Search results for: risk perceptions

Authors: Gayathri Pramod, Sheeja K. P.

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Urban flooding has been seen rising in cities for the past few years. This rise in urban flooding is the result of increasing urbanization and increasing climate change. A resilient city design focuses on 'living with water'. This means that the city is capable of accommodating the floodwaters without having to risk any loss of lives or properties. The resilient city design incorporates green infrastructure, river edge treatment, open space design, etc. to form a city that functions as a whole for resilience. Sponge urbanism is a recent method for building resilient cities and is founded by China in 2014. Sponge urbanism is the apt method for resilience building for a tropical town like Aluva of Kerala. Aluva is a tropical town that experiences rainfall of about 783 mm per month during the rainy season. Aluva is an urbanized town which faces the risk of urban flooding and riverine every year due to the presence of Periyar River in the town. Impervious surfaces and hard construction and developments contribute towards flood risk by posing as interference for a natural flow and natural filtration of water into the ground. This type of development is seen in Aluva also. Aluva is designed in this research as a town that have resilient strategies of sponge city and which focusses on natural methods of construction. The flood susceptibility of Aluva is taken into account to design the spaces for sponge urbanism and in turn, reduce the flood susceptibility for the town. Aluva is analyzed, and high-risk zones for development are identified through studies. These zones are designed to withstand the risk of flooding. Various catchment areas are identified according to the natural flow of water, and then these catchment areas are designed to act as a public open space and as detention ponds in case of heavy rainfall. Various development guidelines, according to land use, is also prescribed, which help in increasing the green cover of the town. Aluva is then designed to be a completely flood-adapted city or sponge city according to the guidelines and interventions.

Keywords: climate change, flooding, resilient city, sponge city, sponge urbanism, urbanization

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Authors: Isabel Latz, Mark Lusk, Josiah Heyman

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The rise of restrictive U.S. immigration policies and their strengthened enforcement has reportedly caused concerns among providers about their inadvertent effects on service utilization among Latinx and immigrant communities. This study presents perceptions on this issue from twenty service providers in health care, mental health, nutrition assistance, legal assistance, and immigrant advocacy in El Paso, Texas. All participants were experienced professionals, with fifteen in CEO, COO, executive director, or equivalent positions, and based at organizations that provide services for immigrant and/or low-income populations in a bi-national border community. Quantitative and qualitative data were collected by two primary investigators via semi-structured telephone interviews with an average length of 20 minutes. A survey script with closed and open-ended questions inquired about participants’ demographic information and perceptions of impacts of immigration enforcement policies under the current federal administration on their work and patient or client populations. Quantitative and qualitative data were analyzed to produce descriptive statistics and identify salient themes, respectively. Nearly all respondents stated that their work has been negatively (N=13) or both positively and negatively (N=5) affected by current immigration enforcement policies. Negative effects were most commonly related to immigration enforcement-related fear and uncertainty among patient or client populations. Positive effects most frequently referred to a sense of increased community organizing and greater cooperation among organizations. Similarly, the majority of service providers either reported an increase (N=8) or decrease (N=6) in service utilization due to changes in immigration enforcement policies. Increased service needs were primarily related to a need for public education about immigration enforcement policy changes, information about how new policies impact individuals’ service eligibility, legal status, and civil rights, as well as a need to correct misinformation. Decreased service utilization was primarily related to fear-related service avoidance. While providers observed changes in service utilization among undocumented immigrants and mixed-immigration status families, in particular, participants also noted ‘spillover’ effects on the larger Latinx community, including legal permanent and temporary residents, refugees or asylum seekers, and U.S. citizens. This study reveals preliminary insights into providers’ widespread concerns about the effects of current immigration enforcement policies on health, social, and legal service utilization among Latinx individuals. Further research is necessary to comprehensively assess impacts of immigration enforcement policies on service utilization in Latinx and immigrant communities. This information is critical to address gaps in service utilization and prevent an exacerbation of health disparities among Latinx, immigrant, and border populations. In a global climate of rising nationalism and xenophobia, it is critical for policymakers to be aware of the consequences of immigration enforcement policies on the utilization of essential services to protect the well-being of minority and immigrant communities.

Keywords: immigration enforcement, immigration policy, provider perceptions, service utilization

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Authors: Demmiele Matu Kiiza, Constantine Steven Labongo Loum, Julaina Obika Asinasi

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Background: The use of traditional medicine in Uganda forms the preliminary therapeutic approaches among many people. Traditional medicines have been used in Uganda for many years, not only for the management of pregnancy-related complications but also for the management of other physical and psychological illnesses. Traditional medicines are always considered the first line of treatment by a considerable number of people. This study, therefore, sought to explore the lived experiences of pregnant women by assessing their perceptions of the transitional use of traditional medicine. Methods: Ethnography was used to capture data from an emic perspective. The ethnographic approach involved visiting a few selected pregnant women to observe and participate in the identification of traditional medicines. The ethnographic fieldwork was carried out within a period of three months. In-depth interviews were carried out and audio recorded and later transcribed verbatim. Data was thereafter analyzed thematically. The thematic analysis involved identifying statements made by research participants by transcribing audio and reading through field notes, coding was done, and themes were generated according to commonly mentioned experiences of using traditional medicine. Results: The findings revealed that women performed a ritual of ‘cutting the cord’ by making a small horizontal incision on the belly across the linea Nigra (also known as a pregnancy line) at around six months of pregnancy to avoid producing a baby with an umbilical cord tied around the baby’s neck. They also used crushed egg shells, crushed snail shells and herbs such as pawpaw roots, Entarahompo (crassocephalum vitelline), Ekyoganyanja (Erlangea tomentose), to manage Omushohokye (a term used by the study participants to refer to a situation where women pass out too much water when giving birth, producing a child with mold and oozing out of a milky liquid through the breasts before giving births); prepare for safe delivery and also to manage pregnancy-related complications. The study recommends the implementation of a traditional medicine use policy using a bottom-up approach. Designing and implementing of culturally sensitive maternal healthcare intervention programs and involving village health teams and the elderly in health education.

