeletal disorders produced by excess physical exertion in marines Introduction: Musculoskeletal injuries during military training are an important medical problem faced by military organizations throughout the world. Military occupations are physically demanding, which represents a high risk of injury "and subsequent disability, these injuries represent important risk factors for hospitalization, disability, and discharge Methodology: This is a causal correlational study in which data were collected in order to find a cause-effect relationship between the physical effort in marines during their career in the Chilean Navy and the musculoskeletal disorders that occur in some from them. Results:100% had experienced musculoskeletal pain in some part of the body and 73.52% of the respondents had experienced limitations in the ability to work, as a consequence forced to change jobs due to musculoskeletal pain. The neck, shoulders and the lumbar dorsal region were the regions with the highest prevalence of pain, as well as pain that limit the ability to work. Conclusion: Musculoskeletal injuries and illnesses related to injuries are common in marines, both in those who operate in campus Charles, as in another operational unit due to the nature of the work. Many of these injuries occur during physical training and sports and various studies have dealt with the descriptive epidemiology of musculoskeletal injuries in military personnel.

Keywords: physical effort, marines, musculoskeletal disorders produced (MSD), training

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28954 Estimation of Reservoirs Fracture Network Properties Using an Artificial Intelligence Technique

Authors: Reda Abdel Azim, Tariq Shehab

Abstract:

The main objective of this study is to develop a subsurface fracture map of naturally fractured reservoirs by overcoming the limitations associated with different data sources in characterising fracture properties. Some of these limitations are overcome by employing a nested neuro-stochastic technique to establish inter-relationship between different data, as conventional well logs, borehole images (FMI), core description, seismic attributes, and etc. and then characterise fracture properties in terms of fracture density and fractal dimension for each data source. Fracture density is an important property of a system of fracture network as it is a measure of the cumulative area of all the fractures in a unit volume of a fracture network system and Fractal dimension is also used to characterize self-similar objects such as fractures. At the wellbore locations, fracture density and fractal dimension can only be estimated for limited sections where FMI data are available. Therefore, artificial intelligence technique is applied to approximate the quantities at locations along the wellbore, where the hard data is not available. It should be noted that Artificial intelligence techniques have proven their effectiveness in this domain of applications.

Keywords: naturally fractured reservoirs, artificial intelligence, fracture intensity, fractal dimension

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28953 Toxic Heavy Metal Accumulation by Algerian Malva sylvestris L. Depending on Location Variation

Authors: Souhila Terfi, Fatma Hassaine-Sadi

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In the present study, wet digestion with HCl and HNO3 mixture was used to extract the heavy metals (copper (Cu), chromium (Cr), zinc (Zn), lead (Pb) and cadmium (Cd)) from the leaves, the stems and the roots of Malva sylvestris L., which were subsequently analyzed by AAS. The samples (soil and parts of species) were collected from different sites: the industrial area (IA) (Rouiba), the rubbish dump area (RDA) (Boudouaou), the residential area (RA) with large open fields and construction activities (Blida), the Montaigne area (MA) (Chrea) and the high plateau area (HPA) (Berouaguia). The study showed differences in metal concentrations according to the analysed parts and the different sampling locations. In the contaminated site of the industrial area (IA), high content of the toxic heavy metals (Cd: 3.18 µg/g DW and Pb: 34.48 µg/g DW) were found in the leaves of Malva sylvestris L. This finding suggests that the consumers of this species could be exposed to a risk associated with this higher level of these toxic metals. It was found that Malva sylvestris L. is rich by Zn and Cu in some sites, which are considered to be the essential elements for the human health. The obtained results with the control site (Montaigne area) suggest that this species can be applicable in both the health and food, feasible alternatives as medicinal plant without any risk.

Keywords: Malva sylvestris L., toxic heavy metal, medicinal plant, impact on human health

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28952 Analysis Customer Loyalty Characteristic and Segmentation Analysis in Mobile Phone Category in Indonesia

Authors: A. B. Robert, Adam Pramadia, Calvin Andika

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The main purpose of this study is to explore consumer loyalty characteristic of mobile phone category in Indonesia. Second, this research attempts to identify consumer segment and to explore their profile in each segment as the basis of marketing strategy formulation. This study used some tools of multivariate analysis such as discriminant analysis and cluster analysis. Discriminate analysis used to discriminate consumer loyal and not loyal by using particular variables. Cluster analysis used to reveal various segment in mobile phone category. In addition to having better customer understanding in each segment, this study used descriptive analysis and cross tab analysis in each segment defined by cluster analysis. This study expected several findings. First, consumer can be divided into two large group of loyal versus not loyal by set of variables. Second, this study identifies customer segment in mobile phone category. Third, exploring customer profile in each segment that has been identified. This study answer a call for additional empirical research into different product categories. Therefore, a replication research is advisable. By knowing the customer loyalty characteristic, and deep analysis of their consumption behavior and profile for each segment, this study is very advisable for high impact marketing strategy development. This study contributes body of knowledge by adding empirical study of consumer loyalty, segmentation analysis in mobile phone category by multiple brand analysis.

Keywords: customer loyalty, segmentation, marketing strategy, discriminant analysis, cluster analysis, mobile phone

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28951 Policy Analysis on Family Planning in Pakistan: Providing Options to Improve Service Provision

Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

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28950 Governance, Risk Management, and Compliance Factors Influencing the Adoption of Cloud Computing in Australia

Authors: Tim Nedyalkov

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A business decision to move to the cloud brings fundamental changes in how an organization develops and delivers its Information Technology solutions. The accelerated pace of digital transformation across businesses and government agencies increases the reliance on cloud-based services. They are collecting, managing, and retaining large amounts of data in cloud environments makes information security and data privacy protection essential. It becomes even more important to understand what key factors drive successful cloud adoption following the commencement of the Privacy Amendment Notifiable Data Breaches (NDB) Act 2017 in Australia as the regulatory changes impact many organizations and industries. This quantitative correlational research investigated the governance, risk management, and compliance factors contributing to cloud security success. The factors influence the adoption of cloud computing within an organizational context after the commencement of the NDB scheme. The results and findings demonstrated that corporate information security policies, data storage location, management understanding of data governance responsibilities, and regular compliance assessments are the factors influencing cloud computing adoption. The research has implications for organizations, future researchers, practitioners, policymakers, and cloud computing providers to meet the rapidly changing regulatory and compliance requirements.

