Search results for: interval regression

Authors: Nepton Kiani

Abstract:

Dental decay is one of the most common chronic diseases worldwide and imposes significant costs annually on people and healthcare systems. Addressing this issue is among the important programs of the World Health Organization in the field of oral and dental disease prevention and health promotion. In this context, oral and dental health in vulnerable groups, especially pregnant women, is of greater importance due to the health maintenance of the mother and fetus. The aim of this study is to investigate the DMFT index and various factors affecting it in order to identify different factors influencing the process of dental decay and to take an effective step in reducing the progression of this disease, control, and prevention. In this cross-sectional descriptive study, 120 pregnant women attending Nepton Policlinica clinic in Malaga, Spain, were evaluated for the DMFT index and oral and dental hygiene. In this regard, interviews, precise observations, and data collection were used. Subsequently, data analysis was performed using SPSS software and employing correlation tests, Kruskal-Wallis, and Mann-Whitney tests. The DMFT index for pregnant women in three age groups 22-26, 27- 31, and 32-36 years was respectively 2.8, 4.5, and 5.6. The results of logistic regression analysis showed that demographic variables (age, education, job, economic status) and the frequency of brushing and flossing lead to preventive behavior up to 49.58 percent (P<0.05). Generally, the results indicated that oral and dental care during pregnancy is poor. Only a small number of pregnant women regularly used toothbrush and dental floss or visited the dentist regularly. On the other hand, poor performance in adopting oral and dental care was more observed in pregnant women with lower economic and educational status. The present study showed that raising the level of awareness and education on oral and dental health in pregnant women is essential. In this field, it is necessary to focus on conducting educational-care courses at the level of healthcare centers for midwives, healthcare personnel, and at the community level for families, to prevent and perform dental treatments before the pregnancy period

Keywords: Malaga, oral and dental health, pregnant women, Spain

Procedia PDF Downloads 58

Authors: Yuanxiaoyue Yang

Abstract:

Emissions trading, or ‘cap-and-trade', has been long promoted by economists as a more cost-effective pollution control approach than traditional performance standard approaches. While there is a large body of empirical evidence for the overall effectiveness of emissions trading, relatively little attention has been paid to other unintended consequences brought by emissions trading. One important consequence is that cap-and-trade could introduce the risk of creating high-level emission concentrations in areas where emitting facilities purchase a large number of emission allowances, which may cause an unequal distribution of environmental benefits. This study will contribute to the current environmental policy literature by linking trading activity with environmental injustice concerns and empirically analyzing the causal relationship between trading activity and emissions reduction under a cap-and-trade program for the first time. To investigate the potential environmental injustice concern in cap-and-trade, this paper uses a differences-in-differences (DID) with instrumental variable method to identify the causal effect of allowance trading behaviors on emission reduction levels under the clean air interstate rule (CAIR), a cap-and-trade program targeting on the power sector in the eastern US. The major data source is the facility-year level emissions and allowance transaction data collected from US EPA air market databases. While polluting facilities from CAIR are the treatment group under our DID identification, we use non-CAIR facilities from the Acid Rain Program - another NOx control program without a trading scheme – as the control group. To isolate the causal effects of trading behaviors on emissions reduction, we also use eligibility for CAIR participation as the instrumental variable. The DID results indicate that the CAIR program was able to reduce NOx emissions from affected facilities by about 10% more than facilities who did not participate in the CAIR program. Therefore, CAIR achieves excellent overall performance in emissions reduction. The IV regression results also indicate that compared with non-CAIR facilities, purchasing emission permits still decreases a CAIR participating facility’s emissions level significantly. This result implies that even buyers under the cap-and-trade program have achieved a great amount of emissions reduction. Therefore, we conclude little evidence of environmental injustice from the CAIR program.

Keywords: air pollution, cap-and-trade, emissions trading, environmental justice

Procedia PDF Downloads 150

Authors: Akiode Ayobami, Akiode Akinsewa, Odeku Mojisola, Salako Busola, Odutolu Omobola, Nuhu Khadija

Abstract:

Purpose: Evidence exists that family planning use can contribute to reduction in infant and maternal mortality in any country. Despite these benefits, contraceptive use in Nigeria still remains very low, only 10% among married women. Understanding factors that predict contraceptive use is very important in order to improve the situation. In this paper, we analysed data from the 2013 Nigerian Demographic and Health Survey (NDHS) to better understand predictors of contraceptive use in Nigeria. The use of logistics regression and other traditional models in this type of situation is not appropriate as they do not account for social structure influence brought about by the hierarchical nature of the data on response variable. We therefore used multilevel modelling to explore the determinants of contraceptive use in order to account for the significant variation in modern contraceptive use by socio-demographic, and other proximate variables across the different Nigerian states. Method: This data has a two-level hierarchical structure. We considered the data of 26, 403 married women of reproductive age at level 1 and nested them within the 36 states and the Federal Capital Territory, Abuja at level 2. We modelled use of modern contraceptive against demographic variables, being told about FP at health facility, heard of FP on TV, Magazine or radio, husband desire for more children nested within the state. Results: Our results showed that the independent variables in the model were significant predictors of modern contraceptive use. The estimated variance component for the null model, random intercept, and random slope models were significant (p=0.00), indicating that the variation in contraceptive use across the Nigerian states is significant, and needs to be accounted for in order to accurately determine the predictors of contraceptive use, hence the data is best fitted by the multilevel model. Only being told about family planning at the health facility and religion have a significant random effect, implying that their predictability of contraceptive use varies across the states. Conclusion and Recommendation: Results showed that providing FP information at the health facility and religion needs to be considered when programming to improve contraceptive use at the state levels.

Keywords: multilevel modelling, family planning, predictors, Nigeria

Procedia PDF Downloads 418

Authors: Mayowa Saheed Sanusi A, Musiliu Olushola Sunmonua, Abdulquadri Alakab Owolabi Raheema, Adeyemi Ikimot Adejokea

Abstract:

The development of healthy cookies for health-conscious consumers cannot be overemphasized in the present global health crisis. This study was aimed to evaluate and model the influence of ripeness levels of papaya puree (unripe, ripe and overripe), oven temperature (130°C, 150°C and 170°C) and oven rack speed (stationary, 10 and 20 rpm) on physicochemical properties of papaya-based cookies using Response Surface Methodology (RSM). The physicochemical properties (baking time, cookies mass, cookies thickness, spread ratio, proximate composition, Calcium, Vitamin C and Total Phenolic Content) were determined using standard procedures. The data obtained were statistically analysed at p≤0.05 using ANOVA. The polynomial regression model of response surface methodology was used to model the physicochemical properties. The adequacy of the models was determined using the coefficient of determination (R²) and the response optimizer of RSM was used to determine the optimum physicochemical properties for the papaya-based cookies. Cookies produced from overripe papaya puree were observed to have the shortest baking time; ripe papaya puree favors cookies spread ratio, while the unripe papaya puree gives cookies with the highest mass and thickness. The highest crude protein content, fiber content, calcium content, Vitamin C and Total Phenolic Content (TPC) were observed in papaya based-cookies produced from overripe puree. The models for baking time, cookies mass, cookies thickness, spread ratio, moisture content, crude protein and TPC were significant, with R2 ranging from 0.73 – 0.95. The optimum condition for producing papaya based-cookies with desirable physicochemical properties was obtained at 149°C oven temperature, 17 rpm oven rack speed and with the use of overripe papaya puree. The Information on the use of puree from unripe, ripe and overripe papaya can help to increase the use of underutilized unripe or overripe papaya and also serve as a strategic means of obtaining a fat substitute to produce new products with lower production cost and health benefit.

