Search results for: risk evaluation

Authors: Taeho Park, Ming Zhou, Sangryul Shim

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With the emergence of the global economy, today’s business environment is getting more competitive than ever in the past. And many supply chain (SC) strategies and operations have significantly been altered over the past decade to overcome more complexities and risks imposed onto the global business. First, offshoring and outsourcing are more adopted as operational strategies. Manufacturing continues to move to better locations for enhancing competitiveness. Second, international operations are a challenge to a company’s SC system. Third, the products traded in the SC system are not just physical goods, but also digital goods (e.g., software, e-books, music, video materials). There are three main flows involved in fulfilling the activities in the SC system: physical flow, information flow, and financial flow. An advance of the Internet and electronic communication technologies has enabled companies to perform the flows of SC activities in electronic formats, resulting in the advent of an electronic supply chain management (e-SCM) system. A SC system for digital goods is somewhat different from the supply chain system for physical goods. However, it involves many similar or identical SC activities and flows. For example, like the production of physical goods, many third parties are also involved in producing digital goods for the production of components and even final products. This research aims at identifying process flows of both physical and digital goods in a SC system, and then investigating all risk elements involved in the physical, information, and financial flows during the fulfilment of SC activities. There are many risks inherent in the e-SCM system. Some risks may have severe impact on a company’s business, and some occur frequently but are not detrimental enough to jeopardize a company. Thus, companies should assess the impact and frequency of those risks, and then prioritize them in terms of their severity, frequency, budget, and time in order to be carefully maintained. We found risks involved in the global trading of physical and digital goods in four different categories: environmental risk, strategic risk, technological risk, and operational risk. And then the significance of those risks was investigated through a survey. The survey asked companies about the frequency and severity of the identified risks. They were also asked whether they had faced those risks in the past. Since the characteristics and supply chain flows of digital goods are varying industry by industry and country by country, it is more meaningful and useful to analyze risks by industry and country. To this end, more data in each industry sector and country should be collected, which could be accomplished in the future research.

Keywords: digital goods, e-SCM, risk analysis, supply chain flows

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Authors: Michael T. Lobmann, Camilla Wellstein, Stefan Zerbe

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Vegetation plays an important role for the stabilization of slopes against erosion processes, such as shallow erosion and landslides. Plant roots reinforce the soil, increase soil cohesion and often cross possible shear planes. Hence, plant roots reduce the risk of slope failure. Generally, shrub and tree roots penetrate deeper into the soil vertically, while roots of forbs and grasses are concentrated horizontally in the topsoil and organic layer. Therefore, shrubs and trees have a higher potential for stabilization of slopes with deep soil layers than forbs and grasses. Consequently, research mainly focused on the vertical root effects of shrubs and trees. Nevertheless, a better understanding of the stabilizing effects of grasses and forbs is needed for better evaluation of the stability of natural and artificial slopes with herbaceous vegetation. Despite the importance of vertical root effects, field observations indicate that horizontal root effects also play an important role for slope stabilization. Not only forbs and grasses, but also some shrubs and trees form tight horizontal networks of fine and coarse roots and rhizomes in the topsoil. These root networks increase soil cohesion and horizontal tensile strength. Available methods for physical measurements, such as shear-box tests, pullout tests and singular root tensile strength measurement can only provide a detailed picture of vertical effects of roots on slope stabilization. However, the assessment of horizontal root effects is largely limited to computer modeling. Here, a method for measurement of in-situ cumulative horizontal root tensile strength is presented. A traction machine was developed that allows fixation of rectangular grass sods (max. 30x60cm) on the short ends with a 30x30cm measurement zone in the middle. On two alpine grass slopes in South Tyrol (northern Italy), 30x60cm grass sods were cut out (max. depth 20cm). Grass sods were pulled apart measuring the horizontal tensile strength over 30cm width over the time. The horizontal tensile strength of the sods was measured and compared for different soil depths, hydrological conditions, and root physiological properties. The results improve our understanding of horizontal root effects on slope stabilization and can be used for improved evaluation of grass slope stability.

Keywords: grassland, horizontal root effect, landslide, mountain, pasture, shallow erosion

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Authors: El Khaddam Safaa, Soulaymani Abdelmajid, Mokhtari Abdelghani, Ouammi Lahcen, Rachida Soulaymani-Beincheikh

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The poisonings represent a problem of health in the world and Morocco, The exact dimensions of this phenomenon are still poorly recorded that we see the lack of exhaustive statistical data. The objective of this retrospective study of a series of cases of the poisonings declared at the level of the region of Tadla-Azilal and collected by the Moroccan Poison Control and Pharmacovigilance Center. An epidemiological profile of the poisonings was to raise, to determine the risk factors influencing the vital preview of the poisoned And to follow the evolution of the incidence, the lethality, and the mortality. During the period of study, we collected and analyzed 9303 cases of poisonings by different incriminated toxic products with the exception of the scorpion poisonings. These poisonings drove to 99 deaths. The epidemiological profile which we raised, showed that the poisoned were of any age with an average of 24.62±16.61 years, The sex-ratio (woman/man) was 1.36 in favor of the women. The difference between both sexes is highly significant (χ2 = 210.5; p<0,001). Most of the poisoned which declared to be of urban origin (60.5 %) (χ2=210.5; p<0,001). Carbon monoxide was the most incriminated among the cases of poisonings (24.15 %), them putting in head, followed by some pesticides and farm produces (21.44 %) and food (19.95 %). The analysis of the risk factors showed that the grown-up patients whose age is between 20 and 74 years have twice more risk of evolving towards the death (RR=1,57; IC95 % = 1,03-2,38) than the other age brackets, so the male genital organ was the most exposed (explained) to the death that the female genital organ (RR=1,59; IC95 % = 1,07-2,38) The patients of rural origin had presented 5 times more risk (RR=4,713; IC95 % = 2,543-8,742). Poisoned by the mineral products had presented the maximum of risk on the vital preview death (RR=23,19, IC95 % = 2,39-224,1). The poisonings by pesticides produce a risk of 9 (RR=9,31; IC95 % = 6,10-14,18). The incidence was 3,3 cases of 10000 inhabitants, and the mortality was 0,004 cases of 1000 inhabitants (that is 4 cases by 1000 000 inhabitants). The rate of lethality registered annually was 10.6 %. The evolution of the indicators of health according to the years showed that the rate of statement measured by the incidence increased by a significant way. We also noted an improvement in the coverage which (who) ended up with a decrease in the rate of the lethality and the mortality during last years. The fight anti-toxic is a work of length time. He asks for a lot of work various levels. It is necessary to attack the delay accumulated by our country on the various legal, institutional and technical aspects. The ideal solution is to develop and to set up a national strategy.