Keywords: cloud compliance, cloud security, data governance, privacy protection

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28949 A Systematic Review of Forest School for Early Childhood Education in China: Lessons Learned from European Studies from a Perspective of Ecological System

Authors: Xiaoying Zhang

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Forest school – an outdoor educational experience that is undertaken in an outdoor environment with trees – becomes an emerging field of early childhood education recently. In China, the benefits of natural outdoor education to children and young people’s wellness have raised attention. Although different types of outdoor-based activities have been involved in some pre-school of China, few study and practice have been conducted in terms of the notion of forest school. To comprehend the impact of forest school for children and young people, this study aims to systematically review articles on the topic of forest school in preschool education from an ecological perspective, i.e. from individual level (e.g., behavior and mental health) to microsystem level (e.g., the relationship between teachers and children) to ecosystem level. Based on PRISMA framework flow, using the key words of “Forest School” and “Early Childhood Education” for searching in Web-of-science database, a total of 33 articles were identified. Sample participants of 13 studies were not preschool children, five studies were not on forest school theme, and two literature review articles were excluded for further analysis. Finally, 13 articles were eligible for thematic analysis. According to Bronfenbrenner's ecological systems theory, there are some fingdings, on the individual level, current forest school studies are concerned about the children behavioral experience in forest school, how these experience may relate to their achievement or to develop children’s wellbeing/wellness, and how this type of learning experience may enhance children’s self-awareness on risk and safety issues. On the microsystem/mesosystem level, this review indicated that pedagogical development for forest school, risk perception from teachers and parents, social development between peers, and adult’s role in the participation of forest school were concerned, explored and discussed most frequently. On the macrosystem, the conceptualization of forest school is the key theme. Different forms of presentation in various countries with diverse cultures could provide various models of forest school education. However, there was no study investigating forest school on an ecosystem level. As for the potential benefits of physical health and mental wellness that results from forest school, it informs us to reflect the system of preschool education from the ecological perspective for Chinese children. For instance, most Chinese kindergartens ignored the significance of natural outdoor activities for children. Preschool education in China is strongly oriented by primary school system, which means pre-school children are expected to be trained as primary school students to do different subjects, such as math. Hardly any kindergarteners provide the opportunities for children and young people to take risks in a natural environment like forest school does. However, merely copying forest school model for a Chinese preschool education system will be less effective. This review of different level concerns could inform us that the localization the idea of forest school to adapt to a Chinese political, educational and cultural background. More detailed results and profound discussions will be presented in the full paper.

Keywords: early childhood education, ecological system, education development prospects in China, forest school

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28948 Hydrogeochemical Investigation of Lead-Zinc Deposits in Oshiri and Ishiagu Areas, South Eastern Nigeria

Authors: Christian Ogubuchi Ede, Moses Oghenenyoreme Eyankware

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This study assessed the concentration of heavy metals (HMs) in soil, rock, mine dump pile, and water from Oshiri and Ishiagu areas of Ebonyi State. Investigations on mobile fraction equally evaluated the geochemical condition of different HM using UV spectrophotometer for Mineralized and unmineralized rocks, dumps, and soil, while AAS was used in determining the geochemical nature of the water system. Analysis revealed very high pollution of Cd mostly in Ishiagu (Ihetutu and Amaonye) active mine zones and with subordinates enrichments of Pb, Cu, As, and Zn in Amagu and Umungbala. Oshiri recorded sparingly moderate to high contamination of Cd and Mn but out rightly high anthropogenic input. Observation showed that most of the contamination conditions were unbearable while at the control but decrease with increasing distance from the mine vicinity. The potential heavy metal risk of the environments was evaluated using the risk factors such as enrichment factor, index of Geoacumulation, Contamination Factor, and Effect Range Median. Cadmium and Zn showed moderate to extreme contamination using Geoaccumulation Index (Igeo) while Pb, Cd, and As indicated moderate to strong pollution using the Effect Range Median. Results, when compared with the allowable limits and standards, showed the concentration of the metals in the following order Cd>Zn>Pb>As>Cu>Ni (rocks), Cd>As>Pb>Zn>Cu>Ni (soil) while Cd>Zn>As>Pb> Cu (for mine dump pile. High concentrations of Zn and As were recorded more in mine pond and salt line/drain channels along active mine zones, it heightened its threat during the rainy period as it settles into river course, living behind full-scale contaminations to inhabitants depending on it for domestic uses. Pb and Cu with moderate pollution were recorded in surface/stream water source as its mobility were relatively low. Results from Ishiagu Crush rock sites and Fedeco metallurgical and auto workshop where groundwater contamination was seen infiltrating some of the wells points gave rise to values that were 4 times high than the allowable limits. Some of these metal concentrations according to WHO (2015) if left unmitigated pose adverse effects to the soil and human community.

Keywords: water, geo-accumulation, heavy metals, mine and Nigeria.

