Search results for: health risk

Authors: Mukondi Nethavhakone

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The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

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Authors: Nabil Mekaoui, Nacer Jabour, Abdelhamid Allaoui, Abderahim Oulidi

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The reliability of several insurance indexes of the seismic risk is evaluated and compared for an efficient seismic risk coverage of buildings in Morocco, thus, reducing the basic risk. A large database of earthquake ground motions is established from recent seismic events in Morocco and synthetic ground motions compatible with the design spectrum in order to conduct nonlinear time history analyses on three building models representative of the building stock in Morocco. The uninhabitability index is evaluated based on the simulated damage index, then correlated with preselected insurance indexes. Interestingly, the commonly used peak ground acceleration index showed poor correlation when compared with other indexes, such as spectral accelerations at low periods. Recommendations on the choice of suitable insurance indexes are formulated for efficient seismic risk coverage in Morocco.

Keywords: catastrophe modeling, damage, earthquake, reinsurance, seismic hazard, trigger index, vulnerability

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Authors: Nicolas Georges, Akiki Simon, Bassil Naim, Nawfal Georges, Abi Fares Georges

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Introduction: Dyslipidemia has been recognized as a risk factor for cardiovascular diseases. While the development of atherosclerotic lesions begins in childhood and progresses throughout life, data on the prevalence of dyslipidemic children in Lebanon is lacking. Objectives: This study was conducted to assess the benefit of a protocol for universal screening for lipid disorder in Lebanese children aged between two and ten years old. Materials and Methods: A total of four hundred children aged 2 to 10 years old (51.5% boys) were included in the study. The subjects were recruited from private pediatric clinics after parental consent. Fasting total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) levels were measured and non-HDL cholesterol was calculated. The values were categorized according to 2011 Expert on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Results: The overall prevalence of high TC ( ≥ 200 mg/dL), high non-HDL-C ( ≥ 145 mg/dL), high LDL ( ≥ 130 mg/dL), high TG ( ≥ 100 mg/dL) and low HDL ( < 40 mg/dL) was respectively 19.5%, 23%, 19%, 31.8% and 20%. The overall frequency of dyslipidemia was 51.7%. In a bivariate analysis, dyslipidemia in children was associated with a BMI ≥ 95ᵗʰ percentile and parents having TC > 240 mg/dL with a P value respectively of 0.006 and 0.0001. Furthermore, high TG was independently associated with a BMI ≥ 95ᵗʰ percentile (P=0.0001). Children with parents having TC > 240 mg/dL was significantly correlated with high TC, high non-HDL-C and high LDL (P=0.0001 for all variables). Finally, according to the Pediatric dyslipidemia screening guidelines from the 2011 Expert Panel, 62.3% of dyslipidemic children had at least 1 risk factor that qualified them for screening while 37.7% of them didn’t have any risk factor. Conclusions: It is preferable to review the latest pediatric dyslipidemia screening guidelines by performing a universal screening program since a third of our dyslipidemic Lebanese children have been missed.

Keywords: cardiovascular risk factors, dyslipidemia, Lebanese children, screening

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Authors: Katerine Moraes dos Satons, Gisele Massante Peixoto Tracera, Regina Célia Gollner Zeitoune

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To analyze the psychosocial risks related to the organization of nursing work in outpatient clinics of university hospitals. Cross-sectional epidemiological study developed in 11 outpatient units linked to the three public universities of the city of Rio de Janeiro, Brazil. Participants were 388 nursing professionals who worked in patient care at the time of the research. Data were collected from July to December 2018, using a self-applicable instrument. A questionnaire was used for sociodemographic, occupational and health characterization, and the Work Organization Scale. The bivariate analyses were performed using the odds ratio (OR), with a confidence interval of 95%, significance level of 5%. The organization of nursing work received an assessment of medium psychosocial risk by the professionals participating in the research, demanding interventions in the short and medium term. There was no association between sociodemographic, occupational and health characteristics and the organization of outpatient work. Interventional measures should be performed in the psychosocial risk factors presented in this research, with a view to improving the work environment, so that the importance of maintaining satisfactory material conditions is considered, as well as the adequate quantity of human resources. In addition, it aims to expand the spaces of nursing participation in decision- making, strengthening its autonomy as a profession.

Keywords: occupational risks, nursing, nursing team, worker’s health, psychosocial risks

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Authors: Hasibe Caballero-Gomez, Richard Pepino

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Childhood lead poisoning is an issue that continues to plague major U.S. cities. Lead poisoning has been linked to decreases in academic achievement and IQ at levels as low as 5 ug/dL. Despite efforts from the Philadelphia Health Department to curtail systemic childhood lead poisoning, children continue to be identified with elevated blood lead levels (EBLLs) above the CDC reference level for diagnosis. This problem disproportionately affects low-income Black communities. At the moment, remediation is costly, and with the current policies in place, comprehensive remediation seems unrealistic. This research investigates community engagement policy and the ways pre-exisiting resources in target communities can be adjusted to decrease childhood lead poisoning. The study was done with two methods: content analysis and case studies. The content analysis includes 12 interviews from stakeholders and five published policy recommendations. The case studies focus on Baltimore, Chicago, Rochester, and St. Louis, four cities with significant childhood lead poisoning. Target communities were identified by mapping five factors that indicate a higher risk for lead poisoning. Seven priority zipcodes were identified for the model developed in this study. For these urban centers, 28 policy solutions and suggestions were identified, with three being identified at least four times in the content analysis and case studies. These three solutions create an interdependent model that offers increased community awareness and engagement with the issue that could potentially improve health and social outcomes for at-risk children.

