Search results for: robust regression

Authors: Stephen Anim, Emmanuel O. Sarpong, Daniel Apaak

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This study investigates the relationship between morphological predictors and running ability, emphasizing gender-specific variations among male and female athletes in Cape Coast Metropolis (CCM), Ghana. The dynamic interplay between an athlete's physique and their performance capabilities holds particular relevance in the realm of sports science, influencing training methodologies and talent identification processes. The research aims to contribute comprehensive insights into the morphological determinants of running proficiency, with a specific focus on the local athletic community in Cape Coast Metropolis. Utilizing a correlational research design, a thorough analysis of morphological features, encompassing 22 morphological features including body weight, 6 measurements related to body length, 7 body girth, and knee diameter, and 7 skinfold measurements against 50m dash, among male and female athletes, was conducted. The study involved 420 athletes both male (N=210) and female (N=210) aged 16-22 from 10 Senior High Schools (SHS) in the Cape Coast Metropolis, providing a representative sample of the local athletic community. The collected data were statistically analysed using means and standard deviation, and stepwise multiple regression to determine how morphological variables contribute to and predict running proficiency outcomes. The investigation revealed that athletes from Senior High Schools (SHS) in Cape Coast Metropolis (CCM) exhibit well-developed physiques and sufficient fitness levels suitable for overall athletic performance, taking into account gender differences. Moreover, the findings suggested that approximately 77% of running ability could be attributed to morphological factors, leading to diverse predictive models for male and female athletes within SHS in CCM, Ghana. Consequently, these formulated equations hold promise for predicting running ability among young athletes, particularly in the context of SHS environments.

Keywords: body fat, body girth, body length, morphological features, running ability, senior high school

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Authors: Phill-Seung Jung, Dae-Yeon Kim

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Objectives: In young, especially nulliparous women, it is not easy to decide on excisional therapy for cervical intraepithelial neoplasia (CIN). We aimed to evaluate how effective topical imiquimod is in the treatment of high-grade CIN so that excisional therapy can be avoided in young women. Methods: Patients with CIN were allocated to this pilot study. They did not want excisional therapy and agreed with topical imiquimod therapy, which required once-a-week hospital visit for 8 weeks for the application of imiquimod to the cervix by a gynecologic oncologist. If the lesion got worse during treatment, it was decided to convert imiquimod therapy to excisional therapy. Results: A total of 36 patients with a median age of 29 years (range, 22–41 years) agreed to receive topical imiquimod therapy. Of these, 32 patients (88.9%) were positive for high-risk human papillomavirus (HR HPV). Twenty-five patients (69.4%) had low-grade squamous intraepithelial lesion (LSIL), and 11 (30.6%) had high-grade squamous intraepithelial lesion (HSIL) on their initial LBC. Twenty-eight patients underwent punch biopsy, which showed CIN 1 in 7 (19.4%), CIN 2 in 11 (30.6%), and CIN 3 in 10 (27.8%) patients. Twenty patients finished the 8-week imiquimod therapy. Among them, 14 patients had CIN 2 or 3, and 6 patients had CIN 1. HR HPV was positive in 12 patients. On the last examination, 14 patients (70.0%) had negative intraepithelial lesions, 3 (15.0%) had atypical squamous cells of undetermined significance, and 1 (5.0%) had LSIL. Two patients had persistent HSIL: 1 patient underwent loop electrosurgical excision procedure, resulting in CIN 3 with positive resection margin, and the other patient underwent punch biopsy, resulting in intermediate cells and restarted imiquimod therapy. Only 7 patients were negative for HR HPV. Conclusions: This study showed that topical imiquimod therapy was effective for the treatment of high-grade CIN, with a histologic regression rate of 85.7% (14/20) and HPV eradication rate of 25.0% (8/32). Based on our findings, topical imiquimod therapy might have a successful therapeutic effect in young women with CIN 2-3 so that they can avoid excisional therapy. In addition, it could be a more reassuring treatment option for CIN 1 than just follow-up after few months. To confirm its efficacy, a phase II study with larger cohort would be needed.

Keywords: Imiquimod, Cervical Intraepthelial Neoplasia, Cervical Dysplasia, Human Papillomavirus

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Authors: Thapa M., J.P. Dutta, K.R. Pandey, R.R. Kattel

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Nepal is extremely vulnerable to the impact of climate change. To mitigate the climate change effects on agricultural production and productivity a range of adaptive strategies needs to be considered. The study was conducted to assess organic paddy production as a coping strategy to the adverse impact of climate change in Phulbari, VDC of Chitwan district. Altogether, 120 respondents (60 adopters of organic farming and 60 from non adopter) were selected using snowball technique of sampling. Pre- tested interview schedule, direct observation, focus group discussion, key informant interview as well as secondary data were used to collect the required information. Factors determining the adoption of organic farming were found to be age, year of schooling, training, frequency of extension contact, perception about climate change, economically active members and poor. A unit increase in these factors except poor would increase the probability of adoption by 4.1%, 7.5%, 7.8%, 43.1%, 41.8% and 7% respectively. However, for poor, it would decrease the probability of adoption of organic farming by 5.1%. Average organic matter content in the adopters' field was higher (2.7%) than the non-adopters' field (2.5%). The regression result showed that type of farmer, price and area under rice cultivation had positive and significant relationship with income; however dependency ratio had negative relationship. As the year of adoption of organic farming increases, the production of rice decline in the first two years then after goes on increasing but the cost of production goes on decreasing with the year of adoption. The respondents adapted to the changing climate through diversification of crops, use of resistance varieties and following good cropping pattern. Gradually growing consumers' awareness about health, preference towards quality food products are the strong points behind organic farming, whereas lacks of bio-fertilizers, lack of effective extension services, no price differentiation between organic and inorganic products were the weak points. There is need for more training and education to change the attitude of farmers and enhance their confidence about the role of organic farming to cope with climate change impact.

Keywords: Organic farming, climate change, sustainable development

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Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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Authors: Yosef Kassa

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Gondar City, a city in Ethiopia, is going through growth and increased use of motor vehicles, causing issues of traffic congestion, pollution, and limited mobility options. Despite the growing number of cars on the road, walking still accounts for 54% of all journeys. However, the city’s transportation planning has mainly focused on accommodating vehicles, leading to a lack of infrastructure for non-motorized transportation (nmt). This study utilized GIS analysis and surveys involving residents to examine how aspects of the city impact motorized transport. The GIS analysis objectively evaluated built environment factors influencing nmt, such as infrastructure quality, land usage patterns, topography features, and environmental factors using a multi-criteria analysis method (mca). The survey gathered feedback from residents on these factors and analyzed them statistically. The GIS analysis pinpointed areas with potential for nmt, slopes (<10.03°), mixed-use developments with 15% coverage, and high intersection densities (> 4.2/100m). On the hand, steep slopes (>23.77°) and low intersection areas require interventions. The MCA analysis indicated that 66% of areas in Gondar City had limited nmt accessibility levels, while only 7% were considered accessible. According to survey findings, environmental characteristics such as building density differed throughout sub-cities and demographics, with 1-3 story townhouses dominating Azezo Teda compared to connected kebele housing in Arada, while agreeing topography has obstructed walking. Correlation analysis shows significant relationships like topographies' negative associations with connectivity (-0.373**) and infrastructure (-0.391**). Although, regression analysis found housing type (1.036), safety (-0.688), land use (0.933), connectedness (0.585), and infrastructure (0.889) with p<0.05 were among the determinants of transportation frequency. The integrated analysis uncovered disparities between survey analysis and GIS analysis. In Azezo Teda, the GIS score is 2.27, while the survey score is 2.89. However, there is a correlation (rho=0.56, p<0.01) indicating the reliability of gis in assessing walkability. This research offers insights for enhancing nmt accessibility in Gondar City by promoting transportation planning that focuses on (nmt) and the needs of residents.

