Search results for: Risk Factors
13598 Socioeconomic Status and Mortality in Older People with Angina: A Population-Based Cohort Study in China
Authors: Weiju Zhou, Alex Hopkins, Ruoling Chen
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Background: China has increased the gap in income between richer and poorer over the past 40 years, and the number of deaths from people with angina has been rising. It is unclear whether socioeconomic status (SES) is associated with increased mortality in older people with angina. Methods: Data from a cohort study of 2,380 participants aged ≥ 65 years, who were randomly recruited from 5-province urban communities were examined in China. The cohort members were interviewed to record socio-demographic and risk factors and document doctor-diagnosed angina at baseline and were followed them up in 3-10 years, including monitoring vital status. Multivariate Cox regression models were employed to examine all-cause mortality in relation to low SES. Results: The cohort follow-up identified 373 deaths occurred; 41 deaths in 208 angina patients. Compared to participants without angina (n=2,172), patients with angina had increased mortality (multivariate adjusted hazard ratio (HR) was 1.41, 95% CI 1.01-1.97). Within angina patients, the risk of mortality increased with low satisfactory income (2.51, 1.08-5.85) and having financial problem (4.00, 1.07-15.00), but significantly with levels of education and occupation. In non-angina participants, none of these four SES indicators were associated with mortality. There was a significant interaction effect between angina and low satisfactory income on mortality. Conclusions: In China, having low income and financial problem increase mortality in older people with angina. Strategies to improve economic circumstances in older people could help reduce inequality in angina survival.Keywords: angina, mortality, older people, socio-economic status
Procedia PDF Downloads 11913597 Knowledge, Attitude, Practice and Contributing Factors on Menstrual Hygiene Among High School Students, Ethiopia: Cross-Sectional Study
Authors: Getnet Gedefaw, Fentanesh Endalew, Bitewush Azmeraw, Bethelhem Walelign, Eyob Shitie
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Introduction: The issue of menstrual hygiene is often overlooked and has not been sufficiently addressed in the fields of reproductive health in low and middle-income countries. Inadequate menstrual hygiene practices can increase the risk of various infectious and chronic obstetric and gynaecological complications for girls and adolescents. Hence, this study seeks to investigate the knowledge, attitudes, and practices related to menstrual hygiene, along with the factors influencing them, among high school students. Methods: A facility based cross-sectional study was conducted involving a total of 423 study subjects. A systematic random sampling technique was utilized. Data was entered and analyzed through Epi data 3.1 and SPSS 22, respectively. Both univariable and multivariable logistic regression models were employed. A p-value of less than 0.05 was considered statistically significant. Results: This study revealed that 365(89.2%), 200(48.9%) and 196(47.9%) of the study participants have good knowledge, good practice, and good attitudes about menstrual hygiene, respectively. Being higher grade students (grade 10) [AOR=3.96, 95% CI =2.0-7.8] and having good practice of menstrual hygiene (AOR=2.52, 95% CI= 1.26-5) had a positive association with menstrual hygiene knowledge. Whereas maternal education level (AOR=1.86, 95% CI=1.18-2.9) and being a grade 10 student (AOR=2.3, 95% CI=1.48-3.56) were associated factors for practising menstrual hygiene. Additionally, being higher grade students (AOR=1.9, 95% CI=1.2-2.8), age ≥18 years (AOR=1.67, 95% CI=1.09-2.55) were statistically and positively associated with the attitude of menstrual hygiene. Conclusion: The study findings indicated that the knowledge of the study participants regarding menstrual hygiene was high, while their attitudes and practices towards menstrual hygiene were low. It is suggested that raising awareness among reproductive health groups and educating their families and parents could potentially lead to a positive change in their poor practices and attitudes towards menstrual hygiene.Keywords: menstrual hygiene, menstruation, students, reproductive health
Procedia PDF Downloads 6113596 Application of Italian Guidelines for Existing Bridge Management
Authors: Giovanni Menichini, Salvatore Giacomo Morano, Gloria Terenzi, Luca Salvatori, Maurizio Orlando
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The “Guidelines for Risk Classification, Safety Assessment, and Structural Health Monitoring of Existing Bridges” were recently approved by the Italian Government to define technical standards for managing the national network of existing bridges. These guidelines provide a framework for risk mitigation and safety assessment of bridges, which are essential elements of the built environment and form the basis for the operation of transport systems. Within the guideline framework, a workflow based on three main points was proposed: (1) risk-based, i.e., based on typical parameters of hazard, vulnerability, and exposure; (2) multi-level, i.e., including six assessment levels of increasing complexity; and (3) multirisk, i.e., assessing structural/foundational, seismic, hydrological, and landslide risks. The paper focuses on applying the Italian Guidelines to specific case studies, aiming to identify the parameters that predominantly influence the determination of the “class of attention”. The significance of each parameter is determined via sensitivity analysis. Additionally, recommendations for enhancing the process of assigning the class of attention are proposed.Keywords: bridge safety assessment, Italian guidelines implementation, risk classification, structural health monitoring
Procedia PDF Downloads 5913595 Selecting the Best Risk Exposure to Assess Collision Risks in Container Terminals
Authors: Mohammad Ali Hasanzadeh, Thierry Van Elslander, Eddy Van De Voorde
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About 90 percent of world merchandise trade by volume being carried by sea. Maritime transport remains as back bone behind the international trade and globalization meanwhile all seaborne goods need using at least two ports as origin and destination. Amid seaborne traded cargos, container traffic is a prosperous market with about 16% in terms of volume. Albeit containerized cargos are less in terms of tonnage but, containers carry the highest value cargos amongst all. That is why efficient handling of containers in ports is very important. Accidents are the foremost causes that lead to port inefficiency and a surge in total transport cost. Having different port safety management systems (PSMS) in place, statistics on port accidents show that numerous accidents occur in ports. Some of them claim peoples’ life; others damage goods, vessels, port equipment and/or the environment. Several accident investigation illustrate that the most common accidents take place throughout transport operation, it sometimes accounts for 68.6% of all events, therefore providing a safer workplace depends on reducing collision risk. In order to quantify risks at the port area different variables can be used as exposure measurement. One of the main motives for defining and using exposure in studies related to infrastructure is to account for the differences in intensity of use, so as to make comparisons meaningful. In various researches related to handling containers in ports and intermodal terminals, different risk exposures and also the likelihood of each event have been selected. Vehicle collision within the port area (10-7 per kilometer of vehicle distance travelled) and dropping containers from cranes, forklift trucks, or rail mounted gantries (1 x 10-5 per lift) are some examples. According to the objective of the current research, three categories of accidents selected for collision risk assessment; fall of container during ship to shore operation, dropping container during transfer operation and collision between vehicles and objects within terminal area. Later on various consequences, exposure and probability identified for each accident. Hence, reducing collision risks profoundly rely on picking the right risk exposures and probability of selected accidents, to prevent collision accidents in container terminals and in the framework of risk calculations, such risk exposures and probabilities can be useful in assessing the effectiveness of safety programs in ports.Keywords: container terminal, collision, seaborne trade, risk exposure, risk probability
