Search results for: accident risk

Authors: M. Pieńko, A. Robak, E. Błazik-Borowa, J. Szer

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This paper presents the results of analysis of 100 full-scale scaffolding structures in terms of compliance with legal acts and safety of use. In 2016 and 2017, authors examined scaffolds in Poland located at buildings which were at construction or renovation stage. The basic elements affecting the safety of scaffolding use such as anchors, supports, platforms, guardrails and toe-boards have been taken into account. All of these elements were checked in each of considered scaffolding. Based on the analyzed scaffoldings, the most common errors concerning assembly process and use of scaffolding were collected. Legal acts on the scaffoldings are not always clear, and this causes many issues. In practice, people realize how dangerous the use of incomplete scaffolds is only when the accident occurs. Despite the fact that the scaffolding should ensure the safety of its users, most accidents on construction sites are caused by fall from a height.

Keywords: façade scaffolds, load capacity, practice, safety of people

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Authors: Singh Baljinder, Sharma Navneet

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Microalbuminuria is the earliest detectable marker of diabetic nephropathy. We planned to evaluate the prevalence of microalbuminuria in type 1 diabetics and correlate with various risk factor. We randomly selected 100 type 1 diabetic patients after inclusion and exclusion criteria from DCRC, S. P. Medical College, Bikaner. Clinical examinations for anthropometeric parameters, hypertension, retinopathy, glycaemic status, lipid profile were done and microalbuminuria was estimated by micral test. Microalbuminuria was seen in 38% patients. The mean urinary albumin concentration was 96.61 mg/l in microalbuminuria positive cases, 134 mg/L in hypertensive patients while 74.5 mg/L in normal patients. Mean diabetic duration was 6.43 years in microalbuminurics. Albumin excretion increased significantly with age at onset of 10-18 years and declined thereafter. Microalbuminuria cases exhibited mean cholesterol 181.63 mg%, TG 130.94 mg%, LDL 109.87 mg%, HDL 57.5 mg% and VLDL 30.64 mg%. Mean urinary albumin concentration in patients with retinopathy was 160.52 mg/L while 78.66 mg/L without retinopathy. In multiple stepwise logistic regression analysis, a strong positive association was seen between microalbuminuria and hypertension (OR=5.087, CI=2.1319-12.101), fasting blood sugar (OR=3. 491, CI=1.138-10.70), duration of diabetes (OR=3.41, CI=1.360-8.55) and HbA1c (OR=2.381, CI-=1.1-5.64). The present study indicates that microalbuminuria is a common complication of type 1 diabetes mellitus and can be prevented by careful management of risk factors.

Keywords: type 1 diabetes, microalbuminuria, diabetic nephropathy, retinopathy, hypertension

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Authors: Atheer Al-Nuaimi, Harry Evdorides

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Daily, many individuals die or get harmed on streets around the globe, which requires more particular solutions for transport safety issues. International road assessment program (iRAP) is one of the models that are considering many variables which influence road user’s safety. In iRAP, roads have been partitioned into five-star ratings from 1 star (the most reduced level) to 5 star (the most noteworthy level). These levels are calculated from risk factors which represent the effect of the geometric and traffic conditions on rod safety. The result of iRAP philosophy are the countermeasures that can be utilized to enhance safety levels and lessen fatalities numbers. These countermeasures can be utilized independently as a single treatment or in combination with other countermeasures for a section or an entire road. There is a general understanding that the efficiency of a countermeasure is liable to reduction when it is used in combination with various countermeasures. That is, crash diminishment estimations of single countermeasures cannot be summed easily. In the iRAP model, the fatalities estimations are calculated using a specific methodology. However, this methodology suffers overestimations. Therefore, this study has developed a calibration method to estimate fatalities numbers more accurately.

Keywords: crash risk factors, international road assessment program, low-income countries, road safety

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Authors: Karlygash Tulendieva

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Presently vaccination is the most effective method of prevention of flu and its complications. The purpose of this study was to analyze the impact of the increase of coverage of the population of South Kazakhstan region with flu vaccination and decrease of the ARVI morbidity. The analysis was performed on the data of flu vaccination of risk groups, including children under one year and pregnant women. Data on ARVI morbidity during 2010-2015 and data on vaccination were taken from the reports of the Epidemiological Surveillance Unit of Department of Consumers’ Rights Protection of South Kazakhstan region. Coverage with flu vaccination of the risk groups was annually increasing and in 2015 it reached 16% (450,000/2,800,682) from the total population. The ARVI morbidity rate in the entire population in 2010 was 2,010.4 per 100,000 of the population and decreased 3.2 times to 609.9 per 100,000 of the population in 2015. Annual growth was observed from 2010 to 2015 of specific weight of the vaccinated main risk groups: healthcare workers by 51% (from 17,331 in 2010 to 33,538 in 2015), children with chronic pulmonary and cardio-vascular diseases, immune deficiency, weak and sickly children above six months by 39% (from 63,122 in 2010 to 158,023 in 2015), adults with chronic co-morbidities by 27% (from 44,271 in 2010 to 162,595 in 2015), persons above 65 by 17% (from 10,276 in 2010 to 57,875 in 2015), and annual coverage of pregnant women on second or third trimester from 34,443 in 2010 to 37,969 in 2015. Starting from 2013 and until 2015 vaccination was performed in the region with coverage of at least 90% of children from 6 months to one year. The ARVI morbidity in this age group decreased 3.3 times from 8,687.8 per 100,000 of the population in 2010 to 2,585.8 per 100,000 of the population in 2015. Vaccination of pregnant women on 2-3 trimester was started in the region in 2012. Annual increase of vaccination coverage of pregnant women from 86.1% (34,443/40,000) in 2012 to 95% (37,969/40,000) in 2015 decreased the morbidity 1.5 times from 4,828.8 per 100,000 of population in 2012 to 3,022.7 per 100,000 of population in 2015. Following the increase of vaccination coverage of the population in South Kazakhstan region, the trend was observed of decrease of ARVI morbidity rates among the population and main risk groups, among pregnant women and children under one year.

