Search results for: relative risk ratios (RRR)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8966

Search results for: relative risk ratios (RRR)

7646 Threats to the Business Value: The Case of Mechanical Engineering Companies in the Czech Republic

Authors: Maria Reznakova, Michala Strnadova, Lukas Reznak

Abstract:

Successful achievement of strategic goals requires an effective performance management system, i.e. determining the appropriate indicators measuring the rate of goal achievement. Assuming that the goal of the owners is to grow the assets they invested in, it is vital to identify the key performance indicators, which contribute to value creation. These indicators are known as value drivers. Based on the undertaken literature search, a value driver is defined as any factor that affects the value of an enterprise. The important factors are then monitored by both financial and non-financial indicators. Financial performance indicators are most useful in strategic management, since they indicate whether a company's strategy implementation and execution are contributing to bottom line improvement. Non-financial indicators are mainly used for short-term decisions. The identification of value drivers, however, is problematic for companies which are not publicly traded. Therefore financial ratios continue to be used to measure the performance of companies, despite their considerable criticism. The main drawback of such indicators is the fact that they are calculated based on accounting data, while accounting rules may differ considerably across different environments. For successful enterprise performance management it is vital to avoid factors that may reduce (or even destroy) its value. Among the known factors reducing the enterprise value are the lack of capital, lack of strategic management system and poor quality of production. In order to gain further insight into the topic, the paper presents results of the research identifying factors that adversely affect the performance of mechanical engineering enterprises in the Czech Republic. The research methodology focuses on both the qualitative and the quantitative aspect of the topic. The qualitative data were obtained from a questionnaire survey of the enterprises senior management, while the quantitative financial data were obtained from the Analysis Major Database for European Sources (AMADEUS). The questionnaire prompted managers to list factors which negatively affect business performance of their enterprises. The range of potential factors was based on a secondary research – analysis of previously undertaken questionnaire surveys and research of studies published in the scientific literature. The results of the survey were evaluated both in general, by average scores, and by detailed sub-analyses of additional criteria. These include the company specific characteristics, such as its size and ownership structure. The evaluation also included a comparison of the managers’ opinions and the performance of their enterprises – measured by return on equity and return on assets ratios. The comparisons were tested by a series of non-parametric tests of statistical significance. The results of the analyses show that the factors most detrimental to the enterprise performance include the incompetence of responsible employees and the disregard to the customers‘ requirements.

Keywords: business value, financial ratios, performance measurement, value drivers

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7645 Establishing a Surrogate Approach to Assess the Exposure Concentrations during Coating Process

Authors: Shan-Hong Ying, Ying-Fang Wang

Abstract:

A surrogate approach was deployed for assessing exposures of multiple chemicals at the selected working area of coating processes and applied to assess the exposure concentration of similar exposed groups using the same chemicals but different formula ratios. For the selected area, 6 to 12 portable photoionization detector (PID) were placed uniformly in its workplace to measure its total VOCs concentrations (CT-VOCs) for 6 randomly selected workshifts. Simultaneously, one sampling strain was placed beside one of these portable PIDs, and the collected air sample was analyzed for individual concentration (CVOCi) of 5 VOCs (xylene, butanone, toluene, butyl acetate, and dimethylformamide). Predictive models were established by relating the CT-VOCs to CVOCi of each individual compound via simple regression analysis. The established predictive models were employed to predict each CVOCi based on the measured CT-VOC for each the similar working area using the same portable PID. Results show that predictive models obtained from simple linear regression analyses were found with an R2 = 0.83~0.99 indicating that CT-VOCs were adequate for predicting CVOCi. In order to verify the validity of the exposure prediction model, the sampling analysis of the above chemical substances was further carried out and the correlation between the measured value (Cm) and the predicted value (Cp) was analyzed. It was found that there is a good correction between the predicted value and measured value of each measured chemical substance (R2=0.83~0.98). Therefore, the surrogate approach could be assessed the exposure concentration of similar exposed groups using the same chemicals but different formula ratios. However, it is recommended to establish the prediction model between the chemical substances belonging to each coater and the direct-reading PID, which is more representative of reality exposure situation and more accurately to estimate the long-term exposure concentration of operators.

