Search results for: health risk

Authors: Malki Nadia Fatima Zahra, Kellal Chaimaa, Brahimi Houria

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Quality is one of the most important modern management patterns that organizations seek to achieve in all areas and sectors in order to meet the needs and desires of customers and to remain continuity, as they constitute a competitive advantage for the organization, and among the most prominent organizations that must be available on the quality factor are health organizations as they relate to the most valuable component of production It is a person and his health, and that any error in it threatens his life and may lead to death, so she must provide health services of high quality to achieve the highest degree of satisfaction for the patient. This research aims to study the quality of health services and the extent of their impact on patient satisfaction, and this is through an applied study that relied on measuring the level of quality of health services in the university hospital center of Algeria and the extent of their impact on patient satisfaction according to the dimensions of the quality of health services, and we reached a conclusion that the determinants of the quality of health services. It affects patient satisfaction, which necessitates developing health services according to patients' requirements and improving their quality to obtain patient satisfaction.

Keywords: health service, health quality, quality determinants, patient satisfaction

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Authors: Mukesh Ravi Raushan

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Despite consideration of obesity as a deadly public health issue contributing 2.6 million deaths worldwide every year developing country like India is facing malnutrition and it is more common than in Sub-Saharan Africa. About one in every three malnourished children in the world lives in India. The paper assess the nutritional health among children using data from total number of 43737 infant and young children aged 0-59 months (µ = 29.54; SD = 17.21) of the selected households by National Family Health Survey, 2005-06. The wasting was measured by a Z-score of standardized weight-for-height according to the WHO child growth standards. The impact of education with place of residence was found to be significantly associated with the complementary food diversity score (CFDS) in India. The education of mother was positively associated with the CFDS but the degree of performance was lower in rural India than their counterpart from urban. The result of binary logistic regression on wasting with WHO seven types of recommended food for children in India suggest that child who consumed the milk product food (OR: 0.87, p<0.0001) were less likely to be malnourished than their counterparts who did not consume, whereas, in case of other food items as the child who consumed food product of seed (OR: 0.75, p<0.0001) were less likely to be malnourished than those who did not. The nutritional status among children were negatively associated with the protein containing complementary food given the child as those child who received pulse in last 24 hour were less likely to be wasted (OR: 0.87, p<0.00001) as compared to the reference categories. The frequency to feed the indexed child increases by 10 per cent the expected change in child health outcome in terms of wasting decreases by 2 per cent in India when place of residence, education, religion, and birth order were controlled. The index gets improved as the risk for malnutrition among children in India decreases.

Keywords: CFDS, food diversity index, India, logistic regression

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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: Deborah Weidner, Melissa Morgera

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The model of care delivery in the Behavioral Health Network (BHN) is integrated across all five regions of Hartford Healthcare and thus spans the entirety of the state of Connecticut, with care provided in seven inpatient settings and over 30 ambulatory outpatient locations. While safety has been a core priority of the BHN in alignment with High Reliability practices, safety initiatives have historically been facilitated locally in each region or within each entity, with interventions implemented locally as opposed to throughout the network. To address this, the BHN introduced a network wide Safety Huddle during 2022. Launched in January, the BHN Safety Huddle brought together internal stakeholders, including medical and administrative leaders, along with executive institute leadership, quality, and risk management. By bringing leaders together and introducing a network-wide safety huddle into the way we work, the benefit has been an increase in awareness of safety events occurring in behavioral health areas as well as increased systemization of countermeasures to prevent future events. One significant discussion topic presented in huddles has pertained to environmental design and patient access to potentially dangerous items, addressing some of the most relevant factors resulting in harm to patients in inpatient and emergency settings for behavioral health patients. The safety huddle has improved visibility of potential environmental safety risks through the generation of over 15 safety alerts cascaded throughout the BHN and also spurred a rapid improvement project focused on standardization of patient belonging searches to reduce patient access to potentially dangerous items on inpatient units. Safety events pertaining to potentially dangerous items decreased by 31% as a result of standardized interventions implemented across the network and as a result of increased awareness. A second positive outcome originating from the BHN Safety Huddle was implementation of a recommendation to increase the emergency Narcan®(naloxone) supply on hand in ambulatory settings of the BHN after incidents involving accidental overdose resulted in higher doses of naloxone administration. By increasing the emergency supply of naloxone on hand in all ambulatory and residential settings, colleagues are better prepared to respond in an emergency situation should a patient experience an overdose while on site. Lastly, discussions in safety huddle spurred a new initiative within the BHN to improve responsiveness to assaultive incidents through a consultation service. This consult service, aligned with one of the network’s improvement priorities to reduce harm events related to assaultive incidents, was borne out of discussion in huddle in which it was identified that additional interventions may be needed in providing clinical care to patients who are experiencing multiple and/ or frequent safety events.

Keywords: quality, safety, behavioral health, risk management

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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: Sadaf Salek