Procedia PDF Downloads 37713594 Assessment of Chromium Concentration and Human Health Risk in the Steelpoort River Sub-Catchment of the Olifants River Basin, South Africa
Authors: Abraham Addo-Bediako
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Many freshwater ecosystems are facing immense pressure from anthropogenic activities, such as agricultural, industrial and mining. Trace metal pollution in freshwater ecosystems has become an issue of public health concern due to its toxicity and persistence in the environment. Trace elements pose a serious risk not only to the environment and aquatic biota but also humans. Chromium is one of such trace elements and its pollution in surface waters and groundwaters represents a serious environmental problem. In South Africa, agriculture, mining, industrial and domestic wastes are the main contributors to chromium discharge in rivers. The common forms of chromium are chromium (III) and chromium (VI). The latter is the most toxic because it can cause damage to human health. The aim of the study was to assess the contamination of chromium in the water and sediments of two rivers in the Steelpoort River sub-catchment of the Olifants River Basin, South Africa and human health risk. The concentration of Cr was analyzed using inductively coupled plasma–optical emission spectrometry (ICP-OES). The concentration of the metal was found to exceed the threshold limit, mainly in areas of high human activities. The hazard quotient through ingestion exposure did not exceed the threshold limit of 1 for adults and children and cancer risk for adults and children computed did not exceed the threshold limit of 10-4. Thus, there is no potential health risk from chromium through ingestion of drinking water for now. However, with increasing human activities, especially mining, the concentration could increase and become harmful to humans who depend on rivers for drinking water. It is recommended that proper management strategies should be taken to minimize the impact of chromium on the rivers and water from the rivers should properly be treated before domestic use.Keywords: land use, health risk, metal pollution, water quality
Procedia PDF Downloads 8813593 Marketing Factors Influencing the Decision to Choose Low Cost Airlines
Authors: Noppadol Sritragool
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The objectives of this research were to investigate the decision of passengers who choose to fry with low cost airlines and to study marketing factors which have the influence to the decision to choose each low cost airlines. This paper was a quantitative research technique. A total of 400 low cost airlines’ passengers were interviewed via English questionnaire to collect the respondents’ opinions. The findings revealed that respondents were male and female at a similar proportion. The majority had at least an undergraduate degree, have a lower management level jobs, and had income in the range of 25,000 -35,000 baht per month.. In addition, the findings also revealed that the first three marketing factors influencing the decision of the respondents to choose low-cost airlines were low price, direct flight, and online system.Keywords: decision to choose, marketing factors, low-cost airlines
Procedia PDF Downloads 42813592 Assessment of the Work-Related Stress and Associated Factors among Sanitation Workers in Public Hospitals during COVID-19, Addis Ababa, Ethiopia
Authors: Zerubabel Mihret
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Background: Work-related stress is a pattern of reactions to work demands unmatched by worker’s knowledge, skills, or abilities. Healthcare institutions are considered high-risk and intensive work areas for work-related stress. However, there is the nonexistence of clear and strong data about the magnitude of work-related stress on sanitation workers in hospitals in Ethiopia. The aim of this study was to determine the magnitude of work-related stress among sanitation workers in public hospitals during COVID-19 in Addis Ababa, Ethiopia. Methods: Institution-based cross-sectional study was conducted from October 2021 to February 2022 among 494 sanitation workers who were selected from 4 hospitals. HSE (Health and Safety Executive of UK) standard data collection tool was used, and an interviewer-administered questionnaire was used to collect the data using KOBO collect application. The collected data were cleaned and analyzed using SPSS version 20.0. Both binary and multivariable logistic regression analyses were done to identify important factors having an association with work-related stress. Variables with p-value ≤ 0.25 in the bivariate analysis were entered into the multivariable logistic regression model. A statistically significant level was declared at a p-value ≤ 0.05. Results: This study revealed that the magnitude of work-related stress among sanitation workers was 49.2% (95% CI 45-54). Significant proportions (72.7%) of sanitation workers were dissatisfied with their current job. Sex, age, experience, and chewing khat were significantly associated with work-related stress. Conclusion: Work-related stress is significantly high among sanitation workers. Sex, age, experience, and chewing khat were identified as factors associated with work-related stress. Intervention program focusing on the prevention and control of stress is desired by hospitals.Keywords: work-related stress, sanitation workers, Likert scale, public hospitals, Ethiopia
Procedia PDF Downloads 8613591 An Analysis of Critical Success Factors of Six Sigma Implementation in Pakistani SMEs
Authors: Zanjbeel Tabassum
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The main purpose of any economic investment is to get profit at the end. As the investment in large organizations bears complexities, investors are influenced to invest in small or medium enterprises. With the increase of global competition in terms of quality and productivity, these small and medium-sized enterprises (SMEs) are trying to convert to modern production practices using Six Sigma. But this concept is still lacking in Pakistani SMEs. There are some critical success factors which influence the successful implementation of Six Sigma. Through this paper, an attempt has been made to identify various CSF for successful implementation of Six Sigma in Pakistani SMEs with the help of a structured survey. On the basis of responses to the questionnaire, factor analysis is performed on the selected critical success factors (from literature) to prioritize the critical factors and those are rated by calculating descriptive statistics. This paper will provide a base for Pakistani SMEs and future researchers working in six sigma implementation and help them to prepare a road map to eradicate the hurdles in six sigma implementation.Keywords: critical success factors, SMEs, Six Sigma, CSF
Procedia PDF Downloads 27913590 Money Laundering and Terror Financing in the Islamic Banking Sector in Bangladesh
Authors: Md. Abdul Kader