Keywords: papaya based-cookies, modeling, response surface methodology, physicochemical properties

Procedia PDF Downloads 167

Authors: Haoyu Zhao, Qianshu Ma, Min Xie, Yunqi Huang, Yunjia Liu, Huan Song, Hongsheng Gui, Mingli Li, Qiang Wang

Abstract:

Rationale: Bipolar disorder (BD) and major depressive disorder (MDD), as severe chronic illnesses that restrict patients’ psychosocial functioning and reduce their quality of life, are both categorized into mood disorders. Emerging evidence has suggested that the reliability of self-rated health (SRH) was wellvalidated and that the risk of various health outcomes, including mortality and health care costs, could be predicted by SRH. Compared with other lengthy multi-item patient-reported outcomes (PRO) measures, SRH was proven to have a comparable predictive ability to predict mortality and healthcare utilization. However, to our knowledge, no study has been conducted to assess the association between SRH and hospitalization among people with mental disorders. Therefore, our study aims to determine the association between SRH and subsequent all-cause hospitalizations in patients with BD and MDD. Methods: We conducted a prospective cohort study on people with BD or MDD in the UK from 2006 to 2010 using UK Biobank touchscreen questionnaire data and linked administrative health databases. The association between SRH and 2-year all-cause hospitalizations was assessed using proportional hazard regression after adjustment for sociodemographics, lifestyle behaviors, previous hospitalization use, the Elixhauser comorbidity index, and environmental factors. Results: A total of 29,966 participants were identified, experiencing 10,279 hospitalization events. Among the cohort, the average age was 55.88 (SD 8.01) years, 64.02% were female, and 3,029 (10.11%), 15,972 (53.30%), 8,313 (27.74%), and 2,652 (8.85%) reported excellent, good, fair, and poor SRH, respectively. Among patients reporting poor SRH, 54.19% had a hospitalization event within 2 years compared with 22.65% for those having excellent SRH. In the adjusted analysis, patients with good, fair, and poor SRH had 1.31 (95% CI 1.21-1.42), 1.82 (95% CI 1.68-1.98), and 2.45 (95% CI 2.22, 2.70) higher hazards of hospitalization, respectively, than those with excellent SRH. Conclusion: SRH was independently associated with subsequent all-cause hospitalizations in patients with BD or MDD. This large study facilitates rapid interpretation of SRH values and underscores the need for proactive SRH screening in this population, which might inform resource allocation and enhance high-risk population detection.

Keywords: severe mental illnesses, hospitalization, risk prediction, patient-reported outcomes

Procedia PDF Downloads 160

Authors: Milica Lazic, Jovana Jestrovic

Abstract:

The aim of this research is to examine moderating role of positive and negative affect, defined as traits, in relationship between a number of stressful life events to which an individual is exposed and life satisfaction. The tendency to experience positive and negative emotions is considered as relatively independent, and life satisfaction depends on presence and intensity of emotions of different valence. However, the role of positive and negative affect can be much more complex. It can change the direction and/or intensity of correlation between a number of stressful life events and life satisfaction. Thus, this question is important for two reasons, (I) better comprehension of inconsistent result of correlation intensity between stressful events and life satisfaction (II) verification on what conditions positive and negative affect have a protective role, and on what conditions the positive and/or negative affect is vulnerability factor. Longitudinal data were collected in two waves from 660 adolescents. Firstly, participants completed the Positive and Negative Affect Schedule. A year later, Life events questionnaire, which measures the number of stressful events in the past six months and Satisfaction with Life Scale were administered. The data were analyzed using hierarchical regression analyses: three-way interaction. The results show that number of life events, positive and negative effect contribute to the level of life satisfaction. The check of moderation role shows the significant three-way interaction of number of life event, and both, positive and negative affect. Individuals who report high level of positive affect, estimate to be moderate to highly satisfied with their lives, regardless of number of stressors to which they are exposed and also how often they experience negative emotions. Individuals, who often experience negative emotions and rarely positive, report the lowest level of life satisfaction. It doesn't change despite the number of stressors they were exposed to. Individuals who report that rarely experience not only positive than also negative emotions estimate different level of life satisfaction depending on number of stressors they were exposed to. Under the influence of numerous stressors, their level of life satisfaction is low, and it's equal to life satisfaction level of individuals who often experience negative and rarely positive emotions. The result of this research shows that tendency to often experience positive emotions is the protective factor in situation when individuals are exposed to high number of stressors. On the other hand, tendency to rarely experience positive emotions present vulnerability factor. Conclusions and practical implications are further discussed.

Keywords: life events, life satisfaction, subjective well-being, positive and negative affect

Procedia PDF Downloads 296

Authors: Elham Falatoonitoosi, Vikki Schaffer, Don Kerr

Abstract:

Over-development for tourism and its consequences on residents’ well-being turn into a critical issue in tourism destinations. Learning about undesirable impacts of tourism has led many people to seek more sustainable and responsible tourism. The main objective of this research is to understand how and to what extent sustainable tourism development enhances locals’ well-being regarding stakeholder perception. The research was conducted in a coastal-hinterland tourism region through two sequential phases. At the first phase, a unique set of 19 sustainable tourism indicators resulted from a triplex model was used to examine the sustainability effects on the main factors of residents’ well-being including equity and living condition, life satisfaction, health condition, and education quality. The triplex model including i) systematic literature search, ii) convergent interviewing, and iii) DEMATEL aimed to develop sustainability indicators, specify them for a particular destination, and identify the dominant sustainability issues acting as key predictors in sustainable development. At the second phase, a hierarchical multiple regression was used to examine the relationship between sustainable development and local residents’ well-being. A number of 167 participants from five different groups of stakeholders perceived the importance level of each sustainability indicators regarding well-being factors on 5-point Likert scale. Results from the first phase indicated that sustainability training, government support, tourism sociocultural effects, tourism revenue, and climate change are the top dominant sustainability issues in the regional sustainable development. Results from the second phase showed that sustainable development considerably improves the overall residents’ well-being and has positive relationships with all well-being factors except life satisfaction. It explains that it was difficult for stakeholders to recognize a link between sustainable development and their overall life satisfaction and happiness. Among well-being’s factors, health condition was influenced the most by sustainability indicators that indicate stakeholders believed sustainability development can promote public health, health sector performance, quality of drinking water, and sanitation. For the future research, it is highly recommended to analysis the effects of sustainable tourism development on the other features of a tourism destination’s well-being including residents sociocultural empowerment, local economic growth, and attractiveness of the destination.