Keywords: epidemiology, poisoning, risk factors, indicators of health, Tadla-Azilal grated by anti-toxic fight

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Authors: Eftychia Pappa, Heleni Vastardis, Christos Rahiotis, Andriani Vazaiou

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The aim of this study was to evaluate the prevalence of dry-mouth symptoms (xerostomia) and compare it with alterations in salivary characteristics of children and adolescents with type 1 diabetes (DM1), as measured with the use of chair-side saliva tests. This study also investigated the possible association between salivary dysfunction and incidence of caries, in relation to the level of metabolic control. A cross-sectional study was performed on young patients (6-18 years old) allocated among 3 groups: 40 patients poorly-controlled (DM1-A, HbA1c>8%), 40 well-controlled (DM1-B, HbA1c≤8%) and 40 age- and sex-matched healthy controls. The study was approved by the Research Ethics Committee of University of Athens and the parents signed written informed consent. All subjects were examined for dental caries, oral hygiene and salivary factors. Assessments of salivary function included self-reported xerostomia, quantification of resting and stimulated whole saliva flow rates, pH values, buffering capacity and saliva’s viscosity. Salivary characteristics were evaluated with the use of GC Saliva Check Buffer (3Μ ESPE). Data were analysed by chi-square and Kruskal-Wallis tests. Subjects with diabetes reported xerostomia more frequently than healthy controls (p<0.05). Unstimulated salivary flow rate and pH values remained significantly lower in DM1-A compared to DM1-B and controls. Low values of resting salivary flow rate were associated with a higher prevalence of dental caries in children and adolescents with poorly-controlled DM1 (p<0.05). The results suggested that diabetes-induced alterations in salivary characteristics are indicative of higher caries susceptibility of diabetics and chair-side saliva tests are a useful tool for the evaluation of caries risk assessment.

Keywords: caries risk assessment, saliva diagnostic tests, type 1 diabetes, xerostomia

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

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

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

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Authors: Angela Luft, Sebastian Bremen, Nicolae Balc

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Additive manufacturing processes have entered large parts of the industry and their range of application have progressed and grown significantly in the course of time. A major advantage of additive manufacturing is the innate flexibility of the machines. This corelates with the ongoing demand of creating highly flexible production environments. However, the potential of additive manufacturing technologies to enhance the flexibility of production systems has not yet been truly considered and quantified in a systematic way. In order to determine the potential of additive manufacturing technologies with regards to the strategic flexibility design in production systems, an integrated evaluation model has been developed, that allows for the simultaneous consideration of both conventional as well as additive production resources. With the described model, an operational scope of action can be identified and quantified in terms of mix and volume flexibility, process complexity, and machine capacity that goes beyond the current cost-oriented approaches and offers a much broader and more holistic view on the potential of additive manufacturing. A respective evaluation model is presented this paper.

Keywords: additive manufacturing, capacity planning, production systems, strategic production planning, flexibility enhancement

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Authors: Yin-Hsuan Wu, Perng-Jy Tsai, Ying-Fang Wang, Shun-Hui Chung

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The present study was conducted to characterize exposure concentrations, concentrations deposited on the different respiratory regions, and resultant health risks associated with heavy metal exposures for road marking workers. Road marking workers of three similar exposure groups (SEGs) were selected, including the paint pouring worker, marking worker, and preparing worker. Personal exposure samples were collected using an inhalable dust sampler (IOM), and the involved particle size distribution samples were estimated using an eight-stage Marple personal cascade impactor during five working days. In total, 25 IOM samples and 20 Marple samples were collected. All collected samples were analyzed for their heavy metal contents using the ICP/MS. The resultant heavy metal particle size distributions were also used to estimate the fractions of particle deposited on the head airways (Chead), tracheobronchial (Cthorac) and alveolar regions (Cresp) of the exposed workers. In addition, Pb and Cr were selected to estimate the incremental cancer risk, and Zn, Ti, and Mo were selected to estimate the corresponding non-cancer risk in the present study. Results show that three heavy metals, including Pb, Cr, and Ti, were found with the highest concentrations for the SEG of the paint pouring worker (=0.585±2.98, 0.307±1.71, 0.902±2.99 μg/m³, respectively). For the fraction of heavy metal particle deposited on the respiratory tract, both alveolar and head regions were found with the highest values (=23-43% and 39-61%, respectively). For both SEGs of the paint pouring and marking, 51% of Cr, 59-61% of Zn, and 48-51% of Ti were found to be deposited on the alveolar region, and 41-43% of Pb was deposited on the head region. Finally, the incremental cancer risk for the SEGs of the paint pouring, marking, and preparing were found as 1.08×10⁻⁵, 2.78×10⁻⁶, and 2.20×10⁻⁶, respectively. In addition, the estimated non-cancer risk for the above three SEGs was found to be consistently less than unity. In conclusion, though the estimated non-cancer risk was less than unity, all resultant incremental cancer risk was greater than 10⁻⁶ indicating the abatement of workers’ exposure is necessary. It is suggested that strategies, including placing on the molten kettle, substitution the currently used paints for less heavy metal containing paints, and wearing fume protecting personal protective equipment can be considered in the future from reducing the worker’s exposure aspect.