Keywords: exposure assessment, exposure prediction model, surrogate approach, TVOC

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7644 Static Balance in the Elderly: Comparison Between Elderly Performing Physical Activity and Fine Motor Coordination Activity

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

Abstract:

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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7643 One-Class Classification Approach Using Fukunaga-Koontz Transform and Selective Multiple Kernel Learning

Authors: Abdullah Bal

Abstract:

This paper presents a one-class classification (OCC) technique based on Fukunaga-Koontz Transform (FKT) for binary classification problems. The FKT is originally a powerful tool to feature selection and ordering for two-class problems. To utilize the standard FKT for data domain description problem (i.e., one-class classification), in this paper, a set of non-class samples which exist outside of positive class (target class) describing boundary formed with limited training data has been constructed synthetically. The tunnel-like decision boundary around upper and lower border of target class samples has been designed using statistical properties of feature vectors belonging to the training data. To capture higher order of statistics of data and increase discrimination ability, the proposed method, termed one-class FKT (OC-FKT), has been extended to its nonlinear version via kernel machines and referred as OC-KFKT for short. Multiple kernel learning (MKL) is a favorable family of machine learning such that tries to find an optimal combination of a set of sub-kernels to achieve a better result. However, the discriminative ability of some of the base kernels may be low and the OC-KFKT designed by this type of kernels leads to unsatisfactory classification performance. To address this problem, the quality of sub-kernels should be evaluated, and the weak kernels must be discarded before the final decision making process. MKL/OC-FKT and selective MKL/OC-FKT frameworks have been designed stimulated by ensemble learning (EL) to weight and then select the sub-classifiers using the discriminability and diversities measured by eigenvalue ratios. The eigenvalue ratios have been assessed based on their regions on the FKT subspaces. The comparative experiments, performed on various low and high dimensional data, against state-of-the-art algorithms confirm the effectiveness of our techniques, especially in case of small sample size (SSS) conditions.

Keywords: ensemble methods, fukunaga-koontz transform, kernel-based methods, multiple kernel learning, one-class classification

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7642 Effect of Cantilever Sheet Pile Wall to Adjacent Buildings

Authors: Ahmed A. Mohamed Aly

Abstract:

Ground movements induced from excavations is a major cause of deformation and damage to the adjacent buildings and utilities. With the increasing rate of construction work in urban area, this problem is growing more significant and has become the cause of numerous legal disputes. This problem is investigated numerically in the present study using finite element method. Five-story reinforced concrete building rests on raft foundation is idealized as two dimensional model. The building is considered to be constructed adjacent to excavation affected by an adjacent excavation in medium sand. Excavation is supported using sheet pile wall. Two dimensional plane strain program PLAXIS is used in this study. 15 nodes triangular element is used to idealize soil with Mohr-Coulomb model. Five nodes isoperimetric beam element is used to idealize sheet pile and building. Interface element is used to represent the contact between beam element and soil. Two parameters were studied, the first is the foundation depth and the second is the building distance from the excavation. Nodal displacements and elements straining actions were obtained and studied from the analyzed finite element model results.

Keywords: excavation, relative distance, effective stresses, lateral deformation, relative depth

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7641 Lacunarity measures on Mammographic Image Applying Fractal Dimension and Lacunarity Measures

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

Abstract:

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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7640 Sensitivity and Specificity of Some Serological Tests Used for Diagnosis of Bovine Brucellosis in Egypt on Bacteriological and Molecular Basis

Authors: Hosein I. Hosein, Ragab Azzam, Ahmed M. S. Menshawy, Sherin Rouby, Khaled Hendy, Ayman Mahrous, Hany Hussien

Abstract:

