Search results for: punjabi population
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5686

Search results for: punjabi population

1666 Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome: Postoperative Complications in Patients on Anticoagulation

Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

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1665 Remedying the Scourge of Poverty as a Social Problem: The Islamic Perspective

Authors: Maryam Umar Ladan, Arshad Munir

Abstract:

Poverty has always been a constant feature of society throughout history. It has existed in the lives of people and it is a fact that although the majority of people lives in poverty, the remaining minority lives in luxury. While some countries called the first World countries lives in luxury, the third World countries lives in poverty. It remains an undesirable phenomenon affecting a vast number of people across the globe despite governmental, institutional and private organizations’ interventions with measures aimed at cushioning its adverse effects. Unequal distribution of societal resources, accumulated wealth in the hands of few, lack of access to education and employment, individual responsibility among others, were highlighted as factors associated with poverty. Poverty predisposes the poor individual to malnutrition and starvation, exposure to disease, thereby resulting to violence, crimes, and experiencing lifelong problems. Evidence show that about 50 percent of the world population lives on less than 2.50 dollar a day, 90 percent of whom are from Sub-Saharan Africa and South Asia including countries where Islam is the major if not one adherent religion. As a solution to poverty, Islam prescribes a system of annual Zakat (charity). The Islamic law prescribes that every person who has a saving that reaches a certain limit should give out 2.5 percent of the total annual earning (as in income, money, farm produce) to deserving and prescribed citizens. This is to, among others; reduce the level of inequality through distribution of wealth among the Muslim Ummah (community). Furthermore, Islam encourages the rich in several places in the Qur’an to spend their wealth on poor people other than the compulsory 2.5%. Therefore, it is inarguable that the Islamic system of distribution of resources (as zakat) is the best strategy to poverty eradication. Thus, strongly recommended for desired results in poverty eradication efforts. If every rich person gives Zakat sincerely, poverty will be eradicated in the world, and not a single person will die of want of food or material things.

Keywords: Islam, charity, poverty, zakat

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1664 Socio-Demographic Factors and Testing Practices Are Associated with Spatial Patterns of Clostridium difficile Infection in the Australian Capital Territory, 2004-2014

Authors: Aparna Lal, Ashwin Swaminathan, Teisa Holani

Abstract:

Background: Clostridium difficile infections (CDIs) have been on the rise globally. In Australia, rates of CDI in all States and Territories have increased significantly since mid-2011. Identifying risk factors for CDI in the community can help inform targeted interventions to reduce infection. Methods: We examine the role of neighbourhood socio-economic status, demography, testing practices and the number of residential aged care facilities on spatial patterns in CDI incidence in the Australian Capital Territory. Data on all tests conducted for CDI were obtained from ACT Pathology by postcode for the period 1st January 2004 through 31 December 2014. Distribution of age groups and the neighbourhood Index of Relative Socio-economic Advantage Disadvantage (IRSAD) were obtained from the Australian Bureau of Statistics 2011 National Census data. A Bayesian spatial conditional autoregressive model was fitted at the postcode level to quantify the relationship between CDI and socio-demographic factors. To identify CDI hotspots, exceedance probabilities were set at a threshold of twice the estimated relative risk. Results: CDI showed a positive spatial association with the number of tests (RR=1.01, 95% CI 1.00, 1.02) and the resident population over 65 years (RR=1.00, 95% CI 1.00, 1.01). The standardized index of relative socio-economic advantage disadvantage (IRSAD) was significantly negatively associated with CDI (RR=0.74, 95% CI 0.56, 0.94). We identified three postcodes with high probability (0.8-1.0) of excess risk. Conclusions: Here, we demonstrate geographic variations in CDI in the ACT with a positive association of CDI with socioeconomic disadvantage and identify areas with a high probability of elevated risk compared with surrounding communities. These findings highlight community-based risk factors for CDI.

Keywords: spatial, socio-demographic, infection, Clostridium difficile

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1663 Long-Term Effects of Psychosocial Interventions for Adolescents on Depression and Anxiety: A Systematic Review and Meta-Analysis

Authors: Denis Duagi, Ben Carter, Maria Farrelly, Stephen Lisk, June S. L. Brown

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Background: Adolescence represents a distinctive phase of development, and variables linked to this developmental period could affect the efficiency of prevention and treatment for depression and anxiety, as well as the long-term prognosis. The objectives of this study were to investigate the long-term effectiveness of psychosocial interventions for adolescents on depression and anxiety symptoms and to assess the influence of different intervention parameters on the long-term effects. Methods: Searches were carried out on the 11ᵗʰ of August 2022 using five databases (Cochrane Library, Embase, Medline, PsychInfo, Web of Science), as well as trial registers. Randomized controlled trials of psychosocial interventions targeting specifically adolescents were included if they assessed outcomes at 1-year post-intervention or more. The Cochrane risk of bias-2 quality assessment tool was used. The primary outcome was depression, and studies were pooled using a standardised mean difference, with an associated 95% confidence interval, p-value, and I². The study protocol was pre-registered (CRD42022348668). Findings: A total of 57 reports (n= 46,678 participants) were included in the review. Psychosocial interventions led to small reductions in depressive symptoms, with a standardised mean difference (SMD) at 1-year of -0.08 (95%CI -0.20, -0.03, p=0.002, I²=72%), 18-months SMD=-0.12, 95% CI -0.22, -0.01, p=0.03, I²=63%) and 2-years SMD=-0.12 (95% CI -0.20, -0.03, p=0.01, I²=68%). Sub-group analyses indicated that targeted interventions produced stronger effects, particularly when delivered by trained mental health professionals (K=18, SMD=-0.24, 95% CI -0.38, -0.10, p=0.001, I²=60%). No effects were detected for anxiety at any assessment. Conclusion: Psychosocial interventions specifically targeting adolescents were shown to have small but positive effects on depression symptoms but not anxiety symptoms, which were sustained for up to 2 years. These findings highlight the potential population-level preventive effects if such psychosocial interventions become widely implemented in accessible settings such as schools.