Keywords: health risk assessment, heavy metal, respiratory track deposition, road marking

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Authors: Bang Haeyong

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Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

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Authors: Natacha Jesus-Silva, Carla S. Pereira, Natercia Durao, Maria Das Dores Formosinho, Cristina Costa-Lobo

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Any assessment process, by its very nature, raises a wide range of doubts, uncertainties, and insecurities of all kinds. The evaluation process should be ethically irreproachable, treating each and every one of the evaluated according to a conduct that ensures that the process is fair, contributing to all recognize and feel well with the processes and results of the evaluation. This is a very important starting point and implies that positive and constructive conceptions and attitudes are developed regarding the evaluation of teaching performance, where students' responsibility is desired. It is not uncommon to find teachers feeling threatened at various levels, in particular as regards their autonomy and their professional dignity. Evaluation must be useful in that it should enable decisions to be taken to improve teacher performance, the quality of teaching or the learning climate of the school. This study is part of a research project whose main objective is to identify, select, evaluate and synthesize the available evidence on Quality Indicators in Higher Education. In this work, the 01 parameters resulting from pedagogical surveys in a Portuguese higher education institution in the north of the country will be presented, surveys for the 2015/2016 school year, presented to 1751 students, in a total of 11 degrees and 18 master's degrees. It has analyzed the evaluation made by students with respect to the performance of a group of 68 teachers working full time. This paper presents the lessons learned in the last three academic years, allowing for the identification of the effects on the following areas: teaching strategies and methodologies, capacity of systematization, learning climate, creation of conditions for active student participation. This paper describes the procedures resulting from the descriptive analysis (frequency analysis, descriptive measures and association measures) and inferential analysis (ANOVA one-way, MANOVA one-way, MANOVA two-way and correlation analysis).

Keywords: teaching performance, higher education, students responsibility, indicators of teaching management

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Authors: Digdem M. Siyez, Bariscan Ozturk, Erol Esen, Ender Siyez, Yelda Kagnici, Bahar Baran

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Infertility is a reproductive disease identified with the absence of pregnancy after regular unprotected sexual intercourse that has been lasting for 12 months or more. Some of the factors that cause infertility, which has been considered as a social and societal issue since the first days of the humankind, are preventable. These are veneral diseases, age, the frequency of the intercourse and its timing, drug use, bodyweight, environmental and professional conditions. Having actual information about the reproductive health is essential to take protective and preventive measures, and it is accepted as the most effective way to reduce the rate of infertility. However, during the literature review, it has been observed that there are so few studies that focus on the prevention of the infertility. The aim of this study is to develop a psycho-education program to reduce infertility among university students and also to evaluate the program’s effectiveness. It is believed that this program will increase the information level about infertility among the university students, help them to adopt healthy attitudes, develop life skills, create awareness about the risk factors and also contribute to the literature. Throughout the study, first, the contents of sexual/reproductive health programs developed for university students were examined by the researches. Besides, “Views about Reproductive Health Psycho-education Program Survey” was developed and applied to 10221 university students from 21 universities. In accordance with the literature and the university students’ views about reproductive health psycho-education program consisting of 9 sessions each of which lasts for 90 minutes was developed. The pilot program was carried out with 16 volunteer undergraduate students attending to a state university. During the evaluation of the pilot study, at the end of each session “Session Evaluation Form” and at the end of the entire program “Program Evaluation Form” were administered to the participants. Besides, one week after the end of the program, a focus group with half of the group, and individual interviews with the rest were conducted. Based on the evaluations, it was determined that the session duration is enough, the teaching methods meet the expectation, the techniques applied are appropriate and clear, and the materials are adequate. Also, an extra session was added to psycho-education program based on the feedbacks of the participants. In order to evaluate program’s effectiveness, Solomon control group design will be used. According to this design, the research has 2 experiment groups and 2 control groups. The participants who voluntarily participated in the research after the announcement of the psycho-education program were divided into experiment and control groups. In the experiment 1 and control 1 groups, “Personal Information Test”, “Infertility Information Test” and “Infertility Attitude Scale”, “Self Identification Inventory” and “Melbourne Decision Scale” were administered as a preliminary test. Currently, at the present stage, psycho-education still continues. After this 10-week program, the same tests will be administered again as the post-tests. The decision upon which statistical method will be applied in the analysis will be made afterwards according to whether the data meets the presuppositions or not.

Keywords: infertility, prevention, psycho-education, reproductive health

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Authors: Erin V. Kelly, Nicola C. Newton, Lexine A. Stapinski, Maree Teesson

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Introduction: There is a lack of targeted prevention programs for reducing bullying and distress among adolescents involved in bullying. The current study aimed to examine the impact of a personality-targeted intervention (Preventure) on bullying (victimization and perpetration) and distress among adolescent victims/bullies with high-risk personality types. Method: A cluster randomized trial (RCT) was conducted in 26 secondary schools (2190 students) in NSW and Victoria, Australia, as part of the Climate Schools and Preventure trial. The schools were randomly allocated to Preventure (13 schools received Preventure, 13 did not). Students were followed up at 4 time points (6, 12, 24 and 36 months post-baseline). Preventure involves two group sessions, based on cognitive behavioral therapy, and tailored to four personality types shown to increase risk of substance misuse and other emotional and behavioural problems, including impulsivity, sensation-seeking, anxiety sensitivity and hopelessness. Students were allocated to the personality-targeted groups based on their scores on the Substance Use Risk Profile Scale. Bullying was measured using an amended version of the Revised Olweus Bully/Victim Scale. Psychological distress was measured using the Kessler Psychological Distress Scale. Results: Among high-risk students classified as victims at baseline, those in Preventure schools reported significantly less victimization and distress over time than those in control schools. Among high-risk students classified as bullies at baseline, those in Preventure schools reported significantly less distress over time than those in control schools (no difference for perpetration). Conclusion: Preventure is a promising intervention for reducing bullying victimization and psychological distress among adolescents involved in bullying.