Brucellosis is a highly contagious bacterial zoonotic disease of a worldwide spread and has different names; Infectious or enzootic abortion and Bang's disease in animals; and Mediterranean or Malta fever, Undulant Fever and Rock fever in humans. It is caused by the different species of genus Brucella which is a Gram-negative, aerobic, non-spore forming, facultative intracellular bacterium. Brucella affects a wide range of mammals including bovines, small ruminants, pigs, equines, rodents, marine mammals as well as human resulting in serious economic losses in animal populations. In human, Brucella causes a severe illness representing a great public health problem. The disease was reported in Egypt for the first time in 1939; since then the disease remained endemic at high levels among cattle, buffalo, sheep and goat and is still representing a public health hazard. The annual economic losses due to brucellosis were estimated to be about 60 million Egyptian pounds yearly, but actual estimates are still missing despite almost 30 years of implementation of the Egyptian control programme. Despite being the gold standard, bacterial isolation has been reported to show poor sensitivity for samples with low-level of Brucella and is impractical for regular screening of large populations. Thus, serological tests still remain the corner stone for routine diagnosis of brucellosis, especially in developing countries. In the present study, a total of 1533 cows (256 from Beni-Suef Governorate, 445 from Al-Fayoum Governorate and 832 from Damietta Governorate), were employed for estimation of relative sensitivity, relative specificity, positive predictive value and negative predictive value of buffered acidified plate antigen test (BPAT), rose bengal test (RBT) and complement fixation test (CFT). The overall seroprevalence of brucellosis revealed (19.63%). Relative sensitivity, relative specificity, positive predictive value and negative predictive value of BPAT,RBT and CFT were estimated as, (96.27 %, 96.76 %, 87.65 % and 99.10 %), (93.42 %, 96.27 %, 90.16 % and 98.35%) and (89.30 %, 98.60 %, 94.35 %and 97.24 %) respectively. BPAT showed the highest sensitivity among the three employed serological tests. RBT was less specific than BPAT. CFT showed the least sensitivity 89.30 % among the three employed serological tests but showed the highest specificity. Different tissues specimens of 22 seropositive cows (spleen, retropharyngeal udder, and supra-mammary lymph nodes) were subjected for bacteriological studies for isolation and identification of Brucella organisms. Brucella melitensis biovar 3 could be recovered from 12 (54.55%) cows. Bacteriological examinations failed to classify 10 cases (45.45%) and were culture negative. Bruce-ladder PCR was carried out for molecular identification of the 12 Brucella isolates at the species level. Three fragments of 587 bp, 1071 bp and 1682 bp sizes were amplified indicating Brucella melitensis. The results indicated the importance of using several procedures to overcome the problem of escaping of some infected animals from diagnosis.Bruce-ladder PCR is an important tool for diagnosis and epidemiologic studies, providing relevant information for identification of Brucella spp.

Keywords: brucellosis, relative sensitivity, relative specificity, Bruce-ladder, Egypt

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7639 Association of Single Nucleotide Polymorphisms in Leptin and Leptin Receptors with Oral Cancer

Authors: Chiung-Man Tsai, Chia-Jui Weng

Abstract:

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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7638 Postural Balance And Falls Risk In Persons With Multiple Sclerosis: Effect Of Gender Differences

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

Abstract:

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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7637 Determination of Crustal Structure and Moho Depth within the Jammu and Kashmir Region, Northwest Himalaya through Receiver Function

Authors: Shiv Jyoti Pandey, Shveta Puri, G. M. Bhat, Neha Raina

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The Jammu and Kashmir (J&K) region of Northwest Himalaya has a long history of earthquake activity which falls within Seismic Zones IV and V. To know the crustal structure beneath this region, we utilized teleseismic receiver function method. This paper presents the results of the analyses of the teleseismic earthquake waves recorded by 10 seismic observatories installed in the vicinity of major thrusts and faults. The teleseismic waves at epicentral distance between 30o and 90o with moment magnitudes greater than or equal to 5.5 that contains large amount of information about the crust and upper mantle structure directly beneath a receiver has been used. The receiver function (RF) technique has been widely applied to investigate crustal structures using P-to-S converted (Ps) phases from velocity discontinuities. The arrival time of the Ps, PpPs and PpSs+ PsPs converted and reverberated phases from the Moho can be combined to constrain the mean crustal thickness and Vp/Vs ratio. Over 500 receiver functions from 10 broadband stations located in the Jammu & Kashmir region of Northwest Himalaya were analyzed. With the help of H-K stacking method, we determined the crustal thickness (H) and average crustal Vp/Vs ratio (K) in this region. We also used Neighbourhood algorithm technique to verify our results. The receiver function results for these stations show that the crustal thickness under Jammu & Kashmir ranges from 45.0 to 53.6 km with an average value of 50.01 km. The Vp/Vs ratio varies from 1.63 to 1.99 with an average value of 1.784 which corresponds to an average Poisson’s ratio of 0.266 with a range from 0.198 to 0.331. High Poisson’s ratios under some stations may be related to partial melting in the crust near the uppermost mantle. The crustal structure model developed from this study can be used to refine the velocity model used in the precise epicenter location in the region, thereby increasing the knowledge to understand current seismicity in the region.

