Search results for: national financial inclusion strategy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11529

Search results for: national financial inclusion strategy

3099 Identifying Biomarker Response Patterns to Vitamin D Supplementation in Type 2 Diabetes Using K-means Clustering: A Meta-Analytic Approach to Glycemic and Lipid Profile Modulation

Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

Abstract:

Background and Aims: This meta-analysis aimed to evaluate the effect of vitamin D supplementation on key metabolic and cardiovascular parameters, such as glycated hemoglobin (HbA1C), fasting blood sugar (FBS), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure (SBP), and total vitamin D levels in patients with Type 2 diabetes mellitus (T2DM). Methods: A systematic search was performed across databases, including PubMed, Scopus, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov, from January 1990 to January 2024. A total of 4,177 relevant studies were initially identified. Using an unsupervised K-means clustering algorithm, publications were grouped based on common text features. Maximum entropy classification was then applied to filter studies that matched a pre-identified training set of 139 potentially relevant articles. These selected studies were manually screened for relevance. A parallel manual selection of all initially searched studies was conducted for validation. The final inclusion of studies was based on full-text evaluation, quality assessment, and meta-regression models using random effects. Sensitivity analysis and publication bias assessments were also performed to ensure robustness. Results: The unsupervised K-means clustering algorithm grouped the patients based on their responses to vitamin D supplementation, using key biomarkers such as HbA1C, FBS, LDL, HDL, SBP, and total vitamin D levels. Two primary clusters emerged: one representing patients who experienced significant improvements in these markers and another showing minimal or no change. Patients in the cluster associated with significant improvement exhibited lower HbA1C, FBS, and LDL levels after vitamin D supplementation, while HDL and total vitamin D levels increased. The analysis showed that vitamin D supplementation was particularly effective in reducing HbA1C, FBS, and LDL within this cluster. Furthermore, BMI, weight gain, and disease duration were identified as factors that influenced cluster assignment, with patients having lower BMI and shorter disease duration being more likely to belong to the improvement cluster. Conclusion: The findings of this machine learning-assisted meta-analysis confirm that vitamin D supplementation can significantly improve glycemic control and reduce the risk of cardiovascular complications in T2DM patients. The use of automated screening techniques streamlined the process, ensuring the comprehensive evaluation of a large body of evidence while maintaining the validity of traditional manual review processes.

Keywords: HbA1C, T2DM, SBP, FBS

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3098 Perceptions of Research Staff on the Implementation of Each-B Study: A Randomised Controlled Trial

Authors: Laila Khawaja

Abstract:

In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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3097 UEFA Super Cup: Economic Effects on Georgian Economy

Authors: Giorgi Bregadze

Abstract:

Tourism is the most viable and sustainable economic development option for Georgia and one of the main sources of foreign exchange earnings. Events are considered as one of the most effective ways to attract foreign visitors to the country, and, recently, the government of Georgia has begun investing in this sector very actively. This article stresses the necessity of research based economic policy in the tourism sector. In this regard, it is of paramount importance to measure the economic effects of the events which are subsidized by taxpayers’ money. The economic effect of events can be analyzed from two perspectives; financial perspective of the government and perspective of economic effects of the tourism administration. The article emphasizes more realistic and all-inclusive focus of the economic effect analysis of the tourism administration as it concentrates on the income of residents and local businesses, part of which generate tax revenues for the government. The public would like to know what the economic returns to investment are. In this article, the methodology used to describe the economic effects of UEFA Super Cup held in Tbilisi, will help to answer this question. Methodology is based on three main principles and covers three stages. Using the suggested methodology article estimates the direct economic effect of UEFA Super cup on Georgian economy. Although the attempt to make an economic effect analysis of the event was successful in Georgia, some obstacles and insufficiencies were identified during the survey. The article offers several recommendations that will help to refine methodology and improve the accuracy of the data. Furthermore, it is very important to receive the correct standard of measurement of events in Georgia. In this caseü non-ethical acts of measurement which are widely utilized by different research companies will not trigger others to show overestimated effects. It is worth mentioning that to author’s best knowledge, this is the first attempt to measure the economic effect of an event held in Georgia.

Keywords: biased economic effect analysis, expenditure of local citizens, time switchers and casuals, UEFA super cup

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3096 Study on the Situation between France and the South China Sea from the Perspective of Balance of Power Theory

Authors: Zhenyi Chen

Abstract:

With the rise of China and the escalation of tension between China and the United States, European countries led by Great Britain, France, and Germany pay increasing attention to the regional situation in the Asia-Pacific (now known as "Indo-Pacific"). Among them, the South China Sea (SCS) is one of the main areas disputed by China, the United States, Southeast Asian countries and some European countries. Western countries are worried that the rise of China's military power will break the stability of the situation in SCS and alter the balance of power among major powers. Therefore, they tried to balance China's rise through alliance. In France's Indo-Pacific strategy, France aims to build a regional order with the alliance of France, India and Australia as the core, and regularly carry out military exercises targeting SCS with the United States, Japan and Southeast Asian countries. For China, the instability of the situation in SCS could also threaten the security of the southeast coastal areas and Taiwan, affect China's peaceful development process, and pose a threat to China's territorial sovereignty. This paper aims to study the activities and motivation of France in the South China Sea, and put the situation in SCS under the perspective of Balance of Power Theory, focusing on China, America and France. To be more specific, this paper will first briefly introduce Balance of Power Theory, then describe the new trends of France in recent years, followed with the analysis on the motivation of the increasing trend of France's involvement in SCS, and finally analyze the situation in SCS from the perspective of "balance of power" theory. It will be argued that great powers are carefully maintaining the balance of military power in SCS, and it is highly possible that this trend would still last in the middle and long term, particularly via military deployment and strategic alliances.