Keywords: non-motorized transportation, accessibility, built environment, infrastructure

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Authors: Panaya Sudta, Wanchalerm Patanacharoenwong, Prachya Bumrungkun

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As With the evolution of smart grids, ensuring the reliability and efficiency of electrical systems in smart cities has become crucial. This paper proposes a distinct approach that combines advanced machine learning techniques to accurately predict electrical failures and address voltage reliability issues. This approach aims to improve the accuracy and efficiency of reliability evaluations in smart cities. The aim of this research is to develop a comprehensive predictive model that accurately predicts electrical failures and voltage reliability in smart cities. This model integrates RFM analysis, K-means clustering, and LSTM networks to achieve this objective. The research utilizes RFM analysis, traditionally used in customer value assessment, to categorize and analyze electrical components based on their failure recency, frequency, and monetary impact. K-means clustering is employed to segment electrical components into distinct groups with similar characteristics and failure patterns. LSTM networks are used to capture the temporal dependencies and patterns in customer data. This integration of RFM, K-means, and LSTM results in a robust predictive tool for electrical failures and voltage reliability. The proposed model has been tested and validated on diverse electrical utility datasets. The results show a significant improvement in prediction accuracy and reliability compared to traditional methods, achieving an accuracy of 92.78% and an F1-score of 0.83. This research contributes to the proactive maintenance and optimization of electrical infrastructures in smart cities. It also enhances overall energy management and sustainability. The integration of advanced machine learning techniques in the predictive model demonstrates the potential for transforming the landscape of electrical system management within smart cities. The research utilizes diverse electrical utility datasets to develop and validate the predictive model. RFM analysis, K-means clustering, and LSTM networks are applied to these datasets to analyze and predict electrical failures and voltage reliability. The research addresses the question of how accurately electrical failures and voltage reliability can be predicted in smart cities. It also investigates the effectiveness of integrating RFM analysis, K-means clustering, and LSTM networks in achieving this goal. The proposed approach presents a distinct, efficient, and effective solution for predicting and mitigating electrical failures and voltage issues in smart cities. It significantly improves prediction accuracy and reliability compared to traditional methods. This advancement contributes to the proactive maintenance and optimization of electrical infrastructures, overall energy management, and sustainability in smart cities.

Keywords: electrical state prediction, smart grids, data-driven method, long short-term memory, RFM, k-means, machine learning

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Authors: Lizel Bertie, Kim Johnston

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Parental emotion regulation plays a central role in the socialisation of emotion, especially when teaching young children to cope with negative emotions. Despite evidence which shows non-supportive parental responses to children’s expression of negative emotions has implications for the social and emotional development of the child, few studies have investigated risk factors which impact parental emotion socialisation processes. The current study aimed to explore the extent to which parental stress contributes to both difficulties in parental emotion regulation and non-supportive parental responses to children’s expression of negative emotions. In addition, the study examined whether parental use of expressive suppression as an emotion regulation strategy facilitates the influence of parental stress on non-supportive responses by testing the relations in a mediation model. A sample of 140 Australian adults, who identified as parents with children aged 5 to 10 years, completed an online questionnaire. The measures explored recent symptoms of depression, anxiety, and stress, the use of expressive suppression as an emotion regulation strategy, and hypothetical parental responses to scenarios related to children’s expression of negative emotions. A mediated regression indicated that parents who reported higher levels of stress also reported higher levels of expressive suppression as an emotion regulation strategy and increased use of non-supportive responses in relation to young children’s expression of negative emotions. These findings suggest that parents who experience heightened symptoms of stress are more likely to both suppress their emotions in parent-child interaction and engage in non-supportive responses. Furthermore, higher use of expressive suppression strongly predicted the use of non-supportive responses, despite the presence of parental stress. Contrary to expectation, no indirect effect of stress on non-supportive responses was observed via expressive suppression. The findings from the study suggest that parental stress may become a more salient manifestation of psychological distress in a sub-clinical population of parents while contributing to impaired parental responses. As such, the study offers support for targeting overarching factors such as difficulties in parental emotion regulation and stress management, not only as an intervention for parental psychological distress, but also the detection and prevention of maladaptive parenting practices.

Keywords: emotion regulation, emotion socialisation, expressive suppression, non-supportive responses, parental stress

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Authors: Jonathan Soliman, Thomas Cavasino, Virginie Pommelet, Lahouari Amor, Pierre Mornand, Simon Escoda, Nina Droz, Soraya Matczak, Julie Toubiana, François Angoulvant, Etienne Carbonnelle, Albert Faye, Loic de Pontual, Luu-Ly Pham

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Background: Typhoid and paratyphoid fever are systemic infections caused by Salmonella enterica serovar Typhi or paratyphi (A, B, C). Children traveling to tropical areas are at risk to contract these diseases which can be complicated. Methods: Clinical, biological and bacteriological data were collected from 78 pediatric cases reported between 2000 and 2017 in six Parisian hospitals. Children aged 0 to 18 years old, with a diagnosis of typhoid or paratyphoid fever confirmed by bacteriological exams, were included. Epidemiologic, clinical, biological features and presence of multidrug-resistant (MDR) bacteria or intermediate susceptibility to ciprofloxacin (nalidixic acid resistant) were examined by univariate analysis and by logistic regression analysis to identify risk factors of severe typhoid in children. Results: 84,6% of the children were imported cases of typhoid fever (n=66/78) and 15,4% were autochthonous cases (n=12/78). 89,7% were caused by S.typhi (n=70/78) and 12,8% by S.paratyphi (n=10/78) including 2 co-infections. 19,2% were intrafamilial cases (n=15/78). Median age at diagnosis was 6,4 years-old [6 months-17,9 years]. 28,2% of the cases were complicated forms (n=22/78): digestive (n=8; 10,3%), neurological (n=7; 9%), pulmonary complications (n=4; 5,1%) and hemophagocytic syndrome (n=4; 5,1%). Only 5% of the children had prior immunization with typhoid non-conjugated vaccine (n=4/78). 28% of the cases (n=22/78) were caused by resistant bacteria. Thrombocytopenia and diagnosis delay was significantly associated with severe infection (p= 0.029 and p=0,01). Complicated forms were more common with MDR (p=0,1) and not statistically associated with a young age or sex in this study. Conclusions: Typhoid and paratyphoid fever are not rare in children back from tropical areas. This multicentric pediatric study seems to show that thrombocytopenia, diagnosis delay, and multidrug resistant bacteria are associated with severe typhoid fever and complicated forms in children.