Keywords: adolescents, bullying, personality, prevention

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Authors: Souheila Zemmouchi

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Introduction: Diabetes is currently the leading cause of end-stage chronic kidney disease and dialysis, so it adds additional complexity to the management of chronic hemodialysis patients. These patients are extremely fragile because of their multiple cardiovascular and metabolic comorbidities. Clear and complete description of the experience: the management of a diabetic on hemodialysis is particularly difficult due to frequent hypoglycaemia and significant inter and perdialyticglycemic variability that is difficult to predict. The aim of our study is to describe the clinical-biological profile and to assess the cardiovascular risk of diabetics undergoing chronic hemodialysis, and compare them with non-diabetic hemodialysis patients. Methods: This cross-sectional, descriptive, and analytical study was carried out between January 01 and December 31, 2018, involving 309 hemodialysis patients spread over 4 centersThe data were collected prospectively then compiled and analyzed by the SPSS Version 10 software The FRAMINGHAM RISK SCORE has been used to assess cardiovascular risk in all hemodialysis patients Results: The survey involved 309 hemodialysis patients, including 83 diabetics, for a prevalence of 27% The average age 53 ± 10.2 years. The sex ratio is 1.5. 50% of diabetic hemodialysis patients retained residual diuresis against 32% in non-diabetics. In the group of diabetics, we noted more hypertension (70% versus 38% non-diabetics P 0.004), more intradialytichypoglycemia (15% versus 3% non-diabetics P 0.007), initially, vascular exhaustion was found in 4 diabetics versus 2 non-diabetics. 70% of diabetics with anuria had postdialytichyperglycemia. The study found a statistically significant difference between the different levels of cardiovascular risk according to the diabetic status. Conclusion: There are many challenges in the management of diabetics on hemodialysis, both to optimize glycemic control according to an individualized target and to coordinate comprehensive and effective care.

Keywords: hemodialysis, diabetes, chronic renal failure, glycemic control

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Authors: Guilhermina Torrao

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An extensive number of studies have been conducted to determine the factors which influence crash injury risk (CIR); however, uncertainties inherent to selected variables have been neglected. A review of existing literature is required to not only obtain an overview of the variables and measures but also ascertain the implications when comparing studies without a systematic view of variable taxonomy. Therefore, the aim of this literature review is to examine and report on peer-reviewed studies in the field of crash analysis and to understand the implications of broad variations in variable selection in CIR analysis. The objective of this study is to demonstrate the variance in variable selection and classification when modeling injury risk involving occupants of light vehicles by presenting an analytical review of the literature. Based on data collected from 64 journal publications reported over the past 21 years, the analytical review discusses the variables selected by each study across an organized list of predictors for CIR analysis and provides a better understanding of the contribution of accident and vehicle factors to injuries acquired by occupants of light vehicles. A cross-comparison analysis demonstrates that almost half the studies (48%) did not consider vehicle design specifications (e.g., vehicle weight), whereas, for those that did, the vehicle age/model year was the most selected explanatory variable used by 41% of the literature studies. For those studies that included speed risk factor in their analyses, the majority (64%) used the legal speed limit data as a ‘proxy’ of vehicle speed at the moment of a crash, imposing limitations for CIR analysis and modeling. Despite the proven efficiency of airbags in minimizing injury impact following a crash, only 22% of studies included airbag deployment data. A major contribution of this study is to highlight the uncertainty linked to explanatory variable selection and identify opportunities for improvements when performing future studies in the field of road injuries.

Keywords: crash, exploratory, injury, risk, variables, vehicle

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Authors: Zaw Z Aung

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Background: High-risk groups for hepatitis B infection (HBV) are people who injected drugs (PWID), men who have sex with men (MSM), people living with HIV (PLHIV) and persons with hepatitis C (HCV), etc. HBV/HCV coinfected patients are at increased risk of cirrhosis, hepatic decompensation and hepatocellular carcinoma. To the best of author’s knowledge, there is currently no data for hepatitis B vaccine utilization in HCV positive patients and their antibody response. Methodology: From February 2018 to May 2018, consented participants at or above 18 years who came to the clinic in Mandalay were tested with the anti-HCV rapid test. Those who tested HCV positive (n=168) were further tested with hepatitis B profile and asked about their previous hepatitis B vaccination history and risk factors. Results: Out of 168 HCV positive participants, three were excluded for active HBV infections. The remaining 165 were categorized into previously vaccinated 64% (n=106) and unvaccinated 36% (n=59) There were three characteristics groups- PWID monoinfected (n=77), General Population (GP) monoinfected (n=22) and HIV/HCV coinfected participants (n=66). Unvaccinated participants were highest in HIV/HCV, with 68%(n=45) followed by GP (23%, n=5) and PWID (12%, n=9). Among previously vaccinated participants, the highest percentage was PWID (88%, n=68), the second highest was GP (77%, n=17) and lowest in HIV/HCV patients (32%, n=21). 63 participants completed third doses of vaccination (PWID=36, GP=13, HIV/HCV=14). 53% of participants who completed 3 dose of hepatitis B were non-responders (n=34): HIV/HCV (86%, n=12), PWID (44%, n=16), and GP (46%, n=6) Conclusion: Even in the presence of effective and safe hepatitis B vaccine, uptake is low among high risk groups especially PLHIV that needs to be improved. Integration or collaboration of hepatitis B vaccination program, HIV/AIDS and hepatitis C treatment centers is desirable. About half of vaccinated participants were non-responders so that optimal doses, schedule and follow-up testing need to be addressed carefully for those groups.