Keywords: residents' well-being, stakeholder perception, sustainability indicators, sustainable tourism

Procedia PDF Downloads 265

Authors: Branka Milicic Stanic, Romana Mijovic

Abstract:

In primary hyperparathyroidism, an increased risk of developing cardiovascular disease may exist due to increased activity of the renin-angiotensin-aldosterone system (RAAS). In adenomatous altered tissue of parathyroid gland, compared to normal tissue, there are two to fourfold increase in the expression of type 1 angiotensin II receptors. As there is a clear evidence of the independent role of aldosterone on the cardiovascular system, the aim of this study was to evaluate the existence of an association between aldosterone secretion and parathyroid hormone in patients with primary hyperparathyroidism. This study included 48 patients with elevated parathyroid hormone who had come to the Departement of Nuclear Medicine, Clinical Center of Vojvodina, for Parathyroid Scintigraphy. The control group consisted of 30 healthy subjects who matched age and gender to the study group. All the results were statistically processed by statistical package STATISTICA 14 (Statsoft Inc,Tulsa, OK, USA). The survey was conducted between February 2017 and April 2018 at the Departement of Nuclear Medicine and at the Departement for Endocinology Diagnoistics, in Clinical Center of Vojvodina, Novi Sad. Compared to the control group, the study group had statistically significantly higher values of aldosterone (p=0.028), total calcium (p=0.01), ionized calcium (p=0.003) and parathyroid hormone (N-TACT PTH) (p=0.00), while statistically a significant lower levels in the study group were for phosphorus (p=0.003) and vitamin D (p=0.04). A linear correlation analysis in the study group revealed a statistically significant degree of positive correlation between renin and N-TACT PTH (r=0.688, p<0.05); renin and calcium (r=0.673, p<0.05) and renin and ionized calcium (r=0.641, p<0.05). Serum aldosterone and parathyroid hormone levels (N-TACT) were correlated positively in patients with primary hyperparathyroidism (r=0.509, p<0.05). According to the linear correlation analysis in the control group, aldosterone showed no positive correlation with N-TACT PTH (r=-0.285, p>0.05), as well as total and ionized calcium (r=-0.200, p>0.05; r=-0.313, p>0.05). In multivariate regression analysis of the study group, the strongest predictive variable of aldosterone secretion was N-TACT PTH (p=0.011). Aldosterone correlated positively to PTH levels in patients with primary hyperparathyroidism, and the fact is that in these patients aldosterone might be a key mediator of cardiovascular symptoms. All this knowledge should help to find new treatments to prevent cardiovascular disease.

Keywords: aldosterone, hyperparathyroidism, parathyroid hormone, parathyroid gland

Procedia PDF Downloads 139

Authors: I. Gupta, C. Kathpal

Abstract:

Introduction: Time is really the only capital that any human being has, and the only thing he cannot afford to lose. Work life balance is a contested term on which researchers have begun to study in 1960s. Work-life balance refers to how people allocate time between their jobs and other pursuits, such as family, hobbies, and community involvement and includes the mental health fitness of the employees so that the future goal of organization to sustain the employees and earning profits can be achieved. Every organization primarily involves making a parity between the employees' work and their personal life by contributing the maximum. Aims and Objectives: The aim of the present study is to examine the impact of work-life balance as well as employee satisfaction on the organizational performance by evaluating the inter-related factors in order to maintain the healthy growth of concerns. Materials and Methods: To realize the aim of the study, an unstructured questionnaire, as well as face to face interview, was conducted from 100 persons which consisted majority of male members of top as well as middle level positions in the various organizations. The prime source of data collection was primary; however, the study has also used the theoretical contribution done in this respective field by various researchers. Results: Majority of the respondents were males(80%) from age group of 25-45. The collected data was analyzed through hypothesis testing statistical techniques such as correlation analysis, single regression analysis and ANOVA which has rejected the null hypothesis that there is no relation between work-life interface and organizational performance. The major finding of this study is that work-life balance is directly related to the organizations performance. The results show that the organization which works on the employee satisfaction earns more. Along with, there is a reduction of turnout rates, absenteeism, moreover, enhancement of productivity as well as revenue of corporations. Conclusion: The present study reflects that the disparity in the work-life balance gives invitation to many disorders either mental or physical which leads the dearth in performance. As a result, not only employees, however, organizations also suffers which is clearly shown in the interviews conducted face to face with employees. The study is not targeting the particular class of audience; however, it brings out benefits to the masses.

Keywords: work-life balance, performance, culture, organization, satisfaction

Procedia PDF Downloads 118

Authors: Sonia Arradaza-Pajaron

Abstract:

This study examined the relationship between transformational leadership (TL) and self-efficacy (SE) of academic heads in the implementation of a customized English language curriculum (CELC) among technological state universities and colleges in Leyte provinces and Biliran, Philippines. Results manifested that academic leaders practiced transformational leadership and are self-efficacious enough but with only moderate level in the effectiveness of CELC implementation. It was found out; further, that of the four identified transformational leadership components, except idealized influence, three of which demonstrated a significant relationship with CELC component variables, although in varying degree. Moreover, self-efficacy sources, especially vicarious experiences and verbal persuasion manifested moderate to high significant relationships with effective CELC curriculum implementation. Further, verbal persuasion and physiological/emotional condition manifested significant relationship with CELC-resource and CELC-contextual/community influence, respectively. Regression analysis showed that TL-individualized consideration component explained wider extent when correlated with CELC contextual/community components, while self-efficacy source-verbal persuasion demonstrated a wider extent with the three CELC components, namely; resource, process and physiological/emotional condition. Results further revealed that TL-individualized consideration manifested lesser influence with CELC implementation, while SE-verbal persuasion demonstrated stronger influence or effect on CELC-process, CELC-physiological/emotional, while lesser influence with CELC-resource. This implies that academic leaders, in order to carry out effective curriculum implementation, should provide more emphasis on school culture, its beliefs, practices and academic atmosphere but most of all empower human resources who are considered the backbone of the work place and can be directly affected by any curriculum shifts and challenges. To realize this, more values-skilled training programs must be designed for academic heads are needed to equip them with the necessary leadership skills, beliefs in their capacity to lead and their own enhance emotional well-being in leading subordinates and facilitating curriculum implementation.

Keywords: Customized English Language curriculum, CELC, self-efficacy, transformational leadership, values-skilled training

Procedia PDF Downloads 122

Authors: Kambiz Rasoulkhani, Jeanne Cole, Sybil Sharvelle, Ali Mostafavi

Abstract:

Dual water distribution systems have been proposed as solutions to enhance the sustainability and resilience of urban water systems by improving performance and decreasing energy consumption. The objective of this study was to evaluate the long-term resilience and robustness of dual water distribution systems versus singular water distribution systems under various stressors such as demand fluctuation, aging infrastructure, and funding constraints. To this end, the long-term dynamics of these infrastructure systems was captured using a simulation model that integrates institutional agency decision-making processes with physical infrastructure degradation to evaluate the long-term transformation of water infrastructure. A set of model parameters that varies for dual and singular distribution infrastructure based on the system attributes, such as pipes length and material, energy intensity, water demand, water price, average pressure and flow rate, as well as operational expenditures, were considered and input in the simulation model. Accordingly, the model was used to simulate various scenarios of demand changes, funding levels, water price growth, and renewal strategies. The long-term resilience and robustness of each distribution infrastructure were evaluated based on various performance measures including network average condition, break frequency, network leakage, and energy use. An ecologically-based resilience approach was used to examine regime shifts and tipping points in the long-term performance of the systems under different stressors. Also, Classification and Regression Tree analysis was adopted to assess the robustness of each system under various scenarios. Using data from the City of Fort Collins, the long-term resilience and robustness of the dual and singular water distribution systems were evaluated over a 100-year analysis horizon for various scenarios. The results of the analysis enabled: (i) comparison between dual and singular water distribution systems in terms of long-term performance, resilience, and robustness; (ii) identification of renewal strategies and decision factors that enhance the long-term resiliency and robustness of dual and singular water distribution systems under different stressors.