Keywords: at-risk populations, community engagement, environmental justice, policy translation

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Authors: Mani Venkatesh, Catarina Delgado, Purvishkumar Patel

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The sustainable supply chain is gaining popularity among practitioners because of increased environmental degradation and stakeholder awareness. On the other hand supply chain, risk management is very crucial for the practitioners as it potentially disrupts supply chain operations. Prediction and addressing the risk caused by social issues in the supply chain is paramount importance to the sustainable enterprise. More recently, the usage of Big data analytics for forecasting business trends has been gaining momentum among professionals. The aim of the research is to explore the application of big data, predictive analytics in successfully mitigating supply chain social risk and demonstrate how such mitigation can help in achieving sustainability (environmental, economic & social). The method involves the identification and validation of social issues in the supply chain by an expert panel and survey. Later, we used a case study to illustrate the application of big data in the successful identification and mitigation of social issues in the supply chain. Our result shows that the company can predict various social issues through big data, predictive analytics and mitigate the social risk. We also discuss the implication of this research to the body of knowledge and practice.

Keywords: big data, sustainability, supply chain social sustainability, social risk, case study

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Authors: Lia Mania, Ketevan Nanobashvili

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Background: The coronavirus disease COVID-19 has become the cause of a global health crisis during the current pandemic. This study aims to fill the paucity of epidemiological studies on the impact of COVID-19 on the oral health of pediatric populations. Methods: It was conducted an observational, cross-sectional study in Georgia, in Tbilisi (capital of Georgia), among 7 to 12-year-old PCR or rapid test-confirmed post-Covid populations in all districts of Tbilisi (10 districts in total). 332 beneficiaries who were infected with Covid within one year were included in the study. The population was selected in schools of Tbilisi according to the principle of cluster selection. A simple random selection took place in the selected clusters. According to this principle, an equal number of beneficiaries were selected in all districts of Tbilisi. By July 1, 2022, according to National Center for Disease Control and Public Health data (NCDC.Ge), the number of test-confirmed cases in the population aged 0-18 in Tbilisi was 115137 children (17.7% of all confirmed cases). The number of patients to be examined was determined by the sample size. Oral screening, microbiological examination of saliva, and administration of oral health questionnaires to guardians were performed. Statistical processing of data was done with SPSS-23. Risk factors were estimated by odds ratio and logistic regression with 95% confidence interval. Results: Statistically reliable differences between the averages of oral health indicators in asymptomatic and symptomatic covid-infected groups are: for caries intensity (DMF+def) t=4.468 and p=0.000, for modified gingival index (MGI) t=3.048, p=0.002, for simplified oral hygiene index (S-OHI) t=4.853; p=0.000. Symptomatic covid-infection has a reliable effect on the oral microbiome (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis); (n=332; 77.3% vs n=332; 58.0%; OR=2.46, 95%CI: 1.318-4.617). According to the logistic regression, it was found that the severity of the covid infection has a significant effect on the frequency of pathogenic and conditionally pathogenic bacteria in the oral cavity B=0.903 AOR=2.467 (CL 1.318-4.617). Symptomatic covid-infection affects oral health indicators, regardless of the presence of other risk factors, such as parental employment status, tooth brushing behaviors, carbohydrate meal, fruit consumption. (p<0.05). Conclusion: Risk factors (parental employment status, tooth brushing behaviors, carbohydrate consumption) were associated with poorer oral health status in a post-Covid population of 7- to 12-year-old children. However, such a risk factor as symptomatic ongoing covid-infection affected the oral microbiome in terms of the abundant growth of pathogenic and conditionally pathogenic bacteria (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis) and further worsened oral health indicators. Thus, a close association was established between symptomatic covid-infection and microbiome changes in the post-covid period; also - between the variables of oral health indicators and the symptomatic course of covid-infection.

Keywords: oral microbiome, COVID-19, population based research, oral health indicators

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Authors: Minbale Aschale, Bitew K. Dessie, Endaweke Assegide, Yosef Abebe, Tena Alamirew, Claire L. Walsh, Gete Zeleke

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The upper Awash Basin faces pollution challenges due to urbanization, population growth, and expanding industries. It receives various pollutants from its catchments. The study aimed to assess the impact of wastewater irrigation on vegetables and inform stakeholders about pollution challenges and consequences. Eighty-two composite samples of matured vegetables were randomly collected from twenty-one agricultural farm sites. These samples were analyzed for potentially toxic elements, including Cd, Pb, Cr, Hg, As, Ni, Sr, B, Co, Cu, Mn, Fe, Zn, and Se. The results indicated significant variations in concentrations across different sites, with localized contributions from various contaminants. Cr, Cd, and Pb concentrations in most vegetables exceeded recommended levels. Pollution levels varied with metals and vegetable types. Different vegetables contribute differently to health risks. The relative contributions of Ethiopian kale, cabbage, red beet, lettuce, Swiss chard, Gurage cabbage, tomato, zucchini, carrot, onion, watermelon, and potato to the aggregated risk were 12.69%, 12.25%, 11.83%, 11.20%, 10.21%, 9.91%, 8.49%, 5.66%, 3.96%, 3.35%, 3.10%, and 2.72%, respectively. Comparison with permissible standards revealed inadequate environmental management by relevant regulatory bodies and industries. Despite good laws and standards at the federal and regional levels, they are ineffectively implemented or enforced to prevent environmental pollution. Mitigation measures are urgently recommended to address the potential health implications of toxic substances.

Keywords: pollution, upper Awash Basin, health risk, Ethiopia

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Authors: Bismina Akbar, Smitha M. V.