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Introduction: Cats are susceptible to various health conditions, and one such ailment that can affect their oral health is epulis in their lips. Epulis refers to a benign tumor or growth that can develop in different areas of a cat's mouth, including the lips. While epulis is not life-threatening, it can still cause discomfort and affect a cat's overall quality of life. This essay aims to delve into the causes, symptoms, and treatment options for epulis in cat's lips, shedding light on this lesser-known oral condition. Causes: Epulis in a cat's lips can have several causes. Firstly, genetic predisposition plays a significant role, with certain breeds being more prone to developing these growths. Secondly, chronic irritation to the mouth, such as from dental diseases or foreign objects, can also contribute to the development of epulis. Lastly, hormonal imbalances, specifically an excess of estrogen, have been associated with the occurrence of these tumors in cats. Understanding these causes can help cat owners take preventive measures to reduce the risk of epulis in their feline companions. Symptoms: Identifying the symptoms of epulis in a cat's lips is vital for early intervention and effective treatment. The most common symptoms include swelling, redness, and the presence of a visible growth or lump on the lip. Cats with epulis may also exhibit drooling, difficulty eating, and a reluctance to groom themselves. Any change in eating habits or oral behavior should not be overlooked and prompt a visit to the veterinarian for a thorough examination. Treatment ptions: When it comes to treating epulis in a cat's lips, various options are available, depending on the size, location, and characteristics of the growth. The primary treatment involves surgical removal of the tumor. This procedure should be performed by a qualified veterinarian, ensuring complete excision of the mass while preserving as much healthy tissue as possible. In some cases, radiation therapy may be necessary, especially if the tumor is large or aggressive. Additionally, a veterinarian may recommend oral hygiene care and regular dental cleaning to prevent further growths and maintain the cat's oral health. Prevention and Care: Preventing epulis in a cat's lips is not always possible, especially if genetic factors are involved. However, certain preventive measures can minimize the risk of these growths. Maintaining good oral hygiene through regular brushing and the use of appropriate dental products can help prevent chronic irritation and dental diseases. Routine veterinary check-ups should also include thorough oral examinations to detect any abnormal growths or changes in the mouth at an early stage. Pet owners should be observant and seek veterinary care promptly for any signs of discomfort or changes in eating habits. Conclusion: Epulis in a cat's lips is a condition that requires attention and proper treatment. Understanding the causes, identifying symptoms, and exploring treatment options are of utmost importance to help improve a cat's oral health and overall well-being.

Keywords: fibroma, cat, lip, epulis

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Authors: Haftay Abraha Tadesse

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Background: Staphylococcus is a genus of worldwide distributed bacteria correlated to several infectious of different sites in human and animals. They are among the most important causes of infection that are associated with the consumption of contaminated food. Objective: The objective of this study was to determine the isolates, antimicrobial susceptibility patterns and public health significance for Staphylococcus aureus in raw meat from butchery and abattoir houses of Mekelle, Northern Ethiopia. Methodology: A cross-sectional study was conducted from April to October 2019. Sociodemographic data and public health significance were collected using predesigned questionnaire. The raw meat samples were collected aseptically in the butchery and abattoir houses and transported using ice box to Mekelle University, College of Veterinary Sciences for isolating and identification of Staphylococcus aureus. Antimicrobial susceptibility tests were determined by disc diffusion method. Data obtained were cleaned and entered in to STATA 22.0 and logistic regression model with odds ratio were calculated to assess the association of risk factors with bacterial contamination. P-value < 0.05 was considered as statistically significant. Results: In present study, 88 out of 250 (35.2%) were found to be contamination with Staphylococcus aureus. Among the raw meat specimens to be positivity rate of Staphylococcus aureus were 37.6% (n=47) and (32.8% (n=41), butchery and abattoir houses, respectively. Among the associated risk factories not using gloves reduces risk was found to (AOR=0.222; 95% CI: 0.104-0.473), Strict Separation b/n clean & dirty (AOR= 1.37; 95% CI: 0.66-2.86) and poor habit of hand washing (AOR=1.08; 95%CI: 0.35-3.35) were found to be statistically significant and ha ve associated with Staphylococcus aureus contamination. All isolates thirty sevevn of Staphyloco ccus aureus were checked displayed (100%) sensitive to doxycycline, trimethoprim, gentamicin, sulphamethoxazole, amikacin, CN, Co trimoxazole and nitrofurantoi. whereas the showed resistance of cefotaxime (100%), ampicillin (87.5%), Penicillin (75%), B (75%), and nalidixic acid (50%) from butchery houses. On the other hand, all isolates of Staphylococcus aur eu isolate 100% (n= 10) showed sensitive chloramphenicol, gentamicin and nitrofurantoin whereas the showed 100% resistance of Penicillin, B, AMX, ceftriaxone, ampicillin and cefotaxime from abattoirs houses. The overall multi drug resistance pattern for Staphylococcus aureus were 90% and 100% of butchery and abattoirs houses, respectively. Conclusion: 35.3% Staphylococcus aureus isolated were recovered from the raw meat samples collected from the butchery and abattoirs houses. More has to be done in the developed of hand washing behavior, and availability of safe water in the butchery houses to reduce burden of bacterial contamination. The results of the present finding highlight the need to implement protective measures against the levels of food contamination and alternative drug options. The development of antimicrobial resistance is nearly always as a result of repeated therapeutic and/or indiscriminate use of them. Regular antimicrobial sensitivity testing helps to select effective antibiotics and to reduce the problems of drug resistance development towards commonly used antibiotics. Key words: abattoir houses, antimicrobial resistance, butchery houses, Ethiopia,

Keywords: abattoir houses, antimicrobial resistance, butchery houses, Ethiopia, staphylococcus aureuse, MDR

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Authors: Muntanavadee Maytapattana

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This research aims to study the effects of the Parent Training Program for Obesity Reduction (PTPOR) on child waist circumference and health behaviors of pre-school children at the Samut-Songkhram kindergarten school, Samut-Songkhram province, Thailand. The objective of this research is to evaluate the effectiveness of the PTPOR on child waist circumference and health behaviors of the pre-school children. The conceptual framework of this study is developed on the basis of the Ecological Systems Theory (EST), not only do the individual factors such as child characteristics and child risk factors contribute to the child’s weight status, but also other factors such as parenting style and family characteristics, as well as community and demographic factors. This research is a quasi-experimental study. Participants were pre-school overweight and obese children and their parents. Forty-one parent-child dyads were recruited into the program. Parents participated in two sessions including an educational session and a group discussion session. Research methodology uses Paired-Samples t-test to determine the difference between groups in the mean scores of the outcome variables of the children and parents. The research results show that there was significant difference between child waist circumferences mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child waist circumference was decrease after finishing the program. And there was no significant difference between child exercise health behaviors mean score at the baseline and finishing the program at the 0.05 level; however, mean score of the child exercise behavior was increase after finishing the program. Meanwhile, there was significant difference between child dietary health behavior mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child dietary was increase after finishing the program.