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Several reports released by Global Financial Integrity (GFI) in recent times have identified Bangladesh as being among the worst affected countries to the scourge of money laundering (ML) and terrorist financing (TF). The money laundering (ML) and terrorist financing (TF) risks associated with conventional finance are generally well identified and understood by the relevant national authorities. There is, however, no common understanding of ML/TF risks associated with Islamic Banking. This paper attempts to examine the issues of money laundering (ML) and terrorist financing (TF) in Islamic Banks of Bangladesh. This study also investigates the risk factors associated with Islamic Banking system of Bangladesh that are favorable for ML and TF and which prevent the government to control such issues in the Islamic Banks of Bangladesh. Qualitative research methods were employed by studying various reports from journals, newspapers, bank reports and periodicals. In addition, five ex-bankers who were in the policy making bodies of three Islamic Banks were also interviewed. Findings suggest that government policies regarding Islamic Banking system in Bangladesh are not well defined and clear. Shariah law, that is the guiding principle of Islamic Banking, is not well recognized by the government policy makers, and thus they left the responsibility to the governing bodies of the banks. Other challenges that were found in the study are: the complexity of some Islamic banking products, the different forms of relationship between the banks and their clients, the inadequate ability and skill in the supervision of Islamic finance, particularly in jurisdictions, to evaluate their activities. All these risk factors paved the ground for ML and TF in the Islamic Banks of Bangladesh. However, due to unconventional nature of Banking and lack of investigative reporting on Islamic Banking, this study could not cover the whole picture of the ML/TF of Islamic Banks of Bangladesh. However, both qualitative documents and interviewees confirmed that Islamic Banking in Bangladesh could be branded as risky when it comes to money laundering and terror financing. This study recommends that the central bank authorities who supervise Islamic finance and the government policy makers should obtain a greater understanding of the specific ML/TF risks that may arise in Islamic Banks and develop a proper response. The study findings are expected to considerably impact Islamic banking management and policymakers to develop strong and appropriate policy to enhance transparency, accountability, and efficiency in banking sector. The regulatory bodies can consider the findings to disseminate anti money laundering and terror financing related rules and regulations.Keywords: money laundering, terror financing, islamic banking, bangladesh
Procedia PDF Downloads 9913589 Key Factors for Stakeholder Engagement and Sustainable Development
Authors: Jo Rhodes, Bruce Bergstrom, Peter Lok, Vincent Cheng
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The aim of this study is to determine key factors and processes for multinationals (MNCs) to develop an effective stakeholder engagement and sustainable development framework. A qualitative multiple-case approach was used. A triangulation method was adopted (interviews, archival documents and observations) to collect data on three global firms (MNCs). 9 senior executives were interviewed for this study (3 from each firm). An initial literature review was conducted to explore possible practices and factors (the deductive approach) to sustainable development. Interview data were analysed using Nvivo to obtain appropriate nodes and themes for the framework. A comparison of findings from interview data and themes, factors developed from the literature review and cross cases comparison were used to develop the final conceptual framework (the inductive approach). The results suggested that stakeholder engagement is a key mediator between ‘stakeholder network’ (internal and external factors) and outcomes (corporate social responsibility, social capital, shared value and sustainable development). Key internal factors such as human capital/talent, technology, culture, leadership and processes such as collaboration, knowledge sharing and co-creation of value with stakeholders were identified. These internal factors and processes must be integrated and aligned with external factors such as social, political, cultural, environment and NGOs to achieve effective stakeholder engagement.Keywords: stakeholder, engagement, sustainable development, shared value, corporate social responsibility
Procedia PDF Downloads 51513588 Fijian Women’s Role in Disaster Risk Management: Climate Change
Authors: Priyatma Singh, Manpreet Kaur
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Climate change is progressively being identified as a global crisis and this has immediate repercussions for Fiji Islands due to its geographical location being prone to natural disasters. In the Pacific, it is common to find significant differences between men and women, in terms of their roles and responsibilities. In the pursuit of prudent preparedness before disasters, Fijian women’s engagement is constrained due to socially constructed roles and expectation of women here in Fiji. This vulnerability is aggravated by viewing women as victims, rather than as key people who have vital information of their society, economy, and environment, as well as useful skills, which, when recognized and used, can be effective in disaster risk reduction. The focus of this study on disaster management is to outline ways in which Fijian women can be actively engaged in disaster risk management, articulating in decision-making, negating the perceived ideology of women’s constricted roles in Fiji and unveiling social constraints that limit women’s access to practical disaster management strategic plan. This paper outlines the importance of gender mainstreaming in disaster risk reduction and the ways of mainstreaming gender based on a literature review. It analyses theoretical study of academic literature as well as papers and reports produced by various national and international institutions and explores ways to better inform and engage women for climate change per ser disaster management in Fiji. The empowerment of women is believed to be a critical element in constructing disaster resilience as women are often considered to be the designers of community resilience at the local level. Gender mainstreaming as a way of bringing a gender perspective into climate related disasters can be applied to distinguish the varying needs and capacities of women, and integrate them into climate change adaptation strategies. This study will advocate women articulation in disaster risk management, thus giving equal standing to females in Fiji and also identify the gaps and inform national and local Disaster Risk Management authorities to implement processes that enhance gender equality and women’s empowerment towards a more equitable and effective disaster practice.Keywords: disaster risk management, climate change, gender mainstreaming, women empowerment
Procedia PDF Downloads 38913587 Investigation of Static Stability of Soil Slopes Using Numerical Modeling
Authors: Seyed Abolhasan Naeini, Elham Ghanbari Alamooti
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Static stability of soil slopes using numerical simulation by a finite element code, ABAQUS, has been investigated, and safety factors of the slopes achieved in the case of static load of a 10-storey building. The embankments have the same soil condition but different loading distance from the slope heel. The numerical method for estimating safety factors is 'Strength Reduction Method' (SRM). Mohr-Coulomb criterion used in the numerical simulations. Two steps used for measuring the safety factors of the slopes: first is under gravity loading, and the second is under static loading of a building near the slope heel. These safety factors measured from SRM, are compared with the values from Limit Equilibrium Method, LEM. Results show that there is good agreement between SRM and LEM. Also, it is seen that by increasing the distance from slope heel, safety factors increases.Keywords: limit equilibrium method, static stability, soil slopes, strength reduction method