Keywords: traditional medicine, pregnant women, uganda, perceptions

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Authors: Jaimin Patel

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Cloud computing is one of the most sharp and important movement in various computing technologies. It provides flexibility to users, cost effectiveness, location independence, easy maintenance, enables multitenancy, drastic performance improvements, and increased productivity. On the other hand, there are also major issues like security. Being a common server, security for a cloud is a major issue; it is important to provide security to protect user’s private data, and it is especially important in e-commerce and social networks. In this paper, encryption algorithms such as Advanced Encryption Standard algorithms, their vulnerabilities, risk of attacks, optimal time and complexity management and comparison with other algorithms based on software implementation is proposed. Encryption techniques to improve the performance of AES algorithms and to reduce risk management are given. Secure Hash Algorithms, their vulnerabilities, software implementations, risk of attacks and comparison with other hashing algorithms as well as the advantages and disadvantages between hashing techniques and encryption are given.

Keywords: Cloud computing, encryption algorithm, secure hashing algorithm, brute force attack, birthday attack, plaintext attack, man in middle attack

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Authors: Balasaheb Bansode

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Diabetes is a very important component in non-communicable diseases. Diabetes ailment is a route of the multi-morbidities ailments. The South Indian states are almost completing the demographic transition in India. The study objectives present the prevalence of diabetes and its association with co-morbidities among the south Indian women. The study based on National Family Health Survey fourth round (NFHS) 4 conducted in 2015-16. The univariate, bivariate and multivariate analyses techniques have been used to find the association of risk factors and comorbidities with diabetics. The result reveals that the prevalence of diabetes is high among South Indian women. The study shows the women with diabetics have more chances to diagnose with hypertension and anemia comorbidities. The factors responsible for co-morbidities are changing the demographic situation, socioeconomic status, overweight and addict with substance use in South India. The awareness about diabetes prevention and management should be increased through health education, disease management programmes, trained peers and community health workers and community-based programmes.

Keywords: diabetes, risk factors, comorbidities, women

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Authors: Umer Malik, David Armstrong, Mark Ashworth, Alex Dregan, Veline L'Esperance, Lucy McDonnell, Mariam Molokhia, Patrick White

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Introduction: The microbiota lining epithelial surfaces is thought to play an important role in many human physiological functions including defense against pathogens and modulation of immune response. The microbiota is susceptible to disruption from external influences such as exposure to antibiotic medication. It is thought that antibiotic-induced disruption of the microbiota could predispose to pathogen overgrowth and invasion. We hypothesized that antibiotic use would be associated with increased risk of future infections. We carried out a systematic review of evidence of associations between antibiotic use and subsequent risk of community-acquired infections. Methods: We conducted a review of the literature for observational studies assessing the association between antibiotic use and subsequent community-acquired infection. Eligible studies were published before April 29th, 2016. We searched MEDLINE, EMBASE, and Web of Science and screened titles and abstracts using a predefined search strategy. Infections caused by Clostridium difficile, drug-resistant organisms and fungal organisms were excluded as their association with prior antibiotic use has been examined in previous systematic reviews. Results: Eighteen out of 21,518 retrieved studies met the inclusion criteria. The association between past antibiotic exposure and subsequent increased risk of infection was reported in 16 studies, including one study on Campylobacter jejuni infection (Odds Ratio [OR] 3.3), two on typhoid fever (ORs 5.7 and 12.2), one on Staphylococcus aureus skin infection (OR 2.9), one on invasive pneumococcal disease (OR 1.57), one on recurrent furunculosis (OR 16.6), one on recurrent boils and abscesses (Risk ratio 1.4), one on upper respiratory tract infection (OR 2.3) and urinary tract infection (OR 1.1), one on invasive Haemophilus influenzae type b (Hib) infection (OR 1.51), one on infectious mastitis (OR 5.38), one on meningitis (OR 2.04) and five on Salmonella enteric infection (ORs 1.4, 1.59, 1.9, 2.3 and 3.8). The effect size in three studies on Salmonella enteric infection was of marginal statistical significance. A further two studies on Salmonella infection did not demonstrate a statistically significant association between prior antibiotic exposure and subsequent infection. Conclusion: We have found an association between past antibiotic exposure and subsequent risk of a diverse range of infections in the community setting. Our findings provide evidence to support the hypothesis that prior antibiotic usage may predispose to future infection risk, possibly through antibiotic-induced alteration of the microbiota. The findings add further weight to calls to minimize inappropriate antibiotic prescriptions.