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Flooding is a global phenomenon that causes widespread devastation, economic damage, and loss of human lives. In the past twenty years, the number of reported flood events has increased significantly. Millions of people around the globe are at risk of flooding from coastal, dam breaks, groundwater, and urban surface water and wastewater sources. Climate change is one of the important causes for them since it affects, directly and indirectly, the river network. Although the contribution of climate change is undeniable, human contributions are there to increase the frequency of floods. There are different types of floods, such as Flash floods, Coastal floods, Urban floods, River (or fluvial) floods, and Ponding (or pluvial flooding). This study focuses on formulating mitigation strategies for urban flood risk reduction through analysis of different best practice case studies, including China, Japan, Indonesia, and Brazil. The mitigation measures suggest that apart from the structural and non-structural measures, environmental considerations like blue-green solutions are beneficial for flood risk reduction. And also, Risk-Informed Master plans are essential nowadays to take risk-based decision processes that enable more sustainability and resilience.

Keywords: hazard, mitigation, risk reduction, urban flood

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Authors: Sri Yusnita Irda Sari, Deni Kurniadi Sunjaya, Ardini Saptaningsih Raksanagara

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Water is one of the fundamental basic needs for human life, particularly drinking water sources. Although water quality is getting better, fecal-contamination of water is still found around the world, especially in the slum area of mid-low income countries. Drinking water source contamination in urban slum dwellers increases the risk of water borne diseases. Low level of sanitation and poor drinking water supply known as risk factors for diarrhea, moreover bacteria-contaminated drinking water source is the main cause of diarrhea in developing countries. This study aimed to assess risk infection due to Fecal Coliform contamination in various drinking water sources in urban area by applying Quantitative Microbiological Risk Assessment (QMRA). A Cross-sectional survey was conducted in a period of August to October 2015. Water samples were taken by simple random sampling from households in Cikapundung river basin which was one of urban slum area in the center of Bandung city, Indonesia. About 379 water samples from 199 households and 15 common wells were tested. Half of the households used treated drinking water from water gallon mostly refill water gallon which was produced in drinking water refill station. Others used raw water sources which need treatment before consume as drinking water such as tap water, borehole, dug well and spring water source. Annual risk to get infection due to Fecal Coliform contamination from highest to lowest risk was dug well (1127.9 x 10-5), spring water (49.7 x 10-5), borehole (1.383 x 10-5) and tap water (1.121 x 10-5). Annual risk infection of refill drinking water was 1.577 x 10-5 which is comparable to borehole and tap water. Household water treatment and storage to make raw water sources drinkable is essential to prevent risk of water borne diseases. Strong regulation and intense monitoring of refill water gallon quality should be prioritized by the government; moreover, distribution of tap water should be more accessible and affordable especially in urban slum area.

Keywords: drinking water, quantitative microbiological risk assessment, slum, urban

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Authors: Mariam Ismail, Kazeem Rufai, Jeremiah Balogun

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A study was conducted to apply fuzzy logic to the development of a monitoring model for child pornography based on associated risk factors, which can be used by forensic experts or integrated into forensic systems for the early detection of child pornographic activities. A number of methods were adopted in the study, which includes an extensive review of related works was done in order to identify the factors that are associated with child pornography following which they were validated by an expert sex psychologist and guidance counselor, and relevant data was collected. Fuzzy membership functions were used to fuzzify the associated variables identified alongside the risk of the occurrence of child pornography based on the inference rules that were provided by the experts consulted, and the fuzzy logic expert system was simulated using the Fuzzy Logic Toolbox available in the MATLAB Software Release 2016. The results of the study showed that there were 4 categories of risk factors required for assessing the risk of a suspect committing child pornography offenses. The results of the study showed that 2 and 3 triangular membership functions were used to formulate the risk factors based on the 2 and 3 number of labels assigned, respectively. The results of the study showed that 5 fuzzy logic models were formulated such that the first 4 was used to assess the impact of each category on child pornography while the last one takes the 4 outputs from the 4 fuzzy logic models as inputs required for assessing the risk of child pornography. The following conclusion was made; there were factors that were related to personal traits, social traits, history of child pornography crimes, and self-regulatory deficiency traits by the suspects required for the assessment of the risk of child pornography crimes committed by a suspect. Using the values of the identified risk factors selected for this study, the risk of child pornography can be easily assessed from their values in order to determine the likelihood of a suspect perpetuating the crime.

Keywords: fuzzy, membership functions, pornography, risk factors

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Authors: Abdullah Alsayeqh

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The burden of foodborne diseases in Saudi Arabia is currently unknown. The objective of this study was to identify risk factors associated with these diseases among women in Riyadh. A cross-sectional study was carried out from March to July, 2013 where participants’ responses indicated that they were at risk of these diseases through improper food-holding temperature (45.28%), inadequate cooking (35.47%), cross-contamination (32.23%), and food from unsafe sources (22.39%). The claimed food safety knowledge by 22.04% of participants was not evidenced by their reported behaviors (p > 0.05). This is the first study to identify the gap in food safety knowledge among women in Riyadh which needs to be addressed by the concerned authorities in the country by engaging women more effectively in food safety educational campaigns.

Keywords: foodborne diseases, risk factors, knowledge, women, Saudi Arabia

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Authors: C. V. Pietreanu, S. E. Zaharia, C. Dinu

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Hazard assessment and risks quantification are key components for estimating the impact of existing regulations. But since regulatory compliance cannot cover all risks in aviation, the authors point out that by studying causal factors and eliminating uncertainty, an accurate analysis can be outlined. The research debuts by making delimitations on notions, as confusion on the terms over time has reflected in less rigorous analysis. Throughout this paper, it will be emphasized the fact that the variation in human performance and organizational factors represent the biggest threat from an operational perspective. Therefore, advanced risk assessment methods analyzed by the authors aim to understand vulnerabilities of the system given by a nonlinear behavior. Ultimately, the mathematical modeling of existing hazards and risks by eliminating uncertainty implies establishing an optimal solution (i.e. risk minimization).