Keywords: psychosocial, adolescent, interventions, depression, anxiety, meta-analysis, randomized controlled trial

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1662 Indoor Air Quality Analysis for Renovating Building: A Case Study of Student Studio, Department of Landscape, Chiangmai, Thailand

Authors: Warangkana Juangjandee

Abstract:

The rapidly increasing number of population in the limited area creates an effect on the idea of the improvement of the area to suit the environment and the needs of people. Faculty of architecture Chiang Mai University is also expanding in both variety fields of study and quality of education. In 2020, the new department will be introduced in the faculty which is Department of Landscape Architecture. With the limitation of the area in the existing building, the faculty plan to renovate some parts of its school for anticipates the number of students who will join the program in the next two years. As a result, the old wooden workshop area is selected to be renovated as student studio space. With such condition, it is necessary to study the restriction and the distinctive environment of the site prior to the improvement in order to find ways to manage the existing space due to the fact that the primary functions that have been practiced in the site, an old wooden workshop space and the new function, studio space, are too different. 72.9% of the annual times in the room are considered to be out of the thermal comfort condition with high relative humidity. This causes non-comfort condition for occupants which could promote mould growth. This study aims to analyze thermal comfort condition in the Landscape Learning Studio Area for finding the solution to improve indoor air quality and respond to local conditions. The research methodology will be in two parts: 1) field gathering data on the case study 2) analysis and finding the solution of improving indoor air quality. The result of the survey indicated that the room needs to solve non-comfort condition problem. This can be divided into two ways which are raising ventilation and indoor temperature, e.g. improving building design and stack driven ventilation, using fan for enhancing more internal ventilation.

Keywords: relative humidity, renovation, temperature, thermal comfort

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1661 Application of Various Methods for Evaluation of Heavy Metal Pollution in Soils around Agarak Copper-Molybdenum Mine Complex, Armenia

Authors: K. A. Ghazaryan, H. S. Movsesyan, N. P. Ghazaryan

Abstract:

The present study was aimed in assessing the heavy metal pollution of the soils around Agarak copper-molybdenum mine complex and related environmental risks. This mine complex is located in the south-east part of Armenia, and the present study was conducted in 2013. The soils of the five riskiest sites of this region were studied: surroundings of the open mine, the sites adjacent to processing plant of Agarak copper-molybdenum mine complex, surroundings of Darazam active tailing dump, the recultivated tailing dump of “ravine - 2”, and the recultivated tailing dump of “ravine - 3”. The mountain cambisol was the main soil type in the study sites. The level of soil contamination by heavy metals was assessed by Contamination factors (Cf), Degree of contamination (Cd), Geoaccumulation index (I-geo) and Enrichment factor (EF). The distribution pattern of trace metals in the soil profile according to Cf, Cd, I-geo and EF values shows that the soil is much polluted. Almost in all studied sites, Cu, Mo, Pb, and Cd were the main polluting heavy metals, and this was conditioned by Agarak copper-molybdenum mine complex activity. It is necessary to state that the pollution problem becomes pressing as some parts of these highly polluted region are inhabited by population, and agriculture is highly developed there; therefore, heavy metals can be transferred into human bodies through food chains and have direct influence on public health. Since the induced pollution can pose serious threats to public health, further investigations on soil and vegetation pollution are recommended. Finally, Cf calculating based on distance from the pollution source and the wind direction can provide more reasonable results.

Keywords: Agarak copper-molybdenum mine complex, heavy metals, soil contamination, enrichment factor (EF), Armenia

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1660 Assessment of Predictive Confounders for the Prevalence of Breast Cancer among Iraqi Population: A Retrospective Study from Baghdad, Iraq

Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

Abstract:

Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m2. 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal Breast Cancer, Hormone Sensitivity, Iraq, Risk Factors

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1659 Tanzanian Food Origins and Protected Geographical Indications

Authors: Innocensia John, Henrik Egelyng, Razack Lokina

Abstract:

As the world`s population is constantly growing, food security has become a thorny trending issue. The impact has particularly been felt more in Africa as most of the people depend on food Agriculture products. Geographical Indications can aid in transforming the Tanzania agriculture-dependent economy through tapping the unique attributes of their quality products like soil, taste color etc. Consumers worldwide demand more uniquer products featuring a ´connect´ with the land use systems producing particular qualities. Tanzania has demonstrated the capacity to tap into the organic world market and has untapped potential for harvesting market value from geographical indications. This paper presents preliminary results from VALOR — a research project investigating conditions under which Tanzanian origin food producers can add value by incorporating territory specific cultural, environmental and social qualities into marketing, production and processing of unique local, niche and specialty products. Cases are investigated of the prospects for Tanzania to leapfrog perhaps into exports of geographical indications products, and certainly into allowing smallholders to create employment and build monetary value, while stewarding local food cultures and natural environments and resources, and increasing the diversity of supply of natural and unique quality products and so contribute to enhanced food security. Rice from Kyela, coffee and Sugar from Kilimanjaro, are some of the product cases investigated and provides for the in-depth case study, as ´landscape´ products incorporating ´taste of place´. Framework conditions for producers creating or capturing market value as stewards of cultural and landscape values and environments and institutional requirements for such creation or capturing to happen, including presence of export opportunities, are discussed.

Keywords: food origins, food security, protected geographical indications, case study analysis

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1658 Human Capital Development: A Pivotal for Sustainable Development in Developing Countries

Authors: Yusuf Ismaila

Abstract:

The developing countries are characterized by inefficient production systems and unequal distribution of wealth. Developing countries are largely populated, yet under developed. This can be attributed partly to the unplanned efforts towards the development of human capital through education and training. In the developed nations a huge attention is accorded to indices such as life expectancy, literacy, infant mortality, education, and the efficient delivery of social services. This is the reason why many developing countries have been scored low by the United Nations in terms of its human development indicators. The population growth continued to expand far beyond the rate of economic growth, a situation that gave rise to increasing poverty. This paper examines the effect of selected human development indicators on the economic development. Thus human capital development is one of the fundamental solutions to enter the international arena. Both quantitative and qualitative analyses were used to demonstrate the effect of selected human capital indices and related literatures were also reviewed for exposition of the human capital concept. It was found that there are no conscious efforts in human capital planning. This has therefore resulted to continuing dwindling of production system and poverty. Recommendations made to redress the situation include that human capital development should be planned and adequately funded in line with the needs of the economy and by applying international standards. Specifically, developing countries must invest necessary resources in developing human capital which tend to have a great impact on sustainable development. Information about the labour market should improve while government policy should favour labour mobility. HCD strategy must focus on improving the skills of the workforce, reducing the cost of doing business and making available the resources business needs to compete and thrive in a fast globalizing economy. There should be regular interaction of planners, employers and builders of human capital to facilitate the process of meaningful national development.