Keywords: antibiotic, infection, risk factor, side effect

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Authors: Da Tao, Mingfu Qin, Wenkai Li, Tieyan Wang

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While the use of electronic personal health portals has gained increasing popularity in the healthcare industry, users usually experience difficulty in comprehending and correctly responding to personal health information, partly due to inappropriate or poor presentation of the information. The way personal health information is visualized may affect how users perceive and assess their personal health information. This study was conducted to examine the effects of information visualization format and visualization mode on the comprehension and perceptions of personal health information among personal health information users with eye tracking techniques. A two-factor within-subjects experimental design was employed, where participants were instructed to complete a series of personal health information comprehension tasks under varied types of visualization mode (i.e., whether the information visualization is static or dynamic) and three visualization formats (i.e., bar graph, instrument-like graph, and text-only format). Data on a set of measures, including comprehension performance, perceptions, and eye movement indicators, were collected during the task completion in the experiment. Repeated measure analysis of variance analyses (RM-ANOVAs) was used for data analysis. The results showed that while the visualization format yielded no effects on comprehension performance, it significantly affected users’ perceptions (such as perceived ease of use and satisfaction). The two graphic visualizations yielded significantly higher favorable scores on subjective evaluations than that of the text format. While visualization mode showed no effects on users’ perception measures, it significantly affected users' comprehension performance in that dynamic visualization significantly reduced users' information search time. Both visualization format and visualization mode had significant main effects on eye movement behaviors, and their interaction effects were also significant. While the bar graph format and text format had similar time to first fixation across dynamic and static visualizations, instrument-like graph format had a larger time to first fixation for dynamic visualization than for static visualization. The two graphic visualization formats yielded shorter total fixation duration compared with the text-only format, indicating their ability to improve information comprehension efficiency. The results suggest that dynamic visualization can improve efficiency in comprehending important health information, and graphic visualization formats were favored more by users. The findings are helpful in the underlying comprehension mechanism of visualized personal health information and provide important implications for optimal design and visualization of personal health information.

Keywords: eye tracking, information comprehension, personal health information, visualization

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Authors: Andreia Guimaraes Farnese, Mateus Fernandes Reu Urban, Leandro Procopio, Renato Zangaro, Regiane Albertini

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Senescence changes include postural balance, inferring the risk of falls, and can lead to fractures, bedridden, and the risk of death. Physical activity, e.g., cardiovascular exercises, is notable for improving balance due to brain cell stimulations, but fine coordination exercises also elevate cell brain metabolism. This study aimed to verify whether the elderly person who performs fine motor activity has a balance similar to that of those who practice physical activity. The subjects were divided into three groups according to the activity practice: control group (CG) with seven participants for the sedentary individuals, motor coordination group (MCG) with six participants, and activity practitioner group (PAG) with eight participants. Data comparisons were from the Berg balance scale, Time up and Go test, and stabilometric analysis. Descriptive statistical and ANOVA analyses were performed for data analysis. The results reveal that including fine motor activities can improve the balance of the elderly and indirectly decrease the risk of falls.

Keywords: balance, barapodometer, coordination, elderly

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Authors: Adem Öğüt, M. Tahir Demirsel

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Rapid changes and developments today, besides the opportunities and facilities they offer to the organization, may also be a source of danger and difficulties due to the uncertainty. In order to take advantage of opportunities and to take the necessary measures against possible uncertainties, organizations must always follow the changes and developments that occur in the business environment and develop flexible structures and strategies for the alternative cases. Perceived environmental uncertainty is an outcome of managers’ perceptions of the combined complexity, instability and unpredictability in the organizational environment. An environment that is perceived to be complex, changing rapidly, and difficult to predict creates high levels of uncertainty about the appropriate organizational responses to external circumstances. In an uncertain and complex environment, organizations experiencing cutthroat competition may be successful by developing their corporate entrepreneurial ability. Corporate entrepreneurship is a process that includes many elements such as innovation, creating new business, renewal, risk-taking and being predictive. Successful corporate entrepreneurship is a critical factor which has a significant contribution to gain a sustainable competitive advantage, to renew the organization and to adapt the environment. In this context, the objective of this study is to investigate the effect of perceived environmental uncertainty of managers on corporate entrepreneurship performance. The research was conducted on 222 business executives in one of the major industrial zones of Turkey, Konya Organized Industrial Zone (KOS). According to the results, it has been observed that there is a positive statistically significant relationship between perceived environmental uncertainty and corporate entrepreneurial activities.

Keywords: corporate entrepreneurship, entrepreneurship, industrial zone, perceived environmental uncertainty, uncertainty

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Authors: S. Sushma, S. Balasubramanian, K. C. Latha, R. Sridhar

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Structural texture measures are used to address the aspect of breast cancer risk assessment in screening mammograms. The current study investigates whether texture properties characterized by local Fractal Dimension (FD) and lacunarity contribute to assess breast cancer risk. Fractal Dimension represents the complexity while the lacunarity characterize the gap of a fractal dimension. In this paper, we present our result confirming that the lacunarity value resulted in algorithm using mammogram images states that level of lacunarity will be low when the Fractal Dimension value will be high.

Keywords: breast cancer, fractal dimension, image analysis, lacunarity, mammogram

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Authors: Chiung-Man Tsai, Chia-Jui Weng