Keywords: H-K stacking, Poisson’s ratios, receiver function, teleseismic

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7636 Application Reliability Method for Concrete Dams

Authors: Mustapha Kamel Mihoubi, Mohamed Essadik Kerkar

Abstract:

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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7635 Simulation of Soil-Pile Interaction of Steel Batter Piles Penetrated in Sandy Soil Subjected to Pull-Out Loads

Authors: Ameer A. Jebur, William Atherton, Rafid M. Alkhaddar, Edward Loffill

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Superstructures like offshore platforms, tall buildings, transition towers, skyscrapers and bridges are normally designed to resist compression, uplift and lateral forces from wind waves, negative skin friction, ship impact and other applied loads. Better understanding and the precise simulation of the response of batter piles under the action of independent uplift loads is a vital topic and an area of active research in the field of geotechnical engineering. This paper investigates the use of finite element code (FEC) to examine the behaviour of model batter piles penetrated in dense sand, subjected to pull-out pressure by means of numerical modelling. The concept of the Winkler Model (beam on elastic foundation) has been used in which the interaction between the pile embedded depth and adjacent soil in the bearing zone is simulated by nonlinear p-y curves. The analysis was conducted on different pile slenderness ratios (lc⁄d) ranging from 7.5, 15.22 and 30 respectively. In addition, the optimum batter angle for a model steel pile penetrated in dense sand has been chosen to be 20° as this is the best angle for this simulation as demonstrated by other researcher published in literature. In this numerical analysis, the soil response is idealized as elasto-plastic and the model piles are described as elastic materials for the purpose of simulation. The results revealed that the applied loads affect the pullout pile capacity as well as the lateral pile response for dense sand together with varying shear strength parameters linked to the pile critical depth. Furthermore, the pile pull-out capacity increases with increasing the pile aspect ratios.

Keywords: slenderness ratio, soil-pile interaction, winkler model (beam on elastic foundation), pull-out capacity

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7634 Risk Factors and Biomarkers for the Recurrence of Ovarian Endometrioma: About the Immunoreactivity of Progesterone Receptor Isoform B and Nuclear Factor Kappa B.

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

Abstract:

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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7633 Liquidity Risk of Banks in Light of a Dominant Share of Foreign Capital in the Polish Banking Sector

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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7632 Walking Cadence to Attain a Minimum of Moderate Aerobic Intensity in People at Risk of Cardiovascular Diseases

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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7631 A U-shaped Relationship between Body Mass Index and Dysmenorrhea: A Longitudinal Study

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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7630 Determining the Prevalence and Risk Factors of Postpartum Depression

Authors: Gerald H. Artisen, Miah Joy O Awing, Elydia O. Ayat, Rachel L. Ayangwa, Zeah D. Baggas, Aspen S. Baguiyac, Delight D. Baguiyac, Kristine G. Bakidan, Nemesis B. Bakidan, Ketly B. Balanggao, Rhea G. Bala-Is, Hope Lulet A. Lomioan

Abstract:

The study investigated the prevalence and risk factors associated with postpartum depression among mothers in the Pasil, Kalinga, contributing to a better understanding of the mental health challenges faced by this specific population. This research utilized a cross-sectional descriptive study to assess postpartum depression prevalence and identify contributing factors in Pasil, utilizing a quantitative approach and collecting data on sociodemographic characteristics, obstetric data, and the Edinburgh Postnatal Depression Scale. The study concluded that probable depression can be seen among mothers in the Pasil, which resulted in a risk of suicidality with a percentage of 40.08. Additionally, most of the respondents are aged 28–32, married, have a college degree, are unemployed, have a monthly income of 1,000–5,000, are female, have hypertension, gave birth naturally, have two children, have a planned pregnancy, and are currently breastfeeding. Lastly, the study found that mothers in Pasil who have unplanned pregnancies under obstetric factors are at high risk of developing postpartum depression, with a p-value below the 0.05 level. The study recommends barangay health professionals develop initiatives to inform aspiring mothers about postpartum depression (PPD) and resources to help them adjust to motherhood. It also recommends frequent check-ins with new mothers to identify special healthcare needs. Programs should be independently funded by LGUs, and support from family and relatives is recommended to prevent PPD.

