Search results for: obstetrical risk factor

Authors: Kamlesh Shashikant Dave

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The global financial crisis is rooted in the sub-prime crisis in U.S.A. During the boom years, mortgage brokers attracted by the big commission, encouraged buyers with poor credit to accept housing mortgages with little or no down payment and without credit check. A combination of low interest rates and large inflow of foreign funds during the booming years helped the banks to create easy credit conditions for many years. Banks lent money on the assumptions that housing price would continue to rise. Also the real estate bubble encouraged the demand for houses as financial assets .Banks and financial institutions later repackaged these debts with other high risk debts and sold them to worldwide investors creating financial instruments called collateral debt obligations (CDOs). With the rise in interest rate, mortgage payments rose and defaults among the subprime category of borrowers increased accordingly. Through the securitization of mortgage payments, a recession developed in the housing sector and consequently it was transmitted to the entire US economy and rest of the world. The financial credit crisis has moved the US and the global economy into recession. Indian economy has also affected by the spill over effects of the global financial crisis. Great saving habit among people, strong fundamentals, strong conservative and regulatory regime have saved Indian economy from going out of gear, though significant parts of the economy have slowed down. Industrial activity, particularly in the manufacturing and infrastructure sectors decelerated. The service sector too, slow in construction, transport, trade, communication, hotels and restaurants sub sectors. The financial crisis has some adverse impact on the IT sector. Exports had declined in absolute terms in October. Higher inputs costs and dampened demand have dented corporate margins while the uncertainty surrounding the crisis has affected business confidence. To summarize, reckless subprime lending, loose monetary policy of US, expansion of financial derivatives beyond acceptable norms and greed of Wall Street has led to this exceptional global financial and economic crisis. Thus, the global credit crisis of 2008 highlights the need to redesign both the global and domestic financial regulatory systems not only to properly address systematic risk but also to support its proper functioning (i.e financial stability).Such design requires: 1) Well managed financial institutions with effective corporate governance and risk management system 2) Disclosure requirements sufficient to support market discipline. 3)Proper mechanisms for resolving problem institution and 4) Mechanisms to protect financial services consumers in the event of financial institutions failure.

Keywords: FIIs, BSE, sensex, global impact

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Authors: Alejandro Arnaldo Barroso Martinez

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Unlike sex, which is constituted by anatomic-physiological differences, gender is a social construction. Our thoughts and behaviors as females and males are not etched in stone by our biology but rather from how society expects us to think and behave based on our sex assignment in the womb. Social expectations, values, and roles are taken on by individuals and shape the ways considered acceptable and linked to our bodies, feelings, and interpersonal relationships. Furthermore, these evolve into dire consequences for those who do not meet these disciplinary, economic, and cultural standards. Then, the social learning of gender identity implies the individual’s psychological sense of being, and it might be highly linked to a sense of life and suicide attempts. As a result, suicide has been considered a gender issue with differences in the rates and means used by men and women worldwide. Nevertheless, there has been a misunderstanding of the meaning of being male or female in a particular context and how it becomes a risk process for suicide attempts. For this reason, the general objective of the current research is to explain how this process occurs in Cuba. From a Critical Sociology and Social Psychology, a qualitative methodology was developed through six case studies and qualitative in-depth interviews. The analysis is focused on the sequence and interplay between two dimensions of meaning: signifiers and voices. Findings show that the risk process of suicide attempts in Cuba means some patriarchal beliefs and practices as part of informal educational models and some positivist practices in mental health attention. Findings also show that community relations create a sense of belonging, and it is a protection against suicide attempts in Cuba. Those frames of signifiers and voices explain in both males and females but differently when and how they are suffering from isolation, violence, the normalization of emotional awareness, and emotional distress expression. Suicide prevention programs should take gender learning into account as a cultural process.

Keywords: social constructions, gender identity, meanings, suicide attempt

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Authors: F. Christie, M. Staber

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Malnutrition is a predictor of poor clinical outcome in the elderly. Up to 60% of hip fracture patients are clinically malnourished on admission. This study assessed the perioperative nutritional state of patients admitted with a proximal femoral fracture and examined if adequate nutritional support was achieved. Methods: Prospective, the observational audit of 30 patients, admitted with a proximal femoral fracture, over a one-month period. We recorded: patient demographics; surgical delay; nutritional state on admission; documentation of Malnutrition Universal Screening Tool (MUST) score; dietician input and daily calorie intake through food charts. The nutritional state was re-assessed weekly and at discharge. The outcome was measured by the length of hospital stay and thirty-day mortality. Results: Mean age 87, M:F 1:2 and all patients were ASA three or four. Five patients (17%) had a prolonged ( >24 hours) fasting period. All patients had a MUST score completed on admission, 27% were underweight and 30% were high risk for malnutrition. Twenty-six patients (87%) were appropriately assessed for dietician referral. Thirteen patients had food charts; on average, hospital meals provided 1500kcal daily. No patient achieved > 75% of the provided calories with 69% of patients achieving 50% or less. Only three patients were started on nutritional supplements. Twenty-three patients (77%) lost weight, averaging 6% weight loss during admission. Mean length of stay (LOS) was 23 days and 30-day mortality 9%. Four patients (13%) gained weight, their mean LOS was 17 days and 30-day mortality 0%. Discussion: Malnutrition in the elderly originates in the community. Following major trauma it’s difficult to reverse nutritional deficits in hospitals. It’s therefore concerning that no high-risk patient achieved their recommended calorie intake. Perioperative optimisation needs to include early nutritional intervention, early anaesthetic review and adjusted anaesthetic techniques to support feeding.