Keywords: PTPOR, child waist circumference, child health behaviors, pre-school children

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Authors: Abid I. Abu-Tair, Gavin M. Wilde, John M. Kinuthia

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Urban Search and Rescue (USAR) is a functional capability that has been developed to allow the United Kingdom Fire and Rescue Service to deal with ‘major incidents’ primarily involving structural collapse. The nature of the work undertaken by USAR means that staying out of a damaged or collapsed building structure is not usually an option for search and rescue personnel. As a result, there is always a risk that they could become victims. For this paper, a systematic and investigative review using desk research was undertaken to explore the role which structural engineering can play in assisting search and rescue personnel to conduct structural assessments when in the field. The focus is on how search and rescue personnel can assess damaged and collapsed building structures, not just in terms of the structural damage that may be countered, but also in relation to structural stability. Natural disasters, accidental emergencies, acts of terrorism and other extreme events can vary significantly in nature and ferocity, and can cause a wide variety of damage to building structures. It is not possible or, even realistic, to provide search and rescue personnel with definitive guidelines and procedures to assess damaged and collapsed building structures as there are too many variables to consider. However, understanding what implications damage may have upon the structural stability of a building structure will enable search and rescue personnel to judge better and quantify the risk from a life-safety standpoint. It is intended that this will allow search and rescue personnel to make informed decisions and ensure every effort is made to mitigate risk so that they do not become victims.

Keywords: damaged and collapsed building structures, life safety, quantifying risk, search and rescue personnel, structural assessments in the field

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Authors: Siamak Feizi, Gunvor Baardvik

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Soil erosion has special consequences for landfills that are more serious than those found at conventional construction sites. Different potential heads between two sides of a landfill and the subsequent movement of water through pores within the soil body could trigger the soil erosion and construction instability. Such a condition was encountered in a landfill project in the southern part of Norway. To check the risk of internal erosion due to changes in the groundwater level (because of seasonal flooding in the river), a series of numerical simulations by means of Geo-Seep software was conducted. Output of this study provides a total picture of the landfill stability, possibilities of erosions, and necessary measures to prevent or reduce the risk for the landfill operator.

Keywords: erosion, seepage, landfill, stability

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Authors: Karuna Sutthibenjakul, Sunisa Chatmongkolchart

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Background: Postinduction hypotension is common and occurs more often in elderly patients. We aimed to determine risk factors for hypotension after induction among elderly patients (aged 65 years and older) who underwent elective non-cardiac surgery under general anesthesia. Methods: This cohort study analyzed from 580 data between December 2017 and July 2018 at a tertiary university hospital in south of Thailand. Hypotension is defined as more than 30% decrease mean arterial pressure from baseline after induction within 20 minutes or the use of vasopressive agent to treat low blood pressure. Intraoperative parameters were blood pressure and heart rate at T0, TEI, T5, T10, T15 and T20 (immediately after arrival at operating room, time after intubation, 5, 10, 15 and 20 minutes after intubation) respectively. Results: The median age was 72.5 (68, 78) years. A prevalence of post-induction hypotension was 64.8%. The highest prevalence (39.7%) was at 15 minutes after intubation. The association of post-induction hypotension is rising with diuretic drug as preoperative medication (P-value=0.016), hematocrit level (P-value=0.031) and the degree of hypertension immediately after arrival at operating room (P-value<0.001). Increasing fentanyl dosage during induction was associated with hypotension at intubation time (P-value<0.01) and 5 minutes after intubation (P-value<0.001). There was no statistically significant difference in the increasing propofol dosage. Conclusion: The degree of hypertension immediately after arrival at operating room and increasing fentanyl dosage were a significant risk factors for postinduction hypotension in elderly patients.

Keywords: risk factors, post-induction, hypotension, elderly

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Authors: Lutfi Abosrra, Alseddeq Alabaoub, Nuri Elhaloudi

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Corrosion processes in the Oil & Gas industry can lead to failures that are usually costly to repair, costly in terms of loss of contaminated product, in terms of environmental damage and possibly costly in terms of human safety. This article describes the results of the corrosion review and criticality assessment done at Mellitah Gas (SRU unit) for pressure equipment and piping system. The information gathered through the review was intended for developing a qualitative RBI study. The corrosion criticality assessment has been carried out by applying company procedures and industrial recommended practices such as API 571, API 580/581, ASME PCC 3, which provides a guideline for establishing corrosion integrity assessment. The corrosion review is intimately related to the probability of failure (POF). During the corrosion study, the process units are reviewed by following the applicable process flow diagrams (PFDs) in the presence of Mellitah’s personnel from process engineering, inspection, and corrosion/materials and reliability engineers. The expected corrosion damage mechanism (internal and external) was identified, and the corrosion rate was estimated for every piece of equipment and corrosion loop in the process units. A combination of both Consequence and Likelihood of failure was used for determining the corrosion risk. A qualitative consequence of failure (COF) for each individual item was assigned based on the characteristics of the fluid as per its flammability, toxicity, and pollution into three levels (High, Medium, and Low). A qualitative probability of failure (POF)was applied to evaluate the internal and external degradation mechanism, a high-level point-based (0 to 10) for the purpose of risk prioritizing in the range of Low, Medium, and High.