Keywords: control, human factor, optimization, risk management, uncertainty

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Authors: S. Alyami, S. Mohammad

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These Risk management practices have a significant impact on construction SMEs. The effective utilisation of these practices depends on culture change in order to optimise decision making for critical activities within construction projects. Thus, successful implementation of empowerment strategies would enhance operational employees to participate in effective decision making. However, there remain many barriers to individuals and organisations within empowerment strategies that require empirical investigation before the industry can benefit from their implementation. Gaps in understanding the relationship between employee empowerment and risk management practices still exist. This research paper aims to examine the impact of the structural empowerment on risk management practices in construction SMEs. The questionnaire has been distributed to participants (162 employees) that involve projects and civil engineers within a case study from Saudi construction SMEs. Partial least squares based structural equation modeling (PLS-SEM) was utilised to perform analysis. The results reveal a positive relationship between empowerment and risk management practices. The study shows how structural empowerment contributes to operational employees in risk management practices through involving activities such as decision making, self-efficiency, and autonomy. The findings of this study will contribute to close the current gaps in the construction SMEs context.

Keywords: construction SMEs, culture, decision making, empowerment, risk management

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Authors: Ram Sharan Mehta, Dina Khanal, Pushpa Parajuli, Gayanand Mandal, Bijaya Bartuala

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Background: Cardiovascular disease (CVD) is the leading cause of death worldwide. Adequate awareness of risk factors of CVD is the first step towards effective preventive strategies to combat the CVD burden in diabetes patients.This study aims to assess the awareness on risk factors of CVD among patients with diabetes mellitus attending diabetic clinic of BPKIHS and to find the association between awareness with their selected socio demographic variables. Methods and Material: A descriptive cross sectional study was conducted among 112 patients with diabetes in diabetic clinic of BPKIHS. Convenient sampling technique was used for data collection over duration of one month using interview schedule by HDFQ II tool. Data were analyzed by using descriptive and inferential statistics. (Chi square). Results: The mean age of respondents was 55.4±12.13 years. That mean HDFQ score was 14.31± 5.08. Only 33% of the respondents had adequate level of awareness whereas majority of the respondents (67%) had inadequate level of awareness. Majority of the respondent (83.9%) were aware about smoking, (78.6%) physical activity, (75%) increasing age, (75.9%) high blood pressure, (71.4%) overweight respectively. Whereas most of the respondents were not aware of high cholesterol, fatty diet, preventive strategies and association of diabetes with CVD. Awareness was statistically significant with (p=0.043) educational status, (p=0.025) monthly income, (p=0.05) residence, (p=0.006) CVD information received and (p=0.022) co morbid condition as a heart disease. Conclusion: The findings of this study concluded most of the respondents had an inadequate level of awareness on risk factors of CVD. So Effective education and appropriate preventive strategies of CVD are indeed important to reduce CVD burden in diabetes patients.

Keywords: cardiovascular disease, awareness, diabetes patients, risk

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

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

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

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Authors: Emmy Pratiwi, Ketut B. Artana, A. A. B. Dinariyana

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Madura Strait is considered as one of the busiest shipping channels in Indonesia. High vessel traffic density in Madura Strait gives serious threat due to navigational safety in this area, i.e. ship collision. This study is necessary as an attempt to enhance the safety of marine traffic. Fuzzy inference system (FIS) is proposed to calculate risk collision of ships. Collision risk is evaluated based on ship domain, Distance to Closest Point of Approach (DCPA), and Time to Closest Point of Approach (TCPA). Data were collected by utilizing Automatic Identification System (AIS). This study considers several ships’ domain models to give the characteristic of marine traffic in the waterways. Each encounter in the ship domain is analyzed to obtain the level of collision risk. Risk level of ships, as the result in this study, can be used as guidance to avoid the accident, providing brief description about safety traffic in Madura Strait and improving the navigational safety in the area.

Keywords: automatic identification system, collision risk, DCPA, fuzzy inference system, TCPA

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Authors: A. Fathianpour, M. B. Jelodar, S. Wilkinson

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This paper outlines the approaches taken to assess multi-hazard assessments. There is currently confusion in assessing multi-hazard impacts, and so this study aims to determine which of the available options are the most useful. The paper uses an international literature search, and analysis of current multi-hazard assessments and a case study to illustrate the effectiveness of the chosen method. Findings from this study will help those wanting to assess multi-hazards to undertake a straightforward approach. The paper is significant as it helps to interpret the various approaches and concludes with the preferred method. Many people in the world live in hazardous environments and are susceptible to disasters. Unfortunately, when a disaster strikes it is often compounded by additional cascading hazards, thus people would confront more than one hazard simultaneously. Hazards include natural hazards (earthquakes, floods, etc.) or cascading human-made hazards (for example, Natural Hazard Triggering Technological disasters (Natech) such as fire, explosion, toxic release). Multi-hazards have a more destructive impact on urban areas than one hazard alone. In addition, climate change is creating links between different disasters such as causing landslide dams and debris flows leading to more destructive incidents. Much of the prevailing literature deals with only one hazard at a time. However, recently sophisticated multi-hazard assessments have started to appear. Given that multi-hazards occur, it is essential to take multi-hazard risk assessment under consideration. This paper aims to review the multi-hazard assessment methods through articles published to date and categorize the strengths and disadvantages of using these methods in risk assessment. Napier City is selected as a case study to demonstrate the necessity of using multi-hazard risk assessments. In order to assess multi-hazard risk assessments, first, the current multi-hazard risk assessment methods were described. Next, the drawbacks of these multi-hazard risk assessments were outlined. Finally, the improvements to current multi-hazard risk assessments to date were summarised. Generally, the main problem of multi-hazard risk assessment is to make a valid assumption of risk from the interactions of different hazards. Currently, risk assessment studies have started to assess multi-hazard situations, but drawbacks such as uncertainty and lack of data show the necessity for more precise risk assessment. It should be noted that ignoring or partial considering multi-hazards in risk assessment will lead to an overestimate or overlook in resilient and recovery action managements.