Keywords: trauma, nutrition, neck of femur fracture

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Authors: Dipendra Kumar Yadav, Nabaraj Paudel, Anjana Yadav

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Background: Low Birth weight (LBW) is defined as the weight at birth less than 2500 grams, irrespective of the period of their gestation. LBW is an important indicator of general health status of population and is considered as the single most important predictors of infant mortality especially of deaths within the first month of life that is birth weight determines the chances of newborn survival. Objective of this study was to identify the maternal risk factors associated with low birth weight neonates. Materials and Methods: A hospital based case-control study was conducted in maternity ward of Manipal Teaching Hospital, Pokhara, Nepal from 23 September 2014 to 12 November 2014. During study period 59 cases were obtained and twice number of control group were selected with frequency matching of the mother`s age with ± 3 years and total controls were 118. Interview schedule was used for data collection along with record review. Data were entered in Epi-data program and analysis was done with help of SPSS software program. Results: From bivariate logistic regression analysis, eighteen variables were found significantly associated with LBW and these were place of residence, family monthly income, education, previous still birth, previous LBW, history of STD, history of vaginal bleeding, anemia, ANC visits, less than four ANC visits, de-worming status, counseling during pregnancy, CVD, physical workload, stress, extra meal during pregnancy, smoking and alcohol consumption status. However after adjusting confounding variables, only six variables were found significantly associated with LBW. Mothers who had family monthly income up to ten thousand rupees were 4.83 times more likely to deliver LBW with CI (1.5-40.645) and p value 0.014 compared to mothers whose family income NRs.20,001-60,000. Mothers who had previous still birth were 2.01 times more likely to deliver LBW with CI (0.69-5.87) and p value 0.02 compared to mothers who did not has previous still birth. Mothers who had previous LBW were 5.472 times more likely to deliver LBW with CI (1.2-24.93) and p value 0.028 compared to mothers who did not has previous LBW. Mothers who had anemia during pregnancy were 3.36 times more likely to deliver LBW with CI (0.77-14.57) and p value 0.014 compared to mothers who did not has anemia. Mothers who delivered female newborn were 2.96 times more likely to have LBW with 95% CI (1.27-7.28) and p value 0.01 compared to mothers who deliver male newborn. Mothers who did not get extra meal during pregnancy were 6.04 times more likely to deliver LBW with CI (1.11-32.7) and p value 0.037 compared to mothers who getting the extra meal during pregnancy. Mothers who consumed alcohol during pregnancy were 4.83 times more likely to deliver LBW with CI (1.57-14.83) and p value 0.006 compared to mothers who did not consumed alcohol during pregnancy. Conclusions: To reduce low birth weight baby through economic empowerment of family and individual women. Prevention and control of anemia during pregnancy is one of the another strategy to control the LBW baby and mothers should take full dose of iron supplements with screening of haemoglobin level. Extra nutritional food should be provided to women during pregnancy. Health promotion program will be focused on avoidance of alcohol and strengthen of health services that leads increasing use of maternity services.

Keywords: low birth weight, case-control, risk factors, hospital based study

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Authors: Kaleeswari R. K., Seevagan L .

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Soil quality in an agroecosystem is influenced by the cropping system, water and soil fertility management. A valid soil quality index would help to assess the soil and crop management practices for desired productivity and soil health. The soil quality indices also provide an early indication of soil degradation and needy remedial and rehabilitation measures. Imbalanced fertilization and inadequate organic carbon dynamics deteriorate soil quality in an intensive cropping system. The rice soil ecosystem is different from other arable systems since rice is grown under submergence, which requires a different set of key soil attributes for enhancing soil quality and productivity. Assessment of the soil quality index involves indicator selection, indicator scoring and comprehensive score into one index. The most appropriate indicator to evaluate soil quality can be selected by establishing the minimum data set, which can be screened by linear and multiple regression factor analysis and score function. This investigation was carried out in intensive rice cultivating regions (having >1.0 lakh hectares) of Tamil Nadu viz., Thanjavur, Thiruvarur, Nagapattinam, Villupuram, Thiruvannamalai, Cuddalore and Ramanathapuram districts. In each district, intensive rice growing block was identified. In each block, two sampling grids (10 x 10 sq.km) were used with a sampling depth of 10 – 15 cm. Using GIS coordinates, and soil sampling was carried out at various locations in the study area. The number of soil sampling points were 41, 28, 28, 32, 37, 29 and 29 in Thanjavur, Thiruvarur, Nagapattinam, Cuddalore, Villupuram, Thiruvannamalai and Ramanathapuram districts, respectively. Principal Component Analysis is a data reduction tool to select some of the potential indicators. Principal Component is a linear combination of different variables that represents the maximum variance of the dataset. Principal Component that has eigenvalues equal or higher than 1.0 was taken as the minimum data set. Principal Component Analysis was used to select the representative soil quality indicators in rice soils based on factor loading values and contribution percent values. Variables having significant differences within the production system were used for the preparation of the minimum data set. Each Principal Component explained a certain amount of variation (%) in the total dataset. This percentage provided the weight for variables. The final Principal Component Analysis based soil quality equation is SQI = ∑ i=1 (W ᵢ x S ᵢ); where S- score for the subscripted variable; W-weighing factor derived from PCA. Higher index scores meant better soil quality. Soil respiration, Soil available Nitrogen and Potentially Mineralizable Nitrogen were assessed as soil quality indicators in rice soil of the Cauvery Delta zone covering Thanjavur, Thiruvavur and Nagapattinam districts. Soil available phosphorus could be used as a soil quality indicator of rice soils in the Cuddalore district. In rain-fed rice ecosystems of coastal sandy soil, DTPA – Zn could be used as an effective soil quality indicator. Among the soil parameters selected from Principal Component Analysis, Microbial Biomass Nitrogen could be used quality indicator for rice soils of the Villupuram district. Cauvery Delta zone has better SQI as compared with other intensive rice growing zone of Tamil Nadu.