Keywords: Hepatitis B vaccine, Hepatitis C, HIV, Myanmar

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Authors: Antonio Horta, Renato Marinho, Raimir Holanda

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Considered as an evolution of the Blockchain, the Ethereum platform, besides allowing transactions of its cryptocurrency named Ether, it allows the programming of decentralised applications (DApps) and smart contracts. However, this functionality into blockchains has raised other types of threats, and the exploitation of smart contracts vulnerabilities has taken companies to experience big losses. This research intends to figure out the number of contracts that are under risk of being drained. Through a deep investigation, more than two hundred thousand smart contracts currently available in the Ethereum platform were scanned and estimated how much money is at risk. The experiment was based in a query run on Google Big Query in July 2022 and returned 50,707,133 contracts published on the Ethereum platform. After applying the filtering criteria, the experimentgot 430,584 smart contracts to download and analyse. The filtering criteria consisted of filtering out: ERC20 and ERC721 contracts, contracts without transactions, and contracts without balance. From this amount of 430,584 smart contracts selected, only 268,103 had source codes published on Etherscan, however, we discovered, using a hashing process, that there were contracts duplication. Removing the duplicated contracts, the process ended up with 20,417 source codes, which were analysed using the open source SAST tool smartbugswith oyente and securify algorithms. In the end, there was nearly $100,000 at risk of being drained from the potentially vulnerable smart contracts. It is important to note that the tools used in this study may generate false positives, which may interfere with the number of vulnerable contracts. To address this point, our next step in this research is to develop an application to test the contract in a parallel environment to verify the vulnerability. Finally, this study aims to alert users and companies about the risk on not properly creating and analysing their smart contracts before publishing them into the platform. As any other application, smart contracts are at risk of having vulnerabilities which, in this case, may result in direct financial losses.

Keywords: blockchain, reentrancy, static application security testing, smart contracts

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Authors: Ayman M. Arfaj, Jose Lauro M. Llamas, Saleh Y Qahtani

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Sulfur Loading Operation (SLO) is an operation that poses risk of exposure to toxic gases such as Hydrogen Sulfid and Sulfur Dioxide during molten sulfur loading operation. In this operation molten sulfur is loaded into a truck tanker in a liquid state and the temperature of the tanker must maintain liquid sulfur within a 43-degree range — between 266 degrees and 309 degrees Fahrenheit in order for safe loading and unloading to occur. Accordingly, in this study, the e potential risk of occupational exposure to the airborne toxic gases was assessed at three sulfur loading facilities. The concentrations of toxic airborne substances such as Hydrogen Sulfide (H2S) and Sulfur Dioxide (SO2), were monitored during operations at the different locations within the sulfur loading operation facilities. In addition to extensive real-time monitoring, over one hundred and fifty samples were collected and analysed at internationally accredited laboratories. The concentrations of H2S, and SO2 were all found to be well below their respective occupational exposure limits. Very low levels of H2S account for the odours observed intermittingly during mixing and application operations but do not pose a considerable health risk and hence these levels are considered a nuisance. These results were comparable to those reported internationally. Aside from observing the usual general safe work practices such as wearing safety glasses, there are no specific occupational health related concerns at the examined sulfur loading facilities.

Keywords: exposure assessment, sulfur loading operation, health risk study, molten sulfur, toxic airborne substances, air contaminants monitoring

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Authors: Nidal F. Shilbayeh, Reem A. Al-Saidi, Ahmed H. Alsswey

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In this paper, we presented an evaluation and analysis of E-Voting Authentication Preparation Scheme (EV-APS). EV-APS applies some modified security aspects that enhance the security measures and adds a strong wall of protection, confidentiality, non-repudiation and authentication requirements. Some of these modified security aspects are Kerberos authentication protocol, PVID scheme, responder certificate validation, and the converted Ferguson e-cash protocol. Authentication and privacy requirements have been evaluated and proved. Authentication guaranteed only eligible and authorized voters were permitted to vote. Also, the privacy guaranteed that all votes will be kept secret. Evaluation and analysis of some of these security requirements have been given. These modified aspects will help in filtering the counter buffer from unauthorized votes by ensuring that only authorized voters are permitted to vote.

Keywords: e-voting preparation stage, blind signature protocol, Nonce based authentication scheme, Kerberos Authentication Protocol, pseudo voter identity scheme PVID

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Authors: Şule Yanık, Hasan Gürgür

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It is thought that it is important for disabled children to have the opportunity to benefit preschool education that smoothens transition process to formal education, and for the constitution of a precondition for their success. Within this context, it is important for the disabled in Turkey to be evaluated medically firstly and then educational-wise in order for them to benefit early inclusive education. Thus, disabled people are both diagnosed in hospitals and at Guidance and Research Centers (GRC) attached to Ministry of Education educational-wise. It is seen that standard evaluation tools are used and evaluations are done by special education teachers (SET) in order for educational diagnosis and evaluation (EDAE) to be realized. The literature emphasizes the importance of informal evaluation tools as well as formal ones. According to this, it is thought that another party, besides students in EDAE process and SETs, is family, because families are primary care takers for their children, and that the most correct and real information can be obtained via families beside results of educational evaluation processes (EEP). It is thought that obtaining opinions of families during EEP is important to be able to exhibit the present EDAE activities in Turkey, materialize any existing problems, and increase quality of the process. Within this context, the purpose of this study is to exhibit experiences regarding EDAE processes of 10 families having preschool children with hearing loss (CHL). The process of research is designed to be descriptive based on qualitative research paradigms. Data were collected via semi-structured interview questions, and the themes were obtained. As a result, it is seen that families, after they realize the hearing loss of their children, do not have any information regarding the subject, and that they consult to an ear-nose-throat doctor or an audiologist for support. It is seen that families go to hospitals for medical evaluation which is a pre-requisite for benefiting early education opportunities. However, during this process, as some families do not have any experience of having a CHL, it is seen that they are late for medical evaluation and hearing aids. Moreover, families stated that they were directed to GRC via audiologists for educational evaluation. Families stated that their children were evaluated regarding language, academic and psychological development in proportion with their ages in GRC after they were diagnosed medically. However, families stated that EEP realized in GRC was superficial, short and lacked detail. It is seen that many families were not included in EEP process, whereas some families stated that they were asked questions because their children are too small to answer. Regarding the benefits of EEP for themselves and their children, families stated that GRC had to give a report to them for benefiting the free support of Special Education and Rehabilitation Center, and that families had to be directed to inclusive education. As a result, it is seen that opinions of families regarding EDAE processes at GRC indicate inefficiency of the process as it is short and superficial, regardless being to the point.