Keywords: acute respiratory viral infections, flu, risk groups, vaccination

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Authors: Navah Z. Ratzon, Shlomit Cohen, Sigal Portnoy

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This work focuses on posture and risk factors for the musculoskeletal disorder in guitarists, which constitutes the largest group of musicians today. The source of the problems experienced by these musicians is linked to physical, psychosocial and personal risk factors. These muscular problems are referred to as Playing Related Musculoskeletal Disorder (PRMD). There is not enough research that specifically studies guitar players, and to the extent of our knowledge, there is almost no reference to the characteristics of their movement patterns while they play. This is in spite of the high prevalence of PRMD in this population. Kinematic research may provide a basis for the development of a prevention plan for this population and their unique characteristics of playing patterns. The aim of the study was to investigate the correlation between risk factors for PRMD among guitar players and self-reporting of pain in the skeletal muscles, and specifically to test whether there are differences in the kinematics of the upper body while playing in a sitting or standing posture. Twenty-five guitarists, aged 18-35, participated in the study. The methods included a motion analysis using a motion capture system, anthropometric measurements and questionnaires relating to risk factors. The questionnaires used were the Standardized Nordic Questionnaire for the Analysis of Musculoskeletal Symptoms and the Demand Control Support Questionnaire, as well as a questionnaire of personal details. All of the study participants complained of musculoskeletal pain in the past year; the most frequent complaints being in the left wrist. Statistically significant correlations were found between biodemographic indices and reports of pain in the past year and the previous week. No significant correlations were found between the physical posture while playing and reports of pain among professional guitarists. However, a difference was found in several kinematic parameters between seated and standing playing postures. In a majority of the joints, the joint angles while playing in a seated position were more extreme than those during standing. This finding may suggest a higher risk for musculoskeletal disorder while playing in a seated position. In conclusion, the results of the present research highlight the prevalence of musculoskeletal problems in guitar players and its correlation with various risk factors. The finding supports the need for intervention in the form of prevention through identifying the risk factors and addressing them. Relating to the person, to their occupation and environment, which are the basis of proper occupational therapy, can help meet this need.

Keywords: body posture, motion tracking, PRMD, guitarists

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Authors: Laxman Budhathoki, Lal Bahadur Shrestha, K. C. Laxman

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Hundreds of people are being lost their life by flood disaster in Nepal every year. Community-based disaster management committee has formed to formulate the disaster management plan including the component of EWS like EWS tower, rain gauge station, flood gauge station, culverts, boats, ropes, life jackets, a communication mechanism, emergency shelter, Spur, dykes, dam, evacuation route, emergency dry food management etc. Now EWS become a successful tool to decrease the human casualty from 13 to 0 every year in Rapti River of Chitwan District.

Keywords: disaster risk reduction, early warning system, flood, participatory approach

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Authors: Isaiah Phillip Smith

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It is reported that alcohol consumption accounts for 3 million annual deaths globally, thus, it is a significant public health challenge internationally. The excessive consumption of alcohol is argued in literature to be related to problematic behaviors like crime, accident, fighting, violence, and unprotected sex, among others. Alcohol consumption among university students in South Africa particularly is considered endemic – with a prevalence rate of 25.27%, 32.34%, and 23.34% across universities, colleges, and high schools. Adopting the tenets of social learning and ecological theories, the culture of drinking amongst male university students is critically explored. This study found that age, gender, early exposure to alcohol, and peer pressure are significant factors contributing to alcohol consumption amongst university students. While participants acknowledged that moderate and responsible consumption of alcohol is necessary, they agree that it does not translate to responsible drinking behaviours.

Keywords: alcohol, drinking, university, students

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Authors: Zahra Solgi, Hossein Rassi

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Colorectal cancer (CRC) is a multi-step disease, and chronic gastric infection with H. pylori could play a role in one or more of the steps in this pathogenic process. Polymorphisms in several miRNAs are considered to increase the risk for the development of CRC by controlling proliferation, apoptosis and H. pylori pathogenesis. Therefore, the aim of this study was to investigate miRNA146a rs2910164 polymorphism and Helicobacter pylori infection in CRC. A total of 65 patients with CRC were divided into 2 groups: 28 patients < 50 years of age and 37 patients ≥ 50 years of age. DNA was extracted from all samples by a standard method and H. pylori cagA and miRNA146a rs2910164 genotypes were determined by PCR method. The results show that there was no significant difference in the frequency of H. pylori cagA gene between the two groups but there was a significant difference in the distribution of rs2910164 genotypes in patients < 50 years of age with the p-value of 0.05 and odds ratio equal to 2.69. On other hand, patients < 50 years of age with genotype CC of miRNA146a showed a significant difference in CRC risk. Furthermore, there was a significant correlation between rs2910164 CC genotype with Helicobacter pylori infection in patients < 50 years of age. The present study suggests that the CC genotype of miRNA146a in combination with H. pylori infection can be effective as risk factors and molecular markers for early diagnosis and treatment of CRC.