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Leptin (LEP) and leptin receptor (LEPR) both play a crucial role in the mediation of physiological reactions and carcinogenesis and may serve as a candidate biomarker of oral cancer. The present case-control study aimed to examine the effects of single nucleotide polymorphisms (SNPs) of LEP -2548 G/A (rs7799039), LEPR K109R (rs1137100), and LEPR Q223R (rs1137101) with or without interacting to environmental carcinogens on the risk for oral squamous cell carcinoma (OSCC). The SNPs of three genetic allele, from 567 patients with oral cancer and 560 healthy controls in Taiwan were analyzed. All of The three genetic polymorphisms exhibited insignificant (P > .05) effects on the risk to have oral cancer. However, the patients with polymorphic allele of LEP -2548 have a significant low risk for the development of clinical stage (A/G, AOR = 0.670, 95% CI = 0.454–0.988, P < .05; A/G+G/G, AOR = 0.676, 95% CI = 0.467–0.978, P < .05) compared to patients with ancestral homozygous A/A genotype. Additionally, an interesting result was found that the impact of LEP -2548 G/A SNP on oral carcinogenesis in subjects without tobacco consumption (A/G, AOR=2.078, 95% CI: 1.161-3.720, p=0.014; A/G+G/G, AOR=2.002, 95% CI: 1.143-3.505, p=0.015) is higher than subjects with tobacco consumption. These results suggest that the genetic polymorphism of LEP -2548 G/A (rs7799039), LEPR K109R (rs1137100), and LEPR Q223R (rs1137101) were not associated with the susceptibility of oral cancer; SNP in LEP -2548 G/A showed a poor clinicopathological development of oral cancer; Population without tobacco consumption and with polymorphic LEP -2548 G/A gene may significantly increase the risk to have oral cancer.

Keywords: carcinogen, leptin, leptin receptor, oral squamous cell carcinoma, single nucleotide polymorphism

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Authors: Sonda Jallouli, Sameh Ghroubi, Salma Sakka, Abdelmoneem Yahia, Mohamed Habib Elleuch, Imen Ben Dhia, Chokri Mhiri, Omar Hammouda

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The pathophysiology, prevalence, and progression of MS are gender dependent. Indeed, the inflammation is more pronounced in women, but the neurodegeneration is more important in men. In addition, women have more sleep disorders while men suffer more from cognitive decline. These non-physical disorders can negatively affect postural balance and fall risk. However, no study has examined the difference between men and women in those physical parameters in MS. Our objective was to determine the effect gender difference on postural balance and fall risk in MS persons. Methods: Eight men and twelve women with relapsing remitting-MS participated in this study. The assessment includes a posturographic examination to assess static (with eyes opened (EO) and eyes closed (EC)) and dynamic (with EO) postural balance. Unipedal balance and fall risk were assessed by a clinical unipedal balance test and the Four Square Step Test, respectively. Sleep quality was assessed using Spiegel's questionnaire, and cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA) and the Simple Reaction Time Test. Results: Compared to men, women showed an increase in CdPVm in static bipedal condition with EC (p=0.037; d=0.71) and a decrease in MoCA scores (p=0.028; d=1.06). No gender differences were found in the other tests. Discussion: Static postural balance was more impaired in women compared to men. This result could be explained by the more pronounced cognitive decline observed in women compared to men. Indeed, cognitive disorders have been shown to be predictive factors of postural balance impairment. Conclusion: women were less stable than men in the static condition, possibly due to their lower cognitive performance. This gender difference could be taken into account by therapists in training programs.

Keywords: multiple sclerosis, bipedal postural balance, fall risk, sleep disturbance, cognitive deficiency

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Authors: Mustapha Kamel Mihoubi, Mohamed Essadik Kerkar

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Probabilistic risk analysis models are used to provide a better understanding of the reliability and structural failure of works, including when calculating the stability of large structures to a major risk in the event of an accident or breakdown. This work is interested in the study of the probability of failure of concrete dams through the application of reliability analysis methods including the methods used in engineering. It is in our case, the use of level 2 methods via the study limit state. Hence, the probability of product failures is estimated by analytical methods of the type first order risk method (FORM) and the second order risk method (SORM). By way of comparison, a level three method was used which generates a full analysis of the problem and involves an integration of the probability density function of random variables extended to the field of security using the Monte Carlo simulation method. Taking into account the change in stress following load combinations: normal, exceptional and extreme acting on the dam, calculation of the results obtained have provided acceptable failure probability values which largely corroborate the theory, in fact, the probability of failure tends to increase with increasing load intensities, thus causing a significant decrease in strength, shear forces then induce a shift that threatens the reliability of the structure by intolerable values of the probability of product failures. Especially, in case the increase of uplift in a hypothetical default of the drainage system.

Keywords: dam, failure, limit-state, monte-carlo, reliability, probability, simulation, sliding, taylor

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Authors: Ae Ra Han, Taek Hoo Lee, Sun Zoo Kim, Hwa Young Lee

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Introduction: Ovarian endometrioma is one of the important causes of poor ovarian reserve and up to half of them have recurred. However, the treatment for recurrence prevention has limited efficiency and repeated surgical management makes worsen the ovarian reserve. To find better management for recurrence prevention, we investigated risk factors and biomarkers for the recurrence of ovarian endometrioma. Methods: The medical records of women with the history of surgical dissection for ovarian endometrioma were collected. After exclusion of the cases with concurrent hysterectomy, been menopaused during follow-up, incomplete medical record, and loss of follow-up, a total of 134 women were enrolled. Immunohistochemical staining for progesterone receptor isoform B (PR-B) and nuclear factor kappa B (NFκB) was done with the fixed tissue blocks of their endometriomas which were collected at the time of surgery. Results: Severity of dysmenorrhea and co-existence of adenomyosis had significant correlation with recurrence of endometrioma. Increased PR-B (P = .041) and decreased NFκB (P = .036) immunoreactivity were found in recurrent group. Serum CA-125 level at the time of recurrence was higher than the highest level of CA-125 during follow-up in unrecurred group (55.6 vs. 21.3 U/mL, P = .014). Conclusion: We found that the severity of dysmenorrhea and coexistence of adenomyosis are risk factors for recurrence of ovarian endometrioma, and serial follow-up of CA-125 is effective to detect and prevent the recurrence. However, to determine the possibility of immunoreactivity of PR-B and NFκB as biomarkers for ovarian endometrioma, further studies of various races and large numbers with prospective design are needed.

