Search results for: multivariate logistic regression

Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: Evidence exists that pneumonia is a frequently encountered complication after stroke which is associated with a higher rate of mortality and increased long-term disability Purpose: To determine the predictors associated with the risk of one-year disability in acute stroke. Methods: Data for this longitudinal follow-up study were extracted from a tertiary referral medical center’s stroke registry database in Northern Taipei. Eligible patients with acute stroke admitted to the hospital and completed a one-year follow up were recruited for analysis. Favorable outcome was defined as a modified Rankin Scale score ≤ 2. SAS version 9.2 was used for the multivariable regression analyses to examine the factors correlated with the one-year disability in stroke patients. Results: From January 2012 to December 2013, a total of 1373 (mean age: 70.49±15.4 years, 913(66.5%) males) consecutively administered acute stroke patients were recruited. Overall, the rate of one-year disability was 37.20%(404/1086) in those without post-stroke pneumonia. It increased to 82.93 %(238/287) in patients developed post-stroke pneumonia. Factors associated with increased risk of disability were age ≧ 75(OR= 4.845, p<.0001), female /gender (OR=1.568, p =.0062), previous stroke (OR= 1.868, p = <. 0001) ,dementia (OR= 2.872, p =.0047), ventilator use (OR= 4.653, p <. 0001),age ≧ 75 /pneumonia (OR=1.236, p <. 0001) , ICU admission (OR=3.314, p <.0001) , nasogastric tube insertion (OR= 4.28, p <.0001), speech therapy (OR= 1.79, p =.0142), urinary tract infection (OR= 1.865, p =.0018), estimated glomerular filtration rate (eGFR > 60 )(OR= 0.525, p= .0029), Admission NIHSS >11 (OR= 2.101, p = .0099), Length of hospitalization > 30(d) (OR= 5.182, p <.0001). Conclusion: Older age, severe neurological deficit, complications, rehabilitation intervention, length of hospitalization >30(d), and cognitive impairment were significantly associated with Post-stroke functional impairment, especially those with post-stroke pneumonia. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, disability

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Authors: Nguyen Tien Thanh, Günter Meon

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Precipitation plays a key role in water cycle, defining the local climatic conditions and in ecosystem. It is also an important input parameter for water resources management and hydrologic models. With spatial continuous data, a certainty of discharge predictions or other environmental factors is unquestionably better than without. This is, however, not always willingly available to acquire for a small basin, especially for coastal region in Vietnam due to a low network of meteorological stations (30 stations) on long coast of 3260 km2. Furthermore, available gridded precipitation datasets are not fine enough when applying to hydrologic models. Under conditions of global warming, an application of spatial interpolation methods is a crucial for the climate change impact studies to obtain the spatial continuous data. In recent research projects, although some methods can perform better than others do, no methods draw the best results for all cases. The objective of this paper therefore, is to investigate different spatial interpolation methods for daily precipitation over a small basin (approximately 400 km2) located in coastal region, Southern Vietnam and find out the most efficient interpolation method on this catchment. The five different interpolation methods consisting of cressman, ordinary kriging, regression kriging, dual kriging and inverse distance weighting have been applied to identify the best method for the area of study on the spatio-temporal scale (daily, 10 km x 10 km). A 30-year precipitation database was created and merged into available gridded datasets. Finally, observed changes in constructed precipitation were performed. The results demonstrate that the method of ordinary kriging interpolation is an effective approach to analyze the daily precipitation. The mixed trends of increasing and decreasing monthly, seasonal and annual precipitation have documented at significant levels.

Keywords: interpolation, precipitation, trend, vietnam

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Authors: Vitus Onyebuchim Onyemailu, Olive Obianuju Okalibe

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The study tried to examine relationship between exchange rate variations on the balance of payments in Nigeria from 1970 to 2012. Using time series on econometric measures such as Granger causality and ordinary least square (OLS), the study found that exchange rate movements especially the depreciation of naira has not contributed significantly on the balance of payments under the year of the study. The granger result conform the Marshall-Lerner short and long run prepositions that exchange rate devaluation enhances balance of payments. On disaggregation exchange rate granger causes current and capital account balances give the Nigeria data from 1970 to 2012. Overall in the long run OLS regression analysis, exchange rate on semi log functional form, exchange rate variation did not record significant effect on balance of payment equation. This height was also maintained in the current or trade balance which does not match the Marshall-Lerner. The capital account balance in reverse reported a significant impact of exchange rate variability on the capital account balance. Finally, on exchange rate determination equation, where many fundamentals were considered including lagged of exchange rate. Thus, the lagged of exchange rate recorded a positive and significant influence on the present exchange rate. This means that players in the financial markets usually out plays authority’s policy’s stances through their speculative tendencies. The work therefore, recommend that effort should be made by the authorities to providing enabling environment for production of goods and services to triumph in order to take advantages of steady devaluation of its currency. This is done by providing infrastructure, provision of science and technology. Thus, when this is done Nigeria would be able to have competitive power against the rest of the world.

Keywords: exchange rate variation, balance of payments, current account, capital account, Marshall-Lerner hypothesis

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Authors: Jungbin Lim, Bohee Kang, Heelim Lee, Sunjin Kim, GeumHee Choi, Jae-Suk Jung, Suk Ji

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Nonsurgical periodontal therapies have, for several decades, been the basis of periodontal treatment concepts. The aim of this paper is to investigate the effectiveness of non-surgical periodontal therapy according to the severity of periodontitis disease. Methods: Retrospective data of patients who visited Department of periodontics in Ajou University Medical Center from 2016 to 2022 were collected. Among the patients, those who took full mouth examination of clinical parameters and non-surgical periodontal therapy were chosen for this study. Selected patients were divided into initial, moderate, and severe periodontitis based on severity and complexity of management (2018 World Workshop EFP/AAP consensus). Recall visits with clinical periodontal examination were scheduled for 1,2,3 months or 1,3,6 months after the treatment. The results were evaluated by recordings of mean probing pocket depth (mean PD), mean clinical attachment levels (mean CAL), bleeding on probing (BOP%), mean gingival index (mean GI), mean regression, mean sulcus bleeding index (mean SBI), mean plaque scores (mean PI). All statistical analyses were performed with R software, version 4.3.0. A level of significance, P<0.05, was considered to be statistically significant. Results: A total of 92 patients were included in this study. 15 patients were diagnosed as initial periodontitis, 14 moderate periodontitis, and 63 severe periodontitis. The all parameters except for mean recession decreased over time in all groups. The amount of mean PD decreased were the greatest in severe periodontitis group followed by moderate and initial, which was found to be statistically significant. The changes of mean PD were 0.15±0.05 mm, 0.37±0.06 mm, and 1.01±0.07 mm (initial, moderate, and severe, respectively, P<0.001). When comparing before and after treatment, the reductions in BOP(%), mean GI, mean SBI, and mean PI were statistically significant. Conclusion: All patients who received non-surgical periodontal therapy showed periodontal healing in terms of improvements in clinical parameters, and it was greater in the severe group.