Keywords: cascading hazards, disaster assessment, mullti-hazards, risk assessment

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Authors: Serpil Kilic, Ihsan Burak Cam, Murat Kilic, Timur Tongur

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Interest in the lead (Pb) has considerably increased due to knowledge about the potential toxic effects of this element, recently. Exposure to heavy metals above the acceptable limit affects human health. Indeed, Pb is accumulated through food chains up to toxic concentrations; therefore, it can pose an adverse potential threat to human health. A sensitive and reliable method for determination of Pb element in red pepper were improved in the present study. Samples (33 red pepper products having different brands) were purchased from different markets in Turkey. The selected method validation criteria (linearity, Limit of Detection, Limit of Quantification, recovery, and trueness) demonstrated. Recovery values close to 100% showed adequate precision and accuracy for analysis. According to the results of red pepper analysis, all of the tested lead element in the samples was determined at various concentrations. A Perkin- Elmer ELAN DRC-e model ICP-MS system was used for detection of Pb. Organic red pepper was used to obtain a matrix for all method validation studies. The certified reference material, Fapas chili powder, was digested and analyzed, together with the different sample batches. Three replicates from each sample were digested and analyzed. The results of the exposure levels of the elements were discussed considering the scientific opinions of the European Food Safety Authority (EFSA), which is the European Union’s (EU) risk assessment source associated with food safety. The Target Hazard Quotient (THQ) was described by the United States Environmental Protection Agency (USEPA) for the calculation of potential health risks associated with long-term exposure to chemical pollutants. THQ value contains intake of elements, exposure frequency and duration, body weight and the oral reference dose (RfD). If the THQ value is lower than one, it means that the exposed population is assumed to be safe and 1 < THQ < 5 means that the exposed population is in a level of concern interval. In this study, the THQ of Pb was obtained as < 1. The results of THQ calculations showed that the values were below one for all the tested, meaning the samples did not pose a health risk to the local population. This work was supported by The Scientific Research Projects Coordination Unit of Akdeniz University. Project Number: FBA-2017-2494.

Keywords: lead analyses, red pepper, risk assessment, daily exposure

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Authors: Afolabi Joseph Fasoranti

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Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis. Tuberculosis is a major public health problem in Nigeria, being one of the ten leading causes of hospital admissions and a leading cause of death in adults, especially among the economically productive age group. This paper critically examined the importance of health education towards the eradication and prevention of tuberculosis in Nigeria. It was reviewed and discussed under the following subheadings; Global burden of tuberculosis in Nigeria, concept, definition and etiology of tuberculosis, Signs and symptoms of tuberculosis, diagnosis of tuberculosis, causative agent, modes of infection and incubation period, risk factors of pulmonary tuberculosis Dots and stop TB programmes in Nigeria Treatment and prevention of tuberculosis TB treatment strategies, Dealing with treatment problems in Nigeria Stigmatization against Tuberculosis Patients Health education as a tool for achieving free tuberculosis country. Emphasis for Tb control has been placed on the development of improved vaccines, diagnostic and treatment courses but less on health education and awareness. Although the need for these tools is indisputable, the obstacle facing the spread of TB go beyond technological. The findings of this study may stimulate health system policy makers, Government and non- governmental organizations, donor agencies and other stakeholders in planning and designing health education intervention programs on the control and eradication of tuberculosis. It therefore recommended that Government should implement health education as part of the DOTs, this will thus empower the tuberculosis patients on ways to live healthy, lifestyle, in doing this, they will recover fast and prevent them from spreading the disease.

Keywords: tuberculosis, health education, panacea, Nigeria, prevention

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Authors: Melkamu A. Zeru, Yamral M. Warkaw, Aweke A. Mitku, Muluwerk Ayele