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28947 Industrial Ergonomics Improvement at a Refrigerator Manufacturing Company in Iran: An Approach on Interventional Ergonomics

Authors: Hassan S. Naeini

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Nowadays a lot of people are working in several sorts of industrial sectors in which there are some risk factors which threaten human being especially in developing countries. One of the main problems which effect on workers’ health refers to Ergonomics. Ergonomics as multidisciplinary science concerns workers’ health and safety in terms of somatic and mental concepts. Surely ergonomics interventions and improvement make a better condition for workers and change the quality of working life to better condition. In this study, one of the factories in Iran which is producing some kinds of small and medium size of refrigerators was chosen as the sample. The preliminary ergonomics observation of the mentioned factory showed that there are some risk factors in terms of ergonomics aspects, so an ergonomic intervention was defined, then some ergonomic assessment methods such as NMQ,OWAS, and Environmental Ergonomic Assessment were used. Also Anthropometric measurement was done. This study shows that there are some workstations and plants which suffer some degrees of ergonomic problems. Considering with the gathered data, illumination, noise control and workstation design in metal workstation are known as the priority actions. Some parts of the mentioned interventions are ongoing actions. it seems that the mentioned intervention and workstations design make a better condition for workers, because ergonomics make a safer and more sustainable environments for human being.

Keywords: anthropometry, ergonomics, health, NMQ, OWAS

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28946 Lifestyle Diseases in Urban India: A Case Study of Obesity

Authors: Monika Yadav

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The incorporation of a healthy lifestyle significantly contributes to the advancement of economic development. Urbanization, industrialization, and economic growth have enhanced living conditions, promoting sedentary behaviours among individuals with elevated socio-economic statuses. The prevalence of overweight and obesity has increased globally, along with the rise in living standards, posing a growing health risk. Overweight and obesity are known to be precursors to a range of modifiable and metabolic risk factors, contributing to the increase in lifestyle diseases. Unhealthy dietary choices and lifestyle practices primarily drive these diseases. Lifestyle diseases refer to chronic and non-communicable illnesses, encompassing conditions such as hypertension, heart disease, kidney disorders, infertility, polycystic ovary syndrome (PCOD), diabetes, respiratory diseases, and certain forms of cancer. This study examines the prevalence of lifestyle diseases among urban Indian women, explicitly differentiating between individuals with normal weight and those classified as obese. The main aim of this study is to investigate whether there is a correlation between a higher body mass index (BMI) in women and an increased vulnerability to lifestyle diseases when compared to women with a normal BMI. This research provides insights into the intricate relationship between lifestyle, health, and economic development within urban areas.

Keywords: urbanization, economic development, BMI, NCDs, urban, women, lifestyle practices

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28945 Analysis of Road Accidents in India 2016 to 2021

Authors: Ajin Frank J., Shridevi Jeevan Kamble

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The primary objective of this research paper is to identify significant patterns and insights in road accident data in India spanning from 2016 to 2021. The study reveals that the frequency of accidents, injuries, and fatalities varies depending on numerous factors such as the type of vehicle, time of accidents, age of the vehicle, age and gender of the driver, among others. Notably, the COVID-19 pandemic and subsequent lockdown measures have significantly impacted these figures. One of the key findings of the analysis is the rise in the number of accidents and deaths involving two-wheeler vehicles, particularly among younger individuals, in major states across India. This trend is of concern, and there is a need for increased awareness and precautions to prevent these types of accidents. Additionally, with the imminent rise of electric vehicles in the coming years, ensuring their safety on the road is a critical matter. Another significant factor contributing to road accidents is the age of vehicles. As vehicles age, their handling becomes more challenging compared to new ones, increasing the risk of accidents. Thus, it is imperative for the government to impose stringent regulations and laws to reduce these accident-causing factors and raise awareness among individuals about taking necessary precautions to avoid accidents. This study highlights the importance of understanding the underlying patterns and factors contributing to road accidents in India. Through this knowledge, policymakers and stakeholders can develop effective strategies to address these challenges and promote road safety, ultimately reducing the number of accidents, injuries, and fatalities on Indian roads.

Keywords: road accidents, India, road safety, accident deaths

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28944 Testing the Effectiveness of a Peer Facilitated Body Project Interventions Among Body Dissatisfied Young Women in China: A Randomized Control Trial

Authors: Todd Jackson

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In this randomized control trial, we tested the effectiveness of a peer-facilitated version of the Body Project (BP) intervention among body-dissatisfied young women in China. Participants were randomly assigned to a peer-facilitator BP condition (N = 94) versus an educational video minimal intervention control condition (N = 89). Questionnaire measures of two primary outcomes (i.e., disordered eating and body dissatisfaction) and six secondary outcomes (thin-ideal internalization, pressure to be thin, negative affect, body surveillance, body shame, body appreciation and interest in cosmetic surgery) were administered at a pre-treatment baseline, a post-treatment assessment, and at a 12-month follow-up. A series of 2 (Group) x 2 (Time) analyses of variance indicated women in the peer-facilitated BP condition reported significant improvements in primary outcome measures of disordered eating and body dissatisfaction compared to women in the educational video control condition following treatment and at the 12-month follow-up. Furthermore, women in the peer-facilitated BP condition reported significant improvements in measures of body surveillance, body shame and body appreciation) compared to educational video controls that extended to the 12-month follow-up. Finally, although women in the peer-facilitated BP condition showed significant post-treatment improvements in thin-ideal internalization, negative affect, perceived pressure to be thin, and interest in cosmetic surgery compared to video controls, these differences were no longer statistically significant at the 12-month follow-up. In conclusion, findings supported the overall effectiveness of a peer-facilitated group version of the BP as an intervention for reducing disordered eating and several associated risk factors among at-risk young women in China.