Keywords: antimicrobial resistance, children, Salmonella enterica typhi and paratyphi, severe typhoid

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Authors: Parikshit Gogo, N. N. Dutta

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The oxidative enzymes specially laccase (benzenediol: oxygen oxidoreductase, E.C.1.10.3.2) from bacteria, fungi and plants have been playing an important role in green technologies due to their specific advantageous properties. Laccase from different sources and in different forms was used as a biocatalyst in many oxidation and conjugation reactions starting from phenol to hydrocarbons. Tea polyphenols and its derivatives attract the scientific community because of their potential use as antioxidants in food, pharmaceutical and cosmetic industries. Conjugate of polyphenols emerged as a novel materials which shows better stability and antioxidant properties in applied fields. The conjugation reaction of catechin with poly (allylamine) has been studied using free, immobilized and cross-linked enzyme crystals (CLEC) of laccase from Trametes versicolor with particular emphasis on the effect of pertinent variables and kinetic aspects of the reaction. The stability and antioxidant property of the conjugated product was improved as compared to the unconjugated tea polyphenols. The reaction was studied in 11 different solvents in order to deduce the solvent effect through an attempt to correlate the initial reaction rate with solvent properties such as hydrophobicity (logP), water solubility (logSw), electron pair acceptance (ETN) and donation abilities (DNN), polarisibility and dielectric constant which exhibit reasonable correlations. The study revealed, in general that polar solvents favour the initial reaction rate. The kinetics of the conjugation reaction conformed to the so-called Ping-Pong-Bi-Bi mechanism with catechin inhibition. The stability as well as activity of the CLEC was better than the free enzymes and immobilized laccase for practical application. In case of immobilized laccase system marginal diffusional limitation could be inferred from the experimental data. The kinetic parameters estimated by non-linear regression analysis were found to be KmPAA(mM) = 0.75, 1.8967 and Kmcat (mM) = 11.769, 15.1816 for free and immobilized laccase respectively. An attempt has been made to assess the activity of the laccase for the conjugation reaction in relation to other reactions such as dimerisation of ferulic acids and develop a protocol to enhance polyphenol antioxidant activity.

Keywords: laccase, catechin, conjugation reaction, antioxidant properties

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Lina Psarra, Manogj Sundaresan, Purjeet Sutar

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In response to the global imperative for sustainable solutions, this article proposes the development of a comprehensive circularity index applicable to a wide range of products across various industries. The absence of a consensus on using a universal metric to assess circularity performance presents a significant challenge in prioritizing and effectively managing sustainable initiatives. This circularity index serves as a quantitative measure to evaluate the adherence of products, processes, and systems to the principles of a circular economy. Unlike traditional distinct metrics such as recycling rates or material efficiency, this index considers the entire lifecycle of a product in one single metric, also incorporating additional factors such as reusability, scarcity of materials, reparability, and recyclability. Through a systematic approach and by reviewing existing metrics and past methodologies, this work aims to address this gap by formulating a circularity index that can be applied to diverse product portfolio and assist in comparing the circularity of products on a scale of 0%-100%. Project objectives include developing a formula, designing and implementing a pilot tool based on the developed Product Circularity Index (PCI), evaluating the effectiveness of the formula and tool using real product data, and assessing the feasibility of integration into various sustainability initiatives. The research methodology involves an iterative process of comprehensive research, analysis, and refinement where key steps include defining circularity parameters, collecting relevant product data, applying the developed formula, and testing the tool in a pilot phase to gather insights and make necessary adjustments. Major findings of the study indicate that the PCI provides a robust framework for evaluating product circularity across various dimensions. The Excel-based pilot tool demonstrated high accuracy and reliability in measuring circularity, and the database proved instrumental in supporting comprehensive assessments. The PCI facilitated the identification of key areas for improvement, enabling more informed decision-making towards circularity and benchmarking across different products, essentially assisting towards better resource management. In conclusion, the development of the Product Circularity Index represents a significant advancement in global sustainability efforts. By providing a standardized metric, the PCI empowers companies and stakeholders to systematically assess product circularity, track progress, identify improvement areas, and make informed decisions about resource management. This project contributes to the broader discourse on sustainable development by offering a practical approach to enhance circularity within industrial systems, thus paving the way towards a more resilient and sustainable future.

Keywords: circular economy, circular metrics, circularity assessment, circularity tool, sustainable product design, product circularity index

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Authors: Justine Jun

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This study aims to reveal migrant women English instructors' workplace learning experiences in Canadian post-secondary institutions in Ontario. Although many scholars have conducted research studies on internationally educated teachers and their professional and employment challenges, few studies have recorded migrant women English language instructors’ professional learning and support experiences in post-secondary English language programs in Canada. This study employs a qualitative research paradigm. Mezirow’s Transformative Learning Theory is an essential lens for the researcher to explain, analyze, and interpret the research data. It is a collaborative research project. The researcher and participants cooperatively create photographic or other artwork data responding to the research questions. Photovoice and arts-informed data collection methodology are the main methods. Research participants engage in the study as co-researchers and inquire about their own workplace learning experiences, actively utilizing their critical self-reflective and dialogic skills. Co-researchers individually select the forms of artwork they prefer to engage with to represent their transformative workplace learning experiences about the Canadian workplace cultures that they underwent while working with colleagues and administrators in the workplace. Once the co-researchers generate their cultural artifacts as research data, they collaboratively interpret their artworks with the researcher and other volunteer co-researchers. Co-researchers jointly investigate the themes emerging from the artworks. They also interpret the meanings of their own and others’ workplace learning experiences embedded in the artworks through interactive one-on-one or group interviews. The following are the research questions that the migrant women English instructor participants examine and answer: (1) What have they learned about their workplace culture and how do they explain their learning experiences?; (2) How transformative have their learning experiences been at work?; (3) How have their colleagues and administrators influenced their transformative learning?; (4) What kind of support have they received? What supports have been valuable to them and what changes would they like to see?; (5) What have their learning experiences transformed?; (6) What has this arts-informed research process transformed? The study findings implicate English language instructor support currently practiced in post-secondary English language programs in Ontario, Canada, especially for migrant women English instructors. This research is a doctoral empirical study in progress. This research has the urgency to address the research problem that few studies have investigated migrant English instructors’ professional learning and support issues in the workplace, precisely that of English instructors working with adult learners in Canada. While appropriate social and professional support for migrant English instructors is required throughout the country, the present workplace realities in Ontario's English language programs need to be heard soon. For that purpose, the conceptualization of this study is crucial. It makes the investigation of under-represented instructors’ under-researched social phenomena, workplace learning and support, viable and rigorous. This paper demonstrates the robust theorization of English instructors’ workplace experiences using Mezirow’s Transformative Learning Theory in the English language teacher education field.