Keywords: endometriosis, recurrence, biomarker, risk factor

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Authors: Rana F. Obeidat, Suzanne S. Dickerson, Gregory G. Homish, Nesreen M. Alqaissi, Robin M. Lally

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Background: Despite the fact that breast cancer is the most prevalent cancer among Jordanian women, practically nothing is known about their perceptions of early stage breast cancer and surgical treatment. Objective: To gain understanding of the diagnosis and surgical treatment experience of Jordanian women diagnosed with early stage breast cancer. Methods: An interpretive phenomenological approach was used for this study. A purposive sample of 28 Jordanian women who were surgically treated for early stage breast cancer within 6 months of the interview was recruited. Data were collected using individual interviews and analyzed using Heideggerian hermeneutical methodology. Results: Fear had a profound effect on Jordanian women’s stories of diagnosis and surgical treatment of early stage breast cancer. Women’s experience with breast cancer and its treatment was shaped by their pre-existing fear of breast cancer, the disparity in the quality of care at various health care institutions, and sociodemographic factors (e.g., education, age). Conclusions: Early after the diagnosis, fear was very strong and women lost perspective of the fact that this disease was treatable and potentially curable. To control their fears, women unconditionally trusted God, the health care system, surgeons, family, friends, and/or neighbors, and often accepted treatment offered by their surgeons without questioning. Implications for practice: Jordanian healthcare providers have a responsibility to listen to their patients, explore meanings they ascribe to their illness, and provide women with proper education and support necessary to help them cope with their illness.

Keywords: breast cancer, early stage, Jordanian, experience, phenomenology

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Authors: Xiaoxue Jin, Qiong Zhang

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The rapid influx and ongoing flow of young migrants in large cities, alongside the emergence and evolution of new social media, have led to increased interpersonal alienation and weakened place attachment. In the interplay between individuals and space, urban public spaces play a pivotal role in meeting the multifaceted needs of individuals and fostering a sense of attachment. This article aims to investigate the relationship between the place characteristics of public spaces and individuals' needs and perceptions, with an aim to identify the factors influencing place attachment among the youth. This study is conducted in the Shekou community of Shenzhen, focusing on the youth residents to evaluate their place attachment levels and to analyze their perceptions of the place characteristics of selected public spaces. The influencing factors of public spaces on place attachment were sorted out through detailed data analysis. Research has found that rapid urbanization has led to spatial homogenization and spatial segregation caused by uneven resource distribution, which in turn diminishes the utilization of public spaces. The social characteristics of public spaces, such as the quality of social activities and spatial openness, are critical in forming place attachment. In this research, place characteristics impacting place attachment are categorized, aiming to reconstruct the characteristics of public space places and use them as a medium to explore the place attachment of young people, promote their independent creation and participation in public life, and enhance the dynamism between individuals and spaces.

Keywords: place attachment, place characteristics, public spaces, spatial perception

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Authors: Eda Ozkara San

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Nurse educators have been charged by several nursing organizations and accrediting bodies to provide innovative and evidence-based educational experiences, both didactic and clinical, to help students to develop the knowledge, skills, and attitudes needed to provide culturally competent nursing care to patients. Clinical simulation, which offers the opportunity for students to practice nursing skills in a risk-free, controlled environment and helps develop self-efficacy (confidence) within the nursing role. As one simulation method, the standardized patients (SPs) simulation helps educators to teach nursing students variety of skills in nursing, medicine, and other health professions. It can be a helpful tool for nurse educators to enhance cultural competence of nursing students. An alarming gap exists within the literature concerning the effectiveness of SP strategy to enhance cultural competence development of diverse student groups, who must work with patients from various backgrounds. This grant-supported, longitudinal, one-group, pretest and post-test educational intervention study aimed to examine the effect of the Diverse Standardized Patient Simulation (DSPS) cultural competence education strategy on students’ (n = 53) transcultural self-efficacy (TSE). The researcher-developed multidimensional DSPS strategy involved careful integration of transcultural nursing skills guided by the Cultural Competence and Confidence (CCC) model. As a carefully orchestrated teaching and learning strategy by specifically utilizing the SP pedagogy, the DSPS also followed international guidelines and standards for the design, implementation, evaluation, and SP training; and had content validity review. The DSPS strategy involved two simulation scenarios targeting underrepresented patient populations (Muslim immigrant woman with limited English proficiency and Irish-Italian American gay man with his partner (Puerto Rican) to be utilized in a second-semester, nine-credit, 15-week medical-surgical nursing course at an urban public US university. Five doctorally prepared content experts reviewed the DSPS strategy for content validity. The item-level content validity index (I-CVI) score was calculated between .80-1.0 on the evaluation forms. Jeffreys’ Transcultural Self-Efficacy Tool (TSET) was administered as a pretest and post-test to assess students’ changes in cognitive, practical, and affective dimensions of TSE. Results gained from this study support that the DSPS cultural competence education strategy assisted students to develop cultural competence and caused statistically significant changes (increase) in students’ TSE perceptions. Results also supported that all students, regardless of their background, benefit (and require) well designed cultural competence education strategies. The multidimensional DSPS strategy is found to be an effective way to foster nursing students’ cultural competence development. Step-by-step description of the DSPS provides an easy adaptation of this strategy with different student populations and settings.