Keywords: colorectal cancer, Helicobacter pylori, miRNA146a, rs2910164 polymorphism

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Authors: Claire Norman-Maillet

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Insider fraud, otherwise known as occupational, employee, or internal fraud, is a financial crime threat. Perpetrated by defrauding (or attempting to defraud) one’s current, prospective, or past employer, an ‘employee’ covers anyone employed by the company, including board members and contractors. The Coronavirus pandemic has forced insider fraud into the spotlight, and it isn’t dimming. As the focus of most academics and practitioners has historically been on that of ‘external fraud’, insider fraud is often overlooked or not considered to be a real threat. However, since COVID-19 changed the working world, pushing most of us into remote or hybrid working, employers cannot easily keep an eye on what their staff are doing, which has led to reliance on trust and transparency. This, therefore, brings about an increased risk of insider fraud perpetration. The objective of this paper is to explore why insider fraud is, therefore, now the biggest threat to a business. To achieve the research objective, participating individuals within the financial crime sector (either as a practitioner or consultants) attended semi-structured interviews with the researcher. The principal recruitment strategy for these individuals was via the researcher’s LinkedIn network. The main findings in the research suggest that insider fraud has been ignored and rejected as a threat to a business, owing to a reluctance to admit that a colleague may perpetrate. A positive of the Coronavirus pandemic is that it has forced insider fraud into a more prominent position and giving it more importance on a business’ agenda and risk register. Despite insider fraud always having been a possibility (and therefore a risk) within any business, it is very rare that a business has given it the attention it requires until now, if at all. The research concludes that insider fraud needs to prioritised by all businesses, and even ahead of external fraud. The research also provides advice on how a business can add new or enhance existing controls to mitigate the risk.

Keywords: insider fraud, occupational fraud, COVID-19, COVID, coronavirus, pandemic, internal fraud, financial crime, economic crime

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Authors: Djeddi Khaled, Houssou Hind, Miloudi Abdelatif, Rabah Siham

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Camels play a vital role as multipurpose animals, providing milk meat and serving as a means of transportation. They serve as a financial reserve for pastoralists and hold significant cultural and social value. Camel milk, known for its exceptional nutritional properties, is considered a valuable substitute for human milk. However, udder infections, particularly mastitis, pose significant challenges to camel farming. Clinical and subclinical mastitis can lead to substantial economic losses. Mastitis, especially the subclinical form, is a persistent and prevalent condition affecting milk hygiene and quality in dairy camels. This review offers insights into the prevalence and risk factors associated with subclinical mastitis in camels. The prevalence of subclinical mastitis in dairy camels was found to range from 9.28% to 87.78%. Major pathogens responsible for camel mastitis include Staphylococcus aureus, Coagulase-negative Staphylococcus, Streptococcus agalactiae, Streptococcus dysgalactiae, Escherichia coli, Micrococcus spp, Pasteurella haemolytica and Corynebacterium spp. The study outlines key risk factors contributing to camel mastitis, emphasizing factors such as severe tick infestation, age, stage of lactation, parity, body condition score, skin lesion on the teats or udders, anti-suckling devices, previous history of the udder, conformation of the udder, breed, unhygienic milking practices, production system, amongst others have been reported to be important in the prevalence of subclinical mastitis. This comprehensive overview provides valuable insights into the multifaceted aspects of camel mastitis, encompassing prevalent bacterial pathogens and diverse risk factors. The findings underscore the importance of holistic management practices, emphasizing hygiene, health monitoring, and targeted interventions to ensure the well-being and productivity of camels in various agro-pastoral contexts.

Keywords: bacterial pathogens, camel, mastitis, risk factors

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Authors: Ons Triki, Fathi Abid

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Along with the increase in the use of leasing contracts in corporate finance, multiple studies aim to model the credit risk of the lease in order to cover the losses of the lessor of the asset if the lessee goes bankrupt. In the current research paper, a convertible lease contract is elaborated in a continuous time stochastic universe aiming to ensure the financial stability of the firm and quickly recover the losses of the counterparties to the lease in case of default. This work examines the term structure of the lease rates taking into account the credit default risk and the capital structure of the firm. The interaction between the lessee's capital structure and the equilibrium lease rate has been assessed by applying the competitive lease market argument developed by Grenadier (1996) and the endogenous structural default model set forward by Leland and Toft (1996). The cumulative probability of default was calculated by referring to Leland and Toft (1996) and Yildirim and Huan (2006). Additionally, the link between lessee credit risk and lease rate was addressed so as to explore the impact of convertible lease financing on the term structure of the lease rate, the optimal leverage ratio, the cumulative default probability, and the optimal firm value by applying an endogenous conversion threshold. The numerical analysis is suggestive that the duration structure of lease rates increases with the increase in the degree of the market price of risk. The maximal value of the firm decreases with the effect of the optimal leverage ratio. The results are indicative that the cumulative probability of default increases with the maturity of the lease contract if the volatility of the asset service flows is significant. Introducing the convertible lease contract will increase the optimal value of the firm as a function of asset volatility for a high initial service flow level and a conversion ratio close to 1.