Keywords: complex systems, dual water distribution systems, long-term resilience performance, multi-agent modeling, sustainable and resilient water systems

Procedia PDF Downloads 292

Authors: Muhammad Asim, Mehvish Amjad

Abstract:

Background: Less than half of women in South Asia (SA) use any modern contraceptive method which leads to a huge burden of unintended pregnancies, unsafe abortions, maternal deaths, and socioeconomic loss. Women empowerment plays a pivotal role in improving various health seeking behaviours, including contraceptive use. The objective of this study to explore the association between women's empowerment and modern contraceptive, among rich and poor segment of population in SA. Methods: We used the most recent, large-scale, demographic health survey data of five South Asian countries, namely Afghanistan, Pakistan, Bangladesh, India, and Nepal. The outcome variable was the current use of modern contraceptive methods. The main exposure variable was a combination (interaction) of socio-economic status (SES) and women’s level of empowerment (low, medium, and high), where SES was bifurcated into poor and rich; and women empowerment was divided into three categories: decision making, attitude to violence and social independence. Moreover, overall women empowerment indicator was also created by using three dimensions of women empowerment. We applied both descriptive statistics and multivariable logistic regression techniques for data analyses. Results: Most of the women possessed ‘medium’ level of empowerment across South Asian Countries. The lowest attitude to violence empowerment was found in Afghanistan, and the lowest social independence empowerment was observed in Bangladesh across SA. However, Pakistani women have the lowest decision-making empowerment in the region. The lowest modern contraceptive use (22.1%) was found in Afghanistan and the highest (53.2%) in Bangladesh. The multivariate results depict that the overall measure of women empowerment does not affect modern contraceptive use among poor and rich women in most of South Asian countries. However, the decision-making empowerment plays a significant role among both poor and rich women to use modern contraceptive methods across South Asian countries. Conclusions: The effect of women’s empowerment on modern contraceptive use is not consistent across countries, and among poor and rich segment of population. Of the three dimensions of women’s empowerment, the autonomy of decision making in household affairs emerged as a stronger determinant of mCPR as compared with social independence and attitude towards violence against women.

Keywords: women empowerment, modern contraceptive use, South Asia, socio economic status

Procedia PDF Downloads 80

Authors: Marianne Simons, Sinan Kurt, Marjolein Stefens, Kai Karos, Johan Lataster

Abstract:

As cultural diversity within older populations in European countries increases, the role of cultural background should be taken account of in aging studies. Bonding social capital (BSC), containing someone’s socio-emotional resources, is recognised as an important ingredient for wellbeing in old age and found to be associated with someone’s cultural background. The current study examined the association between BSC, loneliness and wellbeing in a sample including older Turkish migrants with a collectivistic cultural background and native Dutch older adults, both living in the Netherlands, characterised by an individualistic culture. A sample of 119 Turkish migrants (64.7% male; age 65-87, M(SD)=71.13(5.04) and 124 native Dutch adults (32.3% male, age 65-94, M(SD)= 71.9(5.32) filled out either an online or printed questionnaire measuring BSC, psychological, social and emotional well-being, loneliness and relevant demographic covariates. Regression analysis - including confounders age, gender, level of education, physical health and relationship - showed positive associations between BSC and respectively emotional, social and psychological well-being and a negative association with loneliness in both samples. Moderation analyses showed that these associations were significantly stronger for the Turkish older migrants than for their native peers. Measurement invariance analysis indicated partial metric invariance for the measurement of BSC and loneliness and non-invariance for wellbeing, calling for caution comparing means between samples. The results stress the importance of BSC for wellbeing of older migrants from collectivistic cultures living in individualistic countries. Previous research, shows a trend of older migrants displaying lower levels of BSC as well as associated variables, such as education, physical health, and financial income. This calls for more research of the interplay between demographic and psychosocial factors restraining mental wellbeing of older migrant populations. Measurement invariance analyses further emphasize the importance of taking cultural background into account in positive aging studies.

Keywords: positive aging, cultural background, wellbeing, social capital, loneliness

Procedia PDF Downloads 90

Authors: Suchart Tripopsakul

Abstract:

This paper uses data from the Global Entrepreneurship Monitor (GEM) to investigate the difference of attitudes towards entrepreneurial intention (EI). EI is generally assumed to be the single most relevant predictor of entrepreneurial behavior. The aim of this paper is to examine a range of attitudes effect on individual’s intent to start a new venture. A cross-cultural comparison between Asia and Europe is used to further investigate the possible differences between potential entrepreneurs from these distinct national contexts. The empirical analysis includes a GEM data set of 10 countries (n = 10,306) which was collected in 2013. Logistic regression is used to investigate the effect of individual’s attitudes on EI. Independent variables include individual’s perceived capabilities, the ability to recognize business opportunities, entrepreneurial network, risk perceptions as well as a range of socio-cultural attitudes. Moreover, a cross-cultural comparison of the model is conducted including six ASEAN (Malaysia, Indonesia, Philippines, Singapore, Vietnam and Thailand) and four European nations (Spain, Sweden, Germany, and the United Kingdom). The findings support the relationship between individual’s attitudes and their entrepreneurial intention. Individual’s capability, opportunity recognition, networks and a range of socio-cultural perceptions all influence EI significantly. The impact of media attention on entrepreneurship and was found to influence EI in ASEAN, but not in Europe. On the one hand, Fear of failure was found to influence EI in Europe, but not in ASEAN. The paper develops and empirically tests attitudes toward Entrepreneurial Intention between ASEAN and Europe. Interestingly, fear of failure was found to have no significant effect in ASEAN, and the impact of media attention on entrepreneurship and was found to influence EI in ASEAN. Moreover, the resistance of ASEAN entrepreneurs to the otherwise high rates of fear of failure and high impact of media attention are proposed as independent variables to explain the relatively high rates of entrepreneurial activity in ASEAN as reported by GEM. The paper utilizes a representative sample of 10,306 individuals in 10 countries. A range of attitudes was found to significantly influence entrepreneurial intention. Many of these perceptions, such as the impact of media attention on entrepreneurship can be manipulated by government policy. The paper also suggests strategies by which Asian economy in particular can benefit from their apparent high impact of media attention on entrepreneurship.

Keywords: an entrepreneurial intention, attitude, GEM, ASEAN and Europe

Procedia PDF Downloads 311

Authors: Kristina Sakalauskiene, Renaldas Raisutis, Gintare Linkeviciute, Skaidra Valiukeviciene

Abstract:

Cutaneous melanoma is a melanocytic skin tumour, which has a very poor prognosis while is highly resistant to treatment and tends to metastasize. Thickness of melanoma is one of the most important biomarker for stage of disease, prognosis and surgery planning. In this study, we hypothesized that the automatic analysis of spectrophotometric images and high-frequency ultrasonic 2D data can improve differential diagnosis of cutaneous melanoma and provide additional information about tumour penetration depth. This paper presents the novel complex automatic system for non-invasive melanocytic skin tumour differential diagnosis and penetration depth evaluation. The system is composed of region of interest segmentation in spectrophotometric images and high-frequency ultrasound data, quantitative parameter evaluation, informative feature extraction and classification with linear regression classifier. The segmentation of melanocytic skin tumour region in ultrasound image is based on parametric integrated backscattering coefficient calculation. The segmentation of optical image is based on Otsu thresholding. In total 29 quantitative tissue characterization parameters were evaluated by using ultrasound data (11 acoustical, 4 shape and 15 textural parameters) and 55 quantitative features of dermatoscopic and spectrophotometric images (using total melanin, dermal melanin, blood and collagen SIAgraphs acquired using spectrophotometric imaging device SIAscope). In total 102 melanocytic skin lesions (including 43 cutaneous melanomas) were examined by using SIAscope and ultrasound system with 22 MHz center frequency single element transducer. The diagnosis and Breslow thickness (pT) of each MST were evaluated during routine histological examination after excision and used as a reference. The results of this study have shown that automatic analysis of spectrophotometric and high frequency ultrasound data can improve non-invasive classification accuracy of early-stage cutaneous melanoma and provide supplementary information about tumour penetration depth.