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Introduction: Malaria is a severe health threat in the World, mainly in Africa. It is the major cause of health problems in which the risk of morbidity and mortality associated with malaria cases are characterized by spatial variations across the county. This study aimed to investigate the spatial patterns and predictors of malaria distribution in Ethiopia. Methods: A weighted sample of 15,239 individuals with rapid diagnosis tests was obtained from the Central Statistical Agency and Ethiopia malaria indicator survey of 2015. Global Moran's I and Moran scatter plots were used in determining the distribution of malaria cases, whereas the local Moran's I statistic was used in identifying exposed areas. In data manipulation, machine learning was used for variable reduction and statistical software R, Stata, and Python were used for data management and analysis. The auto logistics spatial binary regression model was used to investigate the predictors of malaria. Results: The final auto logistics regression model reported that male clients had a positive significant effect on malaria cases as compared to female clients [AOR=2.401, 95 % CI: (2.125 - 2.713)]. The distribution of malaria across the regions was different. The highest incidence of malaria was found in Gambela [AOR=52.55, 95%CI: (40.54-68.12)] followed by Beneshangul [AOR=34.95, 95%CI: (27.159 - 44.963)]. Similarly, individuals in Amhara [AOR=0.243, 95% CI:(0.1950.303],Oromiya[AOR=0.197,95%CI:(0.1580.244)],DireDawa[AOR=0.064,95%CI(0.049-0.082)],AddisAbaba[AOR=0.057,95%CI:(0.044-0.075)], Somali[AOR=0.077,95%CI:(0.059-0.097)], SNNPR[OR=0.329, 95%CI: (0.261- 0.413)] and Harari [AOR=0.256, 95%CI:(0.201 - 0.325)] were less likely to had low incidence of malaria as compared with Tigray. Furthermore, for a one-meter increase in altitude, the odds of a positive rapid diagnostic test (RDT) decrease by 1.6% [AOR = 0.984, 95% CI :( 0.984 - 0.984)]. The use of a shared toilet facility was found as a protective factor for malaria in Ethiopia [AOR=1.671, 95% CI: (1.504 - 1.854)]. The spatial autocorrelation variable changes the constant from AOR = 0.471 for logistic regression to AOR = 0.164 for auto logistics regression. Conclusions: This study found that the incidence of malaria in Ethiopia had a spatial pattern that is associated with socio-economic, demographic, and geographic risk factors. Spatial clustering of malaria cases had occurred in all regions, and the risk of clustering was different across the regions. The risk of malaria was found to be higher for those who live in soil floor-type houses as compared to those who live in cement or ceramics floor type. Similarly, households with thatched, metal and thin, and other roof-type houses have a higher risk of malaria than ceramic tiles roof houses. Moreover, using a protected anti-mosquito net reduced the risk of malaria incidence.

Keywords: malaria, Ethiopia, auto logistics, spatial model, spatial clustering

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Authors: David Ahiamadia, Ramilan Thiagarajah, Peter Tozer

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In Sub Saharan Africa, farm typologies have been used as a practical way to address heterogeneity among farming systems which is mostly done by grouping farms into subsets with similar characteristics. Due to the complexity in farming systems among farm households, it is not possible to formulate policy recommendations for individual farmers. As a result, this study employs a multivariate statistical approach using Principal Component Analysis (PCA) coupled with cluster analysis to reduce heterogeneity in a 615-household data set from the Africa Rising Baseline Evaluation Survey for 25 farming communities in Northern Ghana. Variables selected for the study were mostly socio-economic, production potential, production intensity, production orientation, crop diversity, food security, resource endowments, and climate risk variables. To avoid making some individuals in the subpopulation worse off when aclimate risk intervention is broadly implemented, the findings of the study also account for diversity in climate risk perception among the different farm types identified and their response strategies towards climate risk. The climate risk variables used in this study involve the most severeclimate shock types perceived by the household, household response to climate shock type, and reason for crop failure (i.e., maize, rice, and groundnut). Eventually, four farm types, each with an adequate level of homogeneity in climate risk perception and response strategies, were identified. Farm type 1 and 3 were wealthy with a lower degree of climate risk perception compared to farm type 2 and 4. Also, relatively wealthy farmers used asset liquidation as a climate risk management strategy, whereas poor farmers resorted to engaging in spiritual activities such as prayers, sacrifices, and divine consultations.

Keywords: smallholder, households, climate risk, variables, typologies

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Authors: A. Badran, M. Hollocks, H. Markus

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Background: Common risk factors for cardiovascular disease are associated with age-related cognitive decline. There has been much interest in treating modifiable cardiovascular risk factors in the hope of reducing cognitive decline. However, there is currently no validated neuropsychological test to assess the subclinical cognitive effects of vascular risk. The Brief Memory and Executive Test (BMET) is a clinical screening tool, which was originally designed to be sensitive and specific to Vascular Cognitive Impairment (VCI), an impairment characterised by decline in frontally-mediated cognitive functions (e.g. Executive Function and Processing Speed). Objective: To cross-sectionally assess the validity of the BMET as a measure of the subclinical effects of vascular risk on cognition, in an otherwise healthy elderly cohort. Methods: Data from 346 participants (57 ± 10 years) without major neurological or psychiatric disorders were included in this study, gathered as part of a previous multicentre validation study for the BMET. Framingham Vascular Age was used as a surrogate measure of vascular risk, incorporating several established risk factors. Principal Components Analysis of the subtests was used to produce common constructs: an index for Memory and another for Executive Function/Processing Speed. Univariate General Linear models were used to relate Vascular Age to performance on Executive Function/Processing Speed and Memory subtests of the BMET, adjusting for Age, Premorbid Intelligence and Ethnicity. Results: Adverse vascular risk was associated with poorer performance on both the Memory and Executive Function/Processing Speed indices, adjusted for Age, Premorbid Intelligence and Ethnicity (p=0.011 and p<0.001, respectively). Conclusions: Performance on the BMET reflects the subclinical effects of vascular risk on cognition, in age-related cognitive decline. Vascular risk is associated with decline in both Executive Function/Processing Speed and Memory groups of subtests. Future studies are needed to explore whether treating vascular risk factors can effectively reduce age-related cognitive decline.