Procedia PDF Downloads 16413586 The Effects of Circadian Rhythms Change in High Latitudes
Authors: Ekaterina Zvorykina
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Nowadays, Arctic and Antarctic regions are distinguished to be one of the most important strategic resources for global development. Nonetheless, living conditions in Arctic regions still demand certain improvements. As soon as the region is rarely populated, one of the main points of interest is health accommodation of the people, who migrate to Arctic region for permanent and shift work. At Arctic and Antarctic latitudes, personnel face polar day and polar night conditions during the time of the year. It means that they are deprived of natural sunlight in winter season and have continuous daylight in summer. Firstly, the change in light intensity during 24-hours period due to migration affects circadian rhythms. Moreover, the controlled artificial light in winter is also an issue. The results of the recent studies on night shift medical professionals, who were exposed to permanent artificial light, have already demonstrated higher risks in cancer, depression, Alzheimer disease. Moreover, people exposed to frequent time zones change are also subjected to higher risks of heart attack and cancer. Thus, our main goals are to understand how high latitude work and living conditions can affect human health and how it can be prevented. In our study, we analyze molecular and cellular factors, which play important role in circadian rhythm change and distinguish main risk groups in people, migrating to high latitudes. The main well-studied index of circadian timing is melatonin or its metabolite 6-sulfatoxymelatonin. In low light intensity melatonin synthesis is disturbed and as a result human organism requires more time for sleep, which is still disregarded when it comes to working time organization. Lack of melatonin also causes shortage in serotonin production, which leads to higher depression risk. Melatonin is also known to inhibit oncogenes and increase apoptosis level in cells, the main factors for tumor growth, as well as circadian clock genes (for example Per2). Thus, people who work in high latitudes can be distinguished as a risk group for cancer diseases and demand more attention. Clock/Clock genes, known to be one of the main circadian clock regulators, decrease sensitivity of hypothalamus to estrogen and decrease glucose sensibility, which leads to premature aging and oestrous cycle disruption. Permanent light exposure also leads to accumulation superoxide dismutase and oxidative stress, which is one of the main factors for early dementia and Alzheimer disease. We propose a new screening system adjusted for people, migrating from middle to high latitudes and accommodation therapy. Screening is focused on melatonin and estrogen levels, sleep deprivation and neural disorders, depression level, cancer risks and heart and vascular disorders. Accommodation therapy includes different types artificial light exposure, additional melatonin and neuroprotectors. Preventive procedures can lead to increase of migration intensity to high latitudes and, as a result, the prosperity of Arctic region.Keywords: circadian rhythm, high latitudes, melatonin, neuroprotectors
Procedia PDF Downloads 16013585 Risk Management Strategy for Protecting Cultural Heritage: Case Study of the Institute of Egypt
Authors: Amany A. Ragheb, Ghada Ragheb, Abd ElRahman A.
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Egypt has a countless heritage of mansions, castles, cities, towns, villages, industrial and manufacturing sites. This richness of heritage provides endless and matchless prospects for culture. Despite being famous worldwide, Egypt’s heritage still is in constant need of protection. Political conflicts and religious revolutions form a direct threat to buildings in various areas, historic, archaeological sites, and religious monuments. Egypt has witnessed two revolutions in less than 60 years; both had an impact on its architectural heritage. In this paper, the authors aim to review legal and policy framework to protect the cultural heritage and present the risk management strategy for cultural heritage in conflict. Through a review of selected international models of devastated architectural heritage in conflict zones and highlighting some of their changes, we can learn from the experiences of other countries to assist towards the development of a methodology to halt the plundering of architectural heritage. Finally, the paper makes an effort to enhance the formulation of a risk management strategy for protection and conservation of cultural heritage, through which to end the plundering of Egypt’s architectural legacy in the Egyptian community (revolutions, 1952 and 2011); and by presenting to its surrounding community the benefits derived from maintaining it.Keywords: cultural heritage, legal regulation, risk management, preservation
Procedia PDF Downloads 40113584 Study of Silent Myocardial Ischemia in Type 2 Diabeic Males: Egyptian Experience
Authors: Ali Kassem, Yhea Kishik, Ali Hassan, Mohamed Abdelwahab
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Introduction: Accelerated coronary and peripheral vascular atherosclerosis is one of the most common and chronic complications of diabetes mellitus. A recent aspect of coronary artery disease in this condition is its silent nature. The aim of the work: Detection of the prevalence of silent myocardial ischemia (SMI) in Upper Egypt type 2 diabetic males and to select male diabetic population who should be screened for SMI. Patients and methods: 100 type 2 diabetic male patients with a negative history of angina or anginal equivalent symptoms and 30 healthy control were included. Full medical history and thorough clinical examination were done for all participants. Fasting and post prandial blood glucose level, lipid profile, (HbA1c), microalbuminuria, and C-reactive protein were done for all participants Resting ECG, trans-thoracic echocardiography, treadmill exercise ECG, myocardial perfusion imaging were done for all participants and patients positive for one or more NITs were subjected for coronary angiography. Results Twenty nine patients (29%) were positive for one or more NITs in the patients group compared to only one case (3.3%) in the controls. After coronary angiography, 20 patients were positive for significant coronary artery stenosis in the patients group, while it was refused to be done by the patient in the controls. There were statistical significant difference between the two groups regarding, hypertension, dyslipidemia and obesity, family history of DM and IHD with higher levels of microalbuminuria, C-reactive protein, total lipids in patient group versus controls According to coronary angiography, patients were subdivided into two subgroups, 20 positive for SMI (positive for coronary angiography) and 80 negative for SMI (negative for coronary angiography). No statistical difference regarding family history of DM and type of diabetic therapy was found between the two subgroups. Yet, smoking, hypertension, obesity, dyslipidemia and family history of IHD were significantly higher in diabetics positive versus those negative for SMI. 90% of patients in subgroup positive for SMI had two or more cardiac risk factors while only two patients had one cardiac risk factor (10%). Uncontrolled DM was detected more in patients positive for SMI. Diabetic complications were more prevalent in patients positive for SMI versus those negative for SMI. Most of the patients positive for SMI have DM more than 5 years duration. Resting ECG and resting Echo detected only 6 and 11 cases, respectively, of the 20 positive cases in group positive for SMI compared to treadmill exercise ECG and myocardial perfusion imaging that detected 16 and 18 cases respectively, Conclusion: Type 2 diabetic male patients should be screened for detection of SMI when aged above 50 years old, diabetes duration is more than 5 years, presence of two or more cardiac risk factors and/or patients suffering from one or more of the chronic diabetic complications. CRP, is an important parameter for selection of type 2 diabetic male patients who should be screened for SMI. Non invasive cardiac tests are reliable for screening of SMI in these patients in our locality.Keywords: C-reactive protein, Silent myocardial ischemia, Stress tests, type 2 DM