Keywords: children with hearing loss, educational diagnosis and evaluation, guidance and research center, inclusion

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Authors: Mary Allagoa, Abir Al-Tabbaa

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The study explores the use of binders and additives, such as Portland cement, pulverized fuel ash, ground granulated blast furnace slag, and MgO, to decrease the concentration and leachability of pollutants in contaminated site soils. The research investigates their effectiveness and associated risks of using the binders, with a focus on Total Heavy metals (THM) and Total Petroleum Hydrocarbon (TPH). The goal of this research is to evaluate the performance and effectiveness of binders and additives in remediating soil pollutants. The study aims to assess the suitability of the mixtures for ground improvement purposes, determine the optimal dosage, and investigate the associated risks. The research utilizes physical (unconfined compressive strength) and chemical tests (batch leachability test) to assess the efficacy of the binders and additives. A completely randomized design one-way ANOVA is used to determine the significance within mix binders of THM. The study also employs incremental lifetime cancer risk assessments (ILCR) and other indexes to evaluate the associated risks. The study finds that Ground Granulated Blast Furnace Slag (GGBS): MgO is the most effective binder for remediation, particularly when using low dosages of MgO combined with higher dosages of GGBS binders on TPH. The results indicate that binders and additives can encapsulate and immobilize pollutants, thereby reducing their leachability and toxicity. The mean unconfined compressive strength of the soil ranges from 285.0- 320.5 kPa, while THM levels are less than 10 µg/l in GGBS: MgO and CEM: PFA but below 1 µg/l in CEM I based. The ILCR ranged from 6.77E-02 - 2.65E-01 and 5.444E-01 – 3.20 E+00, with the highest values observed under extreme conditions. The hazard index (HI), Risk allowable daily dose intake (ADI), and Risk chronic daily intake (CDI) were all less than 1 for the THM. The study identifies MgO as the best additive for use in soil remediation.

Keywords: risk ADI, risk CDI, ILCR, novel binders, additives binders, hazard index

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Authors: Muhammad Fawad

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Monitoring and structural health assessment are the primary requirements for the performance evaluation of damaged bridges. This paper highlights the case study of a damaged Reinforced Concrete (RC) bridge structure where the Finite element (FE) modelling of this structure was done using the material properties extracted by the in-situ testing. Analysis was carried out to evaluate the bridge damage. On the basis of FE analysis results, this study proposes a proper Structural Health Monitoring (SHM) system that will extend the life cycle of the bridge with minimal repair costs and reduced risk of failure. This system is based on the installation of three different types of sensors: Liquid Levelling sensors (LLS) for measurement of vertical displacement, Distributed Fiber Optic Sensors (DFOS) for crack monitoring, and Weigh in Motion (WIM) devices for monitoring of moving loads on the bridge.

Keywords: bridges, reinforced concrete, finite element method, structural health monitoring, sensors

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Authors: Muhammad Arslan Usman, Muhammad Rehan Usman, Soo Young Shin

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Live video streaming is one of the most widely used service among end users, yet it is a big challenge for the network operators in terms of quality. The only way to provide excellent Quality of Experience (QoE) to the end users is continuous monitoring of live video streaming. For this purpose, there are several objective algorithms available that monitor the quality of the video in a live stream. Subjective tests play a very important role in fine tuning the results of objective algorithms. As human perception is considered to be the most reliable source for assessing the quality of a video stream, subjective tests are conducted in order to develop more reliable objective algorithms. Temporal impairments in a live video stream can have a negative impact on the end users. In this paper we have conducted subjective evaluation tests on a set of video sequences containing temporal impairment known as frame freezing. Frame Freezing is considered as a transmission error as well as a hardware error which can result in loss of video frames on the reception side of a transmission system. In our subjective tests, we have performed tests on videos that contain a single freezing event and also for videos that contain multiple freezing events. We have recorded our subjective test results for all the videos in order to give a comparison on the available No Reference (NR) objective algorithms. Finally, we have shown the performance of no reference algorithms used for objective evaluation of videos and suggested the algorithm that works better. The outcome of this study shows the importance of QoE and its effect on human perception. The results for the subjective evaluation can serve the purpose for validating objective algorithms.

Keywords: objective evaluation, subjective evaluation, quality of experience (QoE), video quality assessment (VQA)

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Authors: Sayali Vyas, Atharva Desai, Shreyas Badave, Apurv Kulkarni, B. Rajiv

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The Failure Modes and Effect Analysis (FMEA) is an efficient evaluation technique to identify potential failures in products, processes, and services. FMEA is designed to identify and prioritize failure modes. It proves to be a useful method for identifying and correcting possible failures at its earliest possible level so that one can avoid consequences of poor performance. In this paper, FMEA tool is used in detection of failures of various components of heat exchanger cycle and to identify critical failures of the components which may hamper the system’s performance. Further, a detailed Pareto analysis is done to find out the most critical components of the cycle, the causes of its failures, and possible recommended actions. This paper can be used as a checklist which will help in maintainability of the system.