Keywords: English teacher education, professional learning, transformative learning theory, workplace learning

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Authors: A. C. Obosi, H. O. Osinowo, L. I. Okeke

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Benign prostatic hyperplasia (BPH) is one among other prostate diseases with an increasing public health concern. The prevalence and increased psychological distress of BPH among men negatively impact on their health-related quality of life (HRQoL). Although several biomedical factors have been implicated in poor HRQoL among people with BPH, there is a dearth of research on the psychosocial factors predicting HRQoL among them especially in developing climes. This study, therefore, examined the psychosocial (knowledge, perceived stigma, depression, anxiety, perceived social support and illness acceptance) predictors of health-related quality of life among persons living with BPH in Ibadan, Nigeria. Biopsychosocial model and Health-related Quality of life guided this study which utilized ex-post facto design. Eighty-seven males living with BPH were purposively selected and actively participated in the study. Participants’ mean age was 61.77 ± 15.80 years. A standardized questionnaire comprising Socio-demographics and measures of health-related quality of life (α = 0.47); knowledge (α = 0.72); psychological distress (α = 0.95); perceived social support (α = 0.96) and Illness acceptance (α = 0.89) scales was utilized in the study. Data were content analysed, while bivariate correlation, hierarchical multiple regression and t-test for independent samples were computed at p < 0.05. Results revealed that 42.5% of the respondents reported poor HRQoL. Furthermore, age, length of illness, perceived stigma, depression, anxiety, knowledge, perceived social support and illness acceptance jointly predicted HRQoL significantly (R2=0.33, F(9,75)=4.05) and accounted for 33% variance in the total observed variance on HRQoL, while Illness acceptance (β=0.43), anxiety (β=-0.54), and perceived social support (β=0.16) had significant independent contributions to the observed variance on HRQoL. Illness acceptance, knowledge, perceived social support and psychological distress such as anxiety, depression and perceived stigma are important predictors of HRQoL. Therefore, it was recommended that urgent psychological intervention targeted at improving the quality of life of these persons be undertaken.

Keywords: benign prostatic hyperplasia, Health-related quality of life, prostate disorders, psychosocial factors

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Authors: Emil Sakharov, Alex Zotov, Ilkin Osmanov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

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Objective: Since 2015, our center has been actively implementing methods of surgical correction of atrial fibrillation, in particular, in patients with coronary heart disease. The study presents a comparative analysis of the late postoperative period in patients with coronary artery bypass grafting and atrial fibrillation. Methods: The study included 150 patients with ischemic heart disease and atrial fibrillation for the period from 2015 to 2021. Patients were divided into 2 groups. The first group is represented by patients with ischemic heart disease and atrial fibrillation who underwent coronary bypass surgery and surgical correction of atrial fibrillation (N=50). The second group is represented by patients with ischemic heart disease and atrial fibrillation who underwent only myocardial revascularization (N=100). Patients were comparable in age, gender, and initial severity of the condition. Among the patients in group 1 there were 82% were men, while in the second group, their number was 75%. Among the patients of the first group, there were 36% with persistent atrial fibrillation, 20% with long-term persistent atrial fibrillation. In the second group, 10% with persistent atrial fibrillation and 17% with long-term persistent atrial fibrillation. Results: Average follow-up for groups 1 and 2 amounted to 47 months. There were no complications in group 1, such as bleeding and stroke. There was only 1 patient in group 1, who had died from cardiovascular disease. Freedom of atrial fibrillation was in 82% without AADs therapy. In group 2 there were 8 patients who had died from cardiovascular diseases and total freedom of atrial fibrillation was in 35% of patients, among which 42.8% had additional AADs therapy. Follow-up data are presented in Table 2. Progression of heart failure was observed in 3% in group 1 and 7% in group 2. Combined endpoints (recurrence of AF, stroke, progression of heart failure, myocardial infarction) were achieved in 16% in group 1 and 34% in group 2, respectively. Freedom from atrial fibrillation without antiarrhythmic therapy was 82% for group 1 and 35% for group 2. In the first group, there is a more pronounced decrease in heart failure rates. Deaths from cardiovascular causes were recorded in 2% for group 1 and 7% for group 2. Conclusion: Surgical treatment of atrial fibrillation helps to reduce adverse complications in the late postoperative period and contributes to the regression of heart failure.

Keywords: atrial fibrillation, coronary artery bypass grafting, ischaemic heart disease, heart failure

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Authors: Nadia Nisar

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Background: In the temperate regions Influenza activities occur sporadically all year round with peaks coinciding during cold months. Meteorological and environmental conditions play significant role in the transmission of influenza globally. In this study, we assessed the relationship between meteorological parameters and influenza activity in two geographical areas of Pakistan. Methods: Influenza data were collected from Islamabad (north) and Multan (south) regions of national influenza surveillance system during 2010-2015. Meteorological database was obtained from National Climatic Data Center (Pakistan). Logistic regression model with a stepwise approach was used to explore the relationship between meteorological parameters with influenza peaks. In statistical model, we used the weekly proportion of laboratory-confirmed influenza positive samples to represent Influenza activity with metrological parameters as the covariates (temperature, humidity and precipitation). We also evaluate the link between environmental conditions associated with seasonal influenza epidemics: 'cold-dry' and 'humid-rainy'. Results: We found that temperature and humidity was positively associated with influenza in north and south both locations (OR = 0.927 (0.88-0.97)) & (OR = 0.1.078 (1.027-1.132)) and (OR = 1.023 (1.008-1.037)) & (OR = 0.978 (0.964-0.992)) respectively, whilst precipitation was negatively associated with influenza (OR = 1.054 (1.039-1.070)) & (OR = 0.949 (0.935-0.963)). In both regions, temperature and humidity had the highest contribution to the model as compared to the precipitation. We revealed that the p-value for all of climate parameters is <0.05 by Independent-sample t-test. These results demonstrate that there were significant relationships between climate factors and influenza infection with correlation coefficients: 0.52-0.90. The total contribution of these three climatic variables accounted for 89.04%. The reported number of influenza cases increased sharply during the cold-dry season (i.e., winter) when humidity and temperature are at minimal levels. Conclusion: Our findings showed that measures of temperature, humidity and cold-dry season (winter) can be used as indicators to forecast influenza infections. Therefore integrating meteorological parameters for influenza forecasting in the surveillance system may benefit the public health efforts in reducing the burden of seasonal influenza. More studies are necessary to understand the role of these parameters in the viral transmission and host susceptibility process.

Keywords: influenza, climate, metrological, environmental

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Authors: Hiromi Takafuji

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It is a well-known fact that health care and welfare are the foundation of human activities, and human service professionals such as nurses and child care workers support these activities. COVID-19 pandemic has made the severity of the working environment in these fields even more known. It is high time to discuss the work of human service workers for the sustainable development of the human environment. Early turnover has been recognized as a long-standing issue in these fields. In Japan, the attrition rate within three years of graduation for these occupations has remained high at about 40% for more than 20 years. One of the reasons for this is Reality Shock: RS, which refers to the stress caused by the gap between pre-employment expectations and the post-employment reality experienced by new workers. The purpose of this study was to academically elucidate the mechanism of RS among human service professionals and to contribute to countermeasures against it. Firstly, to explore the structure of the relationship between professionalism and workers' RS, an exploratory interview survey was conducted and analyzed by text mining and content analysis. The results showed that the expectation of professionalism influences RS as a pre-employment job expectation. Next, the expectations of professionalism were quantified and categorized, and the responses of a total of 282 human service work professionals, nurses, child care workers, and caregivers; were finalized for data analysis. The data were analyzed using exploratory factor analysis, confirmatory factor analysis, multiple regression analysis, and structural equation modeling techniques. The results revealed that self-control orientation and authority orientation by qualification had a direct positive significant impact on RS. On the other hand, interpersonal helping orientation and altruistic orientation were found to have a direct negative significant impact and an indirect positive significant impact on RS.; we were able to clarify the structure of work expectations that affect the RS of welfare professionals, which had not been clarified in previous studies. We also explained the limitations, practical implications, and directions for future research.