Procedia PDF Downloads 38513583 Calendar Anomalies in Islamic Frontier Markets
Authors: Aslam Faheem, Hunjra Ahmed Imran, Tayachi Tahar, Verhoeven Peter, Tariq Yasir
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We investigate the evidence of three risk-adjusted calendar anomalies in eight frontier markets. Our sample consists of the daily closing prices of their stock indices for the period of January 2006 to September 2019. We categorize the data with respect to day-of-the-week, Lunar calendar and Islamic calendar. Using Morgan Stanley Capital International (MSCI) eight Markets Index as our proxy of the market portfolio, most of the frontier markets tested exhibit calendar seasonality. We confirm that systematic risk varies with respect to day-of-the-week, Lunar months and Islamic months. After consideration of time-varying risk and applying Bonferroni correction, few frontier markets exhibit profitable investment opportunities from calendar return anomalies for active investment managers.Keywords: asset pricing, frontier markets, market efficiency, Islamic calendar effects, Islamic stock markets
Procedia PDF Downloads 16813582 Rethinking the Air Quality Health Index: Harmonizing Health Protection and Climate Mitigation
Authors: Kimberly Tasha Jiayi Tang, Changqing Lin, Zhe Wang, Tze-Wai Wong, Md. Shakhaoat Hossain, Jian Yu, Alexis Lau
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Hong Kong has practiced a risk-based Air Quality Health Index (AQHI) system that sums hospitalization risks associated with short-term exposure to air pollu-tants. As an air pollution risk communication tool, it informs the public about the current air quality, anchoring around the World Health Organization's (WHO) 2005 Air Quality Guidelines (AQGs). Given the WHO's recent update in 2021, assessing how Hong Kong’s air quality risk communication can be en-hanced using these updated guidelines is essential. Hong Kong’s AQHI is lim-ited by solely focusing on short-term health risks, which could lead the public to underestimate cumulative health impacts. Therefore, we propose the intro-duction of a composite AQHI that reports both long-term and short-term health risks. Additionally, the WHO interim targets will be considered as anchor points for various health risk categories. Furthermore, with the increasing ozone levels in Hong Kong and Southern China due to improved NOx mitigation measures, it has been a challenging task in balancing health protection against climate mitigation. However, our findings present a promising outlook. Despite the rise in ozone levels, the combined health risks in Hong Kong and Guang-dong have seen a decline, largely due to reductions in NO2 and PM concentra-tions, both having significant health implications. By shifting from a concentra-tion-based approach to a health risk-based system like the AQHI, our study highlights the prospective of harmonizing health protection and climate mitiga-tion goals. This health-focused framework suggests that rigorous NOx controls can effective-ly serve both objectives in parallel.Keywords: air quality management, air quality health index, health risk management, air pollution
Procedia PDF Downloads 7513581 A Comparative Analysis of Global Minimum Variance and Naïve Portfolios: Performance across Stock Market Indices and Selected Economic Regimes Using Various Risk-Return Metrics
Authors: Lynmar M. Didal, Ramises G. Manzano Jr., Jacque Bon-Isaac C. Aboy
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This study analyzes the performance of global minimum variance and naive portfolios across different economic periods, using monthly stock returns from the Philippine Stock Exchange Index (PSEI), S&P 500, and Dow Jones Industrial Average (DOW). The performance is evaluated through the Sharpe ratio, Sortino ratio, Jensen’s Alpha, Treynor ratio, and Information ratio. Additionally, the study investigates the impact of short selling on portfolio performance. Six-time periods are defined for analysis, encompassing events such as the global financial crisis and the COVID-19 pandemic. Findings indicate that the Naive portfolio generally outperforms the GMV portfolio in the S&P 500, signifying higher returns with increased volatility. Conversely, in the PSEI and DOW, the GMV portfolio shows more efficient risk-adjusted returns. Short selling significantly impacts the GMV portfolio during mid-GFC and mid-COVID periods. The study offers insights for investors, suggesting the Naive portfolio for higher risk tolerance and the GMV portfolio as a conservative alternative.Keywords: portfolio performance, global minimum variance, naïve portfolio, risk-adjusted metrics, short-selling
Procedia PDF Downloads 9713580 Montelukast Doesn’t Decrease the Risk of Cardiovascular Disease in Asthma Patients in Taiwan
Authors: Sheng Yu Chen, Shi-Heng Wang
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Aim: Based on human, animal experiments, and genetic studies, cysteinyl leukotrienes, LTC4, LTD4, and LTE4, are inflammatory substances that are metabolized by 5-lipooxygenase from arachidonic acid, and these substances trigger asthma. In addition, the synthetic pathway of cysteinyl leukotriene is relevant to the increase in cardiovascular diseases such as myocardial ischemia and stroke. Given the situation, we aim to investigate whether cysteinyl leukotrienes receptor antagonist (LTRA), montelukast which cures those who have asthma has potential protective effects on cardiovascular diseases. Method: We conducted a cohort study, and enrolled participants which are newly diagnosed with asthma (ICD-9 CM code 493. X) between 2002 to 2011. The data source is from Taiwan National Health Insurance Research Database Patients with a previous history of myocardial infarction or ischemic stroke were excluded. Among the remaining participants, every montelukast user was matched with two randomly non-users by sex, and age. The incident cardiovascular diseases, including myocardial infarction and ischemic stroke, were regarded as outcomes. We followed the participants until outcomes come first or the end of the following period. To explore the protective effect of montelukast on the risk of cardiovascular disease, we use multivariable Cox regression to estimate the hazard ratio with adjustment for potential confounding factors. Result: There are 55876 newly diagnosed asthma patients who had at least one claim of inpatient admission or at least three claims of outpatient records. We enrolled 5350 montelukast users and 10700 non-users in this cohort study. The following mean (±SD) time of the Montelukast group is 5 (±2.19 )years, and the non-users group is 6.2 5.47 (± 2.641) years. By using multivariable Cox regression, our analysis indicated that the risk of incident cardiovascular diseases between montelukast users (n=43, 0.8%) and non-users (n=111, 1.04%) is approximately equal. [adjusted hazard ratio 0.992; P-value:0.9643] Conclusion: In this population-based study, we found that the use of montelukast is not associated with a decrease in incident MI or IS.Keywords: asthma, inflammation, montelukast, insurance research database, cardiovascular diseases