Keywords: convertible lease contract, lease rate, credit-risk, capital structure, default probability

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Authors: Marzieh Karimihaghighi, Carlos Castillo

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This work studies how Machine Learning (ML) may be used to increase the effectiveness of a criminal recidivism risk assessment tool, RisCanvi. The two key dimensions of this analysis are predictive accuracy and algorithmic fairness. ML-based prediction models obtained in this study are more accurate at predicting criminal recidivism than the manually-created formula used in RisCanvi, achieving an AUC of 0.76 and 0.73 in predicting violent and general recidivism respectively. However, the improvements are small, and it is noticed that algorithmic discrimination can easily be introduced between groups such as national vs foreigner, or young vs old. It is described how effectiveness and algorithmic fairness objectives can be balanced, applying a method in which a single error disparity in terms of generalized false positive rate is minimized, while calibration is maintained across groups. Obtained results show that this bias mitigation procedure can substantially reduce generalized false positive rate disparities across multiple groups. Based on these results, it is proposed that ML-based criminal recidivism risk prediction should not be introduced without applying algorithmic bias mitigation procedures.

Keywords: algorithmic fairness, criminal risk assessment, equalized odds, recidivism

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Authors: J. R. Wang, W. Y. Li, H. T. Lin, J. H. Yang, C. Shih, S. W. Chen

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Fuel rod analysis program transient (FRAPTRAN) code was used to study the fuel rod performance during a postulated large break loss of coolant accident (LBLOCA) in Maanshan nuclear power plant (NPP). Previous transient results from thermal hydraulic code, TRACE, with the same LBLOCA scenario, were used as input boundary conditions for FRAPTRAN. The simulation results showed that the peak cladding temperatures and the fuel center line temperatures were all below the 10CFR50.46 LOCA criteria. In addition, the maximum hoop stress was 18 MPa and the oxide thickness was 0.003 mm for the present simulation cases, which are all within the safety operation ranges. The present study confirms that this analysis method, the FRAPTRAN code combined with TRACE, is an appropriate approach to predict the fuel integrity under LBLOCA with operational ECCS.

Keywords: FRAPTRAN, TRACE, LOCA, PWR

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Authors: Giovanni Gonzalez Araujo, Michael Kyrilov, Angelo Kyrilov

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STEAMplug is a web-based innovative educational platform which makes teaching easier and learning more effective. It requires no setup, eliminating the barriers to entry, allowing students to focus on their learning throughreal-world development environments. The student-centric tools enable easy collaboration between peers and teachers. Analyzing user interactions with the system enables us to predict student performance and identify at-risk students, allowing early instructor intervention.

Keywords: plagiarism detection, identifying at-Risk Students, education technology, e-learning system, collaborative development, learning and teaching with technology

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Authors: Lloyd A. Taylor

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An increase in the prevalence of Attention Deficit-Hyperactivity Disorder (ADHD) highlights the need to consider factors that may be exacerbating symptom presentation. Traditional diagnostic criteria provide a little framework for healthcare providers to consider as they attempt to diagnose and treat children with behavioral problems. In fact, aside from exclusion criteria, limited alternative considerations are available, and approaches fail to consider the impact of outside factors that could increase or decrease the likelihood of appropriate diagnosis and success of interventions. This paper will consider specific systems-based factors that influence behavior and intervention successes that, when not considered, could account for the upsurge of diagnoses. These include understanding (1) challenges in the healthcare system, (2) the influence and impact of educators and the educational system, (3) technology use, and (4) patient and parental attitudes about the diagnosis of ADHD. These factors must be considered both individually and as a whole when considering both the increase in diagnoses and the subsequent increases in prescriptions for psychostimulant medication. A theoretical model based on a risk management approach will be presented. Finally, data will be presented that demonstrates pediatric provider satisfaction with this approach to diagnoses and treatment of ADHD as it relates to practice trends.

Keywords: ADHD, diagnostic criteria, risk management model, pediatricians

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Authors: Eiji Okano, Kazuyuki Inagaki

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We revisit Uribe's `Fiscal Theory of Sovereign Risk' advocating that there is a trade-off between stabilizing inflation and suppressing default. We develop a class of dynamic stochastic general equilibrium (DSGE) model with nominal rigidities and compare two de facto inflation stabilization policies, optimal monetary policy and optimal monetary and fiscal policy with the minimizing interest rate spread policy which completely suppress the default. Under the optimal monetary and fiscal policy, not only the nominal interest rate but also the tax rate work to minimize welfare costs through stabilizing inflation. Under the optimal monetary both inflation and output gap are completely stabilized although those are fluctuating under the optimal monetary policy. In addition, volatility in the default rate under the optimal monetary policy is considerably lower than one under the optimal monetary policy. Thus, there is not the SI-SD trade-off. In addition, while the minimizing interest rate spread policy makes inflation rate severely volatile, the optimal monetary and fiscal policy stabilize both the inflation and the default. A trade-off between stabilizing inflation and suppressing default is not so severe what pointed out by Uribe.