Keywords: cutaneous melanoma, differential diagnosis, high-frequency ultrasound, melanocytic skin tumours, spectrophotometric imaging

Procedia PDF Downloads 270

Authors: Chia Yu Chen, Shu Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Shu Jiuan Chen, Yen Ling Liu

Abstract:

Aim: It remains undetermined that whether increased work stress may affect the job satisfaction and career loyalty among nursing staffs in the operating room. The long-term goal of this study is to lengthen the professional life of operating room nurses by attenuating the work stress and enhancing their contentment in work. Method: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in the southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses. Chi-square test was used to analyze the categorical data and Pearson correlation was used to analyze the association between two numerical datasets (SPSS version 20.0). Results: The response rate was 80% (80/100) and a total of 73 (73%) completed forms were eventually proceeded for analysis. The average scores for work stress and job satisfaction of the operating room nurses were 145.96±32.91 and 47.38±6.07, respectively. The correlation coefficients of work stress versus job satisfaction and organizational identity were (r=-0.338, p=0.003 and r=-0.354, p=0.002), respectively. There were more nurses who took rotating shift quitted works from the operating room than those who took only dayshift (2＝5.176, p<0.05). Nurses who reported of having lower job satisfaction were associated with significantly higher turnover intention (t=3.714, p< 0.01). Following multivariate regression analysis, rotating shift and low job satisfaction were identified as the two independent predictors of intention to quit from working in the operating room. Conclusion: Our study clearly demonstrates that increased work stress significantly attenuates job satisfaction and organizational identity. Rotating shift is associated with higher work stress, lower job satisfaction, and higher turnover intention, which is consistent with the previous surveys carried out in the department of medical technology. Therefore, improvement of working quality in the operating rooms is essential to increase the retain intention of the well-trained nursing staffs. Further investigation into types of work shifts and other strategies of attenuating stress in workplace is currently undertaken in order to improve the job satisfaction and to decrease turnover intention in the operating room.

Keywords: rotating shift, work stress, job satisfaction, turnover intention

Procedia PDF Downloads 197

Authors: Alina M. Udall, Judith de Groot, Simon de Jong, Avi Shankar

Abstract:

There are many ways in which environmentally significant behavior can be explained. Dominant psychological theories, namely, the theory of planned behavior, the norm-activation theory, its extension, the value-belief-norm theory, and the theory of habit do not explain large parts of environmentally significant behaviors. A new and rapidly growing approach is to focus on how consumer’s identities predict environmentally significant behavior. Identity may be relevant because consumers have many identities that are assumed to guide their behavior. Therefore, we assume that many identities will guide environmentally significant behavior. Many identities can be relevant for environmentally significant behavior. In reviewing the literature, over 200 identities have been studied making it difficult to establish the key identities for explaining environmentally significant behavior. Therefore, this paper first aims to establish the key identities previously used for explaining environmentally significant behavior. Second, the aim is to test which key identities explain environmentally significant behavior. To address the aims, an online survey study (n = 578) is conducted. First, the exploratory factor analysis reveals 15 identity factors. The identity factors are namely, environmentally concerned identity, anti-environmental self-identity, environmental place identity, connectedness with nature identity, green space visitor identity, active ethical identity, carbon off-setter identity, thoughtful self-identity, close community identity, anti-carbon off-setter identity, environmental group member identity, national identity, identification with developed countries, cyclist identity, and thoughtful organisation identity. Furthermore, to help researchers understand and operationalize the identities, the article provides theoretical definitions for each of the identities, in line with identity theory, social identity theory, and place identity theory. Second, the hierarchical regression shows only 10 factors significantly uniquely explain the variance in environmentally significant behavior. In order of predictive power the identities are namely, environmentally concerned identity, anti-environmental self-identity, thoughtful self-identity, environmental group member identity, anti-carbon off-setter identity, carbon off-setter identity, connectedness with nature identity, national identity, and green space visitor identity. The identities explain over 60% of the variance in environmentally significant behavior, a large effect size. Based on this finding, the article reveals a new, theoretical framework showing the key identities explaining environmentally significant behavior, to help improve and align the field.

Keywords: environmentally significant behavior, factor analysis, place identity, social identity

Procedia PDF Downloads 451

Authors: Alvaro L. Ronco

Abstract:

Background and purpose: Although our country is a developing one, it has a typical Western meat-rich dietary style. Based on estimates of heme and nonheme iron contents in representative foods, we carried out the present epidemiologic study, with the aim of accurately analyzing dietary iron and its role on CRC risk. Subjects/methods: Patients (611 CRC incident cases and 2394 controls, all belonging to public hospitals of our capital city) were interviewed through a questionnaire including socio-demographic, reproductive and lifestyle variables, and a food frequency questionnaire of 64 items, which asked about food intake 5 years before the interview. The sample included 1937 men and 1068 women. Controls were matched by sex and age (± 5 years) to cases. Food-derived nutrients were calculated from available databases. Total dietary iron was calculated and classified by heme or nonheme source, following data of specific Dutch and Canadian studies, and additionally adjusted by energy. Odds Ratios (OR) and 95% confidence intervals were calculated through unconditional logistic regression, adjusting for relevant potential confounders (education, body mass index, family history of cancer, energy, infusions, and others). A heme/nonheme (H/NH) ratio was created and the interest variables were categorized into tertiles, for analysis purposes. Results: The following risk estimations correspond to the highest tertiles. Total iron intake showed no association with CRC risk neither among men (OR=0.83, ptrend =.18) nor among women (OR=1.48, ptrend =.09). Heme iron was positively associated among men (OR=1.88, ptrend < .001) and for the overall sample (OR=1.44, ptrend =.002), however, it was not associated among women (OR=0.91, ptrend =.83). Nonheme iron showed an inverse association among men (OR=0.53, ptrend < .001) and the overall sample (OR=0.78, ptrend =.04), but was not associated among women (OR=1.46, ptrend =.14). Regarding H/NH ratio, risks increased only among men (OR=2.12, ptrend < .001) but lacked of association among women (OR=0.81, ptrend =.29). Conclusions. We have observed different types of associations between CRC risk and high dietary heme, nonheme and H/NH iron ratio. Therefore, the source of the available iron might be of importance as a link to colorectal carcinogenesis, perhaps pointing to reconsider the animal/plant proportions of this vital mineral within diet. Nevertheless, the different associations observed for each sex, demand further studies in order to clarify these points.