Keywords: periodontology, clinical periodontology, oral treatment, comprehensive preventive dentistry, non-surgical periodontal therapy

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Authors: Fatma Abidi, Taoufik Harizi, Slah Msahli, Faouzi Sakli

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Nine different Tunisian handmade carpets were used for the investigation. The raw material of the carpet pile yarns was wool. The influence of the different structure parameters (linear density and pile height) on the carpet compression was investigated. Carpets were tested under dynamic loading in order to evaluate and observe the thickness loss and carpet behavior under dynamic loads. To determine the loss of pile height under dynamic loading, the pile height carpets were measured. The test method was treated according to the Tunisian standard NT 12.165 (corresponds to the standard ISO 2094). The pile height measurements are taken and recorded at intervals up to 1000 impacts (measures of this study were made after 50, 100, 200, 500, and 1000 impacts). The loss of pile height is calculated using the variation between the initial height and those measured after the number of reported impacts. The experimental results were statistically evaluated using Design Expert Analysis of Variance (ANOVA) software. As regards the deformation, results showed that both of the structure parameters of the pile yarn and the pile height have an influence. The carpet with the higher pile and the less linear density of pile yarn showed the worst performance. Results of a polynomial regression analysis are highlighted. There is a good correlation between the loss of pile height and the impacts number of dynamic loads. These equations are in good agreement with measured data. Because the prediction is reasonably accurate for all samples, these equations can also be taken into account when calculating the theoretical loss of pile height for the considered carpet samples. Statistical evaluations of the experimen¬tal data showed that the pile material and number of impacts have a significant effect on mean thickness and thickness loss variations.

Keywords: Tunisian handmade carpet, loss of pile height, dynamic loads, performance

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Authors: Paul Narh Doku

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The relationship between parental HIV/AIDS status or death and child mental health is well known, although the role of child maltreatment as a confounder or mediator in this relationship remains uncertain. This study examined the potential path mechanism through child maltreatment mediating the link between HIV/AIDS family dysfunction trajectories and psychosocial problems. A cross-sectional survey was conducted in the Lower Manya Municipal Assembly of Ghana. A questionnaire which consisted of the Strengths and Difficulties Questionnaire (SDQ), Social and Health Assessment (SAHA), Rosenberg Self-Esteem Scale (RSES), and the Conflict Tactics Scale (CTS) was completed by 291 adolescents. Controlling for relevant sociodemographic confounders, mediation analyses using linear regression were fitted to examine whether the association between family dysfunction and psychosocial problems is mediated by child maltreatment. The results indicate that, among adolescents, child maltreatment fully mediated the association between being orphaned by AIDS and self-esteem, delinquency and risky behaviours, and peer problems. Similarly, child maltreatment fully mediated the association between living with an HIV/AIDS-infected parent and self-esteem, delinquency and risky behaviours, depression/emotional problems, and peer problems. Partial mediation was found for hyperactivity. Child maltreatment mediates the association between the family dysfunction trajectories of parental HIV/AIDS or death and psychosocial problems among adolescents. This implies that efforts to address child maltreatment among families affected by HIV/AIDS may be helpful in the prevention of psychosocial problems among these children, thus enhancing their well-being. The findings, therefore, underscore the need for comprehensive psychosocial interventions that address both the unique negative exposures of HIV/AIDS and maltreatment for children affected by HIV.

Keywords: child maltreatment, child abuse, mental health, psychosocial problems, domestic violence, HIV/AIDS, adolescents

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Authors: Ima Rahmawati, Nur Hafizul Kalam

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Development of industrial and economic sectors in various countries very rapidly caused raising the greenhouse gas (GHG) emissions. Greenhouse gases are dominated by carbon dioxide (CO2) and methane (CH4) in the atmosphere that make the surface temperature of the earth always increase. The increasing gases caused by incomplete combustion of fossil fuels such as petroleum and coals and also high rate of deforestation. Yogyakarta Special Province which every year always become tourist destination, has a great potency in increasing of greenhouse gas emissions mainly from the incomplete combustion. One of effort to reduce the concentration of gases in the atmosphere is keeping and empowering the existing forests in the Province of Yogyakarta, especially forest in Kulonprogro is to be maintained the greenness so that it can absorb and store carbon maximally. Remote sensing technology can be used to determine the ability of forests to absorb carbon and it is connected to the density of vegetation. The purpose of this study is to determine the density of the biomass of forest vegetation and determine the ability of forests to store carbon through Photo-interpretation and Geographic Information System approach. Remote sensing imagery that used in this study is LANDSAT 8 OLI year 2015 recording. LANDSAT 8 OLI imagery has 30 meters spatial resolution for multispectral bands and it can give general overview the condition of the carbon stored from every density of existing vegetation. The method is the transformation of vegetation index combined with allometric calculation of field data then doing regression analysis. The results are model maps of density and capability level of forest vegetation in Kulonprogro, Yogyakarta in storing carbon.

Keywords: remote sensing, carbon, kulonprogo, forest vegetation, vegetation index

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Authors: Yujiang Wu

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As electrical machine (e-machine) power density re-querulents become more stringent in vehicle electrification, mounting a temperature sensor for e-machine stator windings becomes increasingly difficult. This can lead to higher manufacturing costs, complicated harnesses, and reduced reliability. In this paper, we propose a deep-learning method for predicting electric machine winding temperature, which can either replace the sensor entirely or serve as a backup to the existing sensor. We compare the performance of our method, the stateful long short-term memory networks (LSTM) with truncated backpropagation through time (TBTT), with that of linear regression, as well as stateless LSTM with/without residual connection. Our results demonstrate the strength of combining stateful LSTM and TBTT in tackling nonlinear time series prediction problems with long sequence lengths. Additionally, in industrial applications, high-temperature region prediction accuracy is more important because winding temperature sensing is typically used for derating machine power when the temperature is high. To evaluate the performance of our algorithm, we developed a temperature-stratified MSE. We propose a simple but effective data preprocessing trick to improve the high-temperature region prediction accuracy. Our experimental results demonstrate the effectiveness of our proposed method in accurately predicting winding temperature, particularly in high-temperature regions, while also reducing manufacturing costs and improving reliability.