Keywords: soil quality index, soil attributes, soil mapping, and rice soil

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Authors: Mahsa Tavakoli, Seyed Mohammad Hojjati, Yahya Kooch

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In this study, the effect of coal mining activities on lead and cadmium concentrations and distribution in soil was investigated in Hyrcanian forest, North Iran. 16 plots (20×20 m²) were established by systematic-randomly (60×60 m²) in an area of 4 ha (200×200 m²-mine entrance placed at center). An area adjacent to the mine was not affected by the mining activity; considered as the controlled area. In order to investigate soil lead and cadmium concentration, one sample was taken from the 0-10 cm in each plot. To study the spatial pattern of soil properties and lead and cadmium concentrations in the mining area, an area of 80×80m² (the mine as the center) was considered and 80 soil samples were systematic-randomly taken (10 m intervals). Geostatistical analysis was performed via Kriging method and GS⁺ software (version 5.1). In order to estimate the impact of coal mining activities on soil quality, pollution index was measured. Lead and cadmium concentrations were significantly higher in mine area (Pb: 10.97±0.30, Cd: 184.47±6.26 mg.kg^-1) in comparison to control area (Pb: 9.42±0.17, Cd: 131.71±15.77 mg.kg^-1). The mean values of the PI index indicate that Pb (1.16) and Cd (1.77) presented slightly polluted. Results of the NIPI index showed that Pb (1.44) and Cd (2.52) presented slight pollution and moderate pollution respectively. Results of variography and kriging method showed that it is possible to prepare interpolation maps of lead and cadmium around the mining areas in Hyrcanian forest. According to results of pollution and risk assessments, forest soil was contaminated by heavy metals (lead and cadmium); therefore, using reclamation and remediation techniques in these areas is necessary.

Keywords: traditional coal mining, heavy metals, pollution indicators, geostatistics, Caspian forest

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Authors: Reeta Devi, Hitender Kumar Tyagi, Dinesh Kumar

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In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

Keywords: early stage prediction, heart rate variability, linear and non-linear analysis, sudden cardiac death

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Authors: Yasir M. Alyazichi, Brian G. Jones, Errol McLean, Hamd N. Altalyan, Ali K. M. Al-Nasrawi

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The main purpose of this study is to assess the sediment quality and potential ecological risk in marine sediments in Gymea Bay located in south Sydney, Australia. A total of 32 surface sediment samples were collected from the bay. Current track trajectories and velocities have also been measured in the bay. The resultant trace elements were compared with the adverse biological effect values Effect Range Low (ERL) and Effect Range Median (ERM) classifications. The results indicate that the average values of chromium, arsenic, copper, zinc, and lead in surface sediments all reveal low pollution levels and are below ERL and ERM values. The highest concentrations of trace elements were found close to discharge points and in the inner bay, and were linked with high percentages of clay minerals, pyrite and organic matter, which can play a significant role in trapping and accumulating these elements. The lowest concentrations of trace elements were found to be on the shoreline of the bay, which contained high percentages of sand fractions. It is postulated that the fine particles and trace elements are disturbed by currents and tides, then transported and deposited in deeper areas. The current track velocities recorded in Gymea Bay had the capability to transport fine particles and trace element pollution within the bay. As a result, hydrodynamic measurements were able to provide useful information and to help explain the distribution of sedimentary particles and geochemical properties. This may lead to knowledge transfer to other bay systems, including those in remote areas. These activities can be conducted at a low cost, and are therefore also transferrable to developing countries. The advent of portable instruments to measure trace elements in the field has also contributed to the development of these lower cost and easily applied methodologies available for use in remote locations and low-cost economies.

Keywords: current track velocities, gymea bay, surface sediments, trace elements

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Authors: Gary J. Pickering, Sarah Lucas, Catherine E. Klodnicki, Nicole J. Gaudette

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Two taste pheno types that are of interest in the study of habitual diet-related risk factors and disease are 6-n-propylthiouracil (PROP) responsiveness and thermal tasting. Individuals differ considerable in how intensely they experience the bitterness of PROP, which is partially explained by three major single nucleotide polymorphisms associated with the TAS2R38 gene. Importantly, this variable responsiveness is a useful proxy for general taste responsiveness, and links to diet-related disease risk, including body mass index, in some studies. Thermal tasting - a newly discovered taste phenotype independent of PROP responsiveness - refers to the capacity of many individuals to perceive phantom tastes in response to lingual thermal stimulation, and is linked with TRPM5 channels. Thermal tasters (TTs) also experience oral sensations more intensely than thermal non-tasters (TnTs), and this was shown to associate with differences in self-reported food preferences in a previous survey from our lab. Here we report on two related studies, where we sought to determine whether PROP responsiveness and thermal tasting would associate with perceptual differences in the oral sensations elicited by sampled energy-dense foods, and whether in turn this would influence liking. We hypothesized that hyper-tasters (thermal tasters and individuals who experience PROP intensely) would (a) rate sweet and high-fat foods more intensely than hypo-tasters, and (b) would differ from hypo-tasters in liking scores. (Liking has been proposed recently as a more accurate measure of actual food consumption). In Study 1, a range of energy-dense foods and beverages, including table cream and chocolate, was assessed by 25 TTs and 19 TnTs. Ratings of oral sensation intensity and overall liking were obtained using gVAS and gDOL scales, respectively. TTs and TnTs did not differ significantly in intensity ratings for most stimuli (ANOVA). In a 2nd study, 44 female participants sampled 22 foods and beverages, assessing them for intensity of oral sensations (gVAS) and overall liking (9-point hedonic scale). TTs (n=23) rated their overall liking of creaminess and milk products lower than did TnTs (n=21), and liked milk chocolate less. PROP responsiveness was negatively correlated with liking of food and beverages belonging to the sweet or sensory food grouping. No other differences in intensity or liking scores between hyper- and hypo-tasters were found. Taken overall, our results are somewhat unexpected, lending only modest support to the hypothesis that these taste phenotypes associate with energy-dense food liking and consumption through differences in the oral sensations they elicit. Reasons for this lack of concordance with expectations and some prior literature are discussed, and suggestions for future research are advanced.