Keywords: economic development, human capital, economic growth, developing countries

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1657 Deep Learning Prediction of Residential Radon Health Risk in Canada and Sweden to Prevent Lung Cancer Among Non-Smokers

Authors: Selim M. Khan, Aaron A. Goodarzi, Joshua M. Taron, Tryggve Rönnqvist

Abstract:

Indoor air quality, a prime determinant of health, is strongly influenced by the presence of hazardous radon gas within the built environment. As a health issue, dangerously high indoor radon arose within the 20th century to become the 2nd leading cause of lung cancer. While the 21st century building metrics and human behaviors have captured, contained, and concentrated radon to yet higher and more hazardous levels, the issue is rapidly worsening in Canada. It is established that Canadians in the Prairies are the 2nd highest radon-exposed population in the world, with 1 in 6 residences experiencing 0.2-6.5 millisieverts (mSv) radiation per week, whereas the Canadian Nuclear Safety Commission sets maximum 5-year occupational limits for atomic workplace exposure at only 20 mSv. This situation is also deteriorating over time within newer housing stocks containing higher levels of radon. Deep machine learning (LSTM) algorithms were applied to analyze multiple quantitative and qualitative features, determine the most important contributory factors, and predicted radon levels in the known past (1990-2020) and projected future (2021-2050). The findings showed gradual downwards patterns in Sweden, whereas it would continue to go from high to higher levels in Canada over time. The contributory factors found to be the basement porosity, roof insulation depthness, R-factor, and air dynamics of the indoor environment related to human window opening behaviour. Building codes must consider including these factors to ensure adequate indoor ventilation and healthy living that can prevent lung cancer in non-smokers.

Keywords: radon, building metrics, deep learning, LSTM prediction model, lung cancer, canada, sweden

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1656 Women Entrepreneuship in Croatia: Issues and Policies

Authors: Marko Kolakovic, Mihaela Mikic, Martina Taborin

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Women entrepreneurship is often regarded as the unused economical potential in many countries, including Republic of Croatia. Although women represent a majority in the population, they are still a minority in the field of entrepreneurship and face many challenges in fulfilling their entrepreneurship potential. The reasons are often hided in historical distorted perceptions about value, credibility, competitiveness, responsibility and knowledge which women have, or can have. This is significant for at least two reasons. First, in terms of global economic crisis, the economy needs more quality, more skilled and educated people willing to face entrepreneurial challenges and create new jobs, new opportunities and higher living standards. Second, in the entrepreneurial activity, women finally have a chance to highlight their own abilities, such as knowledge, relentless work, organizational skills, communication and negotiation skills, responsibility, flexibility, etc., in order to insure their economic independence, for a better social position, and to increase confidence and faith in their own abilities. This paper empirically analyses characteristics of women entrepreneurship in Croatia and conducted policies for it improvement. An empirical research was conducted with the goal of discovering real life experiences and attitudes of Croatian women entrepreneurs. Results show that Croatian women entrepreneurs are usually highly educated, have previous work experience and operate in service sector, due to lower need for start-up capital. The biggest obstacle on their entrepreneurial path represents government bureaucracy. Although the number of women entrepreneurs is rising today and the gap between male and women entrepreneurs in Croatia, as well as women entrepreneurship levels lower than the European average, we believe that there is still a long way to reach potential and successful women entrepreneurship development. Research showed that by breaking down the barriers as access to finance, education investments, knowledge, skills and confidence development, women will be able to accomplish more significant and more efficient entrepreneurial outcome.

Keywords: Croatia, policy, SMEs, women entrepreneurial strategy, women entrepreneurship

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1655 Comparative Study on the Social Behaviour of Sambar Deer (Rusa unicolor) in Captive Facilities in Peninsular Malaysia

Authors: Kushaal Selvarajah, Geetha Annavi, Mohd Noor Hisham Mohd Nadzir

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Sambar deer (Rusa unicolor) was uplisted from Least Concern to Vulnerable by the International Union for Conservation of Nature Red list in 2015 due to drastic population decline in the wild throughout its geographical range. Sambar deer is a valued prey for the highly endangered species such as the Malayan tiger. Ex-situ conservation efforts, i.e., captive breeding, initiated by local government to boost sambar deer numbers in captivity and to reintroduce into the wild to support a higher number of tigers, consistent with the goal of our National Tiger Conservation Action Plan. The reproductive success of sambar deer and their welfare management practices in captivity are important components for effective captive breeding programs. However, there is a lack of study carried out on sambar deer in recent years and their behavior in captivity. Three captive sites (Zoo Negara, Zoo Taiping, and Sungkai Conservation Centre) were selected and observed for an average of 40 days each site (6 hours/day). A Generalized Linear Model (GLM) was used to determine the correlation between social behavior and extrinsic parameters. A comparison between all three captive sites showed the strongest correlation in behavioral variability, followed by a time of observation. This proves that there is a difference between in behavioral consistency and frequency between herds across captive sites rising to the possibility of external factors that are influential. Time of day of observation also had significant influence on certain extrinsic parameters being skewed to morning observations and this could be due to an adaptive behavior to the feeding time in the captive sites being in the morning which caused the deer to be resting towards the afternoon. Extensive study need to be done on sambar deer to pinpoint the specifics and better understanding of these possible influential factors in their behavior.