Keywords: chelation, colorectal cancer, heme, iron, nonheme

Procedia PDF Downloads 170

Authors: Para Jansuwan, Kerstin K. Zander

Abstract:

Most people in rural Thailand still depend on agriculture. The rural areas are undergoing changes in their demographic structures with an increasing older population, out migration of younger people and a shift away from work in the agricultural sector towards manufacturing and service provisioning. These changes may lead to a decline in agricultural productivity and food insecurity. Our research aims to examine perceptions of older farmers on how rural demographic change affects them, to investigate how farmers may change their agricultural practices to cope with their ageing and to explore the factors affecting these changes, including the opportunities and challenges arising from them. The data were collected through a household survey with 368 farmers in the Prachin Buri province in central Thailand, the main area for agricultural production. A series of binomial logistic regression models were applied to analyse the data. We found that most farmers suffered from age-related diseases, which compromised their working capacity. Most farmers attempted to reduce labour intense work, by either stopping farming through transferring farmland to their children (41%), stopping farming by giving the land to the others (e.g., selling, leasing out) (28%) and continuing farming with making some changes (e.g., changing crops, employing additional workers) (24%). Farmers’ health and having a potential farm successor were positively associated with the probability of stopping farming by transferring the land to the children. Farmers with a successor were also less likely to stop farming by giving the land to the others. Farmers’ age was negatively associated with the likelihood of continuing farming by making some changes. The results show that most farmers base their decisions on the hope that their children will take over the farms, and that without successor, farmers lease out or sell the land. Without successor, they also no longer invest in expansion and improvement of their farm production, especially adoption of innovative technologies that could help them to maintain their farm productivity. To improve farmers’ quality of life and sustain their farm productivity, policies are needed to support the viability of farms, the access to a pension system and the smooth and successful transfer of the land to a successor of farmers.

Keywords: rural demographic change, older farmer, stopping farming, continuing farming, health and age, farm successor, Thailand

Procedia PDF Downloads 114

Authors: A. K. Faizah, G. Vadamalai, S. K. Balasundram, W. L. Lim

Abstract:

Pineapple (Ananas comosus) is a common crop in tropical and subtropical areas of the world. Malaysia once ranked as one of the top 3 pineapple producers in the world in the 60's and early 70's, after Hawaii and Brazil. Moreover, government’s recognition of the pineapple crop as one of priority commodities to be developed for the domestics and international markets in the National Agriculture Policy. However, pineapple industry in Malaysia still faces numerous challenges, one of which is the management of disease and pest. Red tip disease on pineapple was first recognized about 20 years ago in a commercial pineapple stand located in Simpang Renggam, Johor, Peninsular Malaysia. Since its discovery, there has been no confirmation on its causal agent of this disease. The epidemiology of red tip disease is still not fully understood. Nevertheless, the disease symptoms and the spread within the field seem to point toward viral infection. Bioassay test on nucleic acid extracted from the red tip-affected pineapple was done on Nicotiana tabacum cv. Coker by rubbing the extracted sap. Localised lesions were observed 3 weeks after inoculation. Negative staining of the fresh inoculated Nicotiana tabacum cv. Coker showed the presence of membrane-bound spherical particles with an average diameter of 94.25nm under transmission electron microscope. The shape and size of the particles were similar to tospovirus. SDS-PAGE analysis of partial purified virions from inoculated N. tabacum produced a strong and a faint protein bands with molecular mass of approximately 29 kDa and 55 kDa. Partial purified virions of symptomatic pineapple leaves from field showed bands with molecular mass of approximately 29 kDa, 39 kDa and 55kDa. These bands may indicate the nucleocapsid protein identity of tospovirus. Furthermore, a handheld sensor, Greenseeker, was used to detect red tip symptoms on pineapple non-destructively based on spectral reflectance, measured as Normalized Difference Vegetation Index (NDVI). Red tip severity was estimated and correlated with NDVI. Linear regression models were calibrated and tested developed in order to estimate red tip disease severity based on NDVI. Results showed a strong positive relationship between red tip disease severity and NDVI (r= 0.84).

Keywords: pineapple, diagnosis, virus, NDVI

Procedia PDF Downloads 791

Authors: Getahun Nigusie

Abstract:

Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: To assess incidence and predictors of mortality among HIV positive children on ART in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, Ethiopia

Procedia PDF Downloads 22

Authors: Zhi Hao Chow, Cian Mulligan, Jack Walsh, Antonio Garzon Vico, Dimitar Krastev

Abstract:

Drug development is resource-intensive, time-consuming, and increasingly expensive with each developmental stage. The success rates of drug development are also relatively low, and the resources committed are wasted with each failed candidate. As such, a reliable method of predicting the success of drug development is in demand. The hypothesis was that some examples of failed drug candidates are pushed through developmental pipelines based on false confidence and may possess common linguistic features identifiable through sentiment analysis. Here, the concept of using text analysis to discover such features in research publications and investor reports as predictors of success was explored. R studios were used to perform text mining and lexicon-based sentiment analysis to identify affective phrases and determine their frequency in each document, then using SPSS to determine the relationship between our defined variables and the accuracy of predicting outcomes. A total of 161 publications were collected and categorised into 4 groups: (i) Cancer treatment, (ii) Neurodegenerative disease treatment, (iii) Vaccines, and (iv) Others (containing all other drugs that do not fit into the 3 categories). Text analysis was then performed on each document using 2 separate datasets (BING and AFINN) in R within the category of drugs to determine the frequency of positive or negative phrases in each document. A relative positivity and negativity value were then calculated by dividing the frequency of phrases with the word count of each document. Regression analysis was then performed with SPSS statistical software on each dataset (values from using BING or AFINN dataset during text analysis) using a random selection of 61 documents to construct a model. The remaining documents were then used to determine the predictive power of the models. Model constructed from BING predicts the outcome of drug performance in clinical trials with an overall percentage of 65.3%. AFINN model had a lower accuracy at predicting outcomes compared to the BING model at 62.5% but was not effective at predicting the failure of drugs in clinical trials. Overall, the study did not show significant efficacy of the model at predicting outcomes of drugs in development. Many improvements may need to be made to later iterations of the model to sufficiently increase the accuracy.

Keywords: data analysis, drug development, sentiment analysis, text-mining

Procedia PDF Downloads 157

Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

Abstract:

Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

Procedia PDF Downloads 171

Authors: Daijun Chen

Abstract:

Affordable housing is subsidized by the government to meet the housing demand of low and middle-income urban residents in the process of urbanization and to alleviate the housing inequality caused by market-based housing reforms. It is a recognized fact that the living conditions of the insured have been improved while constructing the subsidized housing. However, the choice of affordable housing is mostly in the suburbs, where the surrounding urban functions and infrastructure are incomplete, resulting in the spatial mismatch of "jobs-housing" in affordable housing. The main reason for this problem is that the residents of affordable housing are more sensitive to the spatial location of their residence, but their selectivity and controllability to the housing location are relatively weak, which leads to higher commuting costs. Their real cost of living has not been effectively reduced. In this regard, 92 subsidized housing communities in Nanjing, China, are selected as the research sample in this paper. The residents of the affordable housing and their commuting Spatio-temporal behavior characteristics are identified based on the LBS (location-based service) data. Based on the spatial mismatch theory, spatial mismatch indicators such as commuting distance and commuting time are established to measure the spatial mismatch degree of subsidized housing in different districts of Nanjing. Furthermore, the geographically weighted regression model is used to analyze the influencing factors of the spatial mismatch of affordable housing in terms of the provision of employment opportunities, traffic accessibility and supporting service facilities by using spatial, functional and other multi-source Spatio-temporal big data. The results show that the spatial mismatch of affordable housing in Nanjing generally presents a "concentric circle" pattern of decreasing from the central urban area to the periphery. The factors affecting the spatial mismatch of affordable housing in different spatial zones are different. The main reasons are the number of enterprises within 1 km of the affordable housing district and the shortest distance to the subway station. And the low spatial mismatch is due to the diversity of services and facilities. Based on this, a spatial optimization strategy for different levels of spatial mismatch in subsidized housing is proposed. And feasible suggestions for the later site selection of subsidized housing are also provided. It hopes to avoid or mitigate the impact of "spatial mismatch," promote the "spatial adaptation" of "jobs-housing," and truly improve the overall welfare level of affordable housing residents.