Keywords: South China Sea, France, China, balance of power theory, Indo-Pacific

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3095 Energy Retrofitting Application Research to Achieve Energy Efficiency in Hot-Arid Climates in Residential Buildings: A Case Study of Saudi Arabia

Authors: A. Felimban, A. Prieto, U. Knaack, T. Klein

Abstract:

This study aims to present an overview of recent research in building energy-retrofitting strategy applications and analyzing them within the context of hot arid climate regions which is in this case study represented by the Kingdom of Saudi Arabia. The main goal of this research is to do an analytical study of recent research approaches to show where the primary gap in knowledge exists and outline which possible strategies are available that can be applied in future research. Also, the paper focuses on energy retrofitting strategies at a building envelop level. The study is limited to specific measures within the hot arid climate region. Scientific articles were carefully chosen as they met the expression criteria, such as retrofitting, energy-retrofitting, hot-arid, energy efficiency, residential buildings, which helped narrow the research scope. Then the papers were explored through descriptive analysis and justified results within the Saudi context in order to draw an overview of future opportunities from the field of study for the last two decades. The conclusions of the analysis of the recent research confirmed that the field of study had a research shortage on investigating actual applications and testing of newly introduced energy efficiency applications, lack of energy cost feasibility studies and there was also a lack of public awareness. In terms of research methods, it was found that simulation software was a major instrument used in energy retrofitting application research. The main knowledge gaps that were identified included the need for certain research regarding actual application testing; energy retrofitting strategies application feasibility; the lack of research on the importance of how strategies apply first followed by the user acceptance of developed scenarios.

Keywords: energy efficiency, energy retrofitting, hot arid, Saudi Arabia

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3094 Attempts for the Synthesis of Indol-Ring Fluorinated Tryptophan Derivatives to Enhance the Activity of Antimicrobial Peptides

Authors: Anita K. Kovacs, Peter Hegyes, Zsolt Bozso, Gabor Toth

Abstract:

Fluorination has been used extensively by the pharmaceutical industry as a strategy to improve the pharmacokinetics of drugs due to its effectiveness in increasing the potency of antimicrobial peptides (AMPs). Multiple-fluorinated indole-ring-containing tryptophan derivatives have the potential of having better antimicrobial activity than the widely used mono-fluorinated indole-ring containing tryptophan derivatives, but they are not available commercially. Therefore, our goal is to synthesize multiple-fluorinated indole-ring containing tryptophan derivatives to incorporate them into AMPs to enhance their antimicrobial activity. During our work, we are trying several methods (classical organic synthesis, enzymic synthesis, and solid phase peptide synthesis) for the synthesis of the said compounds, with mixed results. With classical organic synthesis (four different routes), we did not get the desired results. The reaction of serin with substituted indole in the presence of acetic anhydride led to racemic tryptophane; with the reaction of protected serin with indole in the presence of nickel complex was unsuccessful; the reaction of serin containing protected dipeptide with disuccinimidyl carbonate we achieved a tryptophane containing dipeptide, its chiral purity is being examined; the reaction of alcohol with substituted indole in the presence of copper complex was successful, but it was only a test reaction, we could not reproduce the same result with serine. The undergoing tryptophan-synthase method has shown some potential, but our work has not been finished yet. The successful synthesis of the desired multiple-fluorinated indole-ring-containing tryptophan will be followed by solid phase peptide synthesis in order to incorporate it into AMPs to enhance their antimicrobial activity. The successful completion of these phases will mean the possibility of manufacturing new, effective AMPs.

Keywords: halogenation, fluorination, tryptophan, enhancement of antimicrobial activity

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3093 Romantic Theory in Comparative Perspective: Schlegel’s Philosophy of History and the Spanish Question

Authors: Geena Kim

Abstract:

The Romantic movements in Spain and Germany served as turning points in European literary history, advancing cognitive-emotional ideals of the essential unity between literature, life, and the natural world in reaction against the rising tide of mechanization, urban growth, and industrial progress. This paper offers a comparative study of the literary-theoretic underpinnings of the Romantic movements in Spain and Germany, particularly with regard to the reception history of Schlegel’s Romantic philosophy of history. By far one of the better-known figures of the period, Schlegel has traditionally been considered one of the principal theorists of German Romanticism, one of the first to embrace and acknowledge the more radical changes that the movement brought forth. His well-studied contributions to the German Romanticism were certainly significant domestically, but their impact on comparatively less industrialized Spain have been largely neglected, a puzzling oversight in light of Schlegel’s extensive efforts in advocating for the dissemination of Spanish literature under the guise of a kind of pan-European Romanticism. Indeed, Schlegel’s somewhat problematically exoticizing view of Spain as the quintessential embodiment of the spirit of Romanticism was itself enormously influential on the genesis and growth of the Spanish Romantic theory. This was especially significant considering earlier, pre-Romantic tropes of the ‘black legend,’ by which means Spain was demonized with even cruder essentializing, nationalistic language. By comparing Schlegel’s theorizing around Spain with contributions to Romantic theory by Hispanophone writers, this paper sheds light on questions of linguistic identity and national influence from two alas infrequently compared contexts of European Romanticism.

Keywords: schlegel, Spanish romantic theory, German romanticism, romantic philosophy

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3092 Process for Analyzing Information Security Risks Associated with the Incorporation of Online Dispute Resolution Systems in the Context of Conciliation in Colombia

Authors: Jefferson Camacho Mejia, Jenny Paola Forero Pachon, Luis Carlos Gomez Florez

Abstract:

The innumerable possibilities offered by the use of Information Technology (IT) in the development of different socio-economic activities has made a change in the social paradigm and the emergence of the so-called information and knowledge society. The Colombian government, aware of this reality, has been promoting the use of IT as part of the E-government strategy adopted in the country. However, it is well known that the use of IT implies the existence of certain threats that put the security of information in the digital environment at risk. One of the priorities of the Colombian government is to improve access to alternative justice through IT, in particular, access to Alternative Dispute Resolution (ADR): conciliation, arbitration and friendly composition; by means of which it is sought that the citizens directly resolve their differences. To this end, a trend has been identified in the use of Online Dispute Resolution (ODR) systems, which extend the benefits of ADR to the digital environment through the use of IT. This article presents a process for the analysis of information security risks associated with the incorporation of ODR systems in the context of conciliation in Colombia, based on four fundamental stages identified in the literature: (I) Identification of assets, (II) Identification of threats and vulnerabilities (III) Estimation of the impact and 4) Estimation of risk levels. The methodological design adopted for this research was the grounded theory, since it involves interactions that are applied to a specific context and from the perspective of diverse participants. As a result of this investigation, the activities to be followed are defined to carry out an analysis of information security risks, in the context of the conciliation in Colombia supported by ODR systems, thus contributing to the estimation of the risks to make possible its subsequent treatment.