Keywords: body project, disordered eating, body dissatisfaction, risk factors, prevention, China

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28943 Optimization of Reinforced Concrete Buildings According to the Algerian Seismic Code

Authors: Nesreddine Djafar Henni, Nassim Djedoui, Rachid Chebili

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Recent decades have witnessed significant efforts being made to optimize different types of structures and components. The concept of cost optimization in reinforced concrete structures, which aims at minimizing financial resources while ensuring maximum building safety, comprises multiple materials, and the objective function for their optimal design is derived from the construction cost of the steel as well as concrete that significantly contribute to the overall weight of reinforced concrete (RC) structures. To achieve this objective, this work has been devoted to optimizing the structural design of 3D RC frame buildings which integrates, for the first time, the Algerian regulations. Three different test examples were investigated to assess the efficiency of our work in optimizing RC frame buildings. The hybrid GWOPSO algorithm is used, and 30000 generations are made. The cost of the building is reduced by iteration each time. Concrete and reinforcement bars are used in the building cost. As a result, the cost of a reinforced concrete structure is reduced by 30% compared with the initial design. This result means that the 3D cost-design optimization of the framed structure is successfully achieved.

Keywords: optimization, automation, API, Malab, RC structures

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28942 Towards a Vulnerability Model Assessment of The Alexandra Jukskei Catchment in South Africa

Authors: Vhuhwavho Gadisi, Rebecca Alowo, German Nkhonjera

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This article sets out to detail an investigation of groundwater management in the Juksei Catchment of South Africa through spatial mapping of key hydrological relationships, interactions, and parameters in catchments. The Department of Water Affairs (DWA) noted gaps in the implementation of the South African National Water Act 1998: article 16, including the lack of appropriate models for dealing with water quantity parameters. For this reason, this research conducted a drastic GIS-based groundwater assessment to improve groundwater monitoring system in the Juksei River basin catchment of South Africa. The methodology employed was a mixed-methods approach/design that involved the use of DRASTIC analysis, questionnaire, literature review and observations to gather information on how to help people who use the Juskei River. GIS (geographical information system) mapping was carried out using a three-parameter DRASTIC (Depth to water, Recharge, Aquifer media, Soil media, Topography, Impact of the vadose zone, Hydraulic conductivity) vulnerability methodology. In addition, the developed vulnerability map was subjected to sensitivity analysis as a validation method. This approach included single-parameter sensitivity, sensitivity to map deletion, and correlation analysis of DRASTIC parameters. The findings were that approximately 5.7% (45km2) of the area in the northern part of the Juksei watershed is highly vulnerable. Approximately 53.6% (428.8 km^2) of the basin is also at high risk of groundwater contamination. This area is mainly located in the central, north-eastern, and western areas of the sub-basin. The medium and low vulnerability classes cover approximately 18.1% (144.8 km2) and 21.7% (168 km2) of the Jukskei River, respectively. The shallow groundwater of the Jukskei River belongs to a very vulnerable area. Sensitivity analysis indicated that water depth, water recharge, aquifer environment, soil, and topography were the main factors contributing to the vulnerability assessment. The conclusion is that the final vulnerability map indicates that the Juksei catchment is highly susceptible to pollution, and therefore, protective measures are needed for sustainable management of groundwater resources in the study area.

Keywords: contamination, DRASTIC, groundwater, vulnerability, model

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28941 The Influence of Human Factors Education on the Irish Registered Pre-Hospital Practitioner within the National Ambulance Service

Authors: Desmond Wade, Alfredo Ormazabal

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Background: Ever since it commenced its registration process of pre-hospital practitioners in the year 2000 through the Irish Government Statute Instrument (SI 109 of 2000) process, the approach to education of its professionals has changed drastically. The progression from the traditional behaviouristic to the current constructivist approach has been based on experiences from other sectors and industries, nationally and internationally. Today, the delivery of a safe and efficient ambulance service heavily depends on its practitioners’ range of technical skills, academic knowledge, and overall competences. As these increase, so does the level of complexity of paramedics’ everyday practice. This has made it inevitable to consider the 'Human Factor' as a source of potential risk and made formative institutions like the National Ambulance Service College to include it in their curriculum. Methods: This paper used a mixed-method approach, where both, an online questionnaire and a set of semi-structured interviews were the source of primary data. An analysis of this data was carried out using qualitative and quantitative data analysis. Conclusions: The evidence presented leads to the conclusion that in the National Ambulance Service there is a considerable lack of education of Human Factors and the levels in understanding of how to manage Human Factors in practice vary across its spectrum. Paramedic Practitioners in Ireland seem to understand that the responsibility of patient care lies on the team, rather than on the most hierarchically senior practitioner present in the scene.

Keywords: human factors, ergonomics, stress, decision making, pre-hospital care, paramedic, education

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28940 Prognosis of Patients with COVID-19 and Hematologic Malignancies

Authors: Elizabeth Behrens, Anne Timmermann, Alexander Yerkan, Joshua Thomas, Deborah Katz, Agne Paner, Melissa Larson, Shivi Jain, Seo-Hyun Kim, Celalettin Ustun, Ankur Varma, Parameswaran Venugopal, Jamile Shammo