Keywords: human service professional, new hire turnover, SEM, reality shock

Procedia PDF Downloads 99

Authors: Tagel Gebrehiwot, Carolina Castilla

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Food insecurity and child malnutrition are among the most critical issues in Ethiopia. Accordingly, different reform programs have been carried to improve household food security. The Food Security Program (FSP) (among others) was introduced to combat the persistent food insecurity problem in the country. The FSP combines a safety net component called the Productive Safety Net Program (PSNP) started in 2005. The goal of PSNP is to offer multi-annual transfers, such as food, cash or a combination of both to chronically food insecure households to break the cycle of food aid. Food or cash transfers are the main elements of PSNP. The case for cash transfers builds on the Sen’s analysis of ‘entitlement to food’, where he argues that restoring access to food by improving demand is a more effective and sustainable response to food insecurity than food aid. Cash-based schemes offer a greater choice of use of the transfer and can allow a greater diversity of food choice. It has been proven that dietary diversity is positively associated with the key pillars of food security. Thus, dietary diversity is considered as a measure of household’s capacity to access a variety of food groups. Studies of dietary diversity among Ethiopian rural households are somewhat rare and there is still a dearth of evidence on the impact of PSNP on household dietary diversity. In this paper, we examine the impact of the Ethiopia’s PSNP on household dietary diversity and child nutrition using panel household surveys. We employed different methodologies for identification. We exploit the exogenous increase in kebeles’ PSNP budget to identify the effect of the change in the amount of money households received in transfers between 2012 and 2014 on the change in dietary diversity. We use three different approaches to identify this effect: two-stage least squares, reduced form IV, and generalized propensity score matching using a continuous treatment. The results indicate the increase in PSNP transfers between 2012 and 2014 had no effect on household dietary diversity. Estimates for different household dietary indicators reveal that the effect of the change in the cash transfer received by the household is statistically and economically insignificant. This finding is robust to different identification strategies and the inclusion of control variables that determine eligibility to become a PSNP beneficiary. To identify the effect of PSNP participation on children height-for-age and stunting we use a difference-in-difference approach. We use children between 2 and 5 in 2012 as a baseline because by then they have achieved long-term failure to grow. The treatment group comprises children ages 2 to 5 in 2014 in PSNP participant households. While changes in height-for-age take time, two years of additional transfers among children who were not born or under the age of 2-3 in 2012 have the potential to make a considerable impact on reducing the prevalence of stunting. The results indicate that participation in PSNP had no effect on child nutrition measured as height-for-age or probability of beings stunted, suggesting that PSNP should be designed in a more nutrition-sensitive way.

Keywords: continuous treatment, dietary diversity, impact, nutrition security

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Authors: Naridchaya Aberdour, Joanna Kao, Anne Miller, Timothy Shore, Richard Maher, Zhixin Liu

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Background: COVID-19 has and continues to be a strain on healthcare globally, with the number of patients requiring hospitalization exceeding the level of medical support available in many countries. As chest x-rays are the primary respiratory radiological investigation, the Radiological Assessment of Lung Edema (RALE) score was used to quantify the extent of pulmonary infection on baseline imaging. Assessment of RALE score's reproducibility and associations with clinical outcome parameters were then evaluated to determine implications for patient management and prognosis. Methods: A retrospective study was performed with the inclusion of patients testing positive for COVID-19 on nasopharyngeal swab within a single Local Health District in Sydney, Australia and baseline x-ray imaging acquired between January to June 2020. Two independent Radiologists viewed the studies and calculated the RALE scores. Clinical outcome parameters were collected and statistical analysis was performed to assess RALE score reproducibility and possible associations with clinical outcomes. Results: A total of 78 patients met inclusion criteria with the age range of 4 to 91 years old. RALE score concordance between the two independent Radiologists was excellent (interclass correlation coefficient = 0.93, 95% CI = 0.88-0.95, p<0.005). Binomial logistics regression identified a positive correlation with hospital admission (1.87 OR, 95% CI= 1.3-2.6, p<0.005), oxygen requirement (1.48 OR, 95% CI= 1.2-1.8, p<0.005) and invasive ventilation (1.2 OR, 95% CI= 1.0-1.3, p<0.005) for each 1-point increase in RALE score. For each one year increased in age, there was a negative correlation with recovery (0.05 OR, 95% CI= 0.92-1.0, p<0.01). RALE scores above three were positively associated with hospitalization (Youden Index 0.61, sensitivity 0.73, specificity 0.89) and above six were positively associated with ICU admission (Youden Index 0.67, sensitivity 0.91, specificity 0.78). Conclusion: The RALE score can be used as a surrogate to quantify the extent of COVID-19 infection and has an excellent inter-observer agreement. The RALE score could be used to prognosticate and identify patients at high risk of deterioration. Threshold values may also be applied to predict the likelihood of hospital and ICU admission.

Keywords: chest radiography, coronavirus, COVID-19, RALE score

Procedia PDF Downloads 178

Authors: Stefano Zaninotto, Geoffrey Farrugia, Johan Debattista, Jason Gauci

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The need to reduce fuel and noise during taxi operations in the airports with a scenario of constantly increasing air traffic has resulted in an effort by the aerospace industry to move towards electric taxiing. In fact, this is one of the problems that is currently being addressed by SESAR JU and two main solutions are being proposed. With the first solution, electric motors are installed in the main (or nose) landing gear of the aircraft. With the second solution, manned or unmanned electric tow trucks are used to tow aircraft from the gate to the runway (or vice-versa). The presence of the tow trucks results in an increase in vehicle traffic inside the airport. Therefore, it is important to design the system in a way that the workload of Air Traffic Control (ATC) is not increased and the system assists ATC in managing all ground operations. The aim of this work is to develop an electric taxiing system, based on the use of autonomous tow trucks, which optimizes aircraft ground operations while keeping ATC in the loop. This system will consist of two components: an optimization tool and a Graphical User Interface (GUI). The optimization tool will be responsible for determining the optimal path for arriving and departing aircraft; allocating a tow truck to each taxiing aircraft; detecting conflicts between aircraft and/or tow trucks; and proposing solutions to resolve any conflicts. There are two main optimization strategies proposed in the literature. With centralized optimization, a central authority coordinates and makes the decision for all ground movements, in order to find a global optimum. With the second strategy, called decentralized optimization or multi-agent system, the decision authority is distributed among several agents. These agents could be the aircraft, the tow trucks, and taxiway or runway intersections. This approach finds local optima; however, it scales better with the number of ground movements and is more robust to external disturbances (such as taxi delays or unscheduled events). The strategy proposed in this work is a hybrid system combining aspects of these two approaches. The GUI will provide information on the movement and status of each aircraft and tow truck, and alert ATC about any impending conflicts. It will also enable ATC to give taxi clearances and to modify the routes proposed by the system. The complete system will be tested via computer simulation of various taxi scenarios at multiple airports, including Malta International Airport, a major international airport, and a fictitious airport. These tests will involve actual Air Traffic Controllers in order to evaluate the GUI and assess the impact of the system on ATC workload and situation awareness. It is expected that the proposed system will increase the efficiency of taxi operations while reducing their environmental impact. Furthermore, it is envisaged that the system will facilitate various controller tasks and improve ATC situation awareness.