Keywords: corrosion, criticality assessment, RBI, POF, COF

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Authors: Morello Sara, Pederiva Sabina, Bianchi Manila, Martucci Francesca, Marchis Daniela, Decastelli Lucia

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Vegetables represent an integral part of a healthy diet due to their valuable nutritional properties and the growth in consumer demand in recent years is particularly remarkable for a diet rich in vitamins and micronutrients. However, plant-based products are involved in several food outbreaks connected to various sources of contamination and quite often, bacteria responsible for side effects showed high resistance to antibiotics. The abuse of antibiotics can be one of the main mechanisms responsible for increasing antibiotic resistance (AR). Plants grown for food use can be contaminated directly by spraying antibiotics on crops or indirectly by treatments with antibiotics due to the use of manure, which may contain both antibiotics and genes of antibiotic resistance (ARG). Antibiotic residues could represent a potential way of human health risk due to exposure through the consumption of plant-based foods. The presence of antibiotic-resistant bacteria might pose a particular risk to consumers. The present work aims to investigate through a multidisciplinary approach the occurrence of ARG by means of a biomolecular approach (PCR) and the prevalence of antibiotic residues using a multi residues LC-MS/MS method, both in different plant-based products. During the period from July 2020 to October 2021, a total of 74 plant samples (33 lettuces and 41 tomatoes) were collected from 57 farms located throughout the Piedmont area, and18 out of 74 samples (11 lettuces and 7 tomatoes) were selected to LC-MS/MS analyses. DNA extracted (ExtractME, Blirt, Poland) from plants used on crops and isolated bacteria were analyzed with 6 sets of end-point multiplex PCR (Qiagen, Germany) to detect the presence of resistance genes of the main antibiotic families, such as tet genes (tetracyclines), bla (β-lactams) and mcr (colistin). Simultaneous detection of 43 molecules of antibiotics belonging to 10 different classes (tetracyclines, sulphonamides, quinolones, penicillins, amphenicols, macrolides, pleuromotilines, lincosamides, diaminopyrimidines) was performed using Exion LC system AB SCIEX coupled to a triple quadrupole mass spectrometer QTRAP 5500 from AB SCIEX. The PCR assays showed the presence of ARG in 57% (n=42): tetB (4.8%; n=2), tetA (9.5%; n=4), tetE (2.4%; n=1), tetL (12%; n=5), tetM (26%; n=11), blaSHV (21.5%; n=9), blaTEM (4.8%; n =2) and blaCTX-M (19%; n=8). In none of the analyzed samples was the mcr gene responsible for colistin resistance detected. Results obtained from LC-MS/MS analyses showed that none of the tested antibiotics appear to exceed the LOQ (100 ppb). Data obtained confirmed the presence of bacterial populations containing antibiotic resistance determinants such as tet gene (tetracycline) and bla genes (beta-lactams), widely used in human medicine, which can join the food chain and represent a risk for consumers, especially with raw products. The presence of traces of antibiotic residues in vegetables, in concentration below the LOQ of the LC-MS/MS method applied, cannot be excluded. In conclusion, traces of antibiotic residues could be a health risk to the consumer due to potential involvement in the spread of AR. PCR represents a useful and effective approach to characterize and monitor AR carried by bacteria from the entire food chain.

Keywords: plant-based products, ARG, PCR, antibiotic residues

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Authors: Ananya Pappu, Sneha Mishra

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Introduction: The South Asian population experiences unique health challenges that predisposes this demographic to cardiometabolic diseases at lower BMIs. South Asians may therefore benefit from recommendations specific to their cultural needs. Here, we focus on current BMI guidelines for Asians with a discussion of South Asian dietary practices and culturally tailored interventions. By integrating traditional dietary practices with modern nutritional recommendations, this manuscript aims to highlight effective strategies to improving health outcomes among South Asians. Background: The South Asian community, including individuals from India, Pakistan, Bangladesh, and Sri Lanka, experiences high rates of cardiovascular diseases, cancers, diabetes, and strokes. Notably, the prevalence of diabetes and cardiovascular disease among Asians is elevated at BMIs below the WHO's standard overweight threshold. As it stands, a BMI of 25-30 kg/m² is considered overweight in non-Asians, while this cutoff is reduced to 23-27.4 kg/m² in Asians. This discrepancy can be attributed to studies which have shown different associations between BMI and health risks in Asians compared to other populations. Given these significant challenges, optimizing lifestyle management for cardiometabolic risk factors is crucial. Tailored interventions that consider cultural context seem to be the best approach for ensuring the success of both dietary and physical activity interventions in South Asian patients. Adopting a whole food, plant-based diet (WFPD) is one such strategy. The WFPD suggests that half of one meal should consist of non-starchy vegetables. In the South Asian diet, this includes traditional vegetables such as okra, tindora, eggplant, and leafy greens including amaranth, collards, chard, and mustards. A quarter of the meal should include plant-based protein sources like cooked beans, lentils, and paneer, with the remaining quarter comprising healthy grains or starches such as whole wheat breads, millets, tapioca, and barley. Adherence to the WFPD has been shown to improve cardiometabolic risk factors including weight, BMI, total cholesterol, HbA1c, and reduces the risk of developing non-alcoholic fatty liver disease (NAFLD). Another approach to improving dietary habits is timing meals. Many of the major cultures and religions in the Indian subcontinent incorporate religious fasting. Time-restricted eating (TRE), also known as intermittent fasting, is a practice akin to traditional fasting, which involves consuming all daily calories within a specific window. TRE has been shown to improve insulin resistance in prediabetic and diabetic patients. Common regimens include completing all meals within an 8-hour window, consuming a low-calorie diet every other day, and the 5:2 diet, which involves fasting twice weekly. These fasting practices align with the natural circadian rhythm, potentially enhancing metabolic health and reducing obesity and diabetes risks. Conclusion: South Asians develop cardiometabolic disease at lower BMIs; hence, it is important to counsel patients about lifestyle interventions that decrease their risk. Traditional South Asian diets can be made more nutrient-rich by incorporating vegetables, plant proteins like lentils and beans, and substituting refined grains for whole grains. Ultimately, the best diet is one to which a patient can adhere. It is therefore important to find a regimen that aligns with a patient’s cultural and traditional food practices.