Keywords: deep learning, electrical machine, functional safety, long short-term memory networks (LSTM), thermal management, time series prediction

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Authors: Masoud Ghaemi, Mohammadjafar Hedayati, Faezeh Yousefzadeh, Hoseinali Heydarzadeh

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Careful monitoring in the earth dams to measure deformation caused by settlement and movement has always been a concern for engineers in the field. In order to measure settlement and deformation of earth dams, usually, the precision instruments of settlement set and combined Inclinometer that is commonly referred to IS instrument will be used. In some dams, because the thickness of alluvium is high and there is no possibility of alluvium removal (technically and economically and in terms of performance), there is no possibility of placing the end of IS instrument (precision instruments of Inclinometer-settlement set) in the rock foundation. Inevitably, have to accept installing pipes in the weak and deformable alluvial foundation that leads to errors in the calculation of the actual settlement (absolute settlement) in different parts of the dam body. The purpose of this paper is to present new and refine criteria for predicting settlement and deformation in earth dams. The study is based on conditions in three dams with a deformation quite alluvial (Agh Chai, Narmashir and Gilan-e Gharb) to provide settlement criteria affected by the alluvial foundation. To achieve this goal, the settlement of dams was simulated by using the finite difference method with FLAC3D software, and then the modeling results were compared with the reading IS instrument. In the end, the caliber of the model and validate the results, by using regression analysis techniques and scrutinized modeling parameters with real situations and then by using MATLAB software and CURVE FITTING toolbox, new criteria for the settlement based on elasticity modulus, cohesion, friction angle, the density of earth dam and the alluvial foundation was obtained. The results of these studies show that, by using the new criteria measures, the amount of settlement and deformation for the dams with alluvial foundation can be corrected after instrument readings, and the error rate in reading IS instrument can be greatly reduced.

Keywords: earth-fill dam, foundation, settlement, finite difference, MATLAB, curve fitting

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Authors: Maliheh Raji, Hossein Abolghasemi, Jaber Safdari, Ali Kargari

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Samarium as a rare-earth element is playing a growing important role in high technology. Traditional methods for extraction of rare earth metals such as ion exchange and solvent extraction have disadvantages of high investment and high energy consumption. Emulsion liquid membrane (ELM) as an improved solvent extraction technique is an effective transport method for separation of various compounds from aqueous solutions. In this work, the extraction of samarium from aqueous solutions by ELM was investigated using response surface methodology (RSM). The organic membrane phase of the ELM was a nanofluid consisted of multiwalled carbon nanotubes (MWCNT), Span80 as surfactant, Cyanex 272 as mobile carrier, and kerosene as base fluid. 1 M nitric acid solution was used as internal aqueous phase. The effects of the important process parameters on samarium extraction were investigated, and the values of these parameters were optimized using the Central Composition Design (CCD) of RSM. These parameters were the concentration of MWCNT in nanofluid, the carrier concentration, and the volume ratio of organic membrane phase to internal phase (Roi). The three-dimensional (3D) response surfaces of samarium extraction efficiency were obtained to visualize the individual and interactive effects of the process variables. A regression model for % extraction was developed, and its adequacy was evaluated. The result shows that % extraction improves by using MWCNT nanofluid in organic membrane phase and extraction efficiency of 98.92% can be achieved under the optimum conditions. In addition, demulsification was successfully performed and the recycled membrane phase was proved to be effective in the optimum condition.

Keywords: Cyanex 272, emulsion liquid membrane, MWCNT nanofluid, response surface methology, Samarium

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Authors: Ebenezer Amoquandoh, Daniel Bruce Sarpong, Godfred K. Ofosu-Budu, Andreas Fliessbach

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Soil quality is at stake globally, but under tropical conditions, the loss of soil fertility may be existential. The current rates of soil nutrient depletion, erosion and environmental degradation in most of Africa’s farmland urgently require methods for soil fertility restoration through affordable agricultural management techniques. The study assessed the effects of locally available organic resources to improve soil fertility, crop yield and profitability compared to business as usual on farms in the Eastern and Greater Accra regions of Ghana. Apart from this, we analyzed the change of farmers’ perceptions and knowledge upon the experience with the new techniques; the effect of using locally available organic resource on farmers’ yield and determined the factors influencing the profitability of farming. Using the Difference in Mean Score and Proportion to estimate the extent to which farmers’ perceptions, knowledge and practices have changed, the study showed that farmers’ perception, knowledge and practice on the use of locally available organic resources have changed significantly. This paves way for the sustainable use of locally available organic resource for soil fertility improvement. The Propensity Score Matching technique and Endogenous Switching Regression model used showed that using locally available organic resources have the potential to increase crop yield. It was also observed that using the Profit Margin, Net Farm Income and Return on Investment analysis, it is more profitable to use locally available organic resources than other soil fertility amendments techniques studied. The results further showed that socioeconomic, farm characteristics and institutional factors are significant in influencing farmers’ decision to use locally available organic resources and profitability.

Keywords: soil fertility, locally available organic resources, perception, profitability, sustainability

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Authors: Chethika Gunasiri Wadumestrige Dona, Geetha Mohan, Kensuke Fukushi

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Solid waste in urban areas, especially from organic materials like garden waste, food, and degradable sources, can create health and environmental problems if not managed properly. Urban agriculture has emerged as a potential solution in developing countries to mitigate these issues. It offers the possibility of low-carbon economies and knowledge and innovation dissemination. Domestic composting is a significant aspect of urban agriculture, and its success relies on the attitudes of those who practice it. This study examines the perspectives of 402 urban farmers in the Colombo District, Sri Lanka, regarding domestic compost production. It aims to identify the factors that influence these perspectives. The research found that urban farmers are willing to participate in domestic composting because they believe that it facilitates effective recycling of organic waste within their households. The study used an ordinal regression model to determine the factors that shape farmers' perspectives. Age, family size, and crop preferences are significant determinants of the adoption of domestic composting practices among urban farmers in the Colombo District. These findings highlight the importance of understanding and addressing farmers' attitudes in designing effective waste management strategies. In addition, the study also emphasizes the need for tailored interventions that align with farmers' beliefs and preferences to enhance the adoption and implementation of domestic composting practices in urban areas. The insights gained from this study contribute to the academic discourse and offer practical guidance for policymakers and urban planners seeking to promote sustainable waste management practices and support the adoption of urban agriculture in the broader context of urban development.