Keywords: behaviour ecology, captivity, ex-situ conservation, husbandry

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1654 Detecting Local Clusters of Childhood Malnutrition in the Island Province of Marinduque, Philippines Using Spatial Scan Statistic

Authors: Novee Lor C. Leyso, Maylin C. Palatino

Abstract:

Under-five malnutrition continues to persist in the Philippines, particularly in the island Province of Marinduque, with prevalence of some forms of malnutrition even worsening in recent years. Local spatial cluster detection provides a spatial perspective in understanding this phenomenon as key in analyzing patterns of geographic variation, identification of community-appropriate programs and interventions, and focused targeting on high-risk areas. Using data from a province-wide household-based census conducted in 2014–2016, this study aimed to determine and evaluate spatial clusters of under-five malnutrition, across the province and within each municipality at the individual level using household location. Malnutrition was defined as weight-for-age z-score that fall outside the 2 standard deviations from the median of the WHO reference population. The Kulldorff’s elliptical spatial scan statistic in binomial model was used to locate clusters with high-risk of malnutrition, while adjusting for age and membership to government conditional cash transfer program as proxy for socio-economic status. One large significant cluster of under-five malnutrition was found southwest of the province, in which living in these areas at least doubles the risk of malnutrition. Additionally, at least one significant cluster were identified within each municipality—mostly located along the coastal areas. All these indicate apparent geographical variations across and within municipalities in the province. There were also similarities and disparities in the patterns of risk of malnutrition in each cluster across municipalities, and even within municipality, suggesting underlying causes at work that warrants further investigation. Therefore, community-appropriate programs and interventions should be identified and should be focused on high-risk areas to maximize limited government resources. Further studies are also recommended to determine factors affecting variations in childhood malnutrition considering the evidence of spatial clustering found in this study.

Keywords: Binomial model, Kulldorff’s elliptical spatial scan statistic, Philippines, under-five malnutrition

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1653 Legal Personality and Responsibility of Robots

Authors: Mehrnoosh Abouzari, Shahrokh Sahraei

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Arrival of artificial intelligence or smart robots in the modern world put them in charge on pericise and at risk. So acting human activities with robots makes criminal or civil responsibilities for their acts or behavior. The practical usage of smart robots has entered them in to a unique situation when naturalization happens and smart robots are identifies as members of society. There would be some legal situation by adopting these new smart citizens. The first situation is about legal responsibility of robots. Recognizing the naturalization of robot involves some basic right , so humans have the rights of employment, property, housing, using energy and other human rights may be employed for robots. So how would be the practice of these rights in the society and if some problems happens with these rights, how would the civil responsibility and punishment? May we consider them as population and count on the social programs? The second episode is about the criminal responsibility of robots in important activity instead of human that is the aim of inventing robots with handling works in AI technology , but the problem arises when some accidents are happened by robots who are in charge of important activities like army, surgery, transporting, judgement and so on. Moreover, recognizing independent identification for robots in the legal world by register ID cards, naturalization and civilian rights makes and prepare the same rights and obligations of human. So, the civil responsibility is not avoidable and if the robot commit a crime it would have criminal responsibility and have to be punished. The basic component of criminal responsibility may changes in so situation. For example, if designation for criminal responsibility bounds to human by sane, maturity, voluntariness, it would be for robots by being intelligent, good programming, not being hacked and so on. So it is irrational to punish robots by prisoning , execution and other human punishments for body. We may determine to make digital punishments like changing or repairing programs, exchanging some parts of its body or wreck it down completely. Finally the responsibility of the smart robot creators, programmers, the boss in chief, the organization who employed robot, the government which permitted to use robot in important bases and activities , will be analyzing and investigating in their article.

Keywords: robot, artificial intelligence, personality, responsibility

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1652 Evaluation of Simulated Noise Levels through the Analysis of Temperature and Rainfall: A Case Study of Nairobi Central Business District

Authors: Emmanuel Yussuf, John Muthama, John Ng'ang'A

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There has been increasing noise levels all over the world in the last decade. Many factors contribute to this increase, which is causing health related effects to humans. Developing countries are not left out of the whole picture as they are still growing and advancing their development. Motor vehicles are increasing on urban roads; there is an increase in infrastructure due to the rising population, increasing number of industries to provide goods and so many other activities. All this activities lead to the high noise levels in cities. This study was conducted in Nairobi’s Central Business District (CBD) with the main objective of simulating noise levels in order to understand the noise exposed to the people within the urban area, in relation to weather parameters namely temperature, rainfall and wind field. The study was achieved using the Neighbourhood Proximity Model and Time Series Analysis, with data obtained from proxies/remotely-sensed from satellites, in order to establish the levels of noise exposed to which people of Nairobi CBD are exposed to. The findings showed that there is an increase in temperature (0.1°C per year) and a decrease in precipitation (40 mm per year), which in comparison to the noise levels in the area, are increasing. The study also found out that noise levels exposed to people in Nairobi CBD were roughly between 61 and 63 decibels and has been increasing, a level which is high and likely to cause adverse physical and psychological effects on the human body in which air temperature, precipitation and wind contribute so much in the spread of noise. As a noise reduction measure, the use of sound proof materials in buildings close to busy roads, implementation of strict laws to most emitting sources as well as further research on the study was recommended. The data used for this study ranged from the year 2000 to 2015, rainfall being in millimeters (mm), temperature in degrees Celsius (°C) and the urban form characteristics being in meters (m).

Keywords: simulation, noise exposure, weather, proxy

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1651 Assessing Adoption Trends of Mukau (Melia volkensii (Gürke)) Enterprises in Eastern and Coastal Regions of Kenya

Authors: Lydia Murugi Mugendi

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The promotion of tree growing as a lucrative enterprise is the focus of this paper as management practices have shifted focus from protection of natural forest resources to community/government partnerships with the aim of resource conservation, management and increase of on-farm tree growing. Using KEFRI as (the source) of information pertaining Melia volkensii (the medium or message) being transferred, this paper investigates the current perception towards forestry and the behavioural attitudes of recipients of forest intervention activities. The two objectives explored in this paper are to find out the level of adoption of Mukau in Kitui, Kibwezi and Samburu/Taru and secondly, to find out the characteristics of the adoption process between Kitui, Kibwezi and Samburu/Taru. The methodologies used during data collection were participatory rural appraisal tools in conjunction with the social survey questionnaires. Simple random sampling and snowball sampling were used to identify respondents within the three target sites and analysis was done using SPSS. Results of the study of indicating that adoption rates of the Mukau in Samburu/Taru, where forestry-related activities were introduced within the past one decade had significantly increase despite initial resistance. The other areas, which had benefited from numerous decades of intense forestry extension projects and activities, indicated a decline in re-adoption rates of Mukau as an enterprise. This study has brought out the reality of adoption trends and state of Mukau population within the three counties while providing a glimpse towards the communities’ perception in regards to adoption of forestry and other environmental innovations. The outcome of the study is to provide a guideline for extension/ dissemination officers in KEFRI and related stakeholders to promote seamless cohesive interaction between the recipient communities of the proposed interventions.