Keywords: alternative dispute resolution, conciliation, information security, online dispute resolution systems, process, risk analysis

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3091 From Sampling to Sustainable Phosphate Recovery from Mine Waste Rock Piles

Authors: Hicham Amar, Mustapha El Ghorfi, Yassine Taha, Abdellatif Elghali, Rachid Hakkou, Mostafa Benzaazoua

Abstract:

Phosphate mine waste rock (PMWR) generated during ore extraction is continuously increasing, resulting in a significant environmental footprint. The main objectives of this study consist of i) elaboration of the sampling strategy of PMWR piles, ii) a mineralogical and chemical characterization of PMWR piles, and iii) 3D block model creation to evaluate the potential valorization of the existing PMWR. Destructive drilling using reverse circulation from 13 drills was used to collect samples for chemical (X-ray fluorescence analysis) and mineralogical assays. The 3D block model was created based on the data set, including chemical data of the realized drills using Datamine RM software. The optical microscopy observations showed that the sandy phosphate from drills in the PMWR piles is characterized by the abundance of carbonate fluorapatite with the presence of calcite, dolomite, and quartz. The mean grade of composite samples was around 19.5±2.7% for P₂O₅. The mean grade of P₂O₅ exhibited an increasing tendency by depth profile from bottom to top of PMWR piles. 3D block model generated with chemical data confirmed the tendency of the mean grades’ variation and may allow a potential selective extraction according to %P₂O₅. The 3D block model of P₂O₅ grade is an efficient sampling approach that confirmed the variation of P₂O₅ grade. This integrated approach for PMWR management will be a helpful tool for decision-making to recover the residual phosphate, adopting the circular economy and sustainability in the phosphate mining industry.

Keywords: 3D modelling, reverse circulation drilling, circular economy, phosphate mine waste rock, sampling

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3090 Subjective Well-Being in Individuals Diagnosed with an Autoimmune Disease: Resilience, and Rumination as Moderating Factors

Authors: Renae McNair

Abstract:

Subjective well-being levels were assessed in individuals diagnosed with an autoimmune disease. The current exploratory analysis sought to examine two factors that impact subjective well-being in individuals diagnosed with a chronic health condition. The two factors, resilience, and rumination, were assessed as possible moderators in self-reported levels of subjective well-being were measured. The importance of understanding the psychological state of perceived well-being in an individual diagnosed with an autoimmune disease is important given the impact of the level of subjective well-being on life longevity. In previous research, higher levels of subjective well-being are correlated with longer life longevity, including those individuals who have been diagnosed with an autoimmune disease. Conversely, individuals who report higher levels of negative affect have a shorter length of life longevity. According to the Center for Disease Control (CDC) and a report from the National Health Council, currently, 8-10% of individuals in the United States have been diagnosed with at least one autoimmune disease. Although treatment plans are in place to help manage the physical effects of disease, the psychological state of the person impacts life longevity. Resilience and rumination impact subjective well-being as an outcome in individuals diagnosed with an autoimmune disease. Resilience is the ability to adjust or adapt effectively and positively to unfavorable life conditions or events. Resilience acts as a protective factor in life, allowing those who face adversity to successfully adapt, regardless of the health diagnosis. Rumination is the worry or dwelling on the negative aspects of a given situation. Rumination interrupts the adaptive response, leading to a decrease in well-being. The relationship between resilience and subjective well-being were examined correlated with higher levels of resilience and higher levels of self-reported subjective well-being.

Keywords: subjective well-being, rumination, resilience, autoimmune disease

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3089 Heritage Management Planning, Stakeholders and Legal Problematic: The Case of the Archeological Site of Jarash in Jordan

Authors: Abdelkader Ababneh

Abstract:

Heritage management planning is increasingly important throughout the international context, particularly in the developing countries. Jordan has important and unique heritage resources due to its natural topography and climate, but also to its history and old sites. A high number of these archaeological sites are in very good state of preservation. Most natural sites and resources are privately managed while archaeological heritage sites are publicly managed within national legal texts and with some referencing to international legal documents. This study examines the development of cultural heritage management in Jarash, and questions if this heritage has been managed in an appropriate manner. The purpose of this paper is to define and review the stakeholders in charge of the management of the archaeological site of Jarash, the legal texts, laws and documents adopted to apply the site management. Relations and coordination between stakeholders and the challenge of the planning process is also the focus of this paper. A review of pertinent academic, technical studies, reports and projects literature pertaining to the heritage management planning in general and related to the site of Jarash in particular coupled with field study of the site served as the background of the information base for the study. Current context of actors, legislative framework, planning policies and initiatives for the site of Jarash reveal important and continuous challenge for managing the site. Recommendations suggest reviewing and restructuring the entity responsible of the sites management. It is also recommended to review their applied policies and a redevelopment of the legislative frame work.

Keywords: heritage management, stakeholders, legal protection, Jarash

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3088 The Management of Care by People with Type 2 Diabetes versus the Professional Care at Primary Health Care in Brazil

Authors: Nunila Ferreira de Oliveira, Silvana Martins Mishima

Abstract:

Diabetes mellitus type 2 (DM2) prevalence, is increasing on the world, in Brazil is considered a public health problem. Treatment focuses on glycemic control depending primarily of lifestyle changes - not drug treatment (NDT), may involve drug therapy (DT) and requires continuous health monitoring. In Brazil this monitoring is performed by the Unified Health System (SUS) through Primary Health Care (PHC), which stimulate people with DM2 empowerment for care management. SUS was approved in 1988 and the PHC operationalization was strengthened with the creation of the Family Health Strategy (FHS) in 1994. Our aim was to analyze the people with DM2 participation in front of the care management health monitoring in the FHS. Qualitative research was carried out through non-participant observation of attendance of 25 people with DM2 in the FHS and interviewed at home. Ethical guidelines were followed. It was found that people with DM2 only follow professionals’ recommendations that make sense according to their own conceptions of health/disease; most of them emphasize the importance of (DT) with little emphasis on the NDT, was found great difficulty in the NDT and lack of knowledge about the disease and care. As regards monitoring the FHS, were observed therapeutic practices based on the bio medical model, although the APS search for another care perspective; NDT is not systematically accompanied by the health team and takes place a few educational activities on the DM2 in the FHS, with low user adoption. The work of the FHS is done by multidisciplinary teams, but we see the need for greater participation of nurses in clinical-care follow-up of this population and may also act in adapting to the NDT. Finally we emphasize the need for professional practices that consider the difficulties to care management by people with DM2, especially because of the NDT. It is noticed that the measures recommended by the FHS professionals are not always developed by people with DM2. We must seek the empowerment of people with DM2 to manage the form of care associated with the FHS team, seeking to reduce the incidence of complications and higher quality of life.