Keywords: urban agriculture, domestic composting, farmers` perspectives, sustainable urban development

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Authors: Ju-Chun Chien

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The Ottawa Charter for Health Promotion proposed that the role of health services should shift the focus from cure to prevention. Nowadays, besides having physical examinations, people could also conduct genetic tests to provide important information for diagnosing, treating, and/or preventing illnesses. However, because of the incompletion of the Chinese Genetic Database, people in Taiwan were still unfamiliar with genetic testing. The purposes of the present study were to: (1) Figure out people’s attitudes towards genetic testing. (2) Examine factors that influence people’s intention to pursue genetic testing by means of the Health Belief Model (HBM). A pilot study was conducted on 249 Taiwanese in 2017 to test the feasibility of the self-developed instrument. The reliability and construct validity of scores on the self-developed questionnaire revealed that this HBM-based questionnaire with 40 items was a well-developed instrument. A total of 542 participants were recruited and the valid participants were 535 (99%) between the ages of 20 and 86. Descriptive statistics, one-way ANOVA, two-way contingency table analysis, Pearson’s correlation, and stepwise multiple regression analysis were used in this study. The main results were that only 32 participants (6%) had already undergone genetic testing; moreover, their attitude towards genetic testing was more positive than those who did not have the experience. Compared with people who never underwent genetic tests, those who had gone for genetic testing had higher self-efficacy, greater intention to pursue genetic testing, had academic majors in health-related fields, had chronic and genetic diseases, possessed Catastrophic Illness Cards, and all of them had heard about genetic testing. The variables that best predicted people’s intention to pursue genetic testing were cues to action, self-efficacy, and perceived benefits (the three variables all correlated with one another positively at high magnitudes). To sum up, the HBM could be effective in designing and identifying the needs and priorities of the target population to pursue genetic testing.

Keywords: genetic testing, knowledge of GT, people in Taiwan, the health belief model

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Authors: Raya Kathreen T. Fuentes, Christian Owen P. Domingo, Kaisha V. Durana, Kristine Chelsea Shynne M. Evangelista, Nicole A. Feliciano, Kathleen Patricia Q. Ferido, Christianna Joy J. Ferrer

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Diabetes Mellitus (DM) is a global public health concern. The foot ulcer is one of the most serious and costly complications of DM. Among the components of diabetes self-management (DSM), foot self-care was found to be one of the best preventive measures for foot ulcers yet is seldom performed. Thus, the purpose of this study is to determine how adequate foot self-care practices (FSP) are among Filipino adults with DM with the following objectives: 1) determine their DSM, 2) describe their FSP, 3) determine the relationship between FSP and DSM, and 4) determine the relationship of FSP to sociodemographic characteristics, disease-related characteristics, social support, and knowledge. A descriptive correlational design was utilized. 114 respondents aged 19-65 were selected through purposive sampling from diabetes clinics. A self-administered questionnaire regarding FSP, DSM, sociodemographic and disease-related characteristics, social support, and knowledge on diabetes were used. Pearson's correlation was utilized to determine the relationship between FSP and DSM while simple linear regression was used to determine the relationship of FSP to the factors aforementioned. Results showed that majority of the respondents have desirable DSM but inadequate FSP. FSP and DSM were shown to be positively correlated but not statistically significant (p = 0.8). Disparity among the two suggests that there is less emphasis on foot self-care compared to other components of DSM. Findings further revealed that patients diagnosed with DM for < 5 years demonstrated more adequate FSP compared to patients diagnosed for > 5 years which may suggest that newly diagnosed patients are more receptive to new information about DSM. Health education on DSM should place more emphasis on FSP. Reiteration of health education and continuous motivation should be done to all DM patients, not just to newly diagnosed patients, to improve compliance to FSP and enhance patient empowerment regarding self-care.

Keywords: diabetes mellitus, diabetes self-management, foot self-care practices, foot ulcer

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Authors: Cornelius Arome Omatola, Ropo Ebenezer Ogunsakin, Anyebe Bernard Onoja, Martin-Luther Oseni Okolo, Joseph Abraham-Oyiguh, Kehinde Charles Mofolorunso, Phoebe Queen Akoh, Omebije Patience Adejo, Joshua Idakwo, Therisa Ojomideju Okeme, Danjuma Muhammed, David Moses Adaji, Sunday Ocholi Samson, Ruth Aminu, Monday Eneojo Akor

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Gastroenteritis viruses are the leading etiologic agents of diarrhea in children worldwide. We present data from thirty-three (33) eligible studies published between 2003 and 2023 from African countries bearing the brunt of the virus-associated diarrheal mortality. Random effects meta-analysis with proportion, subgroups, and meta-regression analyses were employed. Overall, rotavirus with estimated pooled prevalence of 31.0% (95% CI 24.0–39.0) predominated in all primary care visits and hospitalizations, followed by norovirus, adenovirus, sapovirus, astrovirus, and aichivirus with pooled prevalence estimated at 15.0% (95% CI 12.0–20.0), 10% (95% CI 6-15), 4.0% (95% CI 2.0–6.0), 4% (95% CI 3-6), and 2.3% (95% CI 1-3), respectively. Predominant rotavirus genotype was G1P[8] (38%), followed by G3P[8] (11.7%), G9P[8] (8.7%), and G2P[4] (7.1%); although, unusual genotypes were also observed, including G3P[6] (2.7%), G8P[6] (1.7%), G1P[6] (1.5%), G10P[8] (0.9%), G8P[4] (0.5%), and G4P[8] (0.4%). The genogroup II norovirus predominated over the genogroup I-associated infections (84.6%, 613/725 vs 14.9%, 108/725), with the GII.4 (79.3%) being the most prevalent circulating genotype. In conclusion, this review showed that rotavirus remains the leading driver of viral diarrhea requiring health care visits and hospitalization among under-five years children in Africa. Thus, improved rotavirus vaccination in the region and surveillance to determine the residual burden of rotavirus and the evolving trend of other enteric viruses are needed for effective control and management of cases.