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Coronavirus Disease-2019 (COVID-19) causes persistent concern for poor outcomes in vulnerable populations. Patients with hematologic malignancies (HM) have been found to have higher COVID-19 case fatality rates compared to those without malignancy. While cytopenias are common in patients with HM, especially in those undergoing chemotherapy treatment, hemoglobin (Hgb) and platelet count have not yet been studied, to our best knowledge, as potential prognostic indicators for patients with HM and COVID-19. The goal of this study is to identify factors that may increase the risk of mortality in patients with HM and COVID-19. In this single-center, retrospective, observational study, 65 patients with HM and laboratory confirmed COVID-19 were identified between March 2020 and January 2021. Information on demographics, laboratory data the day of COVID-19 diagnosis, and prognosis was extracted from the electronic medical record (EMR), chart reviewed, and analyzed using the statistical software SAS version 9.4. Chi-square testing was used for categorical variable analyses. Risk factors associated with mortality were established by logistic regression models. Non-Hodgkin lymphoma (37%), chronic lymphocytic leukemia (20%), and plasma cell dyscrasia (15%) were the most common HM. Higher Hgb level upon COVID-19 diagnosis was related to decreased mortality, odd ratio=0.704 (95% confidence interval [CI]: 0.511-0.969; P = .0263). Platelet count the day of COVID-19 diagnosis was lower in patients who ultimately died (mean 127 ± 72K/uL, n=10) compared to patients who survived (mean 197 ±92K/uL, n=55) (P=.0258). Female sex was related to decreased mortality, odd ratio=0.143 (95% confidence interval [CI]: 0.026-0.785; P = .0353). There was no mortality difference between the patients who were on treatment for HM the day of COVID-19 diagnosis compared to those who were not (P=1.000). Lower Hgb and male sex are independent risk factors associated with increased mortality of HM patients with COVID-19. Clinicians should be especially attentive to patients with HM and COVID-19 who present with cytopenias. Larger multi-center studies are urgently needed to further investigate the impact of anemia, thrombocytopenia, and demographics on outcomes of patients with hematologic malignancies diagnosed with COVID-19.

Keywords: anemia, COVID-19, hematologic malignancy, prognosis

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28939 Prevalence, Antimicrobial Susceptibility Pattern and Associated Risk Factors for Salmonella Species and Escherichia Coli from Raw Meat at Butchery Houses in Mekelle, Tigray, Northern Ethiopia

Authors: Haftay Abraha Tadesse, Dawit Gebreegziabiher Hagos, Atsebaha Gebrekidan Kahsay, Mahumd Abdulkader

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Background: Salmonella species and Escherichia coli (E. coli) are important foodborne pathogens affecting humans and animals. They are among the most important causes of infection that are associated with the consumption of contaminated food. This study was aimed to determine the prevalence, antimicrobial susceptibility patterns and associated risk factors for Salmonella species and E. coli in raw meat from butchery houses of Mekelle, Northern Ethiopia. Method: A cross-sectional study was conducted from January to December 2019. Socio-demographic data and risk factors were collected using a predesigned questionnaire. Meat samples were collected aseptically from the butchery houses and transported using icebox to Mekelle University, College of Veterinary Sciences for the isolation and identification of Salmonella species and E. coli. Antimicrobial susceptibility patterns were determined using Kirby disc diffusion method. Data obtained were cleaned and entered into Statistical Package for the Social Sciences version 22 and logistic regression models with odds ratio were calculated. P-value < 0.05 was considered as statistically significant. Results: A total of 153 out of 384 (39.8%) of the meat specimens were found to be contaminated. The contamination of Salmonella species and E. coli were 15.6% (n=60) and 20.8%) (n=80), respectively. Mixed contamination (Salmonella species and E. coli) was observed in 13 (3.4 %) of the analyzed. Poor washing hands regularly (AOR = 8.37; 95% CI: 2.75-25.50) and not using gloves during meat handling (AOR=11. 28; 95% CI:(4.69 27.10) were associated with overall bacterial contamination. About 100% of the tested isolates were sensitive to ciprofloxacin, gentamicin, Co trimoxazole , sulphamethoxazole, ceftriaxone, and trimethoprim and ciprofloxacin, gentamicin, and norfloxacine of E. coli and Salmonella species, respectively, while the resistance of amoxyclav_amoxicillin and erythromycin were both isolated bacteria species. The overall multidrug resistance pattern for Salmonella and E. coli were 51.4% (n=19) and 31.8% (14), respectively. Conclusion: Of the 153 (153/384) contaminated raw meat, 60 (15.6%) and 80 (20.8%) were contaminated by Salmonella species and E. coli, respectively. Poor handwashing practice and not using glove during meat handling showed a significant association with bacterial contamination. Multidrug-resistant showed in Salmonella species, and E. coli were 19 (51.4%) and 14 (31.8%), respectively.

Keywords: antimicrobial susceptibility test, butchery houses, E. coli, raw meat, salmonella species

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28938 Choking among Babies, Toddlers and Children with Special Needs: A Review of Mechanisms, Implications, Incidence, and Recommendations of Professional Prevention Guidelines

Authors: Ella Abaev, Shany Segal, Miri Gabay

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Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.

Keywords: children with special needs, choking, educational system, prevention guidelines

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28937 Performance of Shariah-Based Investment: Evidence from Pakistani Listed Firms

Authors: Mohsin Sadaqat, Hilal Anwar Butt

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Following the stock selection guidelines provided by the Sharia Board (SB), we segregate the firms listed at Pakistan Stock Exchange (PSX) into Sharia Compliant (SC) and Non-Sharia Compliant (NSC) stocks. Subsequently, we form portfolios within each group based on market capitalization and volatility. The purpose is to analyze and compare the performance of these two groups as the SC stocks have lesser diversification opportunities due to SB restrictions. Using data ranging from January 2004 until June 2016, our results indicate that in most of the cases the risk-adjusted returns (alphas) for the returns differential between SC and NCS firms are positive. In addition, the SC firms in comparison to their counterparts in PSX provides excess returns that are hedged against the market, size, and value-based systematic risks factors. Overall, these results reconcile with one prevailing notion that the SC stocks that have lower financial leverage and higher investment in real assets are lesser exposed to market-based risks. Further, the SC firms that are more capitalized and less volatile, perform better than lower capitalized and higher volatile SC and NSC firms. To sum up our results, we do not find any substantial evidence for opportunity loss due to limited diversification opportunities in case of SC firms. To optimally utilize scarce resources, investors should consider SC firms as a candidate in portfolio construction.