Keywords: taste phenotypes, sensory evaluation, PROP, thermal tasting, diet-related health risk

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Authors: Yifan Lu, Ying Cui, Ying Zhu, Edward S. Lu, Rebecca Zeng, Rohan Bajaj, Raviv Katz, Rongrong Le, Jay C. Wang, John B. Miller

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Purpose: Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcome and is associated with an increased risk of cerebral stroke and cardiovascular events. Fluorescein angiography (FA) is the traditional diagnostic tool for RAO; however, wide-field swept-source optical coherence tomography angiography (WF SS-OCTA), as a nascent imaging technology, is able to provide quick and non-invasive angiographic information with a wide field of view. In this study, we looked for associations between OCT-A vascular metrics and visual acuity in patients with prior diagnosis of RAO. Methods: Patients with diagnoses of central retinal artery occlusion (CRAO) or branched retinal artery occlusion (BRAO) were included. A 6mm x 6mm Angio and a 15mm x 15mm AngioPlex Montage OCT-A image were obtained for both eyes in each patient using the Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm x 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The average measurement of the central foveal subfield, inner ring, and outer ring was calculated for each parameter. Non-perfusion area (NPA) was manually measured using 15mm x 15mm Montage images. A linear regression model was utilized to identify a correlation between the imaging metrics and visual acuity. A P-value less than 0.05 was considered to be statistically significant. Results: Twenty-five subjects were included in the study. For RAO eyes, there was a statistically significant negative correlation between vision and retinal thickness as well as superficial capillary plexus vessel density (SCP VD). A negative correlation was found between vision and deep capillary plexus vessel density (DCP VD) without statistical significance. There was a positive correlation between vision and choroidal thickness as well as choroidal volume without statistical significance. No statistically significant correlation was found between vision and the above metrics in contralateral eyes. For NPA measurements, no significant correlation was found between vision and NPA. Conclusions: This is the first study to our best knowledge to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between various retinal vascular imaging metrics and visual outcomes. Further investigations should explore the associations between these imaging findings and cardiovascular risk as RAO patients are at elevated risk for symptomatic stroke. The results of this study provide a basis to understand the structural changes involved in visual outcomes in RAO. Furthermore, they may help guide management of RAO and prevention of cerebral stroke and cardiovascular accidents in patients with RAO.

Keywords: OCTA, swept-source OCT, retinal artery occlusion, Zeiss Plex Elite

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Authors: Taddese Alemu Zerfu, Melaku Umeta Deressa, Kaleab Baye

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Background: Maternal and child under-nutrition is the underlying cause of 3•5 million annual deaths, globally. Anemia during pregnancy is among the leading nutritional disorders with serious short and long term consequences to both the mother and fetus. Objective: Examine the effect of dietary diversity on maternal anemia, nutritional status and key pregnancy outcomes of pregnancy. Methods: A prospective cohort study design, involving a total of 432 eligible pregnant women, in their second antenatal care visit was conducted between August 2014 to March, 2015. The individual dietary diversity status of mothers was used as the exposure variable to select, enroll and follow the mothers. All mothers were enrolled during second antenatal care visit and followed until delivery. Epi-data, SPSS and STATA software are used to enter and analyze the data. Chi-square test, independent 't'-test, and GLM are used to calculate risk, association and differences between key variables at P < 0.05. Results: Study participants did not differ in many of the basic characteristics (p < 0.05). The incidence of maternal anemia increased significantly from 28.6% to 32.1% between baseline and term. Pregnant mothers with inadequate dietary diversity groups had more (56% at baseline and 68% at term) risk of anemia than the comparison (adequate) groups, (RR, 1.56 and 1.68; 95% CI, 1.24 - 1.83 and 1.39 - 2.04). The overall incidence of still birth, low birth weight and pre-term birth was 4.5%, 9.1% and 13.6%, respectively. The variation of these outcomes was significant across study groups (P < 0.05). Conclusion and recommendations: Dietary diversity status of pregnant mothers has significant effect on the incidence of anemia and key pregnancy outcomes in resource limited settings, like rural Ethiopia. Therefore, apart from the ongoing routine IFA supplementation, special emphasis should be given to dietary diversity of mothers to improve related outcomes of pregnancy and maternal health.

Keywords: anemia, birth weight, dietary diversity, pregnancy, pregnancy outcome

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Authors: Magdalena Meusburger, Caroline Hofer

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The advancement of woman entrepreneurship in the last decade has been a vital driver for social and economic development. Despite the positive evolution, women entrepreneurs are still underrepresented in entrepreneurial ecosystems. Fear-of-failure is a major factor affecting their entrepreneurial activity. This survey-based research focuses on aspiring and established entrepreneurial women in Austria and in the USA. It explores and compares the extent to which fear-of-failure influences their self-employment and their aspirations to become self-employed.

Keywords: entrepreneurial ecosystems, fear-of-failure, female entrepreneurship, woman entrepreneurship

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Authors: Mohammad Rahim Rahnama

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Market-transaction price for housing is the main criteria for determining municipality taxes and is determined and announced on an annual basis. Of course, there is a discrepancy between the actual value of transactions in the Bureau of Finance (P for short) or municipality (P´ for short) and the real price on the market (P˝). The present research aims to determine the real price of housing in the metropolis of Mashhad and to pinpoint the price gap with those of the aforementioned apparatuses and identify the factors affecting it. In order to reach this practical objective, Automatic Linear Modeling, which calls for an explanatory research, was utilized. The population of the research consisted of all the residential units in Mashhad, from which 317 residential units were randomly selected. Through cluster sampling, out of the 170 income blocks defined by the municipality, three blocks form high-income (Kosar), middle-income (Elahieh), and low-income (Seyyedi) strata were surveyed using questionnaires during February and March of 2015 and the information regarding the price and specifications of residential units were gathered. In order to estimate the effect of various factors on the price, the relationship between independent variables (8 variables) and the dependent variable of the housing price was calculated using Automatic Linear Modeling in SPSS. The results revealed that the average for housing price index is 788$ per square meter, compared to the Bureau of Finance’s prices which is 10$ and that of municipality’s which is 378$. Correlation coefficient among dependent and independent variables was calculated to be R²=0.81. Out of the eight initial variables, three were omitted. The most influential factor affecting the housing prices is the quality of Quality of construction (Ordinary, Full, Luxury). The least important factor influencing the housing prices is the variable of number of sides. The price gap between low-income (Seyyedi) and middle-income (Elahieh) districts was not confirmed via One-Way ANOVA but their gap with the high-income district (Kosar) was confirmed. It is suggested that city be divided into two low-income and high-income sections, as opposed three, in terms of housing prices.