Keywords: adoption, innovation, enterprise, extension, DOI Theory

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1650 Determinants of Customer Satisfaction: The Case of Abyssinia Bank Customers in Addis Ababa Ethiopia

Authors: Yosef Ferede Bogale

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The purpose of this study was to evaluate the degree of customer satisfaction and the variables influencing it in the instance of the Bank of Abyssinia branches in the districts of Arada and Bole in Addis Ababa. The study was carried out utilizing a mixed research approach and a descriptive and explanatory research design in Addis Ababa, the capital city of Ethiopia. Both primary and secondary data were employed in this investigation. The study's target population consisted of 1000 of the bank's most prestigious clients. With a 93% response rate, 265 respondents from both genders in the active age group had higher levels of education and work experience and were in the active age group. Customers of the case bank under consideration comprised the study's target audience. The respondents, who belonged to both gender groups, were in the active age bracket with superior levels of education and work experience. As a result, this investigation discovered that the degree of client satisfaction was assigned a medium rating. Additionally given a middling rating were the company's image practices, employee competency, technology, and service quality. Further, the results also demonstrate that corporate image, employees’ competency, technology, and service quality all positively and significantly affect customer happiness. This study found that, to varying degrees, company image, technology, competence, and high-quality financial services will all improve consumer happiness. According to this report, banks should monitor customer satisfaction and service quality at least twice a year. This is because there is a growing movement among bank service providers for accountability, and measuring these factors is crucial. This study also recommends that banks make every effort to satisfy consumers' expectations to the highest level.

Keywords: customer satisfaction, corporate image, quality services risk, bank

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1649 Is Class Struggle Still Useful for the Street Children Who Are Working and Committing Crimes in the Urban City of Bangladesh?

Authors: Shidratul Moontaha Suha

Abstract:

Violence is organized and utilized differently in various communities across the globe. The capacity to employ violence in numerous societies is largely limited to the apparatus of the state, like law enforcement officers, and in a small share of contexts, it is controlled within the state institutions as per the rule of law. Contrastingly, in many other societies, a broad array of players, mainly organized criminal gangs, are using violence on a substantial scale to agitate against social ills or attain personal interests. The present paper examined the role of social injustice in driving children living off and on the streets of Dhaka, Bangladesh, into joining organized criminal gangs and committing crimes. The study entailed a comprehensive review of existing literature with theoretical analyses based on three theories: the Marxist’s theory of capitalism and class struggle, the Weberian model of social stratification theory, and the social disorganization theory. The analysis revealed that, in Dhaka, Bangladesh, criminal gangs emerged from social disorganization of communities characterized by absolute poverty, residential mobility, and population heterogeneity, which promote deviance among the youth, and subsequently, led to the rise of organized gangs and delinquency. Although the latter was formed as a response to class struggle, they have been employed by the state and police as the tools of exploitation and oppression to rule the working class. The criminal gangs exploit the vulnerability of street children by using them as sources of cheap labor to peddle drugs, extort, or kill specific individuals who are against their ideals. In retrospect, the street children receive individual, group, and social protection. Therefore, social class struggle plays a central role in the proliferation of organized criminal gangs and the engagement of street children in criminal activities in Dhaka, Bangladesh.

Keywords: cheap labor, organized crimes, poverty, social stratification, social children

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1648 A Game-Based Methodology to Discriminate Executive Function – a Pilot Study With Institutionalized Elderly People

Authors: Marlene Rosa, Susana Lopes

Abstract:

There are few studies that explore the potential of board games as a performance measure, despite it can be an interesting strategy in the context of frailty populations. In fact, board games are immersive strategies than can inhibit the pressure of being evaluated. This study aimed to test the ability of gamed-base strategies to assess executive function in elderly population. Sixteen old participants were included: 10 with affected executive functions (G1 – 85.30±6.00 yrs old; 10 male); 6 with executive functions with non-clinical important modifications (G2 - 76.30±5.19 yrs old; 6 male). Executive tests were assessed using the Frontal Assessment Battery (FAB), which is a quick-applicable cognitive screening test (score<12 means impairment). The board game used in this study was the TATI Hand Game, specifically for training rhythmic coordination of the upper limbs with multiple cognitive stimuli. This game features 1 table grid, 1 set of Single Game cards (to play with one hand); Double Game cards (to play simultaneously with two hands); 1 dice to plan Single Game mode; cards to plan the Double Game mode; 1 bell; 2 cups. Each participant played 3 single game cards, and the following data were collected: (i) variability in time during board game challenges (SD); (ii) number of errors; (iii) execution speed (sec). G1 demonstrated: high variability in execution time during board game challenges (G1 – 13.0s vs G2- 0.5s); a higher number of errors (1.40 vs 0.67); higher execution velocity (607.80s vs 281.83s). These results demonstrated the potential of implementing board games as a functional assessment strategy in geriatric care. Future studies might include larger samples and statistical methodologies to find cut-off values for impairment in executive functions during performance in TATI game.