Keywords: diversification, performance, sharia compliant stocks, risk adjusted returns

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28936 The Delaying Influence of Degradation on the Divestment of Gas Turbines for Associated Gas Utilisation: Part 1

Authors: Mafel Obhuo, Dodeye I. Igbong, Duabari S. Aziaka, Pericles Pilidis

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An important feature of the exploitation of associated gas as fuel for gas turbine engines is a declining supply. So when exploiting this resource, the divestment of prime movers is very important as the fuel supply diminishes with time. This paper explores the influence of engine degradation on the timing of divestments. Hypothetical but realistic gas turbine engines were modelled with Turbomatch, the Cranfield University gas turbine performance simulation tool. The results were deployed in three degradation scenarios within the TERA (Techno-economic and environmental risk analysis) framework to develop economic models. An optimisation with Genetic Algorithms was carried out to maximize the economic benefit. The results show that degradation will have a significant impact. It will delay the divestment of power plants, while they are running less efficiently. Over a 20 year investment, a decrease of $0.11bn, $0.26bn and $0.45bn (billion US dollars) were observed for the three degradation scenarios as against the clean case.

Keywords: economic return, flared associated gas, net present value, optimization

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28935 One-Class Support Vector Machine for Sentiment Analysis of Movie Review Documents

Authors: Chothmal, Basant Agarwal

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Sentiment analysis means to classify a given review document into positive or negative polar document. Sentiment analysis research has been increased tremendously in recent times due to its large number of applications in the industry and academia. Sentiment analysis models can be used to determine the opinion of the user towards any entity or product. E-commerce companies can use sentiment analysis model to improve their products on the basis of users’ opinion. In this paper, we propose a new One-class Support Vector Machine (One-class SVM) based sentiment analysis model for movie review documents. In the proposed approach, we initially extract features from one class of documents, and further test the given documents with the one-class SVM model if a given new test document lies in the model or it is an outlier. Experimental results show the effectiveness of the proposed sentiment analysis model.

Keywords: feature selection methods, machine learning, NB, one-class SVM, sentiment analysis, support vector machine

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28934 The Role of a Specialized Diet for Management of Fibromyalgia Symptoms: A Systematic Review

Authors: Siddhant Yadav, Rylea Ranum, Hannah Alberts, Abdul Kalaiger, Brent Bauer, Ryan Hurt, Ann Vincent, Loren Toussaint, Sanjeev Nanda

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Background and significance: Fibromyalgia (FM) is a chronic pain disorder also characterized by chronic fatigue, morning stiffness, sleep, and cognitive symptoms, psychological disturbances (anxiety, depression), and is comorbid with multiple medical and psychiatric conditions. It has an incidence of 2-4% in the general population and is reported more commonly in women. Oxidative stress and inflammation are thought to contribute to pain in patients with FM, and the adoption of an antioxidant/anti-inflammatory diet has been suggested as a modality to alleviate symptoms. The aim of this systematic review was to evaluate the efficacy of specialized diets (ketogenic, gluten free, Mediterranean, and low carbohydrate) in improving FM symptoms. Methodology: A comprehensive search of the following databases from inception to July 15th, 2021, was conducted: Ovid MEDLINE and Epub ahead of print, in-process and other non-indexed citations and daily, Ovid Embase, Ovid EBM reviews, Cochrane central register of controlled trials, EBSCO host CINAHL with full text, Elsevier Scopus, website and citation index, web of science emerging sources citation and clinicaltrials.gov. We included randomized controlled trials, non-randomized experimental studies, cross-sectional studies, cohort studies, case series, and case reports in adults with fibromyalgia. The risk of bias was assessed with the Agency for Health Care Research and Quality designed, specific recommended criteria (AHRQ). Results: Thirteen studies were eligible for inclusion. This included a total of 761 participants. Twelve out of the 13 studies reported improvement in widespread body pain, joint stiffness, sleeping pattern, mood, and gastrointestinal symptoms, and one study reported no changes in symptomatology in patients with FM on specialized diets. None of the studies showed the worsening of symptoms associated with a specific diet. Most of the patient population was female, with the mean age at which fibromyalgia was diagnosed being 48.12 years. Improvement in symptoms was reported by the patient's adhering to a gluten-free diet, raw vegan diet, tryptophan- and magnesium-enriched Mediterranean diet, aspartame- and msg- elimination diet, and specifically a Khorasan wheat diet. Risk of bias assessment noted that 6 studies had a low risk of bias (5 clinical trials and 1 case series), four studies had a moderate risk of bias, and 3 had a high risk of bias. In many of the studies, the allocation of treatment (diets) was not adequately concealed, and the researchers did not rule out any potential impact from a concurrent intervention or an unintended exposure that might have biased the results. On the other hand, there was a low risk of attrition bias in all the trials; all were conducted with an intention-to-treat, and the inclusion/exclusion criteria, exposures/interventions, and primary outcomes were valid, reliable, and implemented consistently across all study participants. Concluding statement: Patients with fibromyalgia who followed specialized diets experienced a variable degree of improvement in their widespread body pain. Improvement was also seen in stiffness, fatigue, moods, sleeping patterns, and gastrointestinal symptoms. Additionally, the majority of the patients also reported improvement in overall quality of life.

Keywords: fibromyalgia, specialized diet, vegan, gluten free, Mediterranean, systematic review

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28933 Health Promotion Program on Prevention of Zoonotic Diseases among Aborigines in Peninsular Malaysia

Authors: Siti Fatimah Kader Maideen, Abdul Rashid, Nur Indah Ahmad

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Introduction: Indigenous people have an increased risk of contracting zoonotic infections due to their practices. Similarly, the aborigines in Peninsular Malaysia, the Orang Asli, have a higher risk too. This study aimed to empower the Jahai children on the prevention of zoonotic infections by implementing a health promotion intervention program. Methods: A non-experimental pre and post-test interventional study was conducted among the indigenous primary school children aged between nine and 12 years in Perak, Malaysia. A structured questionnaire was used to assess the pre-and post-knowledge and attitudes towards zoonotic infections and hand hygiene practice. This is followed by three sessions of the health promotion program. Ethical approval was obtained prior to the data collection. Data were analysed using SPSS software. Results: The knowledge on whether diseases can spread from animals to humans, transmission via saliva and faeces, types of organisms that can infect, and signs and symptoms increased significantly between pre and post. Significant improvements were observed in the attitude and practices too. Conclusion: The intervention program demonstrated improvement in the knowledge, attitude, and practice among the children. The continuous program needs to be conducted for a sustainable outcome.