Keywords: diabetes mellitus, primary health care, nursing, management of care

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3087 Molecular Genetic Purity Test Using SSR Markers in Pigeon Pea

Authors: Rakesh C. Mathad, G. Y. Lokesh, Basavegowda

Abstract:

In agriculture using quality seeds of improved varieties is very important to ensure higher productivity thereby food security and sustainability. To ensure good productivity, seeds should have characters as described by the breeder. To know whether the characters as described by the breeder are expressing in a variety such as genuineness or genetic purity, field grow out test (GOT) is done. In pigeon pea which is long durational crop, conducting a GOT may take very long time and expensive also. Since in pigeon pea flower character is a most distinguishing character from the contaminants, conducting a field grow out test require 120-130 days or till flower emergence, which may increase cost of storage and seed production. This will also delay the distribution of seed inventory to the pigeon pea growing areas. In this view during 2014-15 with financial support of Govt. of Karnataka, India, a project to develop a molecular genetic test for newly developed variety of pigeon pea cv.TS3R was commissioned at Seed Unit, UAS, Raichur. A molecular test was developed with the help SSR markers to identify pure variety from possible off types in newly released pigeon pea variety TS3R. In the investigation, 44 primer pairs were screened to identify the specific marker associated with this variety. Pigeon pea cv. TS3R could be clearly identified by using the primer CCM 293 based on the banding pattern resolved on gel electrophoresis and PCR reactions. However some of the markers like AHSSR 46, CCM 82 and CCM 57 can be used to test other popular varieties in the region like Asha, GRG-811 and Maruti respectively. Further to develop this in to a lab test, the seed sample size was standardized to 200 seeds and a grow out matrix was developed. This matrix was used to sample 12 days old leaves to extract DNA. The lab test results were validated with actual field GOT test results and found variations within the acceptable limit of 1%. This molecular method can now be employed to test the genetic purity in pigeon pea cv TS3R which reduces the time and can be a cheaper alternative method for field GOT.

Keywords: genuineness, grow-out matrix, molecular genetic purity, SSR markers

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3086 Green Crypto Mining: A Quantitative Analysis of the Profitability of Bitcoin Mining Using Excess Wind Energy

Authors: John Dorrell, Matthew Ambrosia, Abilash

Abstract:

This paper employs econometric analysis to quantify the potential profit wind farms can receive by allocating excess wind energy to power bitcoin mining machines. Cryptocurrency mining consumes a substantial amount of electricity worldwide, and wind energy produces a significant amount of energy that is lost because of the intermittent nature of the resource. Supply does not always match consumer demand. By combining the weaknesses of these two technologies, we can improve efficiency and a sustainable path to mine cryptocurrencies. This paper uses historical wind energy from the ERCOT network in Texas and cryptocurrency data from 2000-2021, to create 4-year return on investment projections. Our research model incorporates the price of bitcoin, the price of the miner, the hash rate of the miner relative to the network hash rate, the block reward, the bitcoin transaction fees awarded to the miners, the mining pool fees, the cost of the electricity and the percentage of time the miner will be running to demonstrate that wind farms generate enough excess energy to mine bitcoin profitably. Excess wind energy can be used as a financial battery, which can utilize wasted electricity by changing it into economic energy. The findings of our research determine that wind energy producers can earn profit while not taking away much if any, electricity from the grid. According to our results, Bitcoin mining could give as much as 1347% and 805% return on investment with the starting dates of November 1, 2021, and November 1, 2022, respectively, using wind farm curtailment. This paper is helpful to policymakers and investors in determining efficient and sustainable ways to power our economic future. This paper proposes a practical solution for the problem of crypto mining energy consumption and creates a more sustainable energy future for Bitcoin.

Keywords: bitcoin, mining, economics, energy

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3085 Management Challenges and Product Quality of Fish Farms in Greece

Authors: S. Anastasiou, C. Nathanailides, S. Logothetis, G. Kanlis

Abstract:

The Greek aquaculture industry is second most important economic sector for the growth of the Greek Economy. The purpose of the present work is to present some data for the management challenges that the Aquaculture industry in Greece is currently facing. Currently the Greek aquaculture industry is going through a series of mergers and restructure. The financial status of the different aquaculture companies, the working conditions and management practices may vary according to lending exposure, market mix, company size, and technological parameters of the different fish farm units and rearing systems. Frequently, the aquaculture personnel are exposed to harsh environmental conditions and to occupational risk. Furthermore, there is pressure on the personnel of fish farms to constantly improve their production efficiency and to enhance their work skills to the new methods and practices which are adopted by the aquaculture industry. There is some data to suggest the existence of gender inequality in the workforce of Greek fish farms. Women are paid less, frequently absent higher managerial positions and most of the male workmates consider the job to harsh for women. Nevertheless, high level of job satisfaction was observed in both men and women. This high level of job satisfaction of the aquaculture personnel can be attributed, at least partially, to the nature of the work which has a very distinct working environment but most of the staff has very positive experiences with the interaction with their workmates and the satisfaction of being in a business which always exceeds its production target. Indeed, there is some evidence to suggest that the Greek aquaculture industry is always exceeding its production targets, while it is rapidly adopting and improving new technology, constantly improving of human resources management practices, which include constant training of the staff, very good communication channels between management and the personnel and reducing the risk of occupational hazard to the aquaculture personnel. All these parameters of management may have a determining role for the volume and quality of the production and future of this sector in Greece.