Keywords: BMI, diet, obesity, South Asian, time-restricted eating

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Authors: Muhammad Wahb

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Physical activity is increasingly recognized as a significant factor in maintaining optimal health and preventing chronic diseases. This research scrutinizes the long-term health benefits of sustained physical activity, employing a systematic review of epidemiological studies and randomized control trials conducted over the past decade. The study illuminates the protective effects of regular physical activity against cardiovascular disease, obesity, diabetes, and mental health disorders, with a special focus on the mechanisms involved. Furthermore, the paper provides insights into how public health initiatives can effectively promote physical activity among diverse populations, contributing to improved community health outcomes.

Keywords: physical activity, long-term health benefits, chronic disease prevention, public health

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Authors: Erica Cochran Hameen, Bobuchi Ken-Opurum, Mounica Guturu

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The United Stated (U.S.) populous spends the majority of their time indoors in spaces where building codes and voluntary sustainability standards provide clear Indoor Environmental Quality (IEQ) metrics. The existing sustainable building standards and codes are aimed towards improving IEQ, health of occupants, and reducing the negative impacts of buildings on the environment. While they address the post-occupancy stage of buildings, there are fewer standards on the pre-occupancy stage thereby placing a large labor population in environments much less regulated. Construction personnel are often exposed to a variety of uncomfortable and unhealthy elements while on construction sites, primarily thermal, visual, acoustic, and air quality related. Construction site power generators, equipment, and machinery generate on average 9 decibels (dBA) above the U.S. OSHA regulations, creating uncomfortable noise levels. Research has shown that frequent exposure to high noise levels leads to chronic physiological issues and increases noise induced stress, yet beyond OSHA no other metric focuses directly on the impacts of noise on contractors’ well-being. Research has also associated natural light with higher productivity and attention span, and lower cases of fatigue in construction workers. However, daylight is not always available as construction workers often perform tasks in cramped spaces, dark areas, or at nighttime. In these instances, the use of artificial light is necessary, yet lighting standards for use during lengthy tasks and arduous activities is not specified. Additionally, ambient air, contaminants, and material off-gassing expelled at construction sites are one of the causes of serious health effects in construction workers. Coupled with extreme hot and cold temperatures for different climate zones, health and productivity can be seriously compromised. This research evaluates the impact of existing green building metrics on construction and risk management, by analyzing two codes and nine standards including LEED, WELL, and BREAM. These metrics were chosen based on the relevance to the U.S. construction industry. This research determined that less than 20% of the sustainability context within the standards and codes (texts) are related to the pre-occupancy building sector. The research also investigated the impact of construction personnel’s health and well-being on construction management through two surveys of project managers and on-site contractors’ perception of their work environment on productivity. To fully understand the risks of limited Environmental and Health Quality metrics for contractors (EHQ) this research evaluated the connection between EHQ factors such as inefficient lighting, on construction workers and investigated the correlation between various site coping strategies for comfort and productivity. Outcomes from this research are three-pronged. The first includes fostering a discussion about the existing conditions of EQH elements, i.e. thermal, lighting, ergonomic, acoustic, and air quality on the construction labor force. The second identifies gaps in sustainability standards and codes during the pre-occupancy stage of building construction from ground-breaking to substantial completion. The third identifies opportunities for improvements and mitigation strategies to improve EQH such as increased monitoring of effects on productivity and health of contractors and increased inclusion of the pre-occupancy stage in green building standards.

Keywords: construction contractors, health and well-being, environmental quality, risk management

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Authors: Eva L. Suarez, Daniel E. Meeroff, Yan Yong

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Current flooding risk modeling focuses on resilience, defined as the probability of recovery from a severe flooding event. However, the long-term damage to property and well-being by nuisance flooding and its long-term effects on communities are not typically included in risk assessments. An approach was developed to address the probability of recovering from a severe flooding event combined with the probability of community performance during a nuisance event. A consolidated model, namely the conflation flooding recovery (&FR) model, evaluates risk-coping mitigation strategies for communities based on the recovery time from catastrophic events, such as hurricanes or extreme surges, and from everyday nuisance flooding events. The &FR model assesses the variation contribution of each independent input and generates a weighted output that favors the distribution with minimum variation. This approach is especially useful if the input distributions have dissimilar variances. The &FR is defined as a single distribution resulting from the product of the individual probability density functions. The resulting conflated distribution resides between the parent distributions, and it infers the recovery time required by a community to return to basic functions, such as power, utilities, transportation, and civil order, after a flooding event. The &FR model is more accurate than averaging individual observations before calculating the mean and variance or averaging the probabilities evaluated at the input values, which assigns the same weighted variation to each input distribution. The main disadvantage of these traditional methods is that the resulting measure of central tendency is exactly equal to the average of the input distribution’s means without the additional information provided by each individual distribution variance. When dealing with exponential distributions, such as resilience from severe flooding events and from nuisance flooding events, conflation results are equivalent to the weighted least squares method or best linear unbiased estimation. The combination of severe flooding risk with nuisance flooding improves flood risk management for highly populated coastal communities, such as in South Florida, USA, and provides a method to estimate community flood recovery time more accurately from two different sources, severe flooding events and nuisance flooding events.