Keywords: sovereign risk, optimal monetary policy, fiscal theory of the price level, DSGE

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Authors: Amer Alsari, Hassan Alhalal, Tahar Ayadat, Andi Asiz, Omar KM Ouda

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Al Khaldiyah is a regional road situated in west-south of Al Khobar, precisely in the area of Half Moon Bay. It is characterized by four lines, which become six lines in some places, in both directions extending over about 10 km length. The road extends between the bridge near the Air Force Base and Half Moon Bay Road. Many accidents have been observed in this road notably over the last two years. Many injuries and deaths were recorded, some of the victims were PMU students. Consequently, management of the road to eliminate or reduce accidents to a large extend becomes imperative. The main goal of this project are to propose sustainable solutions for the purpose optimizing safety and improving its sight view by designing some appropriate junctions including bridge and tunnel in the critical locations.

Keywords: management, road, accident, traffic, safety, sustainable, solutions

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Authors: A. Kourou, M. Panoutsopoulou

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Nowadays, disaster risk reduction requires innovative ways of working collaboratively, monitoring tools, management methods, risk communication, and knowledge, as key factors for decision-making actors. Experience has shown that the assessment of seismic risk and its effective management is still an important challenge. In Greece, Ionian Islands region is characterized as the most seismic area of the country and one of the most active worldwide. It is well known that in case of a disastrous earthquake the local authorities need to assess the situation in the affected area and coordinate the disaster response. In particular, the main outcomes of 'Telemachus' project are the development of an innovative operational system that hosts the needed data of seismic risk management in the Ionian Islands and the implementation of educational actions for the involved target groups. This project is funded in the Priority Axis 'Environmental Protection and Sustainable Development' of Operational Plan 'Ionian Islands 2014-2020'. EPPO is one of the partners of the project and it is responsible, among others, for the development of proper training material. This paper presents the training material of 'Telemachus' and its usage as a helpful, managerial tool in case of earthquake emergency. This material is addressed to different target groups, such as civil protection staff, people that involved with the tourism industry, educators of disabled people, etc. Very positive aspect of the project is the involvement of end-users that should evaluate the training products; test standards; clarify the personnel’s roles and responsibilities; improve interagency coordination; identify gaps in resources; improve individual performance; and identify opportunities for improvement. It is worth mentioning that even though the abovementioned material developed is useful for the training of specific target groups on emergency management issues within Ionian Islands Region, it could be used throughout Greece and other countries too.

Keywords: education of civil protection staff, Ionian Islands Region of Greece, seismic risk, training material

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Authors: Babatunde Dosumu, Obuks Ejohwomu, Akilu Yunusa-Kaltungo

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Cost estimation in construction is often difficult, particularly when dealing with risks and uncertainties, which are inevitable and peculiar to developing countries like Nigeria. Direct consequences of these are major deviations in cost, duration, and quality. The fundamental aim of this study is to develop a framework for assessing the impacts of risk on cost estimation, which in turn causes variabilities between contract sum and final account. This is very important, as initial estimates given to clients should reflect the certain magnitude of consistency and accuracy, which the client builds other planning-related activities upon, and also enhance the capabilities of construction industry professionals by enabling better prediction of the final account from the contract sum. In achieving this, a systematic literature review was conducted with cost variability and construction projects as search string within three databases: Scopus, Web of science, and Ebsco (Business source premium), which are further analyzed and gap(s) in knowledge or research discovered. From the extensive review, it was found that factors causing deviation between final accounts and contract sum ranged between 1 and 45. Besides, it was discovered that a cost estimation framework similar to Building Cost Information Services (BCIS) is unavailable in Nigeria, which is a major reason why initial estimates are very often inconsistent, leading to project delay, abandonment, or determination at the expense of the huge sum of money invested. It was concluded that the development of a cost estimation framework that is adjudged an important tool in risk shedding rather than risk-sharing in project risk management would be a panacea to cost estimation problems, leading to cost variability in the Nigerian construction industry by the time this ongoing Ph.D. research is completed. It was recommended that practitioners in the construction industry should always take into account risk in order to facilitate the rapid development of the construction industry in Nigeria, which should give stakeholders a more in-depth understanding of the estimation effectiveness and efficiency to be adopted by stakeholders in both the private and public sectors.