Keywords: FMEA, heat exchanger cycle, Ishikawa diagram, pareto analysis, RPN (Risk Priority Number)

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Authors: Sharad Kumar Kulshreshtha

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India is a great land of cultural and traditional diversity. Its spectrums create a unique ambiance in all over the country. Specially, fairs and festivals are ancient phenomena in Indian culture. In India, there are thousands of such religious, spiritual, cultural fairs organized on auspicious occasions. These fairs reflect the effective and efficient role of social governance and responsibility of Indian society. In this context a mega event known as ‘Kumbha Mela’ literally mean ‘Kumbha Fair’ which is organize after every twelve years at (Prayaag) Allahabad an ancient city of India, now is in the state of Uttar Pradesh. Kumbh Mela is one of the largest human congregations on the Earth. The Kumbha Mela that is held here is considered to be the largest and holiest city among the four cities where Kubha fair organize. According to the Hindu religious scripture a dip for possessing the holy confluence, known as Triveni Sangam, which is a meeting point of the three sacred rivers of India i.e., –Ganges, Yamuna and Saraswati (mythical). During the Kumbha fair the River Ganges is believed to turn to nectar, bringing great blessing to everyone who bathes in it. Other activities include religious discussions, devotional singings and mass feedings pilgrims and poor. The venue for Kumbh Mela (fair) depends on the position Sun, Moon, and Jupiter which holds in that period in different zodiac signs. More than 120 Millions (12 Crore) people visited in the Kumbha Fair-2013 in Allahabad. A temporary tented city was set up for the pilgrims over an area of 2 hectares of the land along the river of Ganges. As many as 5 power substations, temporary police stations, hospitals, bus terminals, stalls were set up for providing various facilities to the visitors and thousands of volunteers participated for assistance of this event. All efforts made by fair administration to provide facility to visitors, such security and sanitation, medical care and frequent water and power supply. The efficient and timely arrangement at the Kumbha Mela attracted the attention of many government and institutions. The Harvard University of USA conducted research to find out how it was made possible. This paper will focuses on effective and efficient planning and preparation of Kumbha Fair which includes facilitation process, role of various coordinating agencies. risk management crisis management strategies Prevention, Preparedness, Response, and Recovery (PPRR Approach), emergency response plan (ERP), safety and security issues, various environmental aspects along with health hazards and hygiene crowd management, evacuation, monitoring, control and evaluation.

Keywords: event planning and facility arrangement, risk management, crowd management, India

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Authors: Gae Hee Song

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This paper aims to address the evolution of public-private partnerships for mainstreaming an evaluation approach in the community-based education project. It examines the distinctive features of Save the Children’s School Me project in terms of empowerment evaluation principles introduced by David M. Fetterman, especially community ownership, capacity building, and organizational learning. School Me is a Save the Children Korea funded-project, having been implemented in Cote d’Ivoire and Sierra Leone since 2016. The objective of this project is to reduce gender-based disparities in school completion and learning outcomes by creating an empowering learning environment for girls and boys. Both quasi-experimental and experimental methods for impact evaluation have been used to explore changes in learning outcomes, gender attitudes, and learning environments. To locate School Me in the public-private partnership framework for community empowerment and sustainability, the data have been collected from School Me progress/final reports, baseline, and endline reports, fieldwork observations, inter-rater reliability of baseline and endline data collected from a total of 75 schools in Cote d’Ivoire and Sierra Leone. The findings of this study show that School Me project has a significant evaluation component, including qualitative exploratory research, participatory monitoring, and impact evaluation. It strongly encourages key actors, girls, boys, parents, teachers, community leaders, and local education authorities, to participate in the collection and interpretation of data. For example, 45 community volunteers collected baseline data in Cote d’Ivoire; on the other hand, three local government officers and fourteen enumerators participated in the follow-up data collection of Sierra Leone. Not only does this public-private partnership improve local government and community members’ knowledge and skills of monitoring and evaluation, but the evaluative findings also help them find their own problems and solutions with a strong sense of community ownership. Such community empowerment enables Save the Children country offices and member offices to gain invaluable experiences and lessons learned. As a result, empowerment evaluation leads to community-oriented governance and the sustainability of the School Me project.

Keywords: community empowerment, Cote d’Ivoire, empowerment evaluation, public-private partnership, save the children, school me, Sierra Leone, sustainability

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Authors: Mathewos Temesgen, Lemi Geleta

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Lake Koka is one of the Ethiopian Central Rift Valleys lakes, where the absorbance of domestic, agricultural, and industrial waste from the nearby industrial and agro-industrial activities is very common. The aim of this research was to assess the heavy metal bioaccumulation in edible parts of common carp (Cyprinus carpio) in Lake Koka and the health risks associated with the dietary intake of the fish. Three sampling sites were selected randomly for primary data collection. Physicochemical parameters (pH, Total Dissolved Solids, Dissolved Oxygen and Electrical Conductivity) were measured in-situ. Four heavy metals (Cd, Cr, Pb, and Zn) in water and bio-accumulation in the edible parts of the fish were analyzed with flame atomic absorption spectrometry. The mean values of TDS, EC, DO and pH of the lake water were 458.1 mg/L, 905.7 µ s/cm, 7.36 mg/L, and 7.9, respectively. The mean concentrations of Zn, Cr, and Cd in the edible part of fish were also 0.18 mg/kg, ND-0.24 mg/kg, and ND-0.03 mg/kg, respectively. Pb was, however, not identified. The amount of Cr in the examined fish muscle was above the level set by FAO, and the accumulation of the metals showed marked differences between sampling sites (p<0.05). The concentrations of Cd, Pb and were below the maximum permissible limit. The results also indicated that Cr has a high transfer factor value and Zn has the lowest. The carcinogenic hazard ratio values were below the threshold value (<1) for the edible parts of fish. The estimated weekly intake of heavy metals from fish muscles ranked as Cr>Zn>Cd, but the values were lower than the Reference Dose limit for metals. The carcinogenic risk values indicated a low health risk due to the intake of individual metals from fish. Furthermore, the hazard index of the edible part of fish was less than unity. Generally, the water quality is not a risk for the survival and reproduction of fish, and the heavy metal contents in the edible parts of fish exhibited low carcinogenic risk through the food chain.