Keywords: automatic linear modeling, housing prices, Mashhad, Iran

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Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

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Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

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Authors: Elisavet Kechagia

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Due to the interplay of different genetic and environmental risk factors and its heterogeneous nature, the concept of attention deficit hyperactivity disorder (ADHD) has shaped controversy and conflicts, which have been, in turn, reflected in the controversial arguments about its treatment. Taking into account recent well evidence-based researches suggesting that ADHD is a condition, in which biopsychosocial factors are all weaved together, the current paper explores the multiple risk-factors that are likely to influence ADHD, with a particular focus on adolescents with ADHD who might experience comorbid social, emotional and behavioural disorders (SEBD). In the first section of this paper, the primary objective was to investigate the conflicting ideas regarding the definition, diagnosis and treatment of ADHD at an international level as well as to critically examine and identify the limitations of the two most prevailing sets of diagnostic criteria that inform current diagnosis, the American Psychiatric Association’s (APA) diagnostic scheme, DSM-V, and the World Health Organisation’s (WHO) classification of diseases, ICD-10. Taking into consideration the findings of current longitudinal studies on ADHD association with high rates of comorbid conditions and social dysfunction, in the second section the author moves towards an investigation of the transitional points −physical, psychological and social ones− that students with ADHD might experience during early adolescence, as informed by neuroscience and developmental contextualism theory. The third section is an exploration of the different perspectives of ADHD as reflected in individuals’ with ADHD self-reports and the KENT project’s findings on school staff’s attitudes and practices. In the last section, given the high rates of SEBDs in adolescents with ADHD, it is examined how cognitive behavioural therapy (CBT), coupled with other interventions, could be effective in ameliorating anti-social behaviours and/or other emotional and behavioral difficulties of students with ADHD. The findings of a range of randomised control studies indicate that CBT might have positive outcomes in adolescents with multiple behavioural problems, hence it is suggested to be considered both in schools and other community settings. Finally, taking into account the heterogeneous nature of ADHD, the different biopsychosocial and environmental risk factors that take place during adolescence and the discourse and practices concerning ADHD and SEBD, it is suggested how it might be possible to make sense of and meaningful improvements to the education of adolescents with ADHD within a multi-modal and multi-disciplinary whole-school approach that addresses the multiple problems that not only students with ADHD but also their peers might experience. Further research that would be based on more large-scale controls and would investigate the effectiveness of various interventions, as well as the profiles of those students who have benefited from particular approaches and those who have not, will generate further evidence concerning the psychoeducation of adolescents with ADHD allowing for generalised conclusions to be drawn.

Keywords: adolescence, attention deficit hyperctivity disorder, cognitive behavioural theory, comorbid social emotional behavioural disorders, treatment

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Authors: Niaz Gharavi, Hexin Zhang

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In the structural timber design, the shear modulus of the timber beam is an important factor that needs to be determined accurately. According to BS EN 408, shear modulus can be determined using torsion test or shear field test method. Although torsion test creates pure shear status in the beam, it does not represent the real-life situation when the beam is in the service. On the other hand, shear field test method creates similar loading situation as in reality. The latter method is based on shear distortion measurement of the beam at the zone with the constant transverse load in the standardized four-point bending test as indicated in BS EN 408. Current testing practice code advised using two metallic arms act as an instrument to measure the diagonal displacement of the constructing square. Timber is not a homogenous material, but a heterogeneous and this characteristic makes timber to undergo a non-uniform deformation. Therefore, the dimensions and the location of the constructing square in the area with the constant transverse force might alter the shear modulus determination. This study aimed to investigate the impact of the shape, size, and location of the square in the shear field test method. A binocular stereo vision system was developed to capture the 3D displacement of a grid of target points. This approach is an accurate and non-contact method to extract the 3D coordination of targeted object using two cameras. Two group of three glue laminated beams were produced and tested by the mean of four-point bending test according to BS EN 408. Group one constructed using two materials, laminated bamboo lumber and structurally graded C24 timber and group two consisted only structurally graded C24 timber. Analysis of Variance (ANOVA) was performed on the acquired data to evaluate the significance of size and location of the square in the determination of shear modulus of the beam. The results have shown that the size of the square is an affecting factor in shear modulus determination. However, the location of the square in the area with the constant shear force does not affect the shear modulus.

Keywords: shear field test method, BS EN 408, timber shear modulus, photogrammetry approach

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Authors: Deepa Kapoor, Rajshree Singh

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This paper appreciates the emergence and growing importance as a new production factor makes the development of technologies, methodologies and strategies for measurement, creation, and diffusion into one of the main priorities of the organizations in the knowledge society. There are many models for creation and management of knowledge and diverse and varied perspectives for study, analysis, and understanding. In this article, we will conduct a theoretical approach to the type of models for the creation and management of knowledge; we will discuss some of them and see some of the difficulties and the key factors that determine the success of the processes for the creation and management of knowledge.

Keywords: knowledge creation, knowledge management, organizational development, organization learning

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Authors: Mahmoudi Noureddine, Bouregba Rachid

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In this paper the stress intensity factors of a slant-cracked plate of AISI 304 stainless steel, have been calculated using extended finite element method and finite element method (FEM) in ABAQUS software, the results were compared with theoretical values.