Keywords: cost variability, construction projects, future studies, Nigeria

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity and weight gain are associated with increased risk of developing cardiovascular diseases and the progression of liver fibrosis. Aspartate transaminase–to-platelet count ratio index (AST-to-PLT, APRI) and fibrosis-4 (FIB-4) were primarily considered as the formulas capable of differentiating hepatitis from cirrhosis. Recently, they have found clinical use as measures of liver fibrosis and cardiovascular risk. However, their status in children has not been evaluated in detail yet. The aim of this study is to determine APRI and FIB-4 status in obese (OB) children and compare them with values found in children with normal body mass index (N-BMI). A total of sixty-eight children examined in the outpatient clinics of the Pediatrics Department in Tekirdag Namik Kemal University Medical Faculty were included in the study. Two groups were constituted. In the first group, thirty-five children with N-BMI, whose age- and sex-dependent BMI indices vary between 15 and 85 percentiles, were evaluated. The second group comprised thirty-three OB children whose BMI percentile values were between 95 and 99. Anthropometric measurements and routine biochemical tests were performed. Using these parameters, values for the related indices, BMI, APRI, and FIB-4, were calculated. Appropriate statistical tests were used for the evaluation of the study data. The statistical significance degree was accepted as p<0.05. In the OB group, values found for APRI and FIB-4 were higher than those calculated for the N-BMI group. However, there was no statistically significant difference between the N-BMI and OB groups in terms of APRI and FIB-4. A similar pattern was detected for triglyceride (TRG) values. The correlation coefficient and degree of significance between APRI and FIB-4 were r=0.336 and p=0.065 in the N-BMI group. On the other hand, they were r=0.707 and p=0.001 in the OB group. Associations of these two indices with TRG have shown that this parameter was strongly correlated (p<0.001) both with APRI and FIB-4 in the OB group, whereas no correlation was calculated in children with N-BMI. Triglycerides are associated with an increased risk of fatty liver, which can progress to severe clinical problems such as steatohepatitis, which can lead to liver fibrosis. Triglycerides are also independent risk factors for cardiovascular disease. In conclusion, the lack of correlation between TRG and APRI as well as FIB-4 in children with N-BMI, along with the detection of strong correlations of TRG with these indices in OB children, was the indicator of the possible onset of the tendency towards the development of fatty liver in OB children. This finding also pointed out the potential risk for cardiovascular pathologies in OB children. The nature of the difference between APRI vs FIB-4 correlations in N-BMI and OB groups (no correlation versus high correlation), respectively, may be the indicator of the importance of involving age and alanine transaminase parameters in addition to AST and PLT in the formula designed for FIB-4.

Keywords: APRI, children, FIB-4, obesity, triglycerides

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Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

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Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

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Authors: Selim M. Khan, Dustin D. Pearson, Tryggve Rönnqvist, Markus E. Nielsen, Joshua M. Taron, Aaron A. Goodarzi

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Accumulation of radioactive radon gas in indoor air poses a serious risk to human health by increasing the lifetime risk of lung cancer and is classified by IARC as a category one carcinogen. Radon exposure risks are a function of geologic, geographic, design, and human behavioural variables and can change over time. Using time series and deep machine learning modelling, we analyzed long-term radon test outcomes as a function of building metrics from 25,489 Canadian and 38,596 Swedish residential properties constructed between 1945 to 2020. While Canadian and Swedish properties built between 1970 and 1980 are comparable (96–103 Bq/m³), innate radon risks subsequently diverge, rising in Canada and falling in Sweden such that 21st Century Canadian houses show 467% greater average radon (131 Bq/m³) relative to Swedish equivalents (28 Bq/m³). These trends are consistent across housing types and regions within each country. The introduction of energy efficiency measures within Canadian and Swedish building codes coincided with opposing radon level trajectories in each nation. Deep machine learning modelling predicts that, without intervention, average Canadian residential radon levels will increase to 176 Bq/m³ by 2050, emphasizing the importance and urgency of future building code intervention to achieve systemic radon reduction in Canada.

Keywords: radon health risk, time-series, deep machine learning, lung cancer, Canada, Sweden

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Authors: Yo Fukutani, Shuji Moriguchi, Takuma Kotani, Terada Kenjiro

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If risk management of the assets owned by companies, risk assessment of real estate portfolio, and risk identification of the entire region are to be implemented, it is necessary to consider simultaneous damage to multiple buildings. In this research, the Sagami Trough earthquake tsunami that could have a significant effect on the Japanese capital region is focused on, and a method is proposed for simultaneous damage assessment using copulas that can take into consideration the correlation of tsunami depths and building damage between two sites. First, the tsunami inundation depths at two sites were simulated by using a nonlinear long-wave equation. The tsunamis were simulated by varying the slip amount (five cases) and the depths (five cases) for each of 10 sources of the Sagami Trough. For each source, the frequency distributions of the tsunami inundation depth were evaluated by using the response surface method. Then, Monte-Carlo simulation was conducted, and frequency distributions of tsunami inundation depth were evaluated at the target sites for all sources of the Sagami Trough. These are marginal distributions. Kendall’s tau for the tsunami inundation simulation at two sites was 0.83. Based on this value, the Gaussian copula, t-copula, Clayton copula, and Gumbel copula (n = 10,000) were generated. Then, the simultaneous distributions of the damage rate were evaluated using the marginal distributions and the copulas. For the correlation of the tsunami inundation depth at the two sites, the expected value hardly changed compared with the case of no correlation, but the damage rate of the ninety-ninth percentile value was approximately 2%, and the maximum value was approximately 6% when using the Gumbel copula.