Keywords: bio-accumulation, cyprinus carpio, hazard index, heavy metals, Lake Koka

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Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

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Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

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Authors: Abul Bashar

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The recent surge in the adoption of cloud computing systems by various organizations has brought forth the challenge of evaluating their performance. One of the major issues faced by the cloud service providers and customers is to assess the ability of cloud computing systems to provide the desired services in accordance to the QoS and SLA constraints. To this end, an opportunity exists to develop means to ensure that the desired performance levels of such systems are met under simulated environments. This will eventually minimize the service disruptions and performance degradation issues during the commissioning and operational phase of cloud computing infrastructure. However, it is observed that several simulators and modelers are available for simulating the cloud computing systems. Therefore, this paper presents a critical evaluation of the state-of-the-art modeling and simulation frameworks applicable to cloud computing systems. It compares the prominent simulation frameworks in terms of the API features, programming flexibility, operating system requirements, supported services, licensing needs and popularity. Subsequently, it provides recommendations regarding the choice of the most appropriate framework for researchers, administrators and managers of cloud computing systems.

Keywords: cloud computing, modeling framework, performance evaluation, simulation tools

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Authors: Mohammad E. Nikoofal, Mehmet Gumus

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Besides the many benefits of outsourcing, firms are still concerned about the lack of critical information regarding both the risk levels and actions of their suppliers that are just a few links away. In this paper, we study the effectiveness of audit for the manufacturer in managing her supplier’s process improvement effort when the supplier is privately informed about his disruption risk and actions. By comparing the agency costs associated with the optimal menu of contracts with and without audit, we completely characterize the value of audit for all the cases from the perspectives of both manufacturer, and supplier as well as total supply chain. First, the analysis of value of audit from the manufacturer’s perspective shows that she can strictly benefit from auditing her supplier’s actions. To the best of our knowledge, this result has not been documented before in the principal-agent literature under a standard setting where the agent is assumed to be risk-neutral and not protected by limited liability constraints. Second, we find that not only the manufacturer but also the supplier can strictly benefit from audit. Third, the audit enables the manufacturer to customize her contract offerings based on the reliability of the supplier. Finally, by analyzing the impact of problem parameters on the value of audit, we identify the conditions under which an audit would be beneficial for individual supply chain parties as well as total supply chain.

Keywords: supply disruption, adverse selection, moral hazard incentives, audit

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Authors: Seyed Fakhreddin Hejazi, Leili Iranirad, Mohammad Sadeghi, Mohsen Talebizadeh

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Background: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures. We performed this clinical trial to assess the preventive effect of allopurinol against CIN in high-risk patients undergoing coronary angiography. Methods: In this prospective randomized controlled trial, 140 patients with at least two risk factors for CIN undergoing coronary angiography were randomly assigned to either the allopurinol group or the control group. Patients in the allopurinol group received 300 mg allopurinol 24 hours before a procedure and intravenous hydration for 12 hours before and after coronary angiography, whereas patients in the control group received intravenous hydration. Serum creatinine (SCr), blood urea nitrogen (BUN) and uric acid were measured before contrast exposure and at 48 hours. CIN was defined as an increase of 25% in serum creatinine (SCr) or >0.5 mg/dl 48 hours after contrast administration. Results: CIN occurred in 11 out of 70 (7.9%) patients in the control group and in 8 out of 70 (5.7%) patients in the allopurinol group. There was no significant difference in the incidence of CIN between the two groups at 48 hours after administering the radiocontrast agent (p = 0.459). However, there were significant differences between the two groups in SCr, BUN, uric acid, and eGFR 48 hours after radiocontrast administration (p < 0.05). Conclusion: Our findings revealed that allopurinol had no substantial efficacy over hydration protocol in high-risk patients for the development of CIN.

Keywords: contrast-induced nephropathy, allopurinol, coronary angiography, contrast agent

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Authors: P.V. Lostelius, M.Mattebo, E. Thors Adolfsson, A. Söderlund, Å. Revenäs

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Adolescents are vulnerable in healthcare settings. Early detection of poor health in young people is important to support a good quality of life and adult social functioning. Youth Health Clinics (YHCs) in Sweden provide healthcare for young people ages 13-25 years old. Using an overall mixed methods approach, the project’s main objective was to develop and evaluate an electronic health system, including a health questionnaire, a case report form, and an evaluation questionnaire to assess young people’s health risks in early stages, increase health, and quality of life. In total, 72 young people, 16-23 years old, eleven healthcare professionals and eight researchers participated in the three project studies. Results from interviews with fifteen young people gave that an electronic health questionnaire should include questions about physical-, mental-, sexual health and social support. It should specifically include questions about self-harm and suicide risk. The young people said that the questionnaire should be appealing, based on young people’s needs and be user-friendly. It was important that young people felt safe when responding to the questions, both physically and electronically. Also, they found that it had the potential to support the face-to face-meeting between young people and healthcare professionals. The electronic health report system was developed by the researchers, performing a structured development of the electronic health questionnaire, construction of a case report form to present the results from the health questions, along with an electronic evaluation questionnaire. An Information Technology company finalized the development by digitalizing the electronic health system. Four young people, three healthcare professionals and seven researchers evaluated the usability using interviews and a usability questionnaire. The electronic health questionnaire was found usable for YHCs but needed some clarifications. Essentially, the system succeeded in capturing the overall health of young people; it should be able to keep the interest of young people and have the potential to contribute to health assessment planning and young people’s self-reflection, sharing vulnerable feelings with healthcare professionals. In advance of effect studies, a feasibility study was performed by collecting electronic questionnaire data from 54 young people and interview data from eight healthcare professionals to assess the feasibility of the use of the electronic evaluation questionnaire, the case report form, and the planned recruitment method. When merging the results, the research group found that the evaluation questionnaire and the health report were feasible for future research. However, the COVID-19 pandemic, commitment challenges and drop-outs affected the recruitment of young people. Also, some healthcare professionals felt insecure about using computers and electronic devices and worried that their workload would increase. This project contributes knowledge about the development and use of electronic health tools for young people. Before implementation, clinical routines need for using the health report system need to be considered.

Keywords: adolescent health, developmental studies, electronic health questionnaire, mixed methods research

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