Keywords: stress intensity factors, extended finite element method, stainless steel, abaqus

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Authors: Andrey Egorov

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A product of the specific Lagrangian and the entropy factor is defined. Its positive definiteness is stated for the proper coupling constant. The passage from statistical mechanics to quantum field theory is performed by Wick rotation. The Green function (a convolution of the spectral amplitude and the propagator) is positive. Masses of quasiparticles are computed as residues. The role of the zeta derivative at zeta zeros is then highlighted, and the correspondent low bound is obtained.

Keywords: mass gap, positive definite kernels, quantum fields, Riemann zeta zeros

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Authors: Nael Hirzallah, Sana Nseir

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Merchants are competing to offer the use of mobile payment to encourage shopping. many mobile payment systems were made available in various locations worldwide; however, they have various drawbacks. This paper proposes a new mobile payment system that discusses the main drawbacks of these systems, namely security and speed of transaction. The proposal is featured by being simple to use by customers and merchants. Furthermore, the proposed system depends on a new authentication factor that is introduced in this paper and called by Two-Factors Authentication Plus, (2FA+).

Keywords: electronic commerce, payment schemes, mobile payment, authentication factors, mobile applications

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Authors: Charita B. Lasala, Lakambini G. Reluya

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The human factor composing the organization is an asset that needs to be managed conscientiously and to be in tuned with the organization’s need. Thus, the human resources add value to the organization by using their talents, skills and knowledge in transforming the other resources of the organization to either produce or to deliver products and services that generate profits or other valued forms for return. Keeping these kinds of employees has always been the main goal of each Human Resources Department in every company worldwide; regardless of the work being done. They are the most important resource a company can have and treating them well will make them priceless assets that can help make a business a success. Larmen de Guia Memorial College (LGMC) and Royal Oaks International School (ROIS) is one of the many organizations that seek ways to keep the human factor and are in the process of formalization and that people management is on the top of the list thus, this study was made since there was a need for the creation of the Human Resources Department due to its absence in the organization and to help the organization in keeping these valued employees. The study was anchored on the concept that human resources consist of people who perform its activities and that all decisions that affect the workforce concern the organization’s human resources functions. In conducting this study, it made use of the mixed method using both the qualitative and quantitative approaches with focus group discussions. The design has three stages namely: problem conceptualization, case analysis, and output. The output from the survey and interviews tells the abstracted ideas on the proposed HR program for the said institution. Based on the findings of the study, it can be concluded that the personnel in the institution is not in the correct perspective, much more that the personnel has no specific job descriptions. The hiring procedure is not extensive, nor the personnel was given the chance to be exposed to training that would aid them in job development and enhancement of their skills and talents. The compensation package offered by the institution does not commensurate to their services rendered. Lastly, it is concluded that in the opinion/decision rendered by the grievance committee is not fair and that the institution failed to give good motivation/initiative for the employees to be more productive.

Keywords: employee benefits, employee relations, human resources and management, people management, recruitment, trainings

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Authors: Lawong Damian Bernsah

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Neglected Tropical Diseases (NTDs) are most predominant among the poor and rural populations and are endemic in 149 countries. These diseases are the most prevalent and responsible for infecting 1.4 billion people worldwide. There are 17 neglected tropical diseases recognized by WHO that constitute the fourth largest disease health and economic burden of all communicable diseases. Five of these 17 diseases are considered for the cost analysis of this paper: lymphatic filariasis, onchocerciasis, trachoma, schistosomiasis, and soil transmitted helminth infections. WHO has proposed a roadmap for eradication and elimination by 2020 and treatments have been donated through the London Declaration by pharmaceutical manufacturers. The paper estimates the cost of NTD control programme and elimination for each NTD disease and total in Nigeria. This is necessary as it forms the bases upon which programme budget and expenditure could be based. Again, given the opportunity cost the resources for NTD face it is necessary to estimate the cost so as to provide bases for comparison. Cost of NTDs control and elimination programme is estimated using the population at risk for each NTD diseases and for the total. The population at risk is gotten from the national master plan for the 2015 - 2020, while the cost per person was gotten for similar studies conducted in similar settings and ranges from US$0.1 to US$0.5 for Mass Administration of Medicine (MAM) and between US$1 to US$1.5 for each NTD disease. The combined cost for all the NTDs was estimated to be US$634.88 million for the period 2015-2020 and US$1.9 billion for each NTD disease for the same period. For the purpose of sensitivity analysis and for robustness of the analysis the cost per person was varied and all were still high. Given that health expenditure for Nigeria (% of GDP) averages 3.5% for the period 1995-2014, it is very clear that efforts have to be made to improve allocation to the health sector in general which is hoped could trickle to NTDs control and elimination. Thus, the government and the donor partners would need to step-up budgetary allocation and also to be aware of the costs of NTD control and elimination programme since they have alternative uses. Key Words: Neglected Tropical Disease, Cost Analysis, NTD Programme Control and Elimination, Cost per Person

Keywords: Neglected Tropical Disease, Cost Analysis, Neglected Tropical Disease Programme Control and Elimination, Cost per Person

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Authors: A. Kalaei, A. H. W. Ngan

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In this study, a mesoscopic continuum dislocation dynamics (CDD) approach is applied to simulate the intergranular slip transfer. The CDD scheme applies an efficient kinematics equation to model the evolution of the “all-dislocation density,” which is the line-length of dislocations of each character per unit volume. As the consideration of every dislocation line can be a limiter for the simulation of slip transfer in large scales with a large quantity of participating dislocations, a coarse-grained, extensive description of dislocations in terms of their density is utilized to resolve the effect of collective motion of dislocation lines. For dynamics closure, namely, to obtain the dislocation velocity from a velocity law involving the effective glide stress, mutual elastic interaction of dislocations is calculated using Mura’s equation after singularity removal at the core of dislocation lines. The developed scheme for slip transfer can therefore resolve the effects of the elastic interaction and pile-up of dislocations, which are important physics omitted in coarser models like crystal plasticity finite element methods (CPFEMs). Also, the length and timescales of the simulationareconsiderably larger than those in molecular dynamics (MD) and discrete dislocation dynamics (DDD) models. The present work successfully simulates that, as dislocation density piles up in front of a grain boundary, the elastic stress on the other side increases, leading to dislocation nucleation and stress relaxation when the local glide stress exceeds the operation stress of dislocation sources seeded on the other side of the grain boundary. More importantly, the simulation verifiesa phenomenological misorientation factor often used by experimentalists, namely, the ease of slip transfer increases with the product of the cosines of misorientation angles of slip-plane normals and slip directions on either side of the grain boundary. Furthermore, to investigate the effects of the critical stress-intensity factor of the grain boundary, dislocation density sources are seeded at different distances from the grain boundary, and the critical applied stress to make slip transfer happen is studied.