Keywords: enteric viruses, rotavirus, norovirus, adenovirus, astrovirus, gastroenteritis

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Authors: Protus A. Lumiti, Susan O. Wekesa, Mary Omondi

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Performance is a key pillar to the accomplishment of the goals of all organizations, whether private, public or non- profit. Employees are the intellectual assets of the organization and they are an avenue to the achievement of competitive advantage. An employee welfare service in an organization is vital in fostering employee motivation and improving their productivity. In view of this, the main goal of this research was to determine the relationship between employee welfare practices and the performance of non-governmental organizations in Kenya. The study was guided by four objectives, namely: to establish, determine, evaluate and assess the relationship between employee welfare practices and the performance of non-governmental organizations in Kenya. The study utilized a survey design using both qualitative and quantitative approaches. In this study, a purposive, stratified and simple random sampling technique was used to arrive at a sample of 355 respondents who comprised senior managers, middle level managers and operational employees out of the targeted population of 14,283 employees of non-governmental organizations working in Nairobi County. The primary data collection tools were questionnaires supplemented by an interview schedule, while secondary data was obtained from reviewed journals, published books and articles. Data analysis was done using Statistical Packages for Social Sciences Software version 23. The study utilized multiple linear regression and a structural equation model. The findings of the study were that: employee welfare practices had a positive and significant relationship with the performance of Non-governmental organizations in Kenya. In addition, there was also a linear relationship between the independent variables and the dependent variable and the study concluded that there was a relationship between the predictor variable and the dependent variable of the study. The study recommended that management of No-governmental organization boards in Kenya should come up with a comprehensive policy document on employee welfare practices in order to enhance the performance of non-governmental organizations in Kenya.

Keywords: employee, economic, performance, welfare

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Authors: Tew Leh Ghee

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The study's goal is to determine how celebrity endorsement affects Malaysian consumers' attitudes and intentions to buy skincare products. Since customers now largely rely on celebrity endorsement to influence purchasing decisions in almost every business, celebrity endorsement is not, in reality, a new phenomenon. Even though the market for skincare products has a vast potential to be exploited, corporations have yet to seize this niche via celebrity endorsement. Basically, there hasn't been much study done to recognize the significance of celebrity endorsement in this industry. This research combined descriptive and quantitative methods with a self-administered survey as the primary data-gathering tool. All of the characteristics under study were measured using a 5-point Likert scale, and the questionnaire was written in English. A convenience sample method was used to choose respondents, and 360 sets of valid questionnaires were gathered for the study's statistical analysis. Preliminary statistical analyses were analyzed using SPSS version 20.0 (Statistical Package for the Social Sciences). The backdrop of the respondents' demographics was examined using descriptive analysis. All concept assessments' validity and reliability were examined using exploratory factor analysis, item-total statistics, and reliability statistics. Pearson correlation and regression analysis were used, respectively, to assess relationships and impacts between the variables under study. The research showed that, apart from competence, celebrity endorsements of skincare products in Malaysia had a favorable impact on attitudes and purchase intentions as evaluated by attractiveness and dependability. The research indicated that the most significant element influencing attitude and buy intention was the credibility of a celebrity endorsement. The study offered implications in order to provide potential improvements of celebrity endorsement in skincare goods in Malaysia. The study's last portion includes its limits and ideas for the future.

Keywords: trustworthiness, influential, phenomenon, celebrity emdorsement

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Authors: Khader A. Almhdawi, Saddam F. Kanaan

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Background: Allied health (AH) students, including rehabilitation sciences students, are subjected to significant levels of physical and mental stressors, which could affect their education. This study aimed to study physical and mental of Health-related Quality of Life (HR-QoL) levels along with their predictors among students of nine AH majors. Methods: Students filled validated anonymous surveys covering demographics and life style, Nordic Musculoskeletal Questionnaire, 12-item Short-Form Health Survey (SF-12), and Depression Anxiety Stress Scale (DASS- 42). SF-12 Mental (MCS) and Physical (PCS) summary scores were compared between academic majors and gender. Multiple linear regression models were conducted to examine potential predictors of PCS and MCS scores. Results: 838 students (77.4% females) participated in this study. Participants’ PCS mean score was 45.64±7.93 and found statistically different between the nine academic majors (P < 0.001). Additionally, participants’’ MCS mean score was 39.45±10.86 and significantly greater in males (P < 0.001). Significant PCS scores predictors included hip and upper back musculoskeletal pain, anxiety score, diet self-evaluation, and GPA. Finally, MCS scores were statistically associated with neck musculoskeletal pain, stress score, depression score, number of weekly clinical training hours, gender, university year, GPA, sleep quality self-evaluation, and diet self-evaluation. Conclusion: Clinical educators of AH need to account for students’ low levels of HR-QoL and their academic-related, health-related, and lifestyle-related associated factors. More studies are recommended to investigate the progression of HR-QoL throughout university years and to create effective interventions to improve HR-QoL among healthcare students.

Keywords: medical education, quality of life, stress, anxiety, depression

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Authors: Teresita Lopez Joy, Jose A. Acevedo Suarez, Martha I. Gomez Acosta, Ana Julia Acevedo Urquiaga

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Current trends in business competitiveness indicate the need to manage businesses as supply chains and not in isolation. The use of strategies aimed at maximum satisfaction of customers in a network and based on inter-company cooperation; contribute to obtaining successful joint results. In the Cuban economic context, the development of productive linkages to achieve integrated management of supply chains is considering a key aspect. In order to achieve this jump, it is necessary to develop acting capabilities in the entities that make up the chains through a systematic procedure that allows arriving at a management model in consonance with the environment. The objective of the research focuses on: designing a model and procedure for the development of integrated management of supply chains in economic entities. The results obtained are: the Model and the Procedure for the Development of the Supply Chains Integrated Management (MP-SCIM). The Model is based on the development of logistics in the network actors, the joint work between companies, collaborative planning and the monitoring of a main indicator according to the end customers. The application Procedure starts from the well-founded need for development in a supply chain and focuses on training entrepreneurs as doers. The characterization and diagnosis is done to later define the design of the network and the relationships between the companies. It takes into account the feedback as a method of updating the conditions and way to focus the objectives according to the final customers. The MP-SCIM is the result of systematic work with a supply chain approach in companies that have consolidated as coordinators of their network. The cases of the edible oil chain and explosives for construction sector reflect results of more remarkable advances since they have applied this approach for more than 5 years and maintain it as a general strategy of successful development. The edible oil trading company experienced a jump in sales. In 2006, the company started the analysis in order to define the supply chain, apply diagnosis techniques, define problems and implement solutions. The involvement of the management and the progressive formation of performance capacities in the personnel allowed the application of tools according to the context. The company that coordinates the explosives chain for construction sector shows adequate training with independence and opportunity in the face of different situations and variations of their business environment. The appropriation of tools and techniques for the analysis and implementation of proposals is a characteristic feature of this case. The coordinating entity applies integrated supply chain management to its decisions based on the timely training of the necessary action capabilities for each situation. Other cases of study and application that validate these tools are also detailed in this paper, and they highlight the results of generalization in the quantitative and qualitative improvement according to the final clients. These cases are: teaching literature in universities, agricultural products of local scope and medicine supply chains.