Keywords: cultural competence development, the cultural competence and confidence model, CCC model, educational intervention, transcultural self-efficacy, TSE, transcultural self-efficacy tool, TSET

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Authors: Karolina Patora

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This article investigates liquidity risk management by banks, which has gained significant importance since the global financial crisis of 2008. The issue is of particular interest for countries like Poland, in which foreign capital plays a dominant role. Such an ownership structure poses certain risks to the local banking sector, which faces an increased probability of the withdrawal of funding or assets’ transfers abroad in case of a crisis. Both these factors can have a detrimental influence on the liquidity position of foreign-owned banks and hence negatively affect the financial stability of the whole banking sector. The aim of this study is to evaluate the impact of a dominating share of foreign investors in the Polish banking sector on the liquidity position of commercial banks. The study hypothesizes that the ownership structure of the Polish banking sector, in which there are banks predominantly controlled by foreign investors, does not pose a threat to the liquidity position of Polish banks. A supplementary research hypothesis is that the liquidity risk profile of foreign-owned banks differs from that of domestic banks. The sample consists of 14 foreign-owned banks and 5 domestic banks owned by local investors, which together constitute approximately 87% of the banking sector’s assets. The data covers the period of 2004–2014. The results of the regression models show no evidence of significant differences in terms of the dynamics of changes of the liquidity buffers between the foreign-owned and domestic banks, although the signs of the coefficients might suggest that the foreign-owned banks were decreasing the holdings of liquid assets at a slower pace over the examined period, compared to the domestic banks. However, no proof of the statistical significance of these findings has been found. The supplementary research hypothesis that the liquidity risk profile of foreign-controlled banks differs from that of domestic banks was rejected.

Keywords: foreign-owned banks, liquidity position, liquidity risk, financial stability

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Authors: Fagner O. Serrano, Danielle R. Bouchard, Todd A. Duhame

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Walking cadence (steps/min) is an effective way to prescribe exercise so an individual can reach a moderate intensity, which is recommended to optimize health benefits. To our knowledge, there is no study on the required walking cadence to reach a moderate intensity for people that present chronic conditions or risk factors for chronic conditions such as Cardiovascular Diseases (CVD). The objectives of this study were: 1- to identify the walking cadence needed for people at risk of CVD to a reach moderate intensity, and 2- to develop and test an equation using clinical variables to help professionals working with individuals at risk of CVD to estimate the walking cadence needed to reach moderate intensity. Ninety-one people presenting a minimum of two risk factors for CVD completed a medically supervised graded exercise test to assess maximum oxygen consumption at the first visit. The last visit consisted of recording walking cadence using a foot pod Garmin FR-60 and a Polar heart rate monitor, aiming to get participants to reach 40% of their maximal oxygen consumption using a portable metabolic cart on an indoor flat surface. The equation to predict the walking cadence needed to reach moderate intensity in this sample was developed as follows: The sample was randomly split in half and the equation was developed with one half of the participants, and validated using the other half. Body mass index, height, stride length, leg height, body weight, fitness level (VO2max), and self-selected cadence (over 200 meters) were measured using objective measured. Mean walking cadence to reach moderate intensity for people age 64.3 ± 10.3 years old at risk of CVD was 115.8  10.3 steps per minute. Body mass index, height, body weight, fitness level, and self-selected cadence were associated with walking cadence at moderate intensity when evaluated in bivariate analyses (r ranging from 0.22 to 0.52; all P values ≤0.05). Using linear regression analysis including all clinical variables associated in the bivariate analyses, body weight was the significant predictor of walking cadence for reaching a moderate intensity (ß=0.24; P=.018) explaining 13% of walking cadence to reach moderate intensity. The regression model created was Y = 134.4-0.24 X body weight (kg).Our findings suggest that people presenting two or more risk factors for CVD are reaching moderate intensity while walking at a cadence above the one officially recommended (116 steps per minute vs. 100 steps per minute) for healthy adults.

Keywords: cardiovascular disease, moderate intensity, older adults, walking cadence

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Authors: Chupicai Manuel

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The global efforts to end child labour have been increasingly challenged by adages of global capitalism, inequalities and poverty affecting the global south. In the face the of rising inequalities whose origin can be explained from historical and political economy analysis between the poor and the rich countries, child labour is also on the rise particularly on the global south. The socio-economic and political context of Zimbabwe has undergone serious transition from colonial times through the post-independence normally referred to as the transition period up to the present day. These transitions have aided companies and entities in the business and agriculture sector to exploit child labour while country provided conditions that enhance child labour due to vulnerability of children and anomic child welfare system that plagued the country. Children from marginalised communities dominated by plantations and farms are affected most. This paper explores the experiences and perceptions of children working in tea estates, plantations and farms, and the adults who formerly worked in these plantations during their childhood to share their experiences and perceptions on child labour in Zimbabwe. Childhood theories that view children as apprentices and a human rights perspectives were employed to interrogate the concept of childhood, child labour and poverty alleviation strategies. Phenomenological research design was adopted to describe the experiences of children working in plantations and interpret the meanings they have on their work and livelihoods. The paper drew form 30 children from two plantations through semi-structured interviews and 15 key informant interviews from civil society organisations, international labour organisation, adults who formerly worked in the plantations and the personnel of the plantations. The findings of the study revealed that children work on the farms as an alternative model for survival against economic challenges while the majority cited that poverty compel them to work and get their fees and food paid for. Civil society organisations were of the view that child rights are violated and the welfare system of the country is malfunctional. The perceptions of the majority of the children interviewed are that the system on the plantations is better and this confirmed the socio-constructivist theory that views children as apprentices. The study recommended child sensitive policies and welfare regime that protects children from exploitation together with policing and legal measures that secure child rights.