Keywords: copulas, Monte-Carlo simulation, probabilistic risk assessment, tsunamis

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Authors: Sima Hajiazizi

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Tehran is a capital of Iran, with the capitals of the world to natural disasters such as earthquake and flood vulnerable has known. City has stated on three faults, Ray, Mosha, and north according to report of JICA in 2000, the most casualties and destruction was the result of active fault Ray. In 2003, the prevention and management of crisis in Tehran to conduct prevention and rehabilitation of the city, under the Ministry has active. Given the breadth and lack of appropriate access in the city, was considered decentralized management for crisis management support, in each region, in order to position the crisis management headquarters at the time of crises and implementation of programs for prevention and education of the citizens and also to position the bases given in some areas of the neighboring provinces at the time of the accident for help and a number of databases to store food and equipment needed at the time of the disaster. In this study, the bases for one, six, nine and eleven regions of Tehran in the field of management and training are evaluated. Selected areas had local accident and experience of practice for disaster management and local training has been experiencing challenges. The research approach was used qualitative research methods underlying Ground theory. At first, the information obtained through the study of documents and Semi-structured interviews by administrators, officials of training and participant observation in the classroom, line by line, and then it was coded in two stages, by comparing and questioning concepts, categories and extract according to the indicators is obtained from literature studies, subjects were been central. Main articles according to the frequency and importance of the phenomenon were called and they were drawn diagram paradigm and at the end with the intersections phenomena and their causes with indicators extracted from the texts, approach each phenomenon and the effectiveness of the bases was measured. There are two phenomenons in management; 1. The inability to manage the vast and complex crisis events and to resolve minor incidents due to the mismatch between managers. 2. Weaknesses in the implementation of preventive measures and preparedness to manage crisis is causal of situations, fields and intervening. There are five phenomenons in the field of education; 1. In the six-region participation and interest is high. 2. In eleven-region training partnerships for crisis management were to low that next by maneuver in schools and local initiatives such as advertising and use of aid groups have increased. 3. In nine-region, contributions to education in the area of crisis management at the beginning were low that initiatives like maneuver in schools and communities to stimulate and increase participation have increased sensitivity. 4. Managers have been disagreement with the same training in all areas. Finally for the issues that are causing the main issues, with the help of concepts extracted from the literature, recommendations are provided.

Keywords: crises management, crisis management support bases, vulnerability, crisis management headquarters, prevention

Procedia PDF Downloads 174

Authors: Mai A. Ibrahim, Mohammed El-Beltagy, Motaz Khorshid

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Emerging Markets return distributions have shown significance departure from normality were they are characterized by fatter tails relative to the normal distribution and exhibit levels of skewness and kurtosis that constitute a significant departure from normality. Therefore, the classical Markowitz Mean-Variance is not applicable for emerging markets since it assumes normally-distributed returns (with zero skewness and kurtosis) and a quadratic utility function. Moreover, the Markowitz mean-variance analysis can be used in cases of moderate non-normality and it still provides a good approximation of the expected utility, but it may be ineffective under large departure from normality. Higher moments models and median models have been suggested in the literature for asset allocation in this case. Higher moments models have been introduced to account for the insufficiency of the description of a portfolio by only its first two moments while the median model has been introduced as a robust statistic which is less affected by outliers than the mean. Tail risk measures such as Value-at Risk (VaR) and Conditional Value-at-Risk (CVaR) have been introduced instead of Variance to capture the effect of risk. In this research, higher moment models including the Mean-Variance-Skewness (MVS) and Mean-Variance-Skewness-Kurtosis (MVSK) are formulated as single-objective non-linear programming problems (NLP) and median models including the Median-Value at Risk (MedVaR) and Median-Mean Absolute Deviation (MedMAD) are formulated as a single-objective mixed-integer linear programming (MILP) problems. The higher moment models and median models are compared to some benchmark portfolios and tested on real financial data in the Egyptian main Index EGX30. The results show that all the median models outperform the higher moment models were they provide higher final wealth for the investor over the entire period of study. In addition, the results have confirmed the inapplicability of the classical Markowitz Mean-Variance to the Egyptian stock market as it resulted in very low realized profits.

Keywords: Egyptian stock exchange, emerging markets, higher moment models, median models, mixed-integer linear programming, non-linear programming

Procedia PDF Downloads 315

Authors: Xiao Yang, Ji Zhang, Yingli Song, Hui Huang, Jing Zhang, Yan Wang, Rongrong Han, Zhixuan Xiang, Lu Chen, Lingling Gao

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Aim and Objectives: To examine physical activity self-efficacy, identify its predictors, and further explore the mechanism of action among the predictors in mainland Chinese pregnant women with high risk for gestational diabetes mellitus (GDM). Background: Physical activity could protect pregnant women from developing GDM. Physical activity self-efficacy was the key predictor of physical activity. Design: A cross-sectional study was conducted from October 2021 to May 2022 in Zhengzhou, China. Methods: 252 eligible pregnant women completed the Pregnancy Physical Activity Self-efficacy Scale, the Social Support for Physical Activity Scale, the Knowledge on Physical Activity Questionnaire, the 7-item Generalized Anxiety Disorder scale, the Edinburgh Postnatal Depression Scale, and a socio-demographic data sheet. Multiple linear regression was applied to explore the predictors of physical activity self-efficacy. Structural equation modeling was used to explore the mechanism of action among the predictors. Results: Chinese pregnant women with a high risk for GDM reported a moderate level of physical activity self-efficacy. The best-fit regression analysis revealed four variables explained 17.5% of the variance in physical activity self-efficacy. Social support for physical activity was the strongest predictor, followed by knowledge of the physical activity, intention to do physical activity, and anxiety symptoms. The model analysis indicated that knowledge of physical activity could release anxiety and depressive symptoms and then increase physical activity self-efficacy. Conclusion: The present study revealed a moderate level of physical activity self-efficacy. Interventions targeting pregnant women with high risk for GDM need to include the predictors of physical activity self-efficacy. Relevance to clinical practice: To facilitate pregnant women with high risk for GDM to engage in physical activity, healthcare professionals may find assess physical activity self-efficacy and intervene as soon as possible on their first antenatal visit. Physical activity intervention programs focused on self-efficacy may be conducted in further research.