Keywords: air traffic control, electric taxiing, autonomous tow trucks, graphical user interface, ground operations, multi-agent, route optimization

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Authors: Ashenafi Ayele, Shewit Haftu, Tesfalem Araya

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Background: “Post-psychotic depression”, “post schizophrenic depression”, and “secondary depression” have been used to describe the occurrence of depressive symptoms during the chronic phase of schizophrenia. Post-psychotic depression is the most common cause of death due to suicide in schizophrenia patients. Overall lifetime risk for patients with schizophrenia is 50% for suicide attempts and 9-13% lifetime risk for completed suicide and also it is associated with poor prognosis and poor quality of life. Objective: To assess determinant of post psychotic depression in schizophrenia patients ACSH and Mekelle General Hospital, Tigray Ethiopia 2019. Methods: An institutional based unmatched case control study was conducted among 69 cases and 138 controls with the ratio of case to control 1 ratio 2. The sample is calculated using epi-info 3.1 to assess the determinant factors of post-psychotic depression in schizophrenia patients. The cases were schizophrenia patients who have been diagnosed at least for more than one-year stable for two months, and the controls are any patients who are diagnosed as schizophrenia patients. Study subjects were selected using a consecutive sampling technique. The Calgary depression scale for schizophrenia self-administered questionnaire was used. Before the interview, it was assessed the client’s capacity to give intended information using a scale called the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). Bivariant and multiple Logistic regression analysis was performed to determine between the independent and dependent variables. The significant independent predictor was declared at 95% confidence interval and P-value of less than 0.05. Result: Females were affected by post psychotic depression with the (AOR=2.01, 95%CI: 1.003- 4.012, P= 0.49).Patients who have mild form of positive symptom of schizophrenia affected by post psychotic depression with (AOR =4.05, 95%CI: 1.888- 8.7.8, P=0001).Patients who have minimal form of negative symptom of schizophrenia are affected by post psychotic depression with (AOR =4.23, 95%CI: 1.081-17.092, P=.038). Conclusion: In this study, sex (female) and presence of positive and negative symptoms of schizophrenia were significantly associated. It is recommended that the post psychotic depression should be assessed in every schizophrenia patient to decrease the severity of illness, and to improve patient’s quality of life.

Keywords: determinants, post-psychotic depression, Mekelle city

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Authors: Ibrahim Aliyu Isah, Mohd Mansor Ismail, Salim Hassan, Norsida Man, Oluwatoyin Olagunju

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Stingless beekeeping is not only a profitable activity for Malaysian beekeepers but also for the Malaysian economy. However, natural honey has faced some difficulties, which resulted in low production due to a lack of information on improved technology as well as the capacity and potential building of stingless beekeeping farmers, which depend mostly on information received from the extension agents. Hence, it is the responsibility of the extension agents to give useful information on the available technology and develop the capacity of the farmers to make the right decision that will improve their level of production. This study assessed how technology transfer and human resource development skills influence the work performance of the extension agents toward sustainable beekeeping production among beekeepers. The study sought to establish the role of relevant technology transfer and human resource development skills in effective performance. The research design was a descriptive and quantitative survey of stingless beekeepers on technology transfer and human resource development by the extension agent. Data was obtained from 54 beekeeping farmers and was analyzed using descriptive and inferential statistics. The results revealed that technology skill, technology dissemination skill, technology evaluation skill, Decision-making process skill, Leadership development skill and work performance were rated moderate by stingless beekeeping farmers, while Social skill was rated high. A significant and positive correlation (P<0.01) existed between all variables and performance. Regression results showed that leadership development skills, Decision-making process skills, and social skills are significant (P=.05), while technology skills, technology dissemination skills, and technology evaluation skills are not significant. The highest contributing factor is social skill (β=.446). Beekeeping is a profitable project in Malaysia and can be sustained if the extension services and programs are well carried out by competent extension agents and relevant agricultural government agencies.

Keywords: beekeeping, extension agents, human resource development, sustainable, technology transfer, work performance

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Authors: Denise Levy, Gian M. A. A. Sordi

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This web based project focuses on continuing corporate education and improving workers' skills in Brazilian radioactive facilities throughout the country. The potential of Information and Communication Technologies (ICTs) shall contribute to improve the global communication in this very large country, where it is a strong challenge to ensure high quality professional information to as many people as possible. The main objective of this system is to provide Brazilian radioactive facilities a complete web-based repository - in Portuguese - for research, consultation and information, offering conditions for learning and improving professional and personal skills. UNIPRORAD is a web based system to offer unified programs and inter-related information about radiological protection programs. The content includes the best practices for radioactive facilities in order to meet both national standards and international recommendations published by different organizations over the past decades: International Commission on Radiological Protection (ICRP), International Atomic Energy Agency (IAEA) and National Nuclear Energy Commission (CNEN). The website counts on concepts, definitions and theory about optimization and ionizing radiation monitoring procedures. Moreover, the content presents further discussions related to some national and international recommendations, such as potential exposure, which is currently one of the most important research fields in radiological protection. Only two publications of ICRP develop expressively the issue and there is still a lack of knowledge of fail probabilities, for there are still uncertainties to find effective paths to quantify probabilistically the occurrence of potential exposures and the probabilities to reach a certain level of dose. To respond to this challenge, this project discusses and introduces potential exposures in a more quantitative way than national and international recommendations. Articulating ICRP and AIEA valid recommendations and official reports, in addition to scientific papers published in major international congresses, the website discusses and suggests a number of effective actions towards safety which can be incorporated into labor practice. The WEB platform was created according to corporate public needs, taking into account the development of a robust but flexible system, which can be easily adapted to future demands. ICTs provide a vast array of new communication capabilities and allow to spread information to as many people as possible at low costs and high quality communication. This initiative shall provide opportunities for employees to increase professional skills, stimulating development in this large country where it is an enormous challenge to ensure effective and updated information to geographically distant facilities, minimizing costs and optimizing results.

Keywords: distance learning, information and communication technology, nuclear science, radioactive facilities

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Authors: Ben Otange, Wolfgang Parak, Florian Schulz, Michael Alexander Rubhausen

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The feasibility of extending the usage of molecular imprinting technique in complex biomolecules is demonstrated in this research. This technique is promising in diverse applications in areas such as drug delivery, diagnosis of diseases, catalysts, and impurities detection as well as treatment of various complications. While molecularly imprinted polymers MIP remain robust in the synthesis of molecules with remarkable binding sites that have high affinities to specific molecules of interest, extending the usage to complex biomolecules remains futile. This work reports on the successful synthesis of MIP from complex proteins: BSA, Transferrin, and MUC1. We show in this research that despite the heterogeneous binding sites and higher conformational flexibility of the chosen proteins, relying on their respective epitopes and motifs rather than the whole template produces highly sensitive and selective MIPs for specific molecular binding. Introduction: Proteins are vital in most biological processes, ranging from cell structure and structural integrity to complex functions such as transport and immunity in biological systems. Unlike other imprinting templates, proteins have heterogeneous binding sites in their complex long-chain structure, which makes their imprinting to be marred by challenges. In addressing this challenge, our attention is inclined toward the targeted delivery, which will use molecular imprinting on the particle surface so that these particles may recognize overexpressed proteins on the target cells. Our goal is thus to make surfaces of nanoparticles that specifically bind to the target cells. Results and Discussions: Using epitopes of BSA and MUC1 proteins and motifs with conserved receptors of transferrin as the respective templates for MIPs, significant improvement in the MIP sensitivity to the binding of complex protein templates was noted. Through the Fluorescence Correlation Spectroscopy FCS measurements on the size of protein corona after incubation of the synthesized nanoparticles with proteins, we noted a high affinity of MIPs to the binding of their respective complex proteins. In addition, quantitative analysis of hard corona using SDS-PAGE showed that only a specific protein was strongly bound on the respective MIPs when incubated with similar concentrations of the protein mixture. Conclusion: Our findings have shown that the merits of MIPs can be extended to complex molecules of higher biomolecular mass. As such, the unique merits of the technique, including high sensitivity and selectivity, relative ease of synthesis, production of materials with higher physical robustness, and higher stability, can be extended to more templates that were previously not suitable candidates despite their abundance and usage within the body.