Keywords: board game, aging, executive function, evaluation

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1647 Analyzing the Sociolinguistic Profile of the Algerian Community in the UK in terms of French Language Use: The Case of Émigré Ph.D. Students

Authors: Hadjer Chellia

Abstract:

the present study reports on second language use among Algerian international students in the UK. In Algeria, French has an important status among the Algerian verbal repertoires due to colonial reasons. This has triggered many language conflicts and many debates among policy makers in Algeria. In higher education, Algerian English students’ sociolinguistic profile is characterised by the use of French as a sign of prestige. What may leave room for debate is the effect of crossing borders towards the UK as a result of international mobility programmes, a transition which could add more complexity since French, is not so significant as a language in the UK context. In this respect, the micro-objective is to explore the fate of French use among Ph.D. students in the UK as a newly established group vis-à-vis English. To fulfill the purpose of the present inquiry, the research employs multiple approaches in which semi-structured interview is a primary source of data to know participants’ attitudes about French use, targeting both their pre-migratory experience and current one. Web-based questionnaires are set up to access larger population. Focus group sessions are further procedures of scrutiny in this piece of work to explore the actual linguistic behaviours. Preliminary findings from both interviews and questionnaires reveal that students’ current experience, particularly living in the UK, affects their pre-migratory attitudes towards French language and its use. The overall findings are expected to bring manifold contributions to the field of research among which is setting factors that influence language use among newly established émigrés communities. The research is also relevant to international students’ experience of study abroad in terms of language use in the guise of internationalization of higher education, mobility and exchange programmes. It could contribute to the sociolinguistics of the Algerian diaspora: the dispersed residence of non-native communities - not to mention its significance on the Algerian research field abroad.

Keywords: Algerian diaspora, French language, language maintenance, language shift, mobility

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1646 The Impact of CYP2C9 Gene Polymorphisms on Warfarin Dosing

Authors: Weaam Aldeeban, Majd Aljamali, Lama A. Youssef

Abstract:

Background & Objective: Warfarin is considered a problematic drug due to its narrow therapeutic window and wide inter-individual response variations, which are attributed to demographic, environmental, and genetic factors, particularly single nucleotide polymorphism (SNPs) in the genes encoding VKORC1 and CYP2C9 involved in warfarin's mechanism of action and metabolism, respectively. CYP2C9*2rs1799853 and CYP2C9*3rs1057910 alleles are linked to reduced enzyme activity, as carriers of either or both alleles are classified as moderate or slow metabolizers, and therefore exhibit higher sensitivity of warfarin compared with wild type (CYP2C9*1*1). Our study aimed to assess the frequency of *1, *2, and *3 alleles in the CYP2C9 gene in a cohort of Syrian patients receiving a maintenance dose of warfarin for different indications, the impact of genotypes on warfarin dosing, and the frequency of adverse effects (i.e., bleedings). Subjects & Methods: This retrospective cohort study encompassed 94 patients treated with warfarin. Patients’ genotypes were identified by sequencing the polymerase chain reaction (PCR) specific products of the gene encoding CYP2C9, and the effects on warfarin therapeutic outcomes were investigated. Results: Sequencing revealed that 43.6% of the study population has the *2 and/or *3 SNPs. The mean weekly maintenance dose of warfarin was 37.42 ± 15.5 mg for patients with the wild-type allele (CYP2C9*1*1), whereas patients with one or both variants (*2 and/or *3) demanded a significantly lower dose (28.59 ±11.58 mg) of warfarin, (P= 0.015). A higher percentage (40.7%) of patients with allele *2 and/or *3 experienced hemorrhagic accidents compared with only 17.9% of patients with the wild type *1*1, (P = 0.04). Conclusions: Our study proves an association between *2 and *3 genotypes and higher sensitivity to warfarin and a tendency to bleed, which necessitates lowering the dose. These findings emphasize the significance of CYP2C9 genotyping prior to commencing warfarin therapy in order to achieve optimal and faster dose control and to ensure effectiveness and safety.

Keywords: warfarin, CYP2C9, polymorphisms, Syrian, hemorrhage

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1645 The Impact of a Model's Skin Tone and Ethnic Identification on Consumer Decision Making

Authors: Shanika Y. Koreshi

Abstract:

Sri Lanka housed the lingerie product development and manufacturing subsidiary to renowned brands such as La Senza, Marks & Spencer, H&M, Etam, Lane Bryant, and George. Over the last few years, they have produced local brands such as Amante to cater to the local and regional customers. Past research has identified factors such as quality, price, and design to be vital when marketing lingerie to consumers. However, there has been minimum research that looks into the ethnically targeted market and skin colour within the Asian population. Therefore, the main aim of the research was to identify whether consumer preference for lingerie is influenced by the skin tone of the model wearing it. Moreover, the secondary aim was to investigate if the consumer preference for lingerie is influenced by the consumer’s ethnic identification with the skin tone of the model. An experimental design was used to explore the above aims. The participants constituted of 66 females residing in the western province of Sri Lanka and were gathered via convenience sampling. Six computerized images of a real model were used in the study, and her skin tone was digitally manipulated to express three different skin tones (light, tan and dark). Consumer preferences were measured through a ranking order scale that was constructed via a focus group discussion and ethnic identity was measured by the Multigroup Ethnic Identity Measure-Revised. Wilcoxon signed-rank test, Friedman test, and chi square test of independence were carried out using SPSS version 20. The results indicated that majority of the consumers ethnically identified and preferred the tan skin over the light and dark skin tones. The findings support the existing literature that states there is a preference among consumers when models have a medium skin tone over a lighter skin tone. The preference for a tan skin tone in a model is consistent with the ethnic identification of the Sri Lankan sample. The study implies that lingerie brands should consider the model's skin tones when marketing the brand to different ethnic backgrounds.

Keywords: consumer preference, ethnic identification, lingerie, skin tone

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1644 Investigating Clarity Ultrasound Transperineal Ultrasound Imaging as a Method of Localising the Prostate, Compared to Cone Beam Computed Tomography with Fiducials

Authors: Harley Stephens

Abstract:

Although fiducial marker insertion is regarded as the ‘gold standard’ in terms of image guided radiotherapy (IGRT), its application must be considered carefully as the procedure can be invasive, time-consuming, and reliant on consultant expertise. Precision of the fiducials is dependent on these markers remaining in the same location and on the prostate not changing shape during the course treatment. To facilitate the acquirement of non-ionising IGRT and intra-fractional prostate tracking, Clarity TPUS was developed as an alternative imaging system. The main benefits of Clarity TPUS are that it is non-invasive, non-ionising and cost-effective. Other studies have compared fiducials to transabdominal ultrasound, which has since been proven to not be as accurate as trans-perineal imaging, as included in this study. CBCT fiducial translations and Clarity TPUS translations for 120 images as part of the PACE-C prostate SABR trial were retrospectively evaluated by three imaging specialists. Differences were analysed using correlation and Bland-Altman plots. Inter-observer matches agreed within 3mm 88.3 % of the time in left/right direction, 86.7 % of the time in in superior/inferior direction, and 91.7% of the time in ant/post direction. They agreed within 5mm more than 98.3 % of the time in all directions. The intra-class correlation co-efficient was calculated for each direction to show agreement between imaging specialist for inter-observer variability. Each was 0.95 or above, with 1 indicating perfect reliability. Agreement between observers was slightly higher for CBCT and fiducials at 98.7% agreement within 5 mm, compared to clarity TPUS where 96.7% agreement was seen within 5mm. Clarity TPUS has the benefit of no additional dose and intra-fractional monitoring, and results show a good correlation between the different modalities. Inter-observer variability is to be considered, and further research with a larger population would be of benefit.