Keywords: aquaculture, fish quality, management, production targets

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3084 Productive Safety Net Program and Rural Livelihood in Ethiopia

Authors: Desta Brhanu Gebrehiwot

Abstract:

The purpose of this review was to analyze the overall or combined effect of scholarly studies conducted on the impacts of Food for work (FFW) and Productive Safety Net Program (PSNP) on farm households’ livelihood (agricultural investment on the adoption of fertilizer, food security, livestock holding, nutrition and its’ disincentive effect) in Ethiopia. In addition, to make a critical assessment of the internal and external validity of the existing studies, the review also indicates the possibility to redesign the program. The method of selecting eligible studies for review was PICOS (Participants, Intervention, Comparison, Outcomes, and Settings) framework. The method of analysis was the fixed effects model under Meta-Analysis. The findings of this systematic review confirm the overall or combined positive significant impact of PSNP on fertilizer adoption (combined point estimate=0.015, standard error=0.005, variance=0.000, lower limit 0.004 up to the upper limit=0.026, z-value=2.726, and p-value=0.006). And the program had a significant positive impact on the child nutrition of rural households and had no significant disincentive effect. However, the program had no significant impact on livestock holdings. Thus, PSNP is important for households whose livelihood depends on rain-fed agriculture and are exposed to rainfall shocks. Thus, better to integrate the program into the national agricultural policy. In addition, most of the studies suggested that PSNP needs more attention to the design and targeting issued in order to be effective and efficient in social protection.

Keywords: meta-analysis, fixed effect model, PSNP, rural-livelihood, Ethiopia

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3083 A Proposal of Advanced Key Performance Indicators for Assessing Six Performances of Construction Projects

Authors: Wi Sung Yoo, Seung Woo Lee, Youn Kyoung Hur, Sung Hwan Kim

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Large-scale construction projects are continuously increasing, and the need for tools to monitor and evaluate the project success is emphasized. At the construction industry level, there are limitations in deriving performance evaluation factors that reflect the diversity of construction sites and systems that can objectively evaluate and manage performance. Additionally, there are difficulties in integrating structured and unstructured data generated at construction sites and deriving improvements. In this study, we propose the Key Performance Indicators (KPIs) to enable performance evaluation that reflects the increased diversity of construction sites and the unstructured data generated, and present a model for measuring performance by the derived indicators. The comprehensive performance of a unit construction site is assessed based on 6 areas (Time, Cost, Quality, Safety, Environment, Productivity) and 26 indicators. We collect performance indicator information from 30 construction sites that meet legal standards and have been successfully performed. And We apply data augmentation and optimization techniques into establishing measurement standards for each indicator. In other words, the KPI for construction site performance evaluation presented in this study provides standards for evaluating performance in six areas using institutional requirement data and document data. This can be expanded to establish a performance evaluation system considering the scale and type of construction project. Also, they are expected to be used as a comprehensive indicator of the construction industry and used as basic data for tracking competitiveness at the national level and establishing policies.

Keywords: key performance indicator, performance measurement, structured and unstructured data, data augmentation

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3082 Biophysical Characterization of the Inhibition of cGAS-DNA Sensing by KicGAS, Kaposi's Sarcoma-Associated Herpesvirus Inhibitor of cGAS

Authors: D. Bhowmik, Y. Tian, Q. Yin, F. Zhu

Abstract:

Cyclic GMP-AMP synthase (cGAS), recognises cytoplasmic double-stranded DNA (dsDNA), indicative of bacterial and viral infections, as well as the leakage of self DNA by cellular dysfunction and stresses, to elicit the host's immune responses. Viruses also have developed numerous strategies to antagonize the cGAS-STING pathway. Kaposi's sarcoma-associated herpesvirus (KSHV) is a human DNA tumor virus that is the causative agent of Kaposi’s sarcoma and several other malignancies. To persist in the host, consequently causing diseases, KSHV must overcome the host innate immune responses, including the cGAS-STING DNA sensing pathway. We already found that ORF52 or KicGAS (KSHV inhibitor of cGAS), an abundant and basic gamma herpesvirus-conserved tegument protein, directly inhibits cGAS enzymatic activity. To better understand the mechanism, we have performed the biochemical and structural characterization of full-length KicGAS and various mutants in regarding binding to DNA. We observed that KicGAS is capable of self-association and identified the critical residues involved in the oligomerization process. We also characterized the DNA-binding of KicGAS and found that KicGAS cooperatively oligomerizes along the length of the double stranded DNA, the highly conserved basic residues at the c-terminal disordered region are crucial for DNA recognition. Deficiency in oligomerization also affects DNA binding. Thus DNA binding by KicGAS sequesters DNA and prevents it from being detected by cGAS, consequently inhibiting cGAS activation. KicGAS homologues also inhibit cGAS efficiently, suggesting inhibition of cGAS is evolutionarily conserved mechanism among gamma herpesvirus. These results highlight the important viral strategy to evade this innate immune sensor.

Keywords: Kaposi's sarcoma-associated herpesvirus, KSHV, cGAS, DNA binding, inhibition

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3081 Old and New Paradigms for Pre-Earthquake Prevention and Post-Earthquake Regeneration of Territories in Crisis in Italy

Authors: Maria Angela Bedini, Fabio Bronzini

Abstract:

Most of the Italian territory is at seismic risk. Many earthquakes have hit Italy, and devastating effects have been generated. The specific objective of the research is to distinguish the negative approaches that have generated unacceptable social situations of marginalization, abandonment, and economic regression, from positive methodological approaches. On the basis of the different situations examined, the study proposes strategies and guidelines to obtain the best possible results, in Italy or abroad, in the event of new earthquakes. At national and international level, many theoretical studies address the aspects of prevention, while the comparisons, carried out in this study, between the techniques and the operative procedures applied and the results obtained are rare. The adopted methodology compares the different pre-earthquake urban-planning approaches, for the emergency (temporary urban planning), and for the post-earthquake (socio-economic-territorial processes) in Italy. Attention is placed on the current consolidated planning and programming acquisitions, pre and post-earthquake. The main results of the study concern the prospects in Italy of protection from seismic risks in the next decades. An integrated settlement system for a new economic and social model, aimed at the rebirth of territories in crisis, is proposed. Finally, the conclusions describe the disciplinary positions, procedures and the fundamental points generally shared by the scientific community for each approach, in order to identify the strategic choices and the disciplinary and management paths that will be followed in the coming decades.