Keywords: molecularly imprinted polymers, specific binding, drug delivery, high biomolecular mass-templates

Procedia PDF Downloads 55

Authors: Roongtiwa Chobchuen, Siriporn Mongkholthawornchai, Boonsong Hatawaikarn, Uriwan Chaichangreet, Kobkaew Thongtid, Pusda Pukdeekumjorn, Panita Limpawattana

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Background: Age-friendly nursing service system in Srinagarind Hospital has been developed continuously based on the value and cultural background of Thailand which corporates with the modified WHO’s Age friendly Primary Care Service System. It consists of 3 issues; 1) development of staff training, 2) age-friendly service and 3) appropriate physical environment. Objective: To evaluate the efficacy of Age-friendly Nursing Service System: KKU (AFNS:KKU) model and to evaluate factors associated with nursing perception with AFN:KKU. Study design: Descriptive study Setting: 31 wards that served older patients in Srinagarind Hospital Populations: Nursing staff from 11 departments (31 wards) Instrument: Age-friendly nursing care scale as perceived by hospitalized older person Procedure and statistical analysis: All participants were asked questions using age-friendly nursing care scale as perceived by hospitalized older person questionnaires. Descriptive statistics and multiple logistic regression analyses were used to analyse the outcomes. Results: There were 337 participants recruited in this study. The majority of them were women (92%) with the mean ages of 29 years and 77.45% were nurse practitioners. They had average nursing experiences of 5 years. The average scores of age-friendly nursing care scale were high and highest in the area of attitude and communication. Age, sex, educational level, duration of work among, and having experience in aging training were not associated with nursing perception where type of department was an independent factor. Nurses from department of Surgery and Orthopedic, Eye and ENT, special ward and Obstetrics and Gynecological had significant greater perception than nurses from Internal Medicine Department (p < 0.05). Conclusion: Nurses had high scores in all dimensions of age-friendly concept. The result indicates that nurses have good attitude to aging care which can lead to improve quality of care. Organization should support other domains of ageing care to achieve greater effectiveness in geriatric care.

Keywords: age-friendly, nursing service system, excellence model, geriatric care

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Authors: Florian Tille, Heide Weishaar, Bernhard Gibis, Susanne Schnitzer

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Introduction: The quality of patient-doctor communication and of written health information is central to organizational health literacy (HL). Whether patients understand their doctors’ explanations and textual material on health, however, is understudied. This study identifies the overall levels of patient understanding of health information and its associations with patients’ social characteristics in outpatient health care in Germany. Materials & Methods: This analysis draws on data collected via a 2017 national health survey with a sample of 6,105 adults. Quality of communication was measured for consultations with general practitioners (GPs) and specialists (SPs) via the Ask Me 3 program questions, and through a question on written health material. Correlations with social characteristics were explored employing bivariate and multivariate logistic regression analyses. Results: Over 90% of all respondents reported that they had understood their doctors’ explanations during the last consultation. Failed understanding was strongly correlated with patients’ very poor health (Odds Ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10; ref. excellent/very good health), current health problem (OR: 6.54, CI: 1.70–25.12; ref. preventive examination) and age 65 years and above (OR: 2.97, CI: 1.10–8.00; ref. 18 to 34 years). Fewer patients answered they understood written material well (86.7% for las visit at GP, 89.7% at SP). Understanding written material poorly was highly associated with basic education (OR: 4.20, CI: 2.76–6.39; ref. higher education) and 65 years old and above (OR: 2.66, CI: 1.43–4.96). Discussion: Overall ratings of oral patient-doctor communication and written communication of health information are high. Yet, a considerable share of patients reports not-understanding their doctors and poor understanding of the written health-related material. Interventions that can contribute to improving organizational HL in outpatient care in Germany include HL training for doctors, reducing system barriers to easily-accessible health information for patients and combining oral and written health communication means. Conclusion: This work adds to the study of organizational HL in Germany. To increase patient understanding of health-relevant information and thereby possibly reduce health disparities, meeting the communication needs especially of persons in different age groups, with basic education and in very poor health is suggested.

Keywords: health survey, organizational health literacy, patient-doctor communication, social characteristics, outpatient care, Ask Me 3

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Authors: Jonix Owino

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Aging Out of Place refers to the physical and emotional experience of growing older in a foreign or unfamiliar environment. Refugees flee their home countries and migrate to foreign countries such as the United States for safety. The emotional and psychological distress experienced by refugees who are compelled to leave their home countries can compromise their ability to adapt to new countries, thereby affecting their well-being. In particular, implications of immigration may be felt more acutely in later life stages, especially when life-long attachments have been made in the country of origin. However, aging studies in the United States have failed to conceptualize refugee aging experiences, more so for refugees who entered the country as adults. Specifically, little is known about the quality of life among aging refugees. Research studies on whether the quality of life varies among refugees by sociodemographic factors are limited. Research studies examining the role of social connectedness in aging refugees’ quality of life are also sparse. As such, the present study seeks to investigate the sociodemographic (i.e., age, sex, country of origin, and length of residence) and social connection factors associated with quality of life among aging refugees. The study consisted of a total of 108 participants from ages 50 years and above. The refugees represented in the study were from Bhutan, Burundi, and Somalia and were recruited from an upper Midwestern region of the United States. The participants completed an in-depth survey assessing social factors and well-being. Hierarchical regression was used for analysis. The results showed that females, older individuals, and refugees who were from Africa reported lower quality of life. Length of residence was not associated with quality of life. Furthermore, when controlling for sociodemographic factors, greater social integration was significantly associated with a higher quality of life, whereas lower loneliness was significantly associated with a higher quality of life. The results also indicated a significant interaction between loneliness and sex in predicting quality of life. This suggests that greater loneliness was associated with reduced quality of life for female refugees but not males. The present study highlights cultural variations within refugee groups which is important in determining how host communities can best support aging refugees’ well-being and develop social programs that can effectively cater to issues of aging among refugees.