Keywords: age-related cognitive decline, vascular cognitive impairment, subclinical cerebrovascular disease, cognitive aging

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Authors: Arti Singh, Carolyn Jenkins, Oyedunni S. Arulogun, Mayowa O. Owolabi, Fred S. Sarfo, Bruce Ovbiagele, Enzinne Sylvia

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Background: Stroke, the leading cause of adult-onset disability and the second leading cause of death, is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur. The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer the high burden of disease in SSA. This study describes how the SIREN project engaged six sites in Ghana and Nigeria over the past three years, describing the community engagement activities that have arisen since inception. Aim: The aim of community engagement (CE) within SIREN is to elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA, and to educate the community about stroke and ways to decrease disabilities and deaths from stroke using socioculturally appropriate messaging and messengers. Methods: Community Advisory Board (CABs), Focus Group Discussions (FGDs) and community outreach programs. Results: 27 FGDs with 168 participants including community heads, religious leaders, health professionals and individuals with stroke among others, were conducted, and over 60 CE outreaches have been conducted within the SIREN performance sites. Over 5,900 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Other findings include: 1) Most recognize hypertension as a major risk factor for stroke. 2) About 50% report that stroke is hereditary and about 20% do not know organs affected by stroke. 3) More than 95% willing to participate in genetic testing research and about 85% willing to pay for testing and recommend the test to others. 4) Almost all indicated that genetic testing could help health providers better treat stroke and help scientists better understand the causes of stroke. The CABs provided stakeholder input into SIREN activities and facilitated collaborations among investigators, community members and stakeholders. Conclusion: The CE core within SIREN is a first-of-its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high-stroke risk populations. SIREN’s CE program uses best practices to build capacity for community-engaged research, accelerate integration of research findings into practice and strengthen dynamic community-academic partnerships within our communities. CE has had several major successes over the past three years including our multi-site collaboration examining the KABP about stroke (symptoms, risk factors, burden) and genetic testing across SSA.

Keywords: community advisory board, community engagement, focus groups, outreach, SSA, stroke

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Authors: Mirzet SeHo, Alaa Alaabed, Mansur Masih

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In theory, risk-sharing-based financing (RSF) is considered a corner stone of Islamic finance. It is argued to render Islamic banks more resilient to shocks. In practice, however, this feature of Islamic financial products is almost negligible. Instead, debt-based instruments, with conventional like features, have overwhelmed the nascent industry. In addition, the framework of present-day economic, regulatory and financial reality inevitably exposes Islamic banks in dual banking systems to problems of conventional banks. This includes, but is not limited to, interest rate risk. Empirical evidence has, thus far, confirmed such exposures, despite Islamic banks’ interest-free operations. This study applies system GMM in modeling the determinants of RSF, and finds that RSF is insensitive to changes in interest rates. Hence, our results provide support to the “stability” view of risk-sharing-based financing. This suggests RSF as the way forward for risk management at Islamic banks, in the absence of widely acceptable Shariah compliant hedging instruments. Further support to the stability view is given by evidence of counter-cyclicality. Unlike debt-based lending that inflates artificial asset bubbles through credit expansion during the upswing of business cycles, RSF is negatively related to GDP growth. Our results also imply a significantly strong relationship between risk-sharing deposits and RSF. However, the pass-through of these deposits to RSF is economically low. Only about 40% of risk-sharing deposits are channeled to risk-sharing financing. This raises questions on the validity of the industry’s claim that depositors accustomed to conventional banking shun away from risk sharing and signals potential for better balance sheet management at Islamic banks. Overall, our findings suggest that, on the one hand, Islamic banks can gain ‘independence’ from conventional banks and interest rates through risk-sharing products, the potential for which is enormous. On the other hand, RSF could enable policy makers to improve systemic stability and restrain excessive credit expansion through its countercyclical features.

Keywords: Islamic banks, risk-sharing, financing, interest rate, dynamic system GMM

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Authors: Yi-Hsien Wang, Fu-Ju Yang, Hwa-Rong Shen, Rui-Lin Tseng

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The business is notably related to the market risk according to the increase of liberalization of financial markets. Hence, the company usually utilized high financial leverage of derivatives to hedge the risk. When the company choose different hedging instruments to face a variety of exchange rate risk, we employ the Multinomial Logistic-AHP to analyze the impact of various derivatives. Hence, the research summarized the literature on relevant factors affecting managers selected exchange rate hedging instruments, using Multinomial Logistic Model and and further integrate AHP. Using Experts’ Questionnaires can test multi-level selection and hedging effect of different hedging instruments in order to calculate the hedging instruments and the multi-level factors of weights to understand the gap between the empirical results and practical operation. Finally, the Multinomial Logistic-AHP Model will sort the weights to analyze. The research findings can be a basis reference for investors in decision-making.

Keywords: exchange rate risk, derivatives, hedge, multinomial logistic-AHP

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Authors: Go Iwashita

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The paper describes how the frequencies of heatstroke occurring in indoor built environment are related to the outdoor thermal environment with big statistical data. As the statistical accident data of heatstroke, the nationwide accident data were obtained from the National Agency for the Advancement of Sports and Health (NAASH) . The meteorological database of the Japanese Meteorological Agency supplied data about 1-hour average temperature, humidity, wind speed, solar radiation, and so forth. Each heatstroke data point from the NAASH database was linked to the meteorological data point acquired from the nearest meteorological station where the accident of heatstroke occurred. This analysis was performed for a 10-year period (2005–2014). During the 10-year period, 3,819 cases of heatstroke were reported in the NAASH database for the investigated secondary/high schools of the nine Japanese representative cities. Heatstroke most commonly occurred in the outdoor schoolyard at a wet-bulb globe temperature (WBGT) of 31°C and in the indoor gymnasium during athletic club activities at a WBGT > 31°C. The determined accident ratio (number of accidents during each club activity divided by the club’s population) in the gymnasium during the female badminton club activities was the highest. Although badminton is played in a gymnasium, these WBGT results show that the risk level during badminton under hot and humid conditions is equal to that of baseball or rugby played in the schoolyard. Except sports, the high risk of heatstroke was observed in schools houses during cultural activities. The risk level for indoor environment under hot and humid condition would be equal to that for outdoor environment based on the above results of WBGT. Therefore control measures against hot and humid indoor condition were needed as installing air conditions not only schools but also residences.