Keywords: post-earthquake, seismic emergency, seismic prevention, urban planning interventions in Italy

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3080 Analysis of the Barriers and Aids That Lecturers Offer to Students with Disabilities

Authors: Anabel Moriña

Abstract:

In recent years, advances have been made in disability policy at Spanish universities, especially in terms of creating more inclusive learning environments. Nevertheless, while efforts to foster inclusion at the tertiary level -and the growing number of students with disabilities at university- are clear signs of progress, serious barriers to full participation in learning still exist. The research shows that university responses to diversity tend to be reactive, not proactive; as a result, higher education (HE) environments can be especially disabling. It has been demonstrated that the performance of students with disabilities is closely linked to the good will of university faculty and staff. Lectures are key players when it comes to helping or hindering students throughout the teaching/learning process. This paper presents an analysis of how lecturers respond to students with disabilities, the initial question being: do lecturers aid or hinder students? The general aim is to analyse-by listen to the students themselves-lecturers barriers and support identified as affecting academic performance and overall perception of the higher education (HE) experience. Biographical-narrative methodology was employed. This research analysed the results differentiating by fields of knowledge. The research was conducted in two phases: discussion groups along with individual oral/written interviews were set up with 44 students with disabilities and mini life histories were completed for 16 students who participated in the first stage. The study group consisted of students with disabilities enrolled during three academic years. The results of this paper noted that participating students identified many more barriers than bridges when speaking about the role lecturers play in their learning experience. Findings are grouped into several categories: Faculty attitudes when “dealing with” students with disabilities, teaching methodologies, curricular adaptations, and faculty training in working with students. Faculty does not always display appropriate attitudes towards students with disabilities. Study participants speak of them turning their backs on their problems-or behaving in an awkward manner. In many cases, it seems lecturers feel that curricular adaptations of any kind are a form of favouritism. Positive attitudes, however, often depend almost entirely on the good will of faculty and-although well received by students-are hard to come by. As the participants themselves suggest, this study confirms that good teaching practices not only benefit students with disabilities but the student body as a whole. In this sense, inclusive curricula provide new opportunities for all students. A general coincidence has been the lack of training on behalf of lecturers to adequately attend disabled students, and the need to cover this shortage. This can become a primary barrier and is more often due to deficient faculty training than to inappropriate attitudes on the part of lecturers. In conclusion, based on this research we can conclude that more barriers than bridges exist. That said, students do report receiving a good deal of support from their lecturers-although almost exclusively in a spirit of good will; when lecturers do help, however, it tends to have a very positive impact on students' academic performance.

Keywords: barriers, disability, higher education, lecturers

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3079 Foreign Direct Investment and its Role in Globalisation

Authors: Gupta Indu

Abstract:

This paper aims to examine the relationship between foreign direct investment and globalization. Foreign direct investment plays an important role in globalization. It is dramatically increasing in the age of globalization. It has played an important role for economic growth in this global process. It can provide new markets and marketing channels, cheaper production facilities, access to new technology, products to a firm. FDI has come to play a major role in the internationalization of business. FDI has become even more important than trade. Growing liberalization of the national regulatory framework governing investment in enterprises and changes in capital markets profound changes have occurred in the size, scope and methods of FDI. New information technology systems, decline in global communication costs have made management of foreign investments far easier than in the past. FDI provide opportunities to host countries to enhance their economic development and opens new opportunities to home countries to optimize their earnings by employing their ideal resources. Smaller and weaker economies can drive out much local competition. For small and medium sized companies, FDI represents an opportunity to become more actively involved in international business activities. In the past decade, foreign direct investment has expanded its role by change in trade policy, investment policy, tariff liberalization, easing of restrictions on foreign investment and acquisition in many nations, and the deregulation and privatization of many industries. In present competitive scenario, FDI has become a prominent external source of finance for developing countries.

Keywords: foreign direct investment, globalization, economic development, information technology systems new opportunities

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3078 Investigating the Behaviour of Composite Floors (Steel Beams and Concrete Slabs) under Mans Rhythmical Movement

Authors: M. Ali Lotfollahi Yaghin, M. Reza Bagerzadeh Karimi, Ali Rahmani, V. Sadeghi Balkanlou

Abstract:

Structural engineers have long been trying to develop solutions using the full potential of its composing materials. Therefore, there is no doubt that the structural solution progress is directly related to an increase in materials science knowledge. These efforts in conjunction with up-to-date modern construction techniques have led to an extensive use of composite floors in large span structures. On the other hand, the competitive trends of the world market have long been forcing structural engineers to develop minimum weight and labour cost solutions. A direct consequence of this new design trend is a considerable increase in problems related to unwanted floor vibrations. For this reason, the structural floors systems become vulnerable to excessive vibrations produced by impacts such as human rhythmic activities. The main objective of this paper is to present an analysis methodology for the evaluation of the composite floors human comfort. This procedure takes into account a more realistic loading model developed to incorporate the dynamic effects induced by human walking. The investigated structural models were based on various composite floors, with main spans varying from 5 to 10 m. based on an extensive parametric study the composite floors dynamic response, in terms of peak accelerations, was obtained and compared to the limiting values proposed by several authors and design standards. This strategy was adopted to provide a more realistic evaluation for this type of structure when subjected to vibration due to human walking.