Procedia PDF Downloads 8313579 Avoidant Restrictive Food Intake Disorder and Its Impact on Other Eating Disorders
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Avoidant Restrictive Food Intake Disorder (ARFID) was included for the first time in DSM-5, replacing the old diagnosis of DSM-4 'Early Childhood Eating Disorder'. An ARFID is characterized by a restrictive/avoidant eating pattern that can lead to severe nutritional deficiency, weight loss, nutritional supplementation dependence, and poor psychosocial functioning. This eating pattern is associated with decreased interest in food, worries about food characteristics or the act of ingestion, and lack of concern with weight or body image. This paper aims to understand the impact of this new diagnosis in other Eating Disorders (ED) prevalence, as well as to compare their therapeutic approaches. Methodology: Literature reviewed by PubMed with the following keywords: 'ARFID', 'Prevalence', and 'Eating Disorders'. We selected articles related to this theme, written since 2016. Results: In a population of children hospitalized with ED, 5% to 14% was diagnosed with ARFID, and, as outpatient treatment, the prevalence was 22%. People diagnosed with ARFID have more prevalence of other comorbidities, especially autism spectrum, are younger, and are more often male. Regarding the treatment of ARFID, it most often required nasogastric feeding, and with less suffering associated with this procedure, compared to AN. Despite these differences, 12% of patients diagnosed with ARFID transited to AN during treatment, suggesting that the first pathology may be a risk factor for the development of AN. Conclusions: The differences identified between ARFID and the other EDs are important when analyzed as differential diagnostic hypotheses and therapeutic approaches. Further study is necessary regarding its prevalence, risk factors, and treatment.Keywords: avoidant restrictive food intake disorder, ARFID, differential diagnoses, eating disorders, prevalence
Procedia PDF Downloads 11213578 An Investigation of the Compliance of Kermanian College Students' Diet with Who/Fao Nutrition Targets
Authors: Farideh Doostan, Sahar Mohseni Taklloo, Mohammad Nosrati
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Chronic diseases are non-communicable and largely preventable by lifestyle changes including healthy diet consumption. They are the most common cause of death in the world and projected to increase by 15% globally between 2010 and 2020.The hazardous effects of behavioral and dietary risk factors on chronic disease have been established in prospective cohort studies and randomized trials. Because of some changes occur in college students’ lifestyle, assessment of dietary risk factors is important in these populations. Objective: This research was the first study that conducted to evaluate dietary intakes of Kermanian college students with WHO/FAO nutritional objectives. Material and Methods: In this descriptive cross-sectional study, 229 healthy college students of health faculty in Kerman University of Medical Sciences that do not intake any medical drugs were recruited using multistage sampling in 2013.Usual dietary intake was collected using a valid Food Frequency Questionnaire (FFQ) and diet quality was calculated based on WHO nutrient goals. To analysis of data between two groups, independent sample t. test and man whitney were applied. Results: Two hundred and twenty-nine college students; 151 females (65.9%) and 78 males (34.1%), the mean age of 21.9 years were studied. The mean of the Body Mass Index (Kg/m2) and Waist Circumference (cm) in males were 22.34 ±3.52 and 80.76±11.16 and in females were 21.19±2.62 and 73.67±7.65 respectively. Mean of daily cholesterol intake in males was significantly more than females (305±101 VS 268±98; P=0.008) and more than WHO/FAO recommendation (less than 300 mg/day). The mean of daily sodium intake in men and women were 10.4±1 and 10.9±5.3 respectively. These amounts were more than WHO/FAO recommendation (less than 2g/day). In addition, women were consumed fruit and vegetables more than men (839±336 VS 638±281; p ‹ 0.001) and these amounts were more than WHO/FAO recommendation (more than 400g/day) in both groups. Other intake indices were in the range of WHO/FAO recommendations, So that Percent of calories intake from total fat, saturated fatty acids, polyunsaturated fatty acids and added sugar were in compliance with WHO/FAO recommendations. Conclusion: Cholesterol intake in men and sodium intake in all participants were more than WHO/FAO recommendation. These dietary components are the most important causes of cardiovascular disease (one of the main causes of death in our population). These results indicated that proper nutritional education and interventions are needed in this population.Keywords: college students, food intake, WHO /FAO nutrient intake goals, Kerman
Procedia PDF Downloads 40513577 Evaluation of Medication Administration Process in a Paediatric Ward
Authors: Zayed Alsulami, Asma Aldosseri, Ahmed Ezziden, Abdulrahman Alonazi
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Children are more susceptible to medication errors than adults. Medication administration process is the last stage in the medication treatment process and most of the errors detected in this stage. Little research has been undertaken about medication errors in children in the Middle East countries. This study was aimed to evaluate how the paediatric nurses adhere to the medication administration policy and also to identify any medication preparation and administration errors or any risk factors. An observational, prospective study of medication administration process from when the nurses preparing patient medication until administration stage (May to August 2014) was conducted in Saudi Arabia. Twelve paediatric nurses serving 90 paediatric patients were observed. 456 drug administered doses were evaluated. Adherence rate was variable in 7 steps out of 16 steps. Patient allergy information, dose calculation, drug expiry date were the steps in medication administration with lowest adherence rates. 63 medication preparation and administration errors were identified with error rate 13.8% of medication administrations. No potentially life-threating errors were witnessed. Few logistic and administrative factors were reported. The results showed that the medication administration policy and procedure need an urgent revision to be more sensible for nurses in practice. Nurses’ knowledge and skills regarding the medication administration process should be improved.Keywords: medication sasfety, paediatric, medication errors, paediatric ward
Procedia PDF Downloads 39713576 Investigating the Effects of Psychological and Socio-Cultural Factors on the Tendency of Villagers to Use E-Banking Services: Case Study of Agricultural Bank Branches in Ilam
Authors: Nahid Ehsani, Amir Hossein Rezvanfar
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The main objective of this study is to investigate psychological and socio-cultural factors effective on the tendency of the villagers to use e-banking services. The current paper is an applied study considering its objectives. The main data gathering tool in the current study is a made questionnaire which is designed and executed based on the conceptual background of the subject matter and the objectives and hypotheses of the study. The statistical population of this study includes all the customers of rural branches of Agricultural Bank in Ilam Province (N=82885). Among these 120 participants were chosen through sample size determination formula and they were studied using stratified random sampling method. In the analytical statistics level the results obtained from calculating Spearman’s Correlative Coefficient showed that socio-cultural and psychological factors had a significant impact of the extent of the tendency of the villagers to use e-banking services of the Agricultural Bank at the 99% level. Furthermore, stepwise multiple regression analysis showed that both sets of psychological factors as well as socio-economic factors were able to explain 50 percent of the variance of the independent variable; namely the tendency of villagers to use e-banking services.Keywords: e-banking, agricultural bank, tendency, socio-economic factors, psychological factors