Keywords: community resilience, conflation, flood risk, nuisance flooding

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Authors: Walaa Mohammed Saeed

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Studies suggest a crosstalk between bone and metabolism through Osteocalcin (OC), a bone-derived protein that plays an important role in regulating glucose and fat metabolism. Studies relate type II Diabetes Mellitus (DMII) with Homocysteine (Hcy) and cardiovascular diseases (CVD). This study investigates the relationship between levels of OC, Hcy, and DMII in 85 subjects of which 50 were diabetic female patients (29–65 years) and 35 healthy controls. OC and Hcy levels were measured in fasting blood samples using immunoassay analyzer. Fasting serum glucose, glycated hemoglobin, lipid profile, were estimated by automated Siemens Dimension XP auto-analyzer. A significant increase in the frequency of low OC levels (p < 0.001) and high Hcy levels (p < 0.001) was detected in diabetic patients compared to controls (chi-squared test). Using ANOVA test, patients were divided into tertiles based on plasma OC and Hcy levels; fasting serum glucose varied inversely with OC but directly with Hcy tertiles (p=0.049, p=0.033 respectively). Atherogenic Index of Plasma (AIP=Log TG/HDL) predicts that diabetic patients with 36% high and 15% intermediate cardiovascular risk had increased frequency of low OC levels compared to low-risk patients (p=0.047). Another group of diabetic patients with 39% high and 11% intermediate CVD risk had increased frequency of high Hcy levels (p=0.033). A significant negative correlation existed between OC and glucose (r = -0.318; p = 0.035) while correlation between glucose level and Hcy (r = 0.851 p=0.022) was positive. Hence, low serum OC levels and high Hcy levels were associated with impaired glucose metabolism that may increase cardiovascular risk in DMII.

Keywords: osteocalcin, homocysteine, type 2 diabetes, cardiovascular

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Authors: Zahra Bahadoran, Parvin Mirmiran, Fereidoun Azizi

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Background: Higher consumption of white rice has been suggested as a risk factor for development of metabolic abnormalities. In this study we investigated the association between consumption of white rice and the 3-year occurrence of metabolic syndrome (MetS) in adults with and without abdominal obesity. Methods: This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study on 1476 adults, aged 19-70 years. Dietary intakes were measured, using a 168-food items validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were evaluated at both baseline (2006-2008) and after 3-year follow-up (2009-2011). MetS and its components were defined according to the diagnostic criteria proposed by NCEP ATP III, and the new cutoff points of waist circumference for Iranian adults. Multiple logistic regression models were used to estimate the occurrence of the MetS in each quartile of white rice consumption. Results: The mean age of participants was 37.8±12.3 y, and mean BMI was 26.0±4.5 kg/m2 at baseline. The prevalence of MetS in subjects with abdominal obesity was significantly higher (40.9 vs. 16.2%, P<0.01). There was no significant difference in white rice consumption between the two groups. Mean daily intake of white rice was 93±59, 209±58, 262±60 and 432±224 g/d, in the first to fourth quartiles of white rice, respectively. Stratified analysis by categories of waist circumference showed that higher consumption of white rice was more strongly related to the risk of metabolic syndrome in participants who had abdominal obesity (OR: 2.34, 95% CI:1.14-4.41 vs. OR:0.99, 95% CI:0.60-1.65) Conclusion: We demonstrated that higher consumption of white rice may be a risk for development of metabolic syndrome in adults with abdominal obesity.

Keywords: white rice, abdominal obesity, metabolic syndrome, food science, triglycerides

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Authors: M. Ndaw, G. Mendy, S. Ouya

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Risk management in banking sector is a key issue linked to financial system stability and its importance has been elevated by technological developments and emergence of new financial instruments. In this paper, we improve the model previously defined for quantifying internal control impact on banking risks by automatizing the residual criticality estimation step of FMECA. For this, we defined three equations and a maturity coefficient to obtain a mathematical model which is tested on all banking processes and type of risks. The new model allows an optimal assessment of residual criticality and improves the correlation rate that has become 98%.

Keywords: risk, control, banking, FMECA, criticality

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Authors: Rama Bhattacharyya, S. N. Ojha, Umesh K. Singh

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Anthropogenic control on groundwater chemistry has emerged as a critical concern now-a-days, especially in the industrial areas. In view of this, a comprehensive study on the distribution of the heavy metal in the groundwater was conducted to investigate the impact of urbanization in the aquatic media. Water samples either from well or borehole from Fourty different sites in and around, Durgapur, West Bengal were collected for this purpose. The samples were analyzed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) for Calcium (Ca), Cobalt (Co), Chromium (Cr), Copper (Cu), Iron (Fe), Potassium (K), Magnesium (Mg), Manganese (Mn), Sodium (Na), Nickel (Ni), Lead (Pb), Zinc (Zn) content and the levels were compared with WHO specified maximum contaminant level as well as permissible limits given by the Bureau of Indian Standards (BIS). The result obtained from the present study indicates a significant risk to the population of this important emerging ‘smart city’ of eastern India. Because of the toxicity of these metals and the fact that for many tube-wells, dug-wells and bore-wells are the only sources of the water supply for a major fraction of the population in this environment. In this study, an attempt has been made to develop metal contamination risk map.

Keywords: heavy metals, ground water, maximum contamination level, ICP-MS

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Authors: Ramkumar Gunasekaran, John Cater, Vinod Suresh, Haribalan Kumar

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The main objective of this project is to develop a statistical shape model using principal component analysis that could be used for analyzing the shape of the human airway. The ultimate goal of this project is to identify geometric risk factors for diagnosis and management of Obstructive Sleep Apnoea (OSA). Anonymous CBCT scans of 25 individuals were obtained from the Otago Radiology Group. The airways were segmented between the hard-palate and the aryepiglottic fold using snake active contour segmentation. The point data cloud of the segmented images was then fitted with a bi-cubic mesh, and pseudo landmarks were placed to perform PCA on the segmented airway to analyze the shape of the airway and to find the relationship between the shape and OSA risk factors. From the PCA results, the first four modes of variation were found to be significant. Mode 1 was interpreted to be the overall length of the airway, Mode 2 was related to the anterior-posterior width of the retroglossal region, Mode 3 was related to the lateral dimension of the oropharyngeal region and Mode 4 was related to the anterior-posterior width of the oropharyngeal region. All these regions are subjected to the risk factors of OSA.