Keywords: vibration, resonance, composite floors, people’s rhythmic movement, dynamic analysis, Abaqus software

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3077 Reallocation of Bed Capacity in a Hospital Combining Discrete Event Simulation and Integer Linear Programming

Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

Abstract:

The number of inpatient admissions in the UK has been significantly increasing over the past decade. These increases cause bed occupancy rates to exceed the target level (85%) set by the Department of Health in England. Therefore, hospital service managers are struggling to better manage key resource such as beds. On the other hand, this severe demand pressure might lead to confusion in wards. For example, patients can be admitted to the ward of another inpatient specialty due to lack of resources (i.e., bed). This study aims to develop a simulation-optimization model to reallocate the available number of beds in a mid-sized hospital in the UK. A hospital simulation model was developed to capture the stochastic behaviours of the hospital by taking into account the accident and emergency department, all outpatient and inpatient services, and the interactions between each other. A couple of outputs of the simulation model (e.g., average length of stay and revenue) were generated as inputs to be used in the optimization model. An integer linear programming was developed under a number of constraints (financial, demand, target level of bed occupancy rate and staffing level) with the aims of maximizing number of admitted patients. In addition, a sensitivity analysis was carried out by taking into account unexpected increases on inpatient demand over the next 12 months. As a result, the major findings of the approach proposed in this study optimally reallocate the available number of beds for each inpatient speciality and reveal that 74 beds are idle. In addition, the findings of the study indicate that the hospital wards will be able to cope with 14% demand increase at most in the projected year. In conclusion, this paper sheds a new light on how best to reallocate beds in order to cope with current and future demand for healthcare services.

Keywords: bed occupancy rate, bed reallocation, discrete event simulation, inpatient admissions, integer linear programming, projected usage

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3076 A Caged Bird Set Free: The Women Saviors in Fae Myenne Ng's Steer Toward Rock

Authors: Hei Yuen Pak

Abstract:

Steer Toward Rock, Fae Myenne Ng’s second novel after the National Bestseller Bone, is superficially concluded as a story of pessimism, which underestimates the sophistication of Ng’s portrayal. It is often summarized as a “heartbreaking novel of unrequited love” or “a story of timeless and tragic”; yet, Ng’s novel conveys more than a mere sense of tragedy and heartbreak, but rather an overflowing warmth and optimism. Ng is complimented of “illuminating a part of U.S. history few are aware of”—the false identity established on the paper relationships. Nevertheless, toward the end of the novel, this falsity enlightens the male protagonist, Jack Moon Szeto, of the ultimate realization of the “truthfulness” to himself, with the escort of the female characters. This paper intends to investigate how Ng’s depiction subverts the traditional sex/gender system and also the patriarchal savior stereotype. This paper mainly examines the characterization of and the relations among the four major characters: Jack Moon Szeto, Joice Qwan, Veda Qwan, and Ilin Cheung. By deploying Kate Millett’s, Marilyn French’s, Mary Daly’s feminist theories, the first half of the essay elucidates the power relations between Jack and the three females Joice, Veda, and Ilin in terms of gender and sexuality. After analyzing the relations, Jack, this male caged bird, is set free by the epiphany derived from the three female characters, which is the pivot of the second half. In reference to Jean-Paul Sartre and Simone de Beauvoir’s existentialist perspectives, I argue how Jack is transformed from, in Satre’s term, being-for-others to being-for-itself. Hence, the caged bird is free by the women saviors.

Keywords: Fae Myenne Ng, gender and sexuality, feminism, power relations

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3075 Prevalence of Diabetes Mellitus Among Human Immune Deficiency Virus-Positive Patients Under Anti-retroviral Attending in Rwanda, a Case Study of University Teaching Hospital of Butare

Authors: Venuste Kayinamura, V. Iyamuremye, A. Ngirabakunzi

Abstract:

Anti-retroviral therapy (ART) for HIV patient can cause a deficiency in glucose metabolism by promoting insulin resistance, glucose intolerance, and diabetes, diabetes mellitus keep increasing among HIV-infected patients worldwide but there is limited data on levels of blood glucose and its relationship with antiretroviral drugs (ARVs) and HIV-infection worldwide, particularly in Rwanda. A convenient sampling strategy was used in this study and it involved 323 HIV patients (n=323). Patients who are HIV positive under ARVs were involved in this study. The patient’s blood glucose was analyzed using an automated machine or glucometer (COBAS C 311). Data were analyzed using Microsoft Excel and SPSS V. 20.0 and presented in percentages. The highest diabetes mellitus prevalence was 93.33 % in people aged >40 years while the lowest diabetes mellitus prevalence was 6.67% in people aged between 21-and 40 years. The P-value was (0.021). Thus, there is a significant association between age and diabetes occurrence. The highest diabetes mellitus prevalence was 28.2% in patients under ART treatment for more than 10 years, 16.7% were <5years while 20% of patients were on ART treatment between 5-10 years. The P-value here is (0.03), thus the incidence of diabetes is associated with long-term ART use in HIV-infected patients. This study assessed the prevalence of diabetes among HIV-infected patients under ARVs attending the University Teaching Hospital of Butare (CHUB), it shows that the prevalence of diabetes is high in HIV-infected patients under ARTs. This study found no significant relationship between gender and diabetes mellitus growth. Therefore, regular assessment of diabetes mellitus especially among HIV-infected patients under ARVs is highly recommended to control other health issues caused by diabetes mellitus.

Keywords: anti-retroviral, diabetes mellitus, antiretroviral therapy, human immune deficiency virus

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3074 Next-Generation Disability Management: Diverse and Inclusive Strategies for All

Authors: Nidhi Malshe

Abstract:

Background: Currently, there are approximately 1.3 billion individuals worldwide living with significant disabilities, which accounts for 16% of the global population—about 1 in 6 people. As the global population continues to grow, so does the number of people experiencing disabilities. Traffic accidents alone contribute to millions of injuries and disabilities each year, particularly among young people. Additionally, as life expectancy rises, more individuals are likely to experience disabilities in their later years. 27.0% of Canadians aged 15 and over, or 8 million people, had at least one disability in 2022. This represents an increase of 4.7 percentage points from 2017. A person with a disability earns 21.4% less on average as compared to a person without a disability. Using innovative and inclusive methods for accommodations, disability management, and employment, we can progress towards inclusive workplaces and potential income parity for this equity-seeking population. Objective: This study embraces innovative and inclusive approaches to disability management, thereby unlocking the advantages associated with a) fostering equal opportunities for all individuals, b) facilitating streamlined accommodations and making it easier for companies to accommodate people with disabilities, c) harnessing diverse perspectives to drive innovation and enhance overall productivity. Methodology: Literature review, assessments of specific needs and requirements in the workplace. a) Encourage the ability to think out of the box for potential workplace accommodations based on the specific needs of individuals. e.g., propose prolonged integration post disability. b) Perform a cost-benefit analysis of early interventions of return to work vs. duration on disability. c) Expand the scope of vocational assessment/retraining – e.g., retraining a person with permanent physical impairment to become a video game coder. d) Leverage the use of technology while planning to return to work e.g., speech-to-text software for persons with voice impairments. Hypothesized Results: Prolonged progression of return to work increases the potential for sustainable and productive employment. Co-developing a person-centric accommodation plan based on reported functional abilities and applying pioneering methods for extending accommodations to prevent secondary disabilities. Facilitate a sense of belonging by providing employees with benefits and initiatives that honor their unique contributions. Engage individuals with disabilities as active members of the planning committee to ensure the development of innovative and inclusive accommodations that address the needs of all. Conclusion: The global pandemic underscored the need for creativity in our daily routine. It is imperative to integrate the lessons learned from the pandemic, enhance them within employment, and return to work processes. These learnings can also be used to develop creative, distinct methods to ensure equal opportunities for everyone.