Keywords: physical activity, gestational diabetes, self-efficacy, predictors

Procedia PDF Downloads 102

Authors: Maria Angela Bedini, Fabio Bronzini

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The risk of natural disasters affects all the countries of the world, whether it refers to seismic events or tsunamis or hydrogeological disasters. In most cases, the risk can be considered in its three components: hazard, exposure, vulnerability (and urban vulnerability). The aim of this paper is to evaluate how the Italian scientific community has related the contribution of these three components, superimposing the three different maps that summarize the fundamental structure of the risk. Based on the three components considered, the study applies the Regional Planning methodology on the three phases of the risk protection and mitigation process: the prevention phase, the emergency intervention phase, the post-disaster phase. The paper illustrates the Italian experience of the pre-during-post-earthquake intervention. Main results: The study deepens these aspects in the belief that “a historical center” and an “island” can present similar problems at the international level, both in the phase of prevention (earthquake, tsunamis, hydrogeological disasters), in emergency phase (protocols and procedures of intervention) and in the post-disaster phase. The conclusions of the research identify the need to plan in advance how to deal with the post-disaster phase and consider it a priority with respect to the simple reconstruction of destroyed buildings. In fact the main result of the post-disaster intervention must be the return and the social and economic support of the indigenous population, and not only the construction of new housing and equipment. In this sense, the results of the research show that the elderly inhabitants of a historic center can be compared to the indigenous population of an atoll of fishermen, as both constitute the most important resource: the human resource. Their return in conditions of security testifies, with their presence, the culture, customs, and values rooted in the history of a people.

Keywords: post-disaster interventions, risk of natural disasters in Italy and abroad, seismic events in Italy, social and economic protection and support for the native population of historical centers

Procedia PDF Downloads 101

Authors: Prakher Mishra, Dikshant Bodana, Saloni Desai, Sudhanshu Dixit, Sopan Agarwal, Shriraj Patel

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Railways are sometimes lifeline of nations as they consist of huge network of rail lines and bridges. Reportedly many of the bridges are aging, weak, distressed and accident prone. It becomes a really challenging task for Engineers and workers to keep up a regular maintenance schedule for proper functioning which itself is quite a hard hitting job. In this paper we have come up with an innvovative wireless system of maintenance called BriMAIN. In this system we have installed two types of sensors, first one is called a force sensor which will continously analyse the readings of pressure at joints of the bridges and secondly an MPU-6050 triaxial gyroscope+accelerometer which will analyse the deflection of the deck of the bridge. Apart from this a separate database is also being made at the server room so that the data can be visualized by the engineers and a warning can be issued in case reading of the sensors goes above threshold.

Keywords: Accelerometer, B-MAIN, Gyroscope, MPU-6050

Procedia PDF Downloads 383

Authors: Dejana Bouillet, Vlatka Domović

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Both policymakers and researchers recognize that participating in early childhood education and care (ECEC) is useful for all children, especially for those who are exposed to the high risk of social exclusion. Social exclusion of children is understood as a multidimensional construct including economic, social, cultural, health, and other aspects of disadvantage and deprivation, which individually or combined can have an unfavorable effect on the current life and development of a child, as well as on the child’s development and on disadvantaged life chances in adult life. ECEC institutions should be able to promote educational approaches that portray developmental, cultural, language, and other diversity amongst children. However, little is known about the ways in which Croatian ECEC institutions recognize and respect the diversity of children and their families and how they respond to their educational needs. That is why this paper is dedicated to the analysis of the capacities of ECEC professionals to respond to the demands of educational needs of this very diverse group of children and their families. The results obtained in the frame of the project “Models of response to educational needs of children at risk of social exclusion in ECEC institutions,” funded by the Croatian Science Foundation, will be presented. The research methodology arises from explanations of educational processes and risks of social exclusion as a complex and heterogeneous phenomenon. The preliminary results of the qualitative data analysis of educational practices regarding capacities to identify and appropriately respond to the requirements of children at risk of social exclusion will be presented. The data have been collected by interviewing educational staff in 10 Croatian ECEC institutions (n = 10). The questions in the interviews were related to various aspects of inclusive institutional policy, culture, and practices. According to the analysis, it is possible to conclude that Croatian ECEC professionals are still faced with great challenges in the process of implementation of inclusive policies, culture, and practices. There are several baselines of this conclusion. The interviewed educational professionals are not familiar enough with the whole complexity and diversity of needs of children at risk of social exclusion, and the ECEC institutions do not have enough resources to provide all interventions that these children and their families need.

Keywords: children at risk of social exclusion, ECEC professionals, inclusive policies, culture and practices, quallitative analysis

Procedia PDF Downloads 114