Keywords: medical imaging, image processing, FEM/BEM, statistical modelling

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Authors: Naif A. Haddad

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Greek, Hellenistic and Roman theatre heritage are exposed to multiple risks at varied times or simultaneously. There is no single reason why a theatre building becomes ‘at risk’, as each case has different circumstances which have led to the theatre building decay. There are complicated processes of destruction and distress that show divergence in theatre building materials' decay. Theatre modern use for cultural performances causes much of the risks concerning the physical structure and authenticity of theatre sites. In addition, there are some deterioration and deformations due to previous poor quality restorations and interventions through related excavation and conservation programmes as also risks to authenticity due to new additions. For preventive conservation, theatre natural and anthropogenic risks management can provide a framework for decision making. These risks to ancient theatre heritage may stem from exposure to one or more risk or synergy of many factors. We, therefore, need to link the theatre natural risks to the risks that come from anthropogenic factors associated with social and economic development. However, this requires a holistic approach, and systematic methodology for understanding these risks from various sources while incorporating specific actions, planning and strategies for each specific risk. Elaborating on recent relevant studies, and ERATO and ATHENA EU projects for ancient theaters and odea and general surveys, this paper attempts to discuss the main aspects of the ancient Greek, Hellenistic and Roman theatres risk related issues. Relevant case studies shall also be discussed and investigated to examine frameworks for risk mitigation, and related guidelines and recommendations that provide a systematic approach for sustainable management and planning in relation mainly to ‘compatible use’ of theatre sites.

Keywords: cultural heritage management, European ancient theatres projects, Anthropogenic risks mitigation, sustainable management and planning, preventive conservation, modern use, compatible use

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Authors: Manish Madappa, Madhavi Gayathri Raman

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The primary vehicle of human communication is language. A breakdown occurring in any aspect of communication may lead to frustration and isolation among the learners and the teachers. Over seven percent of the population in the world currently experience limitations and those children who exhibit a deviant/deficient language acquisition curve even when being in a language rich environment as their peers may be at risk of having a language disorder or language impairment. The difficulty may be in the word level [vocabulary/word knowledge] and/or the sentence level [syntax/morphology) Children with SLI appear to be developing normally in all aspects except for their receptive and/or expressive language skills. Thus, it is utmost importance to identify children with or at risk of SLI so that an early intervention can foster language and social growth, provide the best possible learning environment with special support for language to be explicitly taught and a step in providing continuous and ongoing support. The present study looks at Kannada English bilingual children and works towards identifying children at risk of “specific language impairment”. The study was conducted through an exploratory study which systematically enquired into the narratives of young Kannada-English bilinguals and to investigate the data for story structure in their narrative formulations. Oral narrative offers a rich source of data about a child’s language use in a relatively natural context. The fundamental objective is to ensure comparability and to be more universal and thus allows for the evaluation narrative text competence. The data was collected from 10 class three students at a primary school in Mysore, Karnataka and analyzed for macrostructure component reflecting the goal directed behavior of a protagonist who is motivated to carry out some kind of action with the intention of attaining a goal. The results show that the children exhibiting a deviation of -1.25 SD are at risk of SLI. Two learners were identified to be at risk of Specific Language Impairment with a standard deviation of more the 1.25 below the mean score.

Keywords: bilingual, oral narratives, SLI, macrostructure

Procedia PDF Downloads 283

Authors: Nayera E. Hassan, Sahar A. El-Masry, Rokia A. El Banna, Mones M. Abu Shady, Muhammad Al-Tohamy, Manal Mouhamed Ali, Mehrevan M. Abd El-Moniem, Mona Anwar

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Association between vitamin D, adiponectin and obesity is a matter of debate, as they play important role in linking obesity with different cardiometabolic risk factors. Objectives: Evaluation of the association between metabolic risk factors with both adiponectin and vitamin D levels and that between adiponectin and vitamin D among obese Egyptian children. Subjects and Methods: This case-control cross-sectional study consisted of 65 obese and 30 healthy children, aged 8-11 years. 25-hydroxy vitamin D (25(OH) D) level, serum adiponectin, total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) were measured. Results: The mean 25(OH) D levels in the obese and control groups were 29.9± 10.3 and 39.7 ± 12.7 ng/mL respectively (P < 0.001). The mean 25(OH) D and adiponectin levels in the obese were lower than that in the control group (P < 0.0001). 25(OH) D were inversely correlated with body mass index (BMI), triglyceride, total cholesterol and LDL-cholesterol (LDL-C), while adiponectin level were inversely correlated with systolic blood pressure (SBP), and diastolic blood pressure (DBP), and positively correlated with HDL-C. However, there is no relation between 25(OH) D and adiponectin levels among obese children and total sample. Conclusion: In spite of strong association between vitamin D and adiponectin levels with metabolic risk factors and obesity, there is no relation between 25(OH) D and adiponectin levels. In obese children, there are significant negative correlations between 25(OH) D with lipid profile, and between adiponectin levels with blood pressure. At certain adiponectin level, the relation between it and BMI disappears.