Keywords: health promotion, zoonotic infections, aborigines, knowledge, practice

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28932 A Two-Pronged Truncated Deferred Sampling Plan for Log-Logistic Distribution

Authors: Braimah Joseph Odunayo, Jiju Gillariose

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This paper is aimed at developing a sampling plan that uses information from precedent and successive lots for lot disposition with a pretention that the life-time of a particular product assumes a Log-logistic distribution. A Two-pronged Truncated Deferred Sampling Plan (TTDSP) for Log-logistic distribution is proposed when the testing is truncated at a precise time. The best possible sample sizes are obtained under a given Maximum Allowable Percent Defective (MAPD), Test Suspension Ratios (TSR), and acceptance numbers (c). A formula for calculating the operating characteristics of the proposed plan is also developed. The operating characteristics and mean-ratio values were used to measure the performance of the plan. The findings of the study show that: Log-logistic distribution has a decreasing failure rate; furthermore, as mean-life ratio increase, the failure rate reduces; the sample size increase as the acceptance number, test suspension ratios and maximum allowable percent defective increases. The study concludes that the minimum sample sizes were smaller, which makes the plan a more economical plan to adopt when cost and time of production are costly and the experiment being destructive.

Keywords: consumers risk, mean life, minimum sample size, operating characteristics, producers risk

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28931 Kinematical Analysis of Tai Chi Chuan Players during Gait and Balance Test and Implication in Rehabilitation Exercise

Authors: Bijad Alqahtani, Graham Arnold, Weijie Wang

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Background—Tai Chi Chuan (TCC) is a type of traditional Chinese martial art and is considered a benefiting physical fitness. Advanced techniques of motion analysis have been routinely used in the clinical assessment. However, so far, little research has been done on the biomechanical assessment of TCC players in terms of gait and balance using motion analysis. Objectives—The aim of this study was to investigate whether TCC improves the lower limb conditions and balance ability using the state of the art motion analysis technologies, i.e. motion capture system, electromyography and force platform. Methods—Twenty TCC (9 male, 11 female) with age between (42-77) years old and weight (56.2-119 Kg), and eighteen Non-TCC participants (7 male, 11 female), weight (50-110 Kg) with age (43- 78) years old at the matched age as a control group were recruited in this study. Their gait and balance were collected using Vicon Nexus® to obtain the gait parameters, and kinematic parameters of hip, knee, and ankle joints in three planes of both limbs. Participants stood on force platforms to perform a single leg balance test. Then, they were asked to walk along a 10 m walkway at their comfortable speed. Participants performed 5 trials of single-leg balance for the dominant side. Also, the participants performed 3 trials of four square step balance and 10 trials of walking. From the recorded trials, three good ones were analyzed using the Vicon Plug-in-Gait model to obtain gait parameters, e.g. walking speed, cadence, stride length, and joint parameters, e.g. joint angle, force, moments, etc. Result— The temporal-spatial variables of TCC subjects were compared with the Non-TCC subjects, it was found that there was a significant difference (p < 0.05) between the groups. Moreover, it was observed that participants of TCC have significant differences in ankle, hip, and knee joints’ kinematics in the sagittal, coronal, and transverse planes such as ankle angle (19.90±19.54 deg) for TCC while (15.34±6.50 deg) for Non-TCC, and knee angle (14.96±6.40 deg) for TCC while (17.63±5.79 deg) for Non-TCC in the transverse plane. Also, the result showed that there was a significant difference between groups in the single-leg balance test, e.g. maintaining single leg stance time in the TCC participants showed longer duration (20.85±10.53 s) in compared to Non-TCC people group (13.39±8.78 s). While the result showed that there was no significant difference between groups in the four square step balance. Conclusion—Our result showed that there are significant differences between Tai Chi Chuan and Non-Tai Chi Chuan participants in the various aspects of gait analysis and balance test, as a consequence of these findings some of biomechanical parameters such as joints kinematics, gait parameters and single leg stance balance test, the Tai Chi Chuan could improve the lower limb conditions and could reduce a risk of fall for the elderly with ageing.

Keywords: gait analysis, kinematics, single leg stance, Tai Chi Chuan

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28930 Association Between Hip Internal and External Rotation Range of Motion and Low Back Pain in Table Tennis Players

Authors: Kaili Wang, Botao Zhang, Enming Zhang

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Background: Low back pain (LBP) is a common problem affecting athletes' training and competition. Although the association between a limited hip range of motion and prevalence of low back pain has been studied extensively, it has not been studied in table tennis. Aim: The main purposes of this study in table tennis players were (1) to investigate if there is a difference in hip internal rotation (HIR) and external rotation (HER) range of motion (ROM) between players with LBP and players without LBP and (2) to analyze the association between HIR and HER ROM and LBP. Methods: Forty-six table tennis players from the Chinese table tennis team were evaluated for passive maximum HIR and HER ROM. LBP was retrospectively recorded for the last 12 months before the date of ROM assessment by a physical therapist. The data were analyzed the difference in HIR and HER ROM between players with LBP and players without LBP by Mann-Whitney U test, and the association between the difference in HIR and HER ROM and LBP was analyzed via a binary logistic regression. Results: The 54% of players had developed LBP during the retrospective study period. Significant difference between LBP group and the asymptomatic group for HIR ROM (z=4.007, p<0.001) was observed. Difference between LBP group and asymptomatic group for HER ROM (z=1.117, p=0.264) was not significant. Players who had HIR ROM deficit had an increased risk of LBP compared with players without HIR ROM deficit (OR=5.344, 95%CI: 1.006-28.395, P=0.049). Conclusion: HIR ROM of a table tennis player with LBP was less than a table tennis player without LBP. Compared with player whose HIR ROM was normal, player who had HIR ROM deficit appeared to have a higher risk for LBP.