Keywords: maternal health, postpartum depression, mothers, Pasil

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7629 Deposition of Size Segregated Particulate Matter in Human Respiratory Tract and Their Health Effects in Glass City Residents

Authors: Kalpana Rajouriya, Ajay Taneja

Abstract:

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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7628 Association of Human Immunodeficiency Virus with Incident Autoimmune Hemolytic Anemia: A Population-Based Cohort Study in Taiwan

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

Abstract:

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

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

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7627 Effects of Roof Materials on Onion Storage

Authors: Imoukhuede Oladunni Bimpe, Ale Monday Olatunbosun

Abstract:

Periodic scarcity of onion requires urgent solution in Nigerian agro-economy. The high percentage of onion losses incurred after harvesting period is due to non-availability of appropriate facility for its storage. Therefore, some storage structures were constructed with different roofing materials. The response of the materials to the weather parameters like temperature and relative humidity were evaluated to know their effects on the performance of the storage structures. The temperature and relative humidity were taken three times daily alongside with the weight of the onion in each of the structures; the losses as indicated by loss indices like shrinkage, rottenness, sprouting and colour were identified and percentage loss per week determined. The highest mean percentage loss (22%) was observed in the structure with iron roofing materials while structure with thatched materials had the lowest (9.4%); The highest temperature was observed in the structure with Asbestos roofing materials and no significant difference in the temperature value in the structure with thatched and Iron materials; highest relatively humidity was found in Asbestos roofing material while the lowest in the structure with Iron materials. It was conclusively found that the storage structure with thatched roof had the best performance in terms of losses.

Keywords: onion, storage structures, weather parameters, roof materials, losses

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7626 Detecting Local Clusters of Childhood Malnutrition in the Island Province of Marinduque, Philippines Using Spatial Scan Statistic

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

Abstract:

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

Procedia PDF Downloads 138
7625 Corporate Cautionary Statement: A Genre of Professional Communication

Authors: Chie Urawa

Abstract:

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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7624 Educational Attainment Inequalities in Depressive Symptoms in More Than 100 000 Individuals in Europe

Authors: Adam Chlapecka, Anna Kagstrom, Pavla Cermakova

Abstract:

Background: Increasing educational attainment (EA) could decrease the occurrence of depression. We investigated the relationship between EA and depressive symptoms in older individuals across four European regions. Methods: We studied 108 315 Europeans (54 % women, median age 63 years old) from the Survey on Health, Ageing and Retirement in Europe assessing EA (7 educational levels based on ISCED classification); and depressive symptoms (≥ 4 points on EURO-D scale). Logistic regression estimated the association between EA and depressive symptoms, adjusting for sociodemographic and health-related factors; testing for sex/age/region and education interactions. Results: Higher EA was associated with lower odds of depressive symptoms, independent of sociodemographic and health-related factors. A threshold of the lowest odds of depressive symptoms was detected at the first stage of tertiary education (OR 0.60; 95% CI 0.55-0.65; p<0.001; relative to no education). Central and Eastern Europe showed the strongest association (OR for high vs. low education 0.37; 95% CI 0.33-0.40; p<0.001) and Scandinavia the weakest (OR for high vs. low education 0.69; 95% CI 0.60-0.80; p<0.001). The association was strongest amongst younger individuals. There was a sex and education interaction only within Central and Eastern Europe. Conclusion: The level of EA is reflected in later-life depressive symptoms, suggesting that supporting individuals in achieving EA, and considering those with lower EA at increased risk for depression, could lead to the decreased burden of depression across the life course. Further educational support in Central and Eastern Europe may decrease the higher burden of depressive symptoms in women.