Procedia PDF Downloads 53313575 Software Vulnerability Markets: Discoverers and Buyers
Authors: Abdullah M. Algarni, Yashwant K. Malaiya
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Some of the key aspects of vulnerability-discovery, dissemination, and disclosure-have received some attention recently. However, the role of interaction among the vulnerability discoverers and vulnerability acquirers has not yet been adequately addressed. Our study suggests that a major percentage of discoverers, a majority in some cases, are unaffiliated with the software developers and thus are free to disseminate the vulnerabilities they discover in any way they like. As a result, multiple vulnerability markets have emerged. In some of these markets, the exchange is regulated, but in others, there is little or no regulation. In recent vulnerability discovery literature, the vulnerability discoverers have remained anonymous individuals. Although there has been an attempt to model the level of their efforts, information regarding their identities, modes of operation, and what they are doing with the discovered vulnerabilities has not been explored. Reports of buying and selling of the vulnerabilities are now appearing in the press; however, the existence of such markets requires validation, and the natures of the markets need to be analysed. To address this need, we have attempted to collect detailed information. We have identified the most prolific vulnerability discoverers throughout the past decade and examined their motivation and methods. A large percentage of these discoverers are located in Eastern and Western Europe and in the Far East. We have contacted several of them in order to collect first-hand information regarding their techniques, motivations, and involvement in the vulnerability markets. We examine why many of the discoverers appear to retire after a highly successful vulnerability-finding career. The paper identifies the actual vulnerability markets, rather than the hypothetical ideal markets that are often examined. The emergence of worldwide government agencies as vulnerability buyers has significant implications. We discuss potential factors that can impact the risk to society and the need for detailed exploration.Keywords: risk management, software security, vulnerability discoverers, vulnerability markets
Procedia PDF Downloads 25313574 Analysis of the Unmanned Aerial Vehicles’ Incidents and Accidents: The Role of Human Factors
Authors: Jacob J. Shila, Xiaoyu O. Wu
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As the applications of unmanned aerial vehicles (UAV) continue to increase across the world, it is critical to understand the factors that contribute to incidents and accidents associated with these systems. Given the variety of daily applications that could utilize the operations of the UAV (e.g., medical, security operations, construction activities, landscape activities), the main discussion has been how to safely incorporate the UAV into the national airspace system. The types of UAV incidents being reported range from near sightings by other pilots to actual collisions with aircraft or UAV. These incidents have the potential to impact the rest of aviation operations in a variety of ways, including human lives, liability costs, and delay costs. One of the largest causes of these incidents cited is the human factor; other causes cited include maintenance, aircraft, and others. This work investigates the key human factors associated with UAV incidents. To that end, the data related to UAV incidents that have occurred in the United States is both reviewed and analyzed to identify key human factors related to UAV incidents. The data utilized in this work is gathered from the Federal Aviation Administration (FAA) drone database. This study adopts the human factor analysis and classification system (HFACS) to identify key human factors that have contributed to some of the UAV failures to date. The uniqueness of this work is the incorporation of UAV incident data from a variety of applications and not just military data. In addition, identifying the specific human factors is crucial towards developing safety operational models and human factor guidelines for the UAV. The findings of these common human factors are also compared to similar studies in other countries to determine whether these factors are common internationally.Keywords: human factors, incidents and accidents, safety, UAS, UAV
Procedia PDF Downloads 24513573 An ANN-Based Predictive Model for Diagnosis and Forecasting of Hypertension
Authors: Obe Olumide Olayinka, Victor Balanica, Eugen Neagoe
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The effects of hypertension are often lethal thus its early detection and prevention is very important for everybody. In this paper, a neural network (NN) model was developed and trained based on a dataset of hypertension causative parameters in order to forecast the likelihood of occurrence of hypertension in patients. Our research goal was to analyze the potential of the presented NN to predict, for a period of time, the risk of hypertension or the risk of developing this disease for patients that are or not currently hypertensive. The results of the analysis for a given patient can support doctors in taking pro-active measures for averting the occurrence of hypertension such as recommendations regarding the patient behavior in order to lower his hypertension risk. Moreover, the paper envisages a set of three example scenarios in order to determine the age when the patient becomes hypertensive, i.e. determine the threshold for hypertensive age, to analyze what happens if the threshold hypertensive age is set to a certain age and the weight of the patient if being varied, and, to set the ideal weight for the patient and analyze what happens with the threshold of hypertensive age.Keywords: neural network, hypertension, data set, training set, supervised learning
Procedia PDF Downloads 39413572 A Prospective Study on the Evaluation of Statins Usage on HbA1c Control among Type 2 Diabetes Mellitus in an Outpatients Setting
Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Abeer Kharshid, Nor Azizah Aziz, Tarek M. Elsayed
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Medication safety is always an issue. In 2015, the National Pharmaceutical Control Bureau released a statement requesting all statins manufacturers in Malaysia to include the risk of diabetes information in the drug information leaflet in response to United States Food and Drug Administration (U.S. FDA) report. However, the data regarding this warning label in Malaysia is limited, so there is still some uncertainty whether such risk can also be observed in the Malaysian population or not. The study aims to determine the effect of statins on HbA1c% in type 2 diabetic outpatients in endocrine clinics at Hospital Pulau Pinang between June 2015 and May 2016 in Malaysia. In a prospective cohort study, records of 400 type 2 diabetic patients (control group 104 patients not using statin and treatment group 296 patients using statin) were reviewed to identify demographic criteria and lab tests. The prevalence of glycemic control (Glycated hemoglobin, HbA1C ≤ 7% for patient < 65 years, and < 8% for patient ≥ 65 years) was estimated, according to American Diabetes Association guidelines 2015. The results were presented as descriptive statistics. From 296 patients with Type 2 diabetes using statins cohort with a mean age of 57.52 ± 12.2 years, only 81 (27.4%) cases had controlled glycemia, and 215 (72.6%) had uncontrolled glycemia, CI: 95% (6.3–11.1). While the control group 104 diabetic patients had a mean age 46.1 ± 18 years and distributed among 59 (56.7%) patients with controlled diabetes and 45 (43.3%) cases, had uncontrolled glycemia, CI: 95% (5.2–10.3). The relative risk (RR) of uncontrolled glycemia in diabetic patients used statins was 1.68, and the excessive relative risk (ERR) was 68%. The absolute risk (AR) was 29.3%, and the number needed to harm (NNH) was 4. Diabetic patients using statins have more risk of uncontrolled glycemia than the patients with Type 2 diabetes non-using statins.Keywords: diabetes mellitus, HbA1c, Malaysia, outpatients, statin, type 2, uncontrolled glycemia