Keywords: oncology, prostate radiotherapy, image guided radiotherapy, IGRT

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1643 Effectiveness of a Sports Nutrition Intervention for High-School Athletes: A Feasibility Study

Authors: Michael Ryan, Rosemary E. Borgerding, Kimberly L. Oliver

Abstract:

The objective of this study was to assess the effectiveness of a sports nutrition intervention on body composition in high-school athletes. The study aimed to improve the food and water intake of high-school athletes, evaluate the cost-effectiveness of the intervention, and assess changes in body fat. Data were collected through observations, questionnaires, and interviews. Additionally, bioelectrical impedance analysis was performed to assess the body composition of athletes both before and after the intervention. Athletes (n=25) participated in researcher-monitored training sessions three times a week over the course of 12 weeks. During these sessions, in addition to completing their auxiliary sports training, participants were exposed to educational interventions aimed at improving their nutrition. These included discussions regarding current eating habits, nutritional guidelines for athletes, and individualized recommendations. Food was also made available to athletes for consumption before and after practice. Meals of balanced macronutrient composition were prepared and provided to athletes on four separate occasions throughout the intervention, either prior to or following a competitive event such as a tournament or game. A paired t-test was used to determine the statistical significance of the changes in body fat percentage. The results showed that there was a statistically significant difference between pre and post-intervention body fat percentage (p= .006). Cohen's d of 0.603 was calculated, indicating a moderate effect size. In conclusion, this study provides evidence that a sports nutrition intervention that combines food availability, explicit prescription, and education can be effective in improving the body composition of high-school athletes. However, it's worth noting that this study had a small sample size, and the conclusions cannot be generalized to a larger population. Further research is needed to assess the scalability of this study. This preliminary study demonstrated the feasibility of this type of nutritional intervention and laid the groundwork for a larger, more extensive study to be conducted in the future.

Keywords: bioelectrical impedance, body composition, high-school athletes, sports nutrition, sports pedagogy

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1642 Mathematical Modeling and Analysis of COVID-19 Pandemic

Authors: Thomas Wetere

Abstract:

Background: The coronavirus disease 2019 (COVID-19) pandemic (COVID-19) virus infection is a severe infectious disease with the highly transmissible variant, which become the global public health treat now. It has taken the life of more than 4 million people so far. What makes the disease the worst of all is no specific effective treatment available, its dynamics is not much researched and understood. Methodology: To end the global COVID-19 pandemic, implementation of multiple population-wide strategies, including vaccination, environmental factors, Government action, testing, and contact tracing, is required. In this article, a new mathematical model incorporating both temperature and government action to study the dynamics of the COVID-19 pandemic has been developed and comprehensively analysed. The model considers eight stages of infection: susceptible (S), infected Asymptomatic and Undetected(IAU ), infected Asymptomatic and detected(IAD), infected symptomatic and Undetected(ISU ), infected Symptomatic and detected(ISD), Hospitalized or threatened(H), Recovered(R) and Died(D). Results: The existence as well as non-negativity of the solution to the model is also verified, and the basic reproduction number is calculated. Besides, stability conditions are also checked, and finally, simulation results are compared with real data. The results demonstrates that effective government action will need to be combined with vaccination to end the ongoing COVID-19 pandemic. Conclusion: Vaccination and Government action are highly the crucial measures to control the COVID-19 pandemic. Besides, as the cost of vaccination might be high, we recommend an optimal control to reduce the cost and number of infected individuals. Moreover, in order to prevent COVID-19 pandemic, through the analysis of the model, the government must strictly manage the policy on COVID-19 and carry it out. This, in turn, helps for health campaigning and raising health literacy which plays a role to control the quick spread of the disease. We finally strongly believe that our study will play its own role in the current effort of controlling the pandemic.

Keywords: modeling, COVID-19, MCMC, stability

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1641 Neuropsychological Deficits in Drug-Resistant Epilepsy

Authors: Timea Harmath-Tánczos

Abstract:

Drug-resistant epilepsy (DRE) is defined as the persistence of seizures despite at least two syndrome-adapted antiseizure drugs (ASD) used at efficacious daily doses. About a third of patients with epilepsy suffer from drug resistance. Cognitive assessment has a crucial role in the diagnosis and clinical management of epilepsy. Previous studies have addressed the clinical targets and indications for measuring neuropsychological functions; best to our knowledge, no studies have examined it in a Hungarian therapy-resistant population. To fill this gap, we investigated the Hungarian diagnostic protocol between 18 and 65 years of age. This study aimed to describe and analyze neuropsychological functions in patients with drug-resistant epilepsy and identify factors associated with neuropsychology deficits. We perform a prospective case-control study comparing neuropsychological performances in 50 adult patients and 50 healthy individuals between March 2023 and July 2023. Neuropsychological functions were examined in both patients and controls using a full set of specific tests (general performance level, motor functions, attention, executive facts., verbal and visual memory, language, and visual-spatial functions). Potential risk factors for neuropsychological deficit were assessed in the patient group using a multivariate analysis. The two groups did not differ in age, sex, dominant hand and level of education. Compared with the control group, patients with drug-resistant epilepsy showed worse performance on motor functions and visuospatial memory, sustained attention, inhibition and verbal memory. Neuropsychological deficits could therefore be systematically detected in patients with drug-resistant epilepsy in order to provide neuropsychological therapy and improve quality of life. The analysis of the classical and complex indices of the special neuropsychological tasks presented in the presentation can help in the investigation of normal and disrupted memory and executive functions in the DRE.