Keywords: accidents in schools, club activity, gymnasium, heatstroke

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Authors: K. P. Fasalu Rahman

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The financial services industry of Islam include large number of institutions, such as investment banks and commercial banks, investment companies and mutual insurance companies. All types of these financial institutions should have to deal with many issues and risks in their field of work. Islamic banks should expect to face two types of risks: risks that are similar to those faced by conventional financial intermediaries and risks that are unique to the Islamic Banks due to their compliance with the Shariah. The use of financial services and products that comply with the Shariah principles cause special issues for supervision and risk management. Risks are uncertain future events that could influence the achievement of the bank’s objectives, including strategic, operational, financial and compliance objectives. In Islamic banks, effective risk management deserves special attention. As an operational problem, risk management is the classification and identification of methods, processes, and risks in banks to supervise, monitor and measure them. In comparison to conventional banks, Islamic banks face big difficulties in identifying and managing risks due to bigger complexities emerging from the profit loss sharing (PLS) concept and nature of particular risks of Islamic financing. As the developing of managing risks tool becomes very essential, especially in Islamic banking as most of the products are depending on PLS principle, identifying and measuring each type of risk is highly important and critical in any Islamic finance based systems. This paper highlights the special and general risks surrounding Islamic banking. And it investigates in detail the need for risk management in Islamic banks. In addition to analyzing the effectiveness of risk management strategies adopted by Islamic financial institutions at present, this research is also suggesting strategies for improving risk management process of Islamic banks in future.

Keywords: Islamic banking, management, risk, risk management

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Authors: Elisabetta Ceretti, Silvia Bonizzoni, Alberto Bonetti, Milena Villarini, Marco Verani, Maria Antonella De Donno, Sara Bonetta, Umberto Gelatti

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Introduction: Air pollution is a global problem. In 2013, the International Agency for Research on Cancer (IARC) classified air pollution and particulate matter as carcinogenic to human. The study of the health effects of air pollution in children is very important because they are a high-risk group in terms of the health effects of air pollution and early exposure during childhood can increase the risk of developing chronic diseases in adulthood. The MAPEC_LIFE (Monitoring Air Pollution Effects on Children for supporting public health policy) is a project founded by EU Life+ Programme which intends to evaluate the associations between air pollution and early biological effects in children and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children. Methods: The study was carried out on 6-8-year-old children living in five Italian towns in two different seasons. Two biomarkers of early biological effects, primary DNA damage detected with the comet assay and frequency of micronuclei, were investigated in buccal cells of children. Details of children diseases, socio-economic status, exposures to other pollutants and life-style were collected using a questionnaire administered to children’s parents. Child exposure to urban air pollution was assessed by analysing PM0.5 samples collected in the school areas for PAHs and nitro-PAHs concentration, lung toxicity and in vitro genotoxicity on bacterial and human cells. Data on the chemical features of the urban air during the study period were obtained from the Regional Agency for Environmental Protection. The project created also the opportunity to approach the issue of air pollution with the children, trying to raise their awareness on air quality, its health effects and some healthy behaviors by means of an educational intervention in the schools. Results: 1315 children were recruited for the study and participate in the first sampling campaign in the five towns. The second campaign, on the same children, is still ongoing. The preliminary results of the tests on buccal mucosa cells of children will be presented during the conference as well as the preliminary data about the chemical composition and the toxicity and genotoxicity features of PM0.5 samples. The educational package was tested on 250 children of the primary school and showed to be very useful, improving children knowledge about air pollution and its effects and stimulating their interest. Conclusions: The associations between levels of air pollutants, air mutagenicity and biomarkers of early effects will be investigated. A tentative model to calculate the global absolute risk of having early biological effects for air pollution and other variables together will be proposed and may be useful to support policy-making and community interventions to protect children from possible health effects of air pollutants.

Keywords: air pollution exposure, biomarkers of early effects, children, public health policy

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Authors: Adam M. Yates, Julie E. Byles

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Hypertension has been identified as a prominent co-morbidity of obesity. To improve clinical intervention of hypertension, it is critical to identify metrics that most accurately reflect risk for increased morbidity. Two of the most relevant and accurate measures for increased risk of hypertension due to excess adipose tissue are Body Mass Index (BMI) and Waist-Height Ratio (WHtR). Previous research has examined these measures in cross-national and cross-ethnic studies, but has most often relied on secondary means such as meta-analysis to identify and evaluate the efficacy of individual body mass measures. In this study, we instead use cross-sectional analysis to assess the cross-ethnic discriminative power of BMI and WHtR to predict risk of hypertension. Using the WHO SAGE survey, which collected anthropometric and biometric data from respondents in six middle-income countries (China, Ghana, India, Mexico, Russia, South Africa), we implement logistic regression to examine the discriminative power of measured BMI and WHtR with a known population of hypertensive and non-hypertensive respondents. We control for gender and age to identify whether optimum cut-off points that are adequately sensitive as tests for risk of hypertension may be different between groups. We report results for OR, RR, and ROC curves for each of the six SAGE countries. As seen in existing literature, results demonstrate that both WHtR and BMI are significant predictors of hypertension (p < .01). For these six countries, we find that cut-off points for WHtR may be dependent upon gender, age and ethnicity. While an optimum omnibus cut-point for WHtR may be 0.55, results also suggest that the gender and age relationship with WHtR may warrant the development of individual cut-offs to optimize health outcomes. Trends through multiple countries show that the optimum cut-point for WHtR increases with age while the area under the curve (AUROC) decreases for both men and women. Comparison between BMI and WHtR indicate that BMI may remain more robust than WHtR. Implications for public health policy are discussed.

Keywords: hypertension, obesity, Waist-Height ratio, SAGE

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