Keywords: aging refugees, quality of life, social integration, migration and integration

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Authors: Alemayehu Muluneh, Saskia Keesstra, Leo Stroosnijder, Woldeamlak Bewket, Ashenafi Burka

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There are some scientific evidences and a belief by many that forests attract rain and deforestation contributes to a decline of rainfall. However, there is still a lack of concrete scientific evidence on the role of forests in rainfall amount. In this paper, we investigate the forest-rainfall relationships in the environmentally hot spot area of the Central Rift Valley (CRV) of Ethiopia. Specifically, we evaluate long term (1970-2009) rainfall variability and its relationship with historical forest cover and the relationship between existing forest cover and topographical variables and rainfall distribution. The study used 16 long term and 15 short term rainfall stations. The Mann-Kendall test, bi variate and multiple regression models were used. The results show forest and wood land cover continuously declined over the 40 years period (1970-2009), but annual rainfall in the rift valley floor increased by 6.42 mm/year. But, on the escarpment and highlands, annual rainfall decreased by 2.48 mm/year. The increase in annual rainfall in the rift valley floor is partly attributable to the increase in evaporation as a result of increasing temperatures from the 4 existing lakes in the rift valley floor. Though, annual rainfall is decreasing on the escarpment and highlands, there was no significant correlation between this rainfall decrease and forest and wood land decline and also rainfall variability in the region was not explained by forest cover. Hence, the decrease in annual rainfall on the escarpment and highlands is likely related to the global warming of the atmosphere and the surface waters of the Indian Ocean. Spatial variability of number of rainy days from systematically observed two-year’s rainfall data (2012-2013) was significantly (R2=-0.63) explained by forest cover (distance from forest). But, forest cover was not a significant variable (R2=-0.40) in explaining annual rainfall amount. Generally, past deforestation and existing forest cover showed very little effect on long term and short term rainfall distribution, but a significant effect on number of rainy days in the CRV of Ethiopia.

Keywords: elevation, forest cover, rainfall, slope

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Authors: Pei-Chih Wu, Hsin-Chih Lai, Yung-Lung Lee, Yun-Yao Chi, Ching-Yi Horng, Hsien-Chang Wang

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The impact of climate change to health has always been well documented. Amongst them, water-borne infectious diseases, chronic adverse effects or cancer risks due to chemical contamination in flooding or drought events are especially important in river basin. This study therefore utilizes GIS and different models to integrate demographic, land use, disaster prevention, social-economic factors, and human health assessment in the Erren River basin. Therefore, through the collecting of climatic, demographic, health surveillance, water quality and other water monitoring data, potential risks associated with the Erren River Basin are established and to understand human exposure and vulnerability in response to climate extremes. This study assesses the temporal and spatial patterns of melioidosis (2000-2015) and various cancer incidents in Tainan and Kaohsiung cities. The next step is to analyze the spatial association between diseases incidences, climatic factors, land uses, and other demographic factors by using ArcMap and GeoDa. The study results show that amongst all melioidosis cases in Taiwan, 24% cases (115) residence occurred in the Erren River basin. The relationship between the cases and in Tainan and Kaohsiung cities are associated with population density, aging indicator, and residence in Erren River basin. Risks from flooding due to heavy rainfall and fish farms in spatial lag regression are also related. Through liver cancer, the preliminary analysis in temporal and spatial pattern shows an increases pattern in annual incidence without clusters in Erren River basin. Further analysis of potential cancers connected to heavy metal contamination from water pollution in Erren River is established. The final step is to develop an assessment tool for human exposure from water contamination and vulnerability in response to climate extremes for the second year.

Keywords: climate change, health impact, health adaptation, Erren River Basin

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Authors: Sukhvinder Kaur, Jayanta Bora, Ashok Agarwal, Sangeeta Kaul

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Background: HIV and STI transmission can be prevented if condoms are used properly, but condom tear may lead to infections even if are used consistently. Studies reveal high rates of condom breakage among Female Sex Workers (FSWs). USAID PHFI-PIPPSE is piloting a prevention model among high risk groups at Thane district of Maharashtra, India by implementing prevention and advocacy efforts for such risk behaviors. The current analysis highlights the correlates of condom breakage among FSWs from Thane. Method: A Behavioral Tracking Survey was conducted in 2014-15 among 503 FSWs through probability-based two stage random sampling from 3,660 FSWs at 100 hotspots, to understand levels of high risk behaviors, awareness and exposure to prevention programs. Bi-variate and multivariate-logistic regression methods used to assess the association of condom breakage while having sex with age, STI occurrence, anal sex with clients and alcohol consumption. Only self-reported STIs (Genital sore/ulcer, yellowish/ greenish discharge from vagina with/without foul smell, lower abdominal pain without diarrhea/dysentery or menses) were considered. Major Findings: Results depicted FSWs who reported condom breakage while having sex with any type of partner (paying clients, non-paying partners and other than main partner husband/boyfriend) had significantly high number of STIs (42.3% vs 16.9 %, P, 0.000) and had started sexual relationship in <16 years of age (31.0% vs 16.4 %, P, 0.000). Multivariate analysis after controlling the age at sex, knowledge about HIV and literacy, highlighted significantly higher odds of condom breakage among FSWs who have reported currently suffering with STI [AOR 2.91, 95% CI 1.75 - 4.83; P, 0.000]; who had anal sex with their paying client [AOR 2.59, 95% CI 1.59 - 4.19; P, 0.000]; and who consumed alcohol in the last 12 months [AOR 1.89, 95% CI 1.01 - 3.53; P, 0.047]. Conclusion: Risky behavior like anal sex with paying clients and impact of alcohol while having sex are main factors for condom breakage among young sex workers; and condom breakage leads to STIs. Hence, program interventions should address measures for prevention of condom breakage for HIV/STI prevention.

Keywords: female sex workers, condom breakage, anal sex, young sex workers

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Authors: Sabina-Adriana Floria, Marius Gavrilescu, Florin Leon, Silvia Curteanu, Costel Anton

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Neuroevolution is a subfield of artificial intelligence used to solve various problems in different application areas. Specifically, neuroevolution is a technique that applies biologically inspired methods to generate neural network architectures and optimize their parameters automatically. In this paper, we use different biologically inspired optimization algorithms in an ensemble strategy with the aim of training multilayer perceptron neural networks, resulting in regression models used to simulate the industrial chemical process of obtaining bricks from silicone-based materials. Installations in the raw ceramics industry, i.e., bricks, are characterized by significant energy consumption and large quantities of emissions. In addition, the initial conditions that were taken into account during the design and commissioning of the installation can change over time, which leads to the need to add new mixes to adjust the operating conditions for the desired purpose, e.g., material properties and energy saving. The present approach follows the study by simulation of a process of obtaining bricks from silicone-based materials, i.e., the modeling and optimization of the process. Optimization aims to determine the working conditions that minimize the emissions represented by nitrogen monoxide. We first use a search procedure to find the best values for the parameters of various biologically inspired optimization algorithms. Then, we propose an adaptive ensemble strategy that uses only a subset of the best algorithms identified in the search stage. The adaptive ensemble strategy combines the results of selected algorithms and automatically assigns more processing capacity to the more efficient algorithms. Their efficiency may also vary at different stages of the optimization process. In a given ensemble iteration, the most efficient algorithms aim to maintain good convergence, while the less efficient algorithms can improve population diversity. The proposed adaptive ensemble strategy outperforms the individual optimizers and the non-adaptive ensemble strategy in convergence speed, and the obtained results provide lower error values.

Keywords: optimization, biologically inspired algorithm, neuroevolution, ensembles, bricks, emission minimization

Procedia PDF Downloads 118