Keywords: depression, education, epidemiology, Europe

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7623 Ideation, Plans, and Attempts for Suicide among Adolescents with Disability

Authors: Nyla Anjum, Humaira Bano

Abstract:

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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7622 Urban Search, Rescue and Rapid Field Assessment of Damaged and Collapsed Building Structures

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

Abstract:

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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7621 Alterations in the Abundance of Ruminal Microbial Species during the Peripartal Period in Dairy Cows

Authors: S. Alqarni, J. C. McCann, A. Palladino, J. J. Loor

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Seven fistulated Holstein cows were used from 3 weeks prepartum to 4 weeks postpartum to determine the relative abundance of 7 different species of ruminal microorganisms. The prepartum diet was based on corn silage. In the postpartum, diet included ground corn, grain by-products, and alfalfa haylage. Ruminal digesta were collected at five times: -14, -7, 10, 20, and 28 days around parturition. Total DNA from ruminal digesta was isolated and real-time quantitative PCR was used to determine the relative abundance of bacterial species. Eubacterium ruminantium and Selenomonas ruminantium were not affected by time (P>0.05). Megasphaera elsdenii and Prevotella bryantii increased significantly postpartum (P<0.001). Conversely, Butyrivibrio proteoclasticus decreased gradually from -14 through 28 days (P<0.001). Fibrobacter succinogenes was affected by time being lowest at day 10 (P=0.02) while Anaerovibrio lipolytica recorded the lowest abundance at -7 d followed by an increase by 20 days postpartum (P<0.001). Overall, these results indicate that changes in diet after parturition affect the abundance of ruminal bacteria, particularly M. elsdenii (a lactate-utilizing bacteria) and P. bryantii (a starch-degrading bacteria) which increased markedly after parturition likely as a consequence of a higher concentrate intake.

Keywords: rumen bacteria, transition cows, rumen metabolism, peripartal period

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7620 Assessments of Internal Erosion in a Landfill Due to Changes in the Groundwater Level

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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7619 Risk Factors for Post-Induction Hypotension Among Elderly Patients Undergoing Elective Non-Cardiac Surgery Under General Anesthesia

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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7618 Corrosion Risk Assessment/Risk Based Inspection (RBI)

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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7617 Factors Contributing to the Risk and Vulnerability to HIV Infection among Individuals with Spinal Cord Injuries (SCI) in South Africa

Authors: J. J. Lloyd, J. S. Phillips

Abstract:

Background: HIV/AIDS has made a huge impact on human development and sexual reproductive habits in this century in the world and especially in sub-Saharan Africa. It has only recently been acknowledged that HIV/AIDS has an equal if not greater effect on or threat to people with disabilities. Survivors of traumatic spinal cord injury (SCI) with resultant disability are incorrectly believed to be sexually inactive, unlikely to use drugs or alcohol and at less risk of violence or rape than their non-disabled peers. This group can thus be described as economically, educationally and socially disadvantaged, which in itself, suggest that they are a high-risk group for HIV infection. Objectives: Thus, the overall objective of this study was to assess the factors that exacerbate the risk and vulnerability of individuals with spinal cord injuries to HIV infection in order to develop a more effective HIV intervention. Methodology: This paper reports on the cross-sectional data gathered from individuals with a traumatic spinal cord injury in 4 conveniently selected provinces in South Africa. Data was collected by means of self-administered questionnaires. The questionnaire consisted of various sections requesting for information on Demographics; HIV-Knowledge (HIV- KQ-18); Sexual behaviours; sexual communication, and negotiation skills and Self-efficacy to refuse sex. Results: The majority of the study sample was males (72.7%) with a mean age of 34.6 years. The majority reported lifetime sexual intercourse (92.4%) but only 31.8% reported condom use with last sexual intercourse. Low level of HIV knowledge, and being male were the strongest predictor of risky sexual behaviours in this sample. Conclusion: Significant numbers of individuals with spinal cord injuries are thus engaging in risky sexual behaviours pointing to a need to strengthen comprehensive sexual health education to increase access to HIV testing, promote safe sex and condom use among this group.

Keywords: Human Immunodeficiency Virus (HIV), individuals with spinal cord injuries, risky sexual behaviours, HIV risk factors, sub-saharan Africa

Procedia PDF Downloads 433