Keywords: grain boundary, dislocation dynamics, slip transfer, elastic stress

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Authors: Dona Pamoda W. Jayatunga, Veer Bala Gupta, Eugene Hone, Ralph N. Martins

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Being a neurodegenerative disorder, Alzheimer’s disease (AD) affects a majority of the elderly demented worldwide. The key risk factors for AD are age, metabolic syndrome, allele status of APOE gene, head injuries and lifestyle. The progressive nature of AD is characterized by symptoms of multiple cognitive deficits exacerbated over time, leading to death within a decade from clinical diagnosis. However, it is revealed that AD originates via a prodromal phase that spans from one to few decades before symptoms first manifest. The key pathological hallmarks of AD brains are deposition of amyloid beta (Aβ) plaques and neurofibrillary tangles (NFT). However, the yet unknown etiology of the disease fails to distinguish mitochondrial dysfunction between a cause or an outcome. The absence of early diagnosis tools and definite therapies for AD have permitted recruits of nutraceutical-based approaches aimed at reducing the risk of AD by modulating lifestyle or be used as preventive tools during AD prodromal state before widespread neurodegeneration begins. The objective of the present study was to investigate beneficial effects of luteolin, a plant-based flavone compound, against AD. The neuroprotective effects of luteolin on amyloid beta (Aβ) (1-42)-induced neurotoxicity was measured using cultured human neuroblastoma BE(2)-M17 cells. After exposure to 20μM Aβ (1-42) for 48 h, the neuroblastoma cells exhibited marked apoptotic death. Co-treatment of 20μM Aβ (1-42) with luteolin (0.5-5μM) significantly protected the cells against Aβ (1-42)-induced toxicity, as assessed by the MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2(4sulfophenyl)-2H-tetrazolium, inner salt; MTS] reduction assay and the lactate dehydrogenase (LDH) cell death assay. The results suggest that luteolin prevents Aβ (1-42)-induced apoptotic neuronal death. However, further studies are underway to determine its protective mechanisms in AD including the activity against tau hyperphosphorylation and mitochondrial dysfunction.

Keywords: Aβ (1-42)-induced toxicity, Alzheimer’s disease, luteolin, neuroblastoma cells

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Authors: Mahmoudi Noureddine

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In this study the use of two variable refined plate theories of laminated composite plates to static response of laminated plates. The plate theory accounts for parabolic distribution of the transverse shear strains, and satisfies the zero traction boundary conditions on the surfaces of the plate without using shear correction factor. The validity of the present theory is demonstrated by comparison with solutions available in the literature and finite element method. The result is presented for the static response of simply supported rectangular plates under uniform sinusoidal mechanical loadings.

Keywords: bending, composite, laminate, plates, fem

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Authors: Abdullah Alenezi, Mane Alsudrawi, Rafat Misak

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Kuwait is faced with a potentially wide and harmful range of both natural and anthropogenic hazardous events such as dust storms, floods, fires, nuclear accidents, earthquakes, oil spills, tsunamis and other disasters. For Kuwait can be highly vulnerable to these complex environmental risks, an up-to-date and in-depth understanding of their typology, genesis, and impact on the Kuwaiti society is needed. Adequate anticipation and management of environmental crises further require a comprehensive system of decision support to the benefit of decision makers to further bridge the gap between (technical) risk understanding and public action. For that purpose, the Kuwait Institute for Scientific Research (KISR), intends to establish a decision support center for management of the environmental crisis in Kuwait. The center will support policy makers, stakeholders and national committees with technical information that helps them efficiently and effectively assess, monitor to manage environmental disasters using decision support tools. These tools will build on state of the art quantification and visualization techniques, such as remote sensing information, Geographical Information Systems (GIS), simulation and prediction models, early warning systems, etc. The center is conceived as a central facility which will be designed, operated and managed by KISR in coordination with national authorities and decision makers of the country. Our vision is that by 2035 the center will be recognized as a leading national source of scientific advice on national risk management in Kuwait and build unity of effort among Kuwaiti’s institutions, government agencies, public and private organizations through provision and sharing of information. The project team now focuses on capacity building through upgrading some KISR facilities manpower development, build strong collaboration with international alliance.

Keywords: decision support, environment, hazard, Kuwait

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Authors: Tadesse Melaku Abegaz

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Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

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Authors: Thomais Tsoulia, Arvind Y. M. Sundaram, Stine Braaen, Øyvind Haugland, Espen Rimstad, Øystein Wessel, Maria K. Dahle