Procedia PDF Downloads 28413571 Investigating the Encouraging Factors for Scholarly Works Contribution towards Institutional Repository: A Case Study at a Malaysian University
Authors: Mohd Rashid bin Ab Hamid, Noor Azura binti Omar, Zainol Bin Mustafa
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Purpose: The aim of this paper is to study the encouraging factors for scholarly works contribution towards among academicians at Malaysian university. Methods: This paper uses questionnaire for data collection on the respondents’ perceptional level on the institutional repository efforts in one of the university under study. Several encouraging factors have been identified and to be measured using descriptive statistics. The factors are related to content contribution, i.e. personal factor, professional factor, organizational factor and technological factor. Findings: The study found that all these four encouraging factors did have a relation to the contribution of scholarly works in the university by the academician. Research Limitations: This study used a case study and generalization to all Malaysian universities should be well taken care of. Practical implications: The library at the university should look into these four encouraging factors in order to enhance the contribution from academician towards the repository. Originality/value: This research paper provides basic information for the knowledge management officers in the university by endeavouring more efforts in order to attract more contributions.Keywords: institutional repository, information retrieval, information storage and retrieval
Procedia PDF Downloads 56213570 Asset Pricing Puzzle and GDP-Growth: Pre and Post Covid-19 Pandemic Effect on Pakistan Stock Exchange
Authors: Mohammad Azam
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This work is an endeavor to empirically investigate the Gross Domestic Product-Growth as mediating variable between various factors and portfolio returns using a broad sample of 522 financial and non-financial firms enlisted on Pakistan Stock Exchange between January-1993 and June-2022. The study employs the Structural Equation modeling and Ordinary Least Square regression to determine the findings before and during the Covid-19 epidemiological situation, which has not received due attention by researchers. The analysis reveals that market and investment factors are redundant, whereas size and value show significant results, whereas Gross Domestic Product-Growth performs significant mediating impact for the whole time frame. Using before Covid-19 period, the results reveal that market, value, and investment are redundant, but size, profitability, and Gross Domestic Product-Growth are significant. During the Covid-19, the statistics indicate that market and investment are redundant, though size and Gross Domestic Product-Growth are highly significant, but value and profitability are moderately significant. The Ordinary Least Square regression shows that market and investment are statistically insignificant, whereas size is highly significant but value and profitability are marginally significant. Using the Gross Domestic Product-Growth augmented model, a slight growth in R-square is observed. The size, value and profitability factors are recommended to the investors for Pakistan Stock Exchange. Conclusively, in the Pakistani market, the Gross Domestic Product-Growth indicates a feeble moderating effect between risk-premia and portfolio returns.Keywords: asset pricing puzzle, mediating role of GDP-growth, structural equation modeling, COVID-19 pandemic, Pakistan stock exchange
Procedia PDF Downloads 7513569 Analysis of Conditional Effects of Forms of Upward versus Downward Counterfactual Reasoning on Gambling Cognition and Decision of Nigerians
Authors: Larry O. Awo, George N. Duru
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There are growing public and mental health concerns over the availability of gambling platforms and shops in Nigeria and the high level of youth involvement in gambling. Early theorizing maintained that gambling involvement was driven by a quest for resource gains. However, evidence shows that the economic model of gambling tends to explain the involvement of the gambling business owners (sport lottery operators: SLOs) as most gamblers lose more than they win. This loss, according to the law of effect, ought to discourage decisions to gamble. However, the quest to recover losses has often initiated prolonged gambling sessions. Therefore, the need to investigate mental contemplations (such as counterfactual reasoning (upward versus downward) of what “would, should, or could” have been, and feeling of the illusion of control; IOC) over gambling outcomes as risk or protective factors in gambling decisions became pertinent. The present study sought to understand the differential contributions and conditional effects of upward versus downward counterfactual reasoning as pathways through which the association between IOC and gambling decisions of Nigerian youths (N = 120, mean age = 18.05, SD = 3.81) could be explained. The study adopted a randomized group design, and data were obtained by means of stimulus material (the Gambling Episode; GE) and self-report measures of IOC and Gambling Decision. One-way analysis of variance (ANOVA) result showed that participants in the upward counterfactual reasoning group (M = 22.08) differed from their colleagues in the downward counterfactual reasoning group (M = 17.33) on the decision to gamble, and this difference was significant [F(1,112) = 23, P < .01]. HAYES PROCESS macro moderation analysis results showed that 1) IOC and upward counterfactual reasoning were positively associated with the decision to gamble (B = 14.21, t = 6.10, p < .01 and B = 7.22, t = 2.07, p <.05, respectively), 2) downward counterfactual reasoning was negatively associated with the decision to gamble more to recover losses (B = 10.03, t = 3.21, p < .01), 3) upward counterfactual reasoning did not moderate the association between IOC and gambling decision (p > .05), and 4) downward counterfactual reasoning negatively moderated the association between IOC and gambling decision (B = 07, t = 2.18, p < .05) such that the association was strong at the low level of downward counterfactual, but wane at high levels of downward counterfactual reasoning. The implication of these findings is that IOC and upward counterfactual reasoning were risk factors and promoted gambling behavior, while downward counterfactual reasoning protects individuals from gambling activities. Thus, it is concluded that downward counterfactual reasoning strategies should be included in gambling therapy and treatment packages as it could diminish feelings of both IOC and negative feelings of missed positive outcomes and the urge to gamble.Keywords: counterfactual reasoning, gambling cognition, gambling decision, Nigeria, youths
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