Keywords: 25-hydroxy vitamin D, adiponectin, lipid profile, blood pressure, children

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Authors: Jae Woong Sull

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Lipid levels are related to the risk of cardiovascular diseases. Cholesterol ester transfer protein (CETP) gene is one of the candidate genes of cardiovascular diseases. A total of 2,304 persons were chosen from a Hospital (N=4,294) in South Korea. Female subjects with the CG/GG genotype had a 2.03 -fold (p=0.0001) higher risk of having abnormal HDL cholesterol levels (<40 mg/dL) than subjects with the CC genotype. Male subjects with the CG/GG genotype had a 1.34 -fold (p=0.0019) higher risk than subjects with the CC genotype. When analyzed by body mass index, the association with CETP was much stronger in male subjects with BMI>=25.69 (OR=1.55, 95% CI: 1.15-2.07, P=0.0037) than in male lean subjects. When analyzed by family history of diabetes, the association with CETP was much stronger in male subjects with positive family history of low physical activity (OR=4.82, 95% CI: 1.86-12.5, P=0.0012) than in male subjects with negative family history of diabetes. This study clearly demonstrates that genetic variants in CETP influence HDL cholesterol levels in Korean adults.

Keywords: CETP, diabetes, obesity, polymorphisms

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Authors: Henrique Veras De Paiva Fonseca

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This paper investigates the long-term relationship between early life exposure to malaria and adult socioeconomic outcomes in Brazil. The identification strategy relies on exogenous variation in the risk of malaria outbreaks in different states and seasons of the year to identify early life exposure according to the timing and location of birth. Furthermore, Brazil has undergone a successful campaign of malaria eradication during the late 1950s, which allows for comparing outcomes of birth cohorts born just prior to and just after eradication to identify the extent of in utero exposure. Instrumental variables estimates find consistent negative treatment effects of in utero exposure to malaria on socioeconomic outcomes, such as educational attainment and health status. The effects are stronger for exposure during the first trimester of pregnancy than during other periods of gestation. Additionally, consistent with previous findings, men are more likely to exhibit larger long-term effects.

Keywords: malaria, exposure, eradication, instrumental variables, education, health

Procedia PDF Downloads 168

Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: Head and neck cancers (HNC) are often associated with the development of non-HNC primaries, as the risk factors that predispose patients to HNC are often risk factors for other cancers. Aim: We sought to evaluate whether there was an increased risk of smoking and alcohol-related cancers and also other cancers in HNC patients and to evaluate whether there is a difference between the rates of non-HNC primaries in Aboriginal compared with non-Aboriginal HNC patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single center in Western Australia, identifying 80 Aboriginal and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, treatments, outcomes, and past and subsequent HNCs and non-HNC primaries. Results: In the overall study population, there were 86 patients (26.9%) with a metachronous or synchronous non-HNC primary. Non-HNC primaries were actually significantly more common in the non-Aboriginal population compared with the Aboriginal population (30% vs. 17.5%, p=0.02); however, half of these were patients with cutaneous squamous or basal cell carcinomas (cSCC/BCC) only. When cSCC/BCCs were excluded, non-Aboriginal patients had a similar rate as Aboriginal patients (16.7% vs. 15%, p=0.73). There were clearly more cSCC/BCCs in non-Aboriginal patients compared with Aboriginal patients (16.7% vs. 2.5%, p=0.001) and more patients with melanoma (2.5% vs. 0%, p value not significant (p=NS). Rates of most cancers were similar between non-Aboriginal and Aboriginal patients, including prostate (2.9% vs. 3.8%), colorectal (2.9% vs. 2.5%), kidney (1.2% vs. 1.2%), and these rates appeared comparable to Australian Age Standardised Incidence Rates (ASIR) in the general community. Oesophageal cancer occurred at double the rate in Aboriginal patients (3.8%) compared with non-Aboriginal patients (1.7%), which was far in excess of ASIRs which estimated a lifetime risk of 0.59% in the general population. Interestingly lung cancer rates did not appear to be significantly increased in our cohort, with 2.5% of Aboriginal patients and 3.3% of non-Aboriginal patients having lung cancer, which is in line with ASIRs which estimates a lifetime risk of 5% (by age 85yo). Interestingly the rate of Glioma in the non-Aboriginal population was higher than the ASIR, with 0.8% of non-Aboriginal patients developing Glioma, with Australian averages predicting a 0.6% lifetime risk in the general population. As these are small numbers, this finding may well be due to chance. Unsurprisingly, second HNCs occurred at an increased incidence in our cohort, in 12.5% of Aboriginal patients and 11.2% of non-Aboriginal patients, compared to an ASIR of 17 cases per 100,000 persons, estimating a lifetime risk of 1.70%. Conclusions: Overall, 26.9% of patients had a non-HNC primary. When cSCC/BCCs were excluded, Aboriginal and non-Aboriginal patients had similar rates of non-HNC primaries, although non-Aboriginal patients had a significantly higher rate of cSCC/BCCs. Aboriginal patients had double the rate of oesophageal primaries; however, this was not statistically significant, possibly due to small case numbers.

Keywords: head and neck cancer, synchronous and metachronous primaries, other primaries, Aboriginal

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Authors: Nidhin Dani Abraham, T. K. Sri Shilpa

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Asset liability management is an important aspect in banking business. Moreover, the today’s banking is based on BASEL III which strictly regulates on the counterparty default. This paper focuses on prediction and analysis of counter party default risk, which is a type of risk occurs when the customers fail to repay the amount back to the lender (bank or any financial institutions). This paper proposes an approach to reduce the counterparty risk occurring in the financial institutions using an appropriate data mining technique and thus predicts the occurrence of NPA. It also helps in asset building and restructuring quality. Liability management is very important to carry out banking business. To know and analyze the depth of liability of bank, a suitable technique is required. For that a data mining technique is being used to predict the dormant behaviour of various deposit bank customers. Various models are implemented and the results are analyzed of saving bank deposit customers. All these data are cleaned using data cleansing approach from the bank data warehouse.

Keywords: data mining, asset liability management, BASEL III, banking

Procedia PDF Downloads 547