Keywords: affordable housing, spatial mismatch, commuting characteristics, spatial adaptation, welfare benefits

Procedia PDF Downloads 108

Authors: J. Niyitegeka, G. Nshimirimana, A. Silverstein, J. Odhiambo, Y. Lin, T. Nkurunziza, R. Riviello, S. Rulisa, P. Banguti, H. Magge, M. Macharia, J. P. Dushime, R. Habimana, B. Hedt-Gauthier

Abstract:

In low-resource settings, women needing an emergency cesarean section experiences various delays in both reaching and receiving care that is often linked to poor neonatal outcomes. In this study, we quantified different measures of delays and assessed the association between these delays and neonatal outcomes at three rural district hospitals in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean sections in 2015 at Butaro, Kirehe and Rwinkwavu District Hospitals. Four possible delays were measured: Time from start of labor to district hospital admission, travel time from a health center to the district hospital, time from admission to surgical incision, and time from the decision for the emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR < 7 or death) and favorable (APGAR ≥ 7). We assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In our study, 38.7% (108 out of 279) of neonates’ mothers labored for 12 to 24 hours before hospital admission and 44.7% (159 of 356) of mothers were transferred from health centers that required 30 to 60 minutes of travel time to reach the district hospital. 48.1% (178 of 370) of caesarean sections started within five hours after admission and 85.2% (288 of 338) started more than thirty minutes after the decision for the emergency cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 minutes of travel time from the health center to the district hospital compared to health centers attached to the hospital (OR = 5.12, p = 0.02). Neonatal outcomes were also significantly different depending on decision to incision intervals; neonates with cesarean deliveries starting more than thirty minutes after decision had better outcomes than those started immediately (OR = 0.32, p = 0.04). Interventions that decrease barriers to access to maternal health care services can improve neonatal outcome after emergency cesarean section. Triaging could explain the inverse relationship between time from decision to incision and neonatal outcome; this must be studied more in the future.

Keywords: Africa, emergency obstetric care, rural health delivery, maternal and child health

Procedia PDF Downloads 224

Authors: Majeda S. Hammoud

Abstract:

Background and Aim: Gestational diabetes mellitus (GDM) is a common pregnancy complication affecting around 14% of pregnancies globally that carries short and long-term consequences to the mother and her child. Pre-pregnancy overweight or obesity is the most consistently and strongly associated modifiable risk factor with GDM development. This analysis aimed to determine whether vitamin D status during pregnancy modulates the effect of pre-pregnancy obesity/overweight on GDM risk while stratifying by maternal age. Methods: Data from the Kuwait Birth Cohort (KBC) study were analyzed, which enrolled pregnant women in the second or third trimester of gestation. Pre-pregnancy body mass index (BMI; kg/m2) was categorized as under/normal weight (<25.0), overweight (25.0 to <30.0), and obesity (≥30.0). 25 hydroxyvitamin D levels were measured in blood samples that were collected at recruitment and categorized as deficiency (<50 nmol/L) and insufficiency/sufficiency (≥50 nmol/L). GDM status was ascertained according to international guidelines. Logistic regression was used to evaluate associations, and adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated. Results: The analyzed study sample included a total of 982 pregnant women, with a mean (SD) age of 31.4 (5.2) years. The prevalence of GDM was estimated to be 17.3% (95% CI: 14.9-19.7), and the prevalence of pre-pregnancy overweight and obesity was 37.8% (95% CI: 34.8-40.8) and 28.8% (95% CI: 26.0-31.7), respectively. The prevalence of gestational vitamin D deficiency was estimated to be 55.3% (95% CI: 52.2-58.4). The association between pre-pregnancy overweight or obesity with GDM risk differed according to maternal age and gestational vitamin D status (Pinteraction[BMI × age × vitamin D = 0.047). Among pregnant women aged <35 years, prepregnancy obesity compared to under/normal weight was associated with increased GDM risk among women with gestational vitamin D deficiency (aOR: 3.65, 95% CI: 1.50-8.86, p = 0.004) and vitamin D insufficiency/sufficiency (aOR: 2.55, 95% CI: 1.16-5.61, p = 0.019). In contrast, among pregnant women aged ≥35 years, pre-pregnancy obesity compared to under/normal weight was associated with increased GDM risk among women with gestational vitamin D deficiency (aOR: 9.70, 95% CI: 2.01-46.69, p = 0.005), but not among women with vitamin D insufficiency/sufficiency (aOR: 1.46, 95% CI: 0.42-5.16, p = 0.553). Conclusion: The effect of pre-pregnancy obesity on GDM risk is modulated by maternal age and gestational vitamin D status, with the effect of pre-pregnancy obesity being more pronounced among older pregnant women (aged ≥35 years) with gestational vitamin D deficiency compared to those with vitamin D insufficiency/sufficiency. Whereas, among younger women (aged <35 years), the effect of pre-pregnancy obesity on GDM risk was not modulated by gestational vitamin D status. Therefore, vitamin D supplementation among pregnant women, specifically older women with pre-pregnancy obesity, may mitigate the effect of pre-pregnancy obesity on GDM risk.

Keywords: gestational diabetes mellitus, vitamin D, obesity, body mass index

Procedia PDF Downloads 38

Authors: Rutej R. Mehta, Michael A. Chappell

Abstract:

Introduction: Arterial spin labelling (ASL) is an increasingly popular perfusion MRI technique, in which arterial blood water is magnetically labelled in the neck before flowing into the brain, providing a non-invasive measure of cerebral blood flow (CBF). The accuracy of ASL CBF measurements, however, is hampered by dispersion effects; the distortion of the ASL labelled bolus during its transit through the vasculature. In spite of this, the current recommended implementation of ASL – the white paper (Alsop et al., MRM, 73.1 (2015): 102-116) – does not account for dispersion, which leads to the introduction of errors in CBF. Given that the transport time from the labelling region to the tissue – the arterial transit time (ATT) – depends on the region of the brain and the condition of the patient, it is likely that these errors will also vary with the ATT. In this study, various dispersion models are assessed in comparison with the white paper (WP) formula for CBF quantification, enabling the errors introduced by the WP to be quantified. Additionally, this study examines the relationship between the errors associated with the WP and the ATT – and how this is influenced by dispersion. Methods: Data were simulated using the standard model for pseudo-continuous ASL, along with various dispersion models, and then quantified using the formula in the WP. The ATT was varied from 0.5s-1.3s, and the errors associated with noise artefacts were computed in order to define the concept of significant error. The instantaneous slope of the error was also computed as an indicator of the sensitivity of the error with fluctuations in ATT. Finally, a regression analysis was performed to obtain the mean error against ATT. Results: An error of 20.9% was found to be comparable to that introduced by typical measurement noise. The WP formula was shown to introduce errors exceeding 20.9% for ATTs beyond 1.25s even when dispersion effects were ignored. Using a Gaussian dispersion model, a mean error of 16% was introduced by using the WP, and a dispersion threshold of σ=0.6 was determined, beyond which the error was found to increase considerably with ATT. The mean error ranged from 44.5% to 73.5% when other physiologically plausible dispersion models were implemented, and the instantaneous slope varied from 35 to 75 as dispersion levels were varied. Conclusion: It has been shown that the WP quantification formula holds only within an ATT window of 0.5 to 1.25s, and that this window gets narrower as dispersion occurs. Provided that the dispersion levels fall below the threshold evaluated in this study, however, the WP can measure CBF with reasonable accuracy if dispersion is correctly modelled by the Gaussian model. However, substantial errors were observed with other common models for dispersion with dispersion levels similar to those that have been observed in literature.