Keywords: assessment, injury prevention, low back pain, table tennis players

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28929 Breast Cancer Awareness among Female Nurses: Time to Scrub off Assumptions

Authors: Rahy Farooq, Maria Ahmad Khan, Ayesha Isani Majeed

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Objective: The main aim of this research is to assess the knowledge, attitude and practices of female nursing staff and nursing students regarding breast cancer, to provide a baseline for monitoring trends of breast cancer awareness in them. Background: Healthcare professionals are a direct source of information for the patients and the general public as a whole. It is, therefore, essential that the information they convey be accurate and helps in building additional awareness. However, clinical experience does not influence the knowledge, attitude and practices regarding breast cancer. Nurses, being the prime part of the healthcare professionals, play a significant role and hence, their awareness regarding this pressing issue is pertinent. Lack of awareness regarding common presenting symptoms or breast cancer risk factors translates to poor breast cancer screening practices and late diagnosis. Methodology: A cross-sectional study of 280 female nurses was conducted at a tertiary care hospital in Islamabad, Pakistan. A pre-tested structured questionnaire with additional variables like cultural barriers to seeking medical help was used. The scores for outcome variables including knowledge, attitude and practices were pre-defined. Data was analyzed using SPSSv23. Results: Of the 280 participants with a mean age of 28.99±9.98 years, 142 (50.7%) were married, and 138 (49.3%) were unmarried. Mean scores were computed to be 6.14±2.93 (out of 12), 0.30±0.7 (out of 3) and 9.53±1.92 (out of 16) for knowledge, attitude and practice respectively. Using independent sample T-test, a statistically significant correlation was found when means for the score of Attitude was compared with age. With a p-value of 0.018, 117 nurses of age more than 30 years, faced more practical, financial, emotional and service barriers as compared to 163 women younger than 30 years of age. Knowledge of age-related lifetime risks was also significantly poor more in single women; with a p-value of 0.006 for identification of correct age as a risk factor and a p-value of 0.005 for correct identification of risk for development of breast cancer in the lifetime of women. By application of Chi-square test, there was a significant correlation between marital status and cultural barriers to seeking medical help, showing that single women (58.7%) shy away from talking about breast cancer considering it a taboo (p-value 0.028) whereas, more married nurses (59.2%) were apprehensive that they might be considered at fault by the society, as compared to 40.8% of single nurses. (p-value 0.038). Conclusion: Owing to the scarcity of awareness among nurses, this study recognizes the need for delivering effective information to the female nurses regarding breast cancer. Educating patients is likely to be effective if the female nurses play their part and have correct attitudes towards breast cancer practices. A better understanding of the knowledge and practices regarding breast cancer among the nursing population will enable high-risk patients to be recognized early. Therefore, we recommend arrangement of special courses and seminars for all healthcare professionals including the nursing staff.

Keywords: breast cancer, cultural barriers, kap, nurses

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28928 Burnout among Healthcare Workers in Poland during the COVID-19 Pandemic

Authors: Zbigniew Izdebski, Alicja Kozakiewicz, Maciej Białorudzki, Joanna Mazur

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Work is an extremely important part of everyone's life and affects functioning in daily life. Healthcare workers (HCW) are suffering from negative actions in and out of the workplace, such as harassment, abuse, long working hours, mental suffering, exhaustion, and professional burnout. Staff burnout is detrimental not only in terms of individual employees but also to working with patients and to the healthcare institution as a whole. The purpose of this study was to explore the level of professional burnout among HCW working in medical institutions during the COVID-19 pandemic in Poland. The extent to which selected sociodemographic factors and perceived stress increase the risk of professional burnout was assessed. In addition, the frequency of use of professional psychological help and less formal support groups by HCW in relation to the level of professional burnout was presented. The survey was conducted as part of a larger project on the humanization of medicine and clinical communication from February-April 2022. This study used a self-administered online survey (CAWI) technique and PAPI (pen and paper interview) technique. The BAT-12 scale was used to measure burnout, the PSS-4 scale was used to measure stress, and questions formulated by the research team were also used. For the purpose of analysis, the sample was limited to 2196 HCWs who worked on a daily basis with patients during the COVID-19 pandemic. Frequency distributions were analyzed, and multivariate logistic regression was performed. The mean scores (scores) of job burnout as measured by the BAT-12 scale ranged among the professional groups from 2.15(0.69) to 2.30 (0.69) and remained highest for the nurses' group. The groups differed significantly in levels of burnout (chi-sq=17.719; d.f.=8; p<0.023). In the final model, raised stress most likely increased the risk of burnout (OR=3.88; 95%CI <3.13-3.81>; p<0,001). Other significant predictors of burnout included: traumatic work-related experience (OR=1.91, p<0.001), mobbing (OR=1.83, p<0.001), and a higher workload than before the pandemic (OR=1.41, p=0.002). Only 7% of respondents decided to use various forms of psychological support during the pandemic. HCW experiences challenges in dealing with an unpredictable pandemic. Limited preparedness can lead to physical and psychological problems such as high-stress levels, anxiety, fear, helplessness, hopelessness, anger and stigma. The workload can lead to professional burnout, as well as threaten patient safety.

Keywords: burnout, work, healthcare, healthcare worker, stress

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