Keywords: integrated management, logistic system, supply chain management, tactical-operative planning

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Authors: John Akpesiri Olotewo

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One of the controversies in existing marketing literatures is on how to retain existing and new customers to have repurchase intention in the long-run; however, empirical answer to this question is scanty in existing studies. Thus, this study investigates the moderating effect of consumer loyalty on long-run repurchase intentions in telecommunication industry using Lagos State environs. The study adopted field survey research design using questionnaire to elicit responses from 250 respondents who were selected using random and stratified random sampling techniques from the telecommunication industry in Lagos State, Nigeria. The internal consistency of the research instrument was verified using the Cronbach’s alpha, the result of 0.89 implies the acceptability of the internal consistency of the survey instrument. The test of the research hypotheses were analyzed using Pearson Product Method of Correlation (PPMC), simple regression analysis and inferential statistics with the aid of Statistical Package for Social Science version 20.0 (SPSS). The study confirmed that customer satisfaction has a significant relationship with customer loyalty in the telecommunication industry; also Service quality has a significant relationship with customer loyalty to a brand; loyalty programs have a significant relationship with customer loyalty to a network operator in Nigeria and Customer loyalty has a significant effect on the long run repurchase intentions of the customer. The study concluded that one of the determinants of long term profitability of a business entity is the long run repurchase intentions of its customers which hinges on the level of brand loyalty of the customer. Thus, it was recommended that service providers in Nigeria should improve on factors like customer satisfaction, service quality, and loyalty programs in order to increase the loyalty of their customer to their brands thereby increasing their repurchase intentions.

Keywords: customer loyalty, long run repurchase intentions, brands, service quality and customer satisfaction

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Authors: Mohamed H. Khalifa, Fikry I. El-Shahawi, Nabil A. Mansour

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The cotton leafworm, Spodoptera littoralis (Boisduval) is a major insect pest of vegetables and cotton crops in Egypt, and exhibits different levels of tolerance to certain insecticides. Chlorantraniliprole has been registered recently in Egypt for control this insect. The susceptibilities of three S. littoralis populations collected from El Behaira governorate, north Egypt to chlorantraniliprole were determined by leaf-dipping technique on 4^th instar larvae. Obvious variation of toxicity was observed among the laboratory susceptible, and three field populations with LC₅₀ values ranged between 1.53 µg/ml and 6.22 µg/ml. However, all the three field populations were less susceptible to chlorantraniliprole than a laboratory susceptible population. The most tolerant populations were sampled from El Delengat (ED) Province where S. littoralis had been frequently challenged by insecticides. Certain enzyme activity assays were carried out to be correlated with the mechanism of the observed field population tolerance. All field populations showed significantly enhanced activities of detoxification enzymes compared with the susceptible strain. The regression analysis between chlorantraniliprole toxicities and enzyme activities revealed that the highest correlation is between α-esterase or β-esterase (α-β-EST) activity and collected field strains susceptibility, otherwise this correlation is not significant (P > 0.05). Synergism assays showed the ED and susceptible strains could be synergized by known detoxification inhibitors such as piperonyl butoxide (PBO), triphenyl phosphate (TPP) and diethyl-maleate (DEM) at different levels (1.01-8.76-fold and 1.09-2.94 fold, respectively), TPP showed the maximum synergism in both strains. The results show that there is a correlation between the enzyme activity and tolerance, and carboxylic-esterase (Car-EST) is likely the main detoxification mechanism responsible for tolerance of S. littoralis to chlorantraniliprole.

Keywords: chlorantraniliprole, detoxification enzymes, Egypt, Spodoptera littoralis

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Authors: Elham Fathi, Seyed Mohammad Kalantarkousheh, Abolfazl Hatami Varzane

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The present study aimed to determine predict capacity of the relationship among attachment styles, humor styles and communication patterns in female married students. Statistical population consisted of female married students from Allameh Tabataba’i University. The research sample consisted of 104 married students selected through convenience sampling. They responded to study instruments that consisted of attachment styles, humor styles and Communication patterns questionnaires. Data was analyzed by means of correlation method. The results indicated significant positive relationship between secure attachment styles with adaptive humor styles, and anxious attachment styles with maladaptive humor styles. Also a negative relationship between avoidant attachment with affiliative humor, and anxious attachment with self-enhancing humor was found. Furthermore, a negative relationship between self- enhancing humor styles with demand – withdraw communication pattern, and between affiliative humor with mutual avoidant communication pattern and a positive relationship between affiliative humor with mutual constructive communication pattern was observed. The relationship between secure attachment with mutual constructive communication pattern was positive, while relationship between avoidant attachment to mutual constructive communication pattern was negative and significant and its relation with mutual avoidant communication pattern was significantly positive. The result of regression analysis indicated that affliative humor style and secure attachment style, positively predicted mutual constructive communication pattern. Avoidant attachment style positively and affliative humor style negatively predicted the mutual avoidant communication pattern. And self-enhancing humor style negatively predicted the demand – withdraw communication pattern style.

Keywords: attachment styles, communication patterns, humor styles, female married students

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Authors: Hsi-Chuan Wang, Hongxi Yin

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Compactness has been proposed as a type of sustainable urban form globally. However, the meanings and the measurements might diverse in regarding to the varying interpretation; moreover, since compactness was proposed to eliminate auto culture and urban sprawl in the developed countries, voices have emerged asking to rethink the suitability of compactness in the developing countries – based upon such understanding, Quality of Life (QOL) has been suggested as a good way to show the overall benefit of compactness. In regarding to such background, two subjects were targeted for discussion in this paper: (I) the meaning and feasibility of compactness between the developing and developed countries, and (II) the interaction between compactness and QOL. This paper argues that compactness should not be considered a universal principle for cities of all kind, but rather an ideal concept for urban designer and planner to consider throughout local practices. It firstly reviewed the benefits of both compactness and sprawl to uncover the features behind these urban forms, and later addressed the meaning and difficulty of adopting compactness in both the developing and developed countries. Secondly, arguing compactness to be positioned as a ‘process’ along the transition from the developing countries to the developed ones, this paper applied both cross-sectional and longitudinal analysis to uncover (I) the relationship between compactness and QOL in regarding to 30 American cities and (II) the impact of ‘becoming compact’ on QOL in regarding to 8 identified American Urbanized Areas (UZAs). The findings indicated that higher compactness could link to lower QOL among the compact cities, but with higher QOL among the sprawl cities. In addition, based upon the comparison between 2000 and 2010 on 8 UZAs, their QOL have escalated during the transition from the sprawl areas into the compact ones, but the extent of improvement in QOL could differ greatly among areas. In regarding to our findings, compact development should be proposed as a general guideline leading the contemporary sprawl cities in transition with sustainable urbanism; however, to prevent the externalities from damaging QOL with over-compactness, the compact policy should be flexible to adjust a long-term roadmap for sustainable development.