Keywords: arterial spin labelling, dispersion, MRI, perfusion

Procedia PDF Downloads 371

Authors: Tanida Julvanichpong

Abstract:

Exercise has been regarded as a necessary and important aspect to enhance physical performance and psychology health. Body weight statistics of students in junior high school students in Chonburi Province beyond a standard risk of obesity. Promoting exercise among Junior high school students in Chonburi Province, essential knowledge concerning factors influencing exercise is needed. Therefore, this study aims to (1) determine the levels of perceived exercise behavior, exercise behavior in the past, perceived barriers to exercise, perceived benefits of exercise, perceived self-efficacy to exercise, feelings associated with exercise behavior, influence of the family to exercise, influence of friends to exercise, and the perceived influence of the environment on exercise. (2) examine the predicting ability of each of the above factors while including personal factors (sex, educational level) for exercise behavior. Pender’s Health Promotion Model was used as a guide for the study. Sample included 652 students in junior high schools, Chonburi Provience. The samples were selected by Multi-Stage Random Sampling. Data Collection has been done by using self-administered questionnaires. Data were analyzed using descriptive statistics, Pearson’s product moment correlation coefficient, Eta, and stepwise multiple regression analysis. The research results showed that: 1. Perceived benefits of exercise, influence of teacher, influence of environmental, feelings associated with exercise behavior were at a high level. Influence of the family to exercise, exercise behavior, exercise behavior in the past, perceived self-efficacy to exercise and influence of friends were at a moderate level. Perceived barriers to exercise were at a low level. 2. Exercise behavior was positively significant related to perceived benefits of exercise, influence of the family to exercise, exercise behavior in the past, perceived self-efficacy to exercise, influence of friends, influence of teacher, influence of environmental and feelings associated with exercise behavior (p < .01, respectively) and was negatively significant related to educational level and perceived barriers to exercise (p < .01, respectively). Exercise behavior was significant related to sex (Eta = 0.243, p=.000). 3. Exercise behavior in the past, influence of the family to exercise significantly contributed 60.10 percent of the variance to the prediction of exercise behavior in male students (p < .01). Exercise behavior in the past, perceived self-efficacy to exercise, perceived barriers to exercise, and educational level significantly contributed 52.60 percent of the variance to the prediction of exercise behavior in female students (p < .01).

Keywords: predictive factors, exercise behaviors, Junior high school, Chonburi Province

Procedia PDF Downloads 616

Authors: Onyinyechi Joy Kingdom

Abstract:

Mergers and Acquisitions (M&A) have been proposed as a mechanism through which, problems associated with inefficiency or poor performance in financial institution could be addressed. The aim of this study is to examine the proposition that recapitalization of banks, which encouraged Mergers and Acquisitions in Nigeria banking system, would strengthen the domestic banks, improve financial deepening and the confidence of depositors. Hence, this study examines the impact of the 2005 M&A in the Nigerian-banking sector on financial deepening using mixed method (quantitative and qualitative approach). The quantitative process of this study utilised annual time series for financial deepening indicator for the period of 1997 to 2012. While, the qualitative aspect adopted semi-structured interview to collate data from three merged banks and three stand-alone banks to explore, understand and complement the quantitative results. Furthermore, a framework thematic analysis is employed to analyse the themes developed using NVivo 11 software. Using the quantitative approach, findings from the equality of mean test (EMT) used suggests that M&A have significant impact on financial deepening. However, this method is not robust enough given its weak validity as it does not control for other potential factors that may determine financial deepening. Thus, to control for other factors that may affect the level of financial deepening, a Multiple Regression Model (MRM) and Interrupted Times Series Analysis (ITSA) were applied. The coefficient for M&A dummy turned negative and insignificant using MRM. In addition, the estimated linear trend of the post intervention when ITSA was applied suggests that after M&A, the level of financial deepening decreased annually; however, this was statistically insignificant. Similarly, using the qualitative approach, the results from the interview supported the quantitative results from ITSA and MRM. The result suggests that interest rate should fall when capital base is increased to improve financial deepening. Hence, this study contributes to the existing literature the importance of other factors that may affect financial deepening and the economy when policies that will enhance bank performance and the economy are made. In addition, this study will enable the use of valuable policy instruments relevant to monetary authorities when formulating policies that will strengthen the Nigerian banking sector and the economy.

Keywords: mergers and acquisitions, recapitalization, financial deepening, efficiency, financial crisis

Procedia PDF Downloads 397

Authors: Carla Idely Palencia-Aguilar

Abstract:

Artificial wetlands play an important role at Guasca Municipality in Colombia, not only because they are used for the agroindustry, but also because more than 45 species were found, some of which are endemic and migratory birds. Remote sensing was used to determine the changes in the area occupied by water of artificial wetlands by means of Aster and Modis images for different time periods. Evapotranspiration was also determined by three methods: Surface Energy Balance System-Su (SEBS) algorithm, Surface Energy Balance- Bastiaanssen (SEBAL) algorithm, and Potential Evapotranspiration- FAO. Empirical equations were also developed to determine the relationship between Normalized Difference Vegetation Index (NDVI) versus net radiation, ambient temperature and rain with an obtained R2 of 0.83. Groundwater level fluctuations on a daily basis were studied as well. Data from a piezometer placed next to the wetland were fitted with rain changes (with two weather stations located at the proximities of the wetlands) by means of multiple regression and time series analysis, the R2 from the calculated and measured values resulted was higher than 0.98. Information from nearby weather stations provided information for ordinary kriging as well as the results for the Digital Elevation Model (DEM) developed by using PCI software. Standard models (exponential, spherical, circular, gaussian, linear) to describe spatial variation were tested. Ordinary Cokriging between height and rain variables were also tested, to determine if the accuracy of the interpolation would increase. The results showed no significant differences giving the fact that the mean result of the spherical function for the rain samples after ordinary kriging was 58.06 and a standard deviation of 18.06. The cokriging using for the variable rain, a spherical function; for height variable, the power function and for the cross variable (rain and height), the spherical function had a mean of 57.58 and a standard deviation of 18.36. Threatens of eutrophication were also studied, given the unconsciousness of neighbours and government deficiency. Water quality was determined over the years; different parameters were studied to determine the chemical characteristics of water. In addition, 600 pesticides were studied by gas and liquid chromatography. Results showed that coliforms, nitrogen, phosphorous and prochloraz were the most significant contaminants.

Keywords: DEM, evapotranspiration, geostatistics, NDVI

Procedia PDF Downloads 120