Keywords: child labour, child rights, phenomenology, poverty reduction

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Authors: H. Ju, M. Jones, G. D. Mishra

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Introduction: Limited longitudinal studies have examined the relationship between BMI and dysmenorrhea, resulting in mixed results. This study aims to investigate the long-term association between BMI and dysmenorrhea. Methods: 9,688 women from Australian Longitudinal Study on Women’s Health (ALSWH), a prospective population-based cohort study, were followed for 13 years. Data were collected through self-reported questionnaires repeatedly on all variables, including dysmenorrhea, weight and height. The longitudinal association between dysmenorrhea and BMI or BMI transition (change of BMI categories between two successive surveys) was investigated by generalized estimating equations. Results: When the women were aged 22 to 27 years, approximately 11% were obese, 7% underweight, and 25% reported dysmenorrhea. Over the study period, the prevalence of obesity doubled whereas that of underweight declined substantially. The prevalence of dysmenorrhea remained relatively stable. Compared to women with a normal weight, significantly higher odds of reporting dysmenorrhea were detected for both women who were underweight (odds ratio (OR) 1.25, 95% confidence interval (CI) 1.09, 1.43) and obese (OR 1.20, 95% CI 1.10, 1.31). Being overweight was not associated with increased risk of dysmenorrhea. Compared to women who remained at normal weight or overweight over time, significant risk was detected for women who: remained underweight or obese (OR 1.35, 95% CI 1.23, 1.49), were underweight but became normal or overweight (OR 1.29, 95% CI 1.11, 1.50), became underweight (OR 1.24, 95% CI 1.01, 1.52). However, the higher risk among obese women disappeared when they lost weight and became normal weight or overweight (OR 1.07, 95% CI 0.87, 1.30). Conclusions: A U-shaped association was revealed between dysmenorrhea and BMI, revealing higher risk of dysmenorrhea for both underweight and obese women. Further, the risk disappeared when obese women lost weight and acquired a healthier BMI. However obesity certainly poses a greater burden of disease from the public health perspective, thus requires greater effort to tackle the increasing problem at the population level. It is important to maintain a healthy weight over time for women to enjoy a better reproductive health.

Keywords: body mass index, dysmenorrhea, obesity, painful period, underweight

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Authors: Noran Adel Emara, Elham Ghazi Mohammad

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Qatar University is engaged in a systemic education reform that includes integrating the latest and most effective technologies for teaching and learning. ICube is high-immersive virtual reality technology is used to teach educational scenarios that are difficult to teach in real situations. The trends toward delivering science education via virtual reality applications have accelerated in recent years. However, research on students perceptions of integrating virtual reality especially ICube technology is somehow limited. Students often have difficulties focusing attention on learning science topics that require imagination and easily lose attention and interest during the lesson. The aim of this study was to examine students’ perception of integrating ICube technology in the solar system lesson. Moreover, to explore how ICube could engage students in learning scientific concept of the solar system. The research framework included the following quantitative research design with data collection and analysis from questionnaire results. The solar system lesson was conducted by teacher candidates (Diploma students) who taught in the ICube virtual lab in Qatar University. A group of 30 students from eighth grade were randomly selected to participate in the study. Results showed that the students were extremely engaged in learning the solar system and responded positively to integrating ICube in teaching. Moreover, the students showed interest in learning more lessons through ICube as it provided them with valuable learning experience about complex situations.

Keywords: ICube, integrating technology, science education, virtual reality

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Authors: Kalpana Rajouriya, Ajay Taneja

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Particulates are ubiquitous in the air environment and cause serious threats to human beings, such as lung cancer, COPD, and Asthma. Particulates mainly arise from industrial effluent, vehicular emission, and other anthropogenic activities. In the glass industrial city Firozabad, real-time monitoring of size segregated Particulate Matter (PM) and black carbon was done by Aerosol Black Carbon Detector (ABCD) and GRIMM portable aerosol Spectrometer at two different sites in which one site is urban and another is rural. The average mass concentration of size segregated PM during the study period (March & April 2022) was recorded as PM10 (223.73 g/m⁻³), PM5.0 (44.955 g/m⁻³), PM2.5 (59.275 g/m⁻³), PM1.0 (33.02 g/m⁻³), PM0.5 (2.05 g/m⁻³), and PM0.25 (2.99 g/m⁻³). The highest concentration of BC was found in Urban due to the emissions from diesel engines and wood burning, while NO2 was highest at the rural sites. The average concentrations of PM10 (6.08 and 2.73 times) PM2.5 exceeded the NAAQS and WHO guidelines. Particulate Matter deposition and health risk assessment was done by MPPD and USEPA model to know about the particulate matter toxicity in industrial residents. Health risk assessment results showed that Children are most likely to be affected by exposure of PM10 and PM2.5 and may have various non-carcinogenic and carcinogenic diseases. Deposition results inferred that the sensitive exposed population, especially 9 years old children, have high PM deposition as well as visualization and may be at risk of developing health-related problems from exposure to size-segregated PM. They will be discussed during presentation.