Keywords: compactness, quality of life, sprawl, sustainable urbanism

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Authors: Natalia Feruleva

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The goal of this paper is to develop the fraud risk assessment model basing on both relational and financial data and test the impact of the relationships between Russian non-public companies on the likelihood of financial fraud commitment. Relationships mean various linkages between companies such as parent-subsidiary relationship and person-related relationships. These linkages may provide additional opportunities for committing fraud. Person-related relationships appear when firms share a director, or the director owns another firm. The number of companies belongs to CEO and managed by CEO, the number of subsidiaries was calculated to measure the relationships. Moreover, the dummy variable describing the existence of parent company was also included in model. Control variables such as financial leverage and return on assets were also implemented because they describe the motivating factors of fraud. To check the hypotheses about the influence of the chosen parameters on the likelihood of financial fraud, information about person-related relationships between companies, existence of parent company and subsidiaries, profitability and the level of debt was collected. The resulting sample consists of 160 Russian non-public firms. The sample includes 80 fraudsters and 80 non-fraudsters operating in 2006-2017. The dependent variable is dichotomous, and it takes the value 1 if the firm is engaged in financial crime, otherwise 0. Employing probit model, it was revealed that the number of companies which belong to CEO of the firm or managed by CEO has significant impact on the likelihood of financial fraud. The results obtained indicate that the more companies are affiliated with the CEO, the higher the likelihood that the company will be involved in financial crime. The forecast accuracy of the model is about is 80%. Thus, the model basing on both relational and financial data gives high level of forecast accuracy.

Keywords: financial fraud, fraud prediction, non-public companies, regression analysis, relational data

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Authors: Tayib Bromand, Keisuke Sato

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This paper presents the introduction to current water balance and climate change assessment in the Kabul river basin. The historical and future impacts of climate change on different components of water resources and hydrology in the Kabul river basin. The eastern part of Afghanistan, the Kabul river basin was chosen due to rapid population growth and land degradation to quantify the potential influence of Gobal Climate Change on its hydrodynamic characteristics. Luck of observed meteorological data was the main limitation of present research, few existed precipitation stations in the plain area of Kabul basin selected to compare with TRMM precipitation records, the result has been evaluated satisfactory based on regression and normal ratio methods. So the TRMM daily precipitation and NCEP temperature data set applied in the SWAT model to evaluate water balance for 2008 to 2012. Middle of the twenty – first century (2064) selected as the target period to assess impacts of climate change on hydrology aspects in the Kabul river basin. For this purpose three emission scenarios, A2, A1B and B1 and four GCMs, such as MIROC 3.2 (Med), CGCM 3.1 (T47), GFDL-CM2.0 and CNRM-CM3 have been selected, to estimate the future initial conditions of the proposed model. The outputs of the model compared and calibrated based on (R2) satisfactory. The assessed hydrodynamic characteristics and precipitation pattern. The results show that there will be significant impacts on precipitation patter such as decreasing of snowfall in the mountainous area of the basin in the Winter season due to increasing of 2.9°C mean annual temperature and land degradation due to deforestation.

Keywords: climate change, emission scenarios, hydrological components, Kabul river basin, SWAT model

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Authors: Olatunde Sunday Eludoyin, Charles Obiechina Olisa

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The study examined the spatial interactions between earthworm abundance (EA) and tree growth characteristics in ecological belts of Western Niger Delta, Nigeria. Eight 20m x 20m quadrat were delimited in the natural vegetation in each of the rainforest (RF), mangrove (M), fresh water swamp (FWS), and guinea savanna (GS) ecological belts to gather data about the tree species (TS) characteristics which included individual number of tree species (IN), diversity (Di), density (De) and richness (Ri). Three quadrats of 1m x 1m were delineated in each of the 20m x 20m quadrats to collect earthworm species the topsoil (0-15cm), and subsoil (15-30cm) and were taken to laboratory for further analysis. Descriptive statistics and inferential statistics were used for data analysis. Findings showed that a total of 19 earthworm species was found, with 58.5% individual species recorded in the topsoil and 41.5% recorded in the subsoil. The total population ofEudriliuseugeniae was predominantly highest in both topsoil (38.4%) and subsoil (27.1%). The total population of individual species of earthworm was least in GS in the topsoil (11.9%) and subsoil (8.4%). A total of 40 different species of TS was recorded, of which 55.5% were recorded in FWS, while RF was significantly highest in the species diversity(0.5971). Regression analysis revealed that Ri, IN, DBH, Di, and De of trees explained 65.9% of the variability of EA in the topsoil, while 46.9 % of the variability of earthworm abundance was explained by the floristic parameters in the subsoil.Similarly, correlation statistics revealed that in the topsoil, EA is positively and significantly correlated with Ri (r=0.35; p<0.05), IN (r=0.523; p<0.05) and De (r=0.469; p<0.05) while DBH was negatively and significantly correlated with earthworm abundance (r=-0.437; p<0.05). In the subsoil, only Ri and DBH correlated significantly with EA. The study concluded that EA in the study locations was highly influenced by tree growth species especially Ri, IN, DBH, Di, and De. The study recommended that the TSabundance should be improved in the study locations to ensure the survival of earthworms for ecosystem functions.

Keywords: interactions, earthworm abundance, tree growth, ecological zones, western niger delta

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Authors: Isaac Kofi Mensah

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The manual system of voting has been the most widely used system of electing representatives around the globe, particularly in Africa. Due to the known numerous problems and challenges associated with the manual system of voting, many countries are migrating to the electronic voting system as a suitable and credible means of electing representatives over the manual paper-based system. This research paper therefore investigated the factors influencing adoption and use of an electronic voting system in Ghana. A total of 400 Questionnaire Instruments (QI) were administered to potential respondents in Ghana, of which 387 responded representing a response rate of 96.75%. The Technology Acceptance Model was used as the theoretical framework for the study. The research model was tested using a simple linear regression analysis with SPSS. A little of over 71.1% of the respondents recommended the Electoral Commission (EC) of Ghana to adopt an electronic voting system in the conduct of public elections in Ghana. The results indicated that all the six predictors such as perceived usefulness (PU), perceived ease of use (PEOU), perceived free and fair elections (PFFF), perceived credible elections (PCE), perceived system integrity (PSI) and citizens trust in the election management body (CTEM) were all positively significant in predicting the readiness of citizens to adopt and use an electronic voting system in Ghana. However, jointly, the hypotheses tested revealed that apart from Perceived Free and Fair Elections and Perceived Credible and Transparent Elections, all the other factors such as PU, Perceived System Integrity and Security and Citizen Trust in the Election Management Body were found to be significant predictors of the Willingness of Ghanaians to use an electronic voting system. All the six factors considered in this study jointly account for about 53.1% of the reasons determining the readiness to adopt and use an electronic voting system in Ghana. The implications of this research finding on elections in Ghana are discussed.