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Fish red blood cells (RBC) are nucleated, and in addition to their function in gas exchange, they have been characterized as mediators of immune responses. Salmonid RBC are the major target cells of Piscineorthoreovirus (PRV), a virus associated with heart and skeletal muscle inflammation (HSMI) in farmed Atlantic salmon. The activation of antiviral response genesin RBChas previously been described in ex vivo and in vivo PRV-infection models, but not explored in the initial virus encounter phase. In the present study, mRNA transcriptome responses were explored in erythrocytes from individual fish, kept ex vivo, and exposed to purified PRV for 24 hours. The responses were compared to responses in macrophage-like salmon head kidney (SHK-1) and endothelial-like Atlantic salmon kidney (ASK) cells, none of which support PRV replication. The comparative analysis showed that the antiviral response to PRV was strongest in the SHK-1 cells, with a set of 80 significantly induced genes (≥ 2-fold upregulation). In RBC, 46 genes were significantly upregulated, while ASK cells were not significantly responsive. In particular, the transcriptome analysis of RBC revealed that PRV significantly induced interferon regulatory factor 1 (IRF1) and interferon-induced protein with tetratricopeptide repeats 5-like (IFIT9). However, several interferon-regulated antiviral genes which have previously been reported upregulated in PRV infected RBC in vivo (myxovirus resistance (Mx), interferon-stimulated gene 15 (ISG15), toll-like receptor 3 (TLR3)), were not significantly induced after 24h of virus stimulation. In contrast to RBC, these antiviral response genes were significantly upregulated in SHK-1. These results confirm that RBC are involved in the innate immune response to viruses, but with a delayed antiviral response compared to SHK-1. A notable difference is that interferon regulatory factor 1 (IRF-1) is the most strongly induced gene in RBC, but not among the significantly induced genes in SHK-1. Putative differences in the binding, recognition, and response to PRV, and any link to effects on the ability of PRV to replicate remains to be explored.

Keywords: antiviral responses, atlantic salmon, piscine orthoreovirus-1, red blood cells, RNA-seq

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Authors: Abraham Finkelman

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Computerized Surgical Guides have been proven to be a predictable way to perform dental implants, with a relatively high accuracy in comparison to a treatment plan. When using the CSG Bone supported, it allows us to make the necessary changes of the hard tissue prior to the implant placement and after the implant placement. The CSG gives us an accurate position for the drilling, and during the implant placement it allows us to alter the vertical position of the implant altering the final position of the abutment and avoiding any risk of any damage to the adjacent anatomical structures. Any Changes required to the bone level can be done prior to the fixation of the CSG using a reduction guide, which incur extra surgical fees and the need of a second surgical guide. Any changes of the bone level after the implant placement are at the risk of damaging the implant neck surface. The technique consists of a universal system that allows us to remove the excess bone around the implant sockets prior to the implant placement which then enables us to place the implant in the vertical position with accuracy as planned with the CSG. The systems consist of a hollow pin of different sizes and diameters. Depending on the implant system that we are using. Length sizes are from 6mm-16mm and a diameter of 2.6mm-4.8mm. Upon the completion of the drilling, the pin is then inserted into the implant socket-using the insertion tool. Once the insertion tool has unscrewed the pin, we can continue with the bone reduction. The bone reduction can be done using conventional methods upon the removal of all the excess bone around the pin. The insertion tool is then screwed into the pin and the pin is then removed. We now, have the new bone level at the crest of the implant socket which is our mark for the vertical position of the implant. In some cases, when we are locating the implant very close to anatomical structures, any form of deviation to the vertical position of the implant during the surgery, can cause damage to such anatomical structures, creating irreversible damages such as paresthesia or dysesthesia of the mandibular nerve. If we are planning for immediate loading and we have done our temporary restauration in base of our computerized plan, deviation in the vertical position of the implant will affect the position of the abutment, affecting the accuracy of the temporary prosthesis, extending the working time till we adapt the prosthesis to the new position.

Keywords: bone reduction, computer aided navigation, dental implant placement, surgical guides

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Authors: P. H. G. J. Pushpakumara, A. M. P. Adikari, S. U. B. Tennakoon, Ranil Abeysinghe, Andrew Dawson

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Introduction: Deliberate Self-harm (DSH) is a global public health problem. Since 1950, suicide rates in Sri Lanka are among the highest national rates in the world. It has become an increasingly common response to emotional distress in young adults. However, it remains unclear the reason for this occurrence. Objectives: The descriptive component of this study was conducted to identify of epidemiological pattern of DSH and suicide in Kurunegala District (KD). Assessment of association between DSH socio-cultural, economical and psychological factors were the objectives of the case control component. Methods: Prospective data collection of DSH and suicide was conducted at all (46) hospitals and all (28) police stations in the KD for thirty six months, from 1st January 2011, as the descriptive component. Case control component was conducted at T.H. Kurunegala (THK) for eighteen months duration, from 1st July 2011. Cases (n=439) were randomly selected from a block of 7 consecutively admitted consenting DSP patients using a computer program. Age, sex and residential divisional secretariat division one to one matched, individuals were randomly selected as controls from patients presented to Out Patient Department. Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders was used to diagnose psychiatric disorders. Validated tools were used to measure other constructs. Results: Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011- 2013 (Male:female ratio 5.7, 4.4 and 6.4). 60% of suicides were due to poisoning. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population in 2011- 2013. Highest age standardized male DSP incidence reported in 20-24 years (769.6/100,000) and female in 15-19 years (1304.0/100,000). Bing married (age >25 years), monthly family income less than Rs.30,000, not achieving G.C.E (O/L) qualifications, a school drop-out, not in a permanent position in occupation, being a manual and an own account worker, were significantly associated with DSP. Perceiving the quality of relationship as bad or very bad with parents, spouse/ girlfriend/ boyfriend and sibling as associated with 8, 40 and 10.5 times higher risk respectively. Feeling and experiences of neglect, other emotional abuses, feeling of insecurity with the family, in child hood, and having a contact history carried an excess risk for DSP. Cases were less likely to seek help. Further, they had significantly lower scores for life skills and life skills application ability. 25.6% DSH patients had DSM TR axis-I and/or TR axis-II disorder. The presence of psychiatric disorder carried 7.7 (95% CI 4.3 – 13.8) times higher risk for DSP. Conclusion: In general, pattern of DSH and suicide is, unique, different from developed, upper and middle income and lower and middle income countries. It is a learned way of expressing emotions in difficult situations of vulnerable people.

Keywords: deliberate self-harm, help-seeking, life-skills, mental- health, psychological, social, suicide

Procedia PDF Downloads 202