Keywords: particulate matter, black carbon, NO2, deposition of PM, health risk

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

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

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

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Authors: Aparna Lal, Ashwin Swaminathan, Teisa Holani

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

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

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Authors: Anne-Marie Dionne

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Teacher reading aloud to students is a practice that is well established in preschool and primary classrooms. Many benefits of this pedagogical activity have been highlighted in multiple studies. However, it has also been shown that teachers are not keen on choosing informational texts for their read aloud, as their selections for this venue are mainly fictional stories, mostly written in a unique narrative story-like structure. Considering that students soon have to read complex informational texts by themselves as they go from one grade to another, there is cause for concern because those who do not benefit from an early exposure to informational texts could be lacking knowledge of informational text structures that they will encounter regularly in their reading. Exposing students to informational texts could be done in different ways in classrooms. However, since read aloud appears to be such a common and efficient practice in preschool and primary grades, it is important to examine more deeply the factors taken into account by teachers when they are selecting their readings for this important teaching activity. Moreover, it seems critical to know why teachers are not inclined to choose more often informational texts when they are reading aloud to their pupils. A group of 22 preschool or primary grade teachers participated in this study. The data collection was done by a survey and an individual semi-structured interview. The survey was conducted in order to get quantitative data on the read-aloud practices of teachers. As for the interviews, they were organized around three categories of questions (exploratory, analytical, opinion) regarding the process of selecting the texts for the read-aloud sessions. A statistical analysis was conducted on the data obtained by the survey. As for the interviews, they were subjected to a content analysis aiming to classify the information collected in predetermined categories such as the reasons given to favor fictional texts over informative texts, the reasons given for avoiding informative texts for reading aloud, the perceptions of the challenges that the informative texts could bring when they are read aloud to students, and the perceived advantages that they would present if they were chosen more often for this activity. Results are showing variable factors that are guiding the teachers when they are making their selection of the texts to be read aloud. As for example, some of them are choosing solely fictional texts because of their convictions that these are more interesting for their students. They also perceive that the informational texts are not good choices because they are not suitable for pleasure reading. In that matter, results are pointing to some interesting elements. Many teachers perceive that read aloud of fictional or informational texts have different goals: fictional texts are read for pleasure and informational texts are read mostly for academic purposes. These results bring out the urgency for teachers to become aware of the numerous benefits that the reading aloud of each type of texts could bring to their students, especially the informational texts. The possible consequences of teachers’ perceptions will be discussed further in our presentation.

Keywords: fictional texts, informational texts, preschool or primary grade teachers, reading aloud

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

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

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

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Authors: Chie Urawa

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Cautionary statements or disclaimers in corporate annual reports need to be carefully designed because clear cautionary statements may protect a company in the case of legal disputes and may undermine positive impressions. This study compares the language of cautionary statements using two corpora, Sony’s cautionary statement corpus (S-corpus) and Panasonic’s cautionary statement corpus (P-corpus), illustrating the differences and similarities in relation to the use of meaningful cautionary statements and critically analyzing why practitioners use the way. The findings describe the distinct differences between the two companies in the presentation of the risk factors and the way how they make the statements. The word ability is used more for legal protection in S-corpus whereas the word possibility is used more to convey a better impression in P-corpus. The main similarities are identified in the use of lexical words and pronouns, and almost the same wordings for eight years. The findings show how they make the statements unique to the company in the presentation of risk factors, and the characteristics of specific genre of professional communication. Important implications of this study are that more comprehensive approach can be applied in other contexts, and be used by companies to reflect upon their cautionary statements.

Keywords: cautionary statements, corporate annual reports, corpus, risk factors

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Authors: Zikra Faiz, Nisar Abid, Muhammad Waqas

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This study aim to examine the challenges faced by teachers during teaching to those students who are intellectually disable, suffering from autism spectrum disorder, learning disability, and ADHD at the primary level. The descriptive research design of quantitative approach was adopted to conduct this study; a cross-sectional survey method was used to collect data. The sample was comprised of 258 (43 male and 215 female) teachers who teach at special education institutes of Lahore district selected through proportionate stratified random sampling technique. Self-developed questionnaire was used which was comprised of 22 closed-ended items. Collected data were analyzed through descriptive and inferential statistical techniques by using Statistical Package for Social Sciences (SPSS) version 21. Results show that teachers faced problems during group activities, to handle bad behavior and different disabilities of students. It is concluded that there was a significant difference between male and female teachers perceptions about challenges faced during teaching with developmental disable students. Furthermore, there was a significant difference exist in the perceptions of teachers regarding challenges faced during teaching to students with developmental disabilities in term of teachers’ age and area of specialization. It is recommended that developmentally disable student require extra attention so that, teacher should trained through pre-service and in-service training to teach developmentally disabled students.

Keywords: intellectual disability, autism spectrum disorder, ADHD, learning disability

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Authors: Nyla Anjum, Humaira Bano

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Disability, regardless of its type and nature limits one or two significant life activities. These limitations constitute risk factors for suicide. Rate and intensity of problem upsurges in critical age of adolescence. Researches in the field of mental health over look problem of suicide among persons with disability. Aim of the study was to investigate prevalence and risk factors for suicide among adolescents with disability. The study constitutes purposive sample of 106 elements of both gender with four major categories of disability: hearing impairment, physical impairment, visual impairment and intellectual disabilities. Face to face interview technique was opted for data collection. Other variable are: socio-economic status, social and family support, provision of services for persons with disability, education and employment opportunities. For data analysis independent sample t-test was applied to find out significant differences in gender and One Way Analysis of variance was run to find out differences among four types of disability. Major predictors of suicide were identified with multiple regression analysis. It is concluded that ideation, plans and attempts of suicide among adolescents with disability is a multifaceted and imperative concern in the area of mental health. Urgent research recommendations contains valid measurement of suicide rate and identification of more risk factors for suicide among persons with disability. Study will also guide towards prevention of this pressing problem and will bring message of happy and healthy life not only for persons with disability but also for their families. It will also help to reduce suicide rate in society.

Keywords: suicide, risk factors, adolescent, disability, mental health

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