Keywords: drug-resistant epilepsy, Hungarian diagnostic protocol, memory, executive functions, cognitive neuropsychology

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1640 Ambulatory Care Utilization of Individuals with Cerebral Palsy in Taiwan- A Country with Universal Coverage and No Gatekeeper Regulation

Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

Abstract:

Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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1639 The Distribution, Productivity and Conservation of Camphor Tree, Dryobalanops Aromatica in West Coast of Sumatra, Indonesia

Authors: Aswandi Anas Husin, Cut Rizlani Kholibrina

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Harvesting camphor resin has been carried out since the beginning of civilization on the west coast of Sumatra. Oil or crystals that containing borneol are harvested from the camphor tree (Dryobalanops aromatica). Non-timber forest products are utilized for the manufacture of fragrances, antiseptics, anti-inflammatory, analgesic as well as effective for the treatment of blocked arteries. Based on exploration on the west coast of Sumatra, these endemic tree species were found remaining growing in groups on small spots in the lowlands to the hills. Some populations are found at an altitude of 700 meters above sea level in Kadabuhan, Jongkong and Sultan Daulat in Subulussalam district, Singkohor and Lake Paris in Aceh Singkil district, and Sirandorung and Manduamas in the north of Barus, Central Tapanuli district. These multi-purpose tree species was also identified as being able to adapt to the Singkil Peat Swamp. The decline in tree population has a direct impact on reducing their productivity. Conventionally, the crystals are harvested by cutting and splitting the stem into wooden blocks. In this way about 1.5-2.5 kg of crystals are obtained with various qualities. Camphor retrieval can also be done by making a notch on a standing tree trunk and collecting liquid resin (ombil) that is removed from the injured resin channel. Twigs and leaves also contain borneol. The aromatic content in this section opens opportunities for the supply of borneol through the distillation process. Vegetative propagation technology is needed to overcome the limitations of available seeds. This breeding strategy for vulnerable species starts with gathering genetic material from various provenances which are then used to support the provision of basic populations, breeding populations, multiplication populations and production populations for extensive development of camphor tree plantations

Keywords: camphor, conservation, natural borneol, productivity, vulnerable species

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1638 An Index to Measure Transportation Sustainable Performance in Construction Projects

Authors: Sareh Rajabi, Taha Anjamrooz, Salwa Bheiry

Abstract:

The continuous increase in the world population, resource shortage and the warning of climate change cause various environmental and social issues to the world. Thus, sustainability concept is much needed nowadays. Organizations are progressively falling under strong worldwide pressure to integrate sustainability practices into their project decision-making development. Construction projects in the industry are amongst the most significant, since it is one of the biggest divisions and of main significance for the national economy and hence has a massive effect on the environment and society. So, it is important to discover approaches to incorporate sustainability into the management of those projects. This study presents a combined sustainability index of projects with sustainable transportation which has been formed as per a comprehensive literature review and survey study. Transportation systems enable the movement of goods and services worldwide, and it is leading to economic growth and creating jobs while creating negative impacts on the environment and society. This research is study to quantify the sustainability indicators, through 1) identifying the importance of sustainable transportation indicators that are based on the sustainable practices used for the construction projects and 2) measure the effectiveness of practices through these indicators on the three sustainable pillars. A total 26 sustainability indicators have been selected and grouped under each related sustainability pillars. A survey was used to collect the opinion about the sustainability indicators by a scoring system. A combined sustainability index considering three sustainable pillars can be helpful in evaluating the transportation sustainable practices of a project and making decisions regarding project selection. In addition to focus on the issue of financial resource allocation in a project selection, the decision-maker could take into account the sustainability as an important key in addition to the project’s return and risk. The purpose of this study is to measure the performance of transportation sustainability which allow companies to assess multiple projects selection. This is useful to decision makers to rank and focus more on future sustainable projects.

Keywords: sustainable transportation, transportation performances, sustainable indicators, sustainable construction practice, sustainability

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1637 The Impact of COVID-19 on Antibiotic Prescribing in Primary Care in England: Evaluation and Risk Prediction of the Appropriateness of Type and Repeat Prescribing

Authors: Xiaomin Zhong, Alexander Pate, Ya-Ting Yang, Ali Fahmi, Darren M. Ashcroft, Ben Goldacre, Brian Mackenna, Amir Mehrkar, Sebastian C. J. Bacon, Jon Massey, Louis Fisher, Peter Inglesby, Kieran Hand, Tjeerd van Staa, Victoria Palin

Abstract:

Background: This study aimed to predict risks of potentially inappropriate antibiotic type and repeat prescribing and assess changes during COVID-19. Methods: With the approval of NHS England, we used the OpenSAFELY platform to access the TPP SystmOne electronic health record (EHR) system and selected patients prescribed antibiotics from 2019 to 2021. Multinomial logistic regression models predicted the patient’s probability of receiving an inappropriate antibiotic type or repeating the antibiotic course for each common infection. Findings: The population included 9.1 million patients with 29.2 million antibiotic prescriptions. 29.1% of prescriptions were identified as repeat prescribing. Those with same-day incident infection coded in the EHR had considerably lower rates of repeat prescribing (18.0%), and 8.6% had a potentially inappropriate type. No major changes in the rates of repeat antibiotic prescribing during COVID-19 were found. In the ten risk prediction models, good levels of calibration and moderate levels of discrimination were found. Important predictors included age, prior antibiotic prescribing, and region. Patients varied in their predicted risks. For sore throat, the range from 2.5 to 97.5th percentile was 2.7 to 23.5% (inappropriate type) and 6.0 to 27.2% (repeat prescription). For otitis externa, these numbers were 25.9 to 63.9% and 8.5 to 37.1%, respectively. Interpretation: Our study found no evidence of changes in the level of inappropriate or repeat antibiotic prescribing after the start of COVID-19. Repeat antibiotic prescribing was frequent and varied according to regional and patient characteristics. There is a need for treatment guidelines to be developed around antibiotic failure and clinicians provided with individualised patient information.

Keywords: antibiotics, infection, COVID-19 pandemic, antibiotic stewardship, primary care

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