Keywords: disbaility management, diversity, inclusion, innovation

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3073 Localization of Geospatial Events and Hoax Prediction in the UFO Database

Authors: Harish Krishnamurthy, Anna Lafontant, Ren Yi

Abstract:

Unidentified Flying Objects (UFOs) have been an interesting topic for most enthusiasts and hence people all over the United States report such findings online at the National UFO Report Center (NUFORC). Some of these reports are a hoax and among those that seem legitimate, our task is not to establish that these events confirm that they indeed are events related to flying objects from aliens in outer space. Rather, we intend to identify if the report was a hoax as was identified by the UFO database team with their existing curation criterion. However, the database provides a wealth of information that can be exploited to provide various analyses and insights such as social reporting, identifying real-time spatial events and much more. We perform analysis to localize these time-series geospatial events and correlate with known real-time events. This paper does not confirm any legitimacy of alien activity, but rather attempts to gather information from likely legitimate reports of UFOs by studying the online reports. These events happen in geospatial clusters and also are time-based. We look at cluster density and data visualization to search the space of various cluster realizations to decide best probable clusters that provide us information about the proximity of such activity. A random forest classifier is also presented that is used to identify true events and hoax events, using the best possible features available such as region, week, time-period and duration. Lastly, we show the performance of the scheme on various days and correlate with real-time events where one of the UFO reports strongly correlates to a missile test conducted in the United States.

Keywords: time-series clustering, feature extraction, hoax prediction, geospatial events

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3072 Association of Human Immunodeficiency Virus with Incident Autoimmune Hemolytic Anemia: A Population-Based Cohort Study in Taiwan

Authors: Yung-Feng Yen, I-an Jen, Yi-Ming Arthur Chen

Abstract:

The molecular mimicry between human immunodeficiency virus (HIV) protein and red blood cell (RBC) antigens could induce the production of anti-RBC autoantibodies. However, the association between HIV infection and subsequent development of autoimmune hemolytic anemia (AIHA) remains unclear. This nationwide population-based cohort study aimed to determine the association between incident AIHA and HIV in Taiwan. From 2000–2012, we identified adult people living with HIV/AIDS (PLWHA) from the Taiwan centers for disease control HIV Surveillance System. HIV-infected individuals were defined by positive HIV-1 western blot. Age- and sex-matched controls without HIV infection were selected from the Taiwan National Health Insurance Research Database for comparison. All patients were followed until Dec. 31, 2012, and observed for occurrence of AIHA. Of 171,468 subjects (19,052 PLWHA, 152,416 controls), 30 (0.02%) had incident AIHA during a mean follow-up of 5.45 years, including 23 (0.12%) PLWHA and 7 (0.01%) controls. After adjusting for potential confounders, HIV infection was found to be an independent risk factor of incident AIHA (adjusted hazard ratio [AHR], 20.9; 95% confidence interval [CI], 8.34-52.3). Moreover, PLWHA receiving HAART were more likely to develop AIHA than those not receiving HAART (AHR, 10.8; 95% CI, 2.90-40.1). Additionally, the risk of AIHA was significantly increased in those taking efavirenz (AHR, 3.15; 95% CI, 1.18-8.43) or atazanavir (AHR, 6.58; 95% CI, 1.88-22.9) component of the HAART. In conclusion, HIV infection is an independent risk factor for incident AIHA. Clinicians need to be aware of the higher risk of AIHA in PLWHA.

Keywords: autoimmune disease , hemolytic anemia, HIV, highly active antiretroviral treatment

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3071 Hydrodynamic and Morphological Simulation of Karnafuli River Using CCHE2D Model

Authors: Shah Md. Imran Kabir, Md. Mostafa Ali

Abstract:

Karnafuli is one of the most important rivers of Bangladesh which is playing a vital role in our national economy. The major sea port of Bangladesh is the Chittagong port located on the right bank of Karnafuli River Bangladesh. Karnafuli river port is considered as the lifeline of the economic activities of the country. Therefore, it is always necessary to keep the river active and live in terms of its navigability. Due to man-made intervention, the river flow becomes interrupted and thereby may cause the change in the river morphology. The specific objective of this study is the application of 2D model to assess different hydrodynamic and morphological characteristics of the river due to normal flow condition and sea level rise condition. The model has been set with the recent bathymetry data collected from CPA hydrography division. For model setup, the river reach is selected between Kalurghat and Khal no-18. Time series discharge and water level data are used as boundary condition at upstream and downstream. Calibration and validation have been carried out with the recent water level data at Khal no-10 and Sadarghat. The total reach length of the river has been divided into four parts to determine different hydrodynamic and morphological assessments like variation of velocity, sediment erosion and deposition and bed level changes also have been studied. This model has been used for the assessment of river response due sediment transport and sea level rise. Model result shows slight increase in velocity. It also changes the rate of erosion and deposition at some location of the selected reach. It is hoped that the result of the model simulation will be helpful to suggest the effect of possible future development work to be implemented on this river.

Keywords: CCHE 2D, hydrodynamic, morphology, sea level rise

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3070 Antibiotic Prescribing Pattern and Associated Risk Factors Promoting Antibiotic Resistance, a Cross Sectional Study in a Regional Hospital in Ghana

Authors: Nicholas Agyepong, Paul Gyan

Abstract:

Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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