Keywords: credible elections, Election Management Body (EMB), electronic voting, Ghana, Technology Acceptance Model (TAM)

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Authors: Mazwane S., Makhura M. N., Ginege A.

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Digitalization in South Africa has received considerable attention from policymakers. The support for the development of the digital economy by the South African government has been demonstrated through the enactment of various national policies and strategies. This study sought to develop an index for agricultural digitalization by applying composite confirmatory analysis (CCA). Another aim was to determine the factors that affect the development of digitalization in PLAS farms. Data on the indicators of the three dimensions of digitalization were collected from 300 Proactive Land Acquisition Strategy (PLAS) farms in South Africa using semi-structured questionnaires. Confirmatory composite analysis (CCA) was employed to reduce the items into three digitalization dimensions and ultimately to a digitalization index. Standardized digitalization index scores were extracted and fitted to a linear regression model to determine the factors affecting digitalization development. The results revealed that the model shows practical validity and can be used to measure digitalization development as measures of fit (geodesic distance, standardized root mean square residual, and squared Euclidean distance) were all below their respective 95%quantiles of bootstrap discrepancies (HI95 values). Therefore, digitalization is an emergent variable that can be measured using CCA. The average level of digitalization in PLAS farms was 0.2 and varied significantly across provinces. The factors that significantly influence digitalization development in PLAS land reform farms were age, gender, farm type, network type, and cellular data type. This should enable researchers and policymakers to understand the level of digitalization and patterns of development, as well as correctly attribute digitalization development to the contributing factors.

Keywords: agriculture, digitalization, confirmatory composite model, land reform, proactive land acquisition strategy, South Africa

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Authors: Mahshid Asadollahi, Mohammad Akbari Asl

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The restaurant industry is highly competitive, and restaurants are constantly looking for ways to attract new customers and retain their existing ones. Nonverbal communication is an important factor in creating a positive customer experience and can play a significant role in attracting customers to restaurants. Nonverbal communication can include body language, facial expressions, tone of voice, and physical proximity, among other things. The present study aimed to investigate the impact of nonverbal communication between restaurant employees and customers on attracting customers in food courts in Tehran. The research method was descriptive-correlational, and the statistical population of this study included all customers of food court restaurants in Tehran, which was about 30 restaurants. The research sample was selected through probability sampling, and 440 customers completed emotional response, customer satisfaction, and nonverbal communication questionnaires in person. The data obtained were analyzed using multiple regression analysis. The results showed that vocal language, employee proximity, physical appearance, and speech movements, as components of nonverbal communication of restaurant employees, had an impact on attracting customers. Additionally, positive and negative emotions of customers have a significant relationship with customer attraction in Food Court restaurants. The study shows that various nonverbal communication factors can play a significant role in attracting customers, and that positive and negative customer emotions can affect customer satisfaction. Therefore, restaurant owners and managers should pay attention to nonverbal communication and train their employees accordingly to create a positive and welcoming atmosphere for customers.

Keywords: verbal language, proximity of employees, physical appearance, speech gestures, nonverbal communication, customer emotions, customer attraction

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Authors: Lamia Bouzgarrou, Irtyah Merchaoui, Amira Omrane, Salma Kammoun, Amine Daafa, Neila Chaari

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Backgrounds: Currently, low back pain (LBP) is one of the most prevalent public health problems, which caused severe morbidity among a large portion of the adult population. It is also associated with heavy direct and indirect costs, in particular, related to absenteeism and early retirement. Health care workers are one of most occupational groups concerned by LBP, especially because of biomechanical and psycho-organizational risk factors. Our current study aims to investigate risk factors associated with chronic low back pain among Tunisian caregivers in university-hospitals. Methods: Cross-sectional study conducted over a period of 14 months, with a representative sample of caregivers, matched according to age, sex and work department, in two university-hospitals in Tunisia. Data collection included items related to socio-professional characteristics, the evaluation of the working capacity index (WAI), the occupational stress (Karazek job strain questionnaire); the quality of life (SF12), the musculoskeletal disorders Nordic questionnaire, and the examination of the spine flexibility (distance finger-ground, sit-stand maneuver and equilibrium test). Results: Totally, 293 caregivers were included with a mean age equal to 42.64 ± 11.65 years. A body mass index (BMI) exceeding 30, was noted in 20.82% of cases. Moreover, no regular physical activity was practiced in 51.9% of cases. In contrast, domestic activity equal or exceeding 20 hours per week, was reported by 38.22%. Job strain was noted in 19.79 % of cases and the work capacity was 'low' to 'average' among 27.64% of subjects. During the 12 months previous to the investigation, 65% of caregivers complained of LBP, with pain rated as 'severe' or 'extremely severe' in 54.4% of cases and with a frequency of discomfort exceeding one episode per week in 58.52% of cases. During physical examination, the mean distance finger-ground was 7.10 ± 7.5cm. Caregivers assigned to 'high workload' services had the highest prevalence of LBP (77.4%) compared to other categories of hospital services, with no statistically significant relationship (P = 0.125). LBP prevalence was statistically correlated with female gender (p = 0.01) and impaired work capacity (p < 10⁻³). Moreover, the increase of the distance finger-ground was statistically associated with LBP (p = 0.05), advanced age (p < 10⁻³), professional seniority (p < 10⁻³) and the BMI ≥ 25 (p = 0.001). Furthermore, others physical tests of spine flexibility were underperformed among LBP suffering workers with a statistically significant difference (sit-stand maneuver (p = 0.03); equilibrium test (p = 0.01)). According to the multivariate analysis, only the domestic activity exceeding 20H/week, the degraded quality of physical life, and the presence of neck pain were significantly corelated to LBP. The final model explains 36.7% of the variability of this complaint. Conclusion: Our results highlighted the elevate prevalence of LBP among caregivers in Tunisian public hospital and identified both professional and individual predisposing factors. The preliminary analysis supports the necessity of a multidimensional approach to prevent this critical occupational and public health problem. The preventive strategy should be based both on the improvement of working conditions, and also on lifestyle modifications, and reinforcement of healthy behaviors in these active populations.

Keywords: health care workers, low back